ASCENDING PATHWAYS

- The ascending pathways carry sensations from the peripheral structures to the
different areas in the brain, mainly via thalamus to the sensory cortex
- These pathways are simply a set of neurons arranged in series. Usually, they
have three sets of neurons: the first order, the second order, and the third order
of neurons

CLASSIFICATION
The ascending pathways are typically divided into three categories:
a) Dorsal column pathways
b) Anterolateral systems and
c) Other ascending pathways

DORSAL COLUMN PATHWAYS

• Fibers ascending in the dorsal column of the spinal cord are included in this
pathway.
• Dorsal column pathways transmit following sensations:
1. Fine touch
2. Vibration
3. Proprioception
4. Tactile localization
5. Tactile discrimination
6. Stereognosis

ANTEROLATERAL SYSTEMS
• It is divided into two parts: anterior spinothalamic tract and lateral
spinothalamic tract.
1. The anterior spinothalamic tract carries the sensation of crude touch
2. The lateral spinothalamic tract carries the sensation of pain and temperature.

OTHER ASCENDING PATHWAYS

These include many other ascending pathways such as:
1. Spinocerebellar tract (dorsal and ventral)- subconscious kinesthetic
sensations
2. Spinoreticulothalamic tract- consciousness and awareness
3. Spinocervicothalamic tract

APPLIED PHYSIOLOGY
Anesthesia: complete loss of all forms of sensations
Hyperesthesia: increased sensitivity to sensory stimuli
Paresthesia: Abnormal sensations (tingling, burning, prickling and numbness)
Hemiesthesia: loss of all sensations in one side of body

PREVIOUS YEAR QUESTION

Two ascending tracts and the sensations carried by them (4 marks)
ANTEROLATERAL SYSTEM/ SPINOTHALAMIC TRACT

It is divided into anterior spinothalamic tract that carries the sensation of crude
touch, and lateral spinothalamic tract that carries the sensation of pain and
temperature

First Order Neuron

These are primarily the afferent fibers originating from nociceptors,
thermoreceptors, and mechanoreceptors
• The fibers enter the spinal cord through dorsal root and the cell bodies are
present in the DRG
• In the spinal cord, fibers terminate on the second order of neurons (laminae I,
II and V) that are present on the same side of the dorsal horn of the spinal cord

Second Order Neuron

The cell bodies of these neurons are present in the dorsal horn of the spinal
cord
• The axons cross the midline in the same spinal segment and ascend up in the
opposite side of the antero- lateral funiculus to reach the thalamus
• The fibers carrying the sensation of crude touch are placed anteriorly and
therefore called anterior spinothalamic tract
• The fibers carrying the sensations of pain and temperature are placed laterally
and therefore called lateral spinothalamic tract

Third Order Neuron

The neurons originate from the VPL, midline and intralaminar nuclei of the
thalamus and project to the specific areas in the sensory cortex
APPLIED PHYSIOLOGY
Hyperalgesia: increased sensitivity to painful stimuli
Hypoalgesia: decreased sensitivity to painful stimuli
Neuropathic pain: injury to nerve causes this

PREVIOUS YEAR QUESTION

Describe the Spinothalamic pathway (subquestion; 7 marks)