8/5/2011. TÁMOP –4.1.2-08/2/A/KMR-2009-0006 1 Development of Complex Curricula for Molecular Bionics and Infobionics Programs within a consortial* framework** Consortium leader PETER PAZMANY CATHOLIC UNIVERSITY Consortium members SEMMELWEIS UNIVERSITY, DIALOG CAMPUS PUBLISHER The Project has been realised with the support of the European Union and has been co-financed by the European Social Fund *** **Molekuláris bionika és Infobionika Szakok tananyagának komplex fejlesztése konzorciumi keretben ***A projekt az Európai Unió támogatásával, az Európai Szociális Alap társfinanszírozásával valósul meg. PETER PAZMANY CATHOLIC UNIVERSITY SEMMELWEIS UNIVERSITY sote_logo.jpg dk_fejlec.gif INFOBLOKK 8/5/2011. TÁMOP –4.1.2-08/2/A/KMR-2009-0006 2 Peter Pazmany Catholic University Faculty of Information Technology BASICS OF NEUROBIOLOGY SPINAL CORD www.itk.ppke.hu Neurobiológia alapjai (Gerincvelő) ZSOLT LIPOSITS Basics of Neurobiology: Spinal cord 8/5/2011. TÁMOP –4.1.2-08/2/A/KMR-2009-0006 3 www.itk.ppke.hu GROSS FEATURES THE SPINAL CORD IS A CYLINDRICAL STRUCTURE SLIGHTLY FLATTENED DORSO-VENTRALLY THE SPINAL CORD IS IN CONTINUITY WITH THE BRAIN AND DEVELOPMENTALLY IT DERIVES FROM THE CAUDAL PART OF THE NEURAL TUBE THE SPINAL CORD IS LOCATED IN THE VERTEBRAL CANAL AND IT IS SURROUNDED BY VERTEBRAE. THE VERTEBRAL COLUMN IS COMPOSED OF BONES, CARTILAGE AND MEMBRANOUS STRUCTURES AND GIVES HIGH-LEVEL PHYSICAL PROTECTION FOR THE SPINAL CORD WHICH HAS A SOFT AND VULNERABLE HISTOLOGICALTEXTURE THE SPINAL CORD IS ENCLOSED BY THE MENINGES, BOTH THE PACHYMENINX AND THE LEPTOMENINX TAKE PART IN ITS ENSHEATING THE CEREBROSPINAL FLUID CIRCULATING IN THE SUBARACHNOID SPACE ALSO SURROUNDS THE SPINAL CORD AND CONTRIBUTES TO ITS PROTECTION THE SPINAL CORD IS SHORTER THAN THE VERTEBRAL CANAL, THEREFORE, IN ADULTS THE CORD ENDS AT THE LEVEL OF UPPER LUMBAR VERTABRAE (L1-L2) FRACTURE OF THE VERTEBRAL COLUMN MIGHT SEVERELY DAMAGE THE CORD Basics of Neurobiology: Spinal cord 8/5/2011. TÁMOP –4.1.2-08/2/A/KMR-2009-0006 4 www.itk.ppke.hu MRI IMAGING OF THE SPINAL CORD SPINAL CORD MESENCEPHALON PONS MEDULLA VERTEBRAL COLUMN CEREBELLUM INTERVERTEBRAL DISC MEDIAN-SAGITTAL MRI IMAGE SHOWS THE BRAIN STEM (HIGHLIGHTED IN RED) AND THE SPINAL CORD (HIGH- LIGHTED IN GREEN). THE CONSTITUENTS OF THE BRAIN STEM ARE DISCERNABLE, THE 4THCEREBRAL VENTRICLE IS VISIBLE (ASTERISK) NOTE THE VERTEBRAL COLUMN CON- TAINING THE SPINAL CORD THE INDIVIDUAL VERTEBRAE ARE SEPA- RATED BY INTERVERTEBRAL DISCS Basics of Neurobiology: Spinal cord 8/5/2011. TÁMOP –4.1.2-08/2/A/KMR-2009-0006 5 www.itk.ppke.hu SPINAL MENINGES THE PACHIMENINX IS FORMED BY THE DURA MATER. IN CASE OF THE SPINAL CORD, THE DURAL SAC HAS TWO LAYERS THAT DEFINE THE EPIDURAL SPACE THE INJECTION OF LOCAL ANESTHETICS INTO THE EPIDURAL SPACE CAN PRODUCE A POWERFUL PARAVERTEBRAL BLOCKADE OF NEURAL TRANSMISSION AND CAUSE ANALGESIA THE ARACHNOID AND THE PIA MATER FORM THE INNER ENVELOPES. THEY ESTABLISH THE LIQUOR-FILLED SUBARACHNOID SPACE THE INNERMOST PIA MATER SMOOTHLY AND TIGHTLY COVERS THE ENTIRE SURFACE OF THE SPINAL CORD. ARISING FROM THIS MEMBRANE ONE CAN FIND SERRATED LIGAMENTS ON BOTH SIDES OF THE SPINAL CORD THAT ATTACH THE CORD TO THE DURA MATER. ACTUALLY, THE SPINAL CORD IS SUSPENDED AND FLOATS IN THE CSF CAUDAL TO TERMINATION OF THE SPINAL CORD, THE MENINGES SURROUND THE BUNDLES OF THE DORSAL AND VENTRAL ROOTS (CAUDA EQUINA) OF LUMBO-SACRAL SEGMENTS. THIS IS THE PREFERRED LOCUS OF LUMBAR PUNCTURE Basics of Neurobiology: Spinal cord 8/5/2011. TÁMOP –4.1.2-08/2/A/KMR-2009-0006 6 www.itk.ppke.hu SPINAL SEGMENTS DORSAL ROOT GANGLION SPINAL NERVE DORSAL ROOT VENTRAL ROOT WHITE MATTER GREY MATTER PIA MATER DURA MATER ARACHNOID SEGMENT 1 SEGMENT 2 Basics of Neurobiology: Spinal cord 8/5/2011. TÁMOP –4.1.2-08/2/A/KMR-2009-0006 7 www.itk.ppke.hu SPINAL SEGMENTS THE GREY MATTER IS LOCATED CENTRALLY WITHIN THE SPINAL CORD. IT IS BUTTERFLY-SHAPED AND COMPOSED OF NEURONS AND GLIAL CELLS THE WHITE MATTER HAS A PERIPHERAL LOCATION SURROUNDING THE GRAY MATTER. IT CONSISTS OF FIBER BUNDLES, SO-CALLED TRACTS AND GLIAL CELLS IN TERMS OF GROSS ANATOMY, THE GRAY AND WHITE MATTER CONSTITUENTS OF THE SPINAL CORD ARE NOT SEGMENTED, BOTH ESTABLISH COLUMNAR, CONTINUOUS ORGANIZATIONS THE INCOMING SENSORY FIBERS AND THE OUTGOING MOTOR AXONS DEFINEPARTICULAR REGIONS OF THE SPINAL CORD CALLED SEGMENTS. THESE ARE1-3 cm HIGH DIVISIONS OF THE CORD THERE ARE 31 SEGMENTS: 8 CERVICAL, 12 THORACIC, 5 LUMBAR, 5 SACRAL AND 1 COCCYGEAL THE DORSAL ROOT AND ITS GANGLION CONVEY SENSORY INFORMATION THE FIBERS OF THE VENTRAL ROOT EXECUTE MOTOR COMMANDS THE DORSAL AND VENTRAL ROOTS JOIN AND FORM THE SPINAL NERVE THATAFTER A SHORT JOURNEY SPLITS INTO VENTRAL AND DORSAL RAMI Basics of Neurobiology: Spinal cord 8/5/2011. TÁMOP –4.1.2-08/2/A/KMR-2009-0006 8 www.itk.ppke.hu SEGMENTAL INERVATION OF THE SKIN DERMATOMES OF THE UPPER LIMB THE SENSORY COMPONENTS OF A GIVEN PAIR OF SPINAL NERVES INNERVATE WELL-DEFINED AND SHAPED SEGMENTED REGIONS OF THE SKIN CALLED DERMATOMES IN GENERAL, THE INNERVATION OF THE SKIN FOL-LOWS THE SEGMENTAL MOTOR NERVE SUPPLY TO THE UNDERLYING MUSCLES THE DERMATOMES ALTHOUGH SEEM TO OVERLAP EXAMINATION OF THE DERMATOMES GIVES A VALU-ABLE INFORMATION FOR THE PHYSICIAN BY REFLECTING THE INTEGRITY AND ACTUAL OPERA-TION OF GIVEN SEGMENTS OF THE SPINAL CORD THE ILLUSTRATION ON THE LEFT SIDE DEPICTS THE DERMATOMES OF THE UPPER LIMB WITH NAMES OF THE CORRESPONDING NERVES AND SEGMENTS Basics of Neurobiology: Spinal cord 8/5/2011. TÁMOP –4.1.2-08/2/A/KMR-2009-0006 9 www.itk.ppke.hu INNERVATION OF MUSCLES. ELECTROMYOGRAM SKELETAL MUSCLES OF THE BODY DEVELOP PREDOMINANTLY FROM MYOTOMES THAT ARE DERIVATIVES OF THE MESODERM LAYER. MYOTOMES PROVIDE MYOGENIC CELLS THAT GENERATE THE MUSCLES THE MYOTOMES ARE SEGMENTED STRUCTURES. ACCORDINGLY, MUSCLES DEVELOPING FROM GIVEN SEGMENTS ARE INNERVATED BY SOMATIC MOTONEURONS DEVELOPING IN THE VENTRAL HORN OF THE SPINAL CORD OF THE SAME SEGMENTS. THESE NEUROMUSCULAR CONNECTIONS ARE ESTABLISHED EARLY. AS MUSCLES MIGRATE TO THEIR FINAL DESTINATION THEY PULL THE MOTONEURON AXONS WITH THEMSELVES THE FUNCTION OF THE MUSCLES AND THEIR INNERVATING NERVES CAN BEEXAMINED BY ELECTROMYOGRAPHY (EMG). EMG IS PERFORMED USING INSTRUMENT CALLED ELECTROMYOGRAPH, TO PRODUCE A RECORD CALLED AN ELECTROMYOGRAM. THE ELECTROMYOGRAPH DETECTS THE ELECTRICAL POTENTIAL GENERATED BY THE MUSCLE WHEN IT IS ACTIVE A B ELECTROMYOGRAMS OF ANTAGONIST FLEXOR (A) AND EXTENSOR (B) MUSCLES RECORDED DURING ALTERNATING FLEXIONS AND EXTENSION OF THE ARM Basics of Neurobiology: Spinal cord 8/5/2011. TÁMOP –4.1.2-08/2/A/KMR-2009-0006 10 www.itk.ppke.hu SEGMENTAL DIFFERENCES WITHIN THE SPINAL CORD THE RATIO OF WHITE/GREY MATTER VOLUME CHANGES ACCORDING TO THE CRANIO-CAUDAL POSITION OF THE SEGMENT. CRANIALLY, THE CERVICAL SEGMENTS ARE LARGER WITH MUCH MORE WHITE MATTER IN THEM IN COMPARISON WITH CAUDAL, SACRAL SEGMENTS THE SPINAL CORD SHOWS TWO ENLARGEMENTS THE CERVICAL ENLARGEMENT INCLUDES SEGMENTS C5-T8. THESE SEGMENTS GIVE RISE TO THE BRACHIAL NERVE PLEXUS THAT SUPPLIES THE UPPER EXTREMITIES THE SECOND ENLARGEMENT IS AT THE LUMBO-SACRAL LEVEL FROM WHERE THE LUMBAR (L1-L4) AND SACRAL (L5-S3) PLEXUSES TAKE THEIR ORIGIN AND PROJECT TO THE LOWER EXTREMITIES TO SUPPLY THEM NOTE, THAT THE CROSS-SECTIONAL PROFILE OF THE GREY MATTER IS HIGHLY CHARACTERISTIC FOR THE SEGMENT Basics of Neurobiology: Spinal cord 8/5/2011. TÁMOP –4.1.2-08/2/A/KMR-2009-0006 11 www.itk.ppke.hu SCHEMATIC ILLUSTRATION OF THE CROSS-SECTIONED SPINAL CORD THE GRAY MATTER IS ORGANIZED INTO DORSAL, LATERAL AND VENTRAL HORNS. THE FIBER TRACTS OF THE WHITE MATTER RUN IN THE POSTERIOR, LATERAL AND ANTERIOR FUNICULI fissura mediana anterior sulcus medianus posterior cornu posterius radix ventralis radix dorsalis Lissauertract funiculus posterior canalis centralis funiculus lateralis cornu anterius funiculus anterior cornu laterale commissura anterior