Chapter 007, Spinal Cord: Connections
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The process continues until the message reaches its destination. There are millions and millions of connections between neurons within the spinal cord alone. These connections are made during development, using positive neurotrophic factors and negative inhibitory proteins signals to fine-tune them.
Amazingly, a single axon can form synapses with as many as 1, other neurons. There is a logical and physical topographical organization to the anatomy of the central nervous system, which is an elaborate web of closely connected neural pathways.
This ordered relationship means that different segmental levels of the cord control different things, and injury to a particular part of the cord will have an impact on neighboring parts of the body. Paralysis occurs when communication between the brain and spinal cord fails. This can result from injury to neurons in the brain a stroke , or in the spinal cord. Trauma to the spinal cord affects only the areas below the level of injury. However, poliomyelitis a viral infection or Lou Gehrig's disease amyotrophic lateral sclerosis, or ALS can affect neurons in the entire spinal cord.
Specialized neurons carry messages from the skin, muscles, joints, and internal organs to the spinal cord about pain, temperature, touch, vibration, and proprioception. These messages are then relayed to the brain along one of two pathways: the spinothalmic tract and the lemniscal pathway. These pathways are in different locations in the spinal cord, so an injury might not affect them in the same way or to the same degree.
Spinal Cord Anatomy
Each segment of the spinal cord receives sensory input from a particular region of the body. Scientists have mapped these areas and determined the "receptive" fields for each level of the spinal cord. Neighboring fields overlap each other, so the lines on the diagram are approximate. Over one million axons travel through the spinal cord, including the longest axons in the central nervous system.
The Representation of White Matter in the Central Nervous System
Neurons in the motor cortex, the region of the brain that controls voluntary movement, send their axons through the corticospinal tract to connect with motor neurons in the spinal cord. The spinal motor neurons project out of the cord to the correct muscles via the ventral root. These connections control conscious movements, such as writing and running. Information also flows in the opposite direction resulting in involuntary movement.
Sensory neurons provide feedback to the brain via the dorsal root. Some of this sensory information is conveyed directly to lower motor neurons before it reaches the brain, resulting in involuntary, or reflex movements. The remaining sensory information travels back to the cortex. The spinal cord is divided into five sections: the cervical, thoracic, lumbar, sacral, and coccygeal regions. No two injuries are alike.
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This diagram illustrates the connections between the major skeletal muscle groups and each level of the spinal cord. A similar organization exists for the spinal control of the internal organs. In addition to the control of voluntary movement, the central nervous system contains the sympathetic and parasympathetic pathways that control the "fight or flight" response to danger and regulation of bodily functions. These include hormone release, movement of food through the stomach and intestines, and the sensations from and muscular control to all internal organs.
This diagram illustrates these pathways and the level of the spinal cord projecting to each organ. Although spinal cord injury causes complex damage, a surprising amount of the basic circuitry to control movement and process information can remain intact. This is because the spinal cord is arranged in layers of circuitry. Many of the connections and neuronal cell bodies forming this circuitry above and below the site of injury survive the trauma.
An important question to research scientists is, how much do these surviving neurons "know? Research points to a multiplicity of possible interventions to promote recovery from a spinal injury. Some would be delivered immediately following the injury; others are less time-specific and involve rebuilding and reconnecting the injured cord. Clearly, both approaches are important: limiting degeneration will enhance the probability of greater recovery, while stimulating regeneration will build upon the remaining system to restore lost connectivity and perhaps to prevent further degeneration.
This is not a comprehensive list of all possible interventions. Grantees undertaking projects under government sponsorship are encouraged to express freely their findings and conclusions. Points of view or opinions do not, therefore, necessarily represent official Administration for Community Living policy. Clinical Radiology. Interventional Radiology.
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Management of Acute Traumatic Central Cord Syndrome (ATCCS) | Neurosurgery | Oxford Academic
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