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Gross Anatomy; the Back September 10, 2015

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Gross Anatomy; the Back September 10, 2015 Introduction to Gross Anatomy; the Back September 10, 2015 Dr. Pawel Kindler Department of Cellular and Physiological Sciences & MD Undergraduate Program LSC 1545 Following the lecture, you should be able to describe and/or define: Muscles - trapezius - latissimus dorsi intrinsic muscles extrinsic muscles - rhomboid major and minor - levator scapulae Bones deep superficial intermediate - scapula o spine o acromion o superior and inferior angles o superior, lateral and medial borders Nerves Accessory nerve (cranial nerve XI (CN XI)) Indicate the vertebral regions of the body Extrinsic muscles are involved with movements of the upper limbs and thoracic wall. This is in contrast to deep muscles which support and move the vertebral column and participate in moving the head. Extrinsic (superficial and intermediate) muscles acromion of scapula Trapezius serratus posterior superior spine of scapula serratus Latissimus dorsi posterior inferior SUPERFICIAL LAYER INTERMEDIATE LAYER Mainly for movement Mainly for breathing 1 very different innervation Superficial layer in more detail rhomboids are responsible for the movement of the scapula Levator scapulae rhomboid minor Trapezius the point that differentiates between minor and major rhomboid major Latissimus dorsi acromion (articulates with Scapula the clavicle) superior superior angle border Spine of the scapula Deep back muscles responsible for movement of the head medial border lateral border Suboccipital Splenius inferior angle Erector spinae 2 Vertebral regions Example lab exam questions: -Where did this scapule come from? which side? -What part of the spine did this vertebra come from? Cervical (7) CERVICAL -Bifid spinous process -Until C6? Thoracic -Body = heart shaped -Long spinous process -Rib facets exist Thoracic (12) Lumbar -Body = kidney shaped and huge -Short thick spinous process Lumbar (5) Sacral (5 fused) Coccyx (3~4 fused) 3 Introduction to the Nervous System and Spinal Nerves September 17, 2015 STRUCTURALLY, the nervous system is organized into CNS and PNS Dr. Pawel Kindler FUNCTIONALLY, the nervous system is organized into somatic and visceral Following the lecture, you should be able to describe, define and/or identify: Subdivisions of the nervous system and their general functions Embryonic origins of motor and sensory neurons Major components of a spinal nerve at a single level of the spinal cord A dermatome vs. myotome Numbering of spinal nerves in relation to vertebrae Spinal cord and meninges NERVOUS SYSTEM: The SOMATIC part (skin and skeletal muscles, concerned with external environment) + The VISCERAL part (organ systems, smooth muscles and glands, concerned with internal Somatic Nervous System: Somatic sensory nerves touch, temperature, proprioception • Carry conscious sensations from the periphery to the CNS + Somatic motor nerves • Innervate voluntary muscles Embryonic differentiation of somites Intrinsic muscles of the back (epaxial) + associated dermis Neural tube Sensory Part of mesoderm CNS and brain neurons Forms the muscles Neural and dentin Broken down into Somite crest sclerotome, myotome, and dermatome SURFACE ECTODERM Gives rise to: -Skin -Epithelium -Enamel SCLEROTOME -Eye structures Forms the vertebrae -Etc and rib cartilage Muscles of the limbs and trunk (hypaxial) + associated dermis Example question: rhomboids will be Body cavity which muscles? -They will be hypaxial because they (coelom) Mesoderm Dermatomyotome are extrinsic muscles -Part of the Gives rise to: Myotome = splits into hypaxial and -Remember: Epaxial muscles are mesodermal Endoderm -Muscles epaxial and forms the muscles really deep epithelium Gives rise to: -Circulatory system Dermatome = gives rise to skin, fat, -Main part of the -GI (red tubes seen and CT of the neck and trunk Also know: hypaxial and epaxial body cavity -Large glands under the somites) muscles are innervated differently -Lungs 1 -Mesenteties -Urinary this is how muscles become innervated during development Embryonic development of somatic motor neurons Neural tube EPAXIAL DIRECTION: -These cells will innervate back muscles KEY POINT: these neurons leave the HYPAXIAL neural tube in the ANTERIOR aspect DIRECTION: -These cells will innervate limbs Motor neurons grew laterally and started in the neural tube Sensory neurons grow laterally AND MEDIALLY and start in the neural crest Embryonic development of somatic sensory neurons It is visible here that the cell Now we're studying innervation of the NEURAL CREST bodies grow in 2 directions MEDIALLY: to the neural tube LATERALLY: to the somite Neural crest Neural tube EACH GROUP OF CELL BODIES IN NEURAL CREST GIVES RISE TO SPINAL (DORSAL ROOT) GANGLION 2 A single level of the spinal cord cross section through a spinal cord with the spinal nerves POSTERIOR DORSAL ROOT drg contains cell bodies of sensory neurons ANTERIOR VENTRAL ROOT POSTERIOR RAMUS -Epaxial muscles -Associated dermis SPINAL NERVE (BOTH MOTOR AND SENSORY) Rami have both motor and sensory neurons ANTERIOR RAMUS -Hypaxial muscles -Associated dermis -Bigger because there are more of them Terminology can be confusing… Somatic sensory neurons (temperature, pain, touch and proprioception from periphery → CNS) Or… Somatic sensory afferents Or… General somatic afferents (GSAs) Somatic motor fibers (CNS → skeletal muscles) Or… Somatic motor efferents Or… General somatic efferents (GSEs) 3 Dermatome vs. myotome ss = somatic sensory 1 cranial nerve Each spinal nerve carries SS information from a specific area of skin or a DERMATOME (Dermatome: an area of skin supplied by a single spinal cord level) imporant because problems in the spinal cord can be pinpointed to the exact level based on how patients perceive stimuli on various areas of the skin Myotome: a portion of a skeletal muscle innervated by a single spinal cord level Less significant VERTEBRA SIDE SPINAL NERVE SIDE Numbering of spinal nerves Cervical nerves are ABOVE its equivalent vertebra However, cervical nerve goes up to C8, which shifts all the nerves down So when we are in the thoracic region, the nerve is below its equivalent vertebra 4 Relationship between vertebral regions, spinal nerves and spinal cord 8 cerival nerves leaves the cord at the C1 - C8 same level as the vertebral column 12 thoracic nerves T1 - T12 5 lumbar nerves L1 - L5 5 sacral nerves S1 - S5 1 coccygeal nerve Co1 cauda equina The spinal cord is shorter than the vertebral column -Reason: spinal cord stops growing during embryonic development much sooner than the vertebral column -Stops at L1 or L2 (some people are L3) -All you will see inferior to this is a bundle of nerves called the cauda equina When you are doing a lumbar puncture: -you don't want the needle to enter into the spinal cord space -Make sure it is below L4 to assure you are not in the cord 5 Spinal cord and meninges There are 3 membranes surrounding the spinal cord. From the outside in: 1. Dura mater: toughest membrane on the outside Cervival enlargement 2. Arachnoid mater: just below the dura, thin layer. Small space between dura and arachnoid (in real life they seem attached) 3. Pia mater: on the surface of the spinal cord (very thin and shiny) Subarachnoid space: where CSF is Lumbosacral enlargement -Due to so many neurons connecting to the lower limbs Anterior face and cross section of the spinal cord Denticulate ligament -very thin blue ligament -anchors the spinal cord to the lateral walls -very very fine Conus medullaris -extension of the pia mater POSTERIOR TO IT: SENSORY ANTERIOR TO IT: MOTOR Pial part of filum terminale Dural part of filum terminale Filum terminale is a very fine thread of fibrous tissue End of subarachnoid space at S2 made of pia mater All figures in this handout: 6 DMD Anatomy: The Visceral Nervous System October 1, 2015 Dr. Pawel Kindler Department of Cellular and Physiological Sciences & MD Undergraduate Program Following the lecture, you should be able to describe and/or define: Subdivisions of the visceral NS The term “autonomic nervous system” The terms “sympathetic” and “parasympathetic” and indicate with which regions of the CNS these elements are associated Preganglionic vs. postganglionic neurons The basic arrangement of visceral motor and visceral sensory pathways as they relate to a typical spinal nerve and to the spinal cord The anatomical and functional features that characterize the visceral motor component of the nervous system Sympathetic trunk, its relationship with the spinal cord and its role in distributing autonomics to the periphery Splanchnic nerves and their role in distributing autonomics to viscera The concepts of paravertebral and prevertebral autonomic plexuses Parasympathetic innervation The SOMATIC part (skin and skeletal muscles, concerned with external environment) NERVOUS SYSTEM + The VISCERAL part (organ systems, smooth muscles and glands, concerned with internal environment) Visceral SENSORY nerves • monitor changes in the viscera Visceral Nervous System + Visceral MOTOR nerves • innervate smooth muscle, cardiac muscle and glands The MOTOR part of the visceral nervous sytem has SNS and PSNS Visceral motor nerves (autonomic division of the PNS) FUNCTIONALLY: -Motor part is most important -Sensory will not be studied in detail Para-sympathetic _____________Sympathetic _____________ 1 Embryonic development of sensory and motor visceral neurons VISCERAL SENSORY: Just like somatic, it originates in the neural crest. The neuron grows LATERALLY and MEDIALLY Innervates: Gut VISCERAL MOTOR: Just like somatic, it originates in the neural
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