10 15a 4 Atlas Neuroanatomy
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ATLAS NEUROANATOMY Somatosensory System Dr. Donald Wong
•Dorsal Column-Medial Lemniscal System •Anterolateral System •Trigeminal System Forebrain
Brainstem
Spinal Cord 1
Dorsal ColumnMedial Lemniscal System •Discriminative (fine) Touch •2-point discrim.
Midbrain
•Stereognosis
•Position sense
Pons
•Vibratory sense Medulla
SpC
Haines Atlas (7th ) 8-4
2
???
Haines Atlas (7th ) 6-1
???
DC-ML 3
Dorsal Column: fasciculus gracilis
Haines Atlas (7th ) 6-1
Sacral level
DC-ML 4
???
? ???
?
???
??? ???
???
Haines Atlas (7th ) 6-3
5 DC-ML
Dorsal Columns T4 level
L uT
Fasc. gracilis
Dorsal root Fasc. cuneatus
(medial): large dia.
T6 and above
Haines Atlas (7th ) 6-3
6 DC-ML
???
??
?? ??
??
??? ???
7
Haines Atlas (7 ) 6-5 th
DC-ML
Post. Intermediate sulcus
FG
FG FC
FC
CST fibers decussating
C1 level
8
Haines Atlas (7 ) 6-5 th
DC-ML
??? ???
???
???
???
???
???
Haines Atlas (7 ) 6-8 th
9
DC-ML
Caudal Medulla: DCN / x- Pyr
GrFs
DCN
GrNu
CuFs
CuNu
Pyramidal decussation
Haines Atlas (7 ) 6-8 th
10
DC-ML
??? ??.
??.
???
??? ??? Haines Atlas (7th ) 6-9
11 DC-ML
G. N. & fasc. C.N.
. C.N
Internal arcuate fibers
Medial lemniscus
Caudal/Mid Medulla: DCN Haines Atlas (7th ) 6-9
12 DC-ML
DC-ML
???
??
??
?? ?? ??
?? ??
??? Haines Atlas (7th ) 6-11
13
Rostral Medulla: XII n. nucleus/ Inf. Olive
XII
DC-ML
XII
MLF TST arm
ML leg
Haines Atlas (7th ) 6-11
ML somatotopy: standing on top of pyramid”
“Man 14
Lower pons: level of facial colliculus, VII n./nucleus
???
*
*
???
*
??
??
??? ?? Haines Atlas (7th ) 6-17
15
DC-ML
Lower pons: level of facial colliculus, VII n./nucleus
Tegmentum
*
*
MCP
*
arm
leg
Base ML Haines Atlas (7th ) 6-17
16
DC-ML
???
*
???
??? ??? ??
* ???
17DC-ML
Haines Atlas (7th ) 6-20
Rostral pons/Caudal midbrain: level of V n./ IV n. exits IV nerve
*
leg arm ML
* V nerve
18DC-ML
Haines Atlas (7th ) 6-20
*
*
???
??? ???
??? ???
* ???
???
?? ???
???
19
Haines Atlas (7th ) 6-22
DC-ML
*
*
Caudal midbrain: Level of Inf. Colliculus
Midbrain leg
X SCP arm
*
Rostral Crus Cerebri pons
ML Crus Cerebri
Pons
20
Haines Atlas (7th ) 6-22
DC-ML
???
*
* ** ??
*
*
DC-ML
Haines Atlas (7 ) 6-25 th
21
Rostral midbrain:
III-
n. nucleus, SC, R.N.
*
* ** ML
*
*
DC-ML
Haines Atlas (7 ) 6-25 th
22
Midbrain/diencephalic junction: level of pretectal area/PC
* *
PC
*
leg
ML
arm
23DC-ML
Haines Atlas (7th ) 6-26
???
??? ???
???
??
???.
??
???
???
???
???
??.
24
Haines Atlas (7th ) 6-30
DC-ML Thal
Forebrain (oblique axial): VP/ Pulvinar, CM, Pineal Pulvinar Pineal
VPL
IntCappost
SS Rad.
CM
Post.
MD VPM
III
Ant.
25
Haines Atlas (7th ) 6-30
DC-ML Thal
???
??
Oblique coronal
??
??
??? ???
???
????
26
Haines Atlas (7th ) 6-33
DC-ML
Level of Ant Thalamic Nucleus & SubThalamus
Ant
Ant
Oblique coronal
SubThal
Int. Caps.: posterior limb Somatosensory radiations
Subst Nigra
Subst Nigra
27
Haines Atlas (7th ) 6-33
DC-ML
Dorsal ColumnMedial Lemniscal System
Arm
Leg
Int. Caps.
Somatotopic representation in SI •Arm- lateral (MCA) •Leg - medial (ACA) •Accurate stimulus localization possible if projs. mapped somatotopically (homunculus) in cerebral cortex
Haines Atlas (7th ) 8-4
28
Anterolateral System •Pain/Temperature •Light (crude) touch
VPL
Spinal lemniscus
•ALS pathways: Spinothalamic, Spinoreticular, Spino-tectal (mesencephalic)
ALS
•At least 20 neurons ALS
•Lower brainstem: ALS • Upper midbrain: mainly Spinothalamic Tract (spinal lemniscus)
Haines Atlas (7th ) 8-6
29
ALS
Large-dia. myelinated fibers: medial entry
Lumbosacral Enlargement (L4)
P/T fibers: lateral entry
Dorsolateral tract of Lissauer
Substantia galatinosa: lamina II
AWC ALS: Spinothalamic, Spinoreticular, Spinotectal
ALS: tract fibersarise from superficial & deep DH layers
Haines Atlas (7 ) 6-2 th
30
ALS
C7: Cervical enlargement
leg ALS
ALS arm
ALS Haines Atlas (7th ) 6-4
31
G. N. & fasc.
C.N.
C.N.
ALS
Medial lemniscus
Caudal/mid Medulla: DCN Haines Atlas (7th ) 6-9
32ALS
Rostral Medulla Cochlear nucleus
*
ALS
33
Haines Atlas (7th ) 6-12
ALS
Lower pons: level of facial colliculus, VII n./nucleus
VII (motor) nucleus
ALS
ML 34
Haines Atlas (7th ) 6-17
ALS
Midpons: V nerve entry (chief sensory/motor V)
S
M
V nerve
Tegmentum
ALS
ML
Base 35
Haines Atlas (7th ) 6-19
ALS
Lower midbrain: Trochlear (4th ) nucleus/ x- SCP
ALS: spinal lemniscus
4th
Su b
s.
ML Ni gr
4th
x- SCP
a
36
Haines Atlas (7th ) 6-23
ALS
Rostral midbrain:
III-
n. nucleus, SC, R.N.
spinal lemniscus
ML
ALS
Haines Atlas (7 ) 6-25 th
37
Forebrain (oblique axial): VP/ Pulvinar, CM, Pineal & Subthalamus pulvinar Pineal
VPL
IntCappost
CM
Post. VPM
III
Ant.
38
Haines Atlas (7th ) 6-30
ALS
Forebrain coronal thru LD/ Subthalamus
LD
Lat.
MD
Int. Caps.: posterior limb Somatosensory radiations
Haines Atlas (7th ) 6-31
39
ALS
Anterolateral System
Arm
Leg
Somatotopic representation in SI •Arm- lateral •Leg- medial
Haines Atlas (7 ) 8-6 th
40
ALS
Trigeminal System 3 brainstem sensory nuclei: •Chief sensory •Fine touch, vibration •Midpons- V-nerve entry DTTT VTTT
•Spinal trigeminal nucleus •Pain/temp. (V, VII, IX, X) •Midpons thru medulla
V
• Mesencephalic nucleus V VII
•Proprioceptive
IX
•VTTT: x trig. pathway
X
•ALL P/T AND •MOST fine touch, vibration •Fully formed in midbrain
•DTTT: un-x trig. Pathway •Fine touch only •Starts above midpons
Haines Atlas (7 ) 8-9 th
41
Trig
Caudal Medulla: DCN/pyramidal decus. Spinal Trig. Nucleus/tract of V
DCN
DCN
Pyramidal decussation
42
Haines Atlas (7th ) 6-8
Trig
Rostral Medulla: XII n. nucleus/ Inf. Olive
XII
Sp Trg Nu & Tr V
XII
MLF TST
Sp Trg Tr & Nu V
Haines Atlas (7th ) 6-11
ML
VTTT
VTTT is lateral to Medial Lemniscus in medulla (no DTTT)
43
Lower pons: facial colliculus
Spinal Trig. Nucleus/tract of V-
*
lateral to VII n.
Haines Atlas (7th ) 6-16
*
44
Trig
Mesencephalic V
VTTT S
M
Chief sensory V ML
VTTT dorsal to ML No DTTT Haines Atlas (7 ) 6-19 th
45
Trig
Rostral pons/Caudal midbrain: level of V n./ IV n. exits IV nerve
DTTT VTTT ALS ML
V nerve
Trig
Haines Atlas (7th ) 6-20
46
Caudal midbrain:
DTTT
Level of Inf. Colliculus
VTTT
X SCP Spinothalamic Tract
Rostral pons ML
47
Haines Atlas (7th ) 6-22
Trig
Midbrain/diencephalic junction: level of pretectal area/PC/pineal
DTTT VTTT
Spinothalamic tract
ML
ML
48 Trig
Haines Atlas (7th ) 6-26
Forebrain (oblique axial): VP/ Pulvinar, CM, Pineal pulvinar Pineal
VPL
IntCappost
CM
Post.
VPM III
Ant.
49
Haines Atlas (7th ) 6-30
Trig
Forebrain coronal thru Ant Thal Nu / MB
Int. Caps.: posterior limb Somatosensory radiations
50
Haines Atlas 5-32
Trig
Trigeminal System Representation of face in SI
•Lateral: near Sylvian fissure •Post to Broca area (left)
Haines Atlas (7 ) 8- 9 th
51
Trig
•Dorsal Column-Medial Lemniscal System •Anterolateral System •Trigeminal System Forebrain
Brainstem
Spinal Cord 1
Dorsal ColumnMedial Lemniscal System •Discriminative (fine) Touch •2-point discrim.
Midbrain
•Stereognosis
•Position sense
Pons
•Vibratory sense Medulla
SpC
Haines Atlas (7th ) 8-4
2
???
Haines Atlas (7th ) 6-1
???
DC-ML 3
Dorsal Column: fasciculus gracilis
Haines Atlas (7th ) 6-1
Sacral level
DC-ML 4
???
? ???
?
???
??? ???
???
Haines Atlas (7th ) 6-3
5 DC-ML
Dorsal Columns T4 level
L uT
Fasc. gracilis
Dorsal root Fasc. cuneatus
(medial): large dia.
T6 and above
Haines Atlas (7th ) 6-3
6 DC-ML
???
??
?? ??
??
??? ???
7
Haines Atlas (7 ) 6-5 th
DC-ML
Post. Intermediate sulcus
FG
FG FC
FC
CST fibers decussating
C1 level
8
Haines Atlas (7 ) 6-5 th
DC-ML
??? ???
???
???
???
???
???
Haines Atlas (7 ) 6-8 th
9
DC-ML
Caudal Medulla: DCN / x- Pyr
GrFs
DCN
GrNu
CuFs
CuNu
Pyramidal decussation
Haines Atlas (7 ) 6-8 th
10
DC-ML
??? ??.
??.
???
??? ??? Haines Atlas (7th ) 6-9
11 DC-ML
G. N. & fasc. C.N.
. C.N
Internal arcuate fibers
Medial lemniscus
Caudal/Mid Medulla: DCN Haines Atlas (7th ) 6-9
12 DC-ML
DC-ML
???
??
??
?? ?? ??
?? ??
??? Haines Atlas (7th ) 6-11
13
Rostral Medulla: XII n. nucleus/ Inf. Olive
XII
DC-ML
XII
MLF TST arm
ML leg
Haines Atlas (7th ) 6-11
ML somatotopy: standing on top of pyramid”
“Man 14
Lower pons: level of facial colliculus, VII n./nucleus
???
*
*
???
*
??
??
??? ?? Haines Atlas (7th ) 6-17
15
DC-ML
Lower pons: level of facial colliculus, VII n./nucleus
Tegmentum
*
*
MCP
*
arm
leg
Base ML Haines Atlas (7th ) 6-17
16
DC-ML
???
*
???
??? ??? ??
* ???
17DC-ML
Haines Atlas (7th ) 6-20
Rostral pons/Caudal midbrain: level of V n./ IV n. exits IV nerve
*
leg arm ML
* V nerve
18DC-ML
Haines Atlas (7th ) 6-20
*
*
???
??? ???
??? ???
* ???
???
?? ???
???
19
Haines Atlas (7th ) 6-22
DC-ML
*
*
Caudal midbrain: Level of Inf. Colliculus
Midbrain leg
X SCP arm
*
Rostral Crus Cerebri pons
ML Crus Cerebri
Pons
20
Haines Atlas (7th ) 6-22
DC-ML
???
*
* ** ??
*
*
DC-ML
Haines Atlas (7 ) 6-25 th
21
Rostral midbrain:
III-
n. nucleus, SC, R.N.
*
* ** ML
*
*
DC-ML
Haines Atlas (7 ) 6-25 th
22
Midbrain/diencephalic junction: level of pretectal area/PC
* *
PC
*
leg
ML
arm
23DC-ML
Haines Atlas (7th ) 6-26
???
??? ???
???
??
???.
??
???
???
???
???
??.
24
Haines Atlas (7th ) 6-30
DC-ML Thal
Forebrain (oblique axial): VP/ Pulvinar, CM, Pineal Pulvinar Pineal
VPL
IntCappost
SS Rad.
CM
Post.
MD VPM
III
Ant.
25
Haines Atlas (7th ) 6-30
DC-ML Thal
???
??
Oblique coronal
??
??
??? ???
???
????
26
Haines Atlas (7th ) 6-33
DC-ML
Level of Ant Thalamic Nucleus & SubThalamus
Ant
Ant
Oblique coronal
SubThal
Int. Caps.: posterior limb Somatosensory radiations
Subst Nigra
Subst Nigra
27
Haines Atlas (7th ) 6-33
DC-ML
Dorsal ColumnMedial Lemniscal System
Arm
Leg
Int. Caps.
Somatotopic representation in SI •Arm- lateral (MCA) •Leg - medial (ACA) •Accurate stimulus localization possible if projs. mapped somatotopically (homunculus) in cerebral cortex
Haines Atlas (7th ) 8-4
28
Anterolateral System •Pain/Temperature •Light (crude) touch
VPL
Spinal lemniscus
•ALS pathways: Spinothalamic, Spinoreticular, Spino-tectal (mesencephalic)
ALS
•At least 20 neurons ALS
•Lower brainstem: ALS • Upper midbrain: mainly Spinothalamic Tract (spinal lemniscus)
Haines Atlas (7th ) 8-6
29
ALS
Large-dia. myelinated fibers: medial entry
Lumbosacral Enlargement (L4)
P/T fibers: lateral entry
Dorsolateral tract of Lissauer
Substantia galatinosa: lamina II
AWC ALS: Spinothalamic, Spinoreticular, Spinotectal
ALS: tract fibersarise from superficial & deep DH layers
Haines Atlas (7 ) 6-2 th
30
ALS
C7: Cervical enlargement
leg ALS
ALS arm
ALS Haines Atlas (7th ) 6-4
31
G. N. & fasc.
C.N.
C.N.
ALS
Medial lemniscus
Caudal/mid Medulla: DCN Haines Atlas (7th ) 6-9
32ALS
Rostral Medulla Cochlear nucleus
*
ALS
33
Haines Atlas (7th ) 6-12
ALS
Lower pons: level of facial colliculus, VII n./nucleus
VII (motor) nucleus
ALS
ML 34
Haines Atlas (7th ) 6-17
ALS
Midpons: V nerve entry (chief sensory/motor V)
S
M
V nerve
Tegmentum
ALS
ML
Base 35
Haines Atlas (7th ) 6-19
ALS
Lower midbrain: Trochlear (4th ) nucleus/ x- SCP
ALS: spinal lemniscus
4th
Su b
s.
ML Ni gr
4th
x- SCP
a
36
Haines Atlas (7th ) 6-23
ALS
Rostral midbrain:
III-
n. nucleus, SC, R.N.
spinal lemniscus
ML
ALS
Haines Atlas (7 ) 6-25 th
37
Forebrain (oblique axial): VP/ Pulvinar, CM, Pineal & Subthalamus pulvinar Pineal
VPL
IntCappost
CM
Post. VPM
III
Ant.
38
Haines Atlas (7th ) 6-30
ALS
Forebrain coronal thru LD/ Subthalamus
LD
Lat.
MD
Int. Caps.: posterior limb Somatosensory radiations
Haines Atlas (7th ) 6-31
39
ALS
Anterolateral System
Arm
Leg
Somatotopic representation in SI •Arm- lateral •Leg- medial
Haines Atlas (7 ) 8-6 th
40
ALS
Trigeminal System 3 brainstem sensory nuclei: •Chief sensory •Fine touch, vibration •Midpons- V-nerve entry DTTT VTTT
•Spinal trigeminal nucleus •Pain/temp. (V, VII, IX, X) •Midpons thru medulla
V
• Mesencephalic nucleus V VII
•Proprioceptive
IX
•VTTT: x trig. pathway
X
•ALL P/T AND •MOST fine touch, vibration •Fully formed in midbrain
•DTTT: un-x trig. Pathway •Fine touch only •Starts above midpons
Haines Atlas (7 ) 8-9 th
41
Trig
Caudal Medulla: DCN/pyramidal decus. Spinal Trig. Nucleus/tract of V
DCN
DCN
Pyramidal decussation
42
Haines Atlas (7th ) 6-8
Trig
Rostral Medulla: XII n. nucleus/ Inf. Olive
XII
Sp Trg Nu & Tr V
XII
MLF TST
Sp Trg Tr & Nu V
Haines Atlas (7th ) 6-11
ML
VTTT
VTTT is lateral to Medial Lemniscus in medulla (no DTTT)
43
Lower pons: facial colliculus
Spinal Trig. Nucleus/tract of V-
*
lateral to VII n.
Haines Atlas (7th ) 6-16
*
44
Trig
Mesencephalic V
VTTT S
M
Chief sensory V ML
VTTT dorsal to ML No DTTT Haines Atlas (7 ) 6-19 th
45
Trig
Rostral pons/Caudal midbrain: level of V n./ IV n. exits IV nerve
DTTT VTTT ALS ML
V nerve
Trig
Haines Atlas (7th ) 6-20
46
Caudal midbrain:
DTTT
Level of Inf. Colliculus
VTTT
X SCP Spinothalamic Tract
Rostral pons ML
47
Haines Atlas (7th ) 6-22
Trig
Midbrain/diencephalic junction: level of pretectal area/PC/pineal
DTTT VTTT
Spinothalamic tract
ML
ML
48 Trig
Haines Atlas (7th ) 6-26
Forebrain (oblique axial): VP/ Pulvinar, CM, Pineal pulvinar Pineal
VPL
IntCappost
CM
Post.
VPM III
Ant.
49
Haines Atlas (7th ) 6-30
Trig
Forebrain coronal thru Ant Thal Nu / MB
Int. Caps.: posterior limb Somatosensory radiations
50
Haines Atlas 5-32
Trig
Trigeminal System Representation of face in SI
•Lateral: near Sylvian fissure •Post to Broca area (left)
Haines Atlas (7 ) 8- 9 th
51
Trig
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