NEUROANATOMY February 04, 2019| DR.

BERNAL
SPINAL CORD AND THE ASCENDING TRACTS

TOPIC OUTLINE - differentiates into a dorsal gray column

I. A Brief Overview of the Vertebral Column b) ____________________________________

A. Vertebral Column - primarily composed of
B. Development of the Spinal Cord ____________________________
C. Composition - becomes a ventral gray column
D. Intervertebral Discs **These two regions are demarcated by
E. Ligaments of the Vertebral Column _____________________________________, a
F. Joints and Innervations of the Spinal groove on the wall of the central canal.
Column
II. Gross Appearance of the Spinal Cord
ARACHNOID and PIA MATER
III. Structure of the Spinal Cord
A. Gray Matter - derived from an investing layer of ectodermal
B. White Matter cells around the primary cord
IV. The Ascending Tracts of the Spinal Cord -
V. Anatomical Organization
VI. Functions of Ascending Tracts
A. Main Function
B. Spinothalamic Tract
C.. Spinocerebellar Tract

A BRIEF OVERVIEW OF THE VERTEBRAL COLUMN

VERTERBRAL COLUMN
- Central bony pillar of the body
- Supports the skull, pectoral girdle, upper limbs,
and thoracic cage and, by way of the pectoral
girdle, transmits body weight to the lower limbs
- Within its cavity lies the spinal cord, the roots of
the spinal nerves, and the covering meninges, to
which the vertebral column gives great protection
-
DEVELOPMENTOF THE SPINAL CORD
 Neural Plate - formed by the ectoderm of the
embryonic disk at about third week of prenatal
development
 ____________________________ – group of
cells which gives rise to dorsal and autonomic
ganglia and other structures
 Middle portion of the neural tube closes first;
the openings at each end close later
MANTLE ZONE - differentiates into two plates
a) Alar plate
- contains mostly
____________________________ DURA MATER
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 SPINAL CORD AND THE ASCENDING TRACTS

- formed from the mesenchyma a) a pair of cylindrical

______________________,
which form the sides of the
arch
b) a pair of flattened
_______________________,
which completes the arch
posteriorly
- gives rise to seven processes: one
spinous, two transverse, four articular
 Spinous processes or Spine
o directed _____________________ from
the junction of the two laminae

 Transverse processes
o directed ______________________form
the junction of the laminae
CLINICAL CORRELATIONS!
 Articular processes
 ________________________________ o arise from the junction of laminae and
- failure of the neural tube to close at the pedicles
cranial end; maldevelopment of brain and o vertically arranged and consists of two
skull superior and two inferior processes
 _______________________________
- Failure of closure at the caudal end;
associated with the maldevelopment of the
vertebrae
 ________________________________
- Results when the meninges balloon out to
COMPOSITION
form a sac;OF THE VERTEBRAL
associated COLUMN
with a defect in the
- 33overlying
vertebraevertebra
(7 cervical, 12 thoracic, 5 lumbar, 5
sacral, and 4 coccygeal)
 __________________________________
- made up of
- The sac contains a nervous tissue;
__________________________________ which
associated with severe disturbances of
is responsible for its flexibility
function

PARTS OF A TYPICAL VERTEBRA:

1. Body – located anteriorly
2. ______________________________________
– where the spinal cord and meninges pass
through
3. Vertebral Arch
- located posteriorly
- consists of:

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 SPINAL CORD AND THE ASCENDING TRACTS
INTERVETEBRAL DISCS
- a type of ____________________________
sandwiched between the vertebral bodies
- serve as shock absorbers as the load on the
vertebral column is suddenly increase
- thickest in
_______________________________________
_____________, where the movements are
greatest
- resilience is gradually lost with advancing age
PARTS:
1. _______________________________________
___
- composed of fibrocartilage
- binds the vertebral column together,
retains the nucleus pulposus, and
permits a limited amount of movement
2. NUCLEUS PULPOSUS
- in young, ovoid mass of gelatinous
material
- ______________________________ of
the nucleus pulposus allows it to change
shape and permits one vertebra to rock
forward or backward on another
- in advancing age, the nucleus pulposus
becomes smaller and is replaced by
fibrocartilage
BANGAYAN, BERNAL, CABAUATAN, CASTRO, TURINGAN
LIGAMENTS OF VERTEBRAL COLUMN
1. Anterior and Posterior Longitudinal Ligaments
- run as continuous bands down the anterior and
posterior surfaces of the vertebral column from
the skull to the sacrum
 ANTERIOR LIGAMENT: wide, strongly
attached
 POSTERIOR LIGAMENT: weak and
narrow
2. Ligamentum Flavum
- connects the laminae of two adjacent vertebrae
- functions to
the ______________________________________
3. Other Ligaments:
a. Supraspinous Ligament - runs between the tips
of adjacent spines
b. Interspinous ligament - connects adjacent
spines
c. Intertransverse ligaments - run between
adjacent transverse processes
JOINTS AND INNERVATIONS OF THE VERTEBRAL
COLUMN
1. Joints of the Vertebral Column
- articulate with each other by means of
_______________________________________
__ between their bodies and by synovial joints
between their articular processes
2. Joints Between Two Vertebral Bodies
- sandwiched between the vertebral bodies is an
intervertebral disc of fibrocartilage
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INNERVATION:
__________________________________________
______________

3. Joints Between Two Vertebral Arches

- the joints between two vertebral arches consist of
__________________________ between the
superior and inferior articular processes of
adjacent vertebrae

** The joints between the articular processes are

innervated by
______________________________________________
_______________.
**The joints of any particular level receive nerve fibers
from two adjacent spinal nerves.

GROSS APPEARANCE OF THE SPINAL CORD

-spinal cord tapers off into the ________________
- roughly __________ in shape -_________________
- averages _____ thick and ______ long -a prolongation of the pia mater
- starts in the _________________ of the skull -descends to be attached to the posterior surface
- continuous with the _______________ of the brain of the ___________
- passes through the ___________________
- Occupies _________ of vertebral canal Longitudinal Grooves On Anterior And Posterior
- ends at the __________ border of : Surface Of Spinal Cord
_____ in adults -Anterior Median Fissure
_____ in young children -groove for _________________________
-Posterior Median Sulcus
Enlargements
-Fusiformly enlarged Divisions of the Spinal Cord:
1. ___________ enlargement 1. Cervical
-Brachial plexus 2. Thoracic
2. ___________enlargement 3. Lumbar
-Lumbosacral Plexus 4. Sacral Regions

Meninges of the Spinal Cord

-Three fibrous connective tissue membranes that
enclose the brain and spinal cord
-separate soft tissue of central nervous system from
bones of cranium and vertebral canal
•from superficial to deep
1. ______________________
2. ______________________
3. ______________________

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 SPINAL CORD AND THE ASCENDING TRACTS

A. Dura Mater • Each root is attached to the cord by a series of

-forms loose-fitting sleeve around spinal cord (dural
sheath)
-tough, collagenous membrane surrounded by epidural
space filled with fat, blood vessels, and
loose connective tissue
-epidural anesthesia utilized during childbirth
__________, which extend the whole length of the
corresponding segment of the cord.
• Each posterior nerve root possesses a
____________________________, which give rise to
peripheral and central nerve fibers.

B. Arachnoid Mater
-__________________ - layer of simple squamous
epithelium lining dura mater and a loose mesh of
collagenous and elastic fibers spanning the gap between
the arachnoid membrane and the pia mater
-__________________ – gap between arachnoid
membrane and the pia mater
• filled with ______________________

C. Pia Mater STRUCTURE OF THE SPINAL CORD

-delicate, translucent membrane that follows the contours
of the spinal cord
-__________________ – fibrous strand of pia mater that
extends beyond the medullary cone within the lumbar
cistern
-__________________ – formed from fusion of terminal
filum and dura mater
- anchors the cord and meninges to vertebra Co1
-__________________ –anchors spinal cord
to limit side to side movement

Gray Matter
 H-shaped or butterfly shaped
 Consist of nerve cells and their processes,
neuroglia, and blood vessels.
 Size is related to the amount of muscle
innervated
Sensory And Motor Roots  Divided into cytoarchitectural areas called
•__________ of spinal nerves ________________________
•Attached Along the entire length of the spinal cord by
the: Divided into 3 horns:
•anterior or __________roots
•and the posterior or ___________ roots A. Posterior Horn

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 SPINAL CORD AND THE ASCENDING TRACTS
1. ______________________ (Rexed Lamina I)
 All cords level
 Associated with light touch, pain and temperature
sensation
 Origin of some fibers of anterolateral system
2. ______________________ (Rexed Lamina II)
 All cords level
 Homologous to the spinal trigeminal nucleus
 Associated with light touch, pain and temperature
sensation
 Origin of some fibers of anterolateral system
3. _________________ (Rexed lamina III and IV)
 All cords level
 Associated with light touch, pain and temperature
sensation
 Origin of some fibers of anterolateral system
4. __________________ (aka ________ _________)
(Rexed lamina VII)
 Base of postetior horn
 Extends from (C8) T1 to L2
 Homologous to the accesory cuneate nucleus of
the medulla
 Subserves unconcious proprioception from
muscle spindles and Golgi tendon organs
 Origin of the posterior spinocerebellar tract.
B. Lateral Horn (Rexed lamina VII)
 Receives ___________________ input
 From _________________
 intermediolateral group (nucleus) of cells that is a
_______________ nucleus
 give rise to preganglionic sympathetic fibers
 T1 and T2 is the __________________
______________, it is the sympathetic
innervation of the eye
C. Anterior Horn
a. ___________________ (Cooper-Sherrington border
cells)
• extend from L2 to S3.
• subserve unconscious proprioception from GTOs
and muscle spindles.
• are the origin of the ventral spinocerebellar tract.
BANGAYAN, BERNAL, CABAUATAN, CASTRO, TURINGAN
b. __________________________ (Rexed lamina VII)
• extends from S2 to S4.
• gives rise to preganglionic parasympathetic fibers
that innervate the pelvic viscera via the pelvic
nerve.
c. __________________________ (Rexed lamina IX)
• are found at all levels.
• are subdivided into medial and lateral groups that
innervate axial and appendicular muscles,
respectively.
d. _________________________ (Rexed lamina IX)
• extends from C1 to C6.
• gives rise to the spinal root of the spinal
accessory nerve (CNXI).
• innervates the sternocleidomastoid and trapezius
muscles.
e. ____________________ (Rexed lamina IX)
• extends from C3 to C6.
• innervates the diaphragm.
Gray Commissure
connects the anterior and posterior gray columns
• posterior gray commissure
• anterior gray commissure
Central Canal
• In the center of the gray commissure
• Present throughout the spinal cord
• Is closed inferiorly and opens superiorly into the
fourth ventricle
• It is filled with cerebrospinal fluid
• Lined with ciliated columnar epithelium, the
________________.
White Matter
• consists of bundles of ______________ that
surround the central gray matter.
• consists of ascending and descending fiber
pathways called tracts.
1. ______________________ (column)
• is located between the posterior median sulcus
and the posterior lateral sulcus.
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 SPINAL CORD AND THE ASCENDING TRACTS

• is subdivided above T6 into two fasciculi:

Anatomical Organization
a. _______________________
 is located between the posterior Three Neurons of the Ascending Pathway
median sulcus and the posterior
intermediate sulcus and septum. First-order Neuron- cell body is in the posterior root
 is found at all cord levels. ganglion of the spinal nerve.
b. ________________________ Second-order Neuron- give rise to an axon that crosses
 is located between the posterior the opposite side and ascends to a higher level of the
intermediate sulcus and septum CNS.
and the posterior lateral sulcus.
 is found only at the upper Third-order Neuron- situated in the thalamus and give
thoracic and cervical cord levels rise to a projection that passes to a sensory region of the
(C1–T6). cerebral cortex.
2. _____________________________
 is located between the posterior lateral FUNCTIONS OF THE ASCENDING TRACTS
and anterior lateral sulci. A = Afferent
S = Sensory
3. _______________________________
 is located between the anterior median 2 Types of Information that conduct by the ascending
fissure and the anterior lateral sulcus. tract
 contains the _______________ 1. Exteroceptive information
______________ 2. Propioceptive information
a. is located between the central canal *These information correspond into certain receptors
and the anterior medial fissure.
b. contains decussating spinothalamic Different Types of Receptors
tracts. 1. Mechanoreceptors
2. Thermoreceptors
THE ASCENDING TRACTS OF THE SPINAL CORD 3. Nociceptors
4. Electromagnetic receptors
-these are bundles of nerve fibers that serve as links from 5. Chemoreceptors
the spinal cord to higher centers of the brain. -it conduct
afferent information which may or may not reach SENSORY PATHWAY
consciousness Stimuli  Receptor  1st order neuron  2nd order
neuron  3rd order neuron  4th order neuron / sensory
cortex

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 SPINAL CORD AND THE ASCENDING TRACTS

*This neuron chain is the most common arrangement in obliquely to the opposite side in the anterior gray and
the ascending pathway white commisures within several spinal segments, as it
ascends it will be accompanied by other fibers namely,
MAIN FUNCTION OF THE ASCENDING TRACT LATERAL SPINOTHALAMIC TRACT and
1. Pain SPINOTECTAL TRACT forming the SPINAL
2. Temperature LEMINISCUS) 3rd order neuron (VENTRAL
3. Pressure and Light touch (two point POSTEROLATERAL NUCLEUS OF THE THALAMUS)
discrimination) Axons of the 3rd order neuron pass through the posterior
4. Vibration limb of the internal capsule and corona radiata to reach
5. Proprioception the post central gyrus (broadman’s area 3,1,2 or
*Each sensation has its own pathway somatosensory area)

Pain, temperature, crude touch (can’t localized) – Lateral

spinothalamic tract
Pressure and light touch (can localize) – Anterior
spinothalamic tract
Vibration and Proprioception – Dorsal Column Pathway
(Fasciculi gracilis and cuneatus)
Proprioception (Position sense) – Spinocerebellar
(Anterior and Posterior)

Three Main Pathways

1. Spinothalamic Tract
2. Dorsal column
3. Spinocerebellar

LIGHT TOUCH AND PRESSURE - It is pick by

CUTANEOUS RECEPTORS (respond to specific type of
touch)
-Free nerve endings – touch and pressure
-Meissner Corpuscles – low frequency vibration
-Merkel Disc – determine texture
SPINOTHALAMIC TRACT -Ruffini – Heavy and prolonged touch
-Pacinian – Tapping, high frequency vibration
ANTERIOR SPINOTHALAMIC TRACT -Merkel and Meissner – 2 point discrimination

Stimuli receptor  send signal through the DORSAL LATERAL SPHINOTHALAMIC TRACT
ROOT GANGLION (1ST order neuron)( Before it synapse
with the 2nd order neuron, the 1st order neuron will divide - It crosses over the opposite side of the spinal
into two branches: ascending and descending branch cord one or two spinal segments above
contributes to the POTEROLATERAL TRACT OF
LISSAUER)  2nd order neuron (Decussation/crossing PAIN and TEMPERATURE
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FAST/ FIRST PAIN SLOW/ SECOND PAIN

After 0.1 sec of stimulus After 1 sec of stimulus
Superficial, rapid onset and Tissue destruction
offset
Localized Poorly localized
A delta fibers C fibers
Neurotransmitter: Glutamate Substance P (Slow
(fast acting localized release diffuses widely
neurotransmitter) and affects many
neurons, produce by
substantia gelatinosa)
*85% of the C fiber terminate at the RETICULAR
*the sensations of heat and cold are also travelled by FORMATION (emotions), 15% ascend to the thalamus
delta A and C fiber (relay center)
*Fast pain fibers directly ascend the spinal cord in the
lateral spinothalamic tract, whereas the slow pain fibers
take part in multiple relays in the posterior gray horn
before ascending to higher centers. MECHANISM
*stimuli are on the right hand, sensation will be processed
by the left side of the brain (due to decussation) Injured right hand  cell damaged  release of
chemicals such as prostaglandins (PG)  sensory fibers
* REXED LAMINAE (I to X) – Location where 1st order all over the body respond to PG  sensory nerve fibers
neuron synapse with 2nd order neuron now will send signal through the DORSAL ROOT
GANGLION (1ST order neuron: it will release
Marginal Nucleus (I) – Fast Fiber SUBSTANCE P. Before it synapse with the 2nd order
Substantia Gelatinosa (II) – Slow Fiber neuron, the 1st order neuron will divide into two branches:
Nucleus Proprius (III-IV) – Touch and ascending and descending branch – POTEROLATERAL
Propriception TRACT OF LISSAUER)  2nd order neuron (cross
Laminae V – no exact function obliquely to the opposite side in the anterior gray and
Laminae VI – muscle spindles white commisures within one spinal segment of the cord
Zona Intermedia (VII) – AKA dorsal nucleus of becoming your LATERAL SPINOTHALAMIC TRACT, as
Clarke, receives the lower extremity and sensory it ascends it will be accompanied by other fibers namely,
information ANTERIOR SPINOTHALAMIC TRACT and
Laminae VIII – Obtain information from the SPINOTECTAL TRACT forming the SPINAL
reticulospinal and vestibulospinal tracts. LEMINISCUS) 3rd order neuron (VENTRAL
Laminae IX – contains alpha, beta, and gamma POSTEROLATERAL NUCLEUS OF THE
motor neurons. THALAMUS) region of the brain corresponds to the
Laminae X – no exact function injured right hand.

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 SPINAL CORD AND THE ASCENDING TRACTS

Gate Control Theory

- The gate allows passage of pain from the point of
stimulus to the cortex
- Excess nonpainful touch release a
chemical/neurotransmitter to block the 1st order
neuron of the pain
- Gate is close, pain decrease
- Gate is open, pain increase
- Examples are massage, acupuncture, application
of liniments relieve pain
-
Note! ANALGESIA SYSTEM
Pain signal from the face follows different signal - Stimulation of certain areas of your brainstem
to the thalamus. 1st order neuron travel via the trigeminal blocks or reduces sensations of pain.
nerve to the brainstem  2nd order neuron  thalamus - Neurotransmitter include serotonin, Epi, and NE
*Pain from the skin, muscle and joints are somatic pain blocks pain signal at entry point in the spinal cord
(for internal organs, VISCERAL PAIN)

*VISCERAL PAIN is usually perceived at different OTHER TERMINATIONS OF THE LST

location and it is called REFERRED PAIN (due to
SHARING of the 2nd order neuron in the spinal cord of
visceral pain fibers and skin pain fibers. It follows the
DERMATOME rule)
Dermatome – sensory region of skin innervated by a
nerve root
- POSTCENTRAL GYRUS – interpretation of pain
in relation to past experiences, primary sensory
area (precentral – for primary motor)
- CINGULATE GYRUS – Interpretation of the
emotional aspect of the pain
- INSULAR GYRUS – interpretation of pain stimuli
from the internal organs of the body

Most Common dermatomal levels (28 levels) CLINICAL CONDITION

T4 – nipples
T10 – umbilicus Brown – Sequard Syndrome
– Condition associated with hemisection (damage) to half
of the spinal cord
-Loss of sensations: Pain, temperature, and touch
-Paralysis
- Cause by vertebral bone fracture or penetrating trauma
(gunshot or stab wound) and it usually happens in the
neck or cervical region

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 SPINAL CORD AND THE ASCENDING TRACTS

Example, lesion at right T4, there will be an

ipsilateral loss in light touch, vibratory, and proprioception
below the lesion (lesion in posterior white column) but the
upper part of the lesion above T4 is still functional
because it still receives signals from the upper motor
neuron. However, since the spinothalamic tract
decussates before ascending one or two level, there will
be a CONTRALATERAL loss of pain and temperature on
the left side and an incomplete or impaired tactile
sensation. It is due to the destruction of the crossed
anterolateral spinothalamic tract that crossed at T5 or T6.

Blue color – Total loss of all sensations
Black color – contraletral loss of pain, temperature,
and impaired tactile sensation (destruction of cross
anterolateral spinothalamic tract)
DORSAL COLUMN PATHWAY
Fasciculus Cuneatus
- Unconscious proprioception from fine/individual
fiber of muscle spindle and golgi tendon organ in
muscles, joints, or tendon in upper extremity
above C8
SPINOCEREBELLAR TRACT
– All that is related to proprioceptor, Muscle joint sense
pathways to the cerebellum.
Anterior Spinocerebellar Tract
- Forward thinking of gross movements
Posterior spinocerebellar tract
- Receive muscle joint information from the muscle
spindles, tendon organs, and joint receptors of
the trunk and lower limbs. The information will be
processed by the cerebellum in the coordination
of the limb movements and the maintenance of
posture.

- Receptors got activated  dorsal root ganglion

 spinal cord at the level of c8 and above 
ascend going to the fasciculus cuneatus  going
to the caudal medulla  synapse at the
accessory or external cuneatus  going to enter
the cerebellum via the inferior peduncle

Fasciculus Gracilis (lower limbs) - C8-T1 below

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 NEUROANATOMY February 04, 2019| DR. BERNAL
SPINAL CORD AND THE ASCENDING TRACTS

SUMMARY

The Main Somatosensory Pathways to Consciousness

Sensation Receptor 1st order 2nd order 3rd order Pathways Destination
neuron neuron neuron
Pain and Free nerve Posterior Ventral Lateral
temperature ending root posterolateral spinothalamic
ganglion nucleus of tract
thalamus
Light touch Posterior Substantia Ventral Anterior Posterior
and pressure root Gelatinosa posterolateral spinothalamic central gyrus
ganglion nucleus of tract
thalamus
Discriminative Meissner’s, Nuclei Ventral Posterior
touch, pacinian, gracilis and posterolateral central gyrus
vibratory muscle cuneatus nucleus of
sense, spindles, thalamus
conscious tendon
muscle joint organ
sense

Muscle Joint Sense Pathways to the Cerebellum

1st order 2nd order
Sensation Receptor Pathways Destination
neuron neuron
Unconscious Muscle Posterior root Anterior and
muscle joint spindles, ganglion Posterior
sense tendon organs, spinocerebellar
joint receptors

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