Ascending& Descending tracts

Dr. Israa M. Sulaiman Department of Anatomy IMS/MSU

The ascending tracts

By the end of the lecture, students should be able to

define the ascending tract enumerate the tracts according to their functional components explain general outline of neuronal chain of ascending tracts illustrate and trace the neuronal chain of each tract apply anatomical knowledge to correlate with the clinical condition in case of injury to these tracts

contents
function of nervous system in general sensory system overview spinal cord and nerve tracts
ascending tracts
organization in general ascending tracts functional components

nervous system
communication receive information transform it into impulses ( transduction ) transmit impulses to the CNS correlate / coordinate transmit impulses to the effector organs response / action

CENTRAL NERVOUS SYSTEM

integration / processing / modulating

motor / descending tracts

sensory / ascending tracts

lower motor neurone

receptor neurone stimulus

transmission

PNS

effector organ / response

Sensory system
sensory information
three basic information

Exteroceptive information
Interoceptive information Proprioceptive information

sensory information
are received and carried by ascending tracts

exteroceptive sensation
origin:outside the body e.g. temp, touch, light, sound, chemicals, mechanical receptors:- surface layer of skin, mucosa

proprioceptive sensation
origin:within the body e.g. muscles, joints, tendons receptors deeper layer of skin, tendons, joints, GTO, muscle spindles, ligaments

sensory information from the peripheral sensory endings is conducted through the nervous system

by a series of neurones

information
conscious sensation
reach the cerebral cortex

unconscious sensation
reach to the areas other than cortex

spinal cord
Grey matter
mostly made up of cell bodies of neurone

White matter
composed of nerve fibres ( ascending and descending tracts ) embedded in neuroglial cells

nerve fibres
enter the spinal cord through posterior nerve root after entering the spinal cord sorted out and segregated into nerve bundles, tracts ( origin, function, termination )

ascending tracts
bundles of nerve fibres linking spinal cord with higher centres of the brain convey information from soma / viscera to higher level of neuraxis

ascending sensory pathway are organized in three neuronal chain

- First order neurone - Second order neurone - Third order neurone

First order neurone

cell body in posterior root ganglion peripheral process connects with sensory receptor ending central process enter the spinal cord through the posterior root synapse with second order neuron in spinal gray matter

dorsal root dorsal horn

dorsal root ganglion spinal nerve

FIRST ORDER NEURON

Second order neurone

cell body in posterior gray column of spinal cord axon crosses the midline ( decussate ) ascend & synapse with third order neuron in VPL nucleus of thalamus

SECOND ORDER NEURON

2nd

VPL

1st

cross the mid line in front of central canal

Third order neurone

cell body in the thalamus give rise to projection fibres to the cerebral cortex, postcentral gyrus ( sensory area )

ascending sensory pathway

( in general form )

from sensory endings

to

cerebral cortex
( note the three neurons chain )

ascending tracts in spinal cord

Tracts & their functional components

lateral spinothalamic tract
pain, temperature

anterior spinothalamic tract

touch, pressure

 posterior white column

conscious proprioceptive sense, discriminative touch, vibratory sense

spinocerebellar tract / cuneocerebellar tract

unconscious information from muscle, joints, skin, subcutaneous tissues

Main somatosensory pathways

sensation Pain and temperature receptors Free nerve endings pathways Lateral STT Spinal lemniscus destination Postcentral gyrus

Light touch and pressure

Free nerve endings

Anterior STT Spinal lemniscus

Postcentral gyrus

Discriminative touch, vibratory sense, conscious muscle joint sense

Meissners corpuscle, pacinian corpuscles, muscle spindles, tendon organs

Fasciculus gracilis and cuneatus Medial lemniscus

Postcentral gyrus

Lateral spinothalamic tract

pain and thermal impulses ( input from free nerve endings, thermal receptors ) transmitted to spinal cord in delta A and C fibres central process enters the spinal cord through posterior nerve root, proceed to the tip of the dorsal gray column

 the central process of 1st order neuron synapse with cell body of 2nd order neuron in substantia gelatinosa of posterior gray column of the spinal cord

 the axon of 2nd order neuron cross to the opposite side in the anterior gray and white commissure and ascend in contralateral white column as lateral spinothalamic tract end by synapsing with 3rd order neuron in the ventral posterolateral nucleus of thalamus

 axon of the 3rd order neuron passes through the posterior limb of internal capsule and corona radiata to reach the postcentral gyrus of cerebral cortex ( area 3, 1 and 2 )

pain and temperature pathways

Clinical application destruction of LSTT loss of

pain and thermal sensation on the contralateral side below the level of the lesion
patient will not respond to pinprick recognize hot and cold

Anterior spinothalamic tract

light touch and pressure impulses ( input from free nerve endings, Merkels tactile disks ) First order neuron
dorsal root ganglion( all level )

Second order neuron

in the dorsal horn, cross to the opposite side (decussate) ascend in the contralateral ventral column as ASTT end in VPL nucleus of thalamus

Third order neuron

in the VPL nucleus of thalamus project to cerebral cortex ( area 3, 1 and 2 )

touch and pressure pathways

Clinical application destruction of ASTT loss of touch and pressure sense

below the level of lesion on the contralateral side of the body

Fasciculus gracilis and fasciculus cuneatus

discriminative touch, vibratory sense and conscious muscle joint sense
( inputs from pacinian corpuscles, Messiners corpuscles, joint receptors, muscle spindles and Golgi tendon organs )

axon of 1st order neuron enter the spinal cord passes directly to the posterior white column of the same side ( without synapsing )

 long ascending fibres travel upward in the posterior column of the same side as fasciculus gracilis and fasciculus cuneatus
( FG carrying fibres from lower thoracic, lumbar and sacral regions / including lower limbs ) ( FC - only in thoracic and cervical segments / including upper limb fibres )

synapse on the 2nd order neuron in the nucleus gracilis and cuneatus of medulla oblongata of the same side.

[ nucleus G & C ]
in medulla fasciculus cuneatus
cervical segments upper 6 thoracic segments

lower 6 thoracic segments lumbar segments sacral segments

C G

fasciculus gracilis

 axons of 2nd order neuron internal arcuate fibres cross the median plane ( sensory decussation )

ascend as medial lemniscus through medulla oblongata, pons, and midbrain

synapse on the 3rd order neuron in ventral posteriolateral nucleus of thalamus

axon of 3rd order neuron leaves and passes through the internal capsule, corona radiata to reach the postcentral gyrus of cerebral cortex area 3, 1 and 2 )

pathways for
conscious proprioception discriminative touch

vibratory sense

Clinical application destruction of fasciculus gracilia and cuneatus loss of muscle joint sense, position sense, vibration sense and tactile discrimination on the same side below the level of the lesion

(extremely rare to have a lesion of the spinal cord to be localized as to affect one sensory tract only )

Posterior & anterior spinocerebellar tract

transmit unconscious proprioceptive information to the cerebellum receive input from muscle spindles, GTOs and pressure receptors involved in coordination of posture and movement of individual muscles of the lower limb

First order neuron

in dorsal root ganglion axons end in nucleus dorsalis of Clarke

Second order neuron

cell body in nucleus dorsalis of Clarke give rise to axons ascending to the cerebellum of the same side
( anterior crossed & uncrossed fibres / posterior uncrossed fibres)

muscle joint sense pathways to cerebellum

 Spinotectal tract
passes pain, thermal, tactile information to superior colliculus for spinovisual reflexes cross the median plane synapse in the superior colliculus integrate visual and somatic sensory information ( it brings about the movement of eye and head towards the source of information )

Spinoreticular tract
uncrossed fibres, synapse with neurones of reticular formation (important role in influencing level of consciousness)

Spino-olivary tract

spinotectal tract
spinoreticular tract spino-oloivary tract

clinical application
relief of pain
posterior rhizotomy (posterior root) cordotomy (lateral STT)

Injury
hemisection of spinal cord

diseases
tabes dorsalis / syringomyelia / vascular

Hemisection of the spinal cord

( Brown Sequards syndrome )
Dorsal column damage Lateral column damage Anterolateral column damage Damage to local cord segment and nerve roots

spinal cord hemisection

below the level of lesion

on the side of lesion
local segment side of lesion Dorsal Root irritate destruction Ventral root flaccid paralysis

lateral column damage

UMNL dorsal column damage

loss of position sense

loss of vibratory sense loss of tactile discrimination

anterolateral system damage loss of sensation of pain and temperature on the side opposite the lesion

Lesions of central gray matter

seen in syringomyelia ( progressive cavitation around or near
the central canal of spinal cord especially in cervical segments )

interrupt fibres of lateral spinothalamic tract that passes in front of the central canal loss of pain and temperature sensibility on both sides ( proprioception and light touch is spared ) sensory dissociation

Posterior root lesions seen in tabes dorsalis ( neurosyphilis ) bilateral degeneration of posterior root and posterior funiculus ( particularly in lower segments of
spinal cord ) Clinically Initial stage Irritation - paraesthesia Intermittant of attack of sharp pain Later decreased sensitivity to pain loss of muscle stretch reflexes loss of position sense, posture senses positive Romberg sign ( visual compensation ) walk with legs apart, high stepping gait

blood supply of spinal cord

Anterior spinal artery

Posterior spinal arteries Segmental spinal arteries - radicular arteries Feeder arteries - Adamkiewicz

posterior 3rd of spinal cord dorsal column

penetrating branches anterior and part of gray matter circumferential branches anterior white matter

dorsal 1/3rd

resulting from occlusion of the posterior spinal artery

ventral 2/3rd

resulting from occlusion of the anterior spinal artery

Descending tracts
By the end of this lecture, students should be able to:
define the tract enumerate the tracts according to their functional components illustrate and trace the neuronal chain of each tract apply their knowledge of anatomy to correlate with the clinical condition in relation to the injury to these tracts

Motor system
areas of the nervous system that are responsible for controlling movements

premotor cortex

SMA

PMC

basal ganglia

cerebellum

II
cortical sensory area premotor cortex

MOTOR SYSTEM

motor cortex

III
extrapyramidal tracts
pyramidal tract

IV sp cd internreurons &
central pattern generator

motor unit muscle spindle

Level I
initiation, planning, programming of movements
in response to desire to move
( probably originate in the limbic system and posterior parietal cortex )

desire is translated into movements

( basal ganglia and their cortical projections in the frontal lobe-SMA, PMC )

Level II coordination of movements

cerebellum
( compare the intended movement / actual movement )

Level III descending pathways

pyramidal tract - CoSt
originates in the motor, premotor and somatosensory corticies synapse direclty on MN , IN

extrapyramidal tract VeSt, ReSt, TeSt, RuSt

originate from subcortical structures receive inputs from motor cortex complex distribution, synapse on MN, IN

Level IV motor organization in spinal cord

alpha & gamma neurons Renshaws cells interneurons / CPGs descending tracts
CoSt, RuSt distal musculature fine skilled movement VeSt- ReSt- TeSt axial, proximal musculature balance, posture

Level V final common pathway

primary structure responsible for translating desire into a movement is the basal ganglia

Introduction
brain exerts powerful and subtle influences upon the activity of the voluntary musculature ( modulate, regulate, bias the activities of LMN )

through the descending pathways

descending tracts
segregated bundles of nerve fibres in the white matter of the spinal cord descending from the supraspinal centres referred to as upper motor neurons ( UMN ) are concerned with somatic and visceral motor activity cells of origin lie in cerebral cortex and brain stem regulate the LMN activity

motor homunculus

cerebral cortex

lower motor neurons ( LMN )

motor neurons that innervate the voluntary muscles in anterior gray column of spinal cord / motor nuclei of brainstem
innervate skeletal muscles

form final common pathway

LMN

LMN constantly bombarded by nerve impulses( excitatory or inhibitory )

that descend from cerebral cortex, pons, midbrain and medulla

sensory inputs from the posterior root

upper motor neurons ( UMN )

the descending supraspinal pathways that influence the activity of the LMN
e.g. CoSt, CoBt, RuSt, TeSt, ReSt, VeSt

UMN
control voluntary motor activity maintenance of posture & equilibrium control of muscle tone and reflex activity generally exerts their effect on groups of muscles ( not on one specific muscle ) reciprocally on agonist and antagonist muscle group

cerebral cortex midbrain - pons - medulla oblongata

descending tracts

sensory inputs

LMN

Corticospinal tract
arises from the pyramidal cells of cerebral cortex fibres travel through
corona radiata posterior limb of the internal capsule cerebral peduncle ( middle 3/ 5th ) pons medulla oblongata ( passed through the pyramids )

 at the caudal part of medulla oblongata

most of the fibres 90 % cross the mid line

(motor decussation)
descend in the lateral column as LCST terminate on LMN of anterior gray column at all spinal level
remaining uncrossed fibres descend as ACST eventually fibres cross the mid line and terminate on LMN of anterior gray column of respective spinal cord segments

motor decussation
medulla oblongata

corticospinal tract
for fine skilled movements

Rubrospinal tract
nerve cells in red nucleus
( tegmentum of midbrain at the level of superior colliculus )

nerve fibres / axons cross the mid line descend as rubrospinal tract
through pons and medulla oblongata

terminate anterior gray column of spinal cord ( facilitate the activity of flexor muscles )

Tectospinal tract
nerve cells in superior colliculus of the midbrain nerve fibres/ axons
cross the mid line descend close to medial longitudinal fasciculus

terminate in the anterior gray column of upper cervical segments of spinal cord
( responsible for reflex movement of head & neck in response to visual stimuli )

Vestibulospinal tract
nerve cells in vestibular nucleus
(in the pons and medulla oblongata received afferents from inner ear and cerebellum

axons descend uncrossed

through medulla and through the length of spinal cord synapse with neuron in the anterior gray column of the spinal cord ( balance by facilitate the activity of the extensor muscles )

Reticulospinal tract
nerve cells in reticular formation fibres pass through
midbrain, pons, and medulla oblongata

end at the anterior gray column of spinal cord

control activity of motor neurons
(influence voluntary movement and reflex activity )

reticulospinal tract

clinical application
pyramidal tract refer to corticospinal tracts

extrapyramidal tract other than corticospinal tract ( VeSt, ReSt, TeSt, RuSt )

upper motor neuron lesion

Babinski sign ( extensor plantar response ) Superficial abdominal reflexes ( absent ) Cremasteric reflex ( absent ) Loss of performance of fine skilled voluntary movement

lower motor neuron lesion

flaccid paralysis atrophy of muscles loss of reflexes muscular fasciculation muscular contracture

extrapyramidal tract lesions

severe paralysis with little or no atrophy spasticity or hypertonicity exaggeration of deep muscular reflexes and clonus clasp-knife reaction

These motor pathways are complex and multisynaptic, and regulate:

Axial muscles that maintain balance and posture Muscles controlling coarse movements of the proximal portions of limbs Head, neck, and eye movement

pyramidal tracts extrapyramidal tracts

dorsal column lateral STT anterior STT

nerve roots

spinal cord hemisection

thank you