13-1

Chapter 13
The Spinal Cord & Spinal Nerves
Together with brain forms the CNS
Functions
spinal cord reflexes
integration (summation of inhibitory and
excitatory) nerve impulses
highway for upward and downward travel of
sensory and motor information

13-2
Structures Covering the Spinal Cord
Vertebrae
Epidural space filled with fat
Dura mater
dense irregular CT tube
Subdural space filled with
interstitial fluid
Arachnoid = spider web of
collagen fibers
Subarachnoid space = CSF
Pia mater
thin layer covers BV
denticulate ligs hold in place

13-3
Spinal Cord Protection
By the vertebral column, meninges, cerebrospinal
fluid, and vertebral ligaments.

13-4
External Anatomy of Spinal Cord
Flattened cylinder
16-18 Inches long &
3/4 inch diameter
In adult ends at L2
In newborn ends at L4
Growth of cord stops at
age 5
Cervical enlargement
upper limbs
Lumbar enlargement
lower limbs

13-5
Inferior End of
Spinal Cord
Conus medullaris
cone-shaped end of spinal cord
Filum terminale
thread-like extension of pia mater
stabilizes spinal cord in canal
Caudae equinae (horses tail)
dorsal & ventral roots of lowest
spinal nerves
Spinal segment
area of cord from which each pair of
spinal nerves arises


13-6
Spinal Cord & Spinal Nerves
Spinal nerves begin as roots
Dorsal or posterior root is incoming sensory fibers
dorsal root ganglion (swelling) = cell bodies of sensory nerves
Ventral or anterior root is outgoing motor fibers

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Gray Matter of the Spinal Cord
Gray matter is shaped like the letter H or a butterfly
contains neuron cell bodies, unmyelinated axons & dendrites
paired dorsal and ventral gray horns
lateral horns only present in thoracic spinal cord
gray commissure crosses the midline
Central canal continuous with 4th ventricle of brain
Note: colors in
reverse due to
staining of tissue

13-8
White Matter of the Spinal Cord
White matter covers gray matter
Anterior median fissure deeper than Posterior median sulcus
Anterior, Lateral and Posterior White Columns contain
axons that form ascending & descending tracts


13-9
Tracts of the Spinal Cord
Function of tracts
highway for sensory & motor information
sensory tracts ascend
motor tracts descend
Naming of tracts
indicates position & direction of signal
example = anterior spinothalamic tract
impulses travel from spinal cord towards brain (thalamus)
found in anterior part of spinal cord

13-10
Location of Tracts inside Cord
Motor tracts Sensory tracts
pyramidal tract (corticospinal) ---spinothalamic tract
extrapyramidal tract ---posterior column
---spinocerebellar


13-11
Function of Spinal Tracts
Spinothalamic tract
pain, temperature, deep pressure & crude touch
Posterior columns
proprioception, discriminative touch, two-point
discrimination, pressure and vibration
Direct pathways (corticospinal & corticobulbar)
precise, voluntary movements
Indirect pathways (rubrospinal, vestibulospinal)
programming automatic movements, posture & muscle
tone, equilibrium & coordination of visual reflexes


13-12
Spinal Reflexes
Automatic response to change in environment
Integration center for spinal reflexes is gray matter
of spinal cord
Examples
somatic reflexes result in skeletal muscle contraction
autonomic (visceral) reflexes involve smooth & cardiac
muscle and glands.
heart rate, respiration, digestion, urination, etc
Note: cranial reflexes involve cranial nerves

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Reflex Arc
Specific nerve impulse pathway
5 components of reflex arc
receptor
sensory neuron
integrating center
motor neuron
effector

4 important somatic spinal reflexes
stretch, tendon, flexor(withdrawal) & crossed extensor
reflexes


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Stretch Reflex (patellar reflex)
Monosynaptic,ipsilateral reflex arc
Prevents injury from over stretching because
muscle contracts when it is stretched
Events of stretch reflex
muscle spindle signals stretch of muscle
motor neuron activated & muscle contracts
Brain sets muscle spindle sensitivity as it sets
muscle tone (degree of muscle contraction at rest)
Reciprocal innervation (polysynaptic- interneuron)
antagonistic muscles relax as part of reflex

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Illustration of the Stretch Reflex

13-16
Tendon Reflex
Controls muscle tension by causing muscle
relaxation that prevents tendon damage
Golgi tendon organs in tendon
activated by stretching of tendon
inhibitory neuron is stimulated (polysynaptic)
motor neuron is hyperpolarized and muscle relaxes
Both tendon & muscle are protected
Reciprocal innervation (polysynaptic)
causes contraction of ipsilateral muscle group

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Illustration of Tendon Reflex

13-18
Flexor (withdrawal) Reflex
Step on tack (pain fibers
send signal to spinal
cord
Interneurons branch to
different spinal cord
segments
Motor fibers in several
segments are activated
More than one muscle
group activated to lift
foot off of tack

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Crossed Extensor Reflex
Lifting left foot requires
extension of right leg to
maintain ones balance
Pain signals cross to
opposite spinal cord
Contralateral extensor
muscles are stimulated
by interneurons to hold
up the body weight
Reciprocal innervation -
when extensors contract
flexors relax, etc

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Clinical Considerations
Checking a patients reflexes may help to detect
disorders/injury
Plantar flexion reflex -- stroke the lateral margin
of the sole
normal response is curling under the toes
abnormal response or response of children under 18
months is called Babinski sign (upward fanning of
toes due to incomplete myelination in child)

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Spinal Nerves
31 Pairs of spinal nerves
Named & numbered by the
cord level of their origin
8 pairs of cervical nerves
(C1 to C8)
12 pairs of thoracic nerves
(T1 to T12)
5 pairs of lumbar nerves
(L1 to L5)
5 pairs of sacral nerves
(S1 to S5)
1 pair of coccygeal nerves
Mixed sensory & motor nerves


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Connective Tissue Coverings
Endoneurium = wrapping of each nerve fibers
Perineurium = surrounds group of nerve fibers forming
a fascicle
Epineurium = covering of entire nerve
dura mater blends into it at intervertebral foramen

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Endoneurium
Perineurium
Epineurium

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Branching of Spinal Nerve
Spinal nerves formed from dorsal & ventral roots
Spinal nerves branch into dorsal & ventral rami
dorsal rami supply skin & muscles of back
ventral rami form plexus supply anterior trunk & limbs
meningeal branches supply meninges, vertebrae & BV



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A Nerve Plexus
Joining of ventral rami of
spinal nerves to form nerve
networks or plexuses
Found in neck, arm, low
back & sacral regions
No plexus in thoracic
region
intercostal nn. innervate
intercostal spaces
T7 to T12 supply abdominal
wall as well

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Cervical Plexus
Ventral rami of spinal
nerves (C1 to C5)
Supplies parts of head,
neck & shoulders
Phrenic nerve (C3-C5)
keeps diaphragm alive
Damage to cord above C3
causes respiratory arrest

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Phrenic Nerve

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Brachial Plexus
Ventral rami from C5 to T1
Supplies shoulder & upper
limb
Passes superior to 1st rib &
under clavicle
Axillary n. = deltoid & teres m.
Musculocutaneous n. = elbow
flexors
Radial n. = shoulder & elbow
extensors
Median & ulnar nn. = flexors
of wrist & hand


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Branches off Brachial Plexus

13-30
Lumbar Plexus
Ventral rami of L1 to L4
Supplies abdominal wall,
external genitals &
anterior/medial thigh
Injury to femoral nerve
causes inability to extend
leg & loss of sensation in
thigh
Injury to obturator nerve
causes paralysis of thigh
adductors

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Branches of Lumbar Plexus
Notice: Femoral and Obturator nerves
Found anterior and medial to hip joint

13-32
Sacral Plexus
Ventral rami of L4-L5 & S1-S4
Anterior to the sacrum
Supplies buttocks, perineum &
part of lower limb
Sciatic nerve = L4 to S3
supplies post thigh & all below
knee
Peroneal nerve injury produces
foot drop or numbness
Tibial nerve injury produces
calcaneovalgus (loss of function
on anterior leg & dorsum of foot)


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Branches of Sacral Plexus
Notice: Sciatic nerve origins

13-34
Sciatic Nerve Branches
Notice: Common
Peroneal nerve and Tibial
nerve behind the knee

Notice: Sciatica pain
extends from the buttock
down the leg to the foot
may be sign of herniated
disc

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Dermatomes & Myotomes
Each spinal nerve contains both sensory & motor
nerve fibers
Dermatome
area of skin supplied by one spinal nerve
overlap prevents loss of sensation if one damaged
sensory anesthesia requires 3 spinal nerves to be
blocked
Skin on face supplied by Cranial Nerve V

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Dermatomes
Damaged regions of the
spinal cord can be
distinguished by patterns
of numbness over a
dermatome region
Infusing local anesthetics
or cutting roots must be
done over 3 adjacent
spinal nerves.
Spinal cord transection
injury that severs the cord
loss of sensation& motor
control below the injury