Ascending Sensory Systems

Note: unconscious pathways terminate in the cerebellum

Conscious sensation, original in periphery, and transmitted to cerebral cortex via neuronal pathway In conscious (cortical) pathway, 3 orders of neurons are present o 1st cell body in !" is primary neuron for all long ascending pathways of spinal cord Ipsilateral nd o # location varies $ain and temperature within dorsal horn close to entry %one &actile vibration and position in the medulla Contralateral o 3rd originate in the thalamus, pro'ecting to somatosensory cortex (conscious) Specific Pathways

Dorsal Column / Medial Lemniscal System (posterior) [A ! 3 orders of neurons

o Conscious discriminative touch *ight touch (pressure+vibrat,), tactile discrimination (si%e+shape), proprioception (-conscious" 'oint position) o .peciali%ed s/in receptors: $acinian Corpuscles flutter + rapidly adapting 0eissner Corpuscles light touch + rapidly adapting + position and movement of ob'ect 0er/el is/s respond to steady touch + slow adapting !uffini vibration o #oute$ 1st order !" axons enter at dorsal horn (sensory) 1st order synapse in the medulla ipsilateral #nd order travel up medial lemniscus, cross midline as the internal arcuate fibers, synapse on the %entral posterior lateral nucleus of the thalamus contralateral 3rd order travel through internal capsule and synapse on &' somatosensory corte(
Internal arcuate fibers medial lemniscus (crosses midline) internal capsule somatosensory cortex

o 1ther information *ower limb sensory is medial gracile fasciculus 2pper limb sensory is lateral cuneate fasciculus

Spinocere)ellar *ract + [A,! # orders of neurons

o -nconscious / proprioceptive 3oint + muscle + body position o 4lso speciali%ed axonal endings in peripheral 'oints + muscles 0uscle spindles + golgi tendon organs + deep pressure sensors o Posterior .pinocerebellar &ract individual muscle in extremity 5 ipsilateral 1st enter dorsal horn of .pinal Cord lower enter at sacral or lumbar levels, then ascend to upper lumbar segments via posterior columns and synapse on #nd neurons of medially located Clarkes nucleus at *#+*3 then to cerebellum via inferior cere)ellar peduncle -pper enter at cervical levels and synapse on # nd neurons of accessory cuneate nucleus of caudal medulla then to cerebellum via inferior cere)ellar peduncle

o Anterior .pinocerebellar &ract entire extremity ipsilateral. )ut due to two crosses 1st order enter dorsal horn and synapse at gray matter

#nd order cross at sacral level and ascend to midbrain, then cross again at this level to synapse at cerebellum via superior cere)ellar peduncle

Pain Systems
o .pinal cord thalamus cerebral cortex via 6 pathways 3 main pathways Spinothalamic *ract/ contralateral o 0ost prominent ascending nociceptive pathway in .,C o #7 neurons from nociceptive specific neurons of I and 858II, ascend to Lissauer0s *ract then crosses midline and ascends to anterolateral 9uadrant o 37 neurons in 1PL or Central Lateral nucleus of thalamus, axons pro'ect to somatosensory cortex o *esions pain reduction to contralateral side Spinoreticular *ract/ contralateral o #7 neurons laminae 8II and 8III, anterolateral 9uadrant o 37 neurons in reticular formation of the pons / reticular formation of the medulla and thalamus, axons pro'ect to somatosensory cortex Spinomesencephalic *ract/ + contralateral o #7 neuron laminae I and 8, ascend via the dorsolateral funiculus and terminate in the mesencephalic reticular formation, peria9ueductal grey matter and via the spinoparabrachial tract in the limbic system &herefore contributes to affecti%e pain component with lesion, will persist

Cer%icothalamic *ract contralateral

o #7 neuron laminae III and I8, synapse in the lateral cer%ical nucleus in C15C#, o 37 neuron cross midline, synapse in medial lemniscus of brainstem to midbrain and thalamus

Spinohypothalamic *ract
o #7 neuron laminae I, 8 and 8III pro'ects to supraspinal autonomic control, activating neuroendocrine and C8 responses

*halamic 2uclei relay information to Corte(

Lateral 2uclear 3roup 8$* + 8$0 + $osterior nuclei of thalamus o *ateral thalamus in'ury location acute pain response o .pinothalamic tract (trun/ and extremities) terminates in lateral 8$ nucleus (8$*) o &rigeminal nucleus (face) terminates in medial 8$ nucleus (8$0) 2eospinothalamic tract 4 Spinothalamic tract Medial 2uclear 3roup central lateral nucleus of thalamus and intralaminar complex o Noxious stimuli arousal and activates nonspecific arousal o *aminae 8II and 8III Paleospinothalamic tract 4 Spinoreticular tract

Descending Motor / Autonomic Systems

8oluntary responses originate in corte( after sensory input modified after passing through the cerebellum and basal ganglia the output is via descending motor autonomic pathways Involuntary responses are from other (a) )rainstem after sensory input from internal receptors o 1r from the (b) spinal cord after innervation of a motor neuron from a 17 sensory neuron 0otor systems two categories

Pyramidal System / Corticospinal *ract + newer system with a ma'or and minor pathway for
voluntary movement o 5unction for conscious movement o 6rigin in the 17 motor cortex in $recentral gyrus, anterior to central .ulcus where conscious movement originates (upper motor neurons) escend through internal capsule. then the thalamus and mid)rain as the cere)ral peduncle $roceed through the pons to the medulla, where they form the pyramids on the %entral surface of the )rainstem o Passage
2pper motor neurons internal capsule cerebral peduncle pyramidal decussation (cross or don:t cross)

Lateral ;contralateral! + <=> 5 cross pyramidal decussation in the caudal medulla, and then travel through the lateral funiculus in the spinal cord, with sacral fibers medial and cervical lateral

1entral [mostly ipsilateral! + 1=> 5 don0t cross pyramidal decussation, then through the anterior funiculus, some axons cross in anterior white commissure at the level of termination 0ost anterior (ventral) fibers end in cervical+thoracic region nec/+shoulder movement o *ermination leave tracts to enter the %entral horn, terminating on motor neurons or interneurons 6=> cervical, 3=> lumbosacral, #=> thoracic

7(trapyramidal System
o 5unction 5 older system for involuntary movement + posture against gravity o 6rigin not in cortex because not voluntary system o Passage below

2ame
1esti)ulospinal #eticulospinal *ectospinal #u)rospinal

6rigin
vestibular nuclei of medulla

Passage

#oute

reticular formation pons+medulla superior colliculi of midbrain red nucleus of midbrain

4nterior part of anterior+lateral Ipsilateral funiculus of 4nterior part of lateral funiculus Ipsilateral 4nterior funiculus *ateral funiculus Contralateral Contralateral

o *ermination leave tracts and enter ventral horn, terminating on motor neurons or interneurons