Copy Right- Hongqi ZHANG-Department of Anatomy-Fudan University Systematic Anatomy (For international students) Department of Anatomy,Fudan University Teaching contents Spinal cord Dr.Hongqi Zhang (张红旗) Email: [email protected] Copy Right- Hongqi ZHANG-Department of Anatomy-Fudan University 1 Copy Right- Hongqi ZHANG-Department of Anatomy-Fudan University Systematic Anatomy (For international students) Department of Anatomy,Fudan University Teaching contents Spinal cord Dr.Hongqi Zhang (张红旗) Email: [email protected] Copy Right- Hongqi ZHANG-Department of Anatomy-Fudan University 2 Copy Right- Hongqi ZHANG-Department of Anatomy-Fudan University Spinal cord Copy Right- Hongqi ZHANG-Department of Anatomy-Fudan University Central nervous system (CNS) Brain Telencephalon Diencephalon Cerebellum Brain stem 1-Midbrain 2-Pons 3-medulla oblongata Spinal cord Position of the Spinal Cord Position: Lies in vertebral canal, 45cm long approximately Upper end: Continuous with medulla oblongata at foramen magnum Lower end: at the lower border of L1 in adult; at newborn at level of L3 Sexual difference: usually a little lower in female than in male Clinic significance: anaesthesia done usually at below the L1 Copy Right- Hongqi ZHANG-Department of Anatomy-Fudan University Anaesthesia in the vertebral canal L1 Lower end Of spinal cord Skin Subcutaneous fascia Supraspinal lig. Interspinal lig. Yellow lig. Needle puncture Draw cerebrospinal fluid From the vertebral canal For lab examination Copy Right- Hongqi ZHANG-Department of Anatomy-Fudan University External Features of Spinal Cord External feature: A long cylindrical structure & slightly flattened anteroposteriorly Two enlargements Cervical enlargement corresponds to the C4 to the T1 segments Lumbosacral enlargement corresponds to the L2 to the S3 segments Conus medullaris Filum terminale-only thin filament Cauda equina Fudan university Zhang Hongqi 张红旗 Lumbosacral enlargement Conus medullaris Filum terminale Cauda equina Conus medullaris and cauda equina External Features of Spinal Cord Fissure and sulci 1 - Anterior median fissure 2 - Posterior median sulcus 3 - Anterolateral sulcus - connect with ant.root (motor) 4 - Posterolateral sulcus - connect with post.root (sense) 2 4 Post.root Spinal ganglion Post.branch Ant.root 1 3 Ant.branch Segments of Spinal Cord A portion of the cord that gives rise to a pair of spinal nerve constitutes a segment. There are 31 segments 8 cervical ss 12 thoracic ss 5 lumbar ss 5 sacral ss 1 coccygeal s Segment - s Copy Right- Hongqi ZHANG-Department of Anatomy-Fudan University Relationship of SC Segments to Vertebral body In the third month of fetal life, the spinal cord occupies the entire length of the vertebral canal. After that time,there are some difference between spinal cord & vertebral canal in growth speed,that is, the vertebral canal grow faster than that of spinal cord, Spinal cord Vertebral canal Sc length = vertebral canal At 3rd fetal month Copy Right- Hongqi ZHANG-Department of Anatomy-Fudan University Copy Right- Hongqi ZHANG-Department of Anatomy-Fudan University Relationship of SC Segments to Vertebrae At birth The inferior ends is below at the lower border of L1 in adult;at birth at level of L3, usually a little lower in female than in male. L3 But each spinal nerve have to come out from their corresponding intervertebral foramina. Sc inf. end is At the level of L 1 at adult Sc inf. end is higher Than that of canal At birth After 3rd month Copy Right- Hongqi ZHANG-Department of Anatomy-Fudan University Copy Right- Hongqi ZHANG-Department of Anatomy-Fudan University More high level More almost horizental. More lower level More obliquity Copy Right- Hongqi ZHANG-Department of Anatomy-Fudan University Relationship of SC Segments to Vertebral Numbers Spinal segments Vertebral levels (spines) Upper cervical region (C1~C4) Lie opposite the corresponding vertebrae Lower cervical and upper thoracic region (C5~8;T1-4) One lower in number than corresponding vertebrae Middle thoracic region (T5~T8) Two lower in number than corresponding vertebrae Lower thoracic region (T9~T12) Three lower in number than corresponding vertebrae Lumber segments T10~T12 Sacral and coccygeal segments L1 Relationship of SC Segments to Vertebral Numbers Spinal segments Upper cervical region (C1~C4) Vertebral levels (spines) = C1 ~ C4 Lower cervical and upper thoracic -1 = C4 ~ T3 region (C5-8;T1~4) Middle thoracic region (T5~T8) -2 = T3 ~ T6 Lower thoracic region (T9~T12) Lumber segments -3 = T6 ~ T9 = T10 ~ T12 Sacral and coccygeal segments = L1 Internal structure of spinal cord C 1 - Gray matter 2 - White matter 3 – reticular formation 1 T 2 L 3 S C-cervical;T-tharacic;L-lumbar;S-sacral Central canal Internal structure of spinal cord Fasciculus gracilis Fasciculus cuneatus Lat. spinothalamic tract Nucleus proprius Lat.corticospinal tract Gray matter Post.root Motor neuron of ant.horn White matter Spinal ganglion Spinal pia matar Spinal n. Spinal arachnoid Spinal dura matar. Ant.root Copy Right- Hongqi ZHANG-Department of Anatomy-Fudan University Gray matter of Spinal Cord Like a butterfly or letter “H” Consist of cell body,neuroglia and dendrite Located around the central canal Post. horn (column) Intermediate zone Post. gray commissures Ant. gray commissures Ant. horn (column) Copy Right- Hongqi ZHANG-Department of Anatomy-Fudan University Gray Matter of Spinal Cord Anterior horn (column) Posterior horn (column) Lateral horn (column) is present in the thoracic & upper lumber segments of the cord (T1-L3) only Intermediate zone Ant. gray commissures Post. gray commissures Gray Matter of Spinal Cord Posterior horn (column): 1- Marginal layer 2- Substantia gelatinosa Situated at the apex of posterior horn throughout the length of spinal cord. Receives fibers are associated with the senses cord. 3- Nucleus proprius Situated anterior to the substantia gelatinosa throughout the length of spinal cord. Concerns the sensations of pain and temperature 1 2 3 Copy Right- Hongqi ZHANG-Department of Anatomy-Fudan University Gray Matter of Spinal Cord Posterior horn (column): Nucleus thoracicus (lable A) Situated at the base of posterior horn and extending from segments C8~L3. Associated with proprioceptive endings A Copy Right- Hongqi ZHANG-Department of Anatomy-Fudan University Intermediate zone Intermediolateral nucleus (labeled 1) Extends from segments T1~L3, Containing sympathetic preganglionic neurons Sacral parasympathetic nucleus Extends from segments S2~S4, Containing parasympathetic preganglionic neurons 1 Copy Right- Hongqi ZHANG-Department of Anatomy-Fudan University Intermediate zone Intermediomedial nucleus (labled A) Throughout the whole length of spinal cord. Associated with receiving viscera afferent information A Copy Right- Hongqi ZHANG-Department of Anatomy-Fudan University Copy Right- Hongqi ZHANG-Department of Anatomy-Fudan University Anterior horn (column): Two groups of nuclei 1-Medial nuclear group: present in most segments of spinal cord, innervating axial (trunk) muscles 2-Lateral nuclear group: present only in cervical and lumbosacral enlargements, innervating limb skeletal muscles 1 2 Copy Right- Hongqi ZHANG-Department of Anatomy-Fudan University Anterior horn (column): labeled with red color three kinds of neurons (motor neuron 2) α- motor neuron: large multipolar neuron, innervates skeletal muscles, producing contraction of muscles γ- motor neuron: smaller multipolar neuron, innervates intrafusal muscle fibers of neuromuscular spindles, regulating muscular tonus Interneuron —Renshaw’s cell: negative feedback Rexed’s lamina Posterior horn is formed by lamina Ⅰ to Ⅵ; Intermediate zone is corresponding to lamina Ⅶ; Anterior horn is composed laminae Ⅷ and Ⅸ; lamina Ⅹ is the gray matter around the central canal. Copy Right- Hongqi ZHANG-Department Anatomy-Fudan University Important Subdivision of SpinalofCord Gray Matter laminae nuclei Ⅰ Posterior marginal nucleus Ⅱ Substantia gelatinosa ⅢⅣ Nucleus proprius Ⅴ Reticular nucleus Ⅵ Base of posterior column Ⅶ Thoracic nucleus Intermediomedial mucleus Intermediolateral nucleus Sacral parasympathetic nucleus ⅧⅨ Medial motor neuron column Lateral motor neuron column Ⅹ gray matter around central canal Copy Right- Hongqi ZHANG-Department of Anatomy-Fudan University Copy Right- Hongqi ZHANG-Department of Anatomy-Fudan University White matter of spinal cord Organization Nerve fiber (tract) Around the grey matter Three parts Ant. Funiculus (A.F) Lat. Funiculus (L.F) Ascending & descending fiber Post. Funiculus (P.F) Ascending fiber only White commissure Ant.commissure of WM Post.commissure of wm P.F L.F A.F matter CopyWM-white Right- Hongqi ZHANG-Department of Anatomy-Fudan University White Matter of Spinal Cord White matter contains three kinds of fibers: ascending, descending and fasciculus proprius Post. funiculus Post. white commissure Lat. funiculus Ant. funiculus Ant. white commissure Copy Right- Hongqi ZHANG-Department of Anatomy-Fudan University White matter of spinal cord Fiber tract: in CNS, fiber bundle which has similar origin, terminal, course and function. Ascending tract: to conduct the sensory impulse from the trunk and limbs to the brain. Descending tract. to convey the motor information from central nervous system to the trunk and limbs. Copy Right- Hongqi ZHANG-Department of Anatomy-Fudan University Copy Right- Hongqi ZHANG-Department of Anatomy-Fudan University White matter of spinal cord Nomenclature : Course: pyramid tract Origin and terminal : Corticospinal tract. Spinothalamic tract Appearance of the tract: Fasciculus gracilis General: lateral corticospinal tract. Fasciculus proprius: both origin & termination of the fascisulus are in the spinal cord.with two direction (ascending & descending), the function take part in different segment reflex. Copy Right- Hongqi ZHANG-Department of Anatomy-Fudan University Major Ascending or sensory Tracts Fasciculus gracilis Fasciculus cuneatus Pos. spinocerebellar tract Ant. spinocerebellar tract Spinothalamic tract Lat.Spinothalamic tract(rough tonch) Ant.Spinothalamic tract(pain,temperature,sensation) Red color means important Fasciculus cuneatus Fasciculus gracilis Fasciculus gracilis and fasciculus cuneatus From pain and temperature And some touch receptors Spinothalamic tract Lateral and anterior spinothalamic tract Summary-ascending tracts Tract Site of origin Funiculu s Termination Function Fasciculus gracilis Spinal ganglia below segment T5 Posterior Gracile nucleus Conscious proprioceptive (vibratory sense, and muscle joint sense) and fine touch sensation of trunk and limbs Fasciculus cuneatus Spinal ganglia above segment T4 Posterior spinocerebellar tract Homolateral nucleus thoracicus Anterior spinocerebellar tract Contralateral Laminae Ⅴ~Ⅶ Lateral Spinothalamic tract Laminae Ⅰ, Ⅳ~Ⅶ anterior Spinothalamic tract Cuneate nucleus Lateral Cerebellum Unconscious proprioception from limbs and trunk Lateral Dorsal thalamus Pain, temperature and crude touch sensation of trunk and limbs anterior Descending Tracts Lateral corticospinal tract Fasciculus proprius Rubrospinal tract Medial longitudinal fasciculus Reticulospinal tract Vestibulospinal tract Tectospinal tract Anterior corticospinal tract Red color means important content Lateral and anterior corticospinal tract Coranal section of cerebrum horizental section of cerebrum horizental section of midbrain horizental section of pons Lateral corticospinal tract Anterior corticospinal tract horizental section of medulla ablongata horizental section of spinal cord Summary - descending tracts Tract Site of origin Funiculus Lateral corticospinal Cerebral cortex Lateral Anterior corticospinal Cerebral cortex Anterior Rubrospinal Red nucleus Vestibulospinal Reticulospinal Termination Function Laminae (Ⅳ~Ⅸ) anterior horn Motor neurons & interneurons Voluntary movement of skeletal muscle of trunk and limbs Lateral Laminae (Ⅴ~Ⅶ) anterior horn Motor neurons & interneuron (for flexor) Facilitates activity of flexor muscles Homolateral vestibular nuclei Anterior Laminae (Ⅶ~Ⅷ) anterior horn Motor neurons & interneuron (for extensor) Facilitates activity of extensor muscles Reticular formation Anterior & lateral Laminae (Ⅶ~Ⅷ) Control Voluntary movement of skeletal muscle of trunk & proximal extremity Summary - descending tracts Tract Site of origin Funiculus Termination Medial longitudinal fasciculus Vestibular nuclei Anterior Laminae (Ⅶ~Ⅷ) Anterior horn cell Coordinate of head and eye movement Tectospinal Superior colliculus Anterior Laminae(Ⅵ~Ⅷ) Reflex head turning Fasciculus proprius Spinal cord Anterior, lateral & posterior Spinal cord Function Intrinsic reflex mechanism of spinal cord Main functions of spinal cord Conduction of excitations bridge; brain - periphery Sensory impulse to brain Motor impulse to periphery Reflex Somatic reflex (skeletal m contration) superficial and deep reflex Tendon (stretch reflex ) arc Flexor reflex Abdominal reflex Visceral reflex (sm,cardiac m,gland) Defecation reflex Carotid reflex Copy Right- Hongqi ZHANG-Department of Anatomy-Fudan University Spinal cord transverse section lesion Complete spinal cord transection results in the immediate Loss of all neural function below the level of the lesion.there is a complete lose below the level of the lesion of : All somatic sensation All motor function All visceral sensation All reflex activity All muscle tone,etc Spinal shock: last for 1~6 weeks Copy Right- Hongqi ZHANG-Department of Anatomy-Fudan University Copy Right- Hongqi ZHANG-Department of Anatomy-Fudan University Hemisection of the spinal cord (brown-sequard syndrome) sensation 2 1 Injured main sensory fasiculus: 1-Fasciculus gracilis 2-Fasciculus cuneatus 3 3 3-Spinothalamic tract motor Injured motor fasiculus: 4 4 - Lat.corticospinal tract 5 5 - Ant.corticospinal tract Right:deep sensation,limb paralysis Left :superficial sensation disfunction Copy RightHongqi ZHANG-Department of Anatomy-Fudan University Copy Right- Hongqi ZHANG-Department of Anatomy-Fudan University Hemisection of the spinal cord Brown-sequard syndrome Result in: The ipsilateral motor neuron paralysis below the level of lesion Resulted from damage to the ipsilateral corticospinal tract. Loss of the ipsilateral deep sensation (proprioceptive,vibratroy and two–point discrimination sense)below the level of lesion . resulted from damage to the fasciculus gracilis and fasciculus cuneatus. Loss of the contralateral superficial sensation (pain & thermal Sense)below the level of lesion. resulted from damage to the lateral spinothalamic tract. Copy Right- Hongqi ZHANG-Department of Anatomy-Fudan University Copy Right- Hongqi ZHANG-Department of Anatomy-Fudan University Lesion of anterior horn of the spinal cord It causes ipsilateral lower motor neuron paralysis in the segments of the lesion (resulting from damage to lower motor neurons)such as infantile paralysis (Poliomyelitis). Usually it is caused by poliomyelitis virus Motor neuron Copy Right- Hongqi ZHANG-Department of Anatomy-Fudan University Copy Right- Hongqi ZHANG-Department of Anatomy-Fudan University Meningocele cleft spine Meningocele Copy Right- Hongqi ZHANG-Department of Anatomy-Fudan University Copy Right- Hongqi ZHANG-Department of Anatomy-Fudan University Copy Right- Hongqi ZHANG-Department of Anatomy-Fudan University Copy Right- Hongqi ZHANG-Department of Anatomy-Fudan University Copy Right- Hongqi ZHANG-Department of Anatomy-Fudan University Copy Right- Hongqi ZHANG-Department of Anatomy-Fudan University FIGURE 3.1.3 At upper thoracic and all cervical levels the dorsal funiculus is further subdivided, as shown here This view also shows the named sulci, fissures Hongqi ZHANG-Department of Anatomy-Fudan University and Copy septi,Rightas well as the course taken by entering and departing axons. Copy Right- Hongqi ZHANG-Department of Anatomy-Fudan University FIGURE 3.1.4 Most of the structures labeled on these slides are ones you have identified in earier views of this module. Try to reconcile the appearance of the structure here with that in views of the brain's surface. All the sections, except the 3 spinal cord ones, are clickable. Clicking on one leads you to enlarged view of the section. Copy Right- Hongqi ZHANG-Department of Anatomy-Fudan University Copy Right- Hongqi ZHANG-Department of Anatomy-Fudan University answer 9 1intermediolateral cell column 2 - dorsal funiculus 3 - lateral funiculus 4 - ventral funiculus Copy Right- Hongqi ZHANG-Department of Anatomy-Fudan University Copy Right- Hongqi ZHANG-Department of Anatomy-Fudan University The end! Hardworking Harvest Copy Right- Hongqi ZHANG-Department of Anatomy-Fudan University
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