系统解剖英文版神经系统脊髓

系统解剖英文版神经系统脊髓第1页/共62页★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Visceralnerves第2页/共62页MajorDivisionsofthe

CentralNervousSystemBrain脑Telencephalon端脑Diencephalon

间脑Cerebellum小脑Midbrain中脑Pons脑桥Medullaoblongata延髓Spinalcord脊髓Brainstem脑干第3页/共62页MajorDivisionsofthe

PeripheralNervousSystem

脑神经Cranialnerves

(12pairs)脊神经Spinalnerves

(31pairs)内脏神经VisceralnervesVisceralsensorynerveVisceralmotornerveSympatheticpart交感神经

Parasympatheticpart副交感神经第4页/共62页CellularOrganizationNeuron神经元Cellbody胞体Axon轴突Dendrites树突

Neuroglia神经胶质－glialcell胶质细胞第5页/共62页ClassificationofNeuronStructuralclassification双极神经元Bipolarneuronhasanaxonandadendrite假单极神经元

Pseudounipolarneuronhasacentralbranchandaperipheralbranch多极神经元Multipolarneuronhasanaxonandtwoormoredendrites第6页/共62页ClassificationofNeuronsFunctionalclassification感觉神经元

Sensory(afferent)neuron运动神经元

Motor(efferent)neuron联络神经元

Associationneuron

第7页/共62页Reflex反射:areactionoftheorganismbythenervoussysteminresponsetoastimulusReflexarc反射弧:has5basiccomponents

Receptor

↓Sensoryneurons

↓CNS

↓Motorneurons↓Effector

★ReflexandReflexArc第8页/共62页深反射（腱反射）-膝跳反射第9页/共62页★BasicTerminologyinNervousSystemIntheCNSGraymatter

灰质:

collectionofnervecellbodiesandtheirdendrites,graycolorduringfreshconditionCortex皮质:

theoutermostlayerofgraymatterincerebrumandcerebellumNucleus神经核:

acollection(group)ofcellbodieswhichhavethesameshapeandfunction第10页/共62页★BasicTerminologyinNervousSystemIntheCNSWhitematter

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

abundleofnervefiberswhichhavethesameorigin,termination,pathwayandfunction第11页/共62页★BasicTerminologyinNervousSystemReticularformation

网状结构:

anadmixtureofcross-crossingfiberswithlargerorsmallergroupsofnervecellsoccupyingthemeshes第12页/共62页★BasicTerminologyinNervousSystemInthePNSGanglion神经节:

acollectionofneuronalcellbodiesoutsidetheCNS.eg.Spinalganglion/gangliaNerve神经:

abundleofnervefibersheldtogetherbyconnectivetissuesheath.eg.Spinalnerve第13页/共62页SpinalCord脊髓

ZhaoxiDingDepartmentofHumanAnatomyMedicalSchool,ShandongUniversitydingzhaoxi@第14页/共62页★Position：Liesintheupper2/3ofthevertebralcanalContinuous

abovewithmedullaoblongata

atlevelofforamenmagnum

Ends

belowatthelowerborderofL1

inadultoratlevelofL3atbirthAbout40~45cminlengthWeightsabout30g.PositionofSpinalCord

第15页/共62页Alongcylindricalstructureandslightlyflattenedanteroposteriorly★TwoenlargementsCervicalenlargement颈膨大correspondstotheC4-T1segmentssendsfiberstosupplytheupperlimbsLumbosacralenlargement腰骶膨大correspondstotheL2-S3segmentssendsfiberstosupplythelowerlimbs

ExternalFeaturesofSpinalCord第16页/共62页★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.

第17页/共62页Lumbarpuncture(spinaltap)腰穿第18页/共62页★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

后中间沟第19页/共62页★SegmentsofSpinalCordAportionofthespinalcordthatgivesrisetoapairofspinalnerveconstitutesasegment.

Thereare31segments

8cervical12thoracic5lumbar5sacral1coccygealRelationshipofspinalCordSegments

toVertebralNumbers第20页/共62页★RelationshipofspinalCordSegments

toVertebralNumbersSpinalsegmentsVertebrallevels(spines)C1~C4LieoppositethecorrespondingvertebraeC5~T4OnelowerinnumberthancorrespondingvertebraeT5~T8TwolowerinnumberthancorrespondingvertebraeT9~T12ThreelowerinnumberthancorrespondingvertebraeL1-L5T10~T12S1-S5andCoL1第21页/共62页RelationshipofspinalCordSegments

toVertebralNumbersSpinalsegmentsVertebrallevels(spines)Uppercervicalregion(C1~C4)=C1~C4Lowercervicalandupperthoracicregion(C5~T4)－1=C4~T3Middlethoracicregion(T5~T8)－2=T3~T6Lowerthoracicregion(T9~T12)－3=T6~T9Lumbersegments=T10~T12Sacralandcoccygealsegments=L1第22页/共62页InternalStructureofSpinalCord

Graymatter

灰质Whitematter

白质Centralcanal

中央管Reticularformation网状结构

第23页/共62页★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

灰质后连合第24页/共62页★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)第25页/共62页★GrayMatterofSpinalCordIntermediatezoneIntermediaolateralnucleus中间外侧核

(lateralhorn)ExtentsfromsegmentsT1~L3,ContainingsympatheticpreganglionicneuronsSacralparasympatheticnucleus

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

ThroughoutthelengthofspinalcordAssociatedwithvisceraafferentinformation第26页/共62页Anteriorhorn(column):

★TwogroupsofnucleiMedialnucleargroup内侧核群:presentinmostsegmentsofspinalcord,innervatingaxialmusclesLateralnucleargroup外侧核群:presentonlyincervicalandlumbosacralenlargements,innervatingupperandlowerlimbmuscles第27页/共62页GrayMatterofSpinalCord

Anteriorhorn(column):Twokindsofmotorneurons

α-motorneuron:

largemultipolarneuron,innervatesskeletalmuscles,producingcontractionofmusclesγ-motorneuron:

smallermultipolarneuron,innervatesintrafusalmusclefibersofneuromuscularspindles,regulatingmusculartonusInterneuron—Renshaw’scell:negativefeedbackmechanism第28页/共62页Rexed’slamina板层PosteriorhornisformedbylaminaⅠtoⅥ；IntermediatezonecorrespondingtolaminaⅦ；AnteriorhorniscomposedlaminaeⅧandⅨ；laminaⅩisthegraymattersurroundingthecentralcanal.第29页/共62页第30页/共62页ImportantSubdivisionsofGrayMatterRegionLaminaNucleusPosteriorhornⅠMarginallayerⅡSubstantiagelatinosaⅢ,ⅣNucleuspropriusIntermediatezoneⅦNucleusthoracicus(C8~L3)ⅦIntermediolateralnucleus(T1~L3)ⅦSacralparasympatheticnucleus(S2~S4)ⅦIntermediomedialnucleusAnteriorhornⅨMotorneuron第31页/共62页WhiteMatterofSpinalCordWhitematter白质

containsthreekindsoffibers:AscendingfibersDescendingfibersFasciculusproprius固有束第32页/共62页WhiteMatterofSpinalCordAnteriorfuniculus前索Lateralfuniculus外侧索Posteriorfuniculus后索Anteriorwhitecommissure白质前连合第33页/共62页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薄束第34页/共62页★Fasciculusgracilis薄束LocatedinthewholeposteriorfuniculusbelowT4andonlyinthemedialpartaboveT4ArisefromthespinalgangliabelowsegmentT4(centralprocessofspinalganglia)TerminateinGracilenucleusinmedullaoblongataConveyproprioceptiveandfinetouchsensationfromlowerpartoftrunkandlowerlimbonthesamesideSpinalganglion

1°neuron

Gracilenuclei

2°neuron

T4FGFG第35页/共62页★FasciculusCuneatus楔束LocatedinthelateralpartofposteriorfuniculusaboveT4ArisefromthespinalgangliaabovesegmentT4(centralprocessofspinalganglia)TerminateincuneatenucleusinmedullaoblongataConveyconsciousproprioceptiveandfinetouchsensationfromupperpartoftrunkandupperlimbonthesamesideSpinalganglion

1°neuron

cuneatenuclei

2°neuron

T4FCFG第36页/共62页LowerlimbupperlimbFasciculusgracilisFasciculuscuneatusCortexofcerebrumdiencephalonMedialleminecusGracileandcuneateNu.第37页/共62页ClinicalnoteLossofproprioceptivesensationonthesamesideLossoffinetouchsensationonthesamesideSensorydystaxia(Incoordination)感觉性共济失调第38页/共62页★Spinothalamictract脊髓丘脑束LocatedintheLateralandanteriorfuniculusArisefromtheneuronsincontralaterallaminaeI,IV~VIIabout1-2segmentbelowTerminateinDorsalthalamusConveypain,temperatureandsimpletouchsensationoftrunkandlimbsSpinalganglia1°neuron

LaminaⅠ,Ⅳ~Ⅶ

2°neuron

VPL

3°neurons

ASTLST第39页/共62页Clinicalnote

Analgesiaandthermo-anesthesiaontheoppositesideofthebody(bellowthedamagedsegment)第40页/共62页Spinocerebellartracts脊髓小脑束LocatedinthesuperficialpartoflateralandanteriorfuniculiConveyunconsciousproprioceptionfromlowerlimbandlowerportionoftrunkonthesamesidetothecerebellumContain:Posteriorspinocerebellartract脊髓小脑后束Anteriorspinocerebellartract脊髓小脑前束第41页/共62页Posteriorspinocerebellartract脊髓小脑后束LocatedintheposteriorandsuperficialpartoflateralfuniculusaboveL3ArisefromthenucleusthoracicusonhomolateralsideTerminateinsuperiorandinferiorvermisofcerebellumConveyunconsciousproprioceptionfromlowerlimbandlowerportionoftrunkonthesamesideSpinalganglion1°neuron

NucleusThoracicus2°neuron第42页/共62页Anteriorspinocerebellartract脊髓小脑前束LocatedanteriortotheposteriorspinocerebellartractinthesuperficialpartoflateralfuniculusArisemainlyfromtheneuronsincontralaterallaminaⅤ～ⅦTerminateinsuperiorvermisofcerebellumConveyunconsciousproprioceptionfromlowerlimbandlowerportionoftrunkontheoppositesideSpinalganglion

1°neuronLaminaⅤ-Ⅶ2°neuron

第43页/共62页AscendingtractsTractSiteoforiginFuniculusTerminationFunctionFasciculusgracilisSpinalgangliabelowsegmentT5PosteriorGracilenucleusConsciousproprioceptive(vibratorysense,andmusclejointsense)andfinetouchsensationoftrunkandlimbsFasciculuscuneatusSpinalgangliaabovesegmentT4CuneatenucleusPosteriorspinocerebellartractHomolateralnucleusthoracicusLateralCerebellumUnconsciousproprioceptionfromlowerlimbandlowerportionoftrunkAnteriorspinocerebellartractContralateralLaminaeⅤ~ⅦSpinothalamic

tractLaminaeⅠ,Ⅳ~ⅦLateralandanteriorDorsalthalamusPain,temperatureandcrudetouchsensationoftrunkandlimbs第44页/共62页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、粗触觉第45页/共62页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顶盖脊髓束第46页/共62页★Corticospinaltracts皮质脊髓束ArisefromthepyramidalneuronsincerebralcortexLateralcorticospinaltract皮质脊髓侧束Anteriorcorticospinaltract皮质脊髓前束AnterolateraltractofBarne第47页/共62页★Lateralcorticospinaltract皮质脊髓侧束LocatedindeeppartoflateralfuniculusArisefromthepyramidalneuronsincontralateralcerebralcortexthroughthedecussationofpyramidtractFibresarrangement

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

disabilityofvoluntarymovement(paralysis)

第48页/共62页★anteriorcorticospinaltract皮质脊髓前束LocatedinmedialpartofanteriorfuniculusArisefromthepyramidalneuronsincontralateralcerebralcortexthroughthedecussationofpyramidtractTerminateinLaminaeⅣ~ⅨonbothanteriorhornConveymotorsignaltocontrolvoluntarymovement(musclesofthetrunk)第49页/共62页第50页/共62页DescendingtractsTractSiteoforiginFuniculusTerminationFunctionLateralcorticospinalCerebralcortexLateralLaminaeⅣ~ⅨanteriorhornVoluntarymovementAnteriorcorticospinalCerebralcortexAnteriorRubrospinalRednucleusLateralLaminaeⅤ~ⅦFacilitatesactivityofflexormusclesVestibulospinalHomolateralvestibularnucleiAnteriorLaminaeⅦ~ⅧFacilitatesactivityofextensormusclesReticulospinalReticularformationAnteriorandlateralLaminaeⅦ~ⅧVoluntarymovementMediallongitudinalfasciculusVestibularnucleiAnteriorLaminaeⅦ~ⅧCoordinateneckwitheyemovementTectospinalSuperiorcolliculusAnteriorLaminaeⅥ~ⅧFasciculuspropriusSpinalcordAnterior,lateralandposteriorSpinalcordIntrinsicreflexmechanismofspinalcord第51页/共62页

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、外侧索、后索脊髓脊髓节段内和节段间的联络

第52页/共62页MainfunctionsofspinalcordConductionof