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Neuroanatomy
Neuroanatomy
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1
Neuroa natomy
Introd uction of the Nervo us Syste m
The nervou s system (NS) consist s of two types of cells:
1) Nerve cells proper (Ne~n s) are variable in size and shape but all of
them have cytoplasmic processes (dendrites and axons). Dendrites
carry impulses towards the nerve cell body (afferent) while axons carry
impulses away from cell body (efferent). Most axons in the central
nervous system are wrapped up in a fatty sheath called myelin sheath
which is segmented and absent at constrictions called nodes of
Ranviere. Myelin sheath is covered by neurolemma (Schwan's cell).
2) Neurog ila cells which are the connective tissue cells of the central
nervous system.
Organization of the Nervous System:
1. Cenbral ,nervous svstem {GBSU Brain-spinal cord.
2. e.eriplier,al naiYou s swtern (PN'SU
i. Cranial nerves (12 pairs, connected to the surface of cerebrum and
brain stem).
ii. Spinal nerves (31 pairs; 8 cervical, 12 thoracic , 5 lumber, 5 sacral
and one coccygeal).
3. Auto,nbnjic nervous,SYJSl em,,(At{$:j:
i. Parasympathetic (craniosacral) division:
► Cranial part: related to cranial nerves 111, VII, ix and X.
► Sacral part: related to sacral spinal nerves 2, 3 and 4. H.
ii. Sympathetic (thoracolumber) division :
► Arises from the spinal cord (T1-13) .
► Forms the sympathetic trunk with its ganglia .
.-::--
2
Neuroanatomy -
[ Spinal Cord ]
I. External Features
• Site and Extent:
a. It begins, above, at the lower border of foramen magnum as a
continuation of the medulla oblongata.
b. It ends, below, at the level of the disc between L 1/L2 vertebrae. The
lower end of the spinal cord tapers off into a conical extremity called
con us medullaris i.e. the spinal cord occupies the upper 2/3 of the
vertebral canal.
• Length:
It is about 45 cm in length (about 25 cm shorter than the length of the
vertebral
column).
• Shape:
The spinal cord is cylinderical, being slightly compressed antero-
posteriorly. Its
thickness is not uniform. It shows two enlargements:
a- Cervical enlargement
b- Lumbar enlargement
• Externa l features: The external surface of the spinal cord shows 6
longitudinal grooves or sulci:
1- Anterior median fissure or sulcus: is the deepest.
2- Posterior median suicus.
3
Neuro anatom y
3- Two anterolateral sulci: Rt and Lt along which emerg e the ventral (motor)
roots of the spinal nerves.
4- Two posterolateral sulci: Rt and Lt along which enter the dorsal (sensory)
roots of the spinal nerve.
• Segm ents: The spinal cord is divided into 31 segments, arranged as follows :
8 cervical segments. 12 thoracic segments.
5 lumbar segments.· 5 sacral segments.
1 (one) coccygeal segment.
- Since the spinal cord is shorte r than the vertebral column, so the segments
of the spinal cord lies above their corresponding vertebrae:
- The cervical region ends at the level of 6th cervical (C6) vertebra.
- The thoracic region ends at the level of 9th thoracic (T9) vertebra.
Dor.sat
Spinal Bram stem ~ 1i,.,-,
Cor d >
Cetvlcal enlargement
>
, _ _ ,c
Lumbosacral enlargement
I > (~
Conus medullarls ' ... \ /)
~ Lumbar
~
Cauda equlna
L ->
" Sacral
,1 Ventral
4
Neuroanatomy
II.Spinal nerves
• Each segment of the spinal cord gives origin to a pair of spinal nerves
(right and left). Accordingly, -there are 31 pairs of spinal nerves (8
cervical, 12 thoracic, 5 lumbar, 5 sacral and one coccygeal nerves).
• Each spinal nerve is attached to the side of its corresponding spinal
segment by two roots:
A- Ventral root {motor): emerges from the antero-lateral sulcus. It
contains somatic efferent (motor) fibres, in addition to sympathetic
and parasympathetic fibres in certain segments of spinal cord.
8- Dorsal root (sensory): enters through the posterolateral sulcus. It
consists of general somatic afferent (sensory) (pain, temperature,
touch, pressure and proprioception) from the body below the head to
enter the spinal cord. Each dorsal root carries the dorsal root or
spinal ganglion. The nerve cells in this ganglion represent the 1st
order neurons in the pathways of the general somatic sensations
from the body below the head.
Posterior
Dorsal
median sulcus Dorsal
III
White matter nerve root
Dorsal horn.---!-
< I (
""'"I!!!! ~
/Dorsal nerve
root ganglion
(splnal ganglion)
Gray matter L t h
aeraI orn--1
Ventral horn,--- \ Dorsal ramus
Ventral ramus
--r [
Ventral Ventral Spinal nerve
median fissure nEtrve root
Anterior
5
Neuroanatomy
o At the corresponding intervertebral foramen , the ventral and dorsal roots
unite together forming the s~inal nerve trunk which is mixed containing both
motor and sensory fibres. It leaves the vertebral canal through the
intervertebral foramen.
• The spinal nerve trunk is very short. Once it emerges from the intervertebral
foramen, it divides into two primary rami {anterior and posterior). Both rami
are mixed and supply the anterior and posterior aspects of the body
respectively.
• Each root 15 covered by the pia, arachnoid and dura maters. At the
intervertebral foramen, only the dural sheath continues outwards
around the spinal nerve trunk.
• Length of the roots and the cauda equina: Since the spinal cord is
shorter than the vertebral column; accordingly:
- Therefore, the roots of the spinal nerves have to descend for some
distances in the subarachnoid space to reach their intervertebral
foramina. Accordingly, the roots of the spinal nerves become
progressively longer and more oblique as we go downwards.
- Below the end of the spinal cord {below Li vertebra), the vertebral
canal is occupied only by a leash of the long lumbar and sacral nerve
roots, surrounding the Ilium terminale together forming the cauda
equine which float in the CSF filling the subarachnoid space. Lumbar
puncture can be safely done below 12 vertebra without any danger of
injury of the spinal cord.
6
Neuroanatomy
The Spinal Cord
and Spinnl Nerve Roots
(inside lhc Vertebral Column)
e5bN1Amsd
'a
cs
cervical spinil nen·e C.
mots for Ct C8 • 5 cs
6 cc
7 . C'f
•~-::11 ~n
3 Tl
..
s
6 ~=:.iiii'
lhoradc spinal nerve
roots for Tl-Tl 2 7 --:1~~!:!
vertebra spinous
processes
I
I
lwnbar spinal nen·e _ _ _ _....,. conus meduJaris
3
roots for LI-Ls
,. ~~~._.,~,,.,~, . , ' ~ - - - - - - cauda cquina
saaum
sacral S(lim1I ner,·c
roots for Sl-SS
cocq:geal ncn·e root
Neu roa nato my
- - - - - - Pio mat er
v.. .- Arachnoid mater
Dura mater
~ ..............._C onu s
medullar1s
-v .- Cau da equlna
m lumb ar cistern
a-t ft- --.- - Filum tenn1nale
internum
--- --L ow er end of
dural tube at S2
vertebra
11 --- --- Filum terminale
□
externum
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Neuroanatomy
111. Coverings of the spinal cord; (Spinal Meninges):
.
• The spinal cord as well as the brain (i.e. the CNS) are surrounded by three
membranes called the meninges; from inside outwards they are: the pia,
arachnoid and dura maters .
• The pia mater is closely adherent to the surface of the brain and the spinal
.
cord. The pia mater is separated from the arachnoid mater by sub-arachnoid
space which is a filled with cerebrospinal fluid (CSI=). The arachnoid mater is
separated from the dura mater by the narrow subdural space containing a thin
film of serous fluid.
Dura mot,,
Arachno,d- - / Pio mottr
Spino/ ga11glion
pinol ntne
Vmtra/ nen:e
root
9
Neur oana tomy
The Spinal Meninges
• The spinal dura mate r is separated from the periostium of the
vertebral cana l
by a spac e called the extradural (or epidural) spac e.
A- Spinal Pia Mater:
- It is a delicate mei;nbrane which is closely adhe rent to the surfa
ce of the
spinal cord.
- It is thickened to form two strong fibrous bands:
a- Dent icu/a te ligam ent:
• Are two thickened lateral extensions (Rt & Lt) arising from the
pla mate r at
the side of the spinal cord; from the foramen magnum (above)
till L 1 vertebra
(belo w).
• It lies midway between the ventral and dorsal spinal nerve root
and its lteral
border shows 21-teeth like processes whic h attached to the dura
mate r.
b- Fi/um terminale :
•At the tip of the conus medullaris, the pia mate r extends as a
fibrou s filament
called the filum terminale, which descend in the centre of the caud
a equina
surrounded by the lowe r lumber and sacral nerves having a gliste
ning silvery
appearance.
• It leaves the sacral canal through the sacral hiatus and gets attached
to the
periosteum on the back of the coccyx.
8- Spin al Arachnid Mater:
- It is a delicate membrane surrounding the pia mate r and deep
to the dur r -
mater.
10
Neuroanatomy
-----------------------
- It is separated from the pia mater (inside it) by the subarachnoid space
which is filled with CSF.
_ It is separated from the dura mater by a narrow subdural space which
-eontains a thin film of serous fluid.
_ Above, it is continuous through the foramen magnum with the arachnoid
mater of the brain. Below, it ends at the level of the 2nd sacral vertebra
where it is pierced by the filum terminale .
.
- Subarachnoid space contains:
• Cerebrospinal fluid (CSF). • Spinal blood vessels.
• Spinal nerve roots. • Filum terminate.
Spinal cord------....
Spinal
nen,e -"""""7--'""'~;:;;.;...,,;
INAL
Oenllculate INGES
ligament la mater
Inner)
rachno,d
lddlo)
...)
/
Subarachrlol<J'--.:.,1
space
Subdural space
11
