USTNotesGroup2010

Transcribed from Dra. Bautista Lecture of Section B Rm 5

Notes from A. Abad and Maueewowee

Vertebral Column

Thoracic Vertebrae
• Body is Heart Shaped
• Spine Long and oriented downwards, because of
the orientation of the spine it’s hard to do a spinal
tab.
• Slide view
a. Intermediolateral Cell Column is found
here T1-L2
b. Sympathetic Preganglionic Efferents
c. Will appear as the LATERAL HORN (only
found in thoracic)
d. Ventral Horn and Dorsal Horn are thin
e. White Matter is Thick

Vertebral Column
• Body is joined by another body through the
Intervertebral Disc, if no glue in between them
your spine will be moving around all the time. Why
Cervical Vertebrae you can have herniated disc
• Bifid spine, • Opening found when one it’s the Vertebral Foramen
• Transverse Foramen @ transverse process which • If you join two or more vertebral foramen it
allows passage of vertebral artery becomes a Vertebral Canal, when formed will allow
• Slide view passage of spinal cord, covering the meninges, CSF,
a. Relatively small dorsal and ventral horn and the nerve roots
b. Thick dorsal, lateral, and ventral funiculus • Two nerve roots dorsal and ventral will unite at the
c. White matter is thicker compared to the vertebral foramen to form Spinal Nerve, so before
gray foramen you have only nerve roots.
d. No lateral horn
 • Boundary of the foramen, anteriorly you have the spinal. Needle is stuck and placed into the
subarachnoid space. In this you want the patient
body posterior laterally is the neural arch. Neural
to flex to open up the interlaminar space so you
Arch made of the Pedicle, Lamina, and Spine
can puncture and pass through the supraspinous,
interspinous, and Ligamentum Flavum. So you can
go directly into the vertebral canal.
• Remember spinal tap is down after L1-L2. So you
do it lower, so god is good since he made it easier
to do the lumbar tap.

Sacrum
• Obvious of course
• Slide
a. very thin film of white matter, surrounding
the very wide grey

Know the parts of the vertebrae and distinguish one from

another.
Lumbar
• Kidney shape
• Spine is hatchet (square) shape and orientation is
horizontal
• Slide View
a. Thicker gray, Thinner white matter
b. Thin ventral funiculus & Thin lateral
funiculus
c. Wide Ventral Horn; Thin Dorsal Horn

Support
• Body joined via Intervertebral Disc
• Supraspinous Ligament connects the tips of the
spine. Puts together all the spine from the cervical
down
• Interspinous Ligament connects in between body of
the spine to the next.
• Ligamentum Flavum- Join the lamina together,
joining one lamina to the one lamina below.
Covers a space so that t
• If flex, it joins the two lamina and covers a space
called Interlaminar Space. Those that have
Appendectomy, Caesarian, and the anesthesia are

Gray Matter-contains nerve cell bodies (nuclei), divided into
3 parts
• Dorsal Horn
o Somatosensory
 Rexed Lamina 1-6
 Dorsal Nucleus of Clark (which
actually belongs to Lamina 7, and
conveys UNCONSCIOUS
proprioception thru the Dorsal
Spinocerebellar Tract)
 Dorsal Spinocerebellar Tract
conveys unconscious
proprioception from Rex Lamina 7
(Dorsal Nucleus of Clark) to
Cerebellum
o Intermediate Zone
 Autonomic (Visceral Motor and
Visceral Sensory); T1-L2
 IMM (Intermediomedial) Cell
Column is found in the
intermediate zone and only T1-L2
 IML (Intermediolateral) Cell
Column at T1-L2, forms a
prominent bulge which forms the
Lateral Horn at the thoracic cord
segment
 Sacral Autonomic Nuclei
 Rexed Lamina 7
 Rexed Lamina 10 surrounds the
central canal
 So remaining nuclei of Rexed
Lamina 7 and Rexed Lamina 10
are autonomic in function
 Lateral Horn (in orange) which is
the origin of your sympathetic
preganglionic efferent nerve
fibers. IML cell column will exit
through the ventral root and pass
through the spinal nerve, leave
the spinal nerve as white ramus.
Can go to the paravertebral
ganglia can go up or down; or
bypass it to prevertebral as your
splenic nerve.
 Sympathetic Preganglionic
Efferent are class B Fibers,
shortest internodes; thinnest
myelin sheath; motor function,
pass through the white rami
o Ventral Horn
 Somatomotor
 Rexed Lamina 8,9
 Motor Neurons A (alpha/gamma):
primarily located in lamina 9
• Medial Motor Neuron
Group *
• Lateral Motor Neuron
Group*
*Proximal-Distal Rule
1. Medial Motor Neurons- will supply the medially
proximally located muscles of the body which will be the
neck, trunk, and girdle muscles (shoulder, pelvic)
2. Lateral Motor Neurons- will supply muscles that
are laterally distally located, both upper and lower
extremities (hands, feet)
- Proprioception is position sense.
- Unconscious will not reach consciousness and will only
reach the cerebellum.
Comparison amongst Vertebral slides
 Have the lateral horn in the thoracic cord segment.
If you find lateral horn, look at the size of the
dorsal and ventral gray is thinner will tell you it’s
thoracic
 Look at the lateral horn compared to cervical,
lumbar, and sacral. The have thicker dorsal and
ventral gray. And no lateral horn
 If want to orientate yourself to see which is dorsal
and which is ventral, look at the dorsal median
fissure.
Fibers pass through the grey rami, are C fiber, slowest
conductive velocity. They are unmyelinated
White Matter- contains the numerous fiber tracts; they
surround the grey and are made up of ascending and
descending fiber tracts
 can be divided into 3 groups
1. Ventral Funiculus- b/w ventral median
fissure and ventrolateral sulci
2. Dorsal Column- b/w dorsal median sulcus
and dorsolateral sulcus
3. Lateral Funiculus- b/w dorsolateral sulci
and ventrolateral sulci
 Fiber tracts- ascend and descend
 Ascending-usually sensory*
 Descending-usually motor8*
*not always
Fiber tracts are ascending and descend. Names are named
after origin and termination.
 Spinothalamic is spinal cord and thalamus
 Corticospinal is cerebral cortex and spinal cord
 Ascending fiber tract have the dorsal root ganglion
giving rise to a central process which is one whole
neuron (body, peripheral process, central process,
and there is no synapse). Synapse only when it
joins or ends in another nucleus so it’s
Pseudounipolar. Nucleus 2 is the nucleus inside.
 Once enters and goes through the dorsal horn
example for pain and temperature will go up
opposite side as the lateral spinothalamic tract in
lateral funiculus. Nerve fibers are A delta and C.
 Crude touch will cross and ascend in ventral
nucleus as ventral funiculus as ventral
spinothalamic tract.
Additional Info
• Spinal Cord anything that is spinal cord in origin
will serve the neck, trunk, and limbs.
• Head is cranial nerve, facial muscle, open eyes,
swallow
• So if you decapitate anything head neck, trunk,
and limb are spinal cord. It will not supply the
face.
• Pain and temperature convey by lateral
spinothalamic tract will come from noiceptors or
neck, trunk, and limbs
• Crude Touch is also for neck, trunk, and limbs.
Which are cutaneous mechanoreceptors.
 • In dorsal column or dorsal furnuculus there is
another ascending fiber tract which is for conscious
proprioception, crude touch, and vibration sense
• Dorsal Nucleus of Clarke, dorsal spinocerebellar
unconscious proprioception for trunks and limb
Dorsal Column
• Conscious proprioception goes up the dorsal column
which goes up to the thalamus and cerebral cortex
for you to perceive consciously.
• If you convey conscious proprioception from the
trunks and limbs, notice the fibers that enter first
enter from below. So the fibers from the lower
limb/trunk entering via dorsal root and ascending
up. Passing through the dorsal folliculus.
Correlations
• When you reach cervical segment, you have fibers
from upper trunk and limb entering the elevator
and occupy the more peripheral portion since they
enter last.
• At cervical segment, you will have division of
dorsal folliculus to Fasciculus Gracilis and
Fasciculus Cuneatus
• Fasciculus Gracilis*-medially located, Conscious
proprioception from lower trunk and extremities
• Fasciculus Cuneatus*- laterally located, Conscious
proprioception from upper trunk and extremities
• Ascending pathway can be found more at cervical
Dorsal Column
• purely ascending fiber tracts (sensory)
• associated with CONSCIOUS proprioception, fine
touch, & vibration sense
• A-alpha fibers
• division of Dorsal Column
o Fasciculus Gracilis
 medially located
 Conscious proprioception from
lower trunk and extremities
o Fasciculus Cuneatus
 laterally located
 Conscious proprioception from
upper trunk and extremities
* The dorsal intermediate sulcus is found between the
fasciculus gracilis and cuneatus only at the cervical and
mid-thoracic level. At the lumbar level, there are no fibers
from the upper trunk/extremities…only fibers from the
lower extremities
Ventral and Lateral Funiculi
o Ventral Funiculus-look for ventral median fissure
o Lateral Funiculus-can be seen without looking
under a microscope
o Both ascending and descending tracts
o Ascending –spinal cord to the thalamus to the
cortex
1. Lateral Spinothalamic Tract- fibers for pain
and temperature
a. Receptor – Free Nerve Endings
b. Nociceptors/ Thermoreceptors
i. peripheral nerve fibers A-
delta & C enter the spinal
cord as the dorsal root,
which will then synapse at
the sensory nucleus in the
dorsal horn that will ascend
as the lateral spinothalamic
tract in the lateral funiculus
for pain
2. Ventral Spinothalamic Tract- fibers for crude
touch
a. Receptor- Mechanoreceptors
i. Peripheral nerve fibers A-
beta will synapse at the
sensory nucleus will ascend
as the ventral spinothalamic
tract in the ventral funiculus.
o Descending – Corticospinal Tract for movement;
from the cortex to the cord
1. Ventral Corticospinal Tract
a. Ventral Funiculus
b. Trunk muscles
2. Lateral Corticospinal Tract
a. Lateral Funiculus
b. Lower and upper extremities
• Descending pathway corticortical spinal track. Only
two lateral in lateral funiculus and ventral at
ventral funiculus.
• Dorsal is purely sensory and ascending from trunk
and limbs
• Ventral and Lateral funiculus is both ascending and
descending.
• Corticospinal from cortex and end in spinal cord,
and ends in a motor nucleus in the cord found in
the ventral grey horn. Which are 8 and 9. 9 is
location of cell body of motor neuron which exit
which gives rise to ventral root and exit as A alpha
and A gamma efferents.
• 9 is divided into two groups that you have lateral
group and medial group. So motor neurons aren’t
distributed randomly which are proximal/distal
rule and flexor/extensor rule.
• Motor neuron lamina 9 is divided in lateral group
and medial group. Medial group supply muscle for
neck trunk and limbs. Motor neurons medial will
give rise to A alpha and A gamma to supply neck,
trunk, and proximal limbs (shoulder, girdle and
pelvic girdle.
• Neurons in lateral group will go out and form A
alpha and A gamma efferent to supply the distal
limb. (look at proximal distal rule above)
• Premise 1 Lateral motor neuron supply distal limb
Premise 2 Lateral corticospinal tract terminates in
lateral motor neurons. So Lateral corticospinal
tract will supply distal limbs
• Ventral corticospinal tract terminate in the medial
motor neuron and is bilateral. The ventral
corticospinal tract will supply the neck, trunk and
proximal limbs.
• Ventral funiculus fibers pass through this convey
Crude Touch because of the Ventral Spinothalamic
Tract. It also supplies proximal limbs because of
Ventral Corticospinal tract.
• Lateral funiculus fibers pass through this convey
pain because of Lateral Spinothalamic Tract. It
also supply the distal limb because of Lateral
Corticospinal Tract
• Doral column convey fine touch
• Know Thoracic cord because has Lateral horn and
very thin ventral horn and dorsal grey.
• Why thin because cervical and lumbosacral for the
limb, while Thoracic for the trunk why small.
 • More Ascending tract and descending tracts
cervical, if you look at ratio of white to grey is
thicker why there is more white matter. Versus the
lumber where the grey is thicker than the white.
• Least number of descending at lumbar
• While at the sacral has a very thin film of white
matter which is surrounding the very wide grey.

USTnotesgroup2010@yahoogroups.com