Sensory Pathways

Dr . Sabri Saad
 Learning Outcomes
Describe the basic structure of a sensory
system

Outline the structure of the following sensory

pathways:
Spinothalamic

Dorsal column

Explain the consequences of damage to these

pathways
 Sensory pathways
Sensory systems allow us to detect, analyse
and determine the response to our environment

ascending pathways

Carry information from sensory receptors to the

CNS

Conscious: reach cerebral cortex

Unconscious: do not reach cerebral cortex

Sensations from body reach the opposite side

 Sensory receptors
A: free nerve endings (pain,
A
temperature)

B: Pacinian corpuscle (touch)

B C C: Meissners corpuscle (pressure)

D: muscle spindle (stretch)

D E:Also special sensation

Sensory pathways: 3 neurons
1st order: enters spinal cord from periphery

2nd order: crosses over (decussates),

ascends in spinal cord to thalamus

3rd order: projects to somatosensory

cortex
 Sensory Representation

Sensation perceived when sensory signals terminate

in somatosensory cortex of brain
Somatotopic representation of sensory information:
body areas represented according to predominant function
Types of ascending pathways

Spinothalamic tract (STT) or (anteriolateral

tract)

Dorsal column tract (DCT) (Lemniscal)

 STT
Carries pain, temperature, crude touch,
sexual sensation and itching sensation

Afferent are type A delta or C fibers

1st neuron enters spinal cord through dorsal

root

Synapse with second order neurons at the

gray matter( dorsal horn )
2nd neuron cross to opposite side in front
of the central canal in spinal cord; ascends
to thalamus

3rd neuron projects from thalamus to

somatosensory cortex
Spinothalamic pathway
spinothalamic
pathway
 Spinothalamic damage
LHS
spinothalamic pathway spinal cord injury

Loss of sense of:

Touch
Pain
Warmth/cold
in right leg
 Dorsal column pathway

Carries fine touch, pressure, vibration and

position sense

Afferent are type A beta fibers

1st neuron enters spinal cord through dorsal

root; ascends to medulla (brain stem)
2nd neuron cross to opposite side in
medulla; ascends to thalamus

3rd neuron projects from the thalamus in

sensory radiation to somatosensory
cortex
DCT
dorsal
cloumn
pathway
 Dorsal column damage

Sensory ataxia

Patient staggers;
cannot perceive
position or movement of
legs
Visual clues help
movement
 SUMMARY
Info carried 2nd neuron Projection Effect of
cross over to somato- injury in
point sensory spinal cord
cortex?

Spino-thalamic pain spinal cord Yes Loss of

temp function:
touch opposite
pressure side

Dorsal column fine touch medulla Yes Loss of

vibration function:
conscious same side
proprioception
 Spinal Cord hemi section
(Brown-Sequard Syndrome)
At the level of the lesion:

* loss of all sensory and motor functions (Lower motor

neuron lesion).

Below the lesion:

* loss of the dorsal tract sensations Ipsilatrally.

* loss of pain and temperature in the contralateral side.

* touch is not lost WHY?

* Upper motor neuron lesion

 Spinothalamic & Dorsal column damage
LHS LHS
spinothalamic pathway spinal cord injury dorsal column spinal cord injury
pathway

Loss of sense of: Loss of sense of:

Touch touch
Pain proprioception
Warmth/cold vibration
in right leg in left leg
 Syringomyelia
Damage of the central part of the cord where
the fibers take pain, temperature and touch
decussate.

Loss of these sensations on both sides of the

body at the affected segment.

As fine touch is not affected still the patient

perceive the touch ( dissociated sensory
loss)
 Tabes dorsalis
Damage of the dorsal root central to the dorsal
root ganglion.

1- loss of tactile discrimination, vibration and

position sensation which leads to sensory
ataxia (Romberg's sign).

2- loss of pain and temperature sensations.

3- loss of all reflexes WHY?

 Brain stem lesion:

Contra lateral loss of all sensations.

Thalamic lesions:

Spontaneous unpleasant pain and

exaggeration of painful stimuli (Secondary
hyperalgesia).

Other sensations are lost from the opposite

side of the body.