Ascending & Sensory Systems 3
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| What are the two primary pathways for unconscious proprioception? | Dorsal spinocerebellar and ventral spinocerebellar tracts. | |
| What is the upper extremity component for the dorsal spinocerebellar tract? | Above C8 – cuneocerebellar. | |
| What is the upper extremity component for the ventral spinocerebellar tract? | Above C8 – rostral spinocerebellar. | |
| What is the pathway of the first order neuron in the dorsal spinocerebellar tract? | Ia muscle spindles or Ib GTO’s synapse in nucleus dorsalis/Clarke’s column (C8-L3) or if above C8, travel in the fasciculus cuneatus to synapse on the accessory cuneate nucleus in the medulla. | |
| What is the pathway of the second order neuron in the dorsal spinocerebellar tract? | After synapse, neurons travel through the dorsal spinocerebellar pathway in the lateral white matter column then enter the inferior cerebellar peduncle at the open medulla or if above C8, travel through the cuneocerebellar tracts and enter the inferior cerebellar peduncle. | |
| Is the dorsal spinocerebellar tract ipsilateral or contralateral? | Ipsilateral pathway. | |
| What is the purpose of the ventral spinocerebellar pathway? | Receives information regarding the activity of the alpha motor neurons in the ventral horn of the spinal cord and relays this to the cerebellum. | |
| What is the pathway of the first order neuron in the ventral spinocerebellar tract? | Ia muscle spindles or Ib GTO’s synapse in intermediate gray nucleus. | |
| What is the pathway of the second order neuron in the ventral spinocerebellar tract? | After synapse in intermediate gray nucleus neurons cross the anterior white commissure then travel through the ventral spinocerebellar tract to enter the superior cerebellar peduncle. | |
| Is the ventral spinocerebellar tract ipsilateral or contralateral? | Contralateral. | |
| What is the ventral spinocerebellar tract pathway above C8 for UE? | The rostral spinocerebellar pathway uses the fasciculus cuneatus then enters the superior cerebellar peduncle. | |
| What are the clinical effects of lesions on the dorsal or ventral spinocerebellar tracts? | Most do not cause symptoms unless affected in certain hereditary diseases, specifically ataxic syndromes such as Friedreich’s ataxia. | |
| What is the purpose of the spinothalamic system? | To carry pain, temperature, crude touch, itch, tickle, and certain visceral sensations. | |
| What are the two main pathways of the spinothalamic system? | The ventral and lateral spinothalamic tracts. | |
| Sharp, well-localized pain and temperature carried by A fibers ascend in which tract? | The lateral spinothalamic tract. | |
| Crude touch and poorly localized pain carried by C fibers ascend in which tract? | The ventral spinothalamic tract. | |
| What is the pathway of the first order neuron in the lateral spinothalamic tract? | Group III A pain enter spinal column at a level (and one above and below through the zone of Lissauer) to synapse in the dorsal horn in the substantia gelatinosa and nucleus proprius. | |
| What is the pathway of the second order neuron in the lateral spinothalamic tract? | The axons cross the midline through the anterior white commissure and enter the lateral spinothalamic tract then in the medulla travel through the spinal lemniscus to the VPL of thalamus. | |
| What is the pathway of the third order neuron in the lateral spinothalamic tract? | After synapse in the VPL, they travel through the posterior limb of the internal capsule and terminate in the primary somatic sensory cortex. | |
| What is the pathway of the first order neuron in the ventral spinothalamic tract? | Group IV C pain enter spinal column at a level (and one above and below through the zone of Lissauer) to synapse in the dorsal horn in the substantia gelatinosa and nucleus proprius. | |
| What is the pathway of the second order neuron in the ventral spinothalamic tract? | The axons cross the midline through the anterior white commissure and enter the lateral spinothalamic tract then in the medulla travel through the spinal lemniscus to themedial thalamus and intralaminar nuclei. | |
| What is the pathway of the third order neuron in the ventral spinothalamic tract? | After synapse, they terminate in the frontal, limbic, and somatosensory cortex. | |
| What are the clinical effects of a lesion in the lateral spinothalamic tracts in the spinal cord? | Loss of pain and temperature on the opposite side of the body below the level of the lesion and perhaps a few segments above the lesion. | |
| What are the clinical effects of a lesion in the brainstem, thalamus, or internal capsule? | Contralateral deficits in the entire ½ of the body. | |
| What are the clinical effects of a lesion in the lateral sensory cortex/middle cerebral artery distribution? | Deficits in the contralateral UE. | |
| What are the clinical effects of a lesion in the medial sensory cortex/anterior cerebral artery distribution? | Deficits in the contralateral LE. | |
| What are the clinical effects of a lesion in the ventral white commissure? | Bilateral loss of pain and temperature localized to a few segments above and below the lesion. | |
| What is a common syndrome that causes damage to the ventral white commissure? | Syringomyelia, caused by a cavitation around the central canal of the spinal cord. | |
| What is thalamic pain syndrome? | A chronic intractable hemi-pain syndrome where touch sensations may be perceived as painful. | |
| What causes thalamic pain syndrome? | A lesion in the posterior cerebral artery. |
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