![]() (The crossing of these fibers is called the decussation, or crossing, of the medial lemniscus the word lemniscus means “ribbon.”) In a cross -section through the medulla, such as the one shown in Figure 9.6A, the medial lemniscal axons carrying information from the lower limbs are located ventrally, whereas the axons related to the upper limbs are located dorsally (again, a fact of some clinical importance). The internal arcuate axons subsequently cross the midline to form another named tract that is elongated dorsoventrally, the medial lemniscus. The axons from dorsal column nuclei project in the dorsal portion of each side of the lower brainstem, where they form the internal arcuate tract. The second- order relay neurons in the dorsal column nuclei send their axons to the somatic sensory portion of the thalamus (see Figure 9.6A). The relatively mild deficit that follows dorsal column lesions is presumably explained by the fact that some axons responsible for cutaneous mechanoreception also run in the spinothalamic (pain and temperature) pathway, as described in Chapter 10. For instance, such individuals have difficulty recognizing numbers and letters drawn on the skin. Dorsal column lesions may also reduce a patient's ability to initiate active movements related to tactile exploration. They do, however, impede the ability to detect the direction and speed of tactile stimuli and degrade the ability to sense the position of the limbs in space. At the level of the upper thorax, the dorsal columns account for more than a third of the cross-sectional area of the human spinal cord.ĭespite their size, lesions limited to the dorsal columns of the spinal cord in both humans and monkeys have only a modest effect on the performance of simple tactile tasks. The lateral subdivision, called the cuneate tract, contains axons conveying information from the upper limbs, trunk, and neck. Axons in the dorsal columns are topographically organized such that the fibers that convey information from lower limbs are in the medial subdivision of the dorsal columns, called the gracile tract, a fact of some significance in the clinical localization of neural injury. The major branch of the incoming axons, however, ascends ipsilaterally through the dorsal columns (also called the posterior funiculi) of the cord, all the way to the lower medulla, where it terminates by contacting second-order neurons in the gracile and cuneate nuclei (together referred to as the dorsal column nuclei see Figures 9.1 and 9.6A). These synapses mediate, among other things, segmental reflexes such as the “knee-jerk” or myotatic reflex described in Chapter 1, and are further considered in Chapters 16 and 17. Some collateral branches penetrate the dorsal horn of the cord and synapse on neurons located mainly in a region called Rexed's laminae III-V. Upon entering the spinal cord, the first- order axons carrying information from peripheral mechanoreceptors bifurcate into ascending and descending branches, which in turn send collateral branches to several spinal segments. (B) The trigeminal portion of the mechanosensory (more.) ![]() ![]() (A) The dorsal column-medial lemniscus pathway carries mechanosensory information from the posterior third of the head and the rest of the body. Schematic representation of the main mechanosensory pathways. The large myelinated fibers that innervate low- threshold mechanoreceptors are derived from the largest neurons in these ganglia, whereas the smaller ganglion cells give rise to smaller afferent nerve fibers that end in the high-threshold nociceptors and thermoceptors (see Table 9.1). The ganglion cells thus give rise to long peripheral axons that end in the somatic receptor specializations already described, and shorter central axons that reach the dorsolateral region of the spinal cord via the dorsal (sensory) roots of each spinal cord segment. Dorsal root ganglion cells are also known as first-order neurons because they initiate the sensory process. The neuronal cell bodies that give rise to these first- order axons are located in the dorsal root (or sensory) ganglia associated with each segmental spinal nerve (see Figure 9.1 and Box C). The action potentials generated by tactile and other mechanosensory stimuli are transmitted to the spinal cord by afferent sensory axons traveling in the peripheral nerves.
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