Spinal Cord

Extends from the foramen magnum of the skull to the level of the first or second lumbar
Provides a two-way conduction pathway to and from the brain
Vertebrae (protected by bone), fluid (CSF), and CT (meninges)
Dura Mater:
Single layer (instead of two layers like in the brain)
Not attached to the bony walls of the vertebral column
Between the bony vertebrae and the dura mater is an epidural space filed with soft
padding of fat and a network of veins
Cerebrospinal fluid fills the subarachnoid space between the arachnoid and pia mater meninges
Conus Medullaris: tapering cone shaped structure; below lumbar enlargement
Filum terminale :fibrous extension of the conus covered by pia mater, extends inferiorly from
the conus medullaris to the coccyx, where it anchors the spinal cord in place so it is not jostled
by body movement
Cauda equine: (resembles horses tail) nerves at the end of the spinal cord; do not exit
immediately but flow down a few vertebral segments
Spinal Cord has 31 paired segments (region of the cord from which spinal nerves arise)
1st spinal nerve exists between atlas and occipital bone, all others exit from
intervertebral foramina between adjoining vertebra & below the numbered segment (1st
nerve leaves from above C1 and the 2nd nerve leaves from below it)
31 pairs: 8 pairs of cervical nerves, 12 pairs of thoracic nerves, 5 pairs of lumbar nerves,
5 pairs of sacral nerves and 1 pair of coccygeal nerves
Cervical enlargement from C4- T1
Lumbar enlargement from T9-T12
Due to extra nerve fibers supplying upper and lower extremities respectively

Cross-Sectional Anatomy:

Ventral (anterior) median fissure/ Dorsal (posterior) median sulcus

Grooves that run the length of the cord and partially divide it into right and left halves

Gray Matter and Spinal Roots

Lateral gray masses (gray matter) made up of nerve cell bodies, neuroglia, unmyelinated
processes and BVs. Masses are divided into sections called horns:
All neurons whos cell bodies are in spinal cord gray matter are multipolar
Grey commissure: nervous tissue, made mostly of cell processes, connects the lateral masses
and contains a canal called the central canal
Dorsal/posterior horns:
house association (interneurons) neurons
Ventral/anterior horns:
contain somatic motor neurons

neurons that send their axons out to the skeletal muscles (their effector organs) via
ventral roots
Lateral horns:
Automatic (sympathetic division) motor neurons that serve visceral organs
Axons leave via ventral root along with those of the somatic motor neurons
Found only in thoracic and upper lumbar regions of the spine

Roots (made of rootlets)

Ventral roots: contain both somatic and autonomic efferent/motor fibers

Dorsal roots: contain afferent/sensory fibers from the periphery, cell bodies of these fibers are
found in dorsal root ganglia

Dorsal root ganglia (spinal ganglia)

Cluster of sensory/afferent nerve cell bodies

May extend into posterior gray horn
The only ganglion in somatic division

Spinal nerves (contain 1000s of nerve processes)

Contain both dorsal and ventral roots

Mixed nerve contains both sensory and motor
Path of communication from CNS to periphery and back

Spinal nerves divide into several rami (branches) also a mixed nerve

Meningeal branch: (rami) reenter the spinal canal through intervertebral foramen to innervate
vertebra, ligaments, BV of spinal cord and meninges
Posterior branch: (rami) innervate deep muscles and skin of back, specifically the dorsal surface
Anterior branch: (rami) innervate superficial back muscles, structures of extremities and back
(both lateral and ventral)
Autonomic branch: (rami)
Rami communicantes (white ramus communicans & ray ramus communicans)
Pre and postganglionic sympathetic fibers; innervate viscera

Nerve plexus (braid)

Divided into roots, trunks, divisions, cords, and branches

(except ventral rami of spinal nerves T2-T12) form intercostal nerves and supply
intercostal muscles, skin of anterior thorax and abdominal wall
All other rami form plexus
Only ventral rami form plexus
4 principal plexi:
Cervical plexus: ventral rami C1-C4

Supplies skin and muscles of the head, neck and upper part of shoulders; also
connect some cranial nerve
o Main nerve: phrenic nerve supplies diaphragm
Brachial plexus: C5-C8; most of T1
o Supplies upper extremities, neck and shoulder muscles
o Main nerves: musculocutaneous, median, ulnar, axillary, and radial
Lumbar plexus: L1-L4
o Supplies anterolateral abdominal wall, external genitals, and part of lower
extremities
o Main nerve: femoral and obturator
Sacral plexus: L4-S4
o Supplies buttock, perineum, and lower extremities
o Main nerve: sciatic (made from tibial and common peroneal, which are
wrapped together
White Matter of the Spinal Cord

Composed of myelinated and unmyelinated nerve fibers that allow communication between
different parts of the spinal cord and between the cord and brain
Funiculi (white columns): an organized region of white matter; mostly myelinated fibers (tracts
or fasciculi)
Each funiculi consists of distinct tracts/fasciculi (which are all part of a multineuron pathways)
which run the length of spinal cord
Ascending tracts: are sensory TO the brain
Descending tracts :are motor FROM the brain TO muscle or glands, or just to lower
levels of spinal cord
Commissural fibers (transversely-association fiber): make up the gray commissure;
some tracts will decussate (go from one side to another) between the two lateral
masses
Funiculi: named according to origin in the spinal cord and destination:
Posterior, lateral and anterior
Other characteristics:
Most decussate at some point
Relay: most pathways contain 1st, 2nd, 3rd order neurons
Symmetry: all are paired, left and right
Somatotopy: reflect orderly mapping of the body in relation to the position of the
funiculi in the spinal cord

Ascending (sensory) pathways and tracts: 6 main pathways

First-order neurons:
Cell bodies reside in a ganglion (dorsal root or cranial)

Conduct impulses from cutaneous receptors of the skin and from proprioceptors to the
spinal cord or brain stem, where they synapse with 2nd order neurons
Second-order neurons:
Cell bodies reside in dorsal horn of the spinal cord or in medullary nuclei (brain stem)
Transmit impulses to the thalamus or to the cerebellum where they synapse
Third-order neurons:
Cell bodies are in thalamus
Relay impulses to the somatosensory cortex of the cerebrum
NO 3rd order neurons in the cerebellum

Dorsal column-medial lemniscal pathways:

Transmit impulses via thalamus to the sensory cortex for conscious interpretation
For discriminating touch and conscious proprioception
Decussate in medulla and then spinal cord
These pathways are formed by the paired tracts of the dorsal white column of the spinal cordfasciculus cuneatus (neck, arms, upper chest) and fasciculus gracilis ( trunk and legs), both are
3rd order chains
Primarily for light touch, stereognosis, proprioception, weight discrimination, vibration
Light touch: able to recognize the exact location of stimuli and two-point discrimination
Stereognosis :able to recognize size, shape, texture of an object by feel (3D sensation)
Proprioception: awareness of precise position of body part and direction of movement
Weight discrimination: assess weight of objects by feel only
Vibration :fluctuating touch

Anterior and lateral spinothalamic tracts:

For pain, temperature, deep pressure, crude touch, some tickle and itch
3rd order chains
Location: ventral (anterior) and lateral white columns of the spinal cord
Receive input from many different types of sensory receptors and make multiple synapses in the
brain stem
Pathways are largely formed by lateral and ventral (anterior) spinothalamic tracts
Fibers cross over in spinal cord
Lateral spinothalamic tract:
Pain and temperature
Sensory input conveyed from thalamus to the cortex
Anterior spinothalamic tracts:
Crude touch and deep pressure
Some awareness in thalamus but not fully perceived until it reaches the cortex

Anterior and posterior spinocerebellar tracts: (trunk and limb)

Both for unconscious proprioception about position of skeletal muscles, tendons, and joints
Some fibers DO NOT decussate (ipsilateral) and some decussate TWICE (either way they are or
become ipsilateral)
Info. Does not reach somatosensory cortex, so NO awareness
Anterior spinocerebeller tracts:
For proprioception
These fibers decussate in the spinal cord but will then cross back to the original side
when in the cerebellum
Are believed to reach the cerebellum via the superior cerebellar peduncles
Posterior spinocerebeller tracts
For proprioception
Ipsilateral to cerebellum
Are believed to reach the cerebellum via the middle cerebellar peduncles

Descending pathways: direct (pyramidal) and indirect (extra-pyramidal) tracts

Contain: upper motor neurons (UMN): neurons from the cortex and subcortical nuclei
Lower motor neurons (LMN): motor neurons from the anterior horns of the spinal cord and/or
cranial nerve motor nuclei that innervate skeletal muscles

Anterior and later conrticospinal tracts, and corticobulbar tracts

Direct (pyramidal) (corticospinal) tracts
m/c: innervates distal extremities
precise control for skilled movement
m/c: decussates just below the medulla (at pyramids)
anterior corticospinal tracts:
innervates neck and part of the trunk
coordinates movement of the axial skeleton
decussate along the spinal cord, usually at the level at which they exit
indirect (extra-pyramidal) tracts (one thought to be completely separate from pyramidal tracts,
but found to be at least effected by them)
the axial muscles that maintain balance and posture
the muscles controlling coarse limb movements
head, neck and eye movements that follow objects in the visual field
Rubrospinal tract:
o Helps maintain and regulate muscle tone and muscle control mostly n distal
muscles of upper limbs
Reticulospinal tract/vestibulospinal tract:
o Maintains balance by varying the tone of postural muscles

 Tectospinal tract: & superior colliculi mediate head movements in response to visual
stimuli
Sensory Integration: From reception to Perception
Perception: interpretation of the meaning of the stimulus
Sensation: awareness of the stimulus
4 prerequisites for sensation:

Stimulus: change of environment (internal or external)

Receptor :picks up stimulus and converts it to nerve impulse-> transduction (not conduction;
just senses and converts)
Conducted (propagate); from receptor to CNS
Translate: the conversion from impulse to sensation either in brain or spinal cord (then it can
produce an effect)

Somatosensory System
1. Receives input from viscera and limbs and is interpreted in somatosensory cortex, and becomes
conscience awareness
Three levels of neural integration: receptor, circuit, and perceptual
General types of receptors:
o Exteroceptors:
Located near surface of body, provides information from outside the
body (external environment) (e.g. hearing, smell, taste, touch, temp,
pain)
o Interoceptors:
Located in BVs and viscera
Provides information from internal environment (e.g. pain, fatigue,
hunger, thirst, nausea
o Proprioceptor:
Information about body position and movement
(e.g. muscles, tendons, joints)
Motor Cortex:
1.
2.
3.
4.

Located in precentral gyrus of frontal lobe

Concerned with skeletal muscle-> precise control, discrete muscular movements
Uses pyramidal (direct) and extrapyramidal (indirect) pathways
Homunculus (little man): caricature indicating location of neuron cell bodies for both motor and
sensory cortex
5. Components:
Receptor (affector): distal end of dendrite or sensory structure; responds to changes

 Sensory neuron (afferent pathways): passes impulse from receptor to CNS

Control center (CNS): where incoming sensory impulse may be inhibited, transmitted or
rerouted (also may have monosynaptic or polysynaptic reflex arc)
Motor neuron (efferent pathway): transmits the impulse to effector
Effector: organ of the body (muscle or gland) that responds
Mechanoceptor :
Detects mechanical deformation of receptor or adjacent cells (e.g. touch, pressure:
proprioception, hearing, equilibrium, and BP
Thermoceptors:
Change in temperature (hot, cold, warm)
Nocioceptors:
Detect pain-> due to physical or chemical damage
Photoceptors:
Rod and cones
Detects light-> retina
Chemoreceptors:
For taste, smell, chemicals in body fluid such as O2, CO2, glucose, etc.