Escolar Documentos
Profissional Documentos
Cultura Documentos
Welke, Ph.D.
Anatomy: Spinal
Cord
31 pairs of spinal
nerves
31 spinal cord
segments
8 cervical
12 thoracic
5 lumbar
5 sacral
1 coccygeal
33 vertebral bodies
Spinal Nerves
Dorsal and ventral roots coalesce
to form spinal nerves after
receiving fibers from the
sympathetic ganglia
Cervical enlargement:
C5-T1
Lumbar enlargement:
L1-S3
Growth of spinal cord
& vertebral column
Conus medullaris in newborns
ends at L3
Conus medullaris in adults
ends at L 1
The spinal root fibers
(lumbar and sacral fibers)
that exit the spinal cord
caudal to L1 form the cauda
equina
These fibers still exit the
vertebral canal at their
appropriate intervertebral
foramina
Lumbar puncture is safe in
adults caudal to L3
Spinal Cord - Orientation
posterior dorsal
R White Matter L
Grey Matter
anterior ventral
Spinal Cord Morphology
Thoracic
Coccygeal Sacral Lumbar (Lower)
(Enlargement)
Enlargements
Posterior Lateral
Sulcus
Spinal Canal
Anterior Funiculus
(Anterior Column)
Major Landmarks
Posterior Intermediate Fasciculus Gracilis
Sulcus
Fasciculus Cuneatus
Dorsal Horn
Intermediate Zone
Ventral Horn
Sensory Input
Dorsal Horn
Intermediate Zone
Ventral Horn
Organization of Spinal Cord Gray Matter
Organization of Spinal Cord Gray Matter
Nuclear groups: Rexeds Laminae:
-Named by location and cell -10 cytoarchitectonic layers or regions
body morphology -I-VI in dorsal horn; VII intermediate zone;
-Leaves much of grey matter IX motor cell columns; X central grey
-Accounts for all of grey matter
unaccounted for
C
A
A
A
A
A
C
A
Nucleus proprius
(all levels)
Gray Matter Lateral Horn
-Intermediate gray and
lateral horn = only from
C8- L2 (Lamina VII)
-Contain preganglionic
sympathetic neuron cell
bodies in lateral horn
-Also, in intermediate
zone sacral autonomic
nuclei S2 S4
WHY?
Somatotopic Organization
of Ventral Horn Neurons
Corticospinal Tract:
Normal
UMN
Lesion
UMN
Lesion
Spinal Cord White Matter
Organization of Spinal Cord White Matter
5 Categories of Fibers:
3-Propriospinal fibers
Posterior
Spinocerebellar
Tract
AC
Anterior Lateral
Spinocerebellar MLF Reticulospinal
Tract Tract
Vestibulospinal
Tract
Medial
Anterior Reticulospinal
Spinothalamic Corticospinal Tectospinal Tract
Tract Tract Tract
Spinal Cord Syndromes
Complete transection
Brown-Squard syndrome
Syringomyelia
Friedrichs ataxia
Subacute combined degeneration
Amyotrophic Lateral Sclerosis
Tabes Dorsalis
Organization of Spinal Cord White Matter
Dorsal
Lateral
Columns
Corticospinal
Tract
Spinothalamic
Tract
Corticospinal Tract
Medial
Lemniscus
System
Spinothalamic /
Anterolateral
System
Transverse Cord
Section
Compression or
transverse lesion of
entire cord
Loss of
vibratory /
positional sense,
pain/temp, &
motor loss from
below the lesion
Brown-Squard
Syndrome
Compression or
lesion of one-half of
spinal cord
Ipsilateral
motor loss
Ipsilateral loss of
proprioception
and discriminative
touch
Contralateral loss
of pain and
temperature
Syringomyelia
Results from formation
of a cyst in the central
portion of the spinal
cord
Loss of Pain/
Temperature at or
just below cavity
due to
compression of
anterior white
commissure
restricted to
region of lesion
Friedrichs Ataxia
A hereditary disease with degeneration of
specific regions of spinal cord white matter
Spinocerebellar tracts
dorsal columns
corticospinal tracts
Subacute Combined Degeneration
Commonly seen
with vitamin B12
deficiency
bilateral spastic
paralysis
bilateral loss of
proprioception and
discriminative
touch
Amyotrophic Lateral Sclerosis
A motor system
disease that affects
both UMNs and LMNs
Begins in upper limbs
(40%), lower limbs
(40%) or brainstem
(20%)
Flaccid paralysis at
the level of the
lesion, spastic
paralysis below level
of the lesion
Tabes Dorsalis
one manifestation of neurosyphilis
destroys large diameter dorsal root fibers and
cell bodies in DRG usually in lumbrosacral
regions
Common symptoms:
1-sensory loss
2-tabetic gait
3-incontinence
End!