MOTOR AND SENSORY

PATHWAYS

Prof. dr Gordana Teofilovski-Parapid

Belgrade University School of Medicine
 Muscle and Joint
Innervations
- mixed nerves
60% motor fibers
40% sensory fibers

- “motor point”
1/3
electrical stimulation
Motor Innervaton of the
Skeletal Muscles
Motor Unit:
- Motor neuron
(spinal cord,
brain stem)

- Muscle fibers
innervated by it
(< 10, > 1000)
 Skeletal Muscles Sensory
Innervations

A. Muscle spindle

B. Goldgy tendon organ

C. Free nerve endings

 Muscle spindle I

L < 1cm
No 12 – n100

Stretch receptor
 Muscle spindle II
Homonym motor
neurons – pozitiv
feedback
(Autogen
excitation)

Reciprocal
inhibition
Golgi tendon organ (GTO) I

At muscle-tendon
junction

Signalizes the
strength of
muscle
contraction
Goldgi tendon organ (GTO) II
Homonim moto
neurons – negativ
feedback
(Autogen
inhibition)

Reciprocial
excitation
 Free Nerve Endings

In intramuscular connective tissue

and fascial sheath

Pain (direct damage, metabolites

accumulation, lactic acid)
 JOUINTS INNERVATION

a) Free non myelinated nerv fibers in

capsulas and ligaments
- pain (stretch/inflamation)

b) Incapsulated nerv endings

- Ruffini endings (tension)
- Lamelar endings (pressure)
- Paccinian corpuscle (vibration)
The Innervation of the Skin (I)
Skin covered with hair
(mammals)
Tip of the fingers (the
best sensitivity)

Senzory unites

Receptiv field
(2cm – 1cm – 5mm)
 The Innervation of the Skin (II)

Free nerv endings (Temperature & Pain)

Merkel cell-neurite complex (Margins)
The Innervation of the Skin (III)
Incapsulated Nerve Endings

Meissner’s corpuscle
(uneven surfaces)

Ruffini ending
(shear)

Pacinian corpuscle
(vibration)
 SENSATION

CONSCIOUS NONCONSCIOUS

Exteroception Proprioception Enteroception

(skin) (mm, joints) (viscera)
 SOMATIC SENORY PATHWAYS

A. Posterior column–medial lemniscal

pathway

B. Spinothalamic pathway
 SOMATIC SENORY PATHWAYS
– Features in common –

• 1st-order, 2nd-order & 3rd-order sets of sensory

neurons
• 2nd-order axons cross the midline
• Thalamus – somatosenzorni korteks
• Somatotopic organization (at each center)
• Synaptic transmision (at each level) can be
modulated
 Posterior Column – Lemniscus Medialis
a. Meissner’s corpuscles
(mechanoreceptors)
Trigeminal
- Paccini corpuscles lemniscus
(vibrations)
- Ruffini endings
(shear)
- Merkel cell – neurit
complex
(margins)

b. Muscle spindle
(stretching)
- GTO
(strength of muscle
contraction)
 Posterior Column – Lemniscus Medialis

a. Discriminative touch

VPM

b. Conscious
proprioception VPL
Posterior Column – Lemniscus Medialis
Sclerosis multiplex & other demyelinating diseases

• Sensory ataxia:
• Romberg’s sign

• “2 point
descrimination test”
Tractus spinothalamicus
 Tractus spinothalamicus

• TSA – touch

• TSL – pain, T
Tractus spinothalamicus
 PAIN PERCEPTION
– propriospinal internuncijal neurons –

1 – ekscitatorni n.
(substantia gelatinosa)

2 – inhibitorni n.
(substantia gelatinosa)

5 – inhibitoni
internuncijski n.

6 – Ranshaw ćelije
 Tractus spinothalamicus

Chordotomy
DESCNEDING MOTOR
PATHWAYS

•CORTICOSPINAL TRACT

•CORTICONUCLEAR TRACT
CORTICOSPINAL TRACT

60-80% - from
precentral gyrus

•Supplement motor
area
•Premotor cortex
•Somatosensory
cortex
•Parietal associativ
cortex
CORTICO
SPINAL
TRACT
80%

10%
10%
CORTICOSPINAL TRACT
Corticospinal Tract – Clinical Panel

Sudden interruption of the

corticospinal tract:

1st phase: flaccid paralysis,

areflexia & atonia;

2nd phase: paresis,

hyperreflexsia, hypertonia &
Babinski sign.
CORTICONUCLEAR TRACT
 CORTICONUCLEAR TRACT
UPPER MOTOR
NEURON

LOWER MOTOR REURON

THANK YOU