Major Pathways of General Sensation

Dorsal Column-Medial Lemniscus Pathway

A. Function: The dorsal column-medial lemniscus pathway
mediates tactile discrimination, vibration sensation, form
recognition, and joint & muscles sensation (conscious
proprioception).
B. Receptors include Pacini's & Meissner's tactile corpuscles,
joint receptors, muscle spindles, and Golgi tendon organs.
C. First-order neurons are located in the dorsal root ganglia at
all levels. They project axons to the spinal cord through
the medial root entry zone. First-order neurons give rise to:
1. The gracile fasciculus from the lower extremity.
2. The cuneate fasciculus from the upper extremity.
3. The collaterals for spinal reflexes, e.g. myotatic
reflex (deep tendon reflex).
4. The axons that ascend in the dorsal columns and
terminate in the gracile & cuneate nuclei of the
caudal medulla.
D. Second-order neurons are located in the gracile & cuneate
nuclei of the caudal medulla. They give rise to axons &
internal arcuate fibers that decussate and form a compact
fiber bundle, i.e. medial lemniscus. The medial lemniscus
ascends through the contralateral brain stem and
terminates in ventral posterolateral (VPL) nucleus of the
thalamus.
E. Third-order neurons are located in the VPL nucleus of the
thalamus. They project through the posterior limb of the
internal capsule to the postcentral gyrus, which is the
primary somatosensory cortex (Brodmann's areas 3, 1, &
2).

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Lateral Spinothalamic tract
A. Function: The lateral spinothalmic tract mediates pain &
temperature sensation.
B. Receptors are free nerve endings. The lateral
spinothalamic tract receives input from fast- & slow-
conducting pain fibers, i.e. A- & C respectively.
C. First-order neurons are found in the dorsal root ganglia at
all levels. They project axons to the spinal cord through
the dorsolateral tract of Lissauer (lateral root entry zone) to
second-order neurons.
D. Second-order neurons are found in the dorsal horn. They
give rise to axons that decussate in the ventral white
commissure and ascend in the contralateral lateral
funiculus. Their axons terminate in the VPS nucleus of the
thalamus.
E. Third-order neurons are found in the VPL nucleus of the
thalamus. They project through the posterior limb of the
internal capsule to the primary somatosensory cortex
(Brodmann's areas 3, 1, & 2).

Summary
A. Pain & Temperature:
Receptors in dermis and epidermis,
Dorsal root ganglion to dorsal horn of spinal cord,
Cross to lateral spinothalamic tract & ascend to VPL
nucleus of the thalamus,
Project to the postcentral gyrus.
Reflex arc present at the spinal cord level.
B. Pressure & Crude Touch:
Receptors in dermis,
Dorsal root ganglion to dorsal horn of spinal cord,
Cross to ventral spinothalamic tract & ascend to VPL
nucleus of the thalamus,
Project to the postcentral gyrus.
C. Proprioception, Fine Touch, & Vibration:
Receptors in muscles, joints and tendons.

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D. Sensation From Face:
Input via the trigeminal nerve (CN: V).
Projections to trigeminal ganglion (pons) and nucleus
(medulla).
Fibers cross and ascend to the VPM nucleus in
thalamus.

Oral Physiology Assignment

By Noor Al-Deen M. Al-Khanati
Reference:
High-Yield Neuroanatomy, 2nd
Edition, James D. Fix, Ph.D.