Ascending Sensory Pathways Flashcards
What are the somatosensory pathways responsible for?
- Consist of the chain of neurons, from receptor organ to cerebral cortex
- Start with the peripheral first-order (1°) afferent
- End in the cerebral cortex
- Responsible for the perception of bodily senses
What are the somatosensory pathways for the body?
- Spinothalmic pathway: Pain, temperature, crude touch, pressure
- Dorsal column medial lemniscus pathway: Fine touch, vibration, pressure and position
Which of the following corresponds to the primary somatosensory cortex? Where is it located?
Red (where all the somatosensory pathways end) –> post central gyrus
What information is received in the primary somatosensory cortex?
Pain, temperature and touch sensation
Which area is responsible for perceiving visual information?
Blue (occipital lobe)
Which area is responsible for perceiving auditory information?
Green - The auditory cortex is the part of the temporal lobe
What is another word for somatosensory?
Somaesthetic
The general sensory (somaesthetic) pathways carry information to the brain from where? What are examples of these modalities?
- Skin
- Mucous membranes
- Joints and muscles
Modalities: vibration, touch, pressure, pain, temperature, proprioception
What is proprioception?
Our awareness of where our body parts are in space
What is each modality detected by (in the general somaesthetic pathways)?
Each modality is detected by specific sensory receptors / specialised nerve endings
e.g. specific receptor for vibration
These receptors then send their axons all the way via the spinal peripheral nerves to enter the spinal cord.
How does sensory info enter the spinal cord?
Dorsally
Sensory pathways travel from peripheral nerves into the CNS and ascend through spinal cord/brainstem to the brain.
Which nerves transmit sensory info from:
- the body?
- the head, face and neck?
In the body: info transmitted by spinal nerves
In head, face and neck: info transmitted by cranial nerves.
What is a dermatome?
A specific region of skin of the body innervated by the sensory fibres of a single segmental spinal nerve (spinal cord segment):
- E.g. Any sensation at level of nipple is transmitted by the T4 segmental spinal nerve
- E.g. Any sensation at level of umbilicus is transmitted by the T10 segmental spinal nerve
Similar to dermatomes, areas of skin of the face supplied by a single cranial nerve can be identified and mapped. BUT this is not called dermatome.
What is the cranial nerve that supplies sensation to areas of the face?
Branches of CN V trigeminal
The herpes varicella zoster virus causes chickenpox. After you recover from chicken pox, the virus can enter your nervous system and lie dormant for years.
- Where does the varicella zoster virus lie dormant?
- What can it reactivate as?
- Which dermatome is affected during reactivation?
- Lies dormant in the sensory (dorsal) roots of specific spinal or cranial nerves
- Shingles
- Cause of reactivation is not well known (but could be linked to dip in immunity)
- Only affects at level of sensory spinal nerves where virus remained dormant
- E.g. in photo, eruption of vesicles is localised to the area of skin supplied by the T4 spinal nerve
What are the 2 groups of somaesthetic modalities?
- Modalities that are essential to survival
- Pain, temperature
- Some touch and pressure
- Modalities that increase detail
- Discriminative touch: 2-point discrimination and pressure vibration
- Proprioception
How are modalities that are essential to survival carried? What is the conduction rate?
- Carried via thin, poorly myelinated or unmyelinated fibres -
- Conduction relatively slow
How are modalities that increase detail carried? What is the conduction rate?
- Carried via large diameter, heavily myelinated fibres
- Fast conduction
Review of Spinal Cord - Transverse Section
- Grey matter confined to inside and subdivided into regions:
- Dorsal grey horn
- Receives sensory fibres
- Many synapses occur here
- Lateral grey horn
- Contains preganglionic visceral neurons
- Ventral grey horn:
- Contains motor somatic neurons
- Dorsal grey horn
- White matter on outside –> this is where we will find the sensory and motor pathway
- Dorsal white column
- Lateral white column
- Ventral white column
- Ventral white commissure
- Allows fibres to cross from either side
Are the sensory and motor pathways found in grey or white matter?
White matter
Functionally, what can the ascending/somatosensory tracts be divided into?
- Conscious tracts: comprised of the dorsal column-medial lemniscal pathway and the anterolateral system.
- Unconscious tracts: comprised of the spinocerebellar tracts.
DCML Pathway:
- What is it?
- Location?
- What information does it carry?
- Where do fibres decussate?
- What: Ascending sensory pathway
- Location: Dorsal column (white matter) of spinal cord
- Information:
- Fine touch
- Vibration
- Joint position sense (proprioception)
- Decussation: Level of medulla
What side of the body does the DCML pathway convey sensory info from? (i.e. ipsilateral or opposite)
Ipsilateral: If the lesion occurs in the spinal cord (which is most common), the sensory loss will be ipsilateral –> decussates at level of brainstem
How would a lesion of the DCML pathway present?
A loss of proprioception and fine touch. However, a small number of tactile fibres travel within the anterolateral system, and so the patient is still able to perform tasks requiring tactile information processing.
What does the dorsal/posterior column refer to?
the posterior spinal cord, which contains ascending sensory pathways
What forms the dorsal column?
Formed by two large fasciculi (bundles of nerve fibers –> white matter) running through the posterior spinal cord:
- fasciculus gracilis
- fasciculus cuneatus.
These fasciculi gather sensory information from our body’s periphery via skin and joint receptors, and send this information to superior cerebral structures.
What 2 parts does the DCML pathway consist of?
- Dorsal column: Nerve tracts in the white matter of the dorsal columns carry info from spinal cord to medulla
- Medial lemniscus: Continuation of the dorsal column, this pathway starts within the brainstem and sends sensory input to the thalamus and postcentral gyrus
Where is the DCML pathway located in the cord?
Dorsally
Spinothalamic Pathway:
- What?
- Location?
- What info does it carry?
- What is it also referred to as?
- Location of decussation of fibres?
- Ascending pathway consisting of 2 separate tracts; anterior spinothalamic and lateral spinothalamic tract
- Location: Anterior and lateral column (white matter) of spinal cord
- Information:
- Anterior spinothalamic –> crude touch and pressure
- Lateral spinothalamic –> pain and temperature
- Also referred to as the ventrolateral (anterolateral) system
- Decussation –> level of spinal cord
Where does the spinothalamic tract decussate? What does this then mean?
Decussates at the level of the spinal cord, rather than at the brainstem –> left spinothalamic tract conveys sensory info of the right
Where is the spinothalamic tract located in the cord?
Anterior (and lateral) part of white matter i.e. anterolateral system
What are the corticospinal tracts (lateral and ventral)?
Descending motor pathways
The general sensory pathways typically consist of a three neuron chain. Describe the 1st neuron in this chain:
- shape?
- location?
- location of cell body: body and head/neck?
Receptor sends info via axon to cell body
- Primary neuron is the sensory receptor in the periphery that detects sensory stimuli
- Pseudounipolar: one branch going to PNS and other to CNS
- If sensation in body: Cell body is housed in the dorsal root ganglion of a spinal nerve
- If sensation is head or neck: Cell body is housed in the ganglia of the trigeminal or cranial nerves
Describe a pseudounipolar neuron
A type of neuron which has one extension from its cell body. This type of neuron contains an axon that has split into two branches; one branch travels to the peripheral nervous system and the other to the central nervous system.
The axon of the 1ary neuron in the 3 neuron chain of the general sensory pathway then enters the spinal cord via the dorsal root of the spinal nerve to synapse with the 2ary neuron.
- Describe the pathway of the 2ary neuron.
- Where does it start?
- Where does it ascend to?
- The secondary neuron acts as a relay and is located in either the spinal cord or the brainstem.
- 2ary neuron is in the ipsilateral grey matter of the CNS
- Axon of 2ary neuron crosses the midline and ascend up the spinal cord to the brain
- Ascends to the ventral posterior thalamus
For info coming from the body, where does the 2ary neuron ascend to?
Ventral posterior thalamus –> to the ventroposterolateral (VPL) nucleus
For info coming from the face, where does the 2ary neuron ascend to?
Ventral posterior thalamus –> VPM (ventroposterior medial nucleus)
Once entering the ventral posterior thalamus, what does the 2ary neuron do?
Synapses with the 3ary neuron (or, some terminate here)
Regarding the 3ary neuron of the 3 neuron chain:
- Where is its cell body?
- Where does it relay info to?
- Cell body in the thalamus
- Projects to the postcentral gyrus (primary sensory cortex) of the parietal lobe
Summary of 3 neuron chain of general sensory pathways:
Comprise 3 neurons (3 neuron chain): first order, second order and third order
- First order neurons
- From PNS to CNS. Cell bodies in peripheral ganglia (eg. Dorsal root ganglion)
- Pseudounipolar.
- Second order neurons
- Cell bodies of 2nd order neurons reside in CNS ipsilateral grey matter
- Axons cross midline.
- Ascend to Ventroposterolateral (VPL) nucleus of thalamus
- Third order neurons
- Cell bodies of 3rd order neurons reside in thalamus and axons project to somato-sensory cortex
It is important to remember that synaptic transmission from 1st, 2nd and 3rd neurons isn’t a simple relay. Can be modified by other inputs: eg. descending pathways.
How are sensory pathways organised?
Somatotopically organised
What is the spinothalamic pathway responsible for?
pain, temperature, crude touch, some pressure
Describe pathway of spinothalamic pathway from receptor to brain
1ary neuron:
- Receptor located in the periphery and fibres are sent using the dorsal aspect of spinal nerve
- Cell body is found in the dorsal root ganglion (pseudounipolar neuron)
- Fiibres enter into spinal cord and pass briefly through Lissauer’s tract to enter the dorsal horn
- Synapses with 2ary neuron either:
- at same level of entry
- or ascends 1-2 segments to synapse with 2ary neuron
2ary neuron:
- Sends axons that cross the midline in the ventral white commissure
- Axon then enters the spinothalamic tract (ventral white matter)
- Axon then ascends contralaterally in the anterolateral section of the spinal cord to the opposite thalamus
Where is a huge collection of cell bodies of 2ary neurons found?
In dorsal grey horn
Regarding the spinothalamic pathway: After the 1ary neuron enters the dorsal grey horn and synapses with the 2ary neuron, where does the 2ary neuron then send its axon?
- Sends axons that cross the midline in the ventral white commissure
- Axon then enters the spinothalamic tract
What does the spinothalamic tract consist of?
collection of axons that have crossed the midline
The spinothalamic pathway retains somatotopic organisation. Describe the order of fibres from the arm, trunk and leg.
- Any fibre from the arm travels more medially in the tract
- Any fibres from the trunk travels in the middle of the tract
- Any fibres from the leg travels more laterally in the tract
(ATL - more medial to lateral)
In which lamina are the synapses from the spinothalamic tract found?
Lamina I, II, III and IV
i.e. any fibres carrying these modalities will synapse in these few lamina