THE SPINAL CORD - uniba.sk · 2020. 3. 13. · the pyramidal pathway • corticospinal fibers •...

THE SPINAL CORD

MUDr. Hisham El Falougy, PhD.hisham.elfalougy@fmed.uniba.sk

CENTRAL NERVOUS SYTEM

Prosencephalon

Mesencephalon

Rhombencephalon

Spinal cord (medulla spinalis)

PROSENCEPHALON

Most rostral part

Telencephalon

Sensory centers

Motor centers

Integration and regulation of cognitive functions

PROSENCEPHALON

Diencephalon

Control relay station

Affernt fibers to telencephalon

Autonomic nervous system

Endocrine glands

BRAIN STEM

• Rhombencephalon

• Medulla oblongata

• Pons

• Cerebellum

• Brain stem (truncus encephali)

• Medulla oblongata

• Pons

• Mesencephalon

SPINAL CORD VERTEBRAL CANAL

1st CERVICAL NERVE

VERTEBRAE L I – L II

NOT STRAGIHT

45 cm (HIGHT), 35 g (WEIGHT), 1 – 1.5 cm

(THICKNESS)

SPINAL CORD VERTEBRO-MEDULLARY TOPOGRAPHY

INTRA-UTERINE

NEWBORN (L3)

ADULT

MALE (L I/L II)

FEMALE (L II)

CAUDA EQUINA

SPINAL CORD

MENINGES

Pachymeninx

Dura mater

Leptomeninges

Pia mater

Arachnoidea mater

SPINAL CORD

PIA MATER

Delicate membrane

Invests the surface of the spinal cord

Follows the contours of the spinal cord

Denticulate ligaments

SPINAL CORD

ARACHNOIDEA AND SUBARACHNOID SPACE

Between archnoid and pia mater

Connected to 4th ventricle

Trabeculae

SPINAL CORD

CEREBROSPINAL FLUID

Clear and colourless

Contains protein and electrolytes

Mostly secreted by choroid plexus of ventricles

SPINAL CORD

Dura mater

Thick, dense and fibrous

Cranial dura mater

Spinal dura mater

Epidural space

Subdural space

SPINAL CORD

• Blood supply

• Vertebral artery – Anterior spinal artery

– Posterior spinal arteries

• Spinal branches – Vertebral artery

– Intercostal arteries

– Lumbar arteries

– Lateral sacral arteries

SPINAL CORD

• Blood supply

• Anterior spinal vein

• Posterior spinal vein

• Lateral spinal veins

SPINAL CORD

ANTERIOR MEDIAN FISSURE

POSTERIOR MEDIAN SULCUS

ANTEROLATERAL SULCUS

POSTEROLATERAL SULCUS

POSTERIOR INTERMEDIUS SULCUS

SPINAL CORD DORSAL ROOTLETS

DORSAL ROOT

AFFERENT NERVE FIBERS

DORSAL ROOT GANGLIA (SPINAL)

VENTRAL ROOTLETS

VENTRAL ROOT

EFFERENT NERVE FIBERS

SPINAL GREY MATTER

SPINAL NERVE

SPINAL CORD SPINAL SEGMENT

CERVICAL SEGMENTS (C 1 – C8)

THORACIC SEGMENTS (T 1 – T 12)

LUMBAR SEGMENTS (L 1 – L5)

SACRAL SEGMENTS (S1 – S 5)

COCCYGEAL SEGMENTS (Co 1 – Co 3)

SPINAL CORD CONUS MEDULLARIS

FILUM TERMINALE

CERVICAL ENLARGEMENT

C II - TII

LUMBOSACRAL ENLARGEMENT

T IX – L I

SPINAL CORD

GREY MATTER

CENTRAL CORE

H OR BUTTERFLY

ANTERIOR HORNS (MOTOR)

ANTERIOR COLUMNS

SPINAL CORD GREY MATTER

POSTERIOR HORNS (SENSORY)

POSTERIOR COLUMNS

APEX

HEAD (CAPUT)

NECK (CERVIX)

BASE (BASIS)

SPINAL CORD GREY MATTER

LATERAL COLUMNS (HORNS)

THORACIC (T 1 – L 1) – SYMPATHETIC

SACRAL (S 2 – S4) – PARASYMPATHETIC

INTERMEDIATE COLUMN

CENTRAL CANAL

THE SPINAL CORD

ORGANIZATION OF SOME NEURONS

COLUMNS

VENTRAL – MOTOR

DORSAL – SENSORY

INTERMEDIATE (LATERAL) – VISCERAL

MOTOR

SPINAL CORD

POSTERIOR HORN EXTEROCEPTIVE, PROPRIOCEPTIVE,

INTEROCEPTIVE

NUCLEUS (LAMINA) MARGINALIS

SUBSTANTIA GELATINOSA NOCICEPTION

NUCLEUS PROPRIUS CAPUT

TEMPERATURE, PAIN, TOUCH

INTERSPINAL COORDINATION

SPINAL CORD

POSTERIOR HORN

NUCLEUS BASILARIS

PROPRIOCEPTION

LATERAL CERVICAL NUCLEUS

C 1 – C 2

THORACIC NUCLEUS (CLARCKE´S)

C 8 – L 3

PROPRIOCEPTION

SPINAL CORD

ANTERIOR HORN

ALFA (α)MOTOR NEURONS

EXTRAFUSAL FIBERS

GAMA (γ) MOTOR NEURONS

INTRAFUSAL FIBERS

MEDIAL TRUNK MUSCLES

LATERAL LIMB MUSCLES

SPINAL CORD

ANTERIOR HORN

POSTEROMEDIAL NUCLEUS

ANTEROMEDIAL NUCLEUS

CENTRAL NUCLEUS

ANTEROLATERAL NUCLEUS

POSTEROLATERAL NUCLEUS

SPINAL CORD

LATERAL HORN

VISCEROMOTOR

INTERMEDIOLATERAL NUCLEUS

C 7 – L 2

SYMPATHETIC

PARASYMPATHETIC SACRAL NUCLEI

S 2 – S4

VISCEROSENSORY

INTERMEDIOMEDIAL NUCLEUS

SPINAL CORD

REXED´S LAMINAE (ZONES)

10 LAYERS

NEURONAL SIZE

SHAPE

CYTOLOGICAL FEATURES

DENSITY

DORSVENTRAL SEQUENCE

SPINAL CORD

REXED´S LAMINAE

GRAY MATTER NUCLEI

I NUCLEUS MARGINALIS

II AND III SUBSTANTIA GELATINOSA

IV AND V NUCLEUS PROPRIUS

VI THORACIC NUCLEUS (CLARKE´S)

VII INTERNEURONS BETWEEN THE ANTERIOR AND POSTERIOR HORNS

VIII POSTEROMEDIAL AND ANTEROMEDIAL NUCLEI

IX CENTRAL, POSTEROLATERAL AND ANTEROLTAERL NUCLEI

X SUBSTANTIA GRISEA INTERMEDIA

SPINAL CORD

White matter

Ascending and descending pathways

Anterior funiculus

Lateral funiculus

Posterior funiculus

Spinal segment

THE ASCENDING PATHWAYS

• PROTOPATHIC AND NOCICEPTIVE PATHWAYS

• SPINOTHALAMIC

• DORSAL HORN

• AXONS DECUSSATE AND ASCEND TO CONTRALATERAL THALAMUS

THE ASCENDING PATHWAYS

• PROTOPATHIC AND NOCICEPTIVE PATHWAYS

• SPINORETICULAR • RETICULAR FORAMTION (BRAIN STEM)

• SPINOTECTAL • SUPERIOR COLLICULI (MESENCEPHALON)

THE ASCENDING PATHWAYS

• PROPRIOCEPTIVE PATHWAYS

• AFFERENTS IN THE PERIPHERY

• CELL BODIES IN SPINAL GANGLIA

• AXON TO CNS THROUGH SPINAL

THE ASCENDING PATHWAYS

• PROPRIOCEPTIVE PATHWAYS • BASILAR NUCLEUS

• THORACIC NUCLEUS

• SPINOCEREBLLAR PATHWAYS (ANTERIOR, POSTERIOR)

• SPINOOLIVARY PATHWAY

• MONOSYNAPTIC MUSCULAR REFLEXES

• POLYSNAPTIC MUSCULAR REFLEXES

• WITH PATHWAYS OF EPICRITIC SENSATION

THE ASCENDING PATHWAYS

• PATHWAYS OF EPICRITIC SENSATION

• AFFERENTS IN THE PERIPHERY

• CELL BODIES IN SPINAL GANGLIA

• FASCICULUS GRACILIS

• FASCICULUS CUNEATUS

• INTERNAL ARCUATE FIBERS

THE ASCENDING PATHWAYS

• PATHWAYS OF EPICRITIC SENSATION

• NUCLEUS GRACILIS

• NUCLEUS CUNEATUS

• THALAMUS

• POSTCENTRAL GYRUS

THE DESCENDING PATHWAYS

• SOMATOMOTOR PATHWAYS

• THE PYRAMIDAL PATHWAY

• FROM THE CEREBRAL CORTEX

• PRECENTRAL GYRUS

• CORTICOSPINAL FIBERS

• CORTICONUCLEAR FIBERS

• CORTICORETICULAR FIBERS

THE DESCENDING PATHWAYS

• THE PYRAMIDAL PATHWAY

• CORTICOSPINAL FIBERS

• PYRAMIDAL DECUSSATION

• LATERAL CORTICOSPINAL PATHWAY

• ANTERIOR CORTICOSPINAL PATHWAY

• MOTOR NEURONS (SPINAL CORD)

• CONTROL FINE, FRACTIONATED MOVEMENTS

THE DESCENDING PATHWAYS

• THE EXTRAPYRAMIDAL PATHWAYS • RETICULOSPINAL PATHWAY

• VESTIBULOSPINAL PATHWAY

• INTERSTITIOSPINAL PATHWAY

• RUBROSPINAL PATHWAY

• TECTOSPINAL PATHWAY

• REGULATION OF MOTOR ACTIVITY (MUSCLE TONE, COORDINATION, REFLEX RECTION TO VARIABLE SENSORY IMPULSES)