Physiology of Spinal cord

1. PHYSIOLOGY OF
SPINAL CORD

3. DERMATOMES

4. SPINAL CORD REFLEXES
TYPES OF
REFLEXES SOMATIC
VEGETATIVE
STRETCHING FLEXION EXTENTION RHYTMIC MOVEMENTS
VASO- URINA- DEFAЕ- OTHERS
MOTOR TION CATION
TENDON REFLEXES: WALKING SCRATCHING
АХИЛЛОВ,
КОЛЕННЫЙ,
с m. BICEPS
с m. TRICEPS
EFFECT MUSCLE PROTECTIVE STANDING WALKING REMOVAL
EFFECTIVE ELIMINATION OF
TONES REACTION POSTURE OF EXCITA-
BLOOD TOXIC
FORMATION TORY STIMULI
SUBSTANCES

5. Sponsored
Medical Lecture Notes – All Subjects
USMLE Exam (America) – Practice

7. DESCENDING TRACTS

8. ASCENDING TRACTS

9. Tracts of tactile & proprio-
sensitivity
Direct tracts (don’t cross)
Fasciculus gracilus & fasciculus cuneatus
(tr.bulbo-thalamo-corticalis)
Tr. Spino-cerebellaris ventralis (Flexig)
Crossed tracts
Tr. Spino-thalamo-corticalis anterior
Tr. Spino-cerebellaris dorsalis (Govers)

10. SPINAL CORD REFLEXES
TYPES OF
REFLEXES SOMATIC
VEGETATIVE
STRETCHING FLEXION EXTENTION RHYTMIC MOVEMENTS
VASO- URINA- DEFAЕ- OTHERS
MOTOR TION CATION
TENDON REFLEXES: WALKING SCRATCHING
АХИЛЛОВ,
КОЛЕННЫЙ,
с m. BICEPS
с m. TRICEPS
EFFECT MUSCLE PROTECTIVE STANDING WALKING REMOVAL
EFFECTIVE ELIMINATION OF
TONES REACTION POSTURE OF EXCITA-
BLOOD TOXIC
FORMATION TORY STIMULI
SUBSTANCES

13. STRETCH REFLEX
Antigravitational- helps to maintain
erect posture regardless of the
influence of the force of gravity
Receptors – muscle spindels
No contact neurons, monosynaptic
reflex arch, short reflex time
Tendon reflexes are clinical variant of
stretch reflex

15. KNEE-JERK REFLEX

16. AHILLES REFLEX

17. SPINAL SHOCK
Decreased excitability of spinal
cord nervous centers below the
level of trauma due to the
absence of impulses from higher
nervous centers

19. SPINAL SHOCK
MANIFESTATIONS
Absence of spinal cord proper
reflexes
Loss of sensitivity (astesia)
Decrease of muscle tone (atonia)
Inability to perform voluntarily
movements

20. RULES OF TOPICAL DIAGNOSTICS :
1. Physician has to take into consideration
all the patient’s feelings (sensations).
2. Each question asked by physician
should get diagnostically valuable answer.
3. There should be a certain scheme of
questions given to the patient.
4. Each question should be targeted at a
certain anatomical structure.
5. If you don’t know what you are looking
for don’t approach the patient!!!

21. PRINCIPLES OF TOPICAL DIAGNOSTICS OF SPINAL CORD DISEASES
Spinal
cord
Patient’s complains Symptoms found at
examination
Posterior horn •Pain in segment projection on
the side of lesion
•Paresthesias
•Disturbed sensitivity
•Disturbed sensitivity
•Perverted sensations
•Decrease in tendon &
periostal reflexes
Anterior horn •Decreased volume of
movements in a certain segment
on the side of lesion
•Decreased muscle power in a
certain segment
•Sensation of smth creeping
under the skin
•Loss of muscle weight
•Muscle atrophy
•Fibrillar contractions
•Decreased muscle tone
•Decrease in tendon &
periostal reflexes or absence
of reflexes

22. Spinal
cord
Patient’s complains Symptoms found at
examination
Grey
commi-
ssurae
Bilateral sensations:
Pain in the segment
projection
Paraesthesias
Disturbed sensitivity
Urination disorders
Dissociated sensory
loss of coat, pants,
gloves, socks
type(decreased pain &
temperature sensations,
preserved tactile)
Decrease or absence of
reflexes in certain
segments
Trophics disorders
(scars after burns)

23. Spinal
cord
Patient’s complains Symptoms found at
examination
Lateral
funiculus
•Decreased volume of movement
on the side of lesion below the
level of lesion
•Decreased muscle power on the
side of lesion below the level of
lesion
•Tetanic contractions below the
level of lesion
•Disturbed sensitivity on the
opposite side (cold feet, feeling
of heat, paraesthesias)
•Increased muscle tone
•Increased reflexes
•Pathological reflexes
•Ascending type of sensitivity
disturbances: pain & temperature
on the opposite side
Anterior
funiculus
Same as at pyramidal tract
lesions
Same as at pyramidal tract lesions

24. Spinal
cord
Patient’s complains Symptoms found at
examination
Posterior
funiculi
Positive Romberg symptom
Disturbed finger-nose & heel-
knee probes
Disturbances in
proprioreception
Disturbances of vibration
sensations
Increased reflexes
Inability to recognize objects by
touch
Complex types sensitivity
disturbances (discrimination in
dimerical space sensations,
sensation of weight, pressure,
kinesthesia)
Positive Romberg symptom
Disturbed finger-nose & heel-
knee probes
Disturbances in
proprioreception чувства
Disturbances of vibration
sensations
Increased reflexes
Inability to recognize objects by
touch
Complex types sensitivity
disturbances (discrimination in
dimerical space sensations,
sensation of weight, pressure,
kinesthesia)