what are the three ascending ascending pathways of sensory information?
which dorsal column/medial lemniscus pathway carries information from the upper limb?
fasciculus cuneatus
which dorsal column/medial lemniscus pathway carries information from the lower limb?
fasciculus gracilis
what type of modal information is carried by the dorsal column pathway? (4)
what type of sensory fibres are the dorsal columns composed of?
AB fibres (fast, large diameter fibres) (30-70m/s conduction velocity, 5-12um diameter)
where does the primary afferent neurone of the medial lemniscus pathway enter from and synapse?
primary afferent neurone enters the dorsal column of spinal cord, synapses on second order neurone in the brain stem (either gracile or cuneate nuclei)
which vertebrae does the fasciculus cuneatus pathway start above?
T6
where does the second order neurone of the medial lemniscus pathway originate and synapse?
comes from the gracile or cuneate nuclei in the brain stem, ascends CONTRALETERALLY as the medial lemniscus and synapses in the ventral posterolateral lobe of the thalamus (VPL)
where does the third order neurone of the medial lemniscus pathway originate and synapse?
originates in the VPL region of the thalamus and projects to corresponding are of the somatosensory cortex
what pathological processes can develop from a lesion in the medial lemniscus pathway BELOW T6?
gait ataxia (brain is deprived of info about feet)
what symptoms does dorsal column disease cause and what is the cause of this disease?
causes paraesthesias in the extremities (i.e. tingling, crawling, numbness, deadness in fingers and toes)
caused by ectopic discharge in damaged dorsal column axons
how can dorsal column function be tested?
by testing proprioception in fingers and toes or testing vibration sense with tuning fork
what does the spinothalamic pathway detect primarily?
PAIN - nociception
what types of pain does the spinothalamic pathway detect? (3)
what type of sensation do Aδ fibres detect?
what do C fibres detect?
- itch sensitive (histamine sensitive)
where do the first order neurones of the spinothalmic pathway originate and synapse?
enter the dorsal horn of spinal cord where they synapse with the second order neurone
where do the second order neurons of the spinothalamic pathway originate and synapse?
organist in dorsal horn and cross immediately to contra-lateral side of spinal cord “QUICK TO CROSS”; ascend in either lateral spinothalmic route or anterior route depending on fibre type; and project to thalamus (VPL region)
where do the third order neurons of the spinothalamic pathway originate and synapse?
originate in VPL region of thalamus and project to somatosensory cortex of brain (Aδ project tp somatosensory cortex to give more precise info about location of pain whereas C fibres do not)
what is the lateral spinothalmic route made up of?
C and Aδ fibres:
pain
temperature
dull pain and itch
what is the ventral anterior spinothalmic rate made up of?
C fibres only:
corse, non discriminating touch
what happens when there is lesions in the spinothalamic tract?
patients have decreased perception of pain on the contraletral side of their body
what substance is used in peripheral nerve endings to modulate pain
substance P
which chemical do chilli peppers contain which mimic tissue damage?
capsaicin - stimulates Trp1 receptors
can be used to treat chronic pain