文稿讲稿第8 9章neuroanatomy.pdf

Neuroanatomy Xiangya 2nd Hospital Zhang He Runner up in Anatomical Society Best Image Award 2013. Axial diffusion-weighted MRI tractography image of living human brain. Spinal cord consist of 8 cervical (C), 12 thoracic (T), 5 lumbar (L), 5 sacral (S), 1 coccygeal segments. • Cervical enlargement consist of C4–T1 and to upper limb via brachial plexus. • Lumbar enlargement is L1–S3 and to lower limb via lumbosacral plexus. • Spinal cord terminate at vertebral leve L1– L2. Rule-of-Thumb (经验原则) Cervical cord lie one spine higher than vertebrae, Thoracic two, Lumbar three. CSF by lumbar puncture at L2–L3, L3–L4. Grey matter of spinal cord • Grey matter is H-shaped or butterfly shaped with four protrusions, dorsal (posterior) and ventral (anterior) horn. • La l horn in thoracic and upper lumbar cord possess preganglionic sympathetic neurone. • Dorsal horn lude substantia gelatinosa for nociceptive impulse. • Ventral horn contain alpha and g motor neurone as lower motor neurone. Lamina VII 8–L3 cord level lie Clarke’scolumn, receive afferent from muscle spindle, Golgi tendon organ, tactile and pressure receptor, then ascend to spinocerebellar tract. Lamina VII in la l horn at thoracic and upper lumbar level contain preganglionic sympathetic neurone; while at sacral level (S2–S4), contain preganglionic parasympathetic neurone. • Substantia gelatinosa （脊髓胶状质）in lamina I– III, receive smallest myelinated (A delta) and unmyelinated (C) nociception afferent with glutamic acid and substan