AscendingSS - Ascending Sensory Pathways Afferents to...

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1 Ascending Sensory Pathways Afferents to Posterior Horns (GSA, GVA) Fiber Distributions (Local & Supraspinal) Posterior Columns & Medial Lemniscus System ( epicritic ) Anterolateral System ( protopathic ) Spinocerebellars (Ant & Post) N euroscience 1: H uman Neuroana m y Posterior Horn Proprioceptive (Deep) MS, JR, GTO [Lpos. Sense]* Exteroceptive (Cutaneous) P (FA, SA)- nocioception [sharp] T (h, c, gradient) [warm v. cold] T (FA, SA; form, direction, vibration, tickle, flutter) [Discriminative Touch]* Segregation of modalities Somatotopic mapping Hierarchical distribution Localized tracts Function to serve “movement” * DC/ML Afferents: GSA & GVA
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2 Posterior Spinocerebellar tract Unconscious Proprioception Nucleus Dorsalis (Clarke’s) & Accessory Cuneate Two Major Systems (& Cerebellum) Dorsal Column- Medial Lemniscus Discriminative T Limb Position Anterolateral- Spinothalamic . – Pain Light touch – Temperature Spinocerebellar (a & p) Note: location, adjacent structures, place of decussation
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3 Basic Dorsal Column-Medial Lemniscus Pathway Rosensweig Dorsal Column System Dorsal Column- Medial Lemniscus Discriminative T Limb Position M-L = Inf-Sup to Nuc G. & C.) Course to VPL & “ body ” S 1 (noting adjacent structures) Trigeminothalamic (PS V, ) Cross & join ML in route to VPM & “ face ” S 1
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4 Dorsal Column System Posterior Columns Limb Pos Sen vibratory deep touch gnostic touch proprioception Basic Anterolater Pathway Rosensweig
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5 Anterolateral System Spinothalamic Tr. Light (libidinal) T Pain & Temperature Ct* PH Ia , II, V , via AWC to AL sys (M-L = Sup- Inf) Sup to Nuc G. & C.) Course to: 1. Pontine RF & PAG* 2. CL & CM & Pf (+ POm + Bla**) 3. VPL & “ body ” S 1 (noting adjacent structures) Trigeminothalamic (Spinal V, ) Cross & join ML in route to VPM & face ” S 1 ** “Activating” & “Affective” * Descending modulation of pain Basic Anterolateral Pathway (reciprocal modulation is hierarchical)
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6 Anterolateral System Ant Spinothalamic tr. Pain Lt. Touch Temp. X Spinal Cord: Fununculi & Paths Ascending white Descending white From-To ( + crossing ) Fasciculus Gracilis: Ipsilateral Lower extremities: 1. Limb position sense ( II &VII: GTO, JR, MS ) 2. Gnostic, 2P disc., Vibration ( II & V: Pachinian, Meissner ) 1 o: Rec. > Ipsilateral Nuc. Gracilis (medulla) Cross: (internal arcuates) to contra. ML 2 o : NG > contralateral VPL 3 o : VPL > contralateral S I ( c =3b & 1, d=3a & 2 ) Visualize pathways & appositions Fasciculus Cuneatus: Ipsilateral Upper extremities: 1. Limb position sense ( II &VII: GTO, JR, MS ) 2. Gnostic, 2P disc., Vibration ( II & V: Pachinian, Meissner ) 1 o: Rec. > Ipsilateral Nuc. Gracilis (medulla) Cross: (internal arcuates) to contra. ML 2 o : NG > contralateral VPL 3 o : VPL > contralateral S I ( c =3b & 1, d=3a & 2 ) Visualize pathways & appositions
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7 Somatosensory Cortex Somatotopic: LE ( callosomarginal ACA ) UE & Face ( sup. div. MCA ) Map very labile!
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