Ascending Tracts

Dr. HARI MOHAN

Associate Professor
Department Of Physiology
LCMCH
Ascending Tracts

Convey impulses arising in various parts of

the body to different parts of the brain

• Ascending tracts connecting spinal cord

Ascending
Tracts
with cerebral cortex

• Ascending tracts ending in the brain stem

• Spinocerebellar pathways
Arrangement of Neurons
• First Order of Neurons – primary afferent neurons.
• start from the receptor
• Cell bodies are located in the DRG.
• Second Order of Neurons – either located in the spinal cord or in the
brainstem.
• transmit impulse from the first order of neurons to the thalamus.
• cross the midline (either in the spinal cord or in the medulla).
• Third Order of Neurons – originate from the specific nuclei in the thalamus
and terminate in the specific areas in the sensory cortex.
• Higher (Fourth) Order of Neurons – originates from the terminals of third
order of neurons in the sensory cortex and project to other association area
Ascending tracts connecting spinal cord with
cerebral cortex

• Posterior column or dorsal column

• Spinothalamic or Anterolateral pathways

• Anterior spinothalamic tracts
• lateral spinothalamic tracts
POSTERIOR COLUMN OR DORSAL
COLUMN

• They carry the sensations of fine touch,

vibration, proprioception, tactile
localization, tactile discrimination and
stereognosis.
• In the spinal cord, they ascend up in two
fasciculi:
• the gracile fasciculus
• the cuneate fasciculus
• These ascending tracts in spinal cord are
also called tract of Goll and Burdach fine touch, vibration,
proprioception, tactile
localization, tactile
discrimination and
stereognosis
First Order of Neuron
• Neurons from lower extremity and
lower part of the trunk ascend up in
the gracile fasciculus which is located
medially located in spinal cord
• Neurons from upper extremity and
upper part of the trunk ascend in the
cuneate fasciculus situated laterally.
• first order of neurons terminate in the
nucleus gracilis and nucleus cuneatus
in the medulla.

fine touch, vibration,

proprioception, tactile
localization, tactile
discrimination and
stereognosis
Second Order of Neuron
• The cell bodies of these neurons are
present in the nucleus gracilis and
cuneatus in the medulla
• The fibers originating from these
nuclei cross the midline and pass on to
the opposite side in the medulla and
ascend up in the medial lemniscus to
reach thalamus
• The second order of neurons, thus
transmit impulses to the contralateral
thalamus.
fine touch, vibration,
proprioception, tactile
localization, tactile
discrimination and
stereognosis
Third Order of Neuron
• originate from the specific nucleus
(the VPL nucleus) in the thalamus
• project to the somatosensory areas of
the cerebral cortex

fine touch, vibration,

proprioception, tactile
localization, tactile
discrimination and
stereognosis
ANTEROLATERAL SYSTEM
• anterior spinothalamic tract – carries
sensation of crude touch
• lateral spinothalamic tract – carries sensation
of pain and temperature

First Order of Neuron

• fibers originating from nociceptors,
thermoreceptors, and mechanoreceptors
enter the spinal cord through dorsal root.
Second Order of Neuron
• The cell bodies of these neurons are present in
the dorsal horn of the spinal cord.
• The axons cross the midline in the same spinal
segment and ascend up in the opposite side of
the anterolateral funiculus to reach the
thalamus
• The fibers carrying the sensation of crude
touch are placed anteriorly and therefore
called anterior or ventral spinothalamic tract.
• The fibers carrying the sensations of pain and
temperature are placed laterally and therefore
called lateral spinothalamic tract.
Third Order of Neuron

• The neurons originate from the VPL, midline

and intralaminar nuclei of the thalamus and
project to the specific areas in the sensory
cortex.
Ascending tracts ending in brain stem
• Spinoreticular tract
• Spinotectal tract
• Spino-olivary tract
Spinoreticular tract
• Location – located in the anterolateral white funiculus
• Origin – begin from the spinal neurons mainly in lamina VII (also V and
VIII).
• Course – partly crossed and partly uncrossed and ascend in the
ventrolateral part of the spinal cord, intermingling with the
spinothalamic tracts.
• Termination – In reticular formation of medulla and pons:
• Medulla – end in nucleus reticularis gigantocellularis and lateral reticular nucleus
of same side, some fibres terminate in the opposite side
• Pons – terminate in the nucleus reticularis pontis caudalis of the same side or
opposite side. Very few fibres terminate in the mid brain.
• Functions – concerned with arousing consciousness or alertness
Spinotectal tract
• Location – In the lateral side of lateral white funiculus anterior to the
lateral spinothalamic tract.
• Origin – from the chief sensory cells of the posterior grey column. In
upper lumbar segments the tract is very prominent.
• Course and termination – origin from the spinal grey matter, the
fibres cross to the opposite side through anterior white commissure
to the lateral funiculus, ascend up to the mid brain along with
anterior spinothalamic tract and end in the superior colliculus and
mid brain reticular nuclei.
• Functions – form alternate route for conduction of slow pain and are
also concerned with spinovisual reflexes
Spino-olivary tract
• Location – In the anterolateral part of white funiculus and occupies
mostly the anterior white funiculus
• Origin, course and termination – origin of the fibres of this tract is
not specific. It is also a crossed tract. Its fibres terminate into olivary
nucleus of medulla oblongata, from where the neurons project into
the cerebellum.
• Function – concerned with proprioception
Spinocerebellar tracts
• Ventral spinocerebellar tract
• Dorsal (posterior) spinocerebellar tract
• Cuneocerebellar tract
• Rostral spinocerebellar tract
Ventral spinocerebellar tract
• Location – In the lateral white funiculus of the spinal cord
• Origin – also known as Gower’s tract is constituted by the neurons of
proprioceptive pathway located in the junctional area between the
ventral and dorsal grey column (laminae V, VI, VII) in the lumbar and
sacral segments of the cord.
• Course – the majority of fibres of cross to the opposite side and
ascend in the lateral funiculus, and finally reach the cerebellum
through the superior cerebellar peduncle.
• Termination – In the lower limb area of the cerebellar cortex
Dorsal (posterior) spinocerebellar tract
• Location – In the lateral funiculus along the posterolateral periphery
of spinal cord.
• Origin – the peripheral processes of first-order neurons receive
impulses from the muscle spindles, Golgi tendon organs and other
proprioceptive receptors.
• Course – tract is uncrossed. The fibres reach the lateral funiculus of
same side and ascends through other spinal segments and reach the
medulla oblongata. From here the fibres reach the cerebellum
through the inferior cerebellar peduncle.
• Termination – In the cortex of anterior lobe of cerebellum
Cuneocerebellar tract
• Origin course & termination – the central processes of some first-
order neurons (related to cervical segments) reach the accessory
cuneate nucleus in the medulla. The central processes of the second-
order neurons located in the accessory cuneate nucleus form the
cuneocerebellar tract (posterior external arcuate fibres), which enter
the inferior cerebellar peduncle of same side to reach the cerebellum.
• Functions – conscious proprioception impulses from the upper limb.
Rostral spinocerebellar tract
• Origin, course and termination – arise from the spinal grey matter in
lower four cervical segments, most of the fibres of this tract are
uncrossed, reach the cerebellum through the inferior and superior
cerebellar peduncles.
• Functions – regarded, functionally, as the forelimb equivalent of the
ventral spinocerebellar tract.
LESIONS OF SPINAL CORD
TRANSECTION OF THE SPINAL CORD
• Complete transection
• Incomplete transection
• Hemisection.
COMPLETE TRANSECTION OF SPINAL CORD

• Gunshot injuries
• Dislocation of spine
• Occlusion of the blood vessels.
Clinical stages
• Stage of spinal shock
• Stage of reflex activity
• Stage of reflex failure.
Stage of spinal shock
• cessation of all the functions and activity below the level of the
section immediately after injury
• complete transection in cervical region (above C5) is usually fatal
• stage of flaccidity is due to cessation of tonic neuronal discharge from
upper brain stem or supraspinal pathway.
• Higher the animal, more profound and longer lasting is the spinal
shock – due to greater dependence of spinal cord on higher centres –
therefore, spinal shock lasts for few minutes in frogs, for few hours in
cats and dogs, for days in monkeys and in human beings it lasts for
about 3 weeks.
• Depending upon the site of lesion, when both lower limbs are
paralysed (transection between cervical and lumbosacral
enlargements), it is called paraplegia and when all the four limbs are
affected (transection below C5) it is called quadriplegia.
• Loss of tone occurs in the paralysed muscles
• Areflexia, i.e. all the superficial and deep reflexes are markedly
decreased or lost.
• Sensory effects – all the sensations are lost below the level of
transections.
• Vasomotor effects – sympathetic vasoconstrictor fibres leave the
spinal cord between T1 and L2 – transection of cord below L2
segment will produce no effect or very little fall in the blood pressure.
• after paralysis of the muscles the body temperature becomes
subnormal (as muscular contraction is a major source of heat
production).
• Visceral effects:
• Urinary bladder is paralysed, however, the sphincter vesicae
regains tone early leading to retention of urine.
• Rectum is also paralysed. Since the bowels become hypotonic
there occurs constipation.
• When lesion is at T6 level, all impulses coming in from the abdominal
viscera are cut off from the brain; therefore, gripping sensations or
distension of viscera are not appreciated.
Stage of reflex activity
• also called stage of recovery.
• After about 3 weeks period, depending largely upon the general
health of the patient
• Smooth muscles regain functional activity first of all and urinary
bladder becomes automatic, i.e. reflex evacuation is gradually
established in a perfectly normal manner, Similarly, reflex
defaecation is also established.
• Sympathetic tone of the blood vessels is regained, as a result blood
pressure is restored to normal
• Skin shows sweating again and becomes more healthy.
• Skeletal muscle tone then recovers slowly after 3–4 weeks – tone of
flexor muscles returns first
• Reflex activity begins to return after few weeks of recovery of muscle
tone - flexor reflexes return first. The first reflex which usually
appears is Babinski’s reflex
• Mass reflex can be elicited in some cases by scratching the skin over
the lower limbs or the anterior abdominal wall, depending upon the
level of lesion – spasm of flexor muscles of both the limbs, evacuation
of bladder and profuse sweating below the level of the lesion.
Stage of reflex failure

• The failure of reflex activity may occur when general condition of the
patient starts deteriorating due to malnutrition, infections or
toxaemia.
• Reflexes become more difficult to elicit
• Mass reflex is abolished and the muscles become extremely flaccid
and undergo wasting.
HEMISECTION OF THE SPINAL CORD
(BROWN-SEQUARD SYNDROME)
• Hemisection of the spinal cord refers to a lesion involving one lateral
half of the spinal cord
• It can occur in following accidental injuries.
• The effects of hemisection of the spinal cord can be described in:
• Changes at the level of section
• Changes below the level of section
• Changes above the level of section.
Changes at the level of hemisection
• Changes on the same side
• Sensory changes – all the sensations are lost (complete
anaesthesia) at the level of hemisection on the same side –
because of complete damage to posterior nerve root, posterior
horn cells
• Motor changes:
• Complete lower motor neuron (LMN) type paralysis is seen due
to damage to the anterior horn cells – flaccid paralysis of
muscles, all the reflexes are lost, muscle power is lost and
ultimately muscles degenerate and undergo wasting due to
loss of tone.
• Complete vasomotor paralysis occurs due to damage of the
lateral horn cells.
Changes at the level of hemisection
• Changes on the opposite side
• Sensory changes – some loss of pain, temperature and crude
touch sensations due to injury to the fibres of spinothalamic tract,
which cross horizontally in the same segment, but dorsal column
pathway are not affected, so the sensations carried by these two
tracts are not affected.
• Motor changes – no motor change occurs, even if it occurs, it is
very mild and is similar to the effects of lower motor neuron
lesion.
fine touch, vibration,
proprioception, tactile
localization, tactile
discrimination and
stereognosis
Changes below the level of section
• Changes on the same side
• Sensory changes
• loss of fine touch, tactile localization, tactile discrimination,
sensation of vibration, conscious kinaesthetic sensation and
stereognosis
• crude touch, pain and temperature sensations are not lost.
• Motor changes
• upper motor neuron (UMN) type of paralysis due to injury to
the pyramidal tracts – increased muscle tone, Loss of
superficial reflexes, Exaggeration of deep reflexes, Positive
Babinski’s sign, Rigidity of limbs and no degeneration and
wasting of muscles.
Changes below the level of section
• Changes on the opposite side
• Sensory changes
• loss of following sensations of crude touch, pain and
temperature.
• fine touch, tactile localization, tactile discrimination, vibratory
sense, conscious kinaesthetic sensation and stereognosis are
intact
• Motor changes
• no motor change on the opposite side below the level of
lesion.
Changes above the level of lesion
• Changes on the same side
• Sensory changes – band of hyperaesthesia, i.e. increased
cutaneous sensations are present in one or two segments above
the level of section on the same side – due to irritation of the
neighbouring posterior nerve roots above the level of section.
• Motor changes – twitching of muscle in upper one or two
segments on the same side may occur due to irritation of the
neighbouring anterior nerve roots above the level of section.