系统解剖学：脊髓脑干复习

1、May 28, 2021温州医学院1 Gross Anatomy May 28, 2021温州医学院2 Spinal Cord CNS tissue is enclosed within the vertebral column from the foramen magnum to L1 Provides two-way communication to and from the brain Protected by bone, meninges, and CSF May 28, 2021温州医学院3 Spinal nerves 31 pairs attach to the cord by p

2、aired roots Cervical and lumbar enlargements sites where nerves serving the upper and lower limbs emerge Conus medullaris terminal portion of the spinal cord Cauda equina collection of nerve roots at the inferior end of the vertebral canal Spinal Cord May 28, 2021温州医学院4 Spinal Cord Cervical and lumb

3、ar enlargements Conus medullaris Cauda equina May 28, 2021温州医学院5 Spinal Cord May 28, 2021温州医学院6 Spinal Cord May 28, 2021温州医学院7 Spinal Cord May 28, 2021温州医学院8 Spinal segments Vertebral levels (spines) Upper cervical region (C1C4) = C1 C4 Lower cervical and upper thoracic region (C5T4) 1 = C4 T3 Middl

4、e thoracic region (T5T8) 2 = T3 T6 Lower thoracic region (T9T12) 3 = T6 T9 Lumber segments = T10 T12 Sacral and coccygeal segments = L1 May 28, 2021温州医学院9 May 28, 2021温州医学院10 May 28, 2021温州医学院11 In medicine, a lumbar puncture (colloquially known as a spinal tap) is a diagnostic and at times therapeu

5、tic procedure that is performed in order to collect a sample of cerebrospinal fluid (CSF) for biochemical, microbiological, and cytological analysis, May 28, 2021温州医学院12 Internally, the spinal cord consists of the gray matter and white matter. The gray matter is centrally located and the white matte

6、r surrounds the gray matter. May 28, 2021温州医学院13 Gray Matter and Spinal Roots Figure 12.30b May 28, 2021温州医学院14 Columns of gray matter May 28, 2021温州医学院15 Internal Structure of Spinal Cord May 28, 2021温州医学院16 Gray Matter: Organization Dorsal half sensory roots and ganglia Ventral half motor roots Do

7、rsal and ventral roots fuse laterally to form spinal nerves Four zones are evident within the gray matter somatic sensory (SS), visceral sensory (VS), visceral motor (VM), and somatic motor (SM) May 28, 2021温州医学院17 Gray Matter: Organization somatic sensory (SS), visceral sensory (VS), visceral motor

8、 (VM), and somatic motor (SM). May 28, 2021温州医学院18 White Matter: Pathway Generalizations Figure 12.32 May 28, 2021温州医学院19 May 28, 2021温州医学院20 Specific Tracts (Medial lemniscus) May 28, 2021温州医学院21 Nonspecific Ascending Pathway Nonspecific pathway for pain, temperature, and crude touch within the lat

9、eral spinothalamic tract May 28, 2021温州医学院22 The Direct (Pyramidal) System May 28, 2021温州医学院23 Pyramidal neurons Corticospinal tracts Anterior horn May 28, 2021温州医学院24 Ascending tracts Fasciculus gracilis Fasciculus cuneatus Posterior spinocerebellar tract Anterior spinocerebellar tract Spinothalami

10、c tract May 28, 2021温州医学院25 Descending tracts Lateral corticospinal tract Anterior corticospinal tract May 28, 2021温州医学院26 May 28, 2021温州医学院27 May 28, 2021温州医学院28 The Brain Composed of wrinkled, pinkish gray tissue Surface anatomy includes cerebral hemispheres (telencephalon), diencephalon， cerebell

11、um, and brain stem May 28, 2021温州医学院29 Midbrain Located between the diencephalon and the pons Midbrain structures include: Cerebral peduncles two bulging structures that contain descending pyramidal motor tracts Cerebral aqueduct hollow tube that connects the third and fourth ventricles May 28, 2021

12、温州医学院30 Interpeduncular fossa Midbrain Cerebral peduncles Oculomotor nerve (III) May 28, 2021温州医学院31 Brain Stem May 28, 2021温州医学院32 Brain Stem Rhomboid fossa May 28, 2021温州医学院33 Nucleus of oculomotor n. Nucleus of trochlear n. Nucleus of abducent n. Nucleus of hypoglossal n. 1) Somatic motor nuclei

13、May 28, 2021温州医学院34 2) Special visceral motor nuclei Motor nucleus of trigeminal n.(m) Nucleus of facial n.(f) Nucleus ambiguus(p & l) Accessory nucleus(s & t) May 28, 2021温州医学院35 3) General visceral motor nuclei parasympathetic preganglia innervation the smooth muscle,glands and muscel of heart Acc

14、essory oculomotor nucleus Superior salivatory nucleus Inferior salivatory nucleus Dorsal nucleus of vagus n. May 28, 2021温州医学院36 4) General and special visceral sensory nuclei Nucleus of solitary tract The upper end of this nucleus is gustatory nucleus, the other is general visceral nucleus May 28,

15、2021温州医学院37 5) General somatic sensory nuclei Mesencephalic nucleus of trigeminal n, proprioception. Pontine nucleus of trigeminal n,touch. Spinal nucleus of trigeminal n, temperature and pain May 28, 2021温州医学院38 Cochlear nuclei: Vestibular nuclei: 6) Special somatic sensory nuclei May 28, 2021温州医学院

16、39 NucleusSiteCranial n. Function Cochlear nuclei Pons and medulla Sense of hearing Vestibular nuclei Pons and medulla Sense of equilibrium 5) General somatic sensory nuclei May 28, 2021温州医学院40 Ascending tracts(p320) Medial lemniscus Ganglion of spinal n Fasciculi of gracile and cuneatus Nuclei of g

17、racile and cuneatus Decussation of medial lemniscus Medial lemniscus Thalamus Cortex of sensroy center Cord Stem Cortex May 28, 2021温州医学院41 Spinal lemniscus Ascending tracts Cortex of sensroy center Thalamus Spinal lemniscus Spinothalmic tracts(ant. and lat.) Anterior white comssiure decussation Pos

18、terior horn Ganglion of spinal n May 28, 2021温州医学院42 Cortex of sensroy center Thalamus Trigeminal lemniscus Trigeminal n Ganglion of trigeminal n Decusstion trigeminal lemniscus Ascending (pontine nucleus) Descending(nucleus of spinal tract) Trigeminal lemniscus Ascending tracts May 28, 2021温州医学院43 Crus cerebrus 3/5 Basilar part Pyramid Decussation of pyramid 3/4 Ant. & lat.Corticospinal tract Corticospinal tract Or pyramidal tract Descending tracts May 28, 2021温州医学院