系统解剖-英文版-神经系统-脊髓Spinal-课件

NervousSystem

神经系统

★Organizations中枢神经系统Centralnervoussystem(CNS)脑Brain脊髓Spinalcord周围神经系统Peripheralnervoussystem(PNS)脑神经Cranialn.(12pairs)脊神经Spinaln.(31pairs)内脏神经VisceralnervesMajorDivisionsofthe

CentralNervousSystemBrain脑Telencephalon端脑Diencephalon间脑Cerebellum小脑Midbrain中脑Pons脑桥Medullaoblongata延髓Spinalcord脊髓Brainstem脑干MajorDivisionsofthe

PeripheralNervousSystem

脑神经Cranialnerves

(12pairs)脊神经Spinalnerves

(31pairs)内脏神经VisceralnervesVisceralsensorynerveVisceralmotornerveSympatheticpart交感神经Parasympatheticpart副交感神经CellularOrganizationNeuron神经元Cellbody胞体Axon轴突Dendrites树突

Neuroglia神经胶质－glialcell胶质细胞ClassificationofNeuronStructuralclassification双极神经元Bipolarneuronhasanaxonandadendrite假单极神经元Pseudounipolarneuronhasacentralbranchandaperipheralbranch多极神经元MultipolarneuronhasanaxonandtwoormoredendritesClassificationofNeuronsFunctionalclassification感觉神经元Sensory(afferent)neuron运动神经元Motor(efferent)neuron联络神经元Associationneuron

Reflex反射:areactionoftheorganismbythenervoussysteminresponsetoastimulusReflexarc反射弧:has5basiccomponents

Receptor

↓Sensoryneurons

↓CNS

↓Motorneurons↓Effector

★ReflexandReflexArc深反射（腱反射）-膝跳反射★BasicTerminologyinNervousSystemIntheCNSGraymatter灰质:

collectionofnervecellbodiesandtheirdendrites,graycolorduringfreshconditionCortex皮质:

theoutermostlayerofgraymatterincerebrumandcerebellumNucleus神经核:

acollection(group)ofcellbodieswhichhavethesameshapeandfunction★BasicTerminologyinNervousSystemIntheCNSWhitematter

白质:collectionofnervefibers,whitecolorduringfreshconditionMedulla髓质:acentralcoreofwhitematterbeneaththecortexofcerebrumandcerebellumFasciculus(tract)纤维束:

abundleofnervefiberswhichhavethesameorigin,termination,pathwayandfunction★BasicTerminologyinNervousSystemReticularformation

网状结构:

anadmixtureofcross-crossingfiberswithlargerorsmallergroupsofnervecellsoccupyingthemeshes★BasicTerminologyinNervousSystemInthePNSGanglion神经节:

acollectionofneuronalcellbodiesoutsidetheCNS.eg.Spinalganglion/gangliaNerve神经:

abundleofnervefibersheldtogetherbyconnectivetissuesheath.eg.SpinalnerveSpinalCord脊髓

ZhaoxiDingDepartmentofHumanAnatomyMedicalSchool,ShandongUniversitydingzhaoxi@★Position：Liesintheupper2/3ofthevertebralcanalContinuous

abovewithmedullaoblongata

atlevelofforamenmagnum

Ends

belowatthelowerborderofL1

inadultoratlevelofL3atbirthAbout40~45cminlengthWeightsabout30g.PositionofSpinalCord

Alongcylindricalstructureandslightlyflattenedanteroposteriorly★TwoenlargementsCervicalenlargement颈膨大correspondstotheC4-T1segmentssendsfiberstosupplytheupperlimbsLumbosacralenlargement腰骶膨大correspondstotheL2-S3segmentssendsfiberstosupplythelowerlimbs

ExternalFeaturesofSpinalCord★脊髓圆锥Conusmedullaris-the

lowerpyramidendofspinalcord★终丝Filumterminale-adelicatefilament,about20cminlength,prolongeddownwardfromtheapexoftheconusmedullaristothebackofthefirstsegmentofthecoccyx,continuousabovewiththatofthe

piamater.

★马尾Caudaequina-collectionofrootsandrootletsofspinaln.(fromL2-5,S1-5,Co1)

aroundthefilum

terminale

belowtheconusmedullaris.Thesefibersgraduallydeclininginnumberfurtherdownasindividualpairsleavethespinalcolumn.

Lumbarpuncture(spinaltap)腰穿★ExternalFeaturesofSpinalCordFissureandsulciAnteriormedianfissure

前正中裂Posteriormediansulcus

后正中沟Anterolateralsulcus

前外侧沟anterior(motor)rootsemergeserially

Posterolateralsulcus

后外侧沟posterior(sensory)rootsenterspinalcord,eachbearaspinalganglionwhichconstitutesthefirstcell-stationofthesensorynervesPosteriorintermediatesulcus

后中间沟★SegmentsofSpinalCordAportionofthespinalcordthatgivesrisetoapairofspinalnerveconstitutesasegment.

Thereare31segments

8cervical12thoracic5lumbar5sacral1coccygealRelationshipofspinalCordSegments

toVertebralNumbers★RelationshipofspinalCordSegments

toVertebralNumbersSpinalsegmentsVertebrallevels(spines)C1~C4LieoppositethecorrespondingvertebraeC5~T4OnelowerinnumberthancorrespondingvertebraeT5~T8TwolowerinnumberthancorrespondingvertebraeT9~T12ThreelowerinnumberthancorrespondingvertebraeL1-L5T10~T12S1-S5andCoL1RelationshipofspinalCordSegments

toVertebralNumbersSpinalsegmentsVertebrallevels(spines)Uppercervicalregion(C1~C4)=C1~C4Lowercervicalandupperthoracicregion(C5~T4)－1=C4~T3Middlethoracicregion(T5~T8)－2=T3~T6Lowerthoracicregion(T9~T12)－3=T6~T9Lumbersegments=T10~T12Sacralandcoccygealsegments=L1InternalStructureofSpinalCord

Graymatter

灰质Whitematter

白质Centralcanal

中央管Reticularformation网状结构

★GrayMatterofSpinalCord

Anteriorhorn(column)

前角(柱)Posteriorhorn(column)后角(柱)Intermediatezone

中间带Lateralhorn(column)

侧角(柱)onlypresentinthethoracicandupperlumbersegmentsofthespinalcord(T1-L3)graycommissures灰质连合

Anteriorgraycommissures

灰质前连合Posteriorgraycommissures

灰质后连合★GrayMatterofSpinalCordPosteriorhorn(column):Marginallayer缘层(posteromarginalnucleus后角边缘核)Substantiagelatinosa胶状质SituatedattheapexofposteriorhornthroughoutthelengthofspinalcordConcernsthesensationsofpainandtemperatureNucleusproprius

后角固有核SituatedanteriortothesubstantiagelationnosathroughoutthelengthofspinalcordReceivesfibersthatareassociatedwiththesuperficialsensesNucleusthoracicus胸核

SituatedatthebaseofposteriorhornandextendingfromsegmentsC8~L3Associatedwiththedeepsenses(proprioceptiveendings)★GrayMatterofSpinalCordIntermediatezoneIntermediaolateralnucleus中间外侧核(lateralhorn)ExtentsfromsegmentsT1~L3,ContainingsympatheticpreganglionicneuronsSacralparasympatheticnucleus

骶副交感核ExtentsfromsegmentsS2~S4,ContainingparasympatheticpreganglionicneuronsIntermediomedialnucleus中间内侧核

ThroughoutthelengthofspinalcordAssociatedwithvisceraafferentinformationAnteriorhorn(column):

★TwogroupsofnucleiMedialnucleargroup内侧核群:presentinmostsegmentsofspinalcord,innervatingaxialmusclesLateralnucleargroup外侧核群:presentonlyincervicalandlumbosacralenlargements,innervatingupperandlowerlimbmusclesGrayMatterofSpinalCord

Anteriorhorn(column):Twokindsofmotorneurons

α-motorneuron:

largemultipolarneuron,innervatesskeletalmuscles,producingcontractionofmusclesγ-motorneuron:

smallermultipolarneuron,innervatesintrafusalmusclefibersofneuromuscularspindles,regulatingmusculartonusInterneuron—Renshaw’scell:negativefeedbackmechanismRexed’slamina板层PosteriorhornisformedbylaminaⅠtoⅥ；IntermediatezonecorrespondingtolaminaⅦ；AnteriorhorniscomposedlaminaeⅧandⅨ；laminaⅩisthegraymattersurroundingthecentralcanal.ImportantSubdivisionsofGrayMatterRegionLaminaNucleusPosteriorhornⅠMarginallayerⅡSubstantiagelatinosaⅢ,ⅣNucleuspropriusIntermediatezoneⅦNucleusthoracicus(C8~L3)ⅦIntermediolateralnucleus(T1~L3)ⅦSacralparasympatheticnucleus(S2~S4)ⅦIntermediomedialnucleusAnteriorhornⅨMotorneuronWhiteMatterofSpinalCordWhitematter白质

containsthreekindsoffibers:AscendingfibersDescendingfibersFasciculusproprius固有束WhiteMatterofSpinalCordAnteriorfuniculus前索Lateralfuniculus外侧索Posteriorfuniculus后索Anteriorwhitecommissure白质前连合AscendingTractsFasciculuscuneatus楔束Posteriorspinocerebellartr.脊髓小脑后束Anteriorspinocerebellartr.脊髓小脑前束Spinothalamic

tract脊髓丘脑束Fasciculusgracilis薄束★Fasciculusgracilis薄束LocatedinthewholeposteriorfuniculusbelowT4andonlyinthemedialpartaboveT4ArisefromthespinalgangliabelowsegmentT4(centralprocessofspinalganglia)TerminateinGracilenucleusinmedullaoblongataConveyproprioceptiveandfinetouchsensationfromlowerpartoftrunkandlowerlimbonthesamesideSpinalganglion

1°neuron

Gracilenuclei

2°neuron

T4FGFG★FasciculusCuneatus楔束LocatedinthelateralpartofposteriorfuniculusaboveT4ArisefromthespinalgangliaabovesegmentT4(centralprocessofspinalganglia)TerminateincuneatenucleusinmedullaoblongataConveyconsciousproprioceptiveandfinetouchsensationfromupperpartoftrunkandupperlimbonthesamesideSpinalganglion

1°neuron

cuneatenuclei

2°neuron

T4FCFGLowerlimbupperlimbFasciculusgracilisFasciculuscuneatusCortexofcerebrumdiencephalonMedialleminecusGracileandcuneateNu.ClinicalnoteLossofproprioceptivesensationonthesamesideLossoffinetouchsensationonthesamesideSensorydystaxia(Incoordination)感觉性共济失调★Spinothalamictract脊髓丘脑束LocatedintheLateralandanteriorfuniculusArisefromtheneuronsincontralaterallaminaeI,IV~VIIabout1-2segmentbelowTerminateinDorsalthalamusConveypain,temperatureandsimpletouchsensationoftrunkandlimbsSpinalganglia1°neuron

LaminaⅠ,Ⅳ~Ⅶ

2°neuron

VPL

3°neurons

ASTLSTClinicalnote

Analgesiaandthermo-anesthesiaontheoppositesideofthebody(bellowthedamagedsegment)Spinocerebellartracts脊髓小脑束LocatedinthesuperficialpartoflateralandanteriorfuniculiConveyunconsciousproprioceptionfromlowerlimbandlowerportionoftrunkonthesamesidetothecerebellumContain:Posteriorspinocerebellartract脊髓小脑后束Anteriorspinocerebellartract脊髓小脑前束Posteriorspinocerebellartract脊髓小脑后束LocatedintheposteriorandsuperficialpartoflateralfuniculusaboveL3ArisefromthenucleusthoracicusonhomolateralsideTerminateinsuperiorandinferiorvermisofcerebellumConveyunconsciousproprioceptionfromlowerlimbandlowerportionoftrunkonthesamesideSpinalganglion1°neuron

NucleusThoracicus2°neuronAnteriorspinocerebellartract脊髓小脑前束LocatedanteriortotheposteriorspinocerebellartractinthesuperficialpartoflateralfuniculusArisemainlyfromtheneuronsincontralaterallaminaⅤ～ⅦTerminateinsuperiorvermisofcerebellumConveyunconsciousproprioceptionfromlowerlimbandlowerportionoftrunkontheoppositesideSpinalganglion

1°neuronLaminaⅤ-Ⅶ2°neuron

AscendingtractsTractSiteoforiginFuniculusTerminationFunctionFasciculusgracilisSpinalgangliabelowsegmentT5PosteriorGracilenucleusConsciousproprioceptive(vibratorysense,andmusclejointsense)andfinetouchsensationoftrunkandlimbsFasciculuscuneatusSpinalgangliaabovesegmentT4CuneatenucleusPosteriorspinocerebellartractHomolateralnucleusthoracicusLateralCerebellumUnconsciousproprioceptionfromlowerlimbandlowerportionoftrunkAnteriorspinocerebellartractContralateralLaminaeⅤ~ⅦSpinothalamic

tractLaminaeⅠ,Ⅳ~ⅦLateralandanteriorDorsalthalamusPain,temperatureandcrudetouchsensationoftrunkandlimbs上行传导束名称起位置止功能薄束T5以下的脊神经节后索薄束核传导同侧躯干和肢体的本体感觉（肌、腱、关节的位置觉、运动觉和震动觉）和精细触觉楔束T4以上的脊神经节楔束核脊髓小脑后束同侧胸核外侧索小脑下肢和躯干下部的非意识性本体感觉脊髓小脑前束对侧板层Ⅴ~Ⅶ脊髓丘脑束板层Ⅰ,Ⅳ~Ⅶ外侧索和前索背侧丘脑痛、温觉、粗触觉DescendingTractsLateralcorticospinaltract皮质脊髓侧束Anteriorcorticospinaltract皮质脊髓前束Rubrospinaltract红核脊髓束Vestibulospinaltract前庭脊髓束Reticulospinaltract网状脊髓束Mediallongitudinalfasciculus内侧纵束Tectospinaltract顶盖脊髓束★Corticospinaltracts皮质脊髓束ArisefromthepyramidalneuronsincerebralcortexLateralcorticospinaltract皮质脊髓侧束Anteriorcorticospinaltract皮质脊髓前束AnterolateraltractofBarne★Lateralcorticospinaltract皮质脊髓侧束LocatedindeeppartoflateralfuniculusArisefromthepyramidalneuronsincontralateralcerebralcortexthroughthedecussationofpyramidtractFibresarrangement

superficialtoprofoundS,L,T,CTerminateinLaminaeⅣ~Ⅸofanteriorhorn,C(55%),T(20%),LS(25%)ConveymotorsignaltocontrolVoluntarymovement(musclesofthelimbs)Clinicalnotes

disabilityofvoluntarymovement(paralysis)

★anteriorcorticospinaltract皮质脊髓前束LocatedinmedialpartofanteriorfuniculusArisefromthepyramidalneuronsincontralateralcerebralcortexthroughthedecussationofpyramidtractTerminateinLaminaeⅣ~ⅨonbothanteriorhornConveymotorsignaltocontrolvoluntarymovement(musclesofthetrunk)DescendingtractsTractSiteoforiginFuniculusTerminationFunctionLateralcorticospinalCerebralcortexLateralLaminaeⅣ~ⅨanteriorhornVoluntarymovementAnteriorcorticospinalCerebralcortexAnteriorRubrospinalRednucleusLateralLaminaeⅤ~ⅦFacilitatesactivityofflexormusclesVestibulospinalHomolateralvestibularnucleiAnteriorLaminaeⅦ~ⅧFacilitatesactivityofextensormusclesReticulospinalReticularformationAnteriorandlateralLaminaeⅦ~ⅧVoluntarymovementMediallongitudinalfasciculusVestibularnucleiAnteriorLaminaeⅦ~ⅧCoordinateneckwitheyemovementTectospinalSuperiorcolliculusAnteriorLaminaeⅥ~ⅧFasciculuspropriusSpinalcordAnterior,lateralandposteriorSpinalcordIntrinsicreflexmechanismofspinalcord

下行传导束名称起位置止功能皮质脊髓侧束大脑皮质外侧索板层Ⅳ~Ⅸ前角随意运动皮质脊髓前束大脑皮质前索红核脊髓束红核外侧索板层Ⅴ~Ⅶ兴奋屈肌前庭脊髓束同侧前庭神经核前索板层Ⅶ~Ⅷ兴奋伸肌网状脊髓束网状结构前索和外侧索板层Ⅶ~Ⅷ协调随意运动内侧纵束前庭神经核前索板层Ⅶ~Ⅷ协调头颈部和眼的运动顶盖脊髓束中脑上丘前索板层Ⅵ~Ⅷ固有束脊髓前索