Survey
* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
Chapter 13: The Spinal Cord and Spinal Nerves Spinal Cord Anatomy Protective structures: Vertebral column and the meninges provide protect the spinal cord and provide physical stability. a. Dura mater, b. Arachnoid, c. Pia mater Epidural space, subdural space and subarachnoid space (filled with CSF) Copyright 2009, John Wiley & Sons, Inc. Tissue Slide Simple Squamous epithelium Copyright 2009, John Wiley & Sons, Inc. Spinal Cord Anatomy 13_06a External Anatomy of the Spinal Cord Two enlargements: cervical and lumbar Conus medullaris – “end” Filum terminale – extension of pia mater Cauda equina – horse tail Posterior (dorsal root) & anterior (ventral) root Posterior (dorsal root) ganglion Spinal nerve Copyright 2009, John Wiley & Sons, Inc. External Anatomy of Spinal Cord Internal Anatomy of the Spinal Cord Anterior median fissure Posterior median sulcus Gray and white commissures Central canal, w/ CSF Anterior, posterior, & lateral gray horns (T upper L) Anterior, posterior & lateral white columns Copyright 2009, John Wiley & Sons, Inc. Internal Anatomy of Spinal Cord Spinal Nerves 31 pairs; mixed nerves (Motor & Sensory). Cervical (C1-C8), thoracic (T1-T12), lumbar (L1-L5), sacral (S1-S5) and coccygeal. Connective tissue coverings of spinal nerves: Epineurium, perineurium and endoneurium: Fascicles Copyright 2009, John Wiley & Sons, Inc. Spinal Nerves Typical Spinal Nerve Distribution of Spinal Nerves Spinal nerves branch and their braches are called rami: Posterior (dorsal) ramus Anterior (ventral) ramus Plexuses: a network of axons except T1-T11 form plexuses. Copyright 2009, John Wiley & Sons, Inc. Cervical Plexus Formed by the anterior rami of C1-C5. Phrenic nerves- important nerves from the cervical plexuses. Copyright 2009, John Wiley & Sons, Inc. Brachial plexus Formed by the anterior rami of C5-C8 & T1. Supplies the shoulders and upper limbs. Roots → trunks → divisions → cords → nerves. Copyright 2009, John Wiley & Sons, Inc. Brachial plexus continued Important nerves that arise from the brachial plexuses are Axillary nerve Musculocutaneous nerve Radial nerve Median nerve Ulnar nerve Copyright 2009, John Wiley & Sons, Inc. Lumbar Plexus Formed by the anterior rami of L1-L4. Supplies the anterolateral abdominal wall, external genitals, and part of the lower limbs. Femoral nerves, obturator nerves. Copyright 2009, John Wiley & Sons, Inc. Sacral Plexus Formed by the anterior rami of L4-L5 and S1S4. Supplies the buttocks, perineum, and lower limbs. Gives rise to the largest nerve in the body- the sciatic nerve. Copyright 2009, John Wiley & Sons, Inc. Distribution of Nerves from the Lumbar and Sacral Plexuses Copyright 2009, John Wiley & Sons, Inc. Coccygeal Plexus Formed by the anterior rami of S4-S5 and the coccygeal nerves. Supplies a small area of skin in the coccygeal region. Copyright 2009, John Wiley & Sons, Inc. Dermatome Dermatome is the area of the skin that provides sensory input to the CNS via one pair of spinal nerves or the trigeminal nerve. Copyright 2009, John Wiley & Sons, Inc. Sensory and Motor Tracts The name of the tract often indicates its location in the white matter and where it begins and ends. The white matter contains both sensory and motor tracts. Copyright 2009, John Wiley & Sons, Inc. Posterior column: Central canal Gracile fasciculus Cuneate fasciculus Lateral corticospinal tract Posterior spinocerebellar tract Rubrospinal tract Anterior spinocerebellar tract Lateral reticulospinal tract Spinal nerve Vestibulospinal tract Spinothalamic tract Medial reticulospinal tract Tectospinal tract Anterior median fissure Anterior corticospinal tract Sensory (ascending) tracts Motor (descending) tracts Sensory and Motor Tracts 2 Sensory impulses (A) - Spinothalamic tract (pain, warmth, coolness, itching, and tickling) and the Posterior column [Gracile fasiculus and Cuneate f.] (touch, pressure, vibration, and proprioception) Motor impulses (D) – Direct (Lateral corticospinal, Anterior c., and Corticobulbar tracts) [voluntary] and Indirect pathways (rubrospinal, tectospinal, vestibulospinal, Lateral reticulospinal and Medial r. tracts) (muscle tone, posture, and balance) [automatic movements] Reflex A reflex is an automatic, sudden, involuntary response to a stimulus. When the integration takes place in the spinal cord, the reflex is a spinal reflex. Copyright 2009, John Wiley & Sons, Inc. Reflex Arc The pathway followed by nerve impulses that produce a reflex is a reflex arc. A reflex arc includes: a. sensory receptor b. sensory neuron c. integrating center (mono and polysynaptic) d. motor neuron e. effector (somatic reflex – skeletal muscle, autonomic (visceral) reflex – smooth muscle, etc.) Copyright 2009, John Wiley & Sons, Inc. Reflex Arc 2 SENSORY NEURON (axon conducts impulses from receptor to integrating center) 1 SENSORY RECEPTOR (responds to a stimulus by producing a generator or receptor potential) Interneuron 3 INTEGRATING CENTER (one or more regions within the CNS that relay impulses from sensory to motor neurons) 4 MOTOR NEURON (axon conducts impulses from integrating center to effector) 5 EFFECTOR (muscle or gland that responds to motor nerve impulses) Reflex Arc The Stretch Reflex Causes contraction of a skeletal muscle in response to stretching of the muscle. Monosynaptic reflex (one synapse). Patellar or knee-jerk reflex: Stretching of a muscle →activation of muscle spindles →sensory neuron →spinal cord→motor neuron → muscle contraction. Ipsilateral reflex– Reciprocal innervation. Copyright 2009, John Wiley & Sons, Inc. Stretch Reflex To brain 1 Stretching stimulates SENSORY RECEPTOR (muscle spindle) + 2 SENSORY NEURON excited EFFECTOR + 5 (same muscle) contracts and relieves the stretching – 4 MOTOR NEURON excited Spinal Nerve + 3 Within INTEGRATING CENTER (spinal cord), sensory neuron activates motor neuron Antagonistic muscles relax Motor neuron to antagonistic muscles is inhibited Inhibitory interneuron The Tendon Reflex Polysynaptic reflex. Control muscle tension by causing muscle relaxation when muscle tension is great. Sensory receptors- Golgi tendon organs. ↑ Tension applied to the tendon → tendon organ stimulation → nerve impulse → spinal cord →motor neuron causes muscle relaxation and relieves tension. Copyright 2009, John Wiley & Sons, Inc. Tendon Reflex To brain Inhibitory interneuron 5 EFFECTOR (muscle attached to same tendon) relaxes and relieves excess tension 4 MOTOR NEURON inhibited + ++ 2 SENSORY NEURON excited – Increased tension stimulates 1 SENSORY RECEPTOR (tendon) + Spinal nerve 3 Within INTEGRATING + Antagonistic muscles contract CENTER (spinal cord), sensory neuron activates inhibitory interneuron Motor neuron to antagonistic muscles is excited Excitatory interneuron Flexor (Withdrawal) Reflex Polysynaptic reflex Ipsilateral. Stepping on a tack (stimulus) → nerve impulse → activation of the interneuron → activation of the motor neuron →muscle contraction →withdrawal of the leg. Copyright 2009, John Wiley & Sons, Inc. Flexor (Withdrawal) Reflex + Spinal nerve + 4 MOTOR NEURON excited Ascending interneuron + + Interneuron + + 5 EFFECTORS (flexor muscles) contract and withdraw leg Descending interneuron + + 4 MOTOR NEURONS excited + + 3 Within INTEGRATING CENTER 2 SENSORY NEURON excited (spinal cord), sensory neuron activates interneurons in several spinal cord segments 1 Stepping on tack stimulates SENSORY RECEPTOR (dendrites of pain-sensitive neuron) Crossed Extensor Reflex Polysynaptic reflex. Contralateral reflex. Contraction of muscles that extend joints in the opposite limb in response to a painful stimulus. Stepping on a tack (stimulus) → nerve impulse →activation of several interneurons → activation of the motor neurons → muscle contraction causing flexion of the leg stepping on a tack & extension on the opposite side. Copyright 2009, John Wiley & Sons, Inc. Crossed Extensor Reflex Copyright 2009, John Wiley & Sons, Inc. + + + Spinal nerve + Ascending interneurons 4 MOTOR NEURONS excited 5 EFFECTORS (extensor muscles) contract, and extend left leg + + Flexor muscles contract and withdrawright leg Interneurons from other side + + + Descending interneurons + + + + + + 4 MOTOR NEURONS excited + + 3 Within INTEGRATING CENTER 2 SENSORY (spinal cord), sensory neuron activates several interneurons NEURON excited 1 Stepping on a tack Withdrawal of right leg (flexor reflex) stimulates SENSORY RECEPTOR (dendrites of pain-sensitive neuron) in right foot Extension of left leg (crossed extensor reflex)