China
Africa
Explore chapters and articles related to this topic
Spinal Cord and Reflexes
Published in Nassir H. Sabah, Neuromuscular Fundamentals, 2020
Positioned closely to the lateral spinothalamic tract, and similarly having its neurons of origin in the dorsal horn of the spinal cord, is the spinoreticular tract. The axons of this tract decussate to the other side of the spinal cord and ascend the spinal cord to terminate on third-order neurons in the medullary-pontine reticular formation. The third-order neurons project to intralaminar nuclei of the thalamus, which in turn project diffusely to many parts of the cerebral cortex. In this way, pain reaches consciousness and results in behavioral arousal and a memory of the pain. In fact, this pathway through the reticular formation is considered part of the ascending reticular arousal system (ARAS), which is responsible for regulating states of consciousness, alertness, and sleep-wake transitions.
The Spinal Cord and the Spinal Canal
Published in Bernard J. Dalens, Jean-Pierre Monnet, Yves Harmand, Pediatric Regional Anesthesia, 2019
Bernard J. Dalens, Jean-Pierre Monnet, Yves Harmand
The lateral spinothalamic tract consists of fibers originating in contralateral laminae VI, VII, and VIII of Rexed where they relay fibers from the dorsal roots before crossing the spinal cord in the anterior commissure. Fibers from the lower part of the body are located more posteriorly and laterally, while those issuing from the upper part are anterior and medial. This tract (Figure 1.27) conveys impulses from cutaneous nociceptors and cold and heat receptors to the ventral posterolateral nucleus of the thalamus and to some intralaminar nuclei.
The nervous system
Published in Peter Kopelman, Dame Jane Dacre, Handbook of Clinical Skills, 2019
Peter Kopelman, Dame Jane Dacre
Afferent fibres convey stimuli to the spinal cord. They enter the spinal cord via the posterior root ganglia and posterior roots. The majority of afferent fibres terminate in the grey matter of the posterior horn, at or near the level at which they enter. The second-order sensory neurone fibres arise from these cells in the posterior horn (Fig. 6.3). Sensations of pain and temperature ascend in the lateral spinothalamic tract, with fibres from the lower part of the body being placed laterally and those from the upper part medially. These fibres cross immediately, or within a few segments, to the opposite lateral and anterior columns of the cord, and ascend to the brainstem as the anterior and lateral spinothalamic tracts. Simple touch also follows this route, largely in the anterior spinothalamic tract. The other afferent fibres do not synapse in the grey matter of the posterior horns of the spinal cord, but ascend in the ipsilateral posterior columns (Fig. 6.4) (transmitting joint position sense, size, shape, discrimination and vibration sense).
Chameleons, red herrings, and false localizing signs in neurocritical care
Published in British Journal of Neurosurgery, 2022
Boyi Li, Tolga Sursal, Christian Bowers, Chad Cole, Chirag Gandhi, Meic Schmidt, Stephan Mayer, Fawaz Al-Mufti
Cervical disc herniation (CDH) typically results in ipsilateral neck and arm pain corresponding to the level of the lesion.73 However, false localizing CDH can present with contralaterally radiating neck pain and contralateral upper and lower extremity pain. Diagnosis can be confirmed on MRI. It is hypothesized that this FLS results from cord compression of the lateral spinothalamic tract.73 The symptoms can be completely resolved by surgical discectomy and fusion, further confirming the false localizing nature of the condition.73 CDH as a FLS can also present as hemifacial hyperhidrosis with no facial flushing, anisocoria or blepharoptosis, compensating for anhidrosis/hypohydrosis on the ipsilateral side below the lesion.74 Useful diagnostic tools include the Minor test, quantitative sudomotor function tests, and microneurography of sudomotor nerve activity.74 Tests showing no intramedullary signal abnormalities on MRI suggest that the pathophysiology may be impairment of premotor neuron from the hypothalamus to the intermediolateral nucleus by the disc herniation.74 The ipsilateral anhidrosis or hypohydrosis can directly be attributed to the disc herniation myelopathy.74 Of note, crossed hypohydrosis can occur ipisilateral but above the hyperhidrosis.74 Thus, when patients present with hemihydrosis, the Minor test should be done to determine the anhidrotic and hyperhidrotic areas, and thermography to determine the localization of the potential CDH to be investigated further.74
Effects of the hybrid of neuromuscular electrical stimulation and noxious thermal stimulation on upper extremity motor recovery in patients with stroke: a randomized controlled trial
Published in Topics in Stroke Rehabilitation, 2019
Chien-Chih Chen, Yu-Ching Tang, Miao-Ju Hsu, Sing-Kai Lo, Jau-Hong Lin
Previous research found that neural pathways connect somatosensory cortices with motor cortices, an idea that formed the basis for using NMES or NTS to promote the activation of the motor cortices and to promote neuroplasticity.22–24 NMES stimulated somatic receptors to send electrical signals from the epidermis, muscles, and joints with light touches, pressure, and proprioception through the gracilis fasciculus and cuneatus fasciculus in the medial lemniscus pathway to the thalamus, projecting to the central posterior somatosensory cortex, reaching the pyramidal cells of the motor cortex, and triggering the activation of the motor cortex.22 NTS causes nociceptors and thermoreceptors to send electrical signals through the dorsal horn of the spinal cord. These signals pass through the lateral spinothalamic tract, reaching the thalamus and spreading to a number of sensory cortices and motor cortices, and thus facilitating the activation of the neuroplasticity.25 The aforementioned research results indicate that the provision of NMES and NTS may benefit motor recovery of the UE in stroke patients.
Syringobulbia: A delayed complication following spinal cord injury – case report
Published in The Journal of Spinal Cord Medicine, 2019
Christina Mousele, Miltiadis Georgiopoulos, Constantine Constantoyannis
Regarding the neuroanatomical background of the aforementioned patient’s clinical presentation the following plausible explanations can be provided. The concurrent existence of sensory loss, concerning pain and temperature sensation, of the right upper extremity and hypoesthesia of the right side of the face can be only explained by dysfunction of the left lateral spinothalamic tract (2nd order neuraxons) and the left trigeminal lemniscus. The muscle wasting and weakness, concerning especially the most delicate movements of the right hand, should be attributed to injury of the left corticospinal tract. The dysphagia and the dysphonia should be associated with dysfunction of the vagus (pneumogastric) nerve.