Spinal Cord

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Study Tools For Spinal Cord

Dermatomes (Image)
Complications of Spinal Cord Injuries (Mnemonic)
Spinal Cord Injury Pathochart (Cheatsheet)
Spinal Nerves (Image)
Spinal Cord Cross Section (Image)
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Outline

Overview

  1. Function
    1. Two-way conduction pathway
      1. Sensory up
      2. Motor down
    2. Reflex center
      1. Somatic or spinal
        1. Usually related to skeletal muscle
      2. Visceral
        1. Usually related to smooth or cardiac muscle

Nursing Points

General

  1. Gross structure
    1. Begins at foramen magnum of skull
    2. Ends at L1 vertebra
    3. Meninges
      1. Meningeal dura mater
      2. Arachnoid
      3. Pia mater
    4. Conus medullaris – end of cord
    5. Cauda equina – last 9 pairs of spinal nerves
      1. Project out of sacrum
    6. Filum terminale
      1. Cord of pia mater which secures the conus to the coccyx
  2. Cross-sectional structure
    1. Oval shape
    2. Divided by:
      1. Posterior median sulcus
      2. Anterior median fissure
    3. Gray matter – “H” shaped in center – cell bodies and unmyelinated fibers
      1. Posterior horn
      2. Lateral horn—only in thoracic region
      3. Anterior horn
      4. Gray commissure
        1. Surrounds central canal
    4. White matter – external to gray matter – myelinated axons and dendrites
      1. Nerve tracts
        1. Funiculi (3) ((posterior, lateral, anterior))
          1. Ascending = sensory
          2. Descending = motor

References
Betts, J.G., et al. (2017). Anatomy and physiology. Houston, TX: OpenStax, Rice University. Retrieved from https://openstax.org/details/books/anatomy-and-physiology?Book%20details

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Transcript

Okay guys, in this lesson we’re going to talk about the spinal cord and its structure and function.

So, the spinal cord functions as a two-way conduction pathway. It is literally what helps our brain control the rest of our body. We have both sensory pathways and motor pathways. We usually say “sensory up” and “motor down”. Sensory pathways take signals from the body to the central nervous system – so the brain and spinal cord. And motor pathways take signals back out to the body to produce some sort of action. When these are working together we call it the reflex arc. So let’s say your hand gets a signal that it’s touching something hot – it sends that sensory signal to the central nervous system, which interprets it and immediately sends a motor signal back down to the muscles in the arm to tell you to pull your hand away – that’s a reflex. We have somatic reflexes – which usually involve skeletal muscle like I just talked about. And we have visceral reflexes, which involve responses in organs and blood vessels that are involuntary. For example a signal that you’re too cold might have your blood vessels react by constricting in your skin to prevent heat loss. That’s a visceral reflex that is involuntary.

Looking at the gross structure of the spinal cord – we see the same meninges that we see around the brain. These are connective and epithelial tissue membranes that help protect the brain and spinal cord. The outermost layer is called the dura mater, the middle layer is the arachnoid layer, and the layer directly around the brain and spinal cord is called the pia mater. You can think DAP or PAD depending on which way you’re going. The spinal cord extends off the brainstem and comes out of the foramen magnum of the skull. That extends all the way down to the L1 vertebrae, which is right about here. That’s where you find what’s called the conus medullaris – basically it’s the end of the actual cord itself. After that, extending down through the lumbar vertebrae and into the sacrum is the cauda equina. It literally means horse tail – and it’s the last 9 pairs of spinal nerves. Basically they’re just loose as opposed to being wrapped in those meninges, that’s the only reason they have a different name. And lastly there’s a thin piece of white fibrous connective tissue called the filum terminale that connects the cord to the coccyx to keep it all in place.

Now let’s look at a cross section of the spinal cord to see a more microscopic structure. It’s an oval shape that is divided left and right by the posterior median sulcus and the anterior median fissure – a fissure is just a deeper groove than a sulcus. Then you’ll see there’s gray matter in the center in kind of an H shape and white matter around the outside. Gray matter contains out neuron cell bodies and the unmyelinated neurons – so remember unmyelinated means things move a little slower. White matter contains our myelinated axons and dendrites – so think myelin equals white. You can also see here the ganglion coming out of the spinal cord. Remember when we talked about the autonomic nervous system we talked about preganglionic and postganglionic. That’s where this happens. Pre is coming off the spinal cord into the ganglion – which remember is just a group of neuron cell bodies in one place. And post is coming off that and out to the body. Now you can see here, inside the gray and white matter there are specific regions or tracts for various sensory and motor pathways. Make sure you check out the spinal cord injury lesson to see what happens when certain parts of this spinal cord are damaged.

So let’s recap. The spinal cord is a two-way conduction pathway, with sensory going up and motor going down that helps our brain control the rest of our body. It goes from the skull down to L1 and then the cauda equina takes the last 9 pairs through the sacrum. Just like the brain, it is surrounded by meninges – the dura mater, arachnoid layer, and pia mater. It contains gray matter in the center which has our neuron cell bodies and unmyelinated axons, and white matter around the outside that has myelinated axons and dendrites. Remember specific parts of the spinal cord have certain tracts for sensory and motor pathways – so an injury would affect those specific tracts.

That’s it for our review of the spinal cord. Make sure you check out all of the images and resources attached to this lesson Now, go out and be your best selves today. And, as always, happy nursing!

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Study Plan Lessons

The 5-Minute Assessment (Physical assessment)
General Assessment (Physical assessment)
Integumentary (Skin) Assessment
Neuro Assessment
Head/Neck Assessment
EENT Assessment
Heart (Cardiac) and Great Vessels Assessment
Thorax and Lungs Assessment
Abdomen (Abdominal) Assessment
Lymphatic Assessment
Peripheral Vascular Assessment
Musculoskeletal Assessment
Genitourinary (GU) Assessment
Communicating with Patients
SATA
Absolute Words
Nursing Process
What do you want me to know?
Duplicate Facts
Repeating Words
Denying Feelings
NCLEX® Question Traps
Opposites
Same
Priority
Acute vs Chronic
Hierarchy of O2 Delivery
Nutrition Assessments
Abuse
Therapeutic Communication
Nurse-Patient Relationship
Thinking Like a Nurse
Critical Thinking
Prioritization
Triage
Maslow’s Hierarchy of Needs in Nursing
Overview of the Nursing Process
Skin Structure & Function
Skeletal Anatomy
Bone Structure
Development of Bones
Joints
Muscle Anatomy (anatomy and physiology)
Muscle Cytology
Skeletal Muscle
Muscle Contraction
Muscle Physiology
Nervous System Anatomy
Membrane Potentials
Nerve Transmission
Autonomic Nervous System (ANS)
Spinal Cord
Cranial Nerves
Sensory Basics
Intro to Circulatory System
The Heart
Cardiac Cycle
Electrical Activity in the Heart
Cardiac (Heart) Physiology
Blood Vessels
Blood Pressure (BP) Control
Blood Plasma
Blood Grouping
Vessels & Fluid
Respiratory Structure & Function
Breathing Movements
Breathing Control
Respiratory Functions of Blood
Digestive System Anatomy
Mouth & Oropharynx
Esophagus
Stomach Video
Small Intestine
Large Intestine
Liver & Gallbladder
Urinary System Anatomy (Anatomy and Physiology)
Renal (Kidney) Structure & Function
Renin Angiotensin Aldosterone System (RAAS)
Formation & Excretion of Urine
Renal (Kidney) Fluid & Electrolyte Balance
Renal (Kidney) Acid-Base Balance
Pituitary Gland
Thyroid Gland
Adrenal Gland
Pancreas
Male Reproductive Anatomy (Anatomy and Physiology)
Female Reproductive Anatomy (Anatomy and Physiology)
Epithelial (Skin) Tissues
Types of Epithelial (Skin) Tissue
Glands
Connective Tissues
Membranes
Fluid Compartments
Fluid Pressures
Fluid Shifts (Ascites) (Pleural Effusion)
Isotonic Solutions (IV solutions)
Hypotonic Solutions (IV solutions)
Hypertonic Solutions (IV solutions)
Potassium-K (Hyperkalemia, Hypokalemia)
Sodium-Na (Hypernatremia, Hyponatremia)
Calcium-Ca (Hypercalcemia, Hypocalcemia)
Chloride-Cl (Hyperchloremia, Hypochloremia)
Magnesium-Mg (Hypomagnesemia, Hypermagnesemia)
Phosphorus-Phos
Heart (Cardiac) Sound Locations and Auscultation
Nursing Care and Pathophysiology for Heart Failure (CHF)
Nursing Care and Pathophysiology of Myocardial Infarction (MI)
Nursing Care and Pathophysiology of Diabetes Mellitus (DM)
Nursing Care and Pathophysiology for Hemorrhagic Stroke (CVA)
Nursing Care and Pathophysiology of COPD (Chronic Obstructive Pulmonary Disease)
Nursing Care and Pathophysiology for Arterial Disorders
Nursing Care and Pathophysiology for Aortic Aneurysm
Venous Disorders (Chronic venous insufficiency, Deep venous thrombosis/DVT)
Nursing Care and Pathophysiology of Coronary Artery Disease (CAD)
GERD (Gastroesophageal Reflux Disease)
Nursing Care and Pathophysiology for Pancreatitis
Nursing Care and Pathophysiology for Diverticulosis – Diverticulitis
Nursing Care and Pathophysiology for Hemorrhoids
Nursing Care and Pathophysiology for Appendicitis
Nursing Care and Pathophysiology for Cholecystitis
Nursing Care and Pathophysiology for Hepatitis (Liver Disease)
Nursing Care and Pathophysiology for Cirrhosis (Liver Disease, Hepatic encephalopathy, Portal Hypertension, Esophageal Varices)
Nursing Care and Pathophysiology of Urinary Tract Infection (UTI)
Nursing Care and Pathophysiology of BPH (Benign Prostatic Hyperplasia)
Nursing Care and Pathophysiology for Syphilis (STI)
Nursing Care and Pathophysiology for Herpes Simplex (HSV, STI)
Nursing Care and Pathophysiology for Menopause
Nursing Care and Pathophysiology of Glomerulonephritis
Pressure Ulcers/Pressure injuries (Braden scale)
Nursing Care and Pathophysiology for Herpes Zoster – Shingles
Skin Cancer
Integumentary (Skin) Important Points
Nursing Care and Pathophysiology for Anaphylaxis
Nursing Care and Pathophysiology for Acquired Immune Deficiency Syndrome (AIDS)
Breast Cancer
Diabetes Management
Nursing Care and Pathophysiology for Sepsis
Fluid Volume Deficit
Fluid Volume Overload
Nursing Care and Pathophysiology for Rheumatoid Arthritis (RA)
Nursing Care and Pathophysiology of Osteoarthritis (OA)
Nursing Care and Pathophysiology of Osteoporosis
Nursing Care and Pathophysiology for Compartment Syndrome
Fractures
Casting & Splinting
Impulse Transmission
Cerebral Metabolism
Blood Brain Barrier (BBB)
Levels of Consciousness (LOC)
Routine Neuro Assessments
Adjunct Neuro Assessments
Brain Death v. Comatose
Intracranial Pressure ICP
Nursing Care and Pathophysiology for Multiple Sclerosis (MS)
Nursing Care and Pathophysiology for Myasthenia Gravis
Nursing Care and Pathophysiology for Parkinsons
Miscellaneous Nerve Disorders
Tension and Cluster Headaches
Migraines
Nursing Care and Pathophysiology for Ischemic Stroke (CVA)
Stroke Assessment (CVA)
Stroke Therapeutic Management (CVA)
Stroke Nursing Care (CVA)
Seizure Causes (Epilepsy, Generalized)
Seizure Assessment
Seizure Therapeutic Management
Nursing Care and Pathophysiology for Seizure
Neurological Fractures
Spinal Cord Injury
Nursing Care and Pathophysiology for Meningitis
Nursing Care and Pathophysiology for Asthma
Nursing Care and Pathophysiology of Acute Respiratory Distress Syndrome (ARDS)
Nursing Care and Pathophysiology for Pulmonary Edema
Nursing Care and Pathophysiology for Influenza (Flu)
Nursing Care and Pathophysiology for Tuberculosis (TB)
Nursing Care and Pathophysiology of Pneumonia
Isolation Precautions (MRSA, C. Difficile, Meningitis, Pertussis, Tuberculosis, Neutropenia)
Coronavirus (COVID-19) Nursing Care and General Information
Artificial Airways
Airway Suctioning
Nursing Care and Pathophysiology for Pneumothorax & Hemothorax
Nursing Care and Pathophysiology for Pulmonary Embolism
Lung Sounds
Alveoli & Atelectasis
Gas Exchange
Wound Care – Assessment
Aortic Aneurysm – Management Nursing Mnemonic (CRAM)
Aortic Aneurysm – Thoracic signs Nursing Mnemonic (PEE BADS)
Bacterial Endocarditis – Symptoms Nursing Mnemonic (Be Joan Of Arc)
Cardiac Valves Blood Flow Nursing Mnemonic (Toilet Paper my Ass)
Circulatory Checks (5 P’s) Nursing Mnemonic (The 5 P’s)
Coronary Arteries – Location Nursing Mnemonic (I have a RIGHT to CAMP if you LEFT off the AC)
Cor Pulmonale – Signs & Symptoms Nursing Mnemonic (Please Read His Text)
CHF Treatment Nursing Mnemonic (UNLOAD FAST)
Cyanotic Defects Nursing Mnemonic (The 4 T’s)
Heart Failure-Left-Sided Nursing Mnemonic (CHOP)
Heart Failure-Origin Nursing Mnemonic (Left – Lung|Right – Rest)
Heart Failure – Right Sided Nursing Mnemonic (HEAD)
Heart Sounds Nursing Mnemonic (APE To Man – All People Enjoy Time Magazine)
Hypertension- Complications Nursing Mnemonic (The 4 C’s)
Hypertension – Nursing care Nursing Mnemonic (DIURETIC)
Increase MAP Nursing Mnemonic (VAK)
Murmur locations Nursing Mnemonic (hARD ASS MRS. MSD)
Shock – Signs and symptoms Nursing Mnemonic (TV SPARC CUBE)
Vascular Disease – Deep Vein Thrombosis Nursing Mnemonic (HIS Leg Might Fall off)
Vascular disease – Raynaud’s symptoms Nursing Mnemonic (COLD HAND)
Digestion & Absorption
Nutrition-related Diseases
CPR-BLS (Basic Life Support)
Advanced Cardiovascular Life Support (ACLS)
Pediatric Advanced Life Support (PALS)
Neonatal Resuscitation Program (NRP)
Prioritizing Assessments
Triage in the ER
Critical Incident Management
Aggressive & Violent Patients
Legal & Ethical Issues in ER
EMTALA & Transfers
Trauma Survey
Blunt Thoracic Trauma
Penetrating Thoracic Trauma
Blunt Abdominal Trauma
Penetrating Abdominal Trauma
Crush Injuries
Head Trauma & Traumatic Brain Injury
Massive Transfusion Protocol
Acute Coronary Syndrome (ACS)
Aneurysm & Dissection
Cardiopulmonary Arrest
Dysrhythmia Emergencies
Heart (Heart) Failure Exacerbation
Hypertensive Emergency
Arterial Pressure Monitoring
Rapid Sequence Intubation
Pulmonary Embolism
Acute Respiratory Distress
Ventilator Settings
Acute Confusion
Intracranial Hemorrhage
Increased Intracranial Pressure
Stroke (CVA) Management in the ER
Seizure Management in the ER
Sodium and Potassium Imbalance for Certified Emergency Nursing (CEN)