Somatosensory Nervous System

General points regarding sensory systems Somatosensory Systems

1. All 1º sensory nerve ending in PNS are a/w specialized receptor end organs which:  DC/ML: Dorsal Column/Medial Lemniscal System
a. Transduce sensory signal or aid in transduction  ALS: Anterolateral system (aka Spinothalamic tract)
b. Exception: free nerve endings carrying noxious (pain) stimuli  Trigeminal (2 systems homologous to DCML and ALS for the head)
2. Sensory info conveyed to cerebral ctx by a series of relay nuclei, incl one in thalamus
Somatosensory Sensations: Keys to clinical testing of one vs other system
a. Major exception: olfaction: no thalamic relay
3. Axons carrying sensory info are organized topographically from relay nuclei to ctx Carried in DCML ONLY Carried in ALS ONLY Carried by both systems
o Somatotopic (sensory) o Viscerotopic (gut layout)  Texture  Temp  Pressure touch
o Tonotopic (auditory) o Retinotopic (visual)  Vibration  Slow pain  Hair-associated touch
4. Cerebral ctx = “center of consciousness” where sensations enter awareness  Proprioception  Visceral sensations  Fast pain
5. Parallel pathways: descending systems govern amt of ascending (i.e. sensory) input
6. Collateral axonal branches may activate other areas of the brain Major differences: DCML vs ALS systems
DCML ALS
Somatosensory sensations: not just the “5 S’s” anymore Medulla:
Somatic: nerves innervating joint capsules and skin 1st synapse occurs at… Gracile nucleus: below T6 Grey matter spinal cord
 Touch  Temperature: warm/cold Cuneate nucleus: above T6
o Pressure  Vibration Large neurons Smaller neurons
o Hair-associated  Pain: fast + slow DRG (1º sensory) neurons + Heavily myelinated Less myelination
o Discriminative (texture)  Proprioception axons subserving >> # fibers reach cerebrum Fewer # fibers reach
o Stretch  localization of sensation cerebrum
Visceral: nerves innervating smooth or cardiac muscle  fullness and ischemia Somatosensory information
Caudal medulla Lumbar spinal cord
crosses the midline at…
Receptor end organs
Receptor Major function Composition Location
Modified Just beneath Higher level somatosensory processing
Meissner’s Low-freq vibration 
Schwann cells epidermis Primary Somatosensory Cortex (S1): Post-central gyrus of parietal lobe
corpuscles texture (discrim. touch)
 Somatotopic organization (point-to-point
Pacinian Subcut. representation/map)
Higher freq vibrations tissue
corpuscle o Lower body = more medial
Deep in skin; o Upper body = more lateral
Ruffini’s
Stretch receptors tendons +  Related to pattern of fibers in
corpuscles
ligaments DCML Plasticity: overuse/
Merkel’s Pressure: Irritate 1º afferent Modified underuse of an area
disks w/glutamic acid (NT)  AP epidermal cells 2º and 3º Somatosensory Ctx: will cause ∆ in amt
Epidermis ctx dedicated to it
All skin, all
 S2: integrates info from 1º
Free nerve Pain chemicals  AP somatosensory ctx over time and
Nerves layers?
endings Temperature space: ex. sense a single object (with multiple inputs) as 1 single object
 S3: integrates more subtle inputs – texture, etc.
Types of Depolarization
 Loss of 2º + 3º ctx  tactile agnosia (inability to
Found where in 1º recognize by feel, can still ID visually) S1 S2
Potential type Definition
afferent axon?  Location: parietal lobe immediately posterior to 1º
Graded “Analog” – gradations of depolarization Receptor end organs somatosensory ctx
receptor No self-regeneration  cannot propagate
potential unless convert into AP above TH level DCML VPL S1 S2 S3
Action potential “Digital” – on or off Axons, begin close to ALS (thalamus)
Self-regenerative  carries signal to CNS receptor end organs
 Somatosensory Nervous System
DCML pathway
Texture, Vibration, Proprioception (efferent)

Primary somatosensory ctx

Leg (postcentral gyrus)
Trunk

Arm
• Synapse at VPL (Ventral
Posterior limb of internal capsule
posterior lateral nucleus of
thalamus)
• Pass through posterior limb
of internal capsule to 1º VPL nucleus, thalamus
somatosensory ctx

@ Pons:
Shift in orientation from vertical to lateral
distribution of neurons such that most
medial = lower body, lateral = upper body

Medial lemniscus Shift in

somatotopic
Internal arcuate: site of DCML decussation orientation
(both gracile + cuneate axons)

Dorsal column nuclei: Decussation:

internal arcuate fibers Cuneate nuc
• Gracile nucleus: axons from
below T6 (lower limb) Gracile nuc
• Cuneate nucleus: axons from
above T6 (upper limb)
Site of first synapse Dorsal column axons stay separated Cuneate +
in DCML pathway as they ascend in the fasciculi gracile fasciculi
DRG
above T6
• Input from upper and lower Additional synapse @ Clarke’s
body areas (separate DRG nucleus before connecting to
DRG
T6 tracts above and below T6) nucleus gracilis  extra neuron
below T6
fibers pass through dorsal spinal
• Make local connections
cerebellar tract in lateral column
(reflexes) in lower body
 proprioceptive info from
lower limb
 Somatosensory Nervous System
Anterolateral system
Pain and Temperature
Primary somatosensory ctx
Trunk Leg (postcentral gyrus)
Arm

Primary somatosensory cortex

Posterior limb of internal capsule
Thalamus: projects to same nucleus as for DCML
VPL, ventral posterior lateral nucleus

VPL nucleus, thalamus

Reticular activating system Note: arm info switches
Midbrain  Location: medulla + pons from medial to lateral @
 Function: collateral fibers from ALS and VPL, opposite for limb
trigeminal pain pathways synapse on RAS
o Activate cerebral cortex via relay Part of RAS
Spinothalamic
nucleus in thalamus
tract
o Produce arousal “hyperalertness”
 2 major activators: auditory info
Mid-pons
and pain
 (Also flash of light, surprise
(sensory stimulus activates),
caffeine!)
 Damage to RAS = one cause of
Middle coma (inability to become alert)
medulla Lissauer’s tract:
Dorsal lateral fasciculus
• 1st synapse: in dorsal horn grey matter of Sp cord Significance: for pain relief in
the olden days, would want to
• Synapse in Laminae 1 or 2 cut several levels above site of
Caudal • Axon crosses midline in ventral white pain (ex. T8) because afferent
medulla commissure, turns 90º at jxn of lateral + ventral info spreads out before
funiculi and heads up reaches spinal cord
“ALS”
Pain + temp info from
DRG
upper body (including
Cervical Enter spinal cord
face)
spinal cord starting @ L5 (big toe)  Synapse in lamina I: postsynaptic fiber
travels all the way to VPL
 Synapse in L2 (substantia gelatinosa)
Pain + temp info from
onto local circuit neurons  make
Lumbar lower body
another synapse @ L5 and then crosses
spinal cord midline
Decussation: ventral white commissure
 Somatosensory Nervous System
Trigeminal nerve Pain sensation and pain response

Sensory information: Approximate borders between dermatomes

Ophthalmic  Pain and temperature: parallels ALS Cervical
o Passes through spinal trigeminal tract to spinal nucleus Thoracic
Maxillary o Decussates at level of spinal cord Lumbar
o Sends fibers to … Sacral
Mandibular  Reticular activating system
 Facial motor nucleus  affects skeletal muscles of
facial expression  basis of grimace
 Mechanosensory: parallels DCML Pain response:
o Discriminative touch and proprioception (mastication)
o Info enters trigeminal ganglion and synapses on principal sensory nucleus of the
trigeminal nerve
o Decussates @ level of pons
Both systems synapse @ VPM nucleus of thalamus, info projects to facial S1
 Nerve endings split  cover > territory
(vs finer sensations – more precise)
 Chemicals released into extracell. space
activate 1º afferent receptors  AP
 When AP reaches branch point: some of
AP may spread retrograde  causes
NT release at other synaptic terminals
mediating pain response
VPM nucleus of the thalamus
o Substance P
Genu of internal capsule o CGRP  leaky RBCs  inflamm.
o Mast cells  histamine
Mesencephalic  Contributes to hyperalgesia (↑ pain response) – for days
Ventral trigeminothalamic tract Proprioceptive info
nucleus
from mm. of mastication
Types of Pain:
Fast Slow Local anesthetic (ex capsaicin):
Principal nucleus ALS ALS Ischemia: Selective block 2nd pain
Discriminative touch
Facial motor nucleus DCML Blocks first pain Short tem pain, LT analgesia
CN VII RAS
Spinal trigeminal
Skeletal muscles of tract Pain
facial expression
Spinal trigeminal
Reticular formation nucleus
 Somatosensory Nervous System
Descending control of pain: regulation within brain and spinal cord Effects of unilateral structural destruction on subjective sensations
 Some ability to ignore pain (“turn off pain pathways”) until out of danger/acute situation Loss of sensation?
 Also site of mechanism of action of some of opioid narcotics Destruction of left…
Proprioception Vibration Pain
Fasciculus gracilis (at C4) L Lower limb L Lower limb –
Higher association cortex:
Cognition, integrated descending pain inputs onto opioid-containing PAG neurons Fasciculus cuneatus (at C4) L Upper limb L Upper limb –
Anterolateral system (at C4) – – R side (exc face)
A dorsal root ganglion (at C4) L neck L neck L neck
Ascending pain info
Caudal spinal trigeminal nucleus – – L face; V1-3???
Lateral 1º somatosensory cortex R arm R arm R arm
Medial primary somatosensory ctx R leg R leg R leg
Lateral pontine medial lemniscus R leg R leg –
Medial pontine medial lemniscus R arm R arm –
Synapse @ PAG, project to serotonergic neurons
in raphé nucleus of rostral medulla
Clinical syndromes involving damage to somatosensory NS (not necc. tissue)
 Anesthesia: no sensations (numbness)
 Paraesthesias: odd (unnatural) sensations – e.g. pins + needles, bugs under skin, etc.
Project to spinal cord  act on 1º afferent neurons – damage to NS, but incomplete damage (arm falls asleep), not painful
 Dysesthesias: odd sensations accompanied by discomfort or pain (“shooting,”
“electrical” pain, etc. – sciatica)
 Tactile agnosias: inability to recognize objects based on tactile info
C-fibers:
express opioid receptors
 Underlying principles RE parasthesia + dysesthesias:
In spinal cord:
o Peripheral axons attempt to regrow following injury; often form neuroma: sensitive
 Serotonergic stimulus activates opioid- to non-specific somatosensory stimuli (random firing; NL pain fibers quiescent)
containing neurons in lamina 2
X  These neurons act presynaptically on
o Higher ctx sensory areas recognize learned patterns of activity from end organs
 Get input that doesn’t match a learned pattern  don’t know how to interpret
C fibers projecting to lamina 2
X  Dump opioid onto C fibers  inhibits
 Produce para/dysesthesia (if pain fibers involved)
Dorsal horn projection o Commonly seen in diabetes – loss of nerve sensations in feet, etc.
neuron (L2  L5) neurotransmission onto dorsal horn
projection neuron sending pain signal
to lamina 5 Brown-Séquard Syndrome: hemisection of
 Result: analgesia the spinal cord (usually d/t trauma, ice pick)
 Damage to:
Utility of opiates and biogenic amine neurotransmitters in the CNS o Ipsilateral dorsal column fibers:
CNS region Receptor expressed Action loss of discriminative touch
Release enkephalin onto µ- o Contralateral pain fibers,
Central gray of the
µ Opioid receptors enkephlinergic R’s on fibers of temperature loss
midbrain (PAG)
reticular formation  Complete loss of sensation @ zone of
Raphé nucleus Activate opioid-containing hemisection
Serotonin
(rostral medulla) neurons in Lamina 2
Inhibit C fiber pain transmission
Substantia gelatinosa (L2) µ Opioid receptors to dorsal horn projection
neuron (site of epidural action)