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Amber Benton Anatomical Organization of Nervous System A. Central Nervous system – brain and spinal cord Nucleus and tract are components of the CNS: -nucleus is a collection of neuronal cell bodies -tract is a collection of axons, or nerve processes B. Peripheral Nervous system – everything outside of CNS -Cranial nerves (attached to brain) – 12 pairs -Spinal nerves (attached to spinal cord) – 31 pairs (8 cervical, 12 thoracic, 5 lumbar, 5 sacral, 1 coccygeal) Ganglion and Nerve are components of the PNS: -ganglion is a collection of neuronal cell bodies -Nerve is a collection of axons, or nerve processes Dendrites (highly branched) receive information while axons (unbranched/singular) deliver signals Sensory (afferent) transmission: involves pseudounipolar neurons receptors in skin → spinal cord (dorsal horn) → brain or another location Motor (efferent) transmission: involves multipolar neurons (most common type) Signal in brain → spinal cord (ventral horn) → peripheral nerves on skeletal muscles Clinical Example: patellar-tendon reflex **Spinal cord is continuous with brainstem and connects brain to the body - “conduit” \ Spinal Cord Protection- 5 levels (Vertebral column, 3 meninges, CSF) 1. Vertebral column is a bony covering that allows spinal cord to pass through vertebral foramen, forming a spinal canal with multiple vertebral foramen stacked on top of each other 2. Meninges (3 connective tissue coverings) – cover brain as well A) Dura mater is outermost dense CT that continues inferiorly to 2 sacral vertebra (end of dural sac-pg.14) and forms anchoring ligament to coccyx (filum terminale externum-pg.14) **Epidural space is above (only in transverse cross section), or superficial, to dura mater (between bone and dura mater) and contains fat and veins which epidural anesthesia is administered **Subdural space is below (only in transverse cross section), or deep to, dura mater and above, or superficial to arachnoid mater (between dura mater and arachnoid mater); described as only potential space, hemorrhage may occur here nd B) Arachnoid mater is a thin, transparent membrane with weblike extensions, or arachanoid trabeculae extending through subarachnoid space to reach pia mater **Subarachnoid space (between arachnoid mater and pia mater) contains cerebrospinal fluid which acts as a defense mechanism, shock absorber, and maintains chemical environment – clinical importance: for a lumbar puncture spinal tap or anesthesia, must poke through dura mater to enter subarachnoid space below L2 to avoid spinal cord puncture even though may risk puncturing cauda equina (between L3 & L4 or L4 & L5) **Traversing the subarachnoid space is the denticulate ligament, which is a lateral extension of pia mater to dura mater anchoring spinal cord C) Pia mater is innermost thin CT layer tightly bound to spinal cord “invests” every contour of spinal cord Filum terminale internum (pg. 14) is inferior extension of pia mater extending from end of conus medullaris (tapered inferior portion of spinal cord) to base of dural sac at S2 (2nd sacral); found within cauda equina, a stretched continuation of dorsal and ventral roots of spinal nerves inferior to L2 (2nd lumbar level, or below conus medullaris) Formation of a Spinal Nerve Receptor on skin of hand receives sensory stimuli and signal travels along peripheral process of pseudounipolar (sensory) neuron through dorsal root ganglion to dorsal root (contains sensory fibers only) where central process, or axon, enters dorsal horn (within unmyelinated gray matter) via dorsal root. Signal is sent to CNS, or brain. Multipolar, or motor, neuron in ventral horn of gray matter sends signal from brain through ventral root and ends on skeletal muscle in hand The dorsal and ventral roots come together at the intervertebral foramen (must have at least two vertebrae) to allow spinal nerve to exit from spinal cord. The sensory and motor neurons in the same “conduit” form a spinal nerve, or mixed nerve Spinal Nerve Branching Once the spinal nerve has been formed from the dorsal root of the sensory neuron and ventral root of the motor neuron coming together in same “conduit”, it can then be branched off into two primary rami (which are both mixed nerves): Dorsal primary ramus: contains sensory neurons (originating from dorsal root and horn) ending on receptors on skin of back region and motor neurons (originating from ventral root and horn) ending on intrinsic and extrinsic muscles of back which flex and extend vertebral column Ventral primary ramus: contains sensory neurons (originating from dorsal root and horn) ending on receptors in skin of anterior/lateral trunk and limbs and motor neurons (originating from ventral root and horn) ending on skeletal muscle of anterior/lateral trunk and skin **Since the dorsal primary ramus only accommodates innervation of the back muscles, the ventral primary ramus is understandably much larger with more networking than the dorsal primary ramus Differential Development of Spinal Cord **Explains why vertebral column and spinal cord are not the same length (vertebral column is longer) and the presence of cauda equina As Early fetus or Embryo: Spinal cord fills bony vertebral column ↓ Dorsal and ventral roots at 1st sacral nerve come together at intervertebral foramen ↓ Bony vertebral column grows more than Spinal cord over time ↓ Dorsal and ventral roots stretch to Accommodate this growth ↓ Cauda equina and filum terminale internum are formed