Sensory Physiology

中山醫大生理科
郭東益 教授
dykuo@csmu.edu.tw
學校分機:11654
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 Contents
Part 1: Basic Concepts of Body Sensation
Part 2: Somatic Sensation (Tactile,Position)
Part 3: Somatic Sensation (Thermal, Pain)

References
1.Textbook of Medical Physiology, Guyton.
2.Review of Medical Physiology, William F. Ganong.
3.Principles of Neuroscience, Eric R. Kandel.
4.Human Physiology, Stuart Ira Fox.
Part 1: Basic Concepts of Body Sensation
1. Sensory modality and their receptors
3.Structure and function of sensory receptors
2. Somatic sensory receptors in the skin
Sensory receptors in the skin
 3. Types of Sensory Receptors

Nociceptor; Thermoreceptor; Baroreceptor; Hair cell receptor

4. Ionic Basis of Receptor Coding

1.Chemoreceptor
chemical stimulant
influx of ion current

2.Mechanoreceptor
mechanical force

3.Photoreceptor
photon is absorbed by
photopigment
 5.Characteristics of Sense Organ

(1). Law of specific nerve modality (Muller’s Law)

A given sensory receptor is specific for a particular
modality.

(2). Receptor adaptation

(a) rapidly adapting receptor: hair follicle receptor
(b) slow adapting receptor: joint capsule receptor
(c) nonadapting receptor: pain
Difference between rapidly and slowly adapting receptors
 Receptor Potential
Variable stimulus
intensity

Produces variable
receptor potentials

Produces variable
patterns of
action potentials
in the CNS

A simplified model showing a possible relationship between the

intensity of peripheral stimuli and CNS activity.
(3) Receptor potential (Generate potential)
Demonstration that RP in a Pacinian corpuscle
originates in the nonmyelinated nerve terminal.
Mechanism for the production of RP in
Pacinian corpuscle.
Pacinian Corpuscle
Sensory receptors can code Relation between RP and AP
for stimulus intensity
(4) Law of projection

• No matter where a sensory pathway is stimulated along its

course to the cortex, the conscious sensation produced is
referred to the location of the receptor.

• Phantom limb phenomenon

The ampulated patients may complain, often bitterly, of
pain and proprioceptive sensation in the absent limb
(phantom limb).
Note: neuroma discharge spontaneously
(5) Sensory receptors can code for stimulus duration

Tonic receptor: Phasic receptor:

6. Sensory Units and Receptive Fields
Coding of stimulus intensity
Testing the receptive field of human receptors
Variations among mechanoreceptors of the skin
 7. Types and Function of Nerve Fiber
(1) Types:
(a)Letter System: • both sensory and motor fiber.
• Aa, Ab, Ag, Ad, B, C.
(b)Number System:
• sensory fiber.
• Ia, Ib, II, III, IV.
 (2) Functions of nerve fiber

(a) The greater the diameter, the greater its speed

of conduction.
(b) The large axons are concerned with
proprioception, somatic motor function,
conscious touch, and pressure, while the
smaller axons subserve pain and temp sensation
and autonomic function.
(c) Sensitivity to hypoxia and anesthesia
(1)Local anesthetics depress transmission in C
fiber before they affect the touch fiber in A group.
(2)Presure on a nerve can cause loss of conduction in large-
diameter motor, touch and pressure fibers while pain remain
intact. (Saturday night or Sunday morning paralysis)
Part 2: Somatic Sensation
(tactile and position sense)
1. Sensory Pathway
2. Dermatomes
(1)The area
of skin
innervated by
a dorsal root.
(2)Adjacent
dermatomes
overlap.
(3) The overlap varies depending on the
modality; pain dermatomes overlap less than
tactile dermatomes. Therefore, injury to a
single dorsal root is more easily identified
by examinating for pain than for touch.

(4) Herpes Zoster (shingles)

A herpes virus infects a dorsal root ganglion,
and causes severe pain in the dermatomal
segment.
Herpes Zoster (shingles)
帶狀皰疹(疱疹)
 3. Peripheral nerve
(1)The area innervated by a
individual dorsal root is
larger than the area
innervated by a single
peripheral nerve.
(3) Damage to a spinal nerve or dorsal root
often results in only a small sensory deficit
throughout the broad area innervated by this
nerves. In contrast, cutting the distal portion
of a peripheral cutaneous nerve results in a
complete loss of sensory receptors in the
circumscribed area innervated by the nerve.
(4) The somatic component of the peripheral nerves
contains both motor and sensory axons.
4. Spinal Cord

(1)DH contains
sensory projection
neurons.
(2)IZ contains motor
neurons (muscle)
(3)VH contains ANS
motor neurons.
(4)Dorsal root fibers branch in the white matter and
terminate in the gray matter.

(5)Large-diameter (LD) fibers terminate in the deeper

portion of the gray matter, whereas the smaller-diameter
(SD) fibers terminate superficially.

(6)The major branch of

LD fibers ascend to the
brain in the dorsal
column, whereas branch
LD SD
of SD fibers ascend and
descends for a few
segments in the tract
of Lissauer.
(7)There are 3 types of primary afferent fibers
that mediate cutaneous sensations
(8)Major ascending (sensory) and descending
(motor) tract in spinal cord
Major sensory pathway and their sensory modality
5. Two Major Ascending Sensory Pathways
6.Comparison of the two ascending pathways
Anterolateral pathway includes 3 subpathways
7. Effects of damaged spinal cord on sensory pathway
(1)Crossed: pain, temp, light touch.
(2)Uncrossed: vibration, pressure, joint position.
Partial cord lesion
(Brown-Sequard
Syndrome)

Source: neurological and

neurosurgery illustrated,
Lindsay KW (ed)
 8. Touch Sensation
(1)Touch is transmitted in both DC and ST
pathway, so that only very extensive lesions
completely interrupt touch sensation.

(2)There are differences in touch transmission

in the 2 systems; DC tract is concerned with
the detailed localization, spatial form, and
temporal pattern of touch sti, but ST tract is
concerned with poorly localized, gross touch
sensation.
(3)When the DC tracts are destroyed,
• Vibration and proprioception are reduced.
• Touch threshold is elevated.
• The number of touch-sensitive area in the
skin is decreased (touch deficit).
• Touch localization is impaired.
(4)When the ST tracts are destroyed,
• Touch threshold is also elevated.
• Touch deficit also observed but is sligh.
• Touch localization remained normal.
 9.The Position Sense (proprioception)
(1) Conscious awareness of the position of the body
in space depends in part upon impulse from sense
organ in and around the joint.
(2) Impulse from joint receptors, touch receptors,
muscle spindles and sense of equilibrium are
synthesized in the cortex into a sense of position.
(3) Disease of the DC tract produces ataxia because
of the interruption of proprioceptive sense.
10. Characteristics in DC-ML pathway

(1) Faithfulness of transmission

• Point (periphery) to Point (Sensory cortex)
discharge.
• Altered moderately by other nervous area.
• Not depressed significantly by general
anesthesia.
(2) Basic discharge pattern: centralmost
neuron discharge
(3) Transmit two-point discrimination
• Two-point
discrimination is a
method used to test
the capability of
touch sense.
 (A) the size of receptive field

Sensory neuron A has a smaller receptive field than

sensory neuron B, thus it can be localized more easily .
Spatial Discrimination of Skin Mechanoreceptors

• SD depends
on both the
receptive field
size and the
density of the
receptors.
 (4) Effect of lateral inhibition
• The capability of
somesthetic cortex to
distinguish between
two points of sti. is
strongly influenced
by lateral inhibition.
• Mechanism of lateral inhibition
 11. Somatic Sensory Cortex
(1) The receptive field of the CNS neuron is
larger than those of sensory receptors in the skin
 (2) Somatic sensory cortex includes 3 parts
(a)S-I (area
1,2,3)
(b)S-II
(c)Posterior
parietal cortex
(area 5,7)
 (3) Spatial projection of the body in S-I
•The sizes of area are
proportional to the
number of sensory
receptors in each
respective peripheral
area of the body.
(lip>trunk)
•The head is
represented in the lower
or lateral portion, while
the lower part of the
body is in the medial or
upper portion of cortex.
(4) Sensory homunculus
 (5) Function of somatic sensory area
• Ablation of S-I causes deficits in position sense
and ability to discriminate size and shape of
objects. (astereognosis)
• Ablation of S-II causes deficits in learning based
on tactile discrimination.
• Cortical lesions do not abolish somatic sensation:
thalamus.(perception is possible in the absence of
cortex)
• Lesion: Proprioception, fine touch>temp>pain
Recovery: Proprioception, fine touch<temp<pain
(6) Function of somatic association area
(area 5,7)
• Combine information from multiple point in
S-I to decipher its meaning.
• Lesion produce complex abnormality of
spatial orientation on the contralateral side
of the body.
• Amorphosynthesis: loses the ability to
recognize complex objects and complex.
 12. Function of Thalamus
(1) Relay station for the somatic sensation to cortex.
(2).Thalamo-cortical projection
(1)specific projection (2)nonspecific projection
•VL,VA,VPL,VPM,etc: intralaminar nucleus:RAS
spinothalamic p.
•LGB:visual P.
•MGB:auditory p.
(3) Destroyed S-I, person loses most critical touch
sensibility, but a slight degree of crude touch
sensibility does return.
(4) Thalamus and other associated basal regions of
the brain play perhaps the dominant role in
discrimination of pain and temp sense. (Loss of
S-I has little effect on the sense of pain and
temp.)
 Part 3: Somatic Sensation
(Thermal and Pain Sensation)
 1. Thermal Sensation
(1) Two types of thermal receptor:
• warmth receptor: 30-45℃, C-fiber.
• cold receptor:10-35 ℃, Ad–fiber, 4-10 times of warmth receptor.
(2) Adaptation:
• 20 ℃↓and 40 ℃↑
(no adaptation)
• 20 ℃ ~ 40 ℃
(adaptation)
• 45 ℃↑, 15℃↓ (pain)
(3) menthol/capsaicin
/ethanol
open the same nonselective
cation channel as
thermoreceptor
(3) Stimulation of thermal receptors

• Thermal receptors are naked nerve endings

that response to absolute temp, not the temp
gradient across the skin.
• A person determines the different gradation
of thermal sensation by the relative
degreesof sti of the different types of endings.
• Extreme degrees of cold or heat can both be
painful.
 (4) Mechanism of stimulation of the
thermal receptors

• Spatial summation of thermal sensation.

• When a large area of the body is stimulated
all at once, the thermal signals from the
entire area summated.
 2. Pain Sensation (Nociception)
(1) Two types of pain:
(a) Fast pain:
• Sharp pain, pricking pain, acute pain, and
electric pain.
• Ad –fiber.
(b) Slow pain:
• Burning pain, aching pain, throbbing pain.
• C-fiber.
• It can occur both in the skin and in deep tissue.
(2) Pain threshold
 (3) Pain receptors (Nociceptors)
(a) Free nerve endings
(b) Located in superficial layer of skin, periosteum,
arterial walls, joint surface, and the falx and
tentorium of the cranial vault.
(c) Three types of sti (thermal, mechanical and
chemical) excite pain receptors.
(d) Nonadaptation
(e) Hyperalgesia
The sensitivity of pain receptors become
progressively greater as the the pain stimulus
continues.
Mechanism of hyperalgesia
 (4) The causes of pain
(a)Tissue damage: pain-producing substance
(b)Tissue ischemia: lactate accumulation
(c)Muscle spasm
 (5) Dual Pain Pathways in Spinal Cord
• Fast-sharp pain pathway (Ad-fiber)
Slow-chronic pain pathway (C-fiber)
(6) Dual Pain Pathway in Brain Stem and Thalamus
(a) Fast pain
• Brain stem (a few),
Thalamus (most)
• Terminate in VBC,
then to S-I.
• To localize fast pain.
(b) Slow pain
• Brain stem (most),
Thalamus (a few)
•Terminate in RAS and
ILN, then to cortex.
• To activate nervous sys.
(7) Pain is conveyed to the brain along 3 major
ascending pathway
(8) Surgical operation used for the relief of pain
(9) Analgesia system in CNS
(a) 3 components
• PV and PA
• RM
• Dorsal horn
(b) 2 major NT
• Enkephalin,
serotonin.
• PA,PV: enkephalin
• RM: serotonin
(10) Pain Mechanism: Gate Control Theory
 Gate Control Theory
(a) Pain results from a complex pattern of interacting
slow and fast pain fibers and descending fibers
from the brain.
(b) The “gate” appears to be in the dorsal horn, where
nerve impulses from peripheral receptors via pain
fibers (Ad, C) and the touch fibers (Ab).
(c) If impulses along pain fiber outnumber the touch
fiber, the gate opens and pain is perceived.
(d) Stimulation of more touch fiber closes the gate,
inhibiting transmission of pain and reducing pain
perception.
 Acupuncture and TENS

• Acupuncture
Acupuncture is thought to activate afferent neurons leading
to spinal cord and midbrain centers that release
endogenous opioids.

• TENS (transcutaneous electric nerve stimulation)

TENS works because the stimulation of nonpain, low
threshold afferent fibers (touch) leads to the inhibition of
neurons in the pain pathway.
TENS
(11) Referred Pain
• RP occurs when
visceral and
somesthetic afferents
converge on the same
second-order neurons
in the spinal cord.
• T1-T4 dermatome
(heart)
• C2-C4 dermatome
(diaphragm, lung)
The theory of referred pain