Spinal cord

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16 Spinal cord

Descending pathways

Anatomy of the Anterior Gray Horn

Cell columns

Each of the columns of motor neurons in the anterior gray horn supplies a group of muscles having similar functions. The individual muscles are supplied from cell groups (nuclei) within the columns. Axial (trunk) muscles are supplied from medially placed columns, proximal limb segment muscles from the midregion, and distal limb segment muscles from lateral columns (Figure 16.1). Columns supplying extensor muscles lie anterior to columns supplying flexors; hence the presence of ventromedial and dorsomedial columns for the trunk, and ventrolateral and dorsolateral columns for the limbs. A retrodorsolateral nucleus is devoted to the intrinsic muscles of the hand and foot. An isolated, central nucleus supplies the diaphragm.

The segmental levels of the six somatomotor cell columns are listed in Table 16.1. The autonomic nervous system is represented by the intermediolateral cell column.

Table 16.1 The somatomotor cell columns

Cell column Muscles
Ventromedial (all segments) Erector spinae
Dorsomedial (T1–L2) Intercostals, abdominals
Ventrolateral (C5–C8, L2–S2) Arm/thigh
Dorsolateral (C6–C8, L3–S3) Forearm/leg
Retrodorsolateral (C8, T1, S1–S2) Hand/foot
Central (C3–C5) Diaphragm

Cell types

Large, α (alpha) motor neurons supply the extrafusal fibers of the skeletal muscles. Interspersed among them are small, γ (gamma) motor neurons supplying the intrafusal fibers of neuromuscular spindles.

Segmental-level inputs to α motor neurons

At each segmental level, α motor neurons receive powerful inputs from muscle spindles, Golgi tendon organs, and joint capsules. Note that any inhibitory effect produced by activity in dorsal nerve root fibers requires interpolation of inhibitory internuncials, since all primary afferent neurons are excitatory in nature.

Segmental-level inputs to a flexor α motor neuron include the following:

In execution of the withdrawal reflex described in Chapter 14, large numbers of excitatory, ‘flexor reflex’ internuncials are activated over several spinal segments on the same side as the stimulus, as well as inhibitory internuncials supplying motor neurons to antagonist muscles.

A reciprocal list can be drawn up for extensor motor neurons, with substitution of extensor thrust inputs for flexor reflex internuncials.

Descending Motor Pathways

Important pathways descending to the spinal cord are the following:

Corticospinal tract

The corticospinal tract is the great voluntary motor pathway. About 40% of its fibers take their origin from the primary motor cortex in the precentral gyrus. Other sources include the supplementary motor area on the medial side of the hemisphere, the premotor cortex on the lateral side, the somatic sensory cortex, the parietal lobe, and the cingulate gyrus (Figure 16.2). The contributions from the two sensory areas mentioned terminate in sensory nuclei of the brainstem and spinal cord, where they modulate sensory transmission.

The corticospinal tract descends through the corona radiata and posterior limb of the internal capsule to reach the brainstem. It continues through the crus of the midbrain and the basilar pons to reach the medulla oblongata (Figure 16.3). Here it forms the pyramid (hence the synonym, pyramidal tract).

During its descent through the brainstem, the corticospinal tract gives off fibers which activate motor cranial nerve nuclei, notably those serving the muscles of the face, jaw, and tongue. These fibers are called corticonuclear (Figure 16.4). (The term ‘corticobulbar’ is sometimes used, but ‘bulb’ is open to different interpretations.)

Just above the spinomedullary junction (Figure 16.5):

The corticospinal tract contains about one million nerve fibers. The average conduction velocity is 60 m/s, indicating an average fiber diameter of 10 µm (‘rule of six’ in Ch. 6). About 3% of the fibers are extra large (up to 20 µm); they arise from giant neurons (cells of Betz), located mainly in the leg area of the motor cortex (Ch. 26). All corticospinal fibers are excitatory and appear to use glutamate as their transmitter substance.

Targets of the lateral corticospinal tract