CHAPTER 37: COORDINATING CARE FOR PATIENTS WITH SPINAL CORD DISORDERS

CHAPTER 37: COORDINATING CARE FOR PATIENTS WITH SPINAL CORD DISORDERS

The Spinal Cord

•         Spinal column is the main support for the spinal cord

o   33 bony vertebrae, 31 pairs of spinal nerves, 40 muscles, and multiple connecting ligaments and tendons

•         Vertebrae

o   cervical spine

o   thoracic spine

o   lumbar spine

o   sacral spine

o   coccyx

•         intervertebral disks lie in between the vertebrae

o   elastic, fibrous cartilage

o   Outer layer: contain concentric rings of tough fibrous tissue (annulus fibrosus)

o   Inner layer: consists of softer, spongier material (nucleus pulposus)

•         Functions: somatic and autonomic reflexes, motor

control centers and sensory and motor modulation

•         Gray matter

o   serves as the processing center by receiving and integrating information

o   contains motor neurons that control movement

•         White matter

o   contains the conduction tracts for nerve impulses consisting of axons

o   Axons: long, thin nerve cell extensions that carry impulses away from the cell body

▪      up toward the brain (ascending

pathways) and down from the brain (descending pathways)

•         The ANS two neuron chain: carries info from the CNS to

the periphery; preganglionic neuron is the first neuron in the chain and has cell bodies located in the CNS

o   sympathetic division cell bodies are located in spinal segments T(thoracic) 1 through L(lumbar) 2 (the thoracolumbar division)

o   parasympathetic division, the cells are located in cranial nerves III, VII, IX, and X and in spinal cord segments S (sacral) 2 through S4 (the craniosacral division)