NervousSystem

神經系統(tǒng)

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

(12pairs)脊神經Spinalnerves

(31pairs)內臟神經VisceralnervesVisceralsensorynerveVisceralmotornerveSympatheticpart交感神經Parasympatheticpart副交感神經CellularOrganizationNeuron神經元Cellbody胞體Axon軸突Dendrites樹突

Neuroglia神經膠質－glialcell膠質細胞ClassificationofNeuronStructuralclassification雙極神經元Bipolarneuronhasanaxonandadendrite假單極神經元Pseudounipolarneuronhasacentralbranchandaperipheralbranch多極神經元MultipolarneuronhasanaxonandtwoormoredendritesClassificationofNeuronsFunctionalclassification感覺神經元Sensory(afferent)neuron運動神經元Motor(efferent)neuron聯(lián)絡神經元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:

collectionofnervecellbodiesandtheirdendrites,graycolorduringfreshconditionCortex皮質:

theoutermostlayerofgraymatterincerebrumandcerebellumNucleus神經核:

acollection(group)ofcellbodieswhichhavethesameshapeandfunction★BasicTerminologyinNervousSystemIntheCNSWhitematter

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

abundleofnervefiberswhichhavethesameorigin,termination,pathwayandfunction★BasicTerminologyinNervousSystemReticularformation

網(wǎng)狀結構:

anadmixtureofcross-crossingfiberswithlargerorsmallergroupsofnervecellsoccupyingthemeshes★BasicTerminologyinNervousSystemInthePNSGanglion神經節(jié):

acollectionofneuronalcellbodiesoutsidetheCNS.eg.Spinalganglion/gangliaNerve神經:

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

前外側溝anterior(motor)rootsemergeserially

Posterolateralsulcus

后外側溝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Whitematter

白質Centralcanal

中央管Reticularformation網(wǎng)狀結構

★GrayMatterofSpinalCord

Anteriorhorn(column)

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

中間帶Lateralhorn(column)

側角(柱)onlypresentinthethoracicandupperlumbersegmentsofthespinalcord(T1-L3)graycommissures灰質連合

Anteriorgraycommissures

灰質前連合Posteriorgraycommissures

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

后角固有核SituatedanteriortothesubstantiagelationnosathroughoutthelengthofspinalcordReceivesfibersthatareassociatedwiththesuperficialsensesNucleusthoracicus胸核

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

骶副交感核ExtentsfromsegmentsS2~S4,ContainingparasympatheticpreganglionicneuronsIntermediomedialnucleus中間內側核

ThroughoutthelengthofspinalcordAssociatedwithvisceraafferentinformationAnteriorhorn(column):

★TwogroupsofnucleiMedialnucleargroup內側核群:presentinmostsegmentsofspinalcord,innervatingaxialmusclesLateralnucleargroup外側核群: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

containsthreekindsoffibers:AscendingfibersDescendingfibersFasciculusproprius固有束WhiteMatterofSpinalCordAnteriorfuniculus前索Lateralfuniculus外側索Posteriorfuniculus后索Anteriorwhitecommissure白質前連合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)感覺性共濟失調★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上行傳導束名稱起位置止功能薄束T5以下的脊神經節(jié)后索薄束核傳導同側軀干和肢體的本體感覺（肌、腱、關節(jié)的位置覺、運動覺和震動覺）和精細觸覺楔束T4以上的脊神經節(jié)楔束核脊髓小腦后束同側胸核外側索小腦下肢和軀干下部的非意識性本體感覺脊髓小腦前束對側板層Ⅴ~Ⅶ脊髓丘腦束板層Ⅰ,Ⅳ~Ⅶ外側索和前索背側丘腦痛、溫覺、粗觸覺DescendingTractsLateralcorticospinaltract皮質脊髓側束Anteriorcorticospinaltract皮質脊髓前束Rubrospinaltract紅核脊髓束Vestibulospinaltract前庭脊髓束Reticulospinaltract網(wǎng)狀脊髓束Mediallongitudinalfasciculus內側縱束Tectospinaltract頂蓋脊髓束★Corticospinaltracts皮質脊髓束ArisefromthepyramidalneuronsincerebralcortexLateralcorticospinaltract皮質脊髓側束Anteriorcorticospinaltract皮質脊髓前束AnterolateraltractofBarne★Lateralcorticospinaltract皮質脊髓側束LocatedindeeppartoflateralfuniculusArisefromthepyramidalneuronsincontralateralcerebralcortexthroughthedecussationofpyramidtractFibresarrangement

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

disabilityofvoluntarymovement(paralysis)

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

下行傳導束名稱起位置止功能皮質脊髓側束大腦皮質外側索板層Ⅳ~Ⅸ前角隨意運動皮質脊髓前束大腦皮質前索紅核脊髓束紅核外側索板層Ⅴ~Ⅶ興奮屈肌前庭脊髓束同側前庭神經核前索板層Ⅶ~Ⅷ興奮伸肌網(wǎng)狀脊髓束網(wǎng)狀結構前索和外側索板層Ⅶ~Ⅷ協(xié)調隨意運動內側縱束前庭神經核前索板層Ⅶ~Ⅷ協(xié)調頭頸部和眼的運動頂蓋脊髓束中腦上丘前索板層Ⅵ~Ⅷ固有束脊髓前索