Spinal nerve in the context of Spinal cord

A sense is a biological system used by an organism for sensation, the process of gathering information about the surroundings through the detection of stimuli. Although, in some cultures, five human senses were traditionally identified as such (namely sight, smell, touch, taste, and hearing), many more are now recognized. Senses used by non-human organisms are even greater in variety and number. During sensation, sense organs collect various stimuli (such as a sound or smell) for transduction, meaning transformation into a form that can be understood by the brain. Sensation and perception are fundamental to nearly every aspect of an organism's cognition, behavior and thought.

In organisms, a sensory organ consists of a group of interrelated sensory cells that respond to a specific type of physical stimulus. Via cranial and spinal nerves (nerves of the central and peripheral nervous systems that relay sensory information to and from the brain and body), the different types of sensory receptor cells (such as mechanoreceptors, photoreceptors, chemoreceptors, thermoreceptors) in sensory organs transduct sensory information from these organs towards the central nervous system, finally arriving at the sensory cortices in the brain, where sensory signals are processed and interpreted (perceived).

In biology, the nervous system is the highly complex part of an animal that coordinates its actions and sensory information by transmitting signals to and from different parts of its body. The nervous system detects environmental changes that impact the body, then works in tandem with the endocrine system to respond to such events. Nervous tissue first arose in wormlike organisms about 550 to 600 million years ago. In vertebrates, it consists of two main parts, the central nervous system (CNS) and the peripheral nervous system (PNS). The CNS consists of the brain and spinal cord. The PNS consists mainly of nerves, which are enclosed bundles of the long fibers, or axons, that connect the CNS to every other part of the body. Nerves that transmit signals from the brain are called motor nerves (efferent), while those nerves that transmit information from the body to the CNS are called sensory nerves (afferent). The PNS is divided into two separate subsystems, the somatic and autonomic nervous systems. The autonomic nervous system is further subdivided into the sympathetic, parasympathetic and enteric nervous systems. The sympathetic nervous system is activated in cases of emergencies to mobilize energy, while the parasympathetic nervous system is activated when organisms are in a relaxed state. The enteric nervous system functions to control the gastrointestinal system. Nerves that exit from the brain are called cranial nerves while those exiting from the spinal cord are called spinal nerves.

The nervous system consists of nervous tissue which, at a cellular level, is defined by the presence of a special type of cell, called the neuron. Neurons have special structures that allow them to send signals rapidly and precisely to other cells. They send these signals in the form of electrochemical impulses traveling along thin fibers called axons, which can be directly transmitted to neighboring cells through electrical synapses or cause chemicals called neurotransmitters to be released at chemical synapses. A cell that receives a synaptic signal from a neuron may be excited, inhibited, or otherwise modulated. The connections between neurons can form neural pathways, neural circuits, and larger networks that generate an organism's perception of the world and determine its behavior. Along with neurons, the nervous system contains other specialized cells called glial cells (or simply glia), which provide structural and metabolic support. Many of the cells and vasculature channels within the nervous system make up the neurovascular unit, which regulates cerebral blood flow in order to rapidly satisfy the high energy demands of activated neurons.

The spinal column, also known as the vertebral column, spine or backbone, is the core part of the axial skeleton in vertebrates. The vertebral column is the defining and eponymous characteristic of the vertebrate. The spinal column is a segmented column of vertebrae that surrounds and protects the spinal cord. The vertebrae are separated by intervertebral discs in a series of cartilaginous joints. The dorsal portion of the spinal column houses the spinal canal, an elongated cavity formed by the alignment of the vertebral neural arches that encloses and protects the spinal cord, with spinal nerves exiting via the intervertebral foramina to innervate each body segment.

There are around 50,000 species of animals that have a vertebral column. The human spine is one of the most-studied examples, as the general structure of human vertebrae is fairly typical of that found in other mammals, reptiles, and birds. The shape of the vertebral body does, however, vary somewhat between different groups of living species.

Degenerative disc disease (DDD) is a medical condition typically brought on by the aging process in which there are anatomic changes and possibly a loss of function of one or more intervertebral discs of the spine. DDD can take place with or without symptoms, but is typically identified once symptoms arise. The root cause is thought to be loss of soluble proteins within the fluid contained in the disc with resultant reduction of the oncotic pressure, which in turn causes loss of fluid volume. Normal downward forces cause the affected disc to lose height, and the distance between vertebrae is reduced. The anulus fibrosus, the tough outer layers of a disc, also weakens. This loss of height causes laxity of the longitudinal ligaments, which may allow anterior, posterior, or lateral shifting of the vertebral bodies, causing facet joint malalignment and arthritis; scoliosis; cervical hyperlordosis; thoracic hyperkyphosis; lumbar hyperlordosis; narrowing of the space available for the spinal tract within the vertebra (spinal stenosis); or narrowing of the space through which a spinal nerve exits (vertebral foramen stenosis) with resultant inflammation and impingement of a spinal nerve, causing a radiculopathy.

DDD can cause mild to severe pain, either acute or chronic, near the involved disc, as well as neuropathic pain if an adjacent spinal nerve root is involved. Diagnosis is suspected when typical symptoms and physical findings are present; and confirmed by x-rays of the vertebral column. Occasionally the radiologic diagnosis of disc degeneration is made incidentally when a cervical x-ray, chest x-ray, or abdominal x-ray is taken for other reasons, and the abnormalities of the vertebral column are recognized. The diagnosis of DDD is not a radiologic diagnosis, since the interpreting radiologist is not aware whether there are symptoms present or not. Typical radiographic findings include disc space narrowing, displacement of vertebral bodies, fusion of adjacent vertebral bodies, and development of bone in adjacent soft tissue (osteophyte formation). An MRI is typically reserved for those with symptoms, signs, and x-ray findings suggesting the need for surgical intervention.

Each vertebra (pl.: vertebrae) is an irregular bone with a complex structure composed of bone and some hyaline cartilage, that make up the vertebral column or spine, of vertebrates. The proportions of the vertebrae differ according to their spinal segment and the particular species.

The basic configuration of a vertebra varies; the vertebral body (also centrum) is of bone and bears the load of the vertebral column. The upper and lower surfaces of the vertebra body give attachment to the intervertebral discs. The posterior part of a vertebra forms a vertebral arch, in eleven parts, consisting of two pedicles (pedicle of vertebral arch), two laminae, and seven processes. The laminae give attachment to the ligamenta flava (ligaments of the spine). There are vertebral notches formed from the shape of the pedicles, which form the intervertebral foramina when the vertebrae articulate. These foramina are the entry and exit conduits for the spinal nerves. The body of the vertebra and the vertebral arch form the vertebral foramen; the larger, central opening that accommodates the spinal canal, which encloses and protects the spinal cord.

In human anatomy, the spinal canal, vertebral canal or spinal cavity is an elongated body cavity enclosed within the dorsal bony arches of the vertebral column, which contains the spinal cord, spinal roots and dorsal root ganglia. It is a process of the dorsal body cavity formed by alignment of the vertebral foramina. Under the vertebral arches, the spinal canal is also covered anteriorly by the posterior longitudinal ligament and posteriorly by the ligamentum flavum. The potential space between these ligaments and the dura mater covering the spinal cord is known as the epidural space. Spinal nerves exit the spinal canal via the intervertebral foramina under the corresponding vertebral pedicles.

In humans, the spinal cord gets outgrown by the vertebral column during development into adulthood, and the lower section of the spinal canal is occupied by the filum terminale and a bundle of spinal nerves known as the cauda equina instead of the actual spinal cord, which finishes at the L1/L2 level.

A dorsal root ganglion (or spinal ganglion; also known as a posterior root ganglion) is a cluster of neurons (a ganglion) in a dorsal root of a spinal nerve. The cell bodies of sensory neurons, known as first-order neurons, are located in the dorsal root ganglia.

The axons of dorsal root ganglion neurons are known as afferents. In the peripheral nervous system, afferents refer to the axons that relay sensory information into the central nervous system (i.e., the brain and the spinal cord).

A mixed nerve is any nerve that contains both sensory (afferent) and motor (efferent) nerve fibers. All 31 pairs of spinal nerves are mixed nerves. Four of the twelve cranial nerves – V, VII, IX and X are mixed nerves.

A nerve plexus is a plexus (branching network) of intersecting nerves. A nerve plexus is composed of afferent and efferent fibers that arise from the merging of the anterior rami of spinal nerves and blood vessels. There are five spinal nerve plexuses, except in the thoracic region, as well as other forms of autonomic plexuses, many of which are a part of the enteric nervous system. The nerves that arise from the plexuses have both sensory and motor functions. These functions include muscle contraction, the maintenance of body coordination and control, and the reaction to sensations such as heat, cold, pain, and pressure. There are several plexuses in the body, including:

• Spinal plexuses
  • Cervical plexus – serves the head, neck and shoulders
  • Brachial plexus – serves the chest, shoulders, arms and hands
  • Lumbosacral plexus
    • Lumbar plexus – serves the back, abdomen, groin, thighs, knees, and calves
      • Subsartorial plexus – below the sartorius muscle of thigh
    • Sacral plexus – serves the pelvis, buttocks, genitals, thighs, calves, and feet
    • Pudendal plexus
  • Coccygeal plexus – serves a small region over the coccyx
• Autonomic plexuses
  • Celiac plexus (solar plexus) – serves internal organs
  • Auerbach's plexus (myenteric plexus) – serves the gastrointestinal tract
  • Meissner's plexus (submucosal plexus) – serves the gastrointestinal tract
  • Pharyngeal plexus of vagus nerve – serves the palate and pharynx
  • Cardiac plexus – serves the heart

The epineurium is the outermost layer of dense irregular connective tissue surrounding a peripheral nerve. It usually surrounds multiple nerve fascicles as well as blood vessels which supply the nerve. Smaller branches of these blood vessels penetrate into the perineurium. In addition to blood vessels which supply the nerve, lymphocytes and fibroblasts are also present and contribute to the production of collagen fibers that form the backbone of the epineurium. In addition to providing structural support, lymphocytes and fibroblasts also play a vital role in maintenance and repair of the surrounding tissues.

When the spinal nerve leaves the vertebral canal via an intervertebral foramen, two layers of the spinal meninges, the arachnoid and the dura invaginate the nerve to form a dural sleeve of connective tissue, which is the epineurium. The outer portion of this sleeve comprises the external epineurium which permits longitudinal nerve excursion and absorption of longitudinal stress. The layer of the epineurium that extends within the nerve to define the fascicles is termed the internal epineurium. Together, these two layers form the epineurium, which varies in thickness along the course of a nerve. The epineurium is usually most abundant around joints, as its function is to protect the nerves from stretching and subsequent injury. Epineurium is primarily made from collagen.

The intervertebral foramen (also neural foramen) (often abbreviated as IV foramen or IVF) is an opening between (the intervertebral notches of) two pedicles (one above and one below) of adjacent vertebra in the articulated spine. Each intervertebral foramen gives passage to a spinal nerve and spinal blood vessels, and lodges a posterior (dorsal) root ganglion. Cervical, thoracic, and lumbar vertebrae all have intervertebral foramina.