“Activate my mechanoreceptive free nerve endings and Pacinian corpuscles” Elmo

The Somatosensory
System
Csilla Egri, KIN 306 Spring 2012
 Outline
2

 Somatosensory system overview

 Sensory transduction
 Sensory receptors
 Cutaneous mechanoreceptors
 Thermoreceptors
 Nociceptors
 Central projections
 Dorsal column medial-lemniscus pathway
 Anterolateral pathway
 Pain sensations
 Pain disorders
 Somatosensory system:
3
function
 Receptors respond to mechanical, thermal & chemical
stimuli within three broad categories:
 Proprioceptive (lecture 6,10)

 Body and limb position

 Enteroreceptive (KIN 305)

 Internal state of the body

 Exteroreceptive

 Touch
 Temperature
 Pain (nociception)
 Somatosensory fibers
4

 Afferent fibers
carrying info of
different
modalities are of
different sizes

What property of large

diameter axons allows
for increased speed of
conduction?
 Somatosensory transduction
5 Receptor potential
 two classes: simple or complex
 mechanical deformation, heat or
chemical stimulus within
receptive field opens ion
channels
 causes a local depolarization
= receptor potential
 propagated by electrotonic
conduction to axon hillock
 Stimulus intensity coded by
number of receptors activated,
and frequency of AP
 Somatosensory transduction
6

 How to convey modality of sensation?

 Labelled line coding

 Type of sensation felt when receptor is stimulated

determined by where the fiber synapses in the CNS
 Examples of “fooled” senses:
 Chewing minty gum  activates cold sensitive
thermoreceptors  sensation of cold
 Seeing stars after being hit on head  forceful blow
activates photoreceptors  see spots
 Cutaneous mechanoreceptors:
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morphology

(slow vibration, texture

(sustained touch,
pressure) (rapid vibration)

(rapid vibration)

(deep pressure)

(movement of hairs)
 Cutaneous mechanoreceptors:
8
adaptation
 receptors are classified not only on their morphology,
but on their adaptation & receptive fields as well
 Cutaneous mechanoreceptors:
9
receptive fields
 small receptive fields permit high resolution of
spatial detail (two point discrimination)
 Discrimination enhanced by lateral inhibition
 Cutaneous mechanoreceptors:
10
adaptation + receptive fields

Adaptation

Kandel Fig. 21-1

 Cutaneous mechanoreceptors:
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summary
Receptor Sensation Adaptation rate Receptive field
Free nerve endings Itch, tickle, pain Tonic or phasic Large or small

Ruffini endings Stretching of skin, Tonic Large

deep pressure
Merkel discs Fine touch and Tonic Small
pressure
Meissner corpuscle Fine touch, pressure, Phasic – moderate Small
slow vibration

Hair follicle Crude touch, Phasic – moderate Small

movement of hairs
Krause bulbs Fast vibration Phasic - fast Small

Pacinian corpuscle Pressure, fast Phasic - fastest Large

vibration, tickling
 Thermoreceptors
12
 Free nerve endings with high thermal sensitivity
 Temperature change activates family of ion channels on the
receptor membrane = TRP (transient receptor potential)
channels
 Each TRP channel has a unique temperature threshold of firing,
and is sensitive to various chemical agonists
 Thermoreceptors: tonic
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responses
Tonic response of thermoreceptors and  Warmth receptors:
thermosensitive pain fibers  Narrow temperature range

 Begin firing at 30ºC, rise

steeply with increased
temperature, then stop
abruptly
 Sensation of pain begins
>45ºC
 Cold receptors:
 Broader temperature range

 Maintain steady discharge

rates, with increased firing
20-30ºC
 <15ºC neuronal firing
ceases

Guyton Fig. 48-10

 Thermoreceptors: phasic
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responses
 Thermoreceptors are more responsive
to changes in temperature than to
constant temperature
 A phasic response in both warm and
cold receptors occurs when the
temperature is changed
 Thermoreceptors adapt to a new
steady state firing level is stimulus
is maintained

Kandel Fig. 22-9

 Nociceptors
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 Free nerve endings that respond to intense stimuli

 Types:
 Mechanical

 Strong pressure, sharp objects

 Thermal

 Burning heat (>45ºC)

 Noxious cold (variable) Check: Which fibers
 Chemical are myelinated?
 pH extremes
 Environmental irritants
 Internal neuroactive substances
 Polymodal

 Sensations mediated by Aδ fibers (sharp, intense pain) and C fibers

(persistent, dull pain).
 Nociceptors: hyperalgesia of
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inflammation
 Nociceptors are non adapting receptors
 Primary hyperalgesia: damaged tissue
has increased sensitivity to pain
 Reduced threshold to pain

 If normally non painful stimuli felt as

painful: allodynia
 Increased intensity of sensation

 Spontaneous pain

 Inflammatory response releases

bradykinin, prostaglandins, serotonin,
substance P, K+, H+
 Substance P activates mast cells 
release histamine  activates
nociceptors
B&B Fig. 13-26
 Somatosensory projections:
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dermatomes
 Sensory neurons (dorsal
root ganglion cells) enter
the spinal cord through the
dorsal roots
 Each dorsal root innervates
a field of skin called a
dermatome
 Dermatomal map used

to determine level of
lesion of spinal injury
 Epidural analgesia

blocks sensations thru

out several dermatomes
B&L Fig. 7-4
 Somatosensory projections:
tracts
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1. Dorsal column-medial lemniscus pathway 2. Anterolateral pathway

 1. Dorsal column-medial lemniscus
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pathway
 Carry signals from mechanoreceptors of the skin, joints
& muscle  fine, discriminatory touch
 Information has high spatial & temporal resolution
 Large, myelinated fibers with rapid conduction velocities
 1º afferents terminate & form synaptic connections with
2nd order neurons in the dorsal column nuclei within the
medulla
 2nd order neurons cross over at the medulla and continue
to the thalamus via the medial lemniscus pathway
 After thalamic processing, 3rd order neurons project to
the primary somatosensory cortex
 2. Anterolateral pathway
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 Pain, temperature, crude touch, tickle, itch, sexual

sensations
 Low spatial or temporal resolution
 Small, myelinated/unmyelinated fibers with slower
conduction velocities
 1° afferents terminate upon entering spinal cord &
synapse on 2nd order neurons
 2nd order neurons cross to contralateral side, ascend to
brain via anterolateral quadrant in spinal cord & project
to thalamic nuclei
 After thalamic processing, 3rd order neurons project to
the primary somatosensory cortex and other cortical
areas
 Somatosensory cortex:
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somatotopy
 Spatial orientation of signals form
different parts of the body: somatotopy
 Size of somatotopic areas is proportional
to density of sensory receptors in that
body region
 Map is plastic (modifiable)
 size of cortical region representing
particular portion of body surface can
expand or contract depending on use
of that body region
 Pain and temperature localization not as
precise
 Integration probably happens more in
B&B Fig. 14-11 the reticular formation and thalamus
 Pain sensation: referred pain
22

 Pain from visceral nociceptors is poorly localized, can be felt as

pain on surface areas
 Knowledge of referred pain maps important in clinical diagnosis

 Somatic and visceral afferents

may converge on same 2nd order

neuron

Kandel Fig. 24-3 Guyton Fig. 48-6

 Pain sensation
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 Sensation of pain intensity not necessarily linked to activation of nociceptors;

under CNS control
 Perception of pain and pain tolerance is subjective

 Gate control theory of pain

 Activation of non-painful fibers (Aα) sends inhibitory signals to

nociceptive afferents traveling to the CNS
 Mechanism of acupressure analgesia?
 Phantom limb pain

 Pain felt even though nociceptors no longer present in missing limb

 Peripheral sensitization
 Somatosensory reorganization
 Neuropathic pain

 Damage to Aδ or C fibers may increase sensitivity or cause

spontaneous AP firing
 Pain disorders: CRPS
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 Complex regional pain syndrome (CRPS)
 Neuropathic pain disorder involving peripheral
and central mechanisms (autonomic nervous
system)
 Changes in somatosensory systems
processing thermal, tactile, noxious stimuli
 Local edema, altered sweating, redness,
Left arm affected by CRPS
skin temperature changes, burning pain,
hyperalgesia, allodynia
 Acute: warm, red extremities
 Chronic: cool, bluish extremities

 CRPS I – no documented nerve injury

 CRPS II – presence of nerve injury
 Surgery, fracture, crush injury, sprains, but can
develop even after minimal injury Right foot affected by CRPS
WebCT readings: Complex Pain Syndrome
 Pain disorders: CRPS
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pathophysiology
 Peripheral and central sensitization
 Tissue injury release of substance P and
bradykinin  increased excitability of
nociceptive neurons in periphery and spinal
cord
 Increased local, systemic, and CSF
inflammatory factors
 Reduced density of Aδ and C fibers
 Altered SNS function and sympatho-afferent
coupling
 Expression of adrenergic receptors on
nociceptors
 Symptoms worsened by emotional arousal
 Reduced representation of affected limb in
somatosensory cortex
 Genetic
WebCT predisposition
readings: Complex Pain Syndrome Bruehl S. Anesthesiology 2010
 Objectives
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After this lecture you should be able to:

 List the structure and function of the various cutaneous
mechanoreceptors
 Describe the mechanism of somatosensory transduction,
including modality coding and receptor adaptation
 Differentiate between tonic and phasic responses of
thermoreceptors
 Compare and contrast the function and anatomy of the dorsal
column-medial lemniscus pathway with the anterolateral
pathway
 List the factors affecting pain sensation

 Relate what we’ve learned in this course so far to the different

theories of CRPS pathophysiology
 Test your knowledge
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1. Predict on which side of the body and what sensations

would be impaired if there was a spinal cord
transection at T4 of:
a) The left dorsal column-medial lemniscus pathway
b) The left anterolateral pathway
2. Describe what would happen to both cold and warm
thermoreceptors in response to an increase in
temperature from 35ºC to 40ºC , sustained for 5 min,
and removed.
3. Meissners corpuscles are __________________
adapting receptors with __________________ receptive
fields.