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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)