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Spinal Cord
Neuroanatomy
Siva Pesala MD
Objectives
• External structure of the spinal cord.
• Internal structure of the spinal cord.
• Blood supply
• Spinal cord lesions and symptoms
Spinal cord
• Spinal cord is cylindrical structure that is
continuous with caudal brain stem and
extends through vertebral column until its
termination( Conus medullaris) at L1-L2.
Gross Appearance
• Foramen magnum  L1/L2 (adult)
• L3 (newborn)
• Occupies upper ⅔ of vertebral canal
• Surrounded by 3 layers of meninges:
– Dura mater
– Arachnoid mater
– Pia mater
• CSF in subarachnoid space
Dura mater
• Dense, strong fibrous membrane
• Encloses the spinal cord & cauda equina
• Ends at the level of S2
• Separated from wall of vertebral canal by
the extradural space
• Contains loose areolar tissue & internal
vertebral venous space
Arachnoid mater
• Delicate impermeable membrane
• Lies between pia and dura mater
• Separated from pia mater by
subarachnoid space
• Ends on filum terminale at level of S2
Pia mater
• Vascular membrane
• Closely covers spinal cord
• Thickened on either side between nerve
roots to form the ligamentum denticulatum
• Ends as filum terminale
Structure Of The Spinal Cord
Gray matter
• H-shaped pillar with anterior & posterior gray
horns
• United by gray commissure containing the
central canal
• Amount of gray matter ~ the amount of
muscle innervated
• Consists of nerve cells, neuroglia, blood
vessels
Gray matter
• Nerve cells in the posterior gray columns
• 4 nerve cell groups
• Substantia gelatinosa
– Situated at the apex
– Throughout the length of spinal cord
– Receives afferent fibres concerning with pain,
temperature & touch from posterior root.
• Nucleus proprius
– anterior to substantia gelatinosa
– present throughout the whole length of spinal
cord
– main bulk of cells in posterior gray column
– receives fibers from posterior white column
that are assoc with proprioception, 2-point
discrimination & vibration
• Nucleus dorsalis (Clark’s column)
– base of posterior column
– C8 – L3 / L4
– associated with proprioceptive endings
(neuromuscular spindles & tendon spindles)
• Visceral afferent nucleus
– lateral to nucleus dorsalis
– T1 – L3
– receives visceral afferent info
White Matter
• Divided into
– Anterior white column
– Lateral white column
– Posterior white column
• Consists of nerve fibres, neuroglia, blood
vessels
• White due to myelinated fibres
Spinal cord tracts
Descending tracts
Corticospinal tract
CST
• Cerebral motor cortex (area 4; precentral gyrus) ->very
long axons->Decussate in lower medulla.
• Enter the LATERAL FUNICULUS where they travel
medial to the DSCT.
• 2 neurons. The first one is an upper motor neuron and
lies in the cerebral cortex. The second one lies in the
contralateral ventral horn and is a
lower motor neuron.
Ascending tracts
Ascending tracts
Ascending tracts
Spinothalamic tract
Spinothalamic tract
Dorsal column /F.G & F.C
Dorsal Column
Dorsal spinocerebellar tract
Dorsal spinocerebellar tract
DSCT
Dorsal spinocerebellar tract
• Clarke column- C8-T3
• Muscle joint sense pathways to cerebellum
• Unconscious proprioception
• Muscle joint info from muscle spindles, GTO,
joint receptors of the trunk & lower limbs
• Info is used by the cerebellum in the
coordination of movements & maintenance of
posture
• Lesion- Incoordination & Ataxia
Blood supply
Arteries of the spinal cord
• Anterior spinal artery
• Posterior spinal artery
• Segmental spinal arteries
Anterior spinal artery
• Formed by the union of 2 arteries
• From vertebral artery
• Supply anterior ⅔ of spinal cord
Posterior spinal arteries
• Arise from vertebral artery or posterior
inferior cerebellar arteries (PICA)
• Descend close to the posterior roots
• Supply posterior ⅓ of spinal cord
Segmental spinal arteries
• Branches of arteries outside the vertebral
column
• Gives off the anterior & posterior radicular
arteries
• Great anterior medullary artery of
Adamkiewicz
• Arise from lateral intercostal artery or
lumbar artery at any level from T8 – L3
Extramedullary vs Intramedullary
Conus medullaris vs Cauda equina
• Thank you.

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spinalcord-171105051759.pdf

  • 2. Objectives • External structure of the spinal cord. • Internal structure of the spinal cord. • Blood supply • Spinal cord lesions and symptoms
  • 3. Spinal cord • Spinal cord is cylindrical structure that is continuous with caudal brain stem and extends through vertebral column until its termination( Conus medullaris) at L1-L2.
  • 4. Gross Appearance • Foramen magnum  L1/L2 (adult) • L3 (newborn) • Occupies upper ⅔ of vertebral canal • Surrounded by 3 layers of meninges: – Dura mater – Arachnoid mater – Pia mater • CSF in subarachnoid space
  • 5. Dura mater • Dense, strong fibrous membrane • Encloses the spinal cord & cauda equina • Ends at the level of S2 • Separated from wall of vertebral canal by the extradural space • Contains loose areolar tissue & internal vertebral venous space
  • 6. Arachnoid mater • Delicate impermeable membrane • Lies between pia and dura mater • Separated from pia mater by subarachnoid space • Ends on filum terminale at level of S2
  • 7. Pia mater • Vascular membrane • Closely covers spinal cord • Thickened on either side between nerve roots to form the ligamentum denticulatum • Ends as filum terminale
  • 8.
  • 9.
  • 10.
  • 11.
  • 12.
  • 13.
  • 14.
  • 15. Structure Of The Spinal Cord
  • 16. Gray matter • H-shaped pillar with anterior & posterior gray horns • United by gray commissure containing the central canal • Amount of gray matter ~ the amount of muscle innervated • Consists of nerve cells, neuroglia, blood vessels
  • 18. • Nerve cells in the posterior gray columns • 4 nerve cell groups • Substantia gelatinosa – Situated at the apex – Throughout the length of spinal cord – Receives afferent fibres concerning with pain, temperature & touch from posterior root.
  • 19. • Nucleus proprius – anterior to substantia gelatinosa – present throughout the whole length of spinal cord – main bulk of cells in posterior gray column – receives fibers from posterior white column that are assoc with proprioception, 2-point discrimination & vibration
  • 20. • Nucleus dorsalis (Clark’s column) – base of posterior column – C8 – L3 / L4 – associated with proprioceptive endings (neuromuscular spindles & tendon spindles) • Visceral afferent nucleus – lateral to nucleus dorsalis – T1 – L3 – receives visceral afferent info
  • 21.
  • 22.
  • 23.
  • 24. White Matter • Divided into – Anterior white column – Lateral white column – Posterior white column • Consists of nerve fibres, neuroglia, blood vessels • White due to myelinated fibres
  • 26.
  • 27.
  • 30.
  • 31. CST • Cerebral motor cortex (area 4; precentral gyrus) ->very long axons->Decussate in lower medulla. • Enter the LATERAL FUNICULUS where they travel medial to the DSCT. • 2 neurons. The first one is an upper motor neuron and lies in the cerebral cortex. The second one lies in the contralateral ventral horn and is a lower motor neuron.
  • 41. DSCT
  • 42. Dorsal spinocerebellar tract • Clarke column- C8-T3 • Muscle joint sense pathways to cerebellum • Unconscious proprioception • Muscle joint info from muscle spindles, GTO, joint receptors of the trunk & lower limbs • Info is used by the cerebellum in the coordination of movements & maintenance of posture • Lesion- Incoordination & Ataxia
  • 43. Blood supply Arteries of the spinal cord • Anterior spinal artery • Posterior spinal artery • Segmental spinal arteries
  • 44.
  • 45.
  • 46. Anterior spinal artery • Formed by the union of 2 arteries • From vertebral artery • Supply anterior ⅔ of spinal cord Posterior spinal arteries • Arise from vertebral artery or posterior inferior cerebellar arteries (PICA) • Descend close to the posterior roots • Supply posterior ⅓ of spinal cord
  • 47.
  • 48.
  • 49.
  • 50.
  • 51. Segmental spinal arteries • Branches of arteries outside the vertebral column • Gives off the anterior & posterior radicular arteries • Great anterior medullary artery of Adamkiewicz • Arise from lateral intercostal artery or lumbar artery at any level from T8 – L3
  • 52.
  • 53.
  • 54.
  • 55.
  • 56.
  • 57.
  • 58.
  • 59.
  • 60.
  • 61.
  • 62.
  • 63.
  • 64.
  • 66. Conus medullaris vs Cauda equina