Presentation by: Abbas Aliaghaei, Ph.D. of Neuroscience ...

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Transcript of Presentation by: Abbas Aliaghaei, Ph.D. of Neuroscience ...

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Presentation by: Abbas Aliaghaei, Ph.D. of Neuroscience, Anatomy and Cell Biology Department, School Of Medicine, Shahid Beheshty University Of Medical Sciences

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Cervical (C) - Neck

(C1-8)

Thoracic (T) - Chest

(T1-12)

Lumbar (L) - Back

(L1-5)

Sacral (S) - Pelvis

(S1-5)

Coxygeal

Spinal cord segments, nerves and vertebrae

Vertebra

Spinal segment

Spinal root

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مننژ

عنکبوتیه

نرم شامه

سخت شامه

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Spinal Cord

• anterior root:

- motor

• posterior root:

- sensory

Law of

Bell-Magendie

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رباط دندانه ایی

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هسته های ماده خاکستری نخاع

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راههای نخاعی

راههای صعودی ، راههای نزولی و راههای بین سگمانی: راههای نخاعی•

تریور انتریور اسپینوتالامیک، لترال اسپینوتالامیک، پوس:راههای صعودی•

ینورتیکولار، فانیکولوس، انتریور اسپینوسربلار، پوستریور اسپینوسربلار، اسپ

اسپینو تکتال، اسپینواولیواری

ر، کورتیکواسپاینال لترال ، کورتیکو اسپاینال انتریو:راههای نزولی•

الروبرواسپاینال، وستیبولواسپاینال، اولیوواسپاینال، رتیکولواسپاین

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DRG (dorsal root ganglion) neuron

pseudounipolar cell

peripheral

process

central

process

telodendron

cell body

in DRG

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(حس لمس خفیف)انتریور اسپینوتالامیک

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اسپینوتالامیک لترال (حس درد و حرارت )

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لترال اسپینو تالامیک

Ventral

Dorsal

Ventral

Dorsal

Dorsal

Dorsal

Ventral

Ventral

Sacral

Lumbar

Thoracic

Cervical

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تالاموس

تشکیلات رتیکولار

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درد سریع درد آهسته

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G C

G C

Gracile N.

Cuneatus N.

IAFMedial lemeniscus

مسیر ستون خلفی

،فشار حس لمس دقیق ،

ارتعاش و لوکالیزاسیون

Ventral

Dorsal

Ventral

Dorsal

Ventral

Dorsal

Ventral

Dorsal

Ventral

Dorsal

Sacral

Lumbar

Thoracic

Cervical

Medulla

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تریجمینوتالامیکمسیر

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&پوستریور اسپینو سربلار

کونئوسربلار

انتریور اسپینوسربلارهسته کونئاتوس فرعی

Sacral

Lumbar

Thoracic

Cervical

Medulla

Ventral

Dorsal

Ventral

Dorsal

Ventral

Dorsal

Ventral

Dorsal

Ventral

Dorsal

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Posterior Column

Ataxia

Friedreich's ataxia

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upper motor neuronUMN

SOMATIC MOTOR SYSTEM

lower motor neuron

LMN

Brain Stem Descending

Pathway

Final Common Pathway

EFFECTORSskeletal muscle

Pyramidal Tract

VOLUNTARYCONTROL

AUTOMATIC CONTROL

Rubrospinal TractTectospinal TractVestibulospinal TractMLFReticulospinal Tract

REFLEX

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cortico spinal tractمسیر کورتیکو اسپاینال

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Internal Capsule

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مغز میانی

پل مغزی

بصل النخاع

نالمسیر کورتیکو اسپای

تقاطع پیرامیدال

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علامت بابینسکی–آسیب به مسیر کورتیکو اسپاینال

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Vestibulospinal Tract

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Reticulospinal Tract

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dorolateralpathway

مسیر تکتواسپاینال مسیر روبرواسپاینال

هسته قرمزهسته های تکتال

ventromedialpathway

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Decorticate sign

Decerebrate sign

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Brown-Séquard syndrome

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Spinal Cord Syndrome

Brown-Sequard syndrome

(spinal cord hemisection)

Major Symptoms

1. ipsilateral UMN syndrome below the level of lesion

2. ipsilateral LMN syndrome at the level of lesion

3. ipsilateral loss of discriminative touch sensation and

conscious proprioception below the level of lesion

(posterior white column lesion)

4. contralateral loss of pain and temperature sensation

below the level of lesion (spinothalamic tract lesion)

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Upper Motor Neuron (UMN) vs Lower Motor Neuron (LMN) Syndrome

UMN syndrome LMN Syndrome

Type of Paralysis Spastic Paresis Flaccid Paralysis

Atrophy No (Disuse) Atrophy Severe Atrophy

Deep Tendon Reflex Increase Absent DTR

Pathological Reflex Positive Babinski Sign Absent

Superficial Reflex Absent Present

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Locked-in syndrome

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LMN Syndrome - Muscular Atrophy

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Guilan, Eshkevar