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. Villoria Free nerve endings pain/ Noxiuous stimuli Cold krause end bulb Warm ruffinis corpuscles Pain & Temperature 1. Kruse end bulb (cold sensation) 2. carried by free nerve endings 3. dorsal ganglion 4. interneuron (V-VII) 5. enter the spinal cord & decussate 6. ascend to LSTT 7. thalamus (VPLN: ventro posterolateral nucleus) 8. cerebrum (primary & secondary area) Light touch & Crude touch 1. Meissners corpuscles 2. Dorsal root ganglion 3. lamina VI-VII (enter upper limb) 4. cross anterior white commisure 5. Ventral spinothalamic tract 6. thalamus (ventro posterolateral nucleus) 7. cerebellum (primary) Discriminative touch there is 3 types 2 point discrimination Stereognosis Vibratory sense (use tuning fork) 1. Pacinian/ Meissners corpuscle 2. Dorsal ganglion 3. Fasciculus gracilis/ cuneatus 4. Nucleus gracilis/ cuneatus 5. Cross (decussation at lower medulla) 6. Medial lemniscus 7. Thalamus (VPLN) 8. Cerebrum (BA 4 primary somesthetic area) Conscious Proprioception 1. __ 2. __ 3. Posterior funiculus 4. Fasciculus gracilis/ cuneatus 5. Nucleus of gracilis/ cuneatus 6. Decussation in medial lemniscus 7. Thalamus (VPLN) 8. Cerebrum
Unconscious Proprioception o Cuneo-cerebellar tract = muscle of the upper extremities o Posterior spinothalamic tract = individual muscles of the lower extremities o Anterior spinocerebellar tract = ___ Cuneocerebellar tract/ Dorsal tract N1 DRG (Dorsal root ganglion); T5-C1 N2 Accessory caudate nucleus (ipsilateral) N3 Posterior Spinothalamic tract N1 DRG level f sacral, lumbar & lower segments N2 Nucleus of caudate (lamina 7) N3 Anterior Spinothalamic tract N1 DRG lumbar & sacral segments N2 Posterior horn cells N3 Cerebellum thru superior cerebellar peduncle GENERAL SENSORY AFFERENT o From anterior head Involves CN 5,7,9,10 PAIN & TEMPERATURE in face N1 (sensory neuron) o CN9 cutaneous br.of the ears o CN8 supply the back of the ears o Ganglion: o trigeminal, o geniculate-CN7, o superior jugular of CN 9 & 10 N2 (association neuron) o muscles of the trigeminospinal tract contralateral side N3 (VPMN) o ventro posteromedian nucleus o ascends thru internal capsule & corona radiata N4 o Cerebrum BA 3,1,2
TOUCH & PRESSURE N1 Trigeminal ganglion Merkels tactile Meissners & Pacinian corpuscles, hair follicles N2 Main sensory nucleus of CN5 Cross at pontine tegmental anterior Trigemino-thalamic tract (contralateral) Uncrossed dorsal trigeminothalamic tract N3 VPMN thalamus (bilateral) N4 BA 3,1,2 Primary somesthetic area (bilateral)
Example: Kiss on the right Cheek
N1 trigeminal ganglion, Right N2 Main sensory nucleus of 5, Right ascending tract VTTT & DTTT N3 VPMN, both sides N4 BA 3,1,2 Primary Somesthetic area, both sides
PROPRIOCEPTION o Proprioceptive impulses arising from muscles of mastication & pressure in the teeth, periodontal membrane, & joint capsule of cranio-mandibular joint N1 Mesencephalic nucleus of 5 N2 Main sensory nucleus of 5 cross to opposite side N3 VPMN of thalamus N4 Primary & Secondary somesthetic area of cerebrum
Example: Awareness of chewing
N1 Mesencephalic nucleus (same side) N2 Main sensory nucleus of 5 (same side) Ascending tract BS-VTTT (opposite side) N3 VPMN of thalamus (opposite side) N4 Primary & Secondary somesthetic area (opposite side)
SPINAL TACTILE, VIBRATORY & LIMB POSITION N1 Dorsal root ganglion N2 Gracile & Cuneate nuclei N3 SPINAL PAIN & TEMPERATURE N1 Dorsal root ganglion N2 Spinal ganglion N3 GENERAL SENSE (HEAT & REST) N1 Tigeminal ganglion CN5 Geniculate ganglion CN7 Superior petrosal ganglion CN9 Superior jugular ganglion CN10 N2 Trigeminal sensory nuclei N3 VPM nucleus of the thalamus
N1 trigeminal ganglion (same side) N2 Nucleus of trigemino-spinal tract Ascending pathway in BS-ATTT (opposite side) Ascending tract anterior trigeminothalamic t. N3 VPMN of thalamus (opposite side) N4 Somesthetic area BA. 3,1,2, (opposite side)