Some aspects of spinal

cord and medulla

Tract, fasciculus and lemniscus
 Tract---collection of nerve fibers (in the
white matter) having the same origin,
course and termination.
 Fasciculi (bundles) and leminisci (ribbons)
are the other names of the tracts.
 Functionwise the tracts are sensory
(ascending, afferent (signals coming to
CNS) and motor (descending,efferent,
signals going away from CNS).
 Naming the tracts
 Named by the grey matter which they
connect.
 E.g. Corticospinal tract (from cerebral
cortex to spinal cord (descending tract),
spinothalamic tract (ascending tract).
 nuclei and ganglia
 Collections of cell bodies of neurons in
CNS are called the nuclei (not to be
confused with the nucleus of a cell!!).
 Collections of neurons in the peripheral
nervous system are called “ganglia”.
 PF

LF

AF

The term FUNICULUS or COLUMN is used for white matter in the cord

WHAT ARE THE COMMISSURES?

 Major ascending tracts, their
function and location in the cord

 Lateral spinothalamic tract—lateral white column--- pain

and temperature from opposite side of the body.
 Spinotectal tract--- lateral white column--- visual
responses ie; turning of head and eyes towards the
source of stimulation.
 Spinocerebellar (dorsal and ventral)– lateral white
column--- proprioception.
 Fasciculus gracilis(Gall) and F.cuneatus (Burdach)---
posterior white column—joint sense,vibration sense, two-
point discrimination. stereognosis,conscious kinesthesia.
Some important descending tracts
in the cord
 Lateral corticospinal tract (crossed
pyramidal tract)--- lateral white column—
skilled movements especially hands and
feet.
 Anterior corticospinal tract (uncrossed
pyramidal)--- anterior white column—same
as above
 Vestibulospinal --- anterior white column–
unconscious maintenance of balance.
 Sensory neurons
 Three order of neurons
 First order neuron– in the dorsal root
ganglion.
 Second order neuron– in the CNS.
 Third order neuron– in the thalamus.
 SYRINGOMYELIA
 Destruction of central canal and its
surrounding areas--- results in injury to
anterior white commissure which contains
crossing anterior spinothalamic tracts.
 This results in bilateral loss of pain and
temperature sensations below the lesion
but other sensations are preserved in the
uncrossed tracts of posterior column.
(dissociated sensory loss)
 Tabes dorsalis
 Tertiarysyphilitic degeneration of posterior
white columns which only sensory tracts.
 There is loss of tactile
discrimination,vibration and position
sense. (Rhomberg’s sign is positive).
Medulla oblongata
 Medulla oblongata
 Lower part of brainstem.
 Contains central canal in the lower part
and its upper part contains IV ventricle.
 Presents pyramids on either side of the
midline anteriorly (formed by corticospinal
tracts on their way to spinal cord) and
olive produced by underlying inferior
olivary nucleus.
 On the back of medulla
are gracile and cuneate
tubercles which contain
nuclei of the same
name(2nd order neurons)
for the fasciculi of the
same name.

Gross features
 structure
 The characteristic appearance of grey
matter in spinal cord is lost in medulla.
 The grey matter contains the nuclei of last
four cranial nerves and reticular formation.
 For the arrangement of grey and white
matters medulla is studied at 3 levels.
 Medulla at the level of pyramidal
decussation
 Important features are:
 1.Spinal nucleus and tract
of V in line with the
posterior horn of spinal
cord.
 2.Pyramidal
decussation(75%of fibers
cross the midline and
descend to the cord as
lat.corticospinal tracts.
 continued
 3.corresponding to
the anterior horn is
the spinal nucleus of
accessory.
 4.diffuse zone of
nerve cells and fibers
corresponding to the
lateral white column
called the reticular
formation. The reticular formation
SPECIAL FEATURES OF V nerve
 Has a large sensory nucleus (V1,V2 and
V3) and a smaller motor nucleus.
 Hence it extends throughout the brain
stem (mesencephalic nucleus, principal
nucleus and spinal tract and nucleus).
 Perhaps the only cranial nerve nucleus to
do so.
Medulla at the level of sensory decussation

 Fasciculi gracilis and

cuneatus end in
corresponding nuclei.
 Second order neurons
begin as internal arcuate
fibres,cross the midline
and form the medial
lemniscus.
 Olivary nucleus makes its
appearance.
 Pyramids on either side
of midline.
Sensory decussation
 continued
 Central grey matter
(close to the central
canal) contains
 1.hypoglossal nucleus
(close to the midline)
 2.dorsal nucleus of
vagus
(parasympathetic)
 3.nucleus of tractus
solitarius (taste)
 Purely motor cranial nerves
 3rd,4th,6th and 12th
cranial nerves lie in
the same line and
have their nuclei
close to the midline of
the brain stem.
 continued
 4.MLF appears just posterior to medial
lemniscus (this is connected to
3rd,4th,6th,8th and spinal nucleus of XI)
 Spinocerebellar and lateral spinothalamic
tracts move laterally to the lateral white
column.
 Lateral and anterior spinothalamic tracts
lie close to each other and form “spinal
lemniscus”.
 Upper medulla (open part)
 central canal opens
into IV ventricle.
 along with XII,
vestibular nuclei(2 of
the 4) appear here.
 nucleus ambiguus
(common motor
nucleus for 9th,10th
and 11th cranial
nerves) is present.
Medulla (clinical aspects)
Cranial nerves IX, X, XI and XII originate from
the medulla.

Functions of the medulla include:

1) control of somatic motor reflexes
of the larynx, pharynx and tongue
which are important in speech and
swallowing. (nucleus ambiguus)

2) control of visceral motor reflexes,

e.g., coughing, swallowing, salivating,
vomiting, secretion, sneezing;
the medulla also receives taste and other
visceral sensations.
 3) the MLF contains fibers for the
regulation of the position of the head and
neck and for coordinated eye movements;
 4) the medulla is a relay for the cochlear
and vestibular responses;
 5) the reticular formation regulates a
variety of functions including skeletal
motor activity, consciousness, visceral
functions, conduction of sensation, etc.
The features of medullary syndromes reflect
its anatomy and physiology, i.e., the
ascending sensory tracts, the descending
motor systems, cranial nerves IX - XI
exiting at this level, and the cranial nerves
that are associated at or near this level,
viz., CN VIII
 Lateral medullary syndrome
(PICA) of Wallenberg
 Dorsolateral aspect of
medulla is supplied by
PICA.
 In this area
spinothalamic tract,
spinal nucleus and
tract of V, nucleus
ambiguus, inferior
cerebellar peduncle,
vestibular nuclei are
situated.
Effects

Inferior cerebellar peduncle
Spinal tract of trigeminal
Spinothalamic tract
Nucleus ambiguus
Ipsilateral ataxia; also vertigo
from interruption of
connections of vestibular
nuclei
Loss of pain and
temperature sensation,
same side of face
Loss of pain and
temperature sensation,
opposite side of the body
Paralysis of vocal cord and
pharyngeal muscles on the
side of the lesion
 Medial medullary syndrome
(hypoglossal alternating hemiplegia)
 Due to thrombosis of
vertebral artery
branches supply
paramedian regions
of medulla.
 Structures present
here are: pyramid,
hypoglossal nerve,
medial lemniscus.

Effects
pyramid Contralateral hemiplegia

Hypoglossal Ipsilateral paralysis and

nucleus atrophy of half of tongue
(when protruded, the tip
deviates to the same side of
lesion)

Medial Contralateral loss of

lemniscus position and vibration sense