ASCENDING PATHWAYS

SENSORY SYSTEM
 Sense
 Special Senses  General Senses
 Olfaction  Touch
 Vision  Pressure
 Taste  Vibration
 Hearing  Pain
 Vestibular function  Thermal sensation
 Propioception
 Receptors

 Skin
 Viscera
 Muscles
 Tendons
 Joints
 Cutaneous Receptors

 Pacinian corpuscle: touch, vibration

 Merkel’s disc: touch, pressure
 Free nerve endings: strong mechanical and thermal impulse, pain
 Meissner’s corpuscles: tactile
 Krauses’ end bulbs: thermoreceptors
 Mechanoreceptors

 Located in joint and muscles

 Proprioception

 Joint receptors
• Golgi type: in the ligaments
• Ruffini terminals: in joint capsule
• Paciniform corpuscles: in joint capsule
• Free nerve endings: in lig. and
capsule

 Muscle receptors
• Golgi tendon organ
• Muscle spindle
Ascending Tracts
 Ascending projections
consist of 3 neurons;
 First order neuron;
dorsal root ganglia
 Second order neuron;
Laminas of spinal cord’s
grey matter
 Third order neuron;
thalamus
 Tracts(fasciculi);
Groups of three
neuronal chains having
same origin, course and
termination
Anterior Spinothalamic Tract
Convey coarse (non-
discriminative) touch and
pressure
 First order neuron;
dorsal root ganglion
 Enters from the tip of
the post gray column
 Ascending and descending
brs. travel one or
two segments of sc and
form posterolateral
tract of Lissauer
Anterior Spinothalamic Tract
 Second order neuron:
Laminae I, IV, V
• Decussation at
anterior white
commissure
• A few fibers do not
cross, ascend in the
ipsilateral tract (%10)
• Ascends in the
contralateral white
column (ant funiculus)
as anterior
spinothalamic tract
 Anterior Spinothalamic Tract
 Third order neuron

• VPL nucleus (thalamus)

• Posterior limb of internal capsule

• Corona radiata

• Cortex: Brodmann 3.1.2

(postcentral gyrus )
Anterior Spinothalamic Tract
• At medulla tract is
accompanied by lat
spinothalamic tract
and spinotectal tract

• All of them form

spinal lemniscus
Anterior Spinothalamic Tract
• New fibers are
added to the medial
aspect of the tract

• So in the upper
cervical segments
sacral fibers are
lateral and cervical
fibers are medial
 Destruction of The Truct

• Loss of light touch and pressure

• Discriminative touch will still be present (fasciculus

gracilis, cuneatus)

• Contralateral below the level of the lesion

• Patient will not feel touch of a cotton or will not

feel pressure from an object placed against the skin
 Lateral Spinothalamic Tract
• Convey pain & thermal
sensation
 First order neuron; Dorsal
root ganglion
 Enters from the tip of the
post gray column
 Ascending and descending
brs. travel one or two
segments of sc and form
posterolateral tract of
Lissauer
 Lateral Spinothalamic Tract
 Second order neuron:
Lamina I, IV, V

• Decussation at anterior white

commissure

• A few fibers do not cross,

ascend in the ipsilateral tract

• Ascends in the contralateral

white column (funiculus
lateralis) as lateral
spinothalamic tract
 Lateral Spinothalamic Tract
 Third order neuron;

• VPL nucleus (talamus)

• Posterior limb of internal

capsule

• Corona radiata

• Cortex: Brodmann 3.1.2

(postcentral gyrus )
• New fibers are added to the anteromedial aspect of
the tract
• So in the upper cervical segments sacral fibers are
posterolateral and cervical segments are anteromedial
• At medulla tract is
accompanied by ant
spinothalamic and
spinotectal tracts
 Spinal Lemniscus;
• Lat spinothalamic
• Ant spinothalamic
• Spinotectal
 Other Terminations of Lateral
Spinothalamic Tract
 Nuclei of reticular formation (burning
pain)
 Motor areas
 Parietal association areas
 Destruction of The Tract

 Loss of pain and thermal senses

 Contralateral below the level of the

lesion

 No damage at perineum because nerves

overlap to the opposite side
 Fasiculus Gracilis and Cuneatus
 Discriminative touch; ability to
localize the area of the body
touched

 Two point discrimination; to be

aware that two points are touched
simultaneously even though they
are close together

 Propioception; Information from

muscles and joints for movement
and position of different parts of
the body in space while eyes are
closed

 Vibration
 First order neuron: Spinal Ganglion

 Posterior white column (posterior

funiculus) of same side

 Fasciculus gracilis ; Co, S, L, T6-T12

 Fasciculus cuneatus; T1-T6 , Cer

 Lower part of thorax and lower limb:

F.Gracilis

 Upper part of thorax, neck, upper

limb: F.Cuneatus
 Second order neuron : Nucleus gracilis
Nucleus
cuneatus

 Internal arcuate fibers

 Decussation

 Medial lemniscus
 Third order neuron: VPL nucleus
(thalamus)

 Posterior limb of internal capsule

 Corona radiata

 Cortex: Brodmann 3.1.2 (postcentral

gyrus )
 Destruction of the tract below the
decussation:
 Ipsilateral, below the level of lesion
 Patients with the closed eyes, unable to
tell where his limb or a part of the body
 Difficulty of walk in the dark
 Loss of vibration and two point
discrimination
 Loss of tactile discrimination
 Touch is not affected but localization of
touch is damaged
 Destruction of the tract above the
decussation:
 Contralateral, below the level of lesion
 Anterior Spinocerebellar Tract

 Unconscious Proprioception
 Conveys muscle joint information
from the muscle spindles, tendon
organs and joint receptors of lower
limb

 First order neuron: Spinal Ganglion

• Dorsal root

 Second order neuron: L V, VI, VII

• Lumbal, sacral, coccygeal (lower
limb)
 Anterior Spinocerebellar Tract
• Decussation: ant. white
commissure

• Ant spinocerebellar
tract (Lateral funiculus)

• Superior cerebellar
peduncle

 Third order neuron:

Vermis (cerebellum)
Lobule I-IV
Anterior Spinocerebellar Tract
 Post Spinocerebellar Tract
 Unconscious Proprioception

 Conveys muscle joint information from

the muscle spindles, tendon organs and
joint receptors of trunk and lower limb

 Controls the coordination of movements and

the maintenance of posture

 First order neuron: Spinal Ganglion

• Dorsal root

 Second order neuron: L VII

• (nucleus dorsalis=Clark’s column)

• Between T1-L2
• Post spinocerebellar
tract (same side
lateral funiculus)

• Inferior cerebellar
peduncle

 Third order neuron:

Vermis (cerebellum)
Lobule I-IV
 Nucleus dorsalis=Clark’s column

• Between T1-L2

• Lower levels of L2 are carried in

fasciculus gracilis until they
reach L2 segment and then
enter into nucleus dorsalis

• Upper levels of T1 are carried in

fasciculus cuneatus. Terminated
upon accessory cuneate nucleus
in medulla and arising axons
form cuneocerebellar tract
 Cuneocerebellar Tract

 Unconscious Proprioception
 Upper limb
 Conveys information of
muscle joint sense to
cerebellum

 First order neuron: Spinal

Ganglion

• Dorsal root

• Fasciculus cuneatus
 Second order neuron: nucleus
cuneatus accessorius (medulla)

• Posterior white column of same

side

• Posterior external arcuate

fibers

• Ipsilateral inf cerebellar

peduncle

 Third order neuron: cerebellar

cortex (lobule V)
Accessory Cuneate Nuc.

Cuneocerebellar tract
• Upper limb
• From inf cerebellar peduncle at
F
F
C8 medulla
G
C
Nucleus
dorsalis Post spinocerebellar tract
T6 (Clark’s • Trunk and lower limb
column) • from inf cerebellar
peduncle at medulla
L2

Ant spinocerebellar tract

• lower limb
• From sup cerebellar
peduncle at midbrain
• Decussation +
Damage to spinocereballar and cuneocerebellar
tracts does not cause any clinical symptoms
since the sense is carried by many tracts to
cerebellum!
 Spinotectal Tract
 First order neuron: Spinal Ganglion

Dorsal root

 Second order neuron: L I-V ???

 Decussation: ant. white commissure

 Spinotectal tract (anterolateral

funiculus)

 Third order neuron:

superior colliculus (midbrain)
 Spinotectal Tract
Conveys impulses of extreme heat or cold
and mechanical stimuli that cause tissue
damage (noxious stim.)

Carries senses to superior colliculus for

spinovisual reflex

Controls the movement of eyes and head

toward the source of the stimulation
Tectospinal tract
 Spinoreticular Tract

An afferent pathway of the reticular

system

Provides a pathway from the muscles,

joints and skin to the reticular
formation

Provides to be aware of consciousness

and environment. Regulates motor,
sensory, cortical activities
 First order neuron: Spinal Ganglion

Dorsal root

 Second order neuron: L V-VII-

VIII ???

 Spinoreticular tract (lateral funiculus)

 Majority of the fibers are uncrossed

 Third order neuron: reticular

formation in the brain stem,
gigantocelluler, lateral
reticular nuclei
 Anterolateral System

Sense of pain is conveyed from spinal cord to the higher

levels by

-Lateral spinothalamic tract

-Spinotectal tract
-Spinoreticular tract

All of these tracts are collectively called anterolateral

system.
 Visceral Sensory Tracts
Pain and stretch receptor endings in the
viscera
Impulse (ischemia, chemical damage,
spasm of smooth mm, distention)

 First order neuron: Spinal gang

dorsal root
 Second order neuron: post, lat gray
column
Join to spinothalamic tract

 Third order neuron: VPL nucleus

(talamus)

 Postcentral gyrus
Referred Pain
Sensations from rectum and urinary bladder (defecation and
micturition) are carried by ascending tracts located in the
posterior white column of spinal cord!
Somesthetic System of
Head

General somatic afferents:

touch, pain, temperature from
skin, mucous membrane of nose
and mouth

Proprioceptive afferent fibers:

from mastication mm, TMJ,
teeth, hard palate.
 Afferent fibers except of
proprioceptives have their cell
bodies in Trigeminal (semilunar)
gang

 Sensory root enters pons

ascending, descending fibers

 Spinal nucleus: pain,

temperature
 Sensory principal nucleus:
touch, pressure
 Mesencephalic nucleus:
proprioception
 Pain and temperature fibers
enter pons
 Descend in the dorsolateral
brainstem

 Form spinal trigeminal tract

 Fibers in tract terminate
upon spinal nucleus
 Spinal nucleus is medial to
the tract and extends upto
C2 segment
Fibers leave trigeminal sensory
nuclei

 Most fibers cross the

midline
 Ascend in the trigeminal
lemniscus
 To the VPM thalamic nucleus
Cortical postcentral gyrus

 Some fibers ascend to same

side thalamic nucleus