NervousSystem

神經(jīng)系統(tǒng)

★Organizations中樞神經(jīng)系統(tǒng)Centralnervoussystem(CNS)腦Brain脊髓Spinalcord周圍神經(jīng)系統(tǒng)Peripheralnervoussystem(PNS)腦神經(jīng)Cranialn.(12pairs)脊神經(jīng)Spinaln.(31pairs)內(nèi)臟神經(jīng)VisceralnervesMajorDivisionsofthe

CentralNervousSystemBrain腦Telencephalon端腦Diencephalon間腦Cerebellum小腦Midbrain中腦Pons腦橋Medullaoblongata延髓Spinalcord脊髓Brainstem腦干MajorDivisionsofthe

PeripheralNervousSystem

腦神經(jīng)Cranialnerves

(12pairs)脊神經(jīng)Spinalnerves

(31pairs)內(nèi)臟神經(jīng)VisceralnervesVisceralsensorynerveVisceralmotornerveSympatheticpart交感神經(jīng)Parasympatheticpart副交感神經(jīng)CellularOrganizationNeuron神經(jīng)元Cellbody胞體Axon軸突Dendrites樹突

Neuroglia神經(jīng)膠質(zhì)－glialcell膠質(zhì)細(xì)胞ClassificationofNeuronStructuralclassification雙極神經(jīng)元Bipolarneuronhasanaxonandadendrite假單極神經(jīng)元Pseudounipolarneuronhasacentralbranchandaperipheralbranch多極神經(jīng)元MultipolarneuronhasanaxonandtwoormoredendritesClassificationofNeuronsFunctionalclassification感覺神經(jīng)元Sensory(afferent)neuron運(yùn)動(dòng)神經(jīng)元Motor(efferent)neuron聯(lián)絡(luò)神經(jīng)元Associationneuron

Reflex反射:areactionoftheorganismbythenervoussysteminresponsetoastimulusReflexarc反射弧:has5basiccomponents

Receptor

↓Sensoryneurons

↓CNS

↓Motorneurons↓Effector

★ReflexandReflexArc深反射（腱反射）-膝跳反射★BasicTerminologyinNervousSystemIntheCNSGraymatter灰質(zhì):

collectionofnervecellbodiesandtheirdendrites,graycolorduringfreshconditionCortex皮質(zhì):

theoutermostlayerofgraymatterincerebrumandcerebellumNucleus神經(jīng)核:

acollection(group)ofcellbodieswhichhavethesameshapeandfunction★BasicTerminologyinNervousSystemIntheCNSWhitematter

白質(zhì):collectionofnervefibers,whitecolorduringfreshconditionMedulla髓質(zhì):acentralcoreofwhitematterbeneaththecortexofcerebrumandcerebellumFasciculus(tract)纖維束:

abundleofnervefiberswhichhavethesameorigin,termination,pathwayandfunction★BasicTerminologyinNervousSystemReticularformation

網(wǎng)狀結(jié)構(gòu):

anadmixtureofcross-crossingfiberswithlargerorsmallergroupsofnervecellsoccupyingthemeshes★BasicTerminologyinNervousSystemInthePNSGanglion神經(jīng)節(jié):

acollectionofneuronalcellbodiesoutsidetheCNS.eg.Spinalganglion/gangliaNerve神經(jīng):

abundleofnervefibersheldtogetherbyconnectivetissuesheath.eg.SpinalnerveSpinalCord脊髓

ZhaoxiDingDepartmentofHumanAnatomyMedicalSchool,ShandongUniversitydingzhaoxi@★Position：Liesintheupper2/3ofthevertebralcanalContinuous

abovewithmedullaoblongata

atlevelofforamenmagnum

Ends

belowatthelowerborderofL1

inadultoratlevelofL3atbirthAbout40~45cminlengthWeightsabout30g.PositionofSpinalCord

Alongcylindricalstructureandslightlyflattenedanteroposteriorly★TwoenlargementsCervicalenlargement頸膨大correspondstotheC4-T1segmentssendsfiberstosupplytheupperlimbsLumbosacralenlargement腰骶膨大correspondstotheL2-S3segmentssendsfiberstosupplythelowerlimbs

ExternalFeaturesofSpinalCord★脊髓圓錐Conusmedullaris-the

lowerpyramidendofspinalcord★終絲Filumterminale-adelicatefilament,about20cminlength,prolongeddownwardfromtheapexoftheconusmedullaristothebackofthefirstsegmentofthecoccyx,continuousabovewiththatofthe

piamater.

★馬尾Caudaequina-collectionofrootsandrootletsofspinaln.(fromL2-5,S1-5,Co1)

aroundthefilum

terminale

belowtheconusmedullaris.Thesefibersgraduallydeclininginnumberfurtherdownasindividualpairsleavethespinalcolumn.

Lumbarpuncture(spinaltap)腰穿★ExternalFeaturesofSpinalCordFissureandsulciAnteriormedianfissure

前正中裂Posteriormediansulcus

后正中溝Anterolateralsulcus

前外側(cè)溝anterior(motor)rootsemergeserially

Posterolateralsulcus

后外側(cè)溝posterior(sensory)rootsenterspinalcord,eachbearaspinalganglionwhichconstitutesthefirstcell-stationofthesensorynervesPosteriorintermediatesulcus

后中間溝★SegmentsofSpinalCordAportionofthespinalcordthatgivesrisetoapairofspinalnerveconstitutesasegment.

Thereare31segments

8cervical12thoracic5lumbar5sacral1coccygealRelationshipofspinalCordSegments

toVertebralNumbers★RelationshipofspinalCordSegments

toVertebralNumbersSpinalsegmentsVertebrallevels(spines)C1~C4LieoppositethecorrespondingvertebraeC5~T4OnelowerinnumberthancorrespondingvertebraeT5~T8TwolowerinnumberthancorrespondingvertebraeT9~T12ThreelowerinnumberthancorrespondingvertebraeL1-L5T10~T12S1-S5andCoL1RelationshipofspinalCordSegments

toVertebralNumbersSpinalsegmentsVertebrallevels(spines)Uppercervicalregion(C1~C4)=C1~C4Lowercervicalandupperthoracicregion(C5~T4)－1=C4~T3Middlethoracicregion(T5~T8)－2=T3~T6Lowerthoracicregion(T9~T12)－3=T6~T9Lumbersegments=T10~T12Sacralandcoccygealsegments=L1InternalStructureofSpinalCord

Graymatter

灰質(zhì)Whitematter

白質(zhì)Centralcanal

中央管Reticularformation網(wǎng)狀結(jié)構(gòu)

★GrayMatterofSpinalCord

Anteriorhorn(column)

前角(柱)Posteriorhorn(column)后角(柱)Intermediatezone

中間帶Lateralhorn(column)

側(cè)角(柱)onlypresentinthethoracicandupperlumbersegmentsofthespinalcord(T1-L3)graycommissures灰質(zhì)連合

Anteriorgraycommissures

灰質(zhì)前連合Posteriorgraycommissures

灰質(zhì)后連合★GrayMatterofSpinalCordPosteriorhorn(column):Marginallayer緣層(posteromarginalnucleus后角邊緣核)Substantiagelatinosa膠狀質(zhì)SituatedattheapexofposteriorhornthroughoutthelengthofspinalcordConcernsthesensationsofpainandtemperatureNucleusproprius

后角固有核SituatedanteriortothesubstantiagelationnosathroughoutthelengthofspinalcordReceivesfibersthatareassociatedwiththesuperficialsensesNucleusthoracicus胸核

SituatedatthebaseofposteriorhornandextendingfromsegmentsC8~L3Associatedwiththedeepsenses(proprioceptiveendings)★GrayMatterofSpinalCordIntermediatezoneIntermediaolateralnucleus中間外側(cè)核(lateralhorn)ExtentsfromsegmentsT1~L3,ContainingsympatheticpreganglionicneuronsSacralparasympatheticnucleus

骶副交感核ExtentsfromsegmentsS2~S4,ContainingparasympatheticpreganglionicneuronsIntermediomedialnucleus中間內(nèi)側(cè)核

ThroughoutthelengthofspinalcordAssociatedwithvisceraafferentinformationAnteriorhorn(column):

★TwogroupsofnucleiMedialnucleargroup內(nèi)側(cè)核群:presentinmostsegmentsofspinalcord,innervatingaxialmusclesLateralnucleargroup外側(cè)核群:presentonlyincervicalandlumbosacralenlargements,innervatingupperandlowerlimbmusclesGrayMatterofSpinalCord

Anteriorhorn(column):Twokindsofmotorneurons

α-motorneuron:

largemultipolarneuron,innervatesskeletalmuscles,producingcontractionofmusclesγ-motorneuron:

smallermultipolarneuron,innervatesintrafusalmusclefibersofneuromuscularspindles,regulatingmusculartonusInterneuron—Renshaw’scell:negativefeedbackmechanismRexed’slamina板層PosteriorhornisformedbylaminaⅠtoⅥ；IntermediatezonecorrespondingtolaminaⅦ；AnteriorhorniscomposedlaminaeⅧandⅨ；laminaⅩisthegraymattersurroundingthecentralcanal.ImportantSubdivisionsofGrayMatterRegionLaminaNucleusPosteriorhornⅠMarginallayerⅡSubstantiagelatinosaⅢ,ⅣNucleuspropriusIntermediatezoneⅦNucleusthoracicus(C8~L3)ⅦIntermediolateralnucleus(T1~L3)ⅦSacralparasympatheticnucleus(S2~S4)ⅦIntermediomedialnucleusAnteriorhornⅨMotorneuronWhiteMatterofSpinalCordWhitematter白質(zhì)

containsthreekindsoffibers:AscendingfibersDescendingfibersFasciculusproprius固有束WhiteMatterofSpinalCordAnteriorfuniculus前索Lateralfuniculus外側(cè)索Posteriorfuniculus后索Anteriorwhitecommissure白質(zhì)前連合AscendingTractsFasciculuscuneatus楔束Posteriorspinocerebellartr.脊髓小腦后束Anteriorspinocerebellartr.脊髓小腦前束Spinothalamic

tract脊髓丘腦束Fasciculusgracilis薄束★Fasciculusgracilis薄束LocatedinthewholeposteriorfuniculusbelowT4andonlyinthemedialpartaboveT4ArisefromthespinalgangliabelowsegmentT4(centralprocessofspinalganglia)TerminateinGracilenucleusinmedullaoblongataConveyproprioceptiveandfinetouchsensationfromlowerpartoftrunkandlowerlimbonthesamesideSpinalganglion

1°neuron

Gracilenuclei

2°neuron

T4FGFG★FasciculusCuneatus楔束LocatedinthelateralpartofposteriorfuniculusaboveT4ArisefromthespinalgangliaabovesegmentT4(centralprocessofspinalganglia)TerminateincuneatenucleusinmedullaoblongataConveyconsciousproprioceptiveandfinetouchsensationfromupperpartoftrunkandupperlimbonthesamesideSpinalganglion

1°neuron

cuneatenuclei

2°neuron

T4FCFGLowerlimbupperlimbFasciculusgracilisFasciculuscuneatusCortexofcerebrumdiencephalonMedialleminecusGracileandcuneateNu.ClinicalnoteLossofproprioceptivesensationonthesamesideLossoffinetouchsensationonthesamesideSensorydystaxia(Incoordination)感覺性共濟(jì)失調(diào)★Spinothalamictract脊髓丘腦束LocatedintheLateralandanteriorfuniculusArisefromtheneuronsincontralaterallaminaeI,IV~VIIabout1-2segmentbelowTerminateinDorsalthalamusConveypain,temperatureandsimpletouchsensationoftrunkandlimbsSpinalganglia1°neuron

LaminaⅠ,Ⅳ~Ⅶ

2°neuron

VPL

3°neurons

ASTLSTClinicalnote

Analgesiaandthermo-anesthesiaontheoppositesideofthebody(bellowthedamagedsegment)Spinocerebellartracts脊髓小腦束LocatedinthesuperficialpartoflateralandanteriorfuniculiConveyunconsciousproprioceptionfromlowerlimbandlowerportionoftrunkonthesamesidetothecerebellumContain:Posteriorspinocerebellartract脊髓小腦后束Anteriorspinocerebellartract脊髓小腦前束Posteriorspinocerebellartract脊髓小腦后束LocatedintheposteriorandsuperficialpartoflateralfuniculusaboveL3ArisefromthenucleusthoracicusonhomolateralsideTerminateinsuperiorandinferiorvermisofcerebellumConveyunconsciousproprioceptionfromlowerlimbandlowerportionoftrunkonthesamesideSpinalganglion1°neuron

NucleusThoracicus2°neuronAnteriorspinocerebellartract脊髓小腦前束LocatedanteriortotheposteriorspinocerebellartractinthesuperficialpartoflateralfuniculusArisemainlyfromtheneuronsincontralaterallaminaⅤ～ⅦTerminateinsuperiorvermisofcerebellumConveyunconsciousproprioceptionfromlowerlimbandlowerportionoftrunkontheoppositesideSpinalganglion

1°neuronLaminaⅤ-Ⅶ2°neuron

AscendingtractsTractSiteoforiginFuniculusTerminationFunctionFasciculusgracilisSpinalgangliabelowsegmentT5PosteriorGracilenucleusConsciousproprioceptive(vibratorysense,andmusclejointsense)andfinetouchsensationoftrunkandlimbsFasciculuscuneatusSpinalgangliaabovesegmentT4CuneatenucleusPosteriorspinocerebellartractHomolateralnucleusthoracicusLateralCerebellumUnconsciousproprioceptionfromlowerlimbandlowerportionoftrunkAnteriorspinocerebellartractContralateralLaminaeⅤ~ⅦSpinothalamic

tractLaminaeⅠ,Ⅳ~ⅦLateralandanteriorDorsalthalamusPain,temperatureandcrudetouchsensationoftrunkandlimbs上行傳導(dǎo)束名稱起位置止功能薄束T5以下的脊神經(jīng)節(jié)后索薄束核傳導(dǎo)同側(cè)軀干和肢體的本體感覺（肌、腱、關(guān)節(jié)的位置覺、運(yùn)動(dòng)覺和震動(dòng)覺）和精細(xì)觸覺楔束T4以上的脊神經(jīng)節(jié)楔束核脊髓小腦后束同側(cè)胸核外側(cè)索小腦下肢和軀干下部的非意識(shí)性本體感覺脊髓小腦前束對(duì)側(cè)板層Ⅴ~Ⅶ脊髓丘腦束板層Ⅰ,Ⅳ~Ⅶ外側(cè)索和前索背側(cè)丘腦痛、溫覺、粗觸覺DescendingTractsLateralcorticospinaltract皮質(zhì)脊髓側(cè)束Anteriorcorticospinaltract皮質(zhì)脊髓前束Rubrospinaltract紅核脊髓束Vestibulospinaltract前庭脊髓束Reticulospinaltract網(wǎng)狀脊髓束Mediallongitudinalfasciculus內(nèi)側(cè)縱束Tectospinaltract頂蓋脊髓束★Corticospinaltracts皮質(zhì)脊髓束ArisefromthepyramidalneuronsincerebralcortexLateralcorticospinaltract皮質(zhì)脊髓側(cè)束Anteriorcorticospinaltract皮質(zhì)脊髓前束AnterolateraltractofBarne★L(fēng)ateralcorticospinaltract皮質(zhì)脊髓側(cè)束LocatedindeeppartoflateralfuniculusArisefromthepyramidalneuronsincontralateralcerebralcortexthroughthedecussationofpyramidtractFibresarrangement

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

disabilityofvoluntarymovement(paralysis)

★anteriorcorticospinaltract皮質(zhì)脊髓前束LocatedinmedialpartofanteriorfuniculusArisefromthepyramidalneuronsincontralateralcerebralcortexthroughthedecussationofpyramidtractTerminateinLaminaeⅣ~ⅨonbothanteriorhornConveymotorsignaltocontrolvoluntarymovement(musclesofthetrunk)DescendingtractsTractSiteoforiginFuniculusTerminationFunctionLateralcorticospinalCerebralcortexLateralLaminaeⅣ~ⅨanteriorhornVoluntarymovementAnteriorcorticospinalCerebralcortexAnteriorRubrospinalRednucleusLateralLaminaeⅤ~ⅦFacilitatesactivityofflexormusclesVestibulospinalHomolateralvestibularnucleiAnteriorLaminaeⅦ~ⅧFacilitatesactivityofextensormusclesReticulospinalReticularformationAnteriorandlateralLaminaeⅦ~ⅧVoluntarymovementMediallongitudinalfasciculusVestibularnucleiAnteriorLaminaeⅦ~ⅧCoordinateneckwitheyemovementTectospinalSuperiorcolliculusAnteriorLaminaeⅥ~ⅧFasciculuspropriusSpinalcordAnterior,lateralandposteriorSpinalcordIntrinsicreflexmechanismofspinalcord

下行傳導(dǎo)束名稱起位置止功能皮質(zhì)脊髓側(cè)束大腦皮質(zhì)外側(cè)索板層Ⅳ~Ⅸ前角隨意運(yùn)動(dòng)皮質(zhì)脊髓前束大腦皮質(zhì)前索紅核脊髓束紅核外側(cè)索板層Ⅴ~Ⅶ興奮屈肌前庭脊髓束同側(cè)前庭神經(jīng)核前索板層Ⅶ~Ⅷ興奮伸肌網(wǎng)狀脊髓束網(wǎng)狀結(jié)構(gòu)前索和外側(cè)索板層Ⅶ~Ⅷ協(xié)調(diào)隨意運(yùn)動(dòng)內(nèi)側(cè)縱束前庭神經(jīng)核前索板層Ⅶ~Ⅷ協(xié)調(diào)頭頸部和眼的運(yùn)動(dòng)頂蓋脊髓束中腦上丘前索板層Ⅵ~Ⅷ固有束脊髓前索