Spinal Cord Organization January 9, 2008. Spinal Cord 31 segments terminates at L1-L2 special...

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Spinal Cord Organization January 9, 2008

Transcript of Spinal Cord Organization January 9, 2008. Spinal Cord 31 segments terminates at L1-L2 special...

Page 1: Spinal Cord Organization January 9, 2008. Spinal Cord 31 segments terminates at L1-L2 special components - conus medularis - cauda equina no input from.

Spinal Cord Organization

January 9, 2008

Page 2: Spinal Cord Organization January 9, 2008. Spinal Cord 31 segments terminates at L1-L2 special components - conus medularis - cauda equina no input from.

Spinal Cord

31 segments

terminates at L1-L2

special components - conus medularis - cauda equina no input from the face

Page 3: Spinal Cord Organization January 9, 2008. Spinal Cord 31 segments terminates at L1-L2 special components - conus medularis - cauda equina no input from.

Spinal Cord, Roots & Nerves

Dorsal root

Ventral root

Spinal nerve

Page 4: Spinal Cord Organization January 9, 2008. Spinal Cord 31 segments terminates at L1-L2 special components - conus medularis - cauda equina no input from.

Dorsal Root Ganglion

Cell bodies of 1st order sensory neurons

Afferent

Page 5: Spinal Cord Organization January 9, 2008. Spinal Cord 31 segments terminates at L1-L2 special components - conus medularis - cauda equina no input from.

Spinal Cord Cross Section

Dorsal root

sensory

afferent

Ventral root

motor

efferent

Page 6: Spinal Cord Organization January 9, 2008. Spinal Cord 31 segments terminates at L1-L2 special components - conus medularis - cauda equina no input from.

Cross Section of Spinal Cord

White matter

peripheralGray matter

central

Central canal

Page 7: Spinal Cord Organization January 9, 2008. Spinal Cord 31 segments terminates at L1-L2 special components - conus medularis - cauda equina no input from.

Volume of Gray & White Matter

Gray matter enlarges at cervical and lumbar regions.

White matter increases at higher levels of the cord.

Page 8: Spinal Cord Organization January 9, 2008. Spinal Cord 31 segments terminates at L1-L2 special components - conus medularis - cauda equina no input from.

Central Gray Matter

Motor neurons

2nd order sensory neurons

Interneurons

Glial cells

Motor neuron = lower motor neuron

= anterior horn cell

= second order motor neuron

Page 9: Spinal Cord Organization January 9, 2008. Spinal Cord 31 segments terminates at L1-L2 special components - conus medularis - cauda equina no input from.

Organization of Gray Matter

Pain

Temperature

Page 10: Spinal Cord Organization January 9, 2008. Spinal Cord 31 segments terminates at L1-L2 special components - conus medularis - cauda equina no input from.

Organization of Gray Matter

Position sense

Vibration

Pressure

Touch

Page 11: Spinal Cord Organization January 9, 2008. Spinal Cord 31 segments terminates at L1-L2 special components - conus medularis - cauda equina no input from.

Organization of Gray Matter

Position sense

from legs

Between T1 and L2 enlarged

Dorsal nucleus of Clarke

2nd order sensory neuron going to cerebellum

Neck & base of Posterior Horn

Page 12: Spinal Cord Organization January 9, 2008. Spinal Cord 31 segments terminates at L1-L2 special components - conus medularis - cauda equina no input from.

Organization of Gray Matter

Interomedio-lateral horn

Between T1 and L2 enlarged

Sympathetic neurons

(preganglionic)

Intermediolateral Horn

Page 13: Spinal Cord Organization January 9, 2008. Spinal Cord 31 segments terminates at L1-L2 special components - conus medularis - cauda equina no input from.

Sympathetic Innervation

Page 14: Spinal Cord Organization January 9, 2008. Spinal Cord 31 segments terminates at L1-L2 special components - conus medularis - cauda equina no input from.

Organization of Gray Matter

.

At S2, S3, and S4

Parasympathetic neurons

(preganglionic)

Intermediolateral Horn

Page 15: Spinal Cord Organization January 9, 2008. Spinal Cord 31 segments terminates at L1-L2 special components - conus medularis - cauda equina no input from.

Parasympathetic Innervation

Page 16: Spinal Cord Organization January 9, 2008. Spinal Cord 31 segments terminates at L1-L2 special components - conus medularis - cauda equina no input from.

Organization of Gray Matter

Modulates motor activity via gamma motor neurons

Adjusts briskness of deep tendon reflexes

Page 17: Spinal Cord Organization January 9, 2008. Spinal Cord 31 segments terminates at L1-L2 special components - conus medularis - cauda equina no input from.

Organization of Gray Matter

Nuclei of alpha and gamma motor neurons

Innervates muscle spindles and muscles

Page 18: Spinal Cord Organization January 9, 2008. Spinal Cord 31 segments terminates at L1-L2 special components - conus medularis - cauda equina no input from.

Lower Motor Neurons

Alpha motor neurons

originate from Rexed lamina IX

ventral – dorsal organization

ventral extensor muscles

dorsal flexor muscles

medial – lateral organization

medial proximal muscles

lateral distal muscles

Page 19: Spinal Cord Organization January 9, 2008. Spinal Cord 31 segments terminates at L1-L2 special components - conus medularis - cauda equina no input from.

Somatotopic Organization

Page 20: Spinal Cord Organization January 9, 2008. Spinal Cord 31 segments terminates at L1-L2 special components - conus medularis - cauda equina no input from.

Coordinating Role of Interneurons

Page 21: Spinal Cord Organization January 9, 2008. Spinal Cord 31 segments terminates at L1-L2 special components - conus medularis - cauda equina no input from.

Breathing

Nuclei of alpha and gamma motor neurons

LMNs from spinal levels C3, C4 & C5 innervate the phrenic nerve

Controls diaphragm

Page 22: Spinal Cord Organization January 9, 2008. Spinal Cord 31 segments terminates at L1-L2 special components - conus medularis - cauda equina no input from.

Control Functions

Nuclei of alpha and gamma motor neurons

At levels S1 - S4 LMNs form Onuf’s nucleus

Innervates anal and urethral spincters; needed for sexual function

Page 23: Spinal Cord Organization January 9, 2008. Spinal Cord 31 segments terminates at L1-L2 special components - conus medularis - cauda equina no input from.

Sacral cord

Page 24: Spinal Cord Organization January 9, 2008. Spinal Cord 31 segments terminates at L1-L2 special components - conus medularis - cauda equina no input from.

Configuration of Gray Matter

Abundant white matter high in the spinal cord

Enlargement of gray matter at the cervical level

Innervates arm muscles

Page 25: Spinal Cord Organization January 9, 2008. Spinal Cord 31 segments terminates at L1-L2 special components - conus medularis - cauda equina no input from.

Configuration of Gray Matter

Enlargement in thoracic region for sympathetic neurons

Enlargement in lumbar region for motor neurons to the legs

Minimal white matter at the lower cord

Page 26: Spinal Cord Organization January 9, 2008. Spinal Cord 31 segments terminates at L1-L2 special components - conus medularis - cauda equina no input from.

Descending Motor Pathway

Upper motor neuron

1st order neuron

synapses on LMN

Crossed pathway

Lateral corticospinal

Uncrossed pathway

Anterior corticospinal

Page 27: Spinal Cord Organization January 9, 2008. Spinal Cord 31 segments terminates at L1-L2 special components - conus medularis - cauda equina no input from.

Somatotopic Organization

Page 28: Spinal Cord Organization January 9, 2008. Spinal Cord 31 segments terminates at L1-L2 special components - conus medularis - cauda equina no input from.

Spinal Cord Tracts

movement

feedback

Unconscious position sense

Page 29: Spinal Cord Organization January 9, 2008. Spinal Cord 31 segments terminates at L1-L2 special components - conus medularis - cauda equina no input from.

Ascending & Descending Tracts

• ↑ Sensory– Gracile tract

• Leg position & vibration– Cuneate tract

• Arm position & vibration– Dorsal spinocerebellar tract

• Strength & muscle speed– Ventral spinocerebellar tract

• Modulation; interneurons– Lateral spinothalamic tract

• Pain & temperature– Anterior spinothalamic tract

• Light touch– Spinocervical thalamic tract

• Kinesthetic movement & discriminative touch

• ↓ Motor– Corticospinal tract

• Speed & agility– Reticulospinal tract

• Differential facilitation of motor neurons

– Rubrospinal tract• Fix movement errors

– Lateral vestibulospinal tract• Extensor & posture

– Medial vestibulospinal tract• Flexor & head position

– Tectospinal tract• Head turning

Page 30: Spinal Cord Organization January 9, 2008. Spinal Cord 31 segments terminates at L1-L2 special components - conus medularis - cauda equina no input from.

Ascending Tracts

SensoryPosition Vibration

SensoryPain Temperature

Page 31: Spinal Cord Organization January 9, 2008. Spinal Cord 31 segments terminates at L1-L2 special components - conus medularis - cauda equina no input from.

Spinal Cord Injury

Position

Pain

Brown – Sequard Syndrome

Page 32: Spinal Cord Organization January 9, 2008. Spinal Cord 31 segments terminates at L1-L2 special components - conus medularis - cauda equina no input from.

Transverse vs Hemi Cord Syndrome

Page 33: Spinal Cord Organization January 9, 2008. Spinal Cord 31 segments terminates at L1-L2 special components - conus medularis - cauda equina no input from.

Anterior vs Posterior Cord Syndromes

Page 34: Spinal Cord Organization January 9, 2008. Spinal Cord 31 segments terminates at L1-L2 special components - conus medularis - cauda equina no input from.

Blood Supply to Spinal Cord

Page 35: Spinal Cord Organization January 9, 2008. Spinal Cord 31 segments terminates at L1-L2 special components - conus medularis - cauda equina no input from.

Traumatic Spinal Cord Injury

DUI: $100 addt’l fine

South Carolina

Spinal Cord Injury

Research Board

Page 36: Spinal Cord Organization January 9, 2008. Spinal Cord 31 segments terminates at L1-L2 special components - conus medularis - cauda equina no input from.

Monday

Brainstem