1 - 6 Players




  1. Play one card, connecting railway tracts.

  2. Verbally declare your statement for each connection played on.

  3. Draw one card (you should always have four cards in-hand at the end of your turn).

  4. Pass the turn in clockwise order.



Once a player runs out of cards,

finish the round.



Notice the 3 colored borders. The blue border will always remain in play.

Use the GREY & blue bordered cards.

Use the BLACK & blue bordered cards.



I’m new to the concept of spinal tracts and it is ridiculous, how do people remember this?” or “Tracts are pretty cloudy to me.”

  • Points optional.

  • Verbalize your statements, it will help you learn.

  • Hand size is increased to 5 cards. Play 2 cards each turn before drawing. You cannot play on the same connection in one turn.



I’m tired of studying alone.” or “I learn best when I’m interacting with someone.”

  • Don’t count points! You’re learning together.

  • Optional: play with your cards face up.

  • Other players can be dealt in partway.

  • If a player needs to leave early, simply shuffle their hand back into the deck.

  • The only way to win in this co-op version, is by learning together.

  • Be encouraging.



I’m pretty good with my tracts” or “I’m competitive”.

  • The following are different ways to play in a group setting:

Every person for themselves. You are earning points for yourself.

Share collective points with one or more players you do not sit beside.




  • Each card is divided into two unrelated halves, each half has 3 railway tracks to make connections with.

  • To create a “connection,” join at least one railway track from the card in your hand with the track(s) of at least one other card in the playing field.

  • Once cards are joined, all following cards added to the same connection must:

    • relate to the same Spinal Tract.

    • have different background colors.

  • Connections are often made by joining half of one card to half of another. However, when the “connection conditions” are met, both sides of one card may be used to make two different connections. You must make two statements. 

  • If you cannot make a connection, you have one of two options:

  1. Replace up to 4 cards in your hand from the top of the deck, shuffling the discarded cards into the deck after. Pass your turn.

  2. Present your hand to all the players, they have 30 seconds to play a card from your hand. If a player:

  • can play a card, they get all the points played. 

  • cannot play a card, you draw another card. You can play the newly drawn card. If you cannot play the new card, discard down to 4 cards.

The THALAMUS cannot connect to the DORSAL COLUMN because it's already connected to the CUNEATUS NUCLEUS on the other side. However, the THALAMUS can connect to TEMPERATURE. The statement would be:

"The lateral spinothalamic has cell bodies in the thalamus and senses temperature."

Scoring 4 points.



  • After playing a card, you must make a verbal statement about the corresponding spinal tract and how it relates to the connection. This is important for retention and to practice sounding like a doctor. 

  • There are 3 parts to a statement:

    1. Spinal tract involved

    2. Card you played

    3. Card you played it on

  • It is not necessary to name every card in the connection.

  • When playing a Spinal Cord location, the statement should include the tract's location in the spinal cord (dorsal, lateral, anteromedial, etc.).

  • If a connection can relate to several Spinal Tracts and has not been connected to a card qualifying the connection to a specific tract, you must temporarily specify one Spinal Tract for this turn. This includes specifying whether it is anterior, lateral, posterior, etc.  

  • If you used one card to make connections with two distinct Spinal Tracts, you must make a statement for both Tracts.

  • You may challenge a player making a false/incorrect statement.

Because this connection can be either the dorsal column or spinocerebellar tract, you would have to make a temporary statement:

"The anterior SPINOCEREBELLAR tract detects PROPRIOCEPTION and has cell bodies in the DORSAL NERVE ROOT GANGLIA."

Scoring 2 points.



  • A moderate playing space (medium kitchen table) to accommodate up to 60 small domino playing cards.

  • For a card to count it must be able to, on its own, stay flat on the table.


  • This is an option when a player makes a statement that doesn’t correlate the played connection with a true fact about Spinal Tracts.

  • Either consult a judge or the rules (technicalities).

  • The challenged player forfeits their turn if they made a false statement.

    • They may replace up to 4 cards.

  • If the statement is true, the challenger skips their next turn.


  • The person or team scoring the most points at the end of the game.


  • Points are recorded after making a statement.

  • Tally the value of each card involved in the played spinal tract.

  • If scoring from multiple tracts, count each card once for each tract.

    • The played card will be counted twice, once for each tract.

  • The starting card is worth double the points for the first card played on it.

    • You cannot make two connections with one card over the two halves of the starting card.

From one played card, the two connections are:

1. "The lateral SPINOTHALAMIC tract has cell bodies in the DORSAL GREY HORN."

Scoring 5 points.

2. "The lateral CORTICOSPINAL tract decussates in the MEDULLA OBLONGATA and travels posterolaterally in the cord."

Scoring 4 points.

Earning 9 points total.



  • Some of the card names aren't on the Train Tracts reference sheet. Ask the internet or look it up in a text book. They could be:

    • synonyms/AKA's

    • different aspects of anatomy



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