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Exercise 21
Spinal Cord and Spinal Nerves
91
Anatomy
Undergraduate 2
12/05/2011

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Term
Indicate two major areas where the spinal cord is enlarged and explain the reason for the enlargements
Definition
Cervical Enlargement - gives rise to nerves of the upper limbs

Lumbar Enlargement - gives rise to nerves of pelvic region and lower limbs
Term
Conus medullaris
Definition
1st and 2nd lumbar vertebra, where it terminates in the cone-shaped.
Term
Cauda equine
Definition
Collection spinal nerves transverse inerior end of vertebral canal.
Term
Filum terminale
Definition
Fibrous extension of the pia matter, extends even farther to attach to posterior coccyx
Term
List two major functions of the spinal cord
Definition
Conducts sensory information from the peripheral nervous system (both somatic and autonomic) to the brain. Conducts motor information from the brain to our various effectors.
Term
Name the meningeal covering of the spinal cord and to state their functions
Definition
Dura mater, arachnoid mater and pia mater
Term
Dura mater
Definition
Protect the spinal cord and the thickest and toughest collagenous memebrante, the outter most layer
Term
Arachnoid mater
Definition
Protect the spinal cord and the middle layer. Gap between the arachnoid membrane and the pia mater called subarachnoid space filled with cerebrospinal fluid.
Term
Pia mater
Definition
Protect the spinal cord. It is the inner most layer that is the most delicate. Regular intervals along the cord, extend of the pia matter called denticulate ligaments and extned through arachnoid to the dura, anchoring the cord and limiting side-to-side movements.
Term
Dorsal rami
Definition
The dorsal rami is smaller serve the skin and musculature of the posterior body trun at their approximate level of emergence.
Term
Ventral rami
Definition
Spinal nerves T2-T12 pass anteriorly as the intercostal nerves to supply the muscles of intercostal spaces, and the skin and muscles of the anterior and lateral trunk. All other spinal nerves form complex networkds of nerves called plexuses
Term
Identify the four major nerve plexes, the major nerves of each, and their distribution
Definition
Cervical Plexus, Brachial Plexus, Lumbar Plexus, Sacral Plexus
Term
Cervical plexus
Definition
Arises from the ventral rami of C1-C5 to supply muscles of the shoulder and neck. Major motor branch is the phrenic nerve
Term
Brachial plexus
Definition
Large and complex arising from ventral rami of C5-C8 and T1. The plexus after being rearranged consecutibely into trunks, divisions, and cords, finally becomes subdivided into five major peripheral nerves
Term
Lumbar plexus
Definition
Arises from ventral rami of L1-L4 and sometime T12. Nerves serve the lower abominopelvic region and the anterior thigh. Largest nerve of this plexus is the femoral nerve and innervate anterior thigh muscles
Term
Sacral plexus
Definition
Arising from L4-S4 nerves supply the buttock, posterior surface of the thigh and virtually all sensory and motor fibers of the leg and foot. Major peripheral nerve of this plexus is the sciatic nerve, largest in the body.
Term
Vertebral canal
Definition
houses and protects the spinal cord - formed by vertebrae
Term
Spinal Cord
Definition
continuation of brain stem; it is the association and communication center of the body
Term
Conus medullaris
Definition
termination point of spinal cord; usually between L1 and L2
Term
Filum terminale
Definition
fibrous extension of Pia Mater; goes from S2 to posterior coccyx
Term
Level of the origin of spinal cord
Definition
brain stem in foramen magnum
Term
Level of the termination of spinal
Definition
L1 to L2 - terminates at conus medullaris
Term
Length of spinal cord
Definition
Brain stem to L1 or just beyond
Term
Denticulate ligaments
Definition
saw-toothed shelves of pia mater, secure spinal cord to bony wall of the vertebral column all along its length
Term
List Meninges and Associated Spaces
Definition
Meninges: dura mater, arachnoid layer, pia mater

Spaces: epidural space, subdural space, subarachnoid space
Term
Meninges
Definition
3 fibrous CT membranes enclosing spinal cord and brain
Term
Cerebrospinal Fluid
Definition
clear colorless liquid produced by ependymal cells, the CSF occupies the space between the
Term
Dura mater
Definition
forms loose fitting sleeve (dural sheath) around the spinal cord - outermost layer of meninges, tough and collagenous
Term
Arachnoid layer
Definition
middle of 3 meninges, simple squamous epithelium
Term
Pia mater
Definition
innermost of 3 meninges, delicate transparent membrane that closely follows contours of the spinal cord
Term
Epidural space
Definition
space between the dura mater and vertebral bones; occupied by blood vessels, adipose tissue, and loose CT.
Term
Subdural space
Definition
the space between the dura mater and the arachnoid (technically this is a potential space, because in healthy people there is no space here)
Term
Subarachnoid space
Definition
gap between the arachnoid layer and the pia mater.
Term
Spinal nerves- 31 pairs
Definition
8 cervical (C1-C8); 12 Thoracic (T1-T12); 5 Lumbar (T1-T5); 5 Sacral (S1-S5); 1 Coccygeal (Co1)
Term
Cervical enlargement
Definition
1 of 2 areas of the spinal cord that is thicker than elsewhere - gives rise to the nerves of the upper limbs
Term
Lumbar enlargement
Definition
1 of 2 spinal cord enlargements - gives rise to the nerves of the pelvic region and lower limbs
Term
Cauda equina
Definition
collection of spinal nerves arising from the medullary cone and lumbar enlargement - occupies vertebral canal from L2 - S5 (below end of spinal cord) - innervates the pelvic organs and lower limbs
Term
Note the location where a lumbar (spinal) tap would be made
Definition
just below L3 (according to lab manual) - CSF sample taken - done at this level because spinal cord does not extend this far down.
Term
Note the location where a saddle block/epidural would be made
Definition
L3 - L5 because spinal cord does not extend this far down - anesthetic introduced into epidural space
Term
Gray matter and Roots
Definition
central core of spinal cord that looks somewhat like a butterfly; spinal nerve branches into 2 roots - anterior (ventral) and posterior (dorsal)
Term
Gray Matter
Definition
dull color because contains little myelin; contains the somas, dendrites and proximal parts of the axons (unmyelinated) of neurons. It is the site of all neural integration in the spinal cord
Term
Posterior (dorsal) horns
Definition
2 dorsal projections of gray matter; contain somatic and visceral sensory nuclei
Term
Anterior (ventral) horns
Definition
2 ventral projections of gray matter; contain somatic motor nuclei
Term
Lateral horns
Definition
only present in thoracic and lumbar regions; contain visceral motor nuclei
Term
Gray commissure
Definition
thin central area of gray matter connecting the 2 vertical regions
Term
Central canal
Definition
central canal of spinal cord - contains CSF - surrounded by gray commissure
Term
Dorsal (posterior) root
Definition
sensory fibers from body periphery enter the spinal cord from dorsal root (afferent=sensory) Spinal nerve --> Dorsal & Ventral Roots --> Dorsal goes to dorsal horn of gray matter.
Term
Dorsal (posterior) root ganglion
Definition
enlarged area of dorsal root
Term
Ventral (anterior) root
Definition
contains axons that issue from the ventral horns; axons enter ventral root and then enter spinal nerve. Mostly somatic or voluntary system. (efferent = motor)
Term
Spinal nerves
Definition
formed by fusion of dorsal and ventral roots
Term
White matter
Definition
surrounds the gray metter and consists of bundles of myelinated axons that course up and down the cord and provide avenues of communication between different levels of CNS.
Term
anterior/ventral median fissure
Definition
more open fissure, ventrally located
Term
posterior/dorsal median sulcus
Definition
dorsal fissure - more shallow than ventral
Term
posterior/dorsal medial septum
Definition
partitions posterior spinal cord into right and left halves - goes from posterior median sulcus to grey commissure
Term
Posterior/dorsal funiculus
Definition
dorsal sloumn of white matter
Term
Lateral funiculus
Definition
lateral column of white matter
Term
Anterior/ventral funiculus
Definition
anterior column of white matter
Term
Tracts
Definition
bundles of axons located in funiculi in CNS
Term
Mixed nerves
Definition
nerve that contains both sensory and motor fibers - all spinal nerves are mixed nerves
Term
Cervical nerves (C1-C8)-named for the vertebrae inferior to the nerve (except C8)
Definition
8 pairs of cervical nerves - emerge above corresponding vertebra (except C8); C1 emerges from between skull and atlas - all others through intervertebral foramina
Term
Thoracic nerves (T1-T12)- these are named for the vertebrae superior to the nerve
Definition
12 pairs - emerge below corresponding vertebra
Term
Lumbar nerves (L1-L5)- these are named for the vertebrae superior to the nerve
Definition
5 pairs - emerge below corresponding vertebra, i.e. - nerve L3 emerges below L3
Term
Sacral nerves (S1-S5)
Definition
5 pairs - emerge below vertebra
Term
Coccygeal nerve (Co1)
Definition
1 pair of nerves - emerge below vertebra
Term
Dorsal ramus
Definition
branching point - spinal nerve branches into dorsal and ventral rami - the smaller dorsal rami serve the skin and musculature of the posterior body trunk at their approximate level of emergence.
Term
Ventral ramus
Definition
branching point - spinal nerve branches into dorsal and ventral rami - some ventral rami give off branches to sympathetic ganglion; other ventral rami mix and match to make up plexuses
Term
Cervical plexus (C1-C5)
Definition
Arises from the ventral rami of C1-C5 to supply muscles of the shoulder and neck. Major motor branch is the phrenic nerve
Term
Phrenic nerve
Definition
Roots: C3-C5
Structures: sole motor nerve supply of diaphragm; susceptible to being severed when neck is broken - diaphragm stops working -> death
Term
Brachial plexus (C5-T1) (list nerves we need to know)
Definition
axillary, musculocutaneous, median, ulnar, radial, dorsal scapular
Term
axillary nerve
Definition
(C5, C6) motor to deltoid and teres minor muscles; sensory to skin of shoulder
Term
musculocutaneous nerve
Definition
(C5-T1) motor to the flexor muscles of the arm (biceps brachii, brachialis, coracobrachialis); sensory to lateral surface of forearm
Term
median nerve
Definition
(C6-T1) travels through the carpel tunnel of the wrist; motor to the flexor muscles on the radial side of forearm; sensory to anterolateral surface of the hand, posterior fingers 1&2, lateral-posterior finger 3
Term
ulnar nerve
Definition
(C8-T1) motor to flexor muscles in anterior forearm (i.e. Flexor carpi ulnaris); sensory to the medial surface of the hand (anatomical position - half of digit 4 and all of digit 5)
Term
radial nerve
Definition
(C5-T1) motor to muscles of posterior arm, forearm, and hand (most arm muscles); sensory to posterior-lateral side of hand but not fingers
Term
dorsal scapular
Definition
(branches of C5 rami) motor to rhomboid muscles and levator scauplae (no sensory listed)
Term
Lumbar plexus (L1-L4)
Definition
L1-L4 and has 2 major nerves: the femoral nerve and the obturator nerver
Term
Femoral nerve
Definition
L2-L4 Motor to quadriceps group, pectineus and Iliopsoas mucles, sensory anterior-medial thigh and medial surface of leg and foot. Injury to this nerve causes inability to extend leg & loss of sensation in thigh
Term
Obturator nerve
Definition
L2-L4 Motor to adductors of hip. Sensory to medial surface of thigh. Injury to this nerve casues paralysis of thigh adductors
Term
Lateral femoral cutaneous nerve
Definition
L2, L3 skin of lateral thigh; some sensory branches to peritoneum
Term
Ilioinguinal nerve
Definition
L1 Skin of external genitalia and proximal medial aspect of the thigh; inferior abdominal muscles
Term
genitorfemoral nerve
Definition
L1, L2 Skin of scrotum in males, of labia majora in females, and of anterior thigh inferior to middle portion of inguinal region; cremaster muscle in males
Term
Sacral plexus (L4-S4)
Definition
L4-S4 and serves the buttock, lower limb, pelvic structures and ther perineum. The major nerves are the sciatic nerve and the pudendal nerve
Term
Sciatic nerve
Definition
L4-S3 branches behind the knee. The common fibular nerver and the tibial nerve
Term
Tibial nerve
Definition
L4-S3 Posterior muscles of the leg. Injury produces dorsiflexion and eversion with loss of sensation on plantar surface of foot
Term
Common fibular
Definition
L4-S2 Lateral and anterior muscles of the leg. Injury produces foot drop (inability to dorsiflex foot) or numbness on dorsum of foot
Term
pundendal
Definition
S2-S4 Supplies most of skin and muscles of perineum (region encompassing external genitalia and anus and including clitoris, labia, and vaginal mucosa in females, and scrotum and penis in males); external anal sphincter
Term
Sural
Definition
Medial sural cutaneous nerve and fibular communicating branch of common fibular nerve; branches, lateral dorsal cutaneous nerve and lateral calcaneal branches; distribution, skin on back of leg, and skin and joints on lateral side of heel and foot
Term
Parasympathetic division (craniosacral)
Definition
Division are located in brain stem nuclei of cranial nerves III, VII, IX, X and in the S2-S4 level of the spinal cord. The axons of the preganglionic neurons of the cranial region travel in their respective cranial nerves to the immediate area of the head and neck organs to be stimulates.
Term
Sympathetic division (thoracolumbar)
Definition
Division are in the lateral horns of the gray matter of the spinal cord from T1-L2. The preganglionic axons leave the cord via the ventral root (in conjuction with the axons of the somatice motor neurons), enter the spinal nerve, and then travel briefly in the ventral ramus.
Term
Sympathetic chain ganglia
Definition
A chain of ganglia stimulated ventural and lateral to the spinal cord, and extends from the upper neck down to the coccyx.
Term
Communicating rami
Definition
Connect with a string of sympathetic chain ganglia alongside the vertebral column. Theare are seen only in spinal nerves T1-L2. They are components of the sympathetic nervous system
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