人体解剖学-神经传导通路课件

神经传导通路

NervousPathways

中枢神经系统

CentralNervousSystemHumanAnatomy神经传导通路中枢神经系统

CentralNervous1CentralNervousSystem

Section3TheNervousPathways

CentralNervousSystem

Sectio2GeneralDescription

Nervouspathwaysareroutesformedbychainsofneurons.Theyareclassifiedinto:

Sensorypathways(ascending)&

Motorpathways(descending).GeneralDescription3Receptor

EffectorCentreEfferentAfferentReflexArcInt,ExtEnvironmentHigherCentreResponsesReceptorEffectorCentreEffer4

Inmostsensorypathwaystherearethreeordersofneuronsinvolved:

①Lowersensoryneurons

--theganglia

②Intermediateneurons

--thespinalcordorbrainstem

③Uppersensoryneurons

--thethalamusspinothalamicpathway(

DeepandSuperficialsensory,VisualandAcousticPathways)I.感觉传导路Sensory(ascending)PathwayInmostsensorypathwayst51stneurons

2ndneurons

3rdneurons

1stneurons2ndneurons3rd6Ⅰ)Deepsensory(orproprioceptive)pathwaysProprioceptiveincluding:

(1)thesensationsofbodyposture(2)themovement(3)thevibration(4)thefinetouchsensation--

two-pointdiscriminationⅠ)Deepsensory(orproprioce71.躯干四肢意识性深感觉传导路Theconsciousdeepsensorypathwaysoftrunkandlimbsreceptorsmuscle,tendon,periosteum,joint,andskinperipheralprocesses

spinalnerve

spinalganglia

1stneurons

fasciculusgracilis&

cuneatus

centralprocesses,posteriorfuniculus

2ndneurons

gracile&cuneatenuclei

decussationoflemniscus&mediallemnisci

ventroposteriorlateralnucleus

3rdneurons

posteriorlimbofinternalcapsulethalamocorticaltract

brainstempostcentralgyrus,posteriorpartofparacentrallobuleandprecentralgyrus1.躯干四肢意识性深感觉传导路Theconscious8Spinalganglion

1°neuron

Fasciculusgracilis

Fasciculuscuneatus

Gracile&cuneatenuclei2°neuron

DecussationofmediallemniscusMediallemniscusVPL3°neurons

Centralthalamicradiation

T4updownpostcentralgyrus,posteriorpartofparacentrallobuleandprecentralgyrusConsciousdeepsensorypathwaysoftrunkandlimbsSpinalganglionFasciculusgr9Lesion&Appearance(1)(2)

(1)

Interruptionofpathwaysbylesionsbelowlevelofdecussation–numbnessontheaffectedsideofbodybelowthelesionlevel

(2)

Interruptionabovelevelofdecussation--hemianesthesiaontheoppositesideofthebodyLesion&Appearance(1)(2)(10dorsalcolumnpathwayLHSspinalcordinjuryLossofsenseof:finetouchproprioceptionvibrationinleftlegDorsalcolumndamagedorsalcolumnLHSLossofsense11AppearanceofDorsalColumnDamage

SensoryataxiaPatientstaggers

cannotperceivepositionormovementoflegsVisualclueshelpmovementAppearanceofDorsalColumnDa122.躯干四肢非意识性深感觉传导路Theunconsciousdeepsensorypathwaysoftrunkandlimbsmuscle,tendon,periosteum,andjointreceptors

peripheralprocesses

spinalnerve

spinalganglia

1stneurons

centralprocesses

dorsalroots

thoracicN.andintermedio-medialN.

2ndneurons

anteriororposteriorspinocerebellartracts

superiorandinferiorcerebellarpedunclespaleocerebellumorspinocerebellumtomaintainthecoordinationmovementandequilibriumandappropriatepostureofthebody

3.Thedeepsensorypathwayofheadandface

Theexactrouteofthispathwayisstillnotknown.No3rdneurontocortex,henceunconscious(Carriesunconsciousproprioceptionsignals)2.躯干四肢非意识性深感觉传导路Theunconsci13Unconscious

proprioceptive

pathwaySpinalganglion

PosteriorspinocerebellartractAnteriorSpinocerebellartractLaminaⅤ-Ⅶ

InferiorcerebellarpeduncleSuperiorcerebellarpeduncleNucleusthoracicusupdownPaleocerebellumUnconscious

proprioceptive

p14Lesion&AppearanceCerebellarataxiaClumsymovementsIncoordinationofthelimbs(intentiontremor)Wide-based,reelinggait(ataxia)Alcoholicintoxicationproducessimilareffects!Lesion&AppearanceCerebell15Ⅱ

)Superficialsensorypathways(pain,thermal,rudetactile,andpressuresensation)Primarysomatosensorycortex(S1)Thalamus(IntralaminarandVPnuclei)MedullaSpinothalamictractSpinalcordSmallsensoryfibres:Pain,temperature,sometouchandpressuresensation

Ⅱ)Superficialsensorypathwa16receptors

skinspinalnerve

peripheralprocesses

spinalganglia

1stneurons

centralprocesses

nucleuspropriuslaminaI.IV.V.

2ndneurons

crosstooppositesideanteriorwhitecommissurelateral&

anteriorspinothalamictract

lateralfuniculusrunsupto

brainstem3rd

neurons

VPLpostcentralgyrus,posteriorpartofparacentrallobule

posteriorlimbofinternalcapsulethalamocorticaltract

1.躯干四肢浅感觉传导路ThesuperficialsensorypathwaysoftrunkandlimbsdorsalrootsLissauer's

fasciculusasend1~2segmentsreceptorsskinspinalnerveper17

Spinalganglia1°neuron

nucleusproprius

LaminaⅠ,Ⅳ~Ⅶ

2°neuron

Lateralspinothalamictract

anteriorspinothalamictract

SpinallemniscusVPL3°neurons

CentralthalamicradiationupdownSuperficialsensorypathwaysoftrunkandlimbspostcentralgyrus&posteriorpartofparacentrallobuleSpinalganglianucleus18nociceptornociceptorAδnerveCnervespinothalamicpathwaytoreticularformationreticularformationspinothalamicpathwaythalamussomato-sensorycortexImpulsestransmittedtospinalcordbyMyelinatedAδnerves:fastpain(80m/s)UnmyelinatedCnerves:slowpain(0.4m/s)Impulsesascendtosomatosensorycortexvia:Spinothalamicpathway(fastpain)Reticularformation(slowpain)nociceptornociceptorAδnerveC19*LesionandAppearance(1)InterruptionofpathwaysbylesionsatanteriorwhitecommissuretocausesSymmetricalhypesthesia(2)Interruptionofpathwaysbylesions

inthelateralfuniculusofthespinalcordBrown-SequardSyndrome

(3)Interruptionofpathwaysbylesionsintheinternalcapsule

tocausesHemihypesthesia

(1)(2)(3)*LesionandAppearance(1)Inte20SpinothalamicdamagespinothalamicpathwayLHSspinalcordinjuryLossofsenseof:TouchPainWarmth/coldinrightlegSpinothalamicdamagespinothala21Brown-SequardSyndromeBrown-SequardSyndrome22receptors

skinmucosa

sensorybranchesoftrigeminalnerveperipheralprocesses

trigeminalganglion

1stneurons

centralprocesses

spinalnucleus&pontinenucleusoftrigeminaln.2ndneurons

crosstooppositeside3rd

neurons

VPM

inferiorpartofpostcentralgyrusposteriorlimbofinternalcapsulethalamocorticaltract

sensoryrootoftrigeminaln.

spinaltractoftrigeminaln.tojointrigeminallemniscus2.头面部的浅感觉传导路Thesuperficialsensorypathwaysofheadandfacereceptorsskinmucosasensory23Trigeminalganglion1°neuron

PontinenucleusofV2°neuronSpinalnucleusofV2°neuronTrigeminallemniscus

Spinaltractoftrigeminaln.

VPM

3°neurons

Centralthalamicradiationupdown

pain,temperatureandsimpletouchpathwayofheadandfaceTrigeminalganglionPontinenu24*LesionandAppearance(1)Interruptionofpathwaysbylesionsattrigeminaln.,trigeminalganglion,trigeminalroot,andspinaltract&spinalnucleusoftrigeminaln.(2)Interruptionofpathwaysbylesions

intrigeminallemniscus,VPM,internalcapsule(thalamocorticaltract),andinferiorpartofpostcentralgyrus(1)(2)*LesionandAppearance(1)Inte25Ⅲ)VisualpathwaysOpticnerveOptictractLateralgeniculatenucleusOpticradiationOpticchiasmPrimaryvisualcortexⅢ)VisualpathwaysOpticnerveO26人体解剖学-神经传导通路课件271.视觉传导路Thevisualpathwayreceptors

rod&conecellsexternallayerofretinaperipheralprocesses

bipolarcells1stneurons

centralprocesses

ganglioniccells2ndneurons

opticnerve

opticchiasmaoptictract3rd

neurons

lateralgeniculatebody

bothbanksofthecalcarinesulcusposteriorlimbofinternalcapsuleopticradiation

middlelayerofretinadecussationoffibersfromnasalhalvesofretinainnermostlayerofretinaaxonsopticdisc

visualarea1.视觉传导路Thevisualpathwayrec28

VisualpathwayVisualareaOpticnerveOpticchiasmaOptictractLateralgeniculatebodyOpticradiationVisualpathwayVisualareaOpti29*LesionandAppearanceInterruptionofpathwaysbylesions

in:

1.Opticnerve

2.Opticchiasma--pituitarytumor

3.Optictract,Lateralgeniculatebody,andOpticradiationCompleteblindness

Bitemporalhemianopia

hemianopiaofoppositehalvesofbothvisualfieldsABC*LesionandAppearanceInterrup302.瞳孔对光反射通路ThepathwayofpupillaryreflexespostganglionicfibersRetinaaxonsofretinalganglioncellsOpticnerveOpticchiasmaBothoptictractdecussationoffibersfromnasalhalvesbrachiumofsuperiorcolliculusPretectalareaE-WnucleustobothsideOculomotorn.CiliaryganglionSphincterofpupilspreganglionicfibers

toform2.瞳孔对光反射通路Thepathwayofpup31Pretectalarea

E-WnucleusOccculomotorn.Ciliaryganglia

Sphincterpupilmuscle

PathwayofpupillaryreflexesPretectalareaE-WnucleusOccc32Lightshoneonretinaofoneeyecausesbothpupilstoconstrictnormally

ResponseinStimulatedeye--directpupillarylightreflexOppositeeye--indirectpupillarylightreflex1.OpticnervedamageTodisappeardirectpupillarylightreflexTobepresentindirectpupillarylightreflex

2.OculomotornervedamageBothtodisappeardirectpupillarylightreflex&indirectpupillarylightreflex*LesionandAppearance12Lightshoneonretinaofonee33visualcenterlightpretectalareaE-Wnucleusvisualpathwaylightreflexlateralgenicularbody(area17)sphincterofirisretina

ⅠⅡⅢⅢ

twosidesposteriorlimbofinternalcapsulevisualradiationcone&rodcellsBipolarcellsGanglioniccellsOpticNOpticchiasmaOptictractSummaryforvisualpathway

ciliaryganglionvisualcenterlightpretectalar34IV)Acoustic(orauditory)pathwayIV)Acoustic(orauditory)p35听觉传导路Thevisualpathwayreceptors

spiralorgan(Corti‘sorgan)ininternalearbipolarcellsperipheralprocesses

cochlearganglion1stneurons

centralprocesses

cochlearnuclei2ndneurons

terminatedirectlyorindirectlyto3rd

neurons

medialgeniculatebody

both

transversetemporalgyriposteriorlimbofinternalcapsule

acousticradiation

cochlearnervebothsidefibers(decussed&undecussedfibers)acousticcentertrapezoidbody

laterallemniscus

听觉传导路Thevisualpathwayrecept36Bipolarneuronofcochlearganglion

CochlearnerveCochlearnucleiTrapezoidbody

Laterallemniscus

Medialgeniculatebody

Acousticradiation

TransversetemporalgyrusAuditorypathwaySpiralorgan

Becauseacousticcenterononesidereceivesfibersfrombilateralcochlearnuclei,damagetoipsilateralacousticpathsdoesnotcauseahearingdefect.BipolarneuronofCochlearner37①

joiningmediallongitudinalfasciculus②

joiningvestibulospinaltractVestibularnucleusⅤ)EquilibratorypathwayOculomotornucleusTrochlearnucleusAbducentnucleusAccessorynucleus①joiningmediallongitudinal38receptors

cristaeampullares,maculaeofutricleandsacculebipolarcellsperipheralprocesses

vestibularganglion1stneurons

centralprocesses

vestibularnucleus2ndneurons

vestibularnerveaxonsaregroupedintofivecourses:

①

joiningmediallongitudinalfasciculusfibersendinoculomotor,abducent,trochlearnuclei,andanteriorhorncellsofuppercervicalcord

②

joiningvestibulospinaltracttoanteriorhorncellsofspinalcord③enteringcerebellumviainferiorcerebellarpeduncle

④connectingwithreticularformationofbrainstem,vagusandglossopharyngealnuclei

⑤

connectingwithtemporal,parietalandfrontalcortexofhemisphere

平衡觉传导路Theequilibratorypathwayreceptorscristaeampullares,39EquilibratorypathwayEquilibratorypathway40II.运动传导路Motor(descending)Pathway

(Includingpyramidalandextrapyramidal)II.运动传导路Motor(descending)Pa41Itisconcernedwithvoluntarymovementofskeletalmuscles.Itiscomposedoftwoordersofneurons--upperandlowermotorneurons.ItistoformCorticonucleartract&Corticospinaltract

Uppermotorneurons

–

Giantpyramidalcells(Betz‘scells)&Otherpyramidalcellslocated--precentralgyrus¶centrallobule

Ⅰ)ThepyramidalsystemItisconcernedwithvolun42

Lowermotorneurons–

(1)CranialmotornucleiofbrainstemLowermotorneurons–43(2)Anteriorhornmotorcellsofspinal

cord(2)Anteriorhornmotorcells44

TheCorticospinalTractTheCorticospinalTract451.皮质脊髓束CorticospinalTractuppermotorneuron

Superior,middlepartsofprecentralgyrus&Paracentrallobule

skeletalmusclesoftrunkandlimbsEffector

①

posteriorlimbofinternalcapsule

②intermediate3/5ofcruscerebri

③basilarpartofpons

④

pyramidofmedullaoblongata

Pyramidaltract--Corticospinaltract

70~90%oftractcrossestooppositesidetoformpyramidaldecussatlon

lateralcorticospinaltract(lateralfuniculus)

(anteriorfuniculus)

anteriorcorticospinal

tract

smallerpartofcrossedfibersoftract

LowermotorneuronAnteriorhornmotorcellsofspinal

cordspinalnerve

1.皮质脊髓束CorticospinalTractup46

CorticospinaltractDecussationofpyramid

LateralcorticospinaltractAnteriorcorticospinaltractuppermotorneuron

LowermotorneuronCorticospinalTractCorticospinaltractDecussatio47

TheCorticonuclearTractTheCorticonuclearTract482.皮质核束CorticonuclearTractuppermotorneuron

PyramidalneuronsinInferiorpartofprecentralgyrus

skeletalmusclesofheadandneckEffector

①

genuofinternalcapsule

②brainstem

tobilateraloculomotor,trochlear,trigeminalmotor,ambiguus,accessorynucleiandsuperiorpartoffacialnucleus,

Pyramidaltract

Lowermotorneuron

Cranialmotornucleicorrespondingcranialnerves

and

tocontralateralhypoglossalnucleusandinferiorpartoffacialnucleusCorticonucleartract2.皮质核束CorticonuclearTractup49Oculomotor

Nucleus

TrochlearNucleus

TrigeminalMotorNucleus

AbducentNucleusSup.partofFacialNucleusInf.partofFacialNucleusAmbiguusNucleusAccessoryNucleus

HypoglossalNucleusCorticonuclearTractOculomotorNucleusTrochl50Infranuclearparalysis

--InjuryofunilateralfacialnerveorhypoglossalnerveParalysisofhomolateralfacialmusclesandglossalmusclesSupranuclearparalysis

--InjuryofunilateralcorticonucleartractParalysisofcontralateralglossalmusclesandfacialmusclesbelowpalpebralfissureSupranuclearparalysisInfranuclearparalysisInfranuclearparalysis--Inju51Infranuclearparalysis

--Injuryofunilateral(left)facialnerveInfranuclearparalysis52Lesionforpyramidalsystem1.Uni-paralysis(cerebralparalysis)–

MotorArea

2.AlternateParalysis–

BrainStem

(1)Alternatingoculomotorhemiplegia--Weber'ssyndrome(2)Alternatingabducenthemiplegia(3)Alternatinghypoglossalhemiplegia3.Paraplegia--

Spinal

Cord

4.InfantileParalysis--

Anteriorhornmotorcellsofspinal

cord

1.cerebralparalysis2.alternateparalysis3.paraplegia4.infantileParalysisLesionforpyramidalsystem1.535.CapsularHemiplegia5.CapsularHemiplegia54AlternatingHemiplegiaAlternatingHemiplegia55Brown-SequardSyndromeBrown-SequardSyndrome56PyramidalsystemPyramidaltractUppermotorneuronsInferiormotorneuronseffectorsParalysisTonicityTendonreflexPathologicreflex(Babinskisign)Muscleatrophyspastic(hard)paralysis

flaccid(soft)paralysis

(+)No(inshortperiod)

(–)Yes(下神经元不断发放冲动保证肌肉的营养代谢)Interruptionofreflexarc

锥体束对下神经元的抑制性影响消失

disappearMotorareaLesionforpyramidalsystemPeripheralnervesSomaticmotorF.PyramidalsystemPyramidaltrac57SignsofUpperMotorNeuron(UMN)

andLowerMotorNeuron(LMN)LesionsSignUMNLesionsLMNLesions

ParalysisHardparalysisFlaccidparalysisToneIncreasedDecreasedTendonreflexDisappearBabinskisignYesNoAtrophyNo*Yes*Mildatrophymaydevelopduetodisuse.IncreasedSignsofUpperMotorNeuron(U58Ⅱ)Theextrapyramidalsystem1.Thedefinition:

descendingpathwaysexceptpyramidalsystem

2.Thefeatures:发生古老,多次中继,联系复杂,形成若干反馈通路3.Thefunctions:RegulatethetonicityofthemusclesCoordinatethemuscularactivityMaintainthenormalpostureProducehabitualandrhythmicmovement4.Theconstituentforextrapyramidalsystem:

Thecortico-neostriatum-dorsalthalamiccircuit

Theneostriatum-substantianigracircuit

Thecorticopoto-cerebellum-cortexcircuitⅡ)Theextrapyramidalsystem1.591.Theneostriatum-glubuspallidussystem(1)Cortico-neostriatum-dorsalthalamic-cortexcircuit

Corticalcellsoffrontal,parietal,andtemporallobescaudatenucleus&putamenglobuspallidusdorsalthalamussomatomotorareasofcortex(feedbackinhibition)(2)Neostriatum-substantianigracircuit

Substantianigraproductingandreleasingdopamine

1.Theneostriatum-glubuspa602.Thecorticoponto-cerebellarsystem

Pyramidalcellsofcortexfrontopontine,parieto-occipito-temporopontinetractsinternalcapsule&cruscerebri

pontinenucleipontinebrachiumneocortexofcerebellumdentatenucleussuperiorcerebellarpeduncleventrolateralnucleusofthalamus&rednucleusrubrospinaltractAnteriorhornmotorcellsofspinal

cord2.Thecorticoponto-cerebellar61环路①环路②

2.Corticoponto-cerebellarsystem

1.Neostriatum-glubuspallidussystem环路环路②2.Corticoponto-cerebel62Lesionforneostriatum--

Chorea

Sydenham'schorea

(Thomassydenham,Englishphysician,sometimescalled“theEnglishHippocrates”,1624~1689)Lesionforpaleostriatum

--ShakingPalsyLesionforcorticoponto-cerebellarsystem--

lossof

coordination

LesionforextrapyramidalsystemChoreaShakingPalsylossof

coordination

Lesionforneostriatum--Chor63Parkinson’sDisease1817,JamesParkinson(Englishphysician,1755~1824)firstobservedthisdiseaseandcalleditTheShakingPalsy.

Cardinalsymptoms--restingtremor,bodilyrigidity,markedslownessofmovement,gaitdisturbances,anddifficultyinitiatingvoluntarymovementParkinson’sDisease1817,J64ThanksThanks65神经传导通路

NervousPathways

中枢神经系统

CentralNervousSystemHumanAnatomy神经传导通路中枢神经系统

CentralNervous66CentralNervousSystem

Section3TheNervousPathways

CentralNervousSystem

Sectio67GeneralDescription

Nervouspathwaysareroutesformedbychainsofneurons.Theyareclassifiedinto:

Sensorypathways(ascending)&

Motorpathways(descending).GeneralDescription68Receptor

EffectorCentreEfferentAfferentReflexArcInt,ExtEnvironmentHigherCentreResponsesReceptorEffectorCentreEffer69

Inmostsensorypathwaystherearethreeordersofneuronsinvolved:

①Lowersensoryneurons

--theganglia

②Intermediateneurons

--thespinalcordorbrainstem

③Uppersensoryneurons

--thethalamusspinothalamicpathway(

DeepandSuperficialsensory,VisualandAcousticPathways)I.感觉传导路Sensory(ascending)PathwayInmostsensorypathwayst701stneurons

2ndneurons

3rdneurons

1stneurons2ndneurons3rd71Ⅰ)Deepsensory(orproprioceptive)pathwaysProprioceptiveincluding:

(1)thesensationsofbodyposture(2)themovement(3)thevibration(4)thefinetouchsensation--

two-pointdiscriminationⅠ)Deepsensory(orproprioce721.躯干四肢意识性深感觉传导路Theconsciousdeepsensorypathwaysoftrunkandlimbsreceptorsmuscle,tendon,periosteum,joint,andskinperipheralprocesses

spinalnerve

spinalganglia

1stneurons

fasciculusgracilis&

cuneatus

centralprocesses,posteriorfuniculus

2ndneurons

gracile&cuneatenuclei

decussationoflemniscus&mediallemnisci

ventroposteriorlateralnucleus

3rdneurons

posteriorlimbofinternalcapsulethalamocorticaltract

brainstempostcentralgyrus,posteriorpartofparacentrallobuleandprecentralgyrus1.躯干四肢意识性深感觉传导路Theconscious73Spinalganglion

1°neuron

Fasciculusgracilis

Fasciculuscuneatus

Gracile&cuneatenuclei2°neuron

DecussationofmediallemniscusMediallemniscusVPL3°neurons

Centralthalamicradiation

T4updownpostcentralgyrus,posteriorpartofparacentrallobuleandprecentralgyrusConsciousdeepsensorypathwaysoftrunkandlimbsSpinalganglionFasciculusgr74Lesion&Appearance(1)(2)

(1)

Interruptionofpathwaysbylesionsbelowlevelofdecussation–numbnessontheaffectedsideofbodybelowthelesionlevel

(2)

Interruptionabovelevelofdecussation--hemianesthesiaontheoppositesideofthebodyLesion&Appearance(1)(2)(75dorsalcolumnpathwayLHSspinalcordinjuryLossofsenseof:finetouchproprioceptionvibrationinleftlegDorsalcolumndamagedorsalcolumnLHSLossofsense76AppearanceofDorsalColumnDamage

SensoryataxiaPatientstaggers

cannotperceivepositionormovementoflegsVisualclueshelpmovementAppearanceofDorsalColumnDa772.躯干四肢非意识性深感觉传导路Theunconsciousdeepsensorypathwaysoftrunkandlimbsmuscle,tendon,periosteum,andjointreceptors

peripheralprocesses

spinalnerve

spinalganglia

1stneurons

centralprocesses

dorsalroots

thoracicN.andintermedio-medialN.

2ndneurons

anteriororposteriorspinocerebellartracts

superiorandinferiorcerebellarpedunclespaleocerebellumorspinocerebellumtomaintainthecoordinationmovementandequilibriumandappropriatepostureofthebody

3.Thedeepsensorypathwayofheadandface

Theexactrouteofthispathwayisstillnotknown.No3rdneurontocortex,henceunconscious(Carriesunconsciousproprioceptionsignals)2.躯干四肢非意识性深感觉传导路Theunconsci78Unconscious

proprioceptive

pathwaySpinalganglion

PosteriorspinocerebellartractAnteriorSpinocerebellartractLaminaⅤ-Ⅶ

InferiorcerebellarpeduncleSuperiorcerebellarpeduncleNucleusthoracicusupdownPaleocerebellumUnconscious

proprioceptive

p79Lesion&AppearanceCerebellarataxiaClumsymovementsIncoordinationofthelimbs(intentiontremor)Wide-based,reelinggait(ataxia)Alcoholicintoxicationproducessimilareffects!Lesion&AppearanceCerebell80Ⅱ

)Superficialsensorypathways(pain,thermal,rudetactile,andpressuresensation)Primarysomatosensorycortex(S1)Thalamus(IntralaminarandVPnuclei)MedullaSpinothalamictractSpinalcordSmallsensoryfibres:Pain,temperature,sometouchandpressuresensation

Ⅱ)Superficialsensorypathwa81receptors

skinspinalnerve

peripheralprocesses

spinalganglia

1stneurons

centralprocesses

nucleuspropriuslaminaI.IV.V.

2ndneurons

crosstooppositesideanteriorwhitecommissurelateral&

anteriorspinothalamictract

lateralfuniculusrunsupto

brainstem3rd

neurons

VPLpostcentralgyrus,posteriorpartofparacentrallobule

posteriorlimbofinternalcapsulethalamocorticaltract

1.躯干四肢浅感觉传导路ThesuperficialsensorypathwaysoftrunkandlimbsdorsalrootsLissauer's

fasciculusasend1~2segmentsreceptorsskinspinalnerveper82

Spinalganglia1°neuron

nucleusproprius

LaminaⅠ,Ⅳ~Ⅶ

2°neuron

Lateralspinothalamictract

anteriorspinothalamictract

SpinallemniscusVPL3°neurons

CentralthalamicradiationupdownSuperficialsensorypathwaysoftrunkandlimbspostcentralgyrus&posteriorpartofparacentrallobuleSpinalganglianucleus83nociceptornociceptorAδnerveCnervespinothalamicpathwaytoreticularformationreticularformationspinothalamicpathwaythalamussomato-sensorycortexImpulsestransmittedtospinalcordbyMyelinatedAδnerves:fastpain(80m/s)UnmyelinatedCnerves:slowpain(0.4m/s)Impulsesascendtosomatosensorycortexvia:Spinothalamicpathway(fastpain)Reticularformation(slowpain)nociceptornociceptorAδnerveC84*LesionandAppearance(1)InterruptionofpathwaysbylesionsatanteriorwhitecommissuretocausesSymmetricalhypesthesia(2)Interruptionofpathwaysbylesions

inthelateralfuniculusofthespinalcordBrown-SequardSyndrome

(3)Interruptionofpathwaysbylesionsintheinternalcapsule

tocausesHemihypesthesia

(1)(2)(3)*LesionandAppearance(1)Inte85SpinothalamicdamagespinothalamicpathwayLHSspinalcordinjuryLossofsenseof:TouchPainWarmth/coldinrightlegSpinothalamicdamagespinothala86Brown-SequardSyndromeBrown-SequardSyndrome87receptors

skinmucosa

sensorybranchesoftrigeminalnerveperipheralprocesses

trigeminalganglion

1stneurons

centralprocesses

spinalnucleus&pontinenucleusoftrigeminaln.2ndneurons

crosstooppositeside3rd

neurons

VPM

inferiorpartofpostcentralgyrusposteriorlimbofinternalcapsulethalamocorticaltract

sensoryrootoftrigeminaln.

spinaltractoftrigeminaln.tojointrigeminallemniscus2.头面部的浅感觉传导路Thesuperficialsensorypathwaysofheadandfacereceptorsskinmucosasensory88Trigeminalganglion1°neuron

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3°neurons

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pain,temperatureandsimpletouchpathwayofheadandfaceTrigeminalganglionPontinenu89*LesionandAppearance(1)Interruptionofpathwaysbylesionsattrigeminaln.,trigeminalganglion,trigeminalroot,andspinaltract&spinalnucleusoftrigeminaln.(2)Interruptionofpathwaysbylesions

intrigeminallemniscus,VPM,internalcapsule(thalamocorticaltract),andinferiorpartofpostcentralgyrus(1)(2)*LesionandAppearance(1)Inte90Ⅲ)VisualpathwaysOpticnerveOptictractL