Lecture Note - Nerve Terminals /Russamee,Chirapha - 1 - Neuroanatomy

NERVE TERMINALS 3. Encapsulated with straight, unbranched nerve

processes
AFFERENTS 4. Encapsulated with other connective tissue
1. Non Encapsulated - “Free” endings elements incorporated in the capsule
2. Encapsulated with coiled and branched nerve
processes

 Myelination terminates prior to nerve ending

 Axon may branch profusely e.g. visceral afferents
 May end in squamous epithelium of skin - pain fibers
Free endings  May end as cup-like ending in contact with a particular
epithelial cell - merkel’s tactile disc
 Also coiled endings surrounding hair follicles - Peritrichial
endings

 Meissner’s corpuscles
 Found in deep epidermis particularly in certain regions
o Fingers
o Palm of Hand
o Toes and sole of foot
o Lips
o Nipple
o Clitoris and Penis
 Axon is coiled and branched inside the thin capsule
 Said to respond to forces perpendicular to skin surface as contrasted
Thinly Encapsulated with Merkel’s discs which supposedly respond to forces tangential to
Endings skin surface
 Discriminatory Tactile Stimuli
 End bulbs of Krausse
- Spherical
- Larger than Meissners
- Possibly stimulated by cold temperatures
 Golgi-Mazzoni Corpuscles
- Smaller than Krausse bulbs
- Slightly thicker capsule
- Less coiled terminals
- said to be responsive to pressure
o Pacinian Corpuscle
o Thick, laminated connective tissue capsule with straight nerve
Encapsulated terminals
Endings with Thick o Layers of collagen fibers form lamellae around nerve ending
Capsules o May be very large (up to 3 or 4 mm)
o Deep Pressure Receptors present in subcutaneous connective tissue,
adventitia of blood vessels, and around joint capsules

 Muscle Spindles
Terminations  Tendon Spindles
Containing Other  Ruffini Corpuscles
Tissue Elements
with the Capsule All contain tissue elements (such as muscle or tendon) as well as nerve
terminals
Lecture Note - Nerve Terminals /Russamee,Chirapha - 2 - Neuroanatomy

Muscle Spindles  Capsule contains modified striated muscle

fibers (intrafusal fibers)
 “Muscle Stretch Receptors”
 These fibers number from 2-10
 Found in striated muscle, where they are per capsule
surrounded by a connective tissue capsule  Striated except at midpoint
 Most numerous in muscles of the (equator of spindle)
extremities  Nuclei of intrafusal fibers
 Least in extraocular muscles accumulated at equator (sometimes
 Vary from 0.75mm to 10mm in length termed nuclear bag)

 Average length 2-4 mm

 The ends of the intrafusal fibers
receive motor innervation (gamma
efferent fibers)

Muscle spindles possess sensor innervations consisting of two types

Annulo-Spiral Endings Flower-Spray Endings

o Extending in o Branched, knobbed

both directions along the length of terminals located at the ends of intrafusal fibers
intrafusal fibers o Thinner Secondary
o Thick Primary Sensory Endings
Sensory Endings

Efferent Termination the presence of normal nerve

o Motor end plates
found on striated muscle fibers
o Myelinated axon
branches at node of Ranvier to
terminate on several muscle fibers
o One Anterior
Horn Cell and all the muscle fibers
supplied by it constitutes
physiological motor unit
o Larger Back
Muscles
- one neuron may innervate up to
100 muscle fibers
o Small Intrinsic
Hard Muscle
- one neuron may only innervate
2 or 3 muscle fibers
o Fibers lose their myelin
prior to termination
o Disorders of the
neuromuscular junctions may occur in
conduction and normally functioning
muscle fibers.
Myasthenia Gravis
- weakness and rapid fatigue of
muscles thought to be due to
insufficient production of acetyl choline
a esterase
- Administration of neostigmine (an
anti-cholinesterase) results in dramatic
improvement for a short time
Endings on Smooth and Cardiac Muscle
and Acini of Glands
 Manner of termination is disputed
 Swellings or Knobs on muscle fibers
 Form a terminal network between
muscle fibers
Lecture Note - Nerve Terminals /Russamee,Chirapha - 3 - Neuroanatomy

GENERAL SENSORY SYSTEMS

Neuronal Pathway
o Receptors
o DRG
o Fibers
- dorsolateral fasciculus, a.k.a. Zone of Lissauer
o Bifurcate and take a short ascending
and descending course (approximately 1 to 2 segments)
o Synapse on the cells of the dorsal horn
of grey matter
Spinothalamic System o Axons of secondary neurons
(Secondary fibers) cross to the contralateral side of the cord in
o the ventral white commissure to form the
pain
o 1. Ventral Spinothalamic Tract – crude touch
thermal sensation 2. Lateral Spinothalamic Tract – pain and thermal
o sense
crude touch o Tract is laminated such that fibers from lower cord
levels are located dorsolaterally and fibers from higher levels are
Receptors located ventromedially
 Naked nerve
endings - pain 3. Spinotectal Tract
 Peritrichial endings  Spinal Lemniscus - level of the Inferior Olivary Nucleus (lower
- pain and crude medulla)
touch  Terminate in the posterior ventral thalamic nucleus (PVTN)
 Merkel’s tactile  Spinotectal Fibers - terminate in the midbrain tectum for the
discs - crude touch reflex movements of the head, etc in response to pain
 Krausse end bulbs  Tertiary neurons from the PVL nucleus
- thermal receptors send axons via the thalamic radiations in the posterior limb of
the internal capsule to terminate in the general sensory cortex of the
cerebral hemisphere
 Post Central Gyrus

 Use of “Light-Pin-Prick”
> sharp vs dull pain

 Hot and Cold Objects

> tests the integrity of the Spinothalamic System

Posterior Column Pathway

o Neuronal Pathway
vibratory sense  Receptors
o  DRG
two point  Fibers – medial portion of the dorsal roots
discrimination
 Posterior White Funiculus of the Cord
o
 Ascend the entire length of the cord without interruption
joint position sense
o  Fibers from higher cord segments - Fasciculus cuneatus
discriminatory touch  Fibers from lower cord segments – Fasciculus gracilis
 Posterior column fibers terminate on cells of the
Receptors respective relay nuclei
 Pacinian > nucleus gracilis/ nucleus cuneatus
Corpuscles – deep  Cross the midline at lower medulla
pressure > Secondary Fibers originating from these nuclei take a ventro-
 Golgi-Mazzoni medial course across the midline as the internal arcuate fibers to form
Corpuscles – Medial lemniscus - contralateral side of the brain stem - courses through
pressure the medulla and becomes horizontally situated at the Pons
 Flower-Spray  And eventually terminates in Posterior ventral lateral
Lecture Note - Nerve Terminals /Russamee,Chirapha - 4 - Neuroanatomy

Endings – thalamic nucleus

Secondary sensory  Tertiary Fibers are projected to Post central Gyrus
Nerve Endings
 Annulo-Spiral
Endings – Primary
Sensory Endings

 Other fibers mediating pain sensation arise from the

Spinoreticular System
intermediate spinal cord gray matter
 Ascend on both sides of the cord
 Lateral and Ventral funiculi
 These constitute the diffuse spinoreticular tracts
 Synapse upon the brainstem reticular formation neurons
 Reticulo-thalamic fibers ascend to the
 Intralaminar and centro median thalamic nuclei
 As well as the posterior ventral thalamic nucleus

SPINOCEREBELLAR SYSTEM spinocerebellar tract arising from the

contralateral nucleus dorsalis
Receptors o There is no nucleus dorsalis
• Muscle spindles located in the cervical cord
• Joint receptors o Impulses from cervical levels
destined to reach the cerebellum ascend
Function in the fasciculus cuneatus to the lower
o Cerebellar coordination of medulla, and terminate in the accessory
muscular activity cuneate nucleus, located just lateral to
o Some posterior column fibers the main cuneate nucleus
synapse on cells of the nucleus dorsalis o Neurons of the accessory
(Clarke’s Column) located in the cuneate nucleus perform the same
ipsilateral lumbar and lower thoracic cord function as nucleus dorsalis neurons, i.e.,
o Fibers project to the relay into the cerebellum
cerebellum as the Spinocerebellar Tracts: o Projection is via the direct
Dorsal, Ventral arcuate fibers, entering the cerebellum
o Dorsal Spinocerebellar Tract via the ipsilateral restiform body
enters Cerebellum via restiform body =
inferior cerebellar peduncle
o Ventral Spinocerebellar Tract THE 12 CRANIAL NERVES
ascends Lower Midbrain - travels via  I, II VIII – Sensory only
brachium conjunctivum = superior  IV, VI, and XII – Somatic Motor only
cerebellar peduncle, entering the  V – Sensory and Motor
Cerebellum  III – Somatic Motor and
o Spinocerebellar fibers ascend Parasympathetic
on the same side as their origin, except  VII, IX and X – Sensory, Somatic Motor
for a small number of fibers in the ventral and Parasympathetic
Lecture Note - Nerve Terminals /Russamee,Chirapha - 5 - Neuroanatomy

Motor Parasympathetic
Sensory
I, II, V, VII, VIII, IX, X III, IV, V, VI, VII, IX, X, XI, XII III, VII, IX, X

TRIGEMINAL SYSTEM • Oral Cavity (including teeth)

Function: General sensations from • Skin of Anterior part of the Head
• Face • Supratentorial Meninges

3 Divisions of Trigeminal System

First Division Second Division Third Division

OPHTHALMIC, V1 MAXILLARY, V2 MANDIBULAR, V3

• Forehead • Upper Lip • Lower Lip
• Upper eyelid • Upper Teeth • Lower Jaw
• Cornea • Lateral portion of the • Lower Teeth
• Conjunctiva Nose • Posterior Cheek and
• Dorsum of Nose • Upper Cheek Temple
• Mucous membranes of • Anterior Temple • External Ear
Nasal Vestibule • Mucous membrane of • Mucous membrane of
• Frontal Sinus the Mouth Lower Jaw
• Roof of Mouth • Floor of Mouth
• Tongue

• All Divisions innervate the supratentorial meninges also

MOTOR DIVISION OF TRIGEMINAL, SVE  Central processes
 Motor nucleus in the PONS - travel to the brainstem where they attach
source of motor fibers innervating the at the level of the Pons
Muscles of Mastication  Centrally, these
- Temporalis sensory fibers form a
- Masseter • short ascending
- Medial pterygoid trigeminal tract terminating in the
- Lateral pterygoid main sensory trigeminal nucleus, and
 Tensor tympani a
 Tensor veli palatini
• longer descending tract
terminating in the descending or
spinal trigeminal nucleus
NEURONAL PATHWAY OF TRIGEMINAL
SENSORY  Note: Descending tract
and nucleus extends down as low as the
 Trigeminal Ganglion:
3rd cervical spinal cord level
Gasserian/Semilunar - comprised of
unipolar neurons situated in Meckel cave  The 3 divisions of the
trigeminal are represented in the
• a shallow
descending tract and nucleus. Such that,
depression on the anterior slope of
• Mandibular = most
the petrous bone in the floor of
dorsal
middle cranial fossa
• Ophthalmic = most
 Peripheral processes of ventral
these cells constitute the divisions of the
• Maxillary =
trigeminal nerve
intermediate
Lecture Note - Nerve Terminals /Russamee,Chirapha - 6 -
 A small skin area
around the external ear has innervation
for general sensation via sensory fibers of
- Cranial Nerve VII:
geniculate ganglion
- CN IX: superior
ganglion
- CN X: jugular ganglion
 The central connections
of these sensory fibers are the same as
the trigeminal sensory fibers
• Main Sensory Nucleus
 dicriminatory touch
 two point discrimination
• Descending Nucleus (rostral
portion)
 crude touch
• Descending Nucleus (caudal
portion, caudal to the inferior
olivary nucleus)
 pain
 thermal sense
 The mesencephalic
nucleus of the trigeminal system located
in the periaqueductal grey matter of the
midbrain, is composed of unipolar
neurons
 These are similar to the
neurons of the trigeminal ganglion
 Their single processes
divide into a peripheral and central
process while still within the brainstem,
and these processes constitute the
Mesencephalic tract of the trigeminal
 The peripheral
processes exit the brainstem and
terminate upon the muscle spindles in
the muscles of mastication, which receive
their motor innervation via the motor
division of the trigeminal nerve
 The central processes
of these cells synapse upon cells in the
main sensory nucleus, and also upon the
cells of the motor nucleus of the
trigeminal located medial to the main
sensory nucleus
 Secondary neurons
from the main sensory nucleus and the
descending trigeminal nucleus project
axons across the midline to form the
Trigeminal Lemniscus = Main Trigemino
Thalamic Pathway; travels in close
association with the fibers of the medial
Neuroanatomy
lemniscus, to terminate in the Posterior
Ventral Medial Thalamic Nucleus
 Some secondary fibers
arise from the main sensory nucleus to
ascend as an uncrossed tract - Dorsal
Trigemino Thalamic Tract terminating in
the Posterior Ventral Medial Thalamic
Nucleus
 Tertiary fibers from this
nucleus travel via the Internal capsule to
terminate in the inferior portion of the
Post-central Gyrus
 Other trigeminal nuclei
connections are with the Reticular
formation and Cerebellum
 Various Reflexes
involve in the Trigeminal Nerve
o Corneal reflex
: V Sensory, VII Motor
o Lacrimal reflex
: V Sensory, Parasympathetics of VII
motor
o Jaw jerk :
stretch reflex of masseter muscle, V
Sensory and motor division of V
Trigeminal Neuralgia
 An excruciatingly painful condition
 Etiology: unclear
 Affect one or more of the peripheral
divisions of the trigeminal nerve
 A.K.A. “Tic Douloureux”
GUSTATORY SYSTEM
Taste Buds
 Anterior 2/3rd of the tongue – innervated
by CN VII - cell bodies in the geniculate
ganglion
 Posterior 3rd – innervated by CN IX - cell
bodies in the petrosal ganglion
 Epiglottis – CN X - cell bodies in the
nodose ganglion
 Centrally, taste fibers form the Solitary
Tract and terminate on the cells of the
Solitary Nucleus which surrounds it
 Secondary fibers from the solitary
nucleus ascend as part of the
contralateral Medial lemniscus
terminating in the Posterior Ventral
Medial Thalamic Nucleus
Lecture Note - Nerve Terminals /Russamee,Chirapha - 7 - Neuroanatomy

 Others make connections with the  The fovea centralis contains

 brainstem reticular formation and the
 salivatory nuclei (superior and inferior) -
provide innervation to the salivatory
glands
- Superior: parasympathetic
preganglionics of the Facial Nerve
- Inferior: parasympathetic
preganglionics of the
Glossopharyngeal Nerve
 Cortical regions concerned with taste are
the Opercular portion of the post central
gyrus and the Insular Cortex
THE VISUAL SYSTEM
The Retina
 Rods and Cones are modified
bipolar neurons
 constitute the light
sensitive components of the visual
system
 their distribution
throughout the retina varies with
the region examined
cones only
 Cones respond to
- daytime high intensity
illumination
- sharp vision
- color discrimination
 Rods respond to
- peripheral vision
- low intensity illumination
- night vision
 Cones and some rods are
scattered in the macula lutea
 Light strikes the Retina Rods
and Cones
 Impulses are relayed via
bipolar neurons to Ganglion cells
 Axons of which constitute the
Optic Nerve fibers - not myelinated while
within the retina
 Fibers are myelinated once the
nerve leaves the globe - myelin is formed
from oligodendrocytes
 At the immediate point of exit
from behind the eyeball,

Macular fibers

o lie on the lateral side of the optic nerve, but rapidly assume a position in the center
of the nerve surrounded by para macular fibers and peripheral retinal fibers on the outside
o Note: The entering central retinal artery and the exiting vein occupy a position in
the center of the optic nerve, at the point of its attachment to the retina - the Optic Papilla

Optic Nerves

Travel via the Optic foramina towards their attachment to the diencephalon, with a partial
decussation
Lecture Note - Nerve Terminals /Russamee,Chirapha - 8 - Neuroanatomy

Optic Chiasm

o occurs superior to the diaphragma sella, just anterior to the

pituitary stalk
o At the Chiasm, fibers from the nasal half of the retina cross the
midline to join with the uncrossed temporal fibers of the opposite eye to form the Optic
Tract
o Some nasal fibers may loop into the contralateral optic nerve or
into the ipsilateral optic tract for a few millimeters before completing their crossing into the
contralateral optic tract - these fibers are referred to as Von Willebrand’s Knee

Optic Tracts

o pass around the lateral surface of the cerebral peduncle to

approach the Lateral Geniculate Body of the thalamus
o As the Optic tract approaches the lateral geniculate body, rotation of fibers is
thought to occur, such that Crossed fibers ( from contralateral nasal retina) become ventro-
lateral, and Uncrossed fibers ( from ipsilateral temporal retina ) become dorsolateral
 Superior Retinal Quadrants of both eyes directed to the Ventro-medial aspect of
the lateral geniculate body
 Inferior Retinal Quadrants of both eyes to Dorsolateral aspect

Lateral Geniculate Body

 Superior Retinal Quadrant – medial portion

 Inferior retinal quadrant – lateral portion
o Macular fibers thought to terminate in a cone Apex of the cone towards the central
portion of the lateral geniculate body and the base of the cone towards the superior portion
o Some fibers of the optic tract continue beyond the lateral geniculate body without
synapse there, as the brachium of the superior colliculus
o These terminate on neurons of the Superior Colliculus or alternatively on neurons
of the Pretectal region
- Pretectal region connections mediate Pupillary Light Reflexes
- Superior colliculus connections mediate Reflex movements of Eyes and
Head in response to visual stimuli
Lecture Note - Nerve Terminals /Russamee,Chirapha - 9 - Neuroanatomy

Visual Radiations = Geniculo Calcarine Tract

Travel from the lateral geniculate body to the visual cortex (calcarine cortex)

Calcarine Cortex

o comprised of the cuneus and lingual cortex on the medial side of

the occipital lobes
o Fibers arising from the medial portion of the lateral geniculate
body, representing the superior retinal quadrants, terminate on the Superior lip of the
calcarine fissure (lingual cortex)
o The macular retinal representation is in the Posterior portion of
the Visual Cortex
o Visual radiations from the medial portion of the lateral geniculate
body (superior retinal quadrants) pass almost directly posteriorly to terminate in the cuneus
o Radiations from the lateral part of the lateral geniculate body
(lower retinal quadrants) pass forward a considerable distance into the Temporal lobe
before looping posteriorly over the temporal horn of the lateral ventricle to terminate in the
Lingual Cortex
o These temporal lobe radiations form the Loop of Meyer