Spinal Cord

The spinothalamic and lemniscal pathways carry somatosensory information from the periphery into the brain while the corticospinal pathway carries motor commands from the brain to motoneurons of the spinal cord. Following these pathways through the spinal cord allows the student to infer lesion location from symptoms. To exemplify the clinical importance of sympathetic outputs from thoracic segments, Horner syndrome is described. Similarly, the common problems caused by spinal cord injury on sacral parasympathetic functions are stressed. The contributions of specific spinal segments to breathing, hand and foot dexterity, and micturition are emphasized. Working through the logic of the symptoms caused by spinal hemisection (Brown-Séquard syndrome), pyramidal stroke, and syringomyelia provides the student with a clear framework for understanding spinal function in the clinical context.