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S
Lahir : 05-12-1976
Pendidikan :
SMA Negeri 3, Bandung
Pekerjaan :
Manager Website FK UNPAD (formerly)
RS Mitra Plumbon
FK UNSWAGATI
THE SPINE,
SPINAL CORD,
& SPINAL NERVES
Cervical vertebrae
Smallest
Foramen in each
transverse process
What is this?
C1 –Atlas
Has no body
AXIS (Second cervical vertebra)
Intermediate in size
Increase in size as one
proceeds down the spine
They are distinguished by
the presence of facets on
the sides of the bodies
Facets on the transverse
processes of all, except the
eleventh and twelfth,
Lumbar Vertebra
C1-C7 ++ ++ ++
T1-T6 0 + +
T7-T12 + ++ ++
L1-sacrum ++ + 0
Abnormalities in curvature
The following abnormal curvatures may occur in some people:
Kyphosis is an exaggerated posterior curvature in the thoracic
region. This produces the so-called "humpback".
Gross anatomy
3 layers of meninges
cauda equina
Cervical & lumbar enlargements
Spinal Cord Anatomy
• Dura mater:
– outer layer of spinal cord
– subdural space:
• between arachnoid mater and dura mater
• Arachnoid mater:
– middle meningeal layer
– subarachnoid space:
• between arachnoid mater and pia mater
• filled with cerebrospinal fluid (CSF)
• Pia mater:
– inner meningeal layer
Structures of the Spinal Cord
Paired denticulate
ligaments:
extend from pia mater to
dura mater
stabilize side-to-side
movement
Blood vessels:
along surface of spinal
pia mater
within subarachnoid
space
Cross-sectional anatomy
White matter
3 funiculi (posterior, lateral,
anterior)
Ascending, descending,
transverse
Consist of “tracts” containing
similarly functional axons
All tracts are paired
Most cross over (decussate) at
some point
Most exhibit somatotopy
(superior part of the tracts are
more lateral that inferior body
regions)
Most consist of a chain of 2 or
3 successive neurons
Gray Matter: Organization
1. Fasciculus Gracilis
2. Fasciculus Cuneatus
3. Tractus spinocerebellaris dorsalis
4. Tractus corticospinalis lateralis
16 5. Tractus spinothalamicus lateralis
6. Tractus spinocerebellaris ventralis
7. Tractus rubrospinalis
8. Tractus spinotectalis
9. Tractus corticospinalis anterior
10. Tractus olivospinalis
11. Tractus spinoolivaris
12. Tractus tectospinalis
13. Tractus reticulospinalis
14. Tractus vestibulospinalis
15. Tractus spinothalamicus anterior
16. Raphe-spinal & Hypothalamospinal fibers
Spinal Cord Tracts
Ascending Tracts
Ascending Tracts
lemniscal decussation
posterior root
Spinothalamic Tract
anterior white
decussation
commissure
posterior root
Spinothalamic Tract
Spinocerebellar Tract
LPF
Corticospinal Tract
Pyr
PD LCST
ventromedial dorsolateral
Descending pathway pathway
Tracts
from
Brain Stem
SOMATIC MOTOR SYSTEM
REFLEX
EFFECTORS
skeletal muscle
3 Connective Tissue Layers
Epineurium:
outer layer
dense network of collagen
fibers
Perineurium:
middle layer
divides nerve into fascicles
(axon bundles)
Endoneurium:
inner layer
surrounds individual axons
Peripheral Distribution of Spinal Nerves
1. Cervical plexus
2. Brachial plexus
3. Lumbar plexus
4. Sacral plexus
Cervical Plexus
Cervical – C1-C4
Phrenic nerve
Brachial – C5 – T1 (roots/trunks/divisions/cords)
Axillary, MC, median, ulnar, radial
Lumbar – L1-L4
Femoral, obturator
Sacral – L4-S4
Sciatic (common peroneal/tibial), pudendal
Dermatomes
Figure 13–8
5 Patterns of Neural Circuits in Neuronal Pools
1. Divergence:
spreads
stimulation to
many neurons or
neuronal pools
in CNS
2. Convergence:
brings input
from many
sources to single
neuron
Figure 13–13a
5 Patterns of Neural Circuits in Neuronal Pools
3. Serial processing:
moves information
in single line
4. Parallel processing:
moves same
information along
several paths
simultaneously
Figure 13–13c
5 Patterns of Neural Circuits in Neuronal Pools
5. Reverberation:
positive feedback mechanism
functions until inhibited
Figure 13–13e
Reflex activity
5 components of a
reflex arc
Receptor
Sensory neuron
Integration center
(CNS)
Motor neuron
Effector
4 Classifications of Reflexes
1. By early development
Innate or Acquired
2. By type of motor response
Somatic or Visceral
3. By complexity of neural circuit
Monosynaptic or Polysynaptic
4. By site of information processing
Spinal or Cranial
Spinal Reflexes
Range in increasing order of complexity:
monosynaptic reflexes
polysynaptic reflexes
Occur simultaneously,
coordinated with flexor
reflex
e.g., flexor reflex causes
leg to pull up:
crossed extensor reflex
straightens other leg
to receive body weight
maintained by
reverberating circuits
Integration and Control
of Spinal Reflexes
Though reflex behaviors are automatic:
processing centers in brain can facilitate or inhibit
reflex motor patterns based in spinal cord
Higher centers of brain incorporate lower, reflexive
motor patterns
Automatic reflexes:
can be activated by brain as needed
use few nerve impulses to control complex motor
functions
walking, running, jumping
Superficial reflexes
Arterial Supply
- Spinal Arteries
Anterior (1) & Posterior (2) Spinal Artery
from Vertebral artery
- Radicular Arteries ----- Segmental arteries
from Vertebral, Ascending Cervical, Intercostal and
Lumbar Artery
Venous Drainage
- Longitudinal & Radicular Veins
to Intervertebral veins ---- to Internal Vertebral Venous Plexus
to external vertebral venous plexus ---- to segmental veins
5. Adamkiwicz artery