The Nervous System

The Spinal Cord and Spinal Nerves

Chapter 14

Introduction
The central nervous system (CNS) consists of the brain and spinal cord Anatomically connected but the brain and SC show significant degree of functional independence The SC is more than a highway for information - integrates and processes information

Gross Anatomy of the SC

Measures ~ 45cm (18 in) in length
- extends from the foramen magnum to inferior border of the first lumbar vertebra

Dorsal and posterior surface of the SC

- posterior median sulcus - anterior median fissure

Gray matter is increased in segments of the SC

- involved with sensory and motor innervation of the limbs - contain interneurons (relay sensory input & motor output) - cervical enlargement (pectoral girdle and upper limbs) - lumbosacral enlargement (pelvis and lower limbs)

Fig 14.1

Gross Anatomy of the Spinal Cord

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Gross Anatomy of the SC

SC tapers to a conical tip - conus medullaris

Filum terminale (terminal thread) provides longitudinal support as part of coccygeal ligament
Divided into 31 segments associated with a pair of dorsal root ganglia
- contain cell bodies of sensory neurons lies between pedicles of adjacent vertebrae - dorsal root contains axons of the sensory neurons - ventral root contains axons of somatic motor neurons - dorsal and ventral roots enter and leave between adjacent vertebrae at the intervertebral foramina

Fig 14.1

Gross Anatomy of the Spinal Cord

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Gross Anatomy of the SC

Distal to each dorsal root ganglion sensory and motor fibers form a single spinal nerve
- classified as mixed nerves, contain both afferent (sensory) and efferent (motor) fibers

SC enlarges and elongates until ~4 years old

- adult SC extends only to the 1st or 2nd lumbar vertebra

Cauda equina complex of the filum terminale and long ventral and dorsal roots

Fig 14.3

Posterior View of Vertebral Column and Spinal Nerves

Spinal Meninges
Specialized membranes that provide protection, physical stability, and shock absorption Cover the SC and surround spinal nerve roots
- BVs provide oxygen and nutrients to the SC - at foramen magnum are continuous with cranial meninges

Three meningeal layers: The dura mater tough, fibrous outermost layer The arachnoid mater middle layer The Pia mater innermost layer

Fig 14.2a

The Spinal Cord and Spinal Meninges

Fig 14.2b

The Spinal Cord and Spinal Meninges

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 Dura mater dense irregular CT whose outer and inner surfaces are covered by simple squamous epithelium
- outer epithelium not bound to walls of the vertebral canal - intervening epidural space contains areolar tissue, BVs and adipose tissue

Arachnoid mater consists of a simple squamous epithelium

- separated from pia mater by the subarachnoid space that contains cerebrospinal fluid (CSF) - arachnoid trabeculae bundles of fibers

Pia mater elastic and collagen fibers interwoven with the arachnoid trabeculae
- contains the BVs supplying the SC - paired denticulate ligaments are extensions of the pia mater

Fig 14.2c

The Spinal Cord and Spinal Meninges

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Fig 14.2d

The Spinal Cord and Spinal Meninges

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Spinal Taps
a) The needle punctures the dura and withdraws CSF - position of the needle is in the subarachnoid space, near the nerves of the cauda equina but below the SC

Myelography
b) introduction of a radiopaque (opaque to xrays) dye into the CSF - CSF appears white on a radiograph - tumors, inflammation, adhesions that distort or divert CSF will be shown
Fig 14.4
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Organization of Gray Matter

Surrounds the central canal and contains cell bodies of neurons and glial cells Groups of nuclei (sensory or motor) with specific functions

Posterior gray horns contain somatic and visceral sensory nuclei; anterior gray horns contain somatic motor nuclei Lateral gray horns contain visceral motor neurons
Gray commissures contain the axons of interneurons that cross from one side of the cord to the other

Organization of White Matter

Divided into 6 columns (funiculi, sing. funiculus)
- contain tracts or fasiculi that convey sensory information or motor commands

Ascending tracts relay information from the SC to the brain Descending tracts carry information from the brain to the SC

Fig 14.5a

Histology of the Spinal Cord, Transverse Section

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Fig 14.5b,c

Spinal Nerves
31 pairs: 8 cervical, 12 thoracic, 5 lumbar, 5 sacral, and 1 coccygeal
- each peripheral nerve has 3 layers of CT

Epineurium outer tough fibrous sheath

- dense irregular CT, 1 of collagen fibers and fibrocytes - forms the blood-nerve barrier

Perineurium composed of collagenous fibers, elastic fibers, and fibrocytes

- divides the nerve into fascicles (bundle of axons)

Endoneurium loose irregular CT

- capillaries from the perineurium provide oxygen and nutrients ot the axons and Schwann cells of the nerve

Fig 14.6

Anatomy of a Peripheral Nerve

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Fig 14.6

Anatomy of a Peripheral Nerve (A Scanning Electron Micrograph)

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Peripheral Distribution of Spinal Nerves

Each spinal nerve forms through fusion of dorsal and ventral nerve roots Distally all spinal nerves form 2 branches
- a dorsal ramus and a ventral ramus

Spinal nerves T1 to L2 contain 4 branches

- a dorsal ramus and a ventral ramus - a white ramus and a gray ramus known as rami communicantes (communicating branches)

Rami Communicantes
Carry visceral motor fibers to and from a nearby autonomic ganglion associated with the sympathetic division of the ANS White ramus carries fibers to the ganglion
- contains preganglionic myelinated axons

Gray ramus innervate glands and smooth muscles

- 2 groups of unmyelinated postganglionic fibers that leave the ganglion

Dorsal and Ventral Rami

Dorsal ramus provides sensory innervation from, and motor innervation to, a specific segment of the skin and muscles of the neck and back Ventral ramus supplies the ventrolateral body surface, structures in the body wall, and the limbs Distribution of sensory fibers within these rami illustrates the segmental division of labor
- each pair of spinal nerves monitors a specific region of the body surface known as a dermatome

Fig 14.7a

Peripheral Distribution of Spinal Nerves (Motor Fibers)

Fig 14.7b

Peripheral Distribution of Spinal Nerves (Sensory Fibers)

Dermatomes
Related spinal nerves are indicated for each dermatome Clinically important damage to a spinal nerve or dorsal root ganglion produces a loss of sensation

Fig 14.8

Nerve Plexus
Complex interwoven network of nerves Occurs in segments that control skeletal musculature of the neck and limbs
- peripheral distribution of the ventral rami do not directly proceed to their peripheral targets

Ventral rami of adjacent spinal nerves blend their fibers to produce compound nerve trunks
- formed during development when small skeletal muscles fuse to form larger muscles with compound origins - compound muscles contain sensory and motor fibers - ventral rami converge and branch to form compound nerves

4 Major Nerve Plexuses Cervical plexus Brachial plexus Lumbar plexus Sacral plexus

Fig 14.9

Cervical Plexus
Consists of cutaneous and muscular branches in the ventral rami of spinal nerves C1-C4, some C5 The cutaneous branches innervate areas on the head, neck, and chest

The muscular branches innervate muscles of the neck and shoulder

Major nerve of this plexus the phrenic nerve provides the entire nerve supply to the diaphragm

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Fig 14.10

The Cervical Plexus

The Brachial Plexus

Larger and more complex innervates the pectoral girdle and upper limb Formed by the ventral rami of spinal nerves C5-T1
- converge to form the superior, middle, and inferior trunks - trunks divide into anterior and posterior divisions - all 3 posterior divisions unite to form the posterior cord - anterior divisions of the superior and middle trunks unite to form the lateral cord - medial cord is formed by continuation of the anterior division of the inferior trunk

Nerves arise from one or more trunks or cords

Fig 14.11

The Trunks and Cords of the Brachial Plexus

Brachial Plexus Organization

Flow chart summarizing relationships within the brachial plexus - dashed lines to the posterior cord merely indicate that the posterior division lie posterior to the anterior divisions

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Brachial Plexus Peripheral distribution of major nerves

Figure 14.11

Brachial Plexus Peripheral distribution of major nerves

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Cervical and Brachial Plexuses

Fig 14.12

Lumbar and Sacral Plexuses

Arise from the lumbar and sacral segments of the SC

Ventral rami of these nerves supply the pelvis and lower limb
- ventral rami of both plexuses are distributed to the lower limb (often referred to as the lumbosacral plexus)

Major nerves of the lumbar plexus

- genitofemoral, lateral femoral cutaneous, and femoral nerve

Major nerves of the sacral plexus

- the sciatic nerve which branches into the common fibular nerve and the tibial nerveand the pudendal nerve

Fig 14.13a

Figure 14.13
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Fig 14.13

Figure 14.13d

Fig 14.14

Lumbar and Sacral Plexuses

Fig 14.14

Reflexes
A reflex is an immediate involuntary response to a specific stimulus

The neural writing of a single reflex is referred to as a reflex arc

Reflexes are classified according to : Their development (innate and acquired) The site where information processing occurs (spinal and cranial) The nature of resulting motor response (somatic and visceral or autonomic) The complexity of the neural circuit (monosynaptic and polysynaptic)

Reflex Arc

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Copyright 2009 Pearson Education, Inc., publishing as Pearson Benjamin Cummings

Figure 14.16

Figure 14.17a,b

Neural Organization- Monosynaptic and Polysynaptic Reflexes

Fig 14.18

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Fig 14.18

Stretch Reflex

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