Expanded Topics

The Spinal Cord and PNS Tutorial

Unit 1: General Information

This section covers two areas, an overview of the divisions of the nervous system and the types of cells in the spinal cord and spinal peripheral nerves. The overview gives a schemata of the sections of the nervous system that can be used when studying the program. The types of cells section reviews the function and structure of the neurons and neuralgia: astrocytes, microglia, oligodendrocytes, and ependyma cells. It includes video clips that cover pathologies such as multiple sclerosis and peripheral nerve injuries. Both medical and nursing interventions are listed. A video clip demonstrating neurovascular assessment is also included.

Unit 2: The Spinal Cord

This unit is broken into five sections:

General Features of the Spinal Cord
Meninges and Spaces
Cerebrospinal Fluid
Blood Supply
Bony Structure

Section 1: General Features of the Spinal Cord

This section discusses the general features of the spinal cord from a longitudinal view and a cross-section view. Topics discussed include: sections of the spinal cord, anatomy of the spinal cord, and the white and gray matter. Each of the ascending and descending tracts are individually discussed. Also included are video clips that cover pathologies such as amyotrophic lateral sclerosis, spinal cord injury, and autonomic dysreflexia. Both medical and nursing interventions are covered. Video clips are used to demonstrate assessment of the spinal tracts.

Section 2. Meninges and Spaces

This section discusses the three meninges that cover the spinal cord as well as their related spaces. A video clip covers myelomeningocele as the clinical application for this section. Nursing interventions for the newborn with myelomeningocele are reviewed.

Section 3. Cerebrospinal Fluid

This section discusses the protective and circulatory function of cerebral spinal fluid. A video clip discusses a lumbar puncture as the clinical application in this section. Nursing interventions for a patient undergoing a lumbar puncture are included.

Section 4. Blood Supply

This section discusses the major blood supply to the spinal cord. The vessels covered include the anterior spinal artery, posterior spinal arteries, and radicular arteries.

Section 5: Bony Structure

This section discusses the bony vertebral column that surrounds and protects the spinal cord. A video clip discusses a herniated disc as the clinical application in this section. Nursing interventions for both medical management and surgical management for a patient with a herniated disc are included. A video clip demonstrates a nurse assessing the vertebral column.

Unit 3: The Peripheral Spinal Nerves

This unit is broken into four sections:

General Features of the Peripheral Spinal Nerves
Sensory (Afferent) System
Motor (Efferent) System
Reflex Pathways

Section 1: General Features of the Peripheral Spinal Nerves

This section discusses general features of peripheral spinal nerves such as the number of pairs of spinal nerves, their anatomical location, and the parts of the single spinal nerve. A video clip discusses Guillain-Barre Syndrome as the clinical application in this section. Both medical management and nursing interventions are listed for the patient with Guillain-Barre Syndrome.

Section 2: Sensory (Afferent) System

This section discusses the sensory afferent system and includes information on sensory impulses, Golgi tendon organs, and dermatomes. The anatomy of the sensory nerve is reviewed. Video clips discuss pathologies such as carpal tunnel syndrome and herpes zoster as the clinical applications in this section. Video clips are also used to demonstrate assessment of the sensory system related to two-point discrimination, proprioception, stereognosis, graphesthesia, temperature, pain, and light/deep touch. A sensory assessment based on dermatome distribution of spinal nerves is also demonstrated.

Section 3: Motor (Efferent) System

This extensive section covers both the somatic efferent nervous system and the visceral efferent nervous system (autonomic nervous system). The somatic efferent system is broken into the pyramidal motor pathways, extrapyramidal motor pathways, and cerebellar system. The autonomic nervous system is broken into the sympathetic and parasympathetic divisions. Video clips discuss pathologies such as myasthenia gravis and pheochromocytoma as the clinical applications in this section.

Both medical management and nursing interventions are listed. Video clips also demonstrate various aspects of physical assessment related to the efferent nervous system.

Section 4: Reflex Pathways

A simple, monosynaptic reflex arc is discussed in this section. The importance of testing reflexes is noted. Video clips provide a look at the assessment of various reflexes.

Unit 4: Changes with Aging

This section covers changes that occur in the nervous system of the elderly. Changes as they relate to the sensory, motor, and autonomic nervous system are covered.

Unit 5: Test Bank for Self Test

This unit consists of a test bank covering all the information presented in the program:

General Information
The Spinal Cord
The Spinal Peripheral Nerves
Changes with Aging

The test bank questions were designed to address all levels of difficulty. Knowledge and comprehension questions are used to ensure the student has mastered the necessary foundation. Synthesis and application questions are used to test the student's ability to apply the information to patient situations.

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