The spinothalamic tract is lateral. Spinothalamic tract: neurons, diagram, functions "Lateral spinothalamic tract" in books

Spinotuberous tract lateral)

projection pathway of pain and temperature sensitivity, passing in the lateral funiculus of the spinal cord, rising through and ending in the ventrolateral nuclei of the thalamus of the opposite side.

1. Small medical encyclopedia. - M.: Medical encyclopedia. 1991-96 2. First aid. - M.: Great Russian Encyclopedia. 1994 3. Encyclopedic Dictionary of Medical Terms. - M.: Soviet Encyclopedia. - 1982-1984.

See what “lateral spinothalamic tract” is in other dictionaries:

- (tractus spinothalamicus lateralis, PNA; synonym spinothalamicus lateral) projection afferent pathway of pain and temperature sensitivity, passing in the lateral cord of the spinal cord, ascending through the brain stem and ending... ... Large medical dictionary

Lateral spinothalamic pathway of cutaneous sensation- One of two pathways of skin sensitivity. The fibers of the lateral spinothalamic system have a small diameter, low speed of crown transmission and transmit information about non-localized touch, temperature and pain to both... ... Psychology of sensations: glossary

Large medical dictionary

- (tractus spinothalamicus lateralis, PNA) see Spinothalamic tract lateral... Medical encyclopedia

The central nervous system (tractus sistematis nervosi centralis) is a group of nerve fibers that are characterized by common structure and functions and connect various parts of the brain and spinal cord. All nerve fibers of one path begin from... Medical encyclopedia

The ascending pathways of the spinal cord and brain stem include sensory (afferent) pathways (Fig. 32).

Spinothalamic tract conducts pain, temperature and partially tactile sensitivity. The receptor apparatus (exteroceptors) is located in the skin and mucous membranes. Impulses from the receptors travel along the spinal nerves to the body of the first sensory neuron located in the intervertebral node. The central processes from the node cells enter the posterior horn of the spinal cord, where the second neuron lies. Nerve fibers from the cells of the posterior horn pass through the anterior gray commissure of the spinal cord to the opposite side and ascend along the lateral column of the spinal cord into the medulla oblongata, then, without interruption, pass through the pons and cerebral peduncles to the optic thalamus, where the third neuron is located. From the optic thalamus, fibers go through the internal capsule to the cerebral cortex - to its posterocentral gyrus and to the parietal lobe. Bulbothalamic tract- conductor of joint-muscular, tactile, vibration sensitivity, feelings of pressure, heaviness. Receptors (proprioceptors) are located in muscles, joints, ligaments, etc. Along the spinal nerves, impulses from the receptors are transmitted to the body of the first neuron (in the intervertebral node). Fibers from the first neurons enter the dorsal funiculi of the spinal cord through the dorsal root. They form Gaulle's bundles (fibers from the lower extremities) and Burdach's bundles (fibers from the upper extremities). The fibers of these conductors end in special nuclei of the medulla oblongata. Upon exiting the nuclei, these fibers cross and connect with the fibers of the spinothalamic tract. Their common path is called the medial (internal) loop (the common path of all types of sensitivity).

Rice. 32. Ascending tracts of the spinal cord:

1 - anterior spinothalamic tract; 2 - medial (internal) loop; 3 - lateral spinothalamic tract; 4- thalamus; 5-moz bug; 6 - posterior spinocerebellar tract (Flexig's bundle); 7 - anterior spinocerebellar tract (Gowers bundle); 8- nuclei of the thin and wedge-shaped fasciculi; 9 - receptors: A- deep sensitivity (receptors of muscles, tendons, joints); B - vibration, tactile sensitivity, feelings, position; IN - touch and pressure; G- pain and temperature sensitivity; 10 - intervertebral node; 11 - posterior horns of the spinal cord

The medial loop ends at the optic thalamus.

Trigeminal loop joins the inner loop, approaching it from the other side.

Lateral, or lateral, loop- auditory pathway of the brain stem.

It ends in the internal geniculate body and in the posterior tubercle of the quadrigeminal.

Spinocerebellar tracts(anterior and posterior) carry proprioceptive information to the cerebellum.

Anterior spinocerebellar tract(Gowers' bundle) begins in the periphery in the proprioceptors. The first neuron, as usual, is located in the intervertebral ganglion. Fibers from it, as part of the dorsal root, enter the dorsal horn. There is a second neuron there. Fibers from the second neurons exit into the lateral column of their side, are directed upward and, as part of the lower cerebellar peduncles, reach the cerebellar vermis.

Posterior spinocerebellar tract(Flexig bundle) has the same beginning. Fibers from the dorsal horn cells of the second neurons are located in the lateral column of the spinal cord and reach the cerebellar vermis through the superior cerebellar peduncles.

These are the main conductors of the spinal cord, medulla oblongata, pons and cerebral peduncles. They provide connection between various parts of the brain and the spinal cord (see Fig. 32).

Spinothalamic tract consist of axons of second-order neurons located in the nucleus proper of the dorsal horn of the spinal cord, which terminate in the nuclei of the contralateral thalamus. Neurons of the nucleus proper form excitatory and inhibitory synapses with neurons of the gelatinous (gelatinous) substance. These synapses perform a regulatory function in the transmission of sensitive impulses.

The axons of neurons in the nucleus propria within the posterior horn of the spinal cord cross the midline in the region of the anterior commissure throughout the entire length of the spinal cord. On the opposite side, they rise up in the anterior part of the spinal cord in a certain somatotopic order: fibers from the lower segments of the spinal cord are located posteriorly and laterally, and fibers from the overlying segments are located anteriorly and medially. Sensitive fibers of the trigeminal nerve, innervating the head region, approach the spinothalamic tract, after which they, together with the fibers of the medial lemniscus, ascend to the ventral posterior nuclei of the thalamus, located behind it. Axons of third-order sensory neurons ascend from the thalamus to the somatosensory cortex (Brodmann areas 3, 1 and 2).

VZVLYAT, VVLYAT - ventral posterolateral and ventral posteromedial nuclei of the thalamus.

Video lesson on the pathways of pain and temperature sensitivity

Video lesson on the path of tactile sensitivity

A) Functions. The “functions” of the spinothalamic tract can be demonstrated by cordotomy. This surgical procedure was often performed in the past to relieve chronic pain and involved unilateral or bilateral division of the spinothalamic tract. For percutaneous cordotomy, a needle is inserted between the first and second cervical vertebrae into the subarachnoid space in a sedated patient. Under radiological control, the needle is advanced to the anterolateral region of the spinal cord. An electrode is then passed through the needle. If the position of the needle corresponds to the spinothalamic pathway, a gentle current causes paresthesia (tingling) on ​​the opposite side of the body.

Then the spinal tract is completely destroyed. After performing this operation, the patient becomes immune to pain and temperature stimuli on the opposite side of the body, while tactile sensitivity decreases. Due to the oblique direction of the spinothalamic fibers in the area of ​​the anterior commissure, loss of sensitivity occurs several segments below the level of the operation.

Cordotomy was sometimes performed on end-stage patients. This operation is not used in the presence of benign formations, since the analgesic (pain-relieving) effect disappears after about a year. Such restoration of function may result from the transmission of nociceptive impulses within non-overlapping fibers of the spinoreticular system or along collaterals, which are C-fibers that arise from some axons of the lateral fibers in the area of ​​entry of dorsal root fibers into the spinal cord.

The spinothalamic pathway is primarily responsible for the localization and intensity of pain, temperature and tactile sensations. In this regard, it is sometimes called the neospinal-thalamic pathway. Other indirect pathways (for example, the paleospinal-thalamic pathway, the fibers of which are directed to other nuclei of the thalamus) provide other characteristic reactions to pain - arousal, as well as affective, motor and autonomic reactions. As a group, these pathways do not have a clear somatotopic organization: they form less discrete bundles of fibers and often form synapses with each other, and also give collaterals to the reticular formation of the brain stem, limbic, hypothalamic and autonomic centers. These pathways pass in one part of the spinal cord and together constitute the anterolateral pathway.

A rare but classic disorder in which dissociated sensory disturbance is observed is demonstrated below.

Analgesia zone (highlighted in red) after left cordotomy at the level of segments C1-C2 of the spinal cord.

b) . Syringomyelia is a disease of unknown etiology, characterized by the formation of cavities (fusiform cysts) in the central part of the spinal cord or behind it. Most often, cavities form in the cervical segments. Initially, symptoms arise due to obliteration of the spinothalamic fibers that intersect at the level of the anterior white commissure.

Early manifestations of the disease consist of a dissociated disturbance of sensitivity (or “disconnection” syndrome), loss of pain and temperature sensitivity with intact tactile sensitivity and proprioception (since the posterior columnar medial lemniscal pathway is not involved in the pathological process). Sensory loss typically occurs in a “jacket” pattern, reflecting typical areas of analgesia.

As the cavity grows, damage to the sacral fibers is not observed, which is due to the peculiarities of the morphological structure of the spinothalamic pathway: fibers from the neck and arms are located more medially than the fibers innervating the torso and legs. Typically, patients experience ulcers on their fingers after cuts and burns that they did not feel. Deformations or even dislocations of the elbow joints, wrist and hand joints are also possible as a result of loss of perception of pain impulses due to excessive stretching of the joint capsule. Progressive expansion of the cavity can impair conduction in the long ascending and descending tracts of the spinal cord.

Syringomyelia. Areas with a lack of pain sensitivity are indicated in red.

The axons of T cells located in the dorsal horns of the spinal cord, moving to its opposite side as part of the anterior commissure of the spinal cord, form several afferent pathways, the main ones being two ascending spinal cords that provide pain impulses. One of them develops earlier in the process of phylogenesis, the other later, the first in this regard is called the paleospinothalamic pathway, the second - the neospinothalamic pathway. The neospinothalamic tract (it also includes the neotrigeminothalamic tract, consisting of part of the axons of the cells of the nucleus of the spinal tract of the trigeminal nerve) is monosynaptic, consisting of relatively thick myelin fibers that have a certain somatotopic organization. In the lateral funiculus of the spinal cord, it occupies a lateral position and carries out rapid transmission of phasic discriminatory information about the onset of a painful stimulus, the exact location of its impact, its nature, intensity and duration. This information, quickly transmitted along the neospinothalamic pathway to the lateral nuclei of the thalamus and further to the somatosensory zone of the cortex, provides the possibility of an immediate motor response of a person to the influence of a painful stimulus, aimed at stopping further damaging effects on the tissue. The nerve structures that are involved in the conduction of pain impulses along the neospino-thalamic pathway, as well as impulses going along the dorsal cord of the spinal cord and the medial lemniscus to the lateral nuclei of the thalamus and further to the somatosensory cortex, constitute the so-called sensory-discriminatory system. Impulses that enter the thalamus along the neospinothalamic pathways, after switching here to the neurons of the cells that make up the ventral posterolateral and posteromedial nuclei of the thalamus, reach the projection zone of general types of sensitivity - the postcentral gyrus. Here, as well as in the adjacent associative zones of the parietal lobe cortex, simple and complex sensations are formed that are adequate to the factors affecting the peripheral receptor apparatus, in particular pain sensations that are adequate to the location and intensity of stimulation of the peripheral pain receptors. In the cortex, a detailed analysis of the spatio-temporal and complex characteristics of information entering its projection zone takes place, which (according to Pavlov I.P.) plays the role of the cortical end of the analyzer of general types of sensitivity. The paleospinothalamic pathway is polysynaptic, extralemniscal. In the spinal cord, it is located medial to the neospinothalamic tract. It is composed of spinoreticular, spinomesencephalic and tri-geminoreticulomesencephalic pathways, consisting of thin nerve fibers that conduct impulses relatively slowly; at the same time, they lack the somatotopic principle of organizing bundles of nerve fibers. The spinoreticular part of the paleospinothalamic tract ends in the nuclei of the reticular formation of the caudal part of the brain stem. The axons of neurons located in these nuclei form the reticulothalamic pathway, which reaches the intralaminar nuclei of the thalamus (median center, paraientral and fascicular nuclei), as well as the hypothalamus and limbic structures. The fibers of the spinomesencephalic part of the paleospinothalamic tract reach the roof of the midbrain (lamina quadrigemina), as well as the central gray matter, where the switching of nerve impulses to the next neurons occurs. The axons of these neurons end in the medial nuclei of the thalamus and in the nuclei of the hypothalamus. Impulses that come to the brain along the polysynaptic paleospinothalamic pathway to the medial and intralaminar nuclei of the thalamus are then sent along the axons of neurons whose bodies are located in these nuclei, to the limbic structures of the cerebral hemispheres and to some nuclei (paraventricular, medial, preoptic). ) posterior parts of the hypothalamus. Under the influence of these impulses, a persistent, painful, poorly localized and differentiated feeling of pain arises, as well as accompanying negative emotional manifestations, vegetative and motivational reactions. The affective reactions that arise in such cases may, to some extent, provoke activation of the antinociceptive system. Connections between the paleospinothalamic tract and the limbic-reticular complex provide motivational and affective reactions to nociceptive impulses arriving through it. Connections of the somatosensory cortex with the temporal lobe cortex and the amygdala play a significant role in the formation of sensory memory, which provides an assessment of the pain sensation, comparing it with previously acquired life experience. There is an opinion that, in addition to the neospinothalamic and paleospinothalamic pathways, propriospinal and proprioreticular structures, which make up numerous chains of short-axonal interneurons, participate in the conduction of pain impulses. On the way to the cells of the reticular formation of the brain stem, they are adjacent to the gray matter of the spinal cord. The impulses passing through them reach the cells of the reticular formation of the trunk and cause a sensation of dull pain that is difficult to localize, and also participate in the formation of autonomic, endocrine and affective reactions caused by pain.

(tractus spinothalamicus lateralis, PNA; synonym spinothalamicus lateral)

projection afferent pathway for pain and temperature sensitivity, passing in the lateral funiculus of the spinal cord, ascending through the brain stem and ending in the ventrolateral nuclei of the thalamus of the opposite side.

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• - projection afferent pathway of tactile sensitivity, passing in the anterior cord of the spinal cord, ascending through the brain stem and ending in the ventrolateral nuclei of the thalamus of the opposite...

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