Spinal Cord

• Spinal cord – long cylindrical structure

occupies upper two-thirds of vertebral canal
• Forms caudal part of central nervous
system
• Gives rise to 31 pairs of spinal nerves
• Connects body and brain through various
ascending and descending tracts
• Executes many reflex actions
Size and shape
• Cylindrical and slightly flattened
anteroposteriorly
Measurements in adults
• Length
• 45 cm (18 inches) in male
• 42 cm in female
• Width: 1.25 cm
• Weight: 30 g
 Extent
• Extends from upper border first cervical
vertebrae (C1) to lower border of first
lumbar vertebra L1 in adults.
• Conus medullaris: Lower tapering end of
spinal cord is called conus medullaris
• Filum terminale: Thin thread-like filament
extends from tip of conus medullaris to 1st
coccygeal vertebra
 EXTERNAL FEATURES OF SPINAL CORD
Include
• Fissures and sulci
• Attachments of spinal nerves
• Enlargements
• Cauda equina
 EXTERNAL FEATURES OF SPINAL CORD
• Fissures and Sulci
Shows following sulci and fissures
• Anterior median fissure
• Deep groove in the midline anteriorly
• Lined by pia mater
• Contains anterior spinal artery
• Posterior median sulcus
• Shallow midline sulcus posteriorly
• From it septum of neurological tissue (posterior median septum)
extends into substance of spinal cord to variable extent
 EXTERNAL FEATURES OF SPINAL CORD
Ventrolateral (anterolateral) sulcus
• Indistinct
• Ventral rootlets of spinal nerve emerge at this sulcus
Dorsolateral (posterolateral) sulcus
• Lies on each side, at about 2 mm from posterior median sulcus
• Corresponds to attachment of dorsal roots of spinal nerve
Dorsointermediate (posterointermediate) sulcus
• Lies between posterior median and posterolateral sulcus
• Present only in cervical and upper thoracic levels
Human Anatomy/Yogesh Sontakke 9
 Coverings of spinal cord

• Covered by spinal meninges: Outer dura mater, middle arachnoid

mater, and innermost pia mater
• Dura mater: Extends from foramen magnum to lower border of second
sacral vertebra
 Coverings of spinal cord

Arachnoid mater (cobweb-like in Latin)

• Thin transparent membrane loosely surrounds spinal cord
• Also extends up to lower border of S2 vertebra
• Pia mater : Thin vascular membrane closely invests spinal cord
 Modifications of spinal pia mater

• Shows modifications help to keep spinal cord in

position during body movement
• Are as follows
• Ligamentum denticulatum
• Are 21 pairs of teeth-like projections of pia
mater
• Extend from lateral surface of spinal cord
and pierce arachnoid mater to get attached
to inner surface of dura mater
 Modifications of spinal pia mater
• Each ligamentum denticulatum lies in
between anterior and posterior roots
of spinal nerves
• First ligamentum denticulatum lies at
level of foramen magnum while last
one lies between T12 and L1 spinal
nerves
Human Anatomy/Yogesh Sontakke 14
 Modifications of spinal pia mater
Filum terminale
• Thin fibrous filament extends from tip
of conus medullaris to first coccygeal
vertebra
• About 20 cm long
 Modifications of spinal pia mater
Consists of two parts
• Filum terminale internum
• Upper part
• About 15 cm long and contained within
dura mater
• Filum terminale externum
• Lower part
• About 5 cm long
• Lies outside dura mater and extends
upto first segment of coccyx
 Modifications of spinal pia mater
Subarachnoid septum
• Midline septum of pia mater
which connects posterior
surface of spinal cord with
arachnoid mater
Linea splendens
• Thickening of pia mater in
anterior median plane in
anterior median fissure of spinal
cord
Human Anatomy/Yogesh Sontakke 18
Human Anatomy/Yogesh Sontakke 19
 Clinical Integration
Ligamentum denticulatum – surgical guide:
• In cordotomy surgery
• Spinal nerve root behind ligamentum denticulatum is
sectioned to relive pain
• Spinal nerve root anterior to ligamentum denticulatum is
sectioned to paralyze muscles
• First lumbar nerve lies just below last pair of ligamentum
denticulatum
• Helps for identification of desired spinal nerves
 Space surrounding spinal cord

• Are epidural, subdural, and

subarachnoid spaces
surrounding spinal cord
Epidural space
• Space between spinal dura
and vertebra canal
 Space surrounding spinal cord
Epidural space
• Contains loose areolar tissue,
adipose tissue, small arteries
and network of internal
vertebral venous plexus, spinal
nerve roots
Subdural space
• Space between dura mater and
arachnoidmater
• Contains thin layer of fluid
 Space surrounding spinal cord
Subarachnoid space
• Space between arachnoid mater
and pia mater
• Filled with cerebrospinal fluid
(CSF)
 Clinical Integration
Epidural anesthesia
• anesthetic agent is injected in epidural space to anesthetize
particular part
• Useful for lower extremity, gynecological surgeries, cesarean
section.
 Clinical Integration
Lumbar puncture
• Indications: Performed to collect CSF for
• Diagnostic purpose in meningitis, subarachnoid
hemorrhage, and other neurological disorders
• Therapeutic purpose to reduce raised intracranial pressure
 Clinical Integration

Procedure
• Insert lumbar puncture needle above or below spine of L4
vertebra which lies in median plane in horizontal line joining
highest point of iliac crests
 Spinal segments
• Portion of spinal cord to which pair of spinal nerve is attached
• Consists of 31 spinal segments as follows: 8 cervical, 12
thoracic, 5 lumbar, 5 sacral, 1 coccygeal
 Spinal segments
• Upper spinal nerves pass almost horizontally, but lower
nerves pass oblique download and laterally to reach their
corresponding intervertebral foramina
 Enlargements of Spinal Cord
• Shows two enlargements due to presence of
large number of motor neurons
Are as follows
• Cervical enlargement
• Due to large number of spinal nerves supplying
upper limbs
• Extends from C4 to T2 segments
 Enlargements of Spinal Cord
Lumbar enlargement
• Due to large number of spinal
nerve supplying lower limbs
• Extends from L2 to S3
segments
 Cauda equina
Q.Write short note on cauda equina
• Definition: Horsetail-like structure formed
by bunch of lower spinal nerves surround
conus medullaris and filum terminale
Components
• Ventral and dorsal roots of lower four
lumbar segments (L2–L5), five sacral
(S1 to S5), and one coccygeal segments
Cauda equina
 INTERNAL STRUCTURE OF SPINAL CORD
Consists of
• Central gray matter
• Peripheral white matter
• Central canal containing CSF
Gray Matter of Spinal Cord
• Lies surrounding central canal of
spinal cord
• Contains numerous neural cell
bodies, their processes, and
neuroglia
 INTERNAL STRUCTURE OF SPINAL CORD
Gray Matter of Spinal Cord
• Shape: H-shaped or butterfly-
shaped
• Divided into right and left symmetric
halves connected to each other by
transverse band of gray matter
called transverse gray commissure
 INTERNAL STRUCTURE OF SPINAL CORD
Divisions of gray matter
• Anterior horn (anterior or ventral gray column)
• Portion of gray matter which lies in front of
transverse gray commissure
• Cells of anterior horn give rise to lower motor
neurons (efferent fibers) which form anterior
root of spinal nerve
 INTERNAL STRUCTURE OF SPINAL CORD
Posterior horn (posterior or dorsal gray
column)
• Portion of gray matter lies behind
transverse gray commissure
• Separated from surface of spinal cord by
thin tract of nerve fibers (dorsolateral
tract)
 INTERNAL STRUCTURE OF SPINAL CORD
Parts of posterior horn
• Substantia gelatinosa
• Gelatinous substance caps
posteriormost end (apex) of posterior
horn
 INTERNAL STRUCTURE OF SPINAL CORD

Lateral horn (lateral gray column)

• Small angular lateral projection of gray matter
• Extent: Extends from T1 to L2 and S2–S4
spinal segments
 Regional characteristics
• Amount and shape of gray matter in segments of
spinal cord corresponds to the mass of tissue
they supply
• More in cervical and lumbar segments and
produces enlargement in these regions
 Structure of Gray Matter of Spinal Cord

Neurons of gray matter

• multipolar and can be : Motor neurons, interneurons, and
sensory neurons
Motor neurons
• present in anterior and lateral horns
• two types: Alpha and gamma neurons
 Structure of Gray Matter of Spinal Cord
Alpha neurons
• large cells (25 μm or more in diameter)
• supply extrafusal fibers of skeletal muscle
Gamma neurons
• small multipolar neurons (15–25 μm in diameter)
• supply intrafusal fibers of muscle spindle
 Structure of Gray Matter of Spinal Cord
Sensory neurons
• present in posterior horn
. receive inputs from neurons of dorsal root ganglion
• axons form ascending or intersegmental tracts

Interneurons (internuncial neurons)

. Connect different type of neurons
 Some Interesting Facts
• Structurally, neurons of spinal cord are classified as
• Golgi type I – with long axons
• Golgi type II – with short axons
• Golgi type II neurons do not leave gray matter and form intrasegmental
or intersegmental tracts
 Nerve Cell Groups on Gray Columns
• Are arranged as follows
• In anterior horn: Medial, lateral, and central
groups
• In posterior horn: Substantia gelatinosa,
marginal nucleus, nucleus proprius, dorsal
nucleus (Clarke’s column), visceral afferent
nucleus
• In lateral horn: Intermediolateral nucleus,
intermediomedial nucleus
CELL GROUPS IN ANTERIOR GREY
COLUMN
• MEDIAL GROUP- Extends along most of the length of spinal cord and
innervates axial musculature of neck and trunk.
• LATERAL GROUP- Present in cervical and lumbosacral enlargements of
spinal cord and supplies limb muscles.
• CENTRAL GROUP- Phrenic nucleus(C3-C5) innervates the diaphragm;
Lumbosacral nucleus(L2-S3)- function unknown; Spinal nucleus of
Accessory(XI cranial) (C1-C5)- gives origin to spinal root of accessory.

Human Anatomy/Yogesh Sontakke 46

CELL GROUPS IN POSTERIOR GREY
COLUMN
• SUBSTANTIA GELATINOSA:
(1) At apex of posterior grey column throughout spinal cord.
(2) Made up of Golgi type II neurons.
(3) Receives fibres conveying pain and temperature sensations.

Human Anatomy/Yogesh Sontakke 47

CELL GROUPS IN POSTERIOR GREY
COLUMN
• NUCLEUS PROPRIUS: extends whole length of spinal cord and
concerned with sense of position, movement, two-point
discrimination and vibration

Human Anatomy/Yogesh Sontakke 48

CELL GROUPS IN POSTERIOR GREY
COLUMN
• NUCLEUS DORSALIS (CLARKE’S COLUMN):
(1) Occupies medial part of base of posterior grey column, extends
from C8 to L2/L3 segments.
(2) Receives proprioceptive afferents and exteroceptive afferents from
trunk and lower limb.

Human Anatomy/Yogesh Sontakke 49

CELL GROUPS IN POSTERIOR GREY
COLUMN
• VISCERAL AFFERENT NUCLEUS:
Extends from T1 to L2 and from S2 to S4 segments and receives
visceral afferent from dorsal nerve roots.

Human Anatomy/Yogesh Sontakke 50

CELL GROUPS IN INTERMEDIATE
GREY COLUMN
• Form two nuclei: (a) Intermediolateral nucleus and (b)
Intermediomedial nucleus.
• Intermediolateral nucleus extends from T1 to L2 segments and gives
origin to preganglionic sympathetic fibres.
• Intermediomedial nucleus extends from S2 to S4 segments and gives
origin to preganglionic parasympathetic fibres.

Human Anatomy/Yogesh Sontakke 51

 Rexed laminae
• Laminar architecture of gray
matter of spinal cord
• Neuronal cells of gray matter –
arranged in 10 zones of Rexed
laminae
 Rexed laminae
Lamina Corresponding gray column
I Posteromarginal nucleus
II Substantia gelatinosa
III, IV Nucleus proprius
V Base of dorsal column
VI
VII Nucleus dorsalis
Lateral horn (intermediolateral,
intermediomedial nuclei)
VIII and IX Medial and lateral groups of nuclei of
anterior grey column
X Surrounds the central canal
 White Matter of Spinal Cord

Divisions of white matter

• Divided into right and left halves by anterior median fissure and
posterior median septum
• Each of spinal cord shows three column or fasiculi of white matter:
• Anterior (ventral) white column (funiculus): Lies between anterior
median fissure and anterior horn(gray)
• Lateral white column (funiculus): Lies between anterior horn and
posterior horn(gray)
• Posterior or dorsal column (funiculus): Lies between posterior
median sulcus and posterior horn(gray)
Human Anatomy/Yogesh Sontakke 55
 White Matter of Spinal Cord
Tracts of Spinal Cord
• Definition: Tract – collection of nerve fibers within central nervous
system, have similar origin, course, termination, and functions
• Synonyms: Fasciculi(bundle), lemnisci(ribbon)
Classification of tracts
• Are classified into three types-
• Descending- conduct impulses to spinal cord from brain
• Ascending- conduct impulses from periphery to brain
• Intersegmental- interconnect neurons of different segmental levels
Human Anatomy/Yogesh Sontakke 57
 DESCENDING
TRACTS
• LATERAL CORTICOSPINAL TRACT(Crossed pyramidal tract)
• Location- lateral white column
• Origin- Upper motor neurons: Areas 4 and 6 of cerebral cortex
• Termination- Lower motor neurons: Contralateral anterior horn
cells
• Execution of rapid, skilled voluntary movements especially of
hand

Human Anatomy/Yogesh Sontakke 58

 DESCENDING TRACT
• ANTERIOR CORTICOSPINAL TRACT(UNCROSSED PYRAMIDAL TRACT):
• LOCATION:Anterior white column
• ORIGIN: Upper motor neurons: Areas 4 and 6 of cerebral cortex
• TERMINATION: Lower motor neurons: Contralateral anterior horn
cells
• FUNCTION: Same as lateral corticospinal tract

Human Anatomy/Yogesh Sontakke 59

 DESCENDING TRACT
• RUBROSPINAL TRACT:
• LOCATION: Lateral white column
• ORIGIN: Red nucleus (midbrain)
• TERMINATION: Contralateral anterior horn cells
• FUNCTION: Unconscious coordination of movements (controls muscle
tone and synergy)

Human Anatomy/Yogesh Sontakke 60

 DESCENDING TRACTS
• VESTIBULOSPINAL TRACT:
• LOCATION: Anterior white column
• ORIGIN: Vestibular nucleus
• TERMINATION: Ipsilateral cells of anterior horn cells of spinal
cord
• FUNCTION: Unconscious maintenance of posture and balance

Human Anatomy/Yogesh Sontakke 61

 DESCENDING TRACTS
• TECTOSPINAL TRACT:
• LOCATION: Anterior white column
• ORIGIN: Superior colliculus (midbrain)
• TERMINATION: Cranial nerve nuclei in medulla and anterior horn cells
of upper spinal segments
• FUNCTION: Controls movements of head, neck and arms in response
to visual stimuli

Human Anatomy/Yogesh Sontakke 62

 DESCENDING TRACTS

• LATERAL RETICULOSPINAL TRACT:

• LOCATION: Lateral white column
• ORIGIN: Reticular formation of brainstem
• TERMINATION: Ipsilateral cells of anterior horn
• FUNCTION: Reflex movements of limb and trunk muscles
(excitatory influence)

Human Anatomy/Yogesh Sontakke 63

 DESCENDING TRACTS
• MEDIAL RETICULOSPINAL TRACT:
• LOCATION: Anterior white column
• ORIGIN: Reticular formation in medulla
• TERMINATION: Ipsilateral cells of anterior horn
• FUNCTION: Reflex movements of limb and trunk muscles
(inhibitory influence)

Human Anatomy/Yogesh Sontakke 64

Human Anatomy/Yogesh Sontakke 65
 ASCENDING TRACT
• LATERAL SPINOTHALAMIC TRACT:
• LOCATION: Lateral white column
• ORIGIN: Posterior horn cells of spinal cord of opposite side
• TERMINATION: Ventral posterolateral(VPN nucleus) of thalamus
• FUNCTION: Carry pain and temperature from opposite side of body

Human Anatomy/Yogesh Sontakke 66

 ASCENDING TRACT
• ANTERIOR SPINOTHALAMIC TRACT:
• LOCATION: Anterior white column
• ORIGIN: Posterior horn cells of spinal cord of opposite side
• TERMINATION: Ventral posterolateral(VPN nucleus) of thalamus
• FUNCTION: Carry light touch, pressure, tickle and itch sensation from
opposite side of body

Human Anatomy/Yogesh Sontakke 67

 ASCENDING TRACT
• SPINOTECTAL TRACT:
• LOCATION: Lateral white column
• ORIGIN: Posterior horn cells of spinal cord of opposite side
• TERMINATION: Superior colliculus of tectum of midbrain
• FUNCTION: Visuomotor reflexes: head and eye movements towards
source of stimulation

Human Anatomy/Yogesh Sontakke 68

 ASCENDING TRACT
• SPINOCEREBELLAR(ANTERIOR & POSTERIOR) TRACTS:
• LOCATION: Lateral white column
• ORIGIN: Posterior horn cells of spinal cord of same side
• TERMINATION: Cerebellum
• FUNCTION: Unconscious kinaesthesia (Proprioception)

Human Anatomy/Yogesh Sontakke 69

Human Anatomy/Yogesh Sontakke 70
 ASCENDING TRACT
• FASCICULUS GRACILIS & CUNEATUS( TRACTS OF GALL & BURDACH)
• LOCATION: Posterior white column of spinal cord
• ORIGIN: Dorsal root ganglia of spinal nerves of same side
• TERMINATION: Nucleus gracilis and nucleus cuneatus in medulla of
same side
• FUNCTION: Joint sense, vibration sense, two-point discrimination,
stereognosis, conscious kinaesthesia

Human Anatomy/Yogesh Sontakke 71

Human Anatomy/Yogesh Sontakke 72
 Clinical Integration
Syringomyelia (central spinal syndrome)
• Involves formation of CSF filled cavities around
central canal of spinal cord, usually in cervical
segments.
• Results in pressure over adjacent tracts cause
following effects
• Compression of lateral spinothalmic fibers
leads to bilateral loss of pain and
temperature sensations below level of
lesion
• Compression of anterior spinothalmic tract
leads to loss of light touch below level of
lesion
 Clinical Integration
Dissociative sensory loss
• Uncrossed tracts – preserved, thus
sensation of proprioception, joint
sense, vibration, two-point
discrimination, stereognosis –
preserved and only selective sense of
pain, temperature – lost.
 Clinical Integration

Tabes dorsalis
• In syphilis, posterior white column
undergoes degenerative changes
• Results in loss of position, vibration, and
two-point discrimination sensation on side
of lesion.
• ROMBERG’S SIGN(positive)- when
patient is asked to stand up with eyes
closed he/she staggers and falls.
 HEMISECTION OF SPINAL
CORD
• Also called Brown-Sequard syndrome.
• C/F-
• Ipsilateral UMN type paralysis below the level of hemisection.
(pyramidal tract lesion)
• Ipsilateral loss of proprioception below the level of hemisection.
(posterior column lesion)
• Contralateral loss of pain,touch and temperature below the level of
hemisection.(lesion of anterior and lateral spinothalamic tract)

Human Anatomy/Yogesh Sontakke 77

Human Anatomy/Yogesh Sontakke 78
Human Anatomy/Yogesh Sontakke 79
 BLOOD SUPPLY OF SPINAL CORD

• Arterial supply
Supplied by
• Anterior spinal artery
• Posterior spinal arteries (right and left)
• Segmental arteries- Spinal branches of deep cervical, ascending
cervical,posterior intercostal, lumbar, and lateral sacral arteries which
reach the spinal cord as anterior(8) and posterior (12) radicular
arteries along the corresponding root of spinal roots.
• The arterial trunks communicate around the cord forming a pial
plexus, the arterial vasa corona/arteriae coronae.
• The arteriae coronae give peripheral branches which supply
superficial regions of the cord.

Human Anatomy/Yogesh Sontakke 81

Anterior spinal artery
• Two spinal branches (right and left) arise from vertebral arteries,
unite to form single anterior spinal artery descends in anterior
median fissures of spinal cord
Anterior spinal artery
• Distribution: Anterior spinal artery supplies anterior two-thirds of
spinal cord.
• Anterior and lateral horn
• Base of posterior horn
• Anterior white column
• Part of lateral white column
Posterior spinal arteries
• Arise from vertebral or posterior inferior cerebellar artery
• Each posterior spinal artery divides into two longitudinal branches
• One descends in front, and another descends behind the dorsal root
• Distribution: Supply posterior one-third spinal cord.
• Posterior horn except base
• Posterior white column
• Peripheral part of lateral white column
Radicular arteries
• Anterior and posterior spinal arteries are small vessels and cannot
sufficiently supply entire length of spinal cord, especially lower part.
• Radicular arteries reinforce anterior and posterior spinal arteries
Arteria radicularis magna (artery of Adamkiewicz):
• Largest radicular artery; usually lies at T11 segment of spinal cord
 Venous drainage
• Drained by six longitudinal venous channels
as follows
• Anteromedian longitudinal venous
channel – in anterior median fissure
• Posteromedian longitudinal venous
channel – in posterior median sulcus
• Pair of anterolateral longitudinal venous
channels – one on each side, behind
ventral root
• Pair of posterolateral longitudinal venous
channels – one on each side, behind
dorsal nerve root
 Venous drainage
• These veins drain into internal
vertebral venous plexus and
veins which leave through
intervertebral foramen and
open into adjacent vertebral,
posterior intercostal, lumbar,
and lateral sacral veins
 Clinical Integration
Anterior spinal artery syndrome
• Cause: Thrombosis or
compression of anterior spinal
artery
• Affected area (supplied by
anterior spinal artery):
• Anterior two-thirds of cord
 Clinical Integration
Effects
• Damage to corticospinal tracts and anterior
horn
• Results in motor symptoms
• Damage to spinothalamic tracts bilateral
loss of pain and temperature sensation
• Note: Posterior spinal artery supplies
posterior white column, hence fasciculus
gracilis and cuneatus – preserved and so
conscious proprioception also preserved
 Relationship of spinal cord segments to vertebral level
Vertebrae Spinal segments
Cervical +1
Upper thoracic +2
Lower thoracic (T7-T9) +3
T10 L1-2 cord segments
T11 L 3-4 cord segment
T 12 L 5 cord segment
L1 Sacral & coccygeal cord
segments