CNS Organization - Axes

Superior (above)
Lateral (to the side)

Rostral Medial (middle)

Anterior (in
front of;
Caudal
toward the
front) Posterior
(behind;
toward the
back)

Inferior (below) Caudal

Fig. 1-9: Purves et al. Neuroscience, Sinauer Associates Inc: Massachusetts, 2001.
Spinal Cord Segments
„ Cervical – 7
„ Thoracic – 12
„ Lumbar – 5
„ Sacral – 5
„ Coccygeal – 1
„ 31 in total
Dermatomes
„ Area of skin supplied by a
single dorsal root.
„ 1 pair per spinal cord
segment
… Left/Right
… None for C1
„ Consecutive segments
are next to each other
„ Clinical sign of where
spinal cord lesion occurs
Myotomes
„ Groups of muscles
innervated by a single
spinal cord segment.
„ 1 pair per
… Left/Right
Meninges
„ Spinal cord is part of CNS
„ Covered by 3 meninges
… Pia– adheres to spinal cord
… Arachnoid
… Dura
„ not attached to bone.
„ Epidural space

„ CSF between arachnoid and pia.

Cross-section
„ Butterfly shaped
grey matter
„ Surrounded by white
matter
„ Dorsal median
septum
„ Ventral fissure
„ Dorsolateral sulcus
„ Ventrolateral sulcus
Delineations of Grey Matter
„ Dorsal horn
… Input from DRG
„ Ventral horn
… Motor neuron output
„ Intermediolateral horn
… Thoracic/upper lumbar
… Neurons of the
sympathetic nervous
system
„ part of autonomic
nervous system
„ rest & digest
10 Laminae of Rexed
„ I-IV: input layers
(somatosensory)
„ V & VI: proprioceptive
„ VII: relay between midbrain
and cerebellum
„ VIII: modulate motor activity
„ IX: main motor area
„ X: neuroglia
 Layer IX Architecture
„ Ventral horn
„ Alpha motor neurons
„ Flexors – dorsal
„ Extensors – ventral
„ Trunk – medial
„ Limbs (periphery) -
lateral
White Matter Architecture
„ Posterior (dorsal) funiculus
„ Dorsal Column-Medial
Lemniscus
… Ascending tract
„ Kinesthesia – position sense
„ Discriminative touch
„ Tests for:
… Vibration sense
… Position sense
… 2-point
… Touch
… Form recognition
 Posterior Column: DC-ML
„ Receptor (peripheral axon)
„ Soma (unipolar) in DRG
„ Proximal axon to spinal cord
„ Dorsal column to medulla
… Gracile and Cuneate nuclei
„ Cross-over (decussation)
„ Medial lemniscus to thalamus
… Ventral posterolateral nucleus
„ Primary somatosensory cortex
(S1)
…3 neurons to reach here
Spinocerebellar Tracts
„ Dorsal
… Ascending
… Proprioception
„ Ventral
… Ascending
… Golgi tendon organ afferents
„ Both terminate in cerebellum
… Unconscious proprioception
… Unlike dorsal column-medial
lemniscus which is conscious
proprioception
Lateral Spinothalamic Tract
„ Pain – anterior
„ Temperature - posterior
„ Cordotomy
… Lesion of anterior LST
… Relief of chronic pain
Corticospinal Tract
„ Descending tract
„ Primary motor cortex (M1)
„ Premotor cortex
„ Pyramidal decussation
… Cross-over at medulla
„ Lateral corticospinal tract
„ Anterior corticospinal tract
„ Skill/precision in movements
… Does not initiate fine movements
Rubrospinal Tract
„ Rubro – ‘red’ nucleus
… In midbrain
„ Ventral tegmental
decussation
… In midbrain
„ Corrects errors in
movements of the
corticospinal tract
Lateral Vestibulospinal Tract
„ Lateral vestibulospinal
nucleus
… Pons

„ Upright posture
Medial Vestibulospinal Tract
„ Medial vestibular
nucleus
… Medulla

„ Control of head
position
Reticulospinal Tracts
„ Reticular Formation
… Pons & Medulla
„ Modulate motor neurons
„ Modulate sensory input
… Modulate spinothalamic
neurons in dorsal horn
Tectospinal Tract
„ Superior Colliculus
(optic tectum)
… Orienting
… Eyes

„ “Turn head in response

to light”
… Combinedhead/eye
movements
Spinal Reflexes
„ Reflexes: movements that don’t need conscious
control
„ Hand in fire
… Remove hand
… Then feel pain/heat

„ Circuit:
… Dorsal horn input
… Ventral horn output
Stretch (Myotactic) Reflex
„ Doctor taps on tendon
… Biceps – flex elbow
… Triceps – extend elbow
… Radial (wrist) – flex wrist
… Knee – extend knee
… Ankle – flex ankle
„ Counteracts external
influences
„ Helps maintain posture
Inverse Myotactic Reflex
„ Severe tension
activates Golgi
tendon organ
„ Reflex relaxes
muscle
„ Prevents tearing of
tendon
Withdrawal (Flexor) Reflex
„ Remove limb from pain
„ Activate flexor muscles
„ Inhibit antagonistic
extensor muscles
„ Polysynaptic
 Crossed Extensor Reflex
„ When flexor reflex occurs,
this occurs too
„ Contralateral limb does the
opposite
… Flexor muscle relaxes
… Extensor contracts
… i.e. opposite limb extends

„ Maintains center of gravity

„ Don’t want to fall in the fire!
Clinical Correlates of Spinal Cord Injury

„ Lesions prevent
input/output
„ Correlates are
related to what
each tract does
normally
„ E.g. Horner’s
Syndrome
Dorsal Column Lesion
„ Loss or lessening of
… Vibration sense
… Position sense
… 2-point discrimination
… Deep touch

„ Ipsilateral (same side)

„ Dermatomes at and
below lesion site
Lateral Spinothalamic Tract
„ Loss or lessening of:
… Pain
… Temperature
„ Contralateral (opposite
side)
„ Dermatomes one or
two segments below
lesion
… Due to cross-over
Dorsal Root Lesion
„ Loss of lessening of:
… All sensory modalities
„ Ipsilateral
„ Only the dermatome
supplied by that DRG
ALS: Amyotrophic Lateral Sclerosis

„ Lou Gehrig’s disease

„ Motor neuron disease
„ Degenerative
… Anterior horn
… Lateral corticospinal
tract
… Bilateral
ALS: Amyotrophic Lateral Sclerosis

„ Signs
… Paralysis
… Muscular atrophy
… Exaggerated myotactic
reflexes
… Babinski sign
„ Run pen down sole of
foot
„ Big toe points up
„ Other toes fan out
ALS: Amyotrophic Lateral Sclerosis
„ Life expectancy: 3-5
years
„ ‘Locked in’
… Paralyzedbody
… Normal mind
„ 2 deaths per 100,000
„ Cause unknown
… Familial ALS
„ Chromosome 21
„ Defect in SOD1 –
superoxide dismutase
… Protects motor neurons
from free radicals
Lou Gehrig
As a first baseman for the New York Yankees baseball
team, Lou Gehrig played in 2,130 consecutive games
from 1925 to 1939, setting a major league record and
had a career batting average of .340. He once hit four
home runs in a game.
On July 4, 1939, he stood before 60,000 fans at Yankee
Stadium and confirmed what everyone seemed to know,
that the "Pride of the Yankees" had been dealt a terrible
blow, diagnosed with amyotrophic lateral sclerosis (now
often called Lou Gehrig's disease), a rare disease that
causes spinal paralysis.
Less than two years later, on June 2, 1941, he died in
Riverdale, N.Y.
 Lou Gehrig’s Speech
Fans, for the past two weeks you have been reading about a bad break I got. Yet
today I consider myself the luckiest man on the face of the earth. I have been in
ballparks for seventeen years and have never received anything but kindness and
encouragement from you fans.
Look at these grand men. Which of you wouldn't consider it the highlight of his career
to associate with them for even one day?
Sure, I'm lucky. Who wouldn't consider it an honor to have known Jacob Ruppert -
also the builder of baseball's greatest empire, Ed Barrow - to have spent the next
nine years with that wonderful little fellow Miller Huggins - then to have spent the
next nine years with that outstanding leader, that smart student of psychology - the
best manager in baseball today, Joe McCarthy!
Sure, I'm lucky. When the New York Giants, a team you would give your right arm to
beat, and vice versa, sends you a gift, that's something! When everybody down to
the groundskeepers and those boys in white coats remember you with trophies,
that's something.
When you have a wonderful mother-in-law who takes sides with you in squabbles
against her own daughter, that's something. When you have a father and mother
who work all their lives so that you can have an education and build your body, it's
a blessing! When you have a wife who has been a tower of strength and shown
more courage than you dreamed existed, that's the finest I know.
So I close in saying that I might have had a tough break - but I have an awful lot to live
for!
Lou Gehrig - July 4,1939