The spinal cord and the descending and ascending  The transverse processes are directed laterally

tracts - 152 from the junction of the laminae and the

pedicles.
Composition of the Vertebral Column
o Both the spinous and transverse
 The vertebral column is composed of 33 processes serve as levers and receive
vertebrae— attachments of muscles and ligaments.
o 7 cervical  The articular processes are vertically arranged
o 12 thoracic and consist of two superior and two inferior
o 5 lumbar processes
o 5 sacral (fused to form the sacrum) o They arise from the junction of the
o 4 coccygeal (the lower 3 are commonly laminae and the pedicles.
fused). o The two superior articular processes of
 Because it is segmented and made up of one vertebral arch articulate with the
vertebrae, joints, and pads of fibrocartilage two inferior articular processes of the
called intervertebral discs, it is a flexible arch above, forming two synovial
structure joints.
o The intervertebral discs form about  The pedicles are notched on their upper and
one-fourth the length of the column. lower borders, forming the superior and
inferior vertebral notches
General Characteristics of a Vertebra
 On each side, the superior notch of one
 A typical vertebra consists of a rounded body vertebra and the inferior notch of an adjacent
anteriorly and a vertebral arch posteriorly. vertebra together form an intervertebral
foramen
o These foramina, in an articulated
skeleton, serve to transmit the spinal
nerves and blood vessels.
o The anterior and posterior nerve roots
of a spinal nerve unite within these
foramina with their coverings of dura to
form the segmental spinal nerves.

Joints of the Vertebral Column

Joints Between Two Vertebral Bodies

 Sandwiched between the vertebral bodies is an

intervertebral disc of fibrocartilage
 These enclose a space called the vertebral
foramen, through which run the spinal cord and Intervertebral Discs
its coverings
 The intervertebral discs are thickest in the
 The vertebral arch consists of a pair of
cervical and lumbar regions, where the
cylindrical pedicles, which form the sides of the
movements of the vertebral column are
arch, and a pair of flattened laminae, which
greatest.
complete the arch posteriorly.
o They serve as shock absorbers when
 The vertebral arch gives rise to seven
the load on the vertebral column is
processes: one spinous, two transverse, and
suddenly increased. Unfortunately,
four articular
their resilience is gradually lost with
 The spinous process, or spine, is directed
advancing age.
posteriorly from the junction of the two
laminae.
 Each disc consists of a peripheral part, the Ligaments
anulus fibrosus, and a central part, the nucleus
 The anterior and posterior longitudinal
pulposus
ligaments run as continuous bands down the
 The anulus fibrosus is composed of
anterior and posterior surfaces of the vertebral
fibrocartilage, which is strongly attached to the
column from the skull to the sacrum
vertebral bodies and the anterior and posterior
 The anterior ligament is wide and is strongly
longitudinal ligaments of the vertebral column.
attached to the front and sides of the vertebral
 The nucleus pulposus in the young is an ovoid
bodies and to the intervertebral discs.
mass of gelatinous material.
 The posterior ligament is weak and narrow and
o It is normally under pressure and
is attached to the posterior borders of the discs.
situated slightly nearer to the posterior
than to the anterior margin of the disc
o The upper and lower surfaces of the
bodies of adjacent vertebrae that abut
onto the disc are covered with thin
plates of hyaline cartilage.
 The semifluid nature of the nucleus pulposus
allows it to change shape and permits one
vertebra to rock forward or backward on
another
o A sudden increase in the compression
load on the vertebral column causes the
nucleus pulposus to become flattened,
and this is accommodated by the
resilience of the surrounding anulus
fibrosus
o Sometimes, the outward thrust is too
great for the anulus fibrosus and it
ruptures, allowing the nucleus pulposus
to 
 herniate and protrude into the
vertebral canal,where it may
press on the spinal nerve roots,
the spinal nerve, or even the
spinal cord.
 With advancing age, the nucleus pulposus
becomes smaller and is replaced by
fibrocartilage.
o The collagen fibers of the anulus
degenerate, and as a result, the anulus
cannot always contain the nucleus
pulposus under stress.
 Old age 
o discs are thin and less elastic, and it is
no longer possible to distinguish the
nucleus from the anulus.
 Nerve Supply of Vertebral Joints

 The joints between the vertebral bodies are

innervated by the small meningeal branches of
each spinal nerve
 The joints between the articular processes are
innervated by branches from the posterior rami
of the spinal nerves;
Joints Between Two Vertebral Arches
o the joints of any particular level receive
 The joints between two vertebral arches consist nerve fibers from two adjacent spinal
of synovial joints between the superior and nerves.
inferior articular processes of adjacent
Gross appearance of the spinal cord
vertebrae
 The spinal cord is roughly cylindrical in shape. It
Ligaments
begins superiorly at the foramen magnum in the
 Supraspinous ligament skull, where it is continuous with the medulla
o This runs between the tips of adjacent oblongata of the brain, and it terminates
spines. inferiorly in the adult at the level of the lower
 Interspinous ligament border of the first lumbar vertebra.
o This connects adjacent spines o In the young child, it is relatively longer
 Intertransverse ligaments: and usually ends at the upper border of
o These run between adjacent transverse the third lumbar vertebra.
processes. o Thus, it occupies the upper two-thirds
 Ligamentum flavum of the vertebral canal of the vertebral
o This connects the laminae of adjacent column and is surrounded by the three
vertebrae meninges, the dura mater, the
 In the cervical region, the supraspinous and arachnoid mater, and the pia mater.
interspinous ligaments are greatly thickened to  Further protection is provided by the
form the strong ligamentum nuchae. cerebrospinal fluid, which surrounds the spinal
cord in the subarachnoid space.
 In the cervical region, where it gives origin to
the brachial plexus, and in the lower thoracic
and lumbar regions, where it gives origin to the
lumbosacral plexus, the spinal cord is fusiformly
 enlarged; the enlargements are referred to as  For a comparison of the structural details in
the cervical and lumbar enlargements different regions of the spinal cord
 Inferiorly, the spinal cord tapers off into the
Gray Matter
conus medullaris
o from the apex of which a prolongation  On cross section, the gray matter is seen as an
of the pia mater, the filum terminale, H-shaped pillar with anterior and posterior
descends to be attached to the gray columns, or horns, united by a thin gray
posterior surface of the coccyx. commissure containing the small central canal
 The cord possesses a deep longitudinal fissure  A small lateral gray column or horn is present
called the anterior median fissure in the in the thoracic and upper lumbar segments of
midline anteriorly and a shallow furrow called the cord.
the posterior median sulcus on the posterior  The amount of gray matter present at any given
surface level of the spinal cord is related to the amount
 Along the entire length of the spinal cord are of muscle innervated at that level.
attached 31 pairs of spinal nerves by the o Thus, its size is greatest within the
anterior or motor roots and the posterior or cervical and lumbosacral enlargements
sensory roots of the cord, which innervate the
 Each root is attached to the cord by a series of muscles of the upper and lower limbs,
rootlets, which extend the whole length of the respectively
corresponding segment of the cord.
 Each posterior nerve root possesses a posterior
root ganglion, the cells of which give rise to
peripheral and central nerve fibers.

Structure of the spinal cord

 The spinal cord is composed of an inner core of

gray matter, which is surrounded by an outer
covering of white matter;
o there is no indication that the cord is
segmented.
  The medial group is present in most segments
of the spinal cord and is responsible for
innervating the skeletal muscles of the:
o neck and trunk, including the
intercostal and abdominal
musculature.
 The central group is the smallest and is present
in some cervical and lumbosacral segments
 In the cervical part of the cord, some of these
nerve cells (segments C3-5) specifically
innervate the diaphragm and are collectively
referred to as the phrenic nucleus.
 In the upper five or six cervical segments, some
of the nerve cells innervate the
sternocleidomastoid and trapezius muscles and
are referred to as the accessory nucleus.
o The axons of these cells form the spinal
part of the accessory nerve.
 The lumbosacral nucleus present in the second
lumbar down to the first sacral segment of the
cord is made up of nerve cells whose axons
have an unknown distribution.
 The lateral group is present in the cervical and
Structure lumbosacral segments of the cord and is
responsible for innervating the skeletal muscles
 As in other regions of the central nervous of the limbs
system, the gray matter of the spinal cord
Nerve Cell Groups in the Posterior Gray Columns
consists of a mixture of nerve cells and their
processes, neuroglia, and blood vessels  There are four nerve cell groups of the
 The nerve cells are multipolar, and the posterior gray column:
neuroglia forms an intricate network around the o two that extend throughout the length
nerve cell bodies and their neurites of the cord and two that are restricted
to the thoracic and lumbar segments.
Nerve Cell Groups in the Anterior Gray Columns
 The substantia gelatinosa group is situated at
 Most nerve cells are large and multipolar, and the apex of the posterior gray column
their axons pass out in the anterior roots of the throughout the length of the spinal cord
spinal nerves as alpha efferents, which o It is largely composed of Golgi type II
innervate skeletal muscles. neurons and receives afferent fibers
 The smaller nerve cells are also multipolar, and concerned with pain, temperature, and
the axons of many of these pass out in the touch from the posterior root.
anterior roots of the spinal nerves as gamma Furthermore, it receives input from
efferents, which innervate the intrafusal descending fibers from supraspinal
muscle fibers of neuromuscular spindles levels.
 For practical purposes, the nerve cells of the o It is believed that the inputs of the
anterior gray column may be divided into three sensations of pain and temperature are
basic groups or columns: modified by excitatory or inhibitory
o medial, central, and lateral information from other sensory inputs
and by information from the cerebral
cortex.
 o It is believed to be associated with
receiving visceral afferent information.

Nerve Cell Groups in the Lateral Gray Columns

 The intermediolateral group of cells form the

small lateral gray column, which extends from
the first thoracic to the second or third lumbar
segment of the spinal cord (Figs.4-6 and 4-8)
o The cells are relatively small and give
rise to preganglionic sympathetic
fibers.
 A similar group of cells found in the second,
third, and fourth sacral segments of the spinal
cord give rise to preganglionic parasympathetic
fibers

The Gray Commissure and Central Canal

 In transverse sections of the spinal cord, the

anterior and posterior gray columns on each
side are connected by a transverse gray
commissure
o the gray matter resembles the letter H
 In the center of the gray commissure is situated
the central canal.
 The nucleus proprius is a group of large nerve
 The part of the gray commissure that is situated
cells situated anterior to the substantia
posterior to the central canal is often referred
gelatinosa throughout the spinal cord
to as the posterior gray commissure;
o This nucleus constitutes the main bulk
o Similarly the part that lies anterior to
of cells present in the posterior gray
the canal is called the anterior gray
column and receives fibers from the
commissure.
posterior white column that are
associated with the senses of position  The central canal is present throughout the
and movement (proprioception), two- spinal cord
point discrimination, and vibration  Superiorly, it is continuous with the central
 The nucleus dorsalis (Clarke’s column) is a canal of the caudal half of the medulla
group of nerve cells situated at the base of the oblongata, and above this, it opens into the
posterior gray column and extending from the cavity of the fourth ventricle.
eighth cervical segment caudally to the third or  Inferiorly in the conus medullaris, it expands
fourth lumbar segment into the fusiform terminal ventricle and
o Most of the cells are comparatively terminates below within the root of the filum
large and are associated with terminale
proprioceptive endings (neuromuscular o It is filled with cerebrospinal fluid and is
spindles and tendon spindles) lined with ciliated columnar
 The visceral afferent nucleus is a group of nerve epithelium, the ependyma.
cells of medium size situated lateral to the o Thus, the central canal is closed
nucleus dorsalis; it extends from the first inferiorly and opens superiorly into the
thoracic to the third lumbar segment of the fourth ventricle.
spinal cord.
White Matter The ascending tracts of the spinal cord

 The white matter, for purposes of description,  On entering the spinal cord, the sensory nerve
may be divided into anterior, lateral, and fibers of different sizes and functions are sorted
posterior white columns or funiculi. out and segregated into nerve bundles or tracts
in the white matter
 Some of the nerve fibers serve to link different
segments of the spinal cord, while others
ascend from the spinal cord to higher centers
and thus connect the spinal cord with the brain.
 It is the bundles of the ascending fibers that are
referred to as the ascending tracts.
 The ascending tracts conduct afferent
information, which may or may not reach
consciousness
 The information may be divided into two main
groups:
o exteroceptive information, which
originates from outside the body, such
as pain, temperature, and touch
o proprioceptive information, which
originates from inside the body, for
example, from muscles and joints.

Anatomical organization

 the ascending pathway to consciousness

consists of three neurons
 The anterior column on each side lies between o The first neuron, the first-order
the midline and the point of emergence of the neuron, has its cell body in the
anterior nerve roots; posterior root ganglion of the spinal
o the lateral column lies between the nerve.
emergence of the anterior nerve roots o A peripheral process connects with a
and the entry of the posterior nerve sensory receptor ending, whereas a
roots; the posterior column lies central process enters the spinal cord
between the entry of the posterior through the posterior root to synapse
nerve roots and the midline. on the second-order neuron.
o The second-order neuron gives rise to
Structure
an axon that decussates (crosses to the
 As in other regions of the central nervous opposite side) and ascends to a higher
system, the white matter of the spinal cord level of the central nervous system,
consists of a mixture of nerve fibers, neuroglia, where it synapses with the third-order
and blood vessels. neuron
 It surrounds the gray matter, and its white color o The third-order neuron is usually in the
is due to the high proportion of myelinated thalamus and gives rise to a projection
nerve fibers fiber that passes to a sensory region of
the cerebral cortex
 This three-neuron chain is the most common
arrangement, but some afferent pathways use
more or fewer neurons
  Many of the neurons in the ascending pathways through the spinotectal tract for the purpose of
branch and give a major input into the reticular spinovisual reflexes
formation, which, in turn, activates the cerebral  The spinoreticular tract provides a pathway
cortex, maintaining wakefulness from the muscles, joints, and skin to the
o Other branches pass to motor neurons reticular formation
and participate in reflex muscular o while the spino-olivary tract provides
activity an indirect pathway for further afferent
information to reach the cerebellum

Pain and Temperature Pathways

FUNCTIONS OF THE ASCENDING TRACTS
Lateral Spinothalamic Tract
 Painful and thermal sensations ascend in the
lateral spinothalamic tract;  The pain and thermal receptors in the skin and
 light (crude) touch and pressure ascend in the other tissues are free nerve endings.
anterior spinothalamic tract  The pain impulses are transmitted to the spinal
 Discriminative touch––that is, the ability to cord in fast-conducting delta A-type fibers and
localize accurately the area of the body touched slow-conducting C-type fibers
and also to be aware that two points are  The fast-conducting fibers alert the individual
touched simultaneously, even though they are to initial sharp pain, and the slow-conducting
close together (two-point discrimination) –– fibers are responsible for prolonged burning,
ascends in the posterior white columns aching pain
 Also ascending in the posterior white columns o Fast conducting – initial sharp pain
is information from muscles and joints o Slow conducting – prolonged burning,
pertaining to movement and position of aching pain.
different parts of the body  The sensations of heat and cold also travel by
 In addition, vibratory sensations ascend in the delta A and C fibers
posterior white column.  The axons entering the spinal cord from the
 Unconscious information from muscles, joints, posterior root ganglion proceed to the tip of the
the skin, and subcutaneous tissue reaches the posterior gray column and divide into ascending
cerebellum by way of the anterior and and descending branches
posterior spinocerebellar tracts and by the o These branches travel for a distance of
cuneocerebellar tract. one or two segments of the spinal cord
 Pain, thermal, and tactile information is passed and form the posterolateral tract of
to the superior colliculus of the midbrain Lissauer
 o These fibers of the first-order neuron o It is believed that here crude pain and
terminate by synapsing with cells in the temperature sensations are appreciated
posterior gray column, including cells in and emotional reactions are initiated.
the substantia gelatinosa.
 Substance P, a peptide, is
thought to be the
neurotransmitter at these
synapses.
 The axons of the second-order neurons now
cross obliquely to the opposite side in the
anterior gray and white commissures within one
spinal segment of the cord, ascending in the
contralateral white column as the lateral
spinothalamic tract
 The lateral spinothalamic tract lies medial to
the anterior spinocerebellar tract.

 the lateral spinothalamic tract ascends through

the spinal cord, new fibers are added to the
anteromedial aspect of the tract.
o Thus, in the upper cervical segments of
the cord, the sacral fibers are lateral  The axons of the third-order neurons in the
and the cervical segments are medial. ventral posterolateral nucleus of the thalamus
o The fibers carrying pain are situated now pass through the posterior limb of the
slightly anterior to those conducting internal capsule and the corona radiata to
temperature. reach the somesthetic area in the postcentral
 As the lateral spinothalamic tract ascends gyrus of the cerebral cortex
through the medulla oblongata, it lies near the
lateral surface and between the inferior olivary Pain Reception
nucleus and the nucleus of the spinal tract of
 The perception of pain is a complex
the trigeminal nerve.
phenomenon that is influenced by the
o It is now accompanied by the anterior
emotional state and past experiences of the
spinothalamic tract and the spinotectal
individual.
tract; together they form the spinal
 Pain can be divided into two main types: fast
lemniscus
pain and slow pain.
 The spinal lemniscus continues to ascend
o Fast pain is experienced within about
through the posterior part of the pons
0.1 second after the pain stimulus is
o In the midbrain, it lies in the
applied
tegmentum lateral to the medial
o Slow pain is felt 1.0 second or later
lemniscus
after the stimulation.
o Many of the fibers of the lateral
 Fast pain is described by the patient as sharp
spinothalamic tract end by synapsing
pain, acute pain, or pricking pain and is the type
with the third-order neuron in the
of pain felt after pricking the finger with a
ventral posterolateral nucleus of the
needle
thalamus
  Slow pain is described as burning pain, aching o Whereas glutamate is a fast-acting
pain, and throbbing pain and is produced when localized neurotransmitter, substance P
there is tissue destruction, as for example, in has a slow release and diffuses widely
the development of an abscess or in severe in the posterior horn and can influence
arthritis. many neurons.
o Slow pain can occur in any tissue of the  The initial sharp, pricking, fast-acting pain fibers
body. stimulate the second-order neurons of the
 All types of pain reception take place in free lateral spinothalamic tract
nerve endings o The axons immediately cross to the
 Fast pain is experienced by mechanical or opposite side of the spinal cord and
thermal types of stimuli, and slow pain may be ascend to the thalamus where they are
elicited by mechanical, thermal, and chemical relayed to the sensory post central
stimuli. gyrus.
 Many chemical substances have been found in  The burning, aching, slow-acting pain fibers
extracts from damaged tissue that will excite also stimulate the second order neurons of the
free nerve endings. These include: lateral spinal thalamic tract in the posterior gray
o Serotonin horn and ascend with the axons of the fast-
o Histamine acting pain fibers.
o Bradykinin  It is now believed, however, that most of the
o acids, such as lactic acid incoming slow fibers to the spinal cord take part
o K ions. in additional relays involving several neurons in
 The threshold for pain endings can be lowered the posterior horn before ascending in the
by prostaglandins and substance P, but they spinal cord
cannot stimulate the endings directly by o The repeated arrival of noxious stimuli
themselves. through the C fibers in the posterior
 pain receptors have little or no adaptation. gray horn during severe injury results in
an increased response of the second-
order neurons.
Conduction of Pain to the Central Nervous System o This winding up phenomenon is
attributed to the release of the
 Fast pain travels in peripheral nerves in large neurotransmitter glutamate from the C
diameter A delta axons at velocities of between fibers.
6 and 30 msec.  The fast type of pain is precisely localized.
 Slow pain travels in the small diameter C fibers  The slow type of pain is only poorly localized
at velocities between 0.5 and 2.0 msec. o Ratio
 The fast pain impulses reach consciousness first  fast pain fibers directly ascend
to alert the individual to danger so that a the spinal cord in the lateral
suitable protective response may take place spinothalamic tract
Conduction of Pain in the Central Nervous System  slow pain fibers take part in
multiple relays in the posterior
 The afferent pain fibers enter the spinal cord, gray horn before ascending to
for example, in the posterior roots of a spinal higher centers.
nerve and terminate predominantly in the
superficial layers of the posterior gray horn.
o The main excitatory neurotransmitter
released by the A delta fibers and the C
fibers is the amino acid glutamate.
 Substance P, a neuropeptide, is
also released from the C fibers.
Other Terminations of the Lateral Spinothalamic Tract The Analgesia System

 It is now generally agreed that the fast pain  Stimulation of certain areas of the brainstem
impulses travel directly up to the ventral can reduce or block sensations of pain
posterolateral nucleus of the thalamus and are  These areas include:
then relayed to the cerebral cortex. o periventricular area of the
 The majority of the slow pain fibers in the diencephalon
lateral spinothalamic tract terminate in the o the periaqueductal gray matter of the
reticular formation, which then activates the midbrain
entire nervous system o midline nuclei of the brainstem.
o Slow pain = reticular formation  It is believed that fibers of the reticulospinal
o Fast pain = Directly ascends tract pass down to the spinal cord and synapse
 It is in the lower areas of the brain that the on cells concerned with pain sensation in the
individual becomes aware of the chronic, posterior gray column
nauseous, suffering type of pain.  The analgesic system can suppress both sharp
 Parts of the brain responsible for reception and pricking pain and burning pain sensations.
interpretation of the nociceptor information  Recently, two compounds with morphine like
o postcentral gyrus actions, called the enkephalins and the
 responsible for the endorphins, have been isolated in the central
interpretation of pain in nervous system.
relation to past experiences o These compounds and serotonin serve
o cingulate gyrus of the limbic system as neurotransmitter substances in the
 Involved with the interpretation analgesic system of the brain, and they
of the emotional aspect of pain may inhibit the release of substance P
o insular gyrus in the posterior gray column.
 interpretation of pain stimuli
from the internal organs of the
Light (Crude) Touch and Pressure Pathways
body and brings about an
autonomic response Anterior Spinothalamic Tract
 The reception of pain information by the central
nervous system can be modulated first in the  The axons enter the spinal cord from the
posterior gray horns of the spinal cord and at posterior root ganglion and proceed to the tip
other sites at higher levels. of the posterior gray column, where they divide
into ascending and descending branches
Pain Control in the Central Nervous System

The Gating Theory

 It was suggested that at the site where the pain

fiber enters the central nervous system,
inhibition could occur by means of connector
neurons excited by large, myelinated afferent
fibers carrying information of nonpainful touch
and pressure.
 The excess tactile stimulation produced by
massage, for example, “closed the gate” for
pain.
 Once the nonpainful tactile stimulation ceased,
however, “the gate was opened,” and
information on the painful stimuli ascended the
lateral spinothalamic tract
  These branches travel for a distance of one or o Here, the fibers divide into long
two segments of the spinal cord, contributing to ascending and short descending
the posterolateral tract of Lissauer. branches.
o It is believed that these fibers of the  The descending branches pass down a variable
first-order neuron terminate by number of segments, giving off collateral
synapsing with cells in the substantia branches that synapse with cells in the posterior
gelatinosa group in the posterior gray gray horn, with internuncial neurons, and with
column anterior horn cells
 The axons of the second-order neuron now o It is clear that these short descending
cross very obliquely to the opposite side in the fibers are involved with intersegmental
anterior gray and white commissures within reflexes
several spinal segments  The long ascending fibers may also end by
 As the anterior spinothalamic tract ascends synapsing with cells in the posterior gray horn,
through the spinal cord, new fibers are added with internuncial neurons, and with anterior
to the medial aspect of the tract. horn cells.
o Thus, in the upper cervical segments of  Many of the long ascending fibers travel
the cord, the sacral fibers are mostly upward in the posterior white column as the
lateral and the cervical segments are fasciculus gracilis and fasciculus cuneatus
mostly medial  The fasciculus gracilis is present throughout the
 As the anterior spinothalamic tract ascends length of the spinal cord and contains the long
through the medulla oblongata, it accompanies ascending fibers from the sacral, lumbar, and
the lateral spinothalamic tract and the lower six thoracic spinal nerves.
spinotectal tract, all of which form the spinal  The fasciculus cuneatus is situated laterally in
lemniscus the upper thoracic and cervical segments of the
 The spinal lemniscus continues to ascend spinal cord and is separated from the fasciculus
through the posterior part of the pons, and the gracilis by a septum
tegmentum of the midbrain and the fibers of
the anterior spinothalamic tract terminate by
synapsing with the third-order neuron in the
ventral posterolateral nucleus of the thalamus
o Crude awareness of touch and pressure
is believed to be appreciated here.
 The axons of the third-order neurons in the
ventral posterolateral nucleus of the thalamus
pass through the posterior limb of the internal
capsule and the corona radiata to reach the
somesthetic area in the postcentral gyrus of the
cerebral cortex.

Discriminative Touch, Vibratory Sense, and Conscious

Muscle Joint Sense

Posterior White Column: Fasciculus Gracilis and

Fasciculus Cuneatus

 The axons enter the spinal cord from the

posterior root ganglion and pass directly to the
posterior white column of the same side
 The fasciculus cuneatus contains the long o The function of these fibers is to convey
ascending fibers from the upper six thoracic information of muscle joint sense to
and all the cervical spinal nerves the cerebellum.
o Cuneatus – 6 thoracic/all cervical spinal
Muscle Joint Sense Pathways to the Cerebellum
nerves
 The fibers of the fasciculus gracilis and Posterior Spinocerebellar Tract
fasciculus cuneatus ascend ipsilaterally and
 The axons entering the spinal cord from the
terminate by synapsing on the second-order
posterior root ganglion enter the posterior gray
neurons in the nuclei gracilis and cuneatus of
column and terminate by synapsing on the
the medulla oblongata
o The axons of the second-order neurons, second-order neurons at the base of the
called the internal arcuate fibers sweep posterior gray column
o These neurons are known collectively as
anteromedially around the central gray
the nucleus dorsalis (Clarke’s column).
matter and cross the median plane,
decussating with the corresponding  The axons of the second-order neurons enter
fibers of the opposite side in the the posterolateral part of the lateral white
sensory decussation column on the same side and ascend as the
o The fibers then ascend as a single posterior spinocerebellar tract to the medulla
compact bundle, the medial lemniscus, oblongata.
through the medulla oblongata, the  Here, the tract joins the inferior cerebellar
pons, and the midbrain peduncle and terminates in the cerebellar
o The fibers terminate by synapsing on cortex
the third-order neurons in the ventral o Note that it does not ascend to the
posterolateral nucleus of the thalamus cerebral cortex
 The axons of the third-order neuron leave and  Because the nucleus dorsalis (Clarke’s column)
pass through the posterior limb of the internal extends only from the eighth cervical segment
capsule and corona radiata to reach the caudally to the third or fourth lumbar segment,
somesthetic area in the postcentral gyrus of the axons entering the spinal cord from the
cerebral cortex posterior roots of the lower lumbar and sacral
 In this manner, the impressions of touch with segments ascend in the posterior white column
fine gradations of intensity, exact localization, until they reach the third or fourth lumbar
and two-point discrimination can be segment, where they enter the nucleus
appreciated dorsalis.
o Vibratory sense and the position of the
different parts of the body can be
consciously recognized
 Many fibers in the fasciculus cuneatus from the
cervical and upper thoracic segments, having
terminated on the second-order neuron of the
nucleus cuneatus, are relayed and travel as the
axons of the second-order neurons to enter the
cerebellum through the inferior cerebellar
peduncle of the same side
o The pathway is referred to as the
cuneocerebellar tract, and the fibers
are known as the posterior external
arcuate fibers.
 o It is also believed that the cerebellum
receives information from the skin and
superficial fascia by this tract.

Cuneocerebellar Tract

 originate in the nucleus cuneatus and enter the

cerebellum through the inferior cerebellar
peduncle of the same side
 The fibers are known as the posterior external
 The posterior spinocerebellar fibers receive arcuate fibers, and their function is to convey
muscle joint information from the muscle information of muscle joint sense to the
spindles, tendon organs, and joint receptors of cerebellum
the trunk and lower limbs
o This information concerning tension of Other Ascending Pathways
muscle tendons and the movements of
muscles and joints is used by the Spinotectal Tract
cerebellum in the coordination of limb
 The axons enter the spinal cord from the
movements and the maintenance of
posterior root ganglion and travel to the gray
posture
matter where they synapse on unknown
Anterior Spinocerebellar Tract second-order neurons
 The axons of the second-order neurons cross
 The axons entering the spinal cord from the
the median plane and ascend as the spinotectal
posterior root ganglion terminate by synapsing
tract in the anterolateral white column lying
with the second-order neurons in the nucleus
close to the lateral spinothalamic tract
dorsalis at the base of the posterior gray
 After passing through the medulla oblongata
column
and pons, they terminate by synapsing with
o The majority of the axons of the
neurons in the superior colliculus of the
second-order neurons cross to the
midbrain
opposite side and ascend as the
 This pathway provides afferent information for
anterior spinocerebellar tract in the
spinovisual reflexes and brings about
contralateral white column
movements of the eyes and head toward the
o the minority of the axons ascend as the
source of the stimulation
anterior spinocerebellar tract in the
lateral white column of the same side Spinoreticular Tract
 The fibers, having ascended through the
 The axons enter the spinal cord from the
medulla oblongata and pons, enter the
posterior root ganglion and terminate on
cerebellum through the superior cerebellar
unknown second-order neurons in the gray
peduncle and terminate in the cerebellar
matter
cortex.
o It is believed that those fibers that  The axons from these second order neurons
crossed over to the opposite side in the ascend the spinal cord as the spinoreticular
spinal cord cross back within the tract in the lateral white column mixed with the
cerebellum lateral spinothalamic tract.
 The anterior spinocerebellar tract conveys  Most of the fibers are uncrossed and terminate
muscle joint information from the muscle by synapsing with neurons of the reticular
spindles, tendon organs, and joint receptors of formation in the medulla oblongata, pons, and
the trunk and the upper and lower limbs midbrain
 The spinoreticular tract provides an afferent
pathway for the reticular formation, which
 plays an important role in influencing levels of  The peripheral processes of these cells receive
consciousness. nerve impulses from pain and stretch receptor
endings in the viscera.
 The central processes, having entered the spinal
cord, synapse with second-order neurons in the
gray matter, probably in the posterior or lateral
gray columns.
 The final destination of the axons of the third-
order neurons is probably in the postcentral
gyrus of the cerebral cortex.

 Many of the visceral afferent fibers that enter

the spinal cord branch participate in reflex
activity

THE DESCENDING TRACTS OF THE SPINAL CORD

 The motor neurons situated in the anterior gray

columns of the spinal cord send axons to
Spino-olivary Tract innervate skeletal muscle through the anterior
 The axons enter the spinal cord from the roots of the spinal nerves
posterior root ganglion and terminate on o These motor neurons are sometimes
unknown second-order neurons in the posterior referred to as the lower motor neurons
and constitute the final common
gray column
pathway to the muscles
 The axons from the second-order neurons cross
the midline and ascend as the spino-olivary
tract in the white matter at the junction of the
anterior and lateral columns.
 The axons end by synapsing on third-order
neurons in the inferior olivary nuclei in the
medulla oblongata
 The axons of the third-order neurons cross the
midline and enter the cerebellum through the
inferior cerebellar peduncle.
 The spino-olivary tract conveys information to
the cerebellum from 
o cutaneous and proprioceptive organs

Visceral Sensory Tracts

 Sensations that arise in viscera located in the

thorax and abdomen enter the spinal cord
through the posterior roots.
 The cell bodies of the first-order neuron are
situated in the posterior root ganglia
 ANATOMICAL ORGANIZATION o Those fibers that are associated with
the sympathetic neurons in the lateral
 The first neuron, the first-order neuron, has its
gray column are concerned with the
cell body in the cerebral cortex.
pupillodilation reflex in response to
 Its axon descends to synapse on the second- darkness.
order neuron, an internuncial neuron, situated
 The rubrospinal tract (Fig. 4-20) acts on both
in the:
the alpha and gamma motor neurons in the
o anterior gray column of the spinal cord
anterior gray columns and facilitates the activity
 The axon of the second-order neuron is short of flexor muscles
and synapses with the third-order neuron, the o inhibits the activity of extensor or
lower motor neuron, in the anterior gray antigravity muscles
column
 The vestibulospinal tract (Fig. 4-20), by acting
 The axon of the third-order neuron innervates on the motor neurons in the anterior gray
the skeletal muscle through the anterior root columns, facilitates the activity of the extensor
and spinal nerve. muscles 
 In some instances, the axon of the first-order o inhibits the activity of the flexor
neuron terminates directly on the third-order muscles, and is concerned with the
neuron (as in reflex arcs) postural activity associated with
balance.
 The olivospinal tract (Fig. 4-20) may play a role
FUNCTIONS OF THE DESCENDING TRACTS in muscular activity, but there is doubt that it
 The corticospinal tracts are the pathways exists
concerned with voluntary, discrete, skilled  The descending autonomic fibers are
movements, especially those of the distal parts concerned with the control of visceral activity
of the limbs. CORTICOSPINAL TRACTS

 Fibers of the corticospinal tract arise as axons of

pyramidal cells situated in the fifth layer of the
cerebral cortex
o About one-third of the fibers originate
from the primary motor cortex (area 4),
one-third originate from the secondary
motor cortex (area 6), and one-third
originate from the parietal lobe (areas
3, 1, and 2)
 thus, two-thirds of the fibers arise from the
precentral gyrus, and one-third of the fibers
arise from the postcentral gyrus.
 The descending fibers converge in the corona
radiata and then pass through the posterior
 The reticulospinal tracts may facilitate or inhibit
limb of the internal capsule
the activity of the alpha and gamma motor
o Here, the fibers are organized so that
neurons in the anterior gray columns and may,
those closest to the genu are
therefore 
concerned with 
o facilitate or inhibit voluntary movement
 cervical portions of the body
or reflex activity
o those situated more posteriorly are
 The tectospinal tract (Fig. 4-20) is concerned
concerned with the 
with reflex postural movements in response to
 lower extremity
visual stimuli.
 The tract then continues through the middle spinal cord segments in the cervical and upper
three-fifths of the basis pedunculi of the thoracic regions.
midbrain  The lateral corticospinal tract descends the
o Here, the fibers concerned with cervical length of the spinal cord; its fibers terminate in
portions of the body are situated the anterior gray column of all the spinal cord
medially, while those concerned with segments
the leg are placed laterally  Most corticospinal fibers synapse with
internuncial neurons, which, in turn, synapse
with alpha motor neurons and some gamma
motor neurons
o Only the largest corticospinal fibers
synapse directly with the motor
neurons.
 The corticospinal tracts are not the sole
pathway for serving voluntary movement.
Rather, they form the pathway that confers
speed and agility to voluntary movements and
is thus used in performing rapid skilled
movements
o Many of the simple, basic voluntary
movements are mediated by other
descending tracts.

Branches

 Branches are given off early in their descent and

return to the cerebral cortex to inhibit activity
in adjacent regions of the cortex.
 Branches pass to the caudate and lentiform
nuclei, the red nuclei, and the olivary nuclei
and the reticular formation.
o These branches keep the subcortical
 On entering the pons, the tract is broken into regions informed about the cortical
many bundles by the transverse motor activity
pontocerebellar fibers o Once alerted, the subcortical regions
 In the medulla oblongata, the bundles become may react and send their own nervous
grouped together along the anterior border to impulses to the alpha and gamma
form a swelling known as the pyramid (hence motor neurons by other descending
the alternative name, pyramidal tract) pathways.
 At the junction of the medulla oblongata and
the spinal cord, most of the fibers cross the
midline at the decussation of the pyramids and
enter the lateral white column of the spinal
cord to form the lateral corticospinal tract
o The remaining fibers do not cross in the
decussation but descend in the anterior
white column of the spinal cord as the
anterior corticospinal tract
 These fibers eventually cross the midline and
terminate in the anterior gray column of the
 o The reticulospinal tracts thus provide a
pathway by which the hypothalamus
can control the sympathetic outflow
and the sacral parasympathetic
outflow.

RETICULOSPINAL TRACTS TECTOSPINAL TRACT

 Throughout the midbrain, pons, and medulla  Fibers of this tract arise from nerve cells in the
oblongata, groups of scattered nerve cells and superior colliculus of the midbrain
nerve fibers exist that are collectively known as o Most of the fibers cross the midline
the reticular formation. soon after their origin and descend
through the brainstem close to the
 From the pons, these neurons send axons,
medial longitudinal fasciculus.
which are mostly uncrossed
o The tectospinal tract descends through
o down into the spinal cord and form the
pontine reticulospinal tract the anterior white column of the spinal
cord close to the anterior median
 From the medulla similar neurons send axons,
fissure
which are crossed and uncrossed, to the spinal
o The majority of the fibers terminate in
cord and form the medullary reticulospinal
the anterior gray column in the upper
tract.
cervical segments of the spinal cord by
 The reticulospinal fibers from the pons descend
synapsing with internuncial neurons
through the anterior white column, while those
 These fibers are believed to be concerned with
from the medulla oblongata descend in the
reflex postural movements in response to visual
lateral white column
stimuli
 Both sets of fibers enter the anterior gray
columns of the spinal cord and may facilitate or RUBROSPINAL TRACT
inhibit the activity of the alpha and gamma
motor neurons  The red nucleus is situated in the tegmentum of
 By these means, the reticulospinal tracts the midbrain at the level of the superior
influence voluntary movements and reflex colliculus
activity  The axons of neurons in this nucleus cross the
 The reticulospinal fibers are also now thought midline at the level of the nucleus and descend
to include the descending autonomic fibers as the rubrospinal tract through the pons and
medulla oblongata to enter the lateral white
column of the spinal cord
  The fibers terminate by synapsing with muscles and inhibit the activity of the flexor
internuncial neurons in the anterior gray muscles in association with the maintenance of
column of the cord balance
 The neurons of the red nucleus receive afferent
impulses through connections with the cerebral
cortex and the cerebellum.
o This is believed to be an important
indirect pathway by which the cerebral
cortex and the cerebellum can influence
the activity of the alpha and gamma
motor neurons of the spinal cord.
 The tract facilitates the activity of the flexor
muscles and inhibits the activity of the extensor
or antigravity muscles.

OLIVOSPINAL TRACT

 arise from the inferior olivary nucleus and to

descend in the lateral white column of the
spinal cord 
o to influence the activity of the motor
VESTIBULOSPINAL TRACT neurons in the anterior gray column.

 The vestibular nuclei are situated in the pons

and medulla oblongata beneath the floor of the
fourth ventricle
 The vestibular nuclei receive afferent fibers
from the inner ear through the vestibular nerve
and from the cerebellum
 The neurons of the lateral vestibular nucleus
give rise to the axons that form the
vestibulospinal tract.
 The tract descends uncrossed through the
medulla and through the length of the spinal
cord in the anterior white column
 The fibers terminate by synapsing with
internuncial neurons of the anterior gray
column of the spinal cord.
 The inner ear and the cerebellum, by means of
this tract, facilitate the activity of the extensor
 DESCENDING AUTONOMIC FIBERS

 The higher centers of the central nervous

system associated with the control of
autonomic activity are situated in the cerebral
cortex, hypothalamus, amygdaloid complex,
and reticular formation.
 Although distinct tracts have not been
recognized, investigation of spinal cord lesions
has demonstrated that descending autonomic
tracts do exist and probably form part of the
reticulospinal tract.
 The fibers arise from neurons in the higher
centers and cross the midline in the brainstem
 They are believed to descend in the lateral
white column of the spinal cord and to
terminate by synapsing on the autonomic
motor cells in the lateral gray columns in the
thoracic and upper lumbar (sympathetic
outflow)
o midsacral (parasympathetic) levels of
the spinal cord.

INTERSEGMENTAL TRACTS

 Short ascending and descending tracts that

originate and end within the spinal cord exist in
the anterior, lateral, and posterior white
columns
 The function of these pathways is to
interconnect the neurons of different
segmental levels, and the pathways are
particularly important in intersegmental spinal
reflexes.