Somatosensory System Flashcards

1
Q

How can sensation be classified

A

Sensation can be split into the following classification
o General sensation, referring to the body wall and viscera (including parietal
layer of serous membranes and mucosa of pharynx, nasal cavity and anus)
 Subdivided into somatic sensation (conscious), and visceral sensation
(usually unconscious)
o Special sensation, referring the special senses of vision, hearing, balance,
taste and smell

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2
Q

What is a modality

A

Somatic sensation
o There are a variety of modalities of somatic sensation. A modality can be
thought of as a ‘unit’ of sensation, relying on a distinct receptor type
Spinothalamic vs dorsalcolumn medial lemniscus

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3
Q

What are the functions of the spinothalamic system

A

Spinothalamic system
• Temperature (thermoreceptors)
• Pain (nociceptors)
• Pressure/crude touch (mechanoreceptors)

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4
Q

What are the functions of the demo system

A

Dorsal column-medial lemniscus system
• Vibration (mechanoreceptors)
• Proprioception, or joint position sense, or kinaesthetic sense
(detected by a variety of receptors such as muscle spindles
and Golgi tendon organs)
• Fine touch (mechanoreceptors)
• Two point discrimination (mechanoreceptors)

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5
Q

Describe primary sensory neurones

A

Primary sensory neurones (aka dorsal root ganglion neurones or primary
afferents or first order sensory neurones or psueudunipolar neurones) receive information from receptors and are responsible for the initial encoding of sensory information
 Each individual primary neurone receives input from a single receptor type
 Primary sensory neurones have their cell body in the dorsal root ganglion, and collect information from a single dermatome along their peripheral axon
 Primary sensory neurones project into the spinal cord along their central axon

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6
Q

Describe strength of receptor activation

A

The strength of receptor activation is converted from an analogue signal (related to ion flux during the generator potential) to a digital signal (which is the frequency of action potentials in the primary sensory neurone)
 Strong receptor activation causes high frequency of action potentials in the primary sensory neurone
 Weak receptor activation causes a low frequency of action potentials in the primary sensory neurone

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7
Q

What are rapidly and slowly adapting receptors

A

o Rapidly adapting receptors (e.g. mechanoreceptors) respond best to changes in strength of stimulation. However, their frequency of firing diminishes rapidly after the initial stimulus (i.e. they rapidly adapt). Adaptation of these receptors explains why you are not aware of your clothes on your skin
o Slowly adapting receptors (e.g. nociceptors) change their frequency of firing very little after the initial stimulus. This explains why pain can be so persistent, and you never really get ‘used to’ having pain

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8
Q

What are receptive fields

A

Receptive fields
o A single primary sensory neurone supplies a given area of skin (it’s receptive
field)
o If an area of skin is supplied by sensory neurones with relatively large
receptive fields, this area will have low sensory acuity (it would have poor two-point discrimination where two points would need to be far apart to be distinguished). The skin of the back has relatively low acuity
o If an area of skin is supplied by sensory neurones with relatively small receptive fields, this area will have high sensory acuity (it would have great two-point discrimination where two points could be very close together to be distinguished). The skin of the fingertip has relatively high acuity
o The overlap of receptive fields of primary sensory neurones from adjacent dermatomes is one of the reasons why dermatomes can have ‘fuzzy’ boundaries

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9
Q

Wgat are the chain of 3 neurones

A

First, second and third order

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10
Q

Describe first order neurones

A

First order sensory neurones
 Have their cell bodies in the DRG
 Communicate with a receptor
 Their central axon projects ipsilateral to the cell body  Project onto second order neurones

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11
Q

Describe second order neurones

A

Second order sensory neurones
 Have their cell bodies in the spinal cord dorsal horn or medulla  Decussate
 Project onto third order neurones

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12
Q

Describe third order neurones

A

Thirdorderneurones
 Have their cell bodies in the thalamus
 Project to the primary sensory cortex (postcentral gyrus)

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13
Q

What is topographical representation

A

Somatotopy, or topographical representation
o The principle relating to the idea that for every point on the surface of the
body, an equivalent point can be identified along the sensory pathway
o With some exceptions, adjacent body regions map to adjacent regions of the
sensory system (e.g. in the sensory cortex, the hand is represented adjacent to the wrist)
o This way of organising the pathways minimises the amount of ‘wiring’
required to transmit sensory information
o The motor system has a similar organisation, but running in reverse
o Information becomes reorganised as we move upwards through the neuraxis,
such that at the level of spinal nerves and spinal cord we have a dermatomal
organisation, but at levels of the thalamus and above we have a ‘homuncular’
pattern
o At the level of the sensory homunculus, all modalities converge (i.e. the head
area of the sensory cortex deals with pain, temperature, vibration etc. all at the same time)

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14
Q

Descrbe the dcml system

A

The dorsal column-medial lemniscus system (DCML)
o Responsible for carrying impulses concerning light touch, vibration, two point
discrimination and proprioception
o Axons of first order neurones ascend ipsilaterally through the dorsal columns
of the spinal cord

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15
Q

Describe 1o neurones in the dcml system

A

Concerning first order neurones of the DCML system:
 Those from the lower body (T7 and below) ascend through the gracile fasciculus to the gracile nucleus in the medulla)
 Those from the upper half of the body (T6 and above) ascend through the cuneate fasciculus to the cuneate nucleus in the medulla

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16
Q

Describe 2o neurones in the dcml system

A

Concerning second order neurones of the DCML system:
 Neurones in the gracile nucleus project to the contralateral thalamus
in the medial lemniscus
 Neurones in the cuneate nucleus project to the contralateral
thalamus in the medial lemniscus

17
Q

Describe 3o neurones in the dcml system

A

ConcerningthirdorderneuronesoftheDCMLsystem:
 Thalamic neurones receiving information ultimately from the lower half of the body (via gracile nucleus) project to the medial part of the primary sensory cortex
 Thalamic neurones receiving information ultimately from the upper half of the body (via cuneate nucleus) project to the lateral part of the primary sensory cortex

18
Q

Describe teh topographical organisation of the dorsal columns

A

Topographical organisation of the dorsal columns
 Axons from the lower parts of the body run most medially
 Axons from progressively superior body segments are added laterally
to the dorsal columns

19
Q

Gove an overview os the stt system

A

The spinothalamic pathway or anterolateral system or spinothalamic tract (STT)
o Responsible for carrying impulses concerning pain, temperature and crude
touch
o Axons of first order neurones project to the ipsilateral dorsal cord, but the
spinothalamic tract supplies the contralateral half of the body

20
Q

Describe 1o neurones of the stt

A

Concerning first order neurones of the STT:
 They project onto second order neurones in the ipsilateral spinal cord dorsal horn in the segment at which they enter the cord through the dorsal root (generally)

21
Q

Describe 2o neurones of the stt

A

Concerning second order neurones of the STT:
 Their cell bodies are in the dorsal horn
 Their axons decussate in the ventral white commissure of the cord
and then go on to form the spinothalamic tract  The spinothalamic tract projects to the thalamus

22
Q

Describe 3o neurones of the stt

A

ConcerningthirdorderneuronesoftheSTT:
 Thalamic neurones receiving information ultimately from more
inferior parts of the body project to the medial part of the primary
sensory cortex
 Thalamic neurones receiving information ultimately from more
superior parts of the body project to the lateral part of the primary sensory cortex

23
Q

Describe the topographical organisation of the stt

A

Topographical organisation of the spinothalamic tract
 Axons from the lower parts of the body run most
laterally/superficially
 Axons from progressively superior body segments are added
medially/deeper onto the spinothalamic tract
 This is the opposite of the situation for the dorsal columns, and is due
to the decussation of the STT second order neurones at the level of entry of the first order neurones

24
Q

What is brown-syquard syndrome

A

Brown-Sequard syndrome (limited to sensory features)
o If we consider a complete cord hemisection causing destruction of one lateral
half of a single cord segment resulting from trauma or ischaemia, the following structures will be completely destroyed unilaterally:
 The dorsal horn
 The ventral horn
 All other cord grey matter
 All white matter pathways
 Dorsal and ventral roots

25
Q

What are th signs of brown-syquard syndrome

A

This will lead to the following signs (making reference to the side of the lesion):
 Ipsilateral complete segmental anaesthesia affecting a single dermatome (due to destruction of dorsal root and dorsal horn)
 Ipsilateral loss of dorsal column modalities below the destroyed segment
 Contralateral loss of spinothalamic modalities at and below the destroyed segment (although level can be up to a couple of segments lower due to ascent of some primary afferents in Lissauer’s tract – advanced, so only pursue if you are keen!)

26
Q

Describe descending modulation ofpain

A

Descending modulation of pain
o Second order neurones of the spinothalamic system dealing with pain receive
nociceptive primary afferents as well as inhibitory interneurones which
contain the endorphin encephalin
o These encephalinergic interneurones can be activated by incoming impulses
from mechanoreceptors (hence explaining why rubbing a sore area relieves the pain)
o Additionally, these encephalinergic interneurones can also be activated by descending inputs from higher centres such as the periaqueductal grey matter or the nucleus raphe magnus