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Central Nervous System Side Effects from HIV Treatment
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The spinal cord is a long column of neural tissue that extends from the base of the brain, downward (inferiorly) through a canal created by the spinal vertebral foramina. The spinal cord is between 16.9 and 17.7 inches (43 and 45 centimeters) long in the average woman and man, respectively. The spinal cord usually terminates at the level of the first lumbar vertebra.
The spinal cord is enclosed and protected by the vertebra of the spinal column. There are four regions of vertebrae. Beginning at the skull and moving downward, there are the eight cervical vertebrae, 12 thoracic vertebrae, five lumbar vertebrae, five sacral vertebrae, and one set of fused coccygeal vertebra.
Along the length of the spinal cord are positioned 31 pairs of nerves. These are known as mixed spinal nerves, as they convey sensory information to the brain and response information back from the brain. Spinal nerve roots emerge from the spinal cord that lies within the spinal canal. Both dorsal and ventral roots fuse in the intervertebral foramen to create a spinal nerve.
Although there are only seven cervical vertebra, there are eight cervical nerves. Cervical nerves one through seven (C1–C7) emerge above (superior to) the corresponding cervical vertebrae. The last cervical nerve (C8) emerges below (inferior to) the last cervical vertebrae from that point downward the spinal nerves exit below the corresponding vertebrae for which they are named.
In the spinal cord of humans, the myelin-coated axons are on the surface and the axon-dendrite network is on the inside. In cross-section, the pattern of contrasting color of these regions produces an axon-dendrite shape that is reminiscent of a butterfly.
The nerves of the spinal cord correspond to the arrangement of the vertebrae. There are 31 pairs of nerves, grouped as eight cervical pairs, 12 thoracic pairs, five lumbar pairs, five sacral pairs, and one coccygeal pair. The nerves toward the top of the cord are oriented almost horizontally. Those further down are oriented on a progressively upward slanted angle toward the bottom of the cord.
Toward the bottom of the spinal cord, the spinal nerves connect with cells of the sympathetic nervous system. These cells are called pre-ganglionic and ganglionic cells. One branch of these cells is called the gray ramus communicans and the other branch is the white ramus communicans. Together they are referred to as the rami. Other rami connections lead to the pelvic area.
The bi-directional (two-way) communication network of the spinal cord allows the reflex response to occur. This type of rapid response occurs when a message from one type of nerve fiber, the sensory fiber, stimulates a muscle response directly, rather than the impulse traveling to the brain for interpretation. For example, if a hot stove burner is touched with a finger, the information travels from the finger to the spinal cord and then a response to move muscles away from the burner is sent rapidly and directly back. This response is initiated when speed is important.
Both the spinal cord and the brain are made up of structures of nerve cells called neurons. The long main body extension of a neuron is called an axon. Depending on the type of nerve, the axons may be coated with a material called myelin. Both the brain and spinal cord components of the central nervous system contain bundles of cell bodies (out of which axons grow) and branched regions of nerve cells that are called dendrites. Between the axon of one cell body and the dendrite of another nerve cell is an intervening region called the synapse. In the spinal cord of humans, the myelin-coated axons are on the surface and the axon-dendrite network is on the inside. In the brain, this arrangement is reversed.
The brain begins as a swelling at the cephalic end of the neural tube that ultimately will become the spinal cord. The neural tube is continuous and contains primitive cerebrospinal fluids. Enlargements of the central cavity (neural tube lumen) in the region of the brain become the two lateral, third, and forth ventricles of the fully developed brain.
The embryonic brain is differentiated in several anatomical regions. The most cephalic region is the telencephalon. Ultimately, the telencephlon will develop the bilateral cerebral hemispheres, each containing a lateral ventricle, cortex (surface) layer of gray cells, a white matter layer, and basal nuclei. Caudal (inferior) to the telecephalon is the diencephalon that will develop the epithalamus, thalamus, and hypothalamus
Caudal to the diencephalon is the mesencephalon, the midbrain region that includes the cerebellum and pons. Within the myelencephalon region is the medulla oblongata.
Neural development inverts the gray matter and white matter relationship within the brain. The outer cortex is
The meninges that protect and help nourish neural tissue are formed from embryonic mesoderm that surrounds the axis established by the primitive neural tube and notochord. The cells develop many fine capillaries that supply the highly oxygen-demanding neural tissue.
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Author Info: Brian Douglas Hoyle PhD, Paul Arthur, The Gale Group Inc., Gale, Detroit, Gale Encyclopedia of Neurological Disorders, 2005 |