PATHWAYS FOR NEUROANATOMY SCT

1. Pathways to Know in Detail: Ascending: 1. Burdach (Cuneate) 2. Goll (Gracile) 3. Medial Lemniscus 4. Trigeminal Lemniscus 5. Lateral Lemniscus 6. Spinothalamic 7. Olivocerebellar 8. Medial Longitudinal Fasciculus Descending: 9. Corticospinal 10. Corticopontine 11. Temporo-occipito-pontine Lateral: 12. Dentatorubral 2. Pathways to Understand: Ascending: 1. Anterior spinocerebellar 2. Posterior spinocerebellar 3. Cuneocerebellar 4. Mamillothalamic Descending: 5. Corticobulbar 6. Rubrospinal 7. Striatonigral 8. Tectospinal Other: 9. Fornix 3. Pathways to be Familiar with: Ascending: 1. Spinomesencephalic 2. Spinohypothalamic 3. Spinocervical Descending: 4. Aminergic 5. Peptidergic 6. Fasciculus tengmentalis centralis 7. Fasciculus longitudinalis dorsalis (Schultz) 8. Fastigiospinal 9. Hypothalamospinal 10. Reticulospinal 11. Raphespinal 12. Vestibulospinal

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1. Ascending Pathways:

PATHWAYS TO KNOW IN DETAIL

Tract of Burdach / Cuneate Fasciculus SS - Receptors: Pacinian corpuscles, Meissners corpuscles, muscle spindle receptor; carrying info for discriminative touch, vibration, conscious muscle joint sense (muscle spindle receptor) - Present only in the cervical and upper thoracic segments of the spinal cord, separated from gracilis pathway via a septum. - Runs in Posterior Funiculus - Synapse occurs at the Cuneate nucleus in the medulla oblongata. As synapsis does not occur in the spinal cord (as these are first order neurons ascending to the nucleus) the fibres are known as Primary Afferents - Part of Posterior Column-Medial Lemniscus Pathway - Carries sensory information from upper limb (i.e. fine touch, proprioception) - Begins at dorsal-root ganglia above T6 and ends at Cuneate nucleus - Axons from the cuneate nucleus are known as Internal Arcuate Fibres Tract of Goll / Gracile Fasciculus SS - Receptors: Pacinian corpuscles, Meissners corpuscles, muscle spindle receptor; carrying info for discriminative touch, vibration, conscious muscle joint sense (muscle spindle receptor) - Fasciculus gracilis is present throughout the ENTIRE spinal cord. - Runs in Posterior Funiculus - Part of Posterior Column-Medial Lemniscus Pathway - Carries sensory information from lower limb (i.e. fine touch, proprioception) - Begins at dorsal-root ganglia below T6 and ends at Gracile nucleus - Termination occurs in the Gracile nucleus of the medulla oblongata. Fibres from this nucleus are known as Internal Arcuate Fibres. Medial Lemniscus - SS - Part of Posterior Column-Medial Lemniscus System - Internal arcuate fibres ascend the medulla oblongata and cross the pyramid (In the spinal cord the fasciculus gracilis and cuneatus never crossed) at the Decussation of Medial Lemnisci (Great Sensory Decussation) - From this decussation the fibres ascend as the Medial Lemniscus - Carries sensory information from dorsal column nuclei to VPL of thalamus - Axons from VPL pass through posterior limb of the internal capsule to reach the primary somatosensory cortex in the post-central gyrus. - Sensory information from lower extremity runs in the anterior portion - Sensory information from the upper extremity runs in the posterior portion Ventral Trigeminal Lemniscus - SS - Runs in Posterior Funiculus in close proximity to medial lemniscus - Carries sensory information form the face to the contralateral VPM of the thalamus - Fibers begin from ventrolateral Principal Nucleus of Trigeminal and Spinal Nucleus of Trigeminal Dorsal Trigeminal Lemniscus - SS - Runs in Pontine Tegmnetum, lateral to periaqueductal gray matter - Carries sensory information from the face to the ipsilateral VPM of the thalamus - Fibers begin from dorsomedial division of Principal Nucleus of Tigeminal

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Lateral Lemniscus - VS - Auditory information is transmitted from the spiral ganglia in the modiolus of the cochlea to the dorsal and ventral cochlear nuclei via the vestibulocochlear nerve - Fibres from these nuclei decussate at the trapezoid body (formed by these fibres and the nucleus of the trapezoid body) located on the tegmentum of the pons, to reach the superior olive. - From the superior olive, the fibres arise as the Lateral Lemniscus which ascends to the inferior colliculus. - The inferior colliculus transmits this information to the medial geniculate body via the inferior brachium. - From the medial geniculate body, auditory information is conveyed as the auditory radiation through the posterior limb of the internal capsule. - Terminate in the Transverse gyri of Heschl (Primary Auditory Cortex, Brodmanns # 41, 42) Spinothalamic Tract SS - Axons from skin receptors enter spinal cord from the dorsal root ganglion as the Posterior Tract of Lissauer and synapse in the dorsal gray horn. - Decussation occurs in anterior white commissure and gray comissure of the spinal cord - Both tracts run in the in Lateral Funiculus - The lateral spinothalamic tract carries information on pain and temperature, and the anterior spinothalamic tract carries information on superficial (light) touch and pressure. - Fibers begin from Rexed laminae I, IV V of spinal cord grey matter - Fibers travel in Anterolateral White Matter of spinal cord - Ascends through medulla oblongata and joins with the Tectospinal tract to form the Medial Lemniscus. - Terminates on VPL (Ventroposterolateral) nucleus of the thalamus. - After VPL fibers travel in thalamocortical tracts to post central gyrus (parietal lobe) of cerebral cortex - Part of Anterolateral System (ALS) along with spinotectal and spinoreticular tracts Olivocerebellar Tract - Formed by Climbing Fibers from the hilum of the Inferior Olivary Nucleus and terminate on contralateral Dentate Nucleus of the cerebellum - Decussation occurs at the raphe nuclei (medial portion of reticular formation) - Fibers pass through the Inferior Cerebellar Peduncle to enter the cerebellum (along with posterior spinocerebellar, reticulocerebllar and cuneocerebllar tracts; together these 4 make the Restiform Body) - Triangle of Guillain-Mollaret / Myocloni Triangle: Feedback system that modulates spinal cord motor activity. Formed by olivocerebellar, dentatorubral, and rubroolivary tracts between their respective nuclei Medial Longitudinal Fasciculus - SM - Runs in Anterior Funiculus - Main pathway connecting the vestibular and cochlear nuclei with the nuclei controlling the extraocular muscles (oculomotor, trochlear, and abducens) - Made of both ascending and descending tracts - Fibers originate from Vestibular Nuclear Complex and ascend to Occulomotor Centers and descend to the spinal cord - Terminations points: Motor nuclei of eye moving cranial nerves (III, IV, VI), interstitial nucleus of Cajal (subcortical gaze center), cervical spinal cord (to control neck muscles) and Darkschewitsch nucleus - Plays a major role in Vestibulo-ocular Reflex - MLF is made up by: 1. Medial Vestibulospinal Tract: Vestibular nucleus to laminae VII-VIII 2. Reticulospinal Tract: Magnocellular nuclei to laminae VI-IX 3. Tectospinal Tract: Superior Colliculus to laminae VI-VIII

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Descending Pathways: Corticospinal Tract - SM - Part of Pyramidal Tract - Has both an Anterior and Lateral tract - Both arise as axons of pyramidal cells in the 5th layer of the cerebral cortex (1/3 from primary motor cortext, 1/3 from the secondary, and 1/3 from the parietal lobe) mostly from primary motor cortex (precentral gyrus), though the supplementary motor area, premotor cortex, and somatosensory cortex, among other, contribute - Controls contralateral distal limb movement mainly. Concerned with voluntary, discrete/skilled movement (especially of the distal parts of the limbs) - Fibers pass through the genu of the internal capsule and enter cerebral peduncle - When entering the pons, tract is broken down into smaller bundles by the transverse pontocerebellar fibres - Smaller bundles group together to form the Pyramid of the medulla oblongata - Decussation occurs at Pyramidal Decussation (Great Motor Decussation) - Lateral Corticospinal tract is larger and runs in Lateral Funiculus - Anterior Corticospinal tract is smaller and runs in the Anterior Funiculus ends by mid-thoracic region - Decussation occurs in Anterior White Commissure at the exit level (or do not cross at all) - Termination occurs by synapsing with neurons in the Ventral Horn of the spinal cord Corticopontine Tract SM, SS - From Cortex to ipsilateral pontine nuclei - Name depends on lobe of origin: Frontopontine, Parietopontine, Occipitopontine, and Temporopontine - Most fibers arise from motor and somatosensory cortexes - Fibers pass through the Anterior limb of the internal capsule and the lateral portion of the Cerebral Peduncle - After synapsing in pons, fibers run to ipsilateral cerebellar nuclei through the Middle Cerebellar Peduncle Temporo-occipito-pontine Tract - Part of Extrapyramidal System - Terminate in Pontine Nuclei of caudal part of pons Dentatorubral Tract - From Dentate Nucles of cerebellum to parvocellular part of Red Nucleus of mesencephalon - Exits cerebellum via Superior Cerebellar Peduncle - Part of Triangle of Guillain-Mollaret / Myocloni Triangle - This tracts runs laterally

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2. PATHWAYS TO UNDERSTAND Ascending Pathways Anterior (Ventral) Spinocerebellar Tract - SS - Runs in Lateral Funiculus - From laminae V-VIII of lumbosacral spinal cord to Globose and Emboliform nuclei of cerebellum, as well as cortex of anterior lobes, and vermis of posterior lobe - Proprioceptive, vibration, and fine touch information to cerebellum (SS) - Crosses to opposite side twice (double cross) once in spinal cord, once in cerebellum - Enters cerebellum via Superior Cerebellar Peduncle and terminates in the cerebellar cortex - Aka: Gowers fasciculus - Information: Unconscious muscle joint sense - Receptors: Muscle spindles Posterior (Dorsal) Spinocerebellar Tract - SS - Runs in Lateral Funiculus parallel with anterior spinocerebllar tract - Does not cross midline ever (ipsilateral) - Enters cerebellum through Inferior Cerebellar Peduncle and terminates in the cerebellar cortex - Carries proprioceptive information from lamina VII (Clarks / Posterior Thoracic Nucleus) of C8 to L2/L3 Cuneocerebellar Tract - SS - Aka: Posterior External Arcuate Fibers - Runs in Lateral Funiculus - From Gracile and Cuneate nuclei to ipsilateral cerebellum via the Inferior Cerebellar Peduncle (also known as Restiforms Body) - Terminate in lobule 5 of cerebellum - It is the upper-limb equivalent of the Posterior Spinocerebellar tract - Fibers arrive to cuneate nucleus from posterior root fibers of C2 to T4 via the cuneate fasciculus - Information: Muscle joint sense to cerebellum - Random: Anterior external arcuate fibres arise from the anterior median fissure of the pyramid to enter the cerebellum. Mamillothalamic Tract - Arises from both medial and lateral nuclei of the mammillary bodies as well as fibers that continue from the fornix - Terminates on the Dorsal and Ventral Tegmental nuclei, and Anterior Thalamic Nucleus of the thalamus - Aka: Bundle of Vicq dAzyr - Infarction results in Korsakoffs Syndrom: amnesia, confabulation, apathy Descending Pathways Corticobulbar Tract - SM - From Precentral Gyrus (primary motor cortex) of cerebral cortex to nuclei of medulla oblongata - Runs through the Posterior Limb of the internal capsule and passes though cerebral peduncle - Directly innervates nuclei of CNV, CNVII, CNXI and CNXII - Indirectly innervated nuclei of CNIII, CNIV and CNVI via interneurons - Also contributes to nucleus ambiguus (CNIX and CNX)

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Rubrospinal Tract - SM - Runs in Lateral Funiculus - From Red Nucleus of tegmentum of mesencephalon at the level of the superior colliculus to laminae V VIII - Aids in maintaining posture - Crosses to opposite side in mesencephalon then travels in Lateral Tegmentum of brainstem - Accompanies lateral corticospinal tract - Rubrospinal tract can assume role of corticospinal tract if damage occurs Striatonigral Tract - From Dorsal Basal Gangli, aka Striatum, (Caudate nucleus, Putamen and Globus Pallidus) to the Substantia Nigra - This is a bidirectional connection goes back and forth between the suctures - Fibers from striatum to substantia nigra are inhibitory and use GABA as their neurotransmitter - Nigrostriatal fibers (go to striatum) are Dopaminergic Tectospinal Tract - SM - Descends through Anterior Funiculus - From Tectum (Superior Colliculi) of mesencephalon to laminae VI VIII of cervical spinal cord - Mediates reflex movements of the head in response to visual and auditory stimuli - Part of Medial Longitudinal Fasciculus (MLF) Other Fornix - C-shaped fiber bundle carrying fibers from Hippocampus to Mammillary Bodies and Septal Nuclei - It is the largest single input to the hypothalamus - Divides into Precommissural and Postcommissural Bundles - Precommissural fibers pass to Septal and Preoptic Nuclei and to anterior hypothalamus - Postcommissural fibers pass mainly to Medial Mammillary Nucleus, some fibers go to anterior thalamic nucleus and lateral hypothalamus

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3. PATHWAYS TO BE FAMILIAR WITH Ascending Pathways Spinomesencephalic - SS - Runs in Lateral Funiculus - Part of Anterolateral System (ALS) - From laminae I-VII to contralateral periaqueductal gray matter of midbrain - Decussation occurs in spinal cord - Carries somatosensory information Spinohypothalamic - SS - Runs in Lateral Funiculus - Part of Anterolateral System (ALS) - From laminae I-VII to contralateral thalamus - Decussation occurs in spinal cord - Carries somatosensory information (pain, temperature, etc) - Divided into lateral and anterior spinothalamic tracts Spinocervical - SS - Runs in Lateral Funiculus - From lamina III - V to Lateral Cervical Nucleus in white matter of cervical spinal cord - Carries tactile touch and pressure information ipsilaterally - somatosensory - Part of Dorsal Column System - After synapsing at LCN it continues to the contralateral thalamus via the Medial Lemniscus Descending Pathways Aminergic Tract - Terminates all over gray matter of spinal cord - Increases excitation level of interneurons that influence motor function - Coerulospinal tract: arise mainly from the locus ceruleus and nucleus subceruleus of pons - Raphe Spinal tract: arise from raphe nuclei of medulla oblongata Peptidergic Tract - Originates in Pons Fasciculus Tengmentalis Centralis - Aka: Central Tegmental Tract - Contains ascending and descending fibers - Ascending fibers arise from rostral Nucleus Solitarius and terminate in VPM of thalamus - From thalamus the fibers run to Insula of frontal operculum (taste) - Descending fibers arise from Red Nucleus and terminate in Inferior Olivary Nucleus (Aka: Rubroolivary tract) Fasciculus Longitudinalis Dorsalis (Schultz) - SS - Aka: Posterior Longitudinal Fasciculus - Fibers arise from the nuclei of the hypothalamus and terminate in the periaqueductal gray area of spinal cord - Influences pain response and modulates other neurobehaviors. Fastigiospinal Tract - SM - From Fastigial Nucleus of the vermis of the cerebellum and terminates in laminae VII-IX - Maintains posture

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Hypothalamospinal Tract - SM - Runs in Lateral Funiculus - From hypothalamus to ipsilateral Intermediolateral Cell Column of spinal cord - Provides sympathetic stimulation to the face (Hornes Syndrom if damaged) Reticulospinal Tract SM, SS - From Magnocellular Reticular Nucleus (reticular formation) to lamiae VI-IX - Maintains muscle tone (posture) and modulates pain - Divided into medial (pontine) and lateral (medullary) tracts - MRST is responsible for anti-gravity muscles - Anterior Funiculus - LRST is for muscle movement - Lateral Funiculus - Spinoreticular tract brings sensory information back up Raphespinal Tract - SS - From nucleus raphe magnus, in pons, to dorsal horn of spinal cord - Mediates pain information (inhibition) - Runs in posterior portion of Lateral Funiculus - Part of anterolateral system (ALS) - 2 parts: Anterior and Lateral Raphespinal tracts Lateral Vestibulospinal Tract - SM - Runs ipsilaterally in Lateral Funiculus - From Lateral Vestibular Nucleus of CN VIII in the medulla to laminae VII VIII - Maintains posture by stimulating extensor muscles

Medial Vestibulospinal Tract - SM - Descends bilaterally in Anterior Funiculus - From Vestibular Nucleus of CN VIII in medulla to laminae VII VIII - Maintains posture by stimulating extensor muscles - Part of Medial Longitudinal Fasciculus (MLF)

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MEDULLA OBLONGATA Cranial nerve nuclei 1. Glossopharyngeal nerve, CN IX -ambiguus nucleus (SM) -spinal nucleus of trigeminal nerve (SS) -inferior salivatory nucleus (VM) -nucleus of solitary tract (VS) 2. Vagus nerve, CN X -ambiguus nucleus (SM) -spinal nucleus of trigeminal nerve (SS) -dorsal nucleus of vagus (VM); scattered neurons dorsolaterally to the ambiguus nucleus (VM) -nucleus of solitary tract (VS) 3. Accessory nerve, CN XI -motor nucleus of accessory nerve (SM) 4. Hypoglossal nerve, CN XII -motor nucleus of hypoglossal nerve (SM) Exit of cranial nerves 1. CN IX 2. CN X 3. CN XI 4. CN XII Descending pathways traveling though Medulla: 1. Corticobulbar, corticospinal (pyramidal tract) 2. Extrapyramidal tracts: - Vestibulospinal - Medial longitudinal fascicle - Tectospinal - Reticulospinal - Rubrospinal 3. Others: - Raphespinal - Aminergic pathways - Peptidergic pathways - Fasciculus longitudinalis dorsalis (Schtz) Pathways originating in Medulla Medial lemniscus Olivocerebellar tract Reticulospinal tract Medial longitudinal fascicle Vestibulospinal Olivospinal Pathways terminating in Medulla Fasciculus tegmentalis centralis Corticobulbar tract

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PONS Cranial nerve nuclei 1. Trigeminal nerve, CN V -motor nucleus of trigeminal nerve (SM) -principal (chief) nucleus of trigeminal nerve (SS) -spinal nucleus of trigeminal nerve (SS) 2. Abducens nerve, CN VI -motor nucleus of abducens nerve (SM) 3. Facial nerve, CN VII -motor nucleus of facial nerve (SM) -superior salivatory nucleus (VM) -nucleus of solitary tract (VS) 4. Vestibulocochlear (statoacustic) CN VIII -dorsal & ventral cochlear nuclei -superior, medial, lateral (Deiters) & inferior vestibular nuclei Exit of cranial nerves 1. CN V 2. CN VI 3. CN VII 4. CN VIII Ascending pathways travelling though Pons 1. Spinothalamic tract 2. Medial lemniscus 3. Anterior spinocerebellar tract Descending pathway travelling through Pons 1. Corticobulbar, corticospinal (pyramidal tract) 2. Extrapyramidal tracts: - Tectospinal - Fasciculus tegmentalis centralis - Rubrospinal 3. Others: - Fasciculus longitudinalis dorsalis (Schtz) - Raphespinal - Aminergic pathways - Peptidergic pathways Pathways originating in Pons - Vestibulospinal - Medial longitudinal fascicle - Reticulospinal - Pontocerebellar - Aminergic pathway - Peptidergic Pathway - Lateral lemniscus (ascending) - Trigeminal (dorsal) lemniscus (ascending) - Raphespinal (descending) Pathways terminating in Pons - Frontopontine tract (descending) - Temporo-occipito-pontine (descending) - corticobulbar tract

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MESENCEPHALON Cranial nerve (CN) nuclei 1. Oculomotor nerve, CN III -motor nucleus of oculomotor nerve (SM) -Edinger-Westphal nucleus: (VM) 2. Trochlear nerve, CN IV -motor nucleus of trochlear nerve (SM) 3. Trigeminal nerve, CN V mesencephalic nucleus of trigeminal nerve (SS) Exit of cranial nerves from the mesencephalon 1. CN III 2. CN IV Other nuclei 1. Red nucleus 2. Substantia Nigra 3. Reticular formation - Interstitial nucleus of Cajal - Interpeduncular nucleus Ascending pathways through Mesencephalon - Medial lemniscus - Trigeminal lemniscus (dorsal) - Spinothalamic tract - Ventral spinocerebellar tract (through the cerebellar peduncle to the cerebellum) Descending pathways through Mesencephalon - Corticobulbar, corticospinal - Frontopontine tract - Temporo-occipito-pontine - Fasciculus longitudinalis dorsalis (Schtz) Pathways originating in Mesencephalon - Tr. nigrostriatal, - Tr. tectospinal - Tr. rubrospinalis - Rubrothalamic - Fasciculus tegmentalis centralis (originates in the red nucleus and thalamus) - Part of auditory pathway (from inferior collicle to medial geniculate body) Pathways terminating in Mesencephalon - Lateral lemniscus (part of the auditory pathway) - Medial longitudinal fascicle (part of the vestibular system, contains descending fibers also) - Striatonigral - Dentatorubral

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Nerve III IV V

SM + + +

Name
Motor nucleus of Motor nucleus of Motor nucleus of

VM +

Name
Edinger-Westphal

SS

Name

VS

name

+ + + + + + +
Sup. salivatory Inf. salivatory 1. Dorsal nucleus of 2. - no name -

1. Mesencephalic n. 2. Chief nucleus 3. Spinal nucleus

VI VII IX X XI XII

+ + + + + +

Motor nucleus of Motor nucleus of Motor nucleus of Motor nucleus of Motor nucleus of Motor nucleus of

? (may have a nucleus) + +

Spinal nucleus Spinal nucleus

+ + +

nucleus of solitary tracts

+ dorsolateral group + Ventromedial group

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R. Heaslip M. James

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1 Overview of spinal cord axial cross-section

R. Heaslip M. James

Posterior median septum

Gracile Cuneate Fasciculus Fasciculus II III & IV V VI

Thoracic level 6

I
I

Posterior Funiculus Posterior horn

Posterior spinocerebellar tract

II

III

Hypothalamospinal Legs

IV

V Lateral Funiculus
Anterior spinocerebellar tract Ventral commissure

Lateral corticospinal

Arms

VI

Rubrospinal Distal Lateral reticulospinal Lateral vestibulospinal Medial reticulospinal

Flexors Proximal Extensors Medial vestibulospinal Anterior corticospinal

Central canal Intermediate VII horn Anterior horn

s Leg

VIII & IX

Proprius fasciculus Anterior funiculus

Arms

Anterolateral system

Anterior Median Fissure

Figure 16-4 Complete axial section of ascending tracts

Figure 16-6 Complete axial section of descending tracts

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GOODLUCK TO ALL

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