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)