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CNS Pathways Functionalfunctional Systemssystems Inin Thethe CNSCNS FunctionalFunctional SystemsSystems inin thethe CNSCNS 1. Afferent (sensory) pathways: general sensation – superficial and deep (proprioceptive) interoceptive sensation special sensations – vision and hearing 2. Efferent (motor) pathways: pyramidal system extrapyramidal system 3. Meninges and cerebrospinal fluid 4. Blood supply of the brain CNS Pathways FunctionalFunctional systemssystems inin thethe CNSCNS Sensory (afferent ) systems Motor (efferent ) systems Limbic system Reticular system Central transmitter systems: cholinergic system monoaminergic system amino acid transmitters peptidergic system central neuroendocrine system Prof. Dr. Nikolai Lazarov 2 CNS Pathways SensorySensory (afferent)(afferent) pathwayspathways Sensory (afferent ) systems:systems general (somatic) sensations:sensations superficial (exteroceptive ) – skin • pain and temperature • vibration, touch and pressure • stereognosia deep (proprioceptive ) • joints and tendons interoceptive (visceroceptive ) • organs and blood vessels special sensations:sensations visual system vestibulocochlear system gustatory system olfactory system Prof. Dr. Nikolai Lazarov 3 CNS Pathways MechanoreceptionMechanoreception systemsystem posterior column-medial lemniscus pathway (lemniscus medialis):medialis) touch, pressure and stereognosia І neuron – ganglion spinale ІІ neuron – nucl. gracilis et cuneatus ІІІ neuron – nucleus ventralis posterolateralis thalami 2 gyrus postcentralis (upper /3) low touch and pressure tractus spinothalamicus anterior (ventralis) trigeminal lemniscus (lemniscus trigeminalis):trigeminalis) orofacial touch and pressure І neuron – ganglion trigeminale ІІ neuron – nucl. pontinus (sensorius principalis) ІІІ neuron – nucleus ventralis posteromedialis thalami 1 gyrus postcentralis (lower /3) Prof. Dr. Nikolai Lazarov 4 CNS Pathways PainPain andand temperaturetemperature systemsystem Ascending nociceptive pathways (anterolateral system):system pain (nociception) and temperature І neuron – ganglion spinale ІІ neuron – spinal laminae І, ІІ and V tractus spinothalamicus lateralis lemniscus medialis ІІІ neuron – nucleus ventralis posterolateralis thalami 1 gyrus postcentralis (middle and upper /3), rostral part of gyrus cinguli, insular cortex (limbic system) Spinal pain system:system lateral pain system – “rapid pain” (“neospinothalamic system”) tractus spinothalamicus lateralis medial pain system – “slow pain” (“paleospinoreticulothalamic system”) tractus spinoreticularis et tractus spinotectalis tractus spinotectalis colliculi superiores Dorsolateral system : laminae ІІІ and ІV, І and V tractus spinocervicalis nucleus cervicalis lateralis tractus spinomesencephalicus substantia grisea centralis Prof. Dr. Nikolai Lazarov 5 CNS Pathways PainPain andand temperaturetemperature systemsystem Head pain and temperature system:system І neuron – ganglion trigeminale tractus spinalis n. trigemini ІІ neuron – nucl. spinalis n. trigemini lemniscus trigeminalis ІІІ neuron – nucleus ventralis posteromedialis thalami gyrus postcentralis 1 (lower /3) Prof. Dr. Nikolai Lazarov 6 CNS Pathways ProprioceptiveProprioceptive pathwayspathways from the lower limb to the cerebral cortex: posterior column-medial lemniscus pathway: І neuron – ganglion spinale ІІ neuron – nucl. thoracicus (Clarke-Stilling) ІІІ neuron – nucleus Z in the medulla ІV neuron – thalamus cerebral cortex from the trunk to the cerebellum: tractus spinocerebellaris posterior І neuron – ganglion spinale ІІ neuron – nucl. thoracicus (Clarke-Stilling) tractus spinocerebellaris posterior (Flechsig) cortex cerebelli tractus spinocerebellaris anterior ІІ neuron – nucl. thoracicus (Clarke-Stilling) tractus spinocerebellaris anterior (Gowers) rostral part of cortex cerebelli tractus bulbocerebellaris – from the upper limb І neuron – ganglion spinale ІІ neuron – nucl. cuneatus accessorius tractus cuneocerebellaris cortex cerebelli Prof. Dr. Nikolai Lazarov 7 CNS Pathways ProprioceptiveProprioceptive pathwayspathways proprioceptive pathways of the head: І neuron – nucl. mesencephalicus n. trigemini tractus mesencephalicus n. trigemini nucl. motorius n. trigemini ІІ neuron – nucl. ventralis posteromedialis gyrus postcentralis Prof. Dr. Nikolai Lazarov 8 CNS Pathways AscendingAscending interoceptiveinteroceptive pathwayspathways Sensitivity from body’s viscera (organs) – predominantly nociceptive,nociceptive common way with pain and temperature pathway: conventional visceroceptive pathway:pathway І neuron – ganglion spinale ІІ neuron – subst. intermedia medialis tractus spinothalamicus lateralis ІІІ neuron – nucleus ventralis posterolateralis thalami somatosensory cortical areas accessory visceroceptive pathway:pathway І neuron – nervus vagus ІІ neuron – nucl. tractus solitarii ІIІ neuron – nucl. ventralis posterolateralis Prof. Dr. Nikolai Lazarov 9 CNS Pathways MotorMotor (efferent)(efferent) pathwayspathways PyramidalPyramidal motormotor systemsystem – two neuron system:system tractus corticospinalis (pyramidalis) tractus corticonuclearis (corticonuclear system) ExtrapyramidalExtrapyramidal motormotor systemsystem (basal ganglia system) – multineuronal and polysynaptic Oculomotor system: frontal eye area (area 8, parts of 6 and 9 areas) prefrontal cortex Prof. Dr. Nikolai Lazarov 10 CNS Pathways PyramidalPyramidal motormotor systemsystem corticospinal (pyramidal) tract – 1 million fibers: controls all of our voluntary movements spastic cerebral palsy 1 /3 of the fibers from gyrus precentralis (“motor strip ”) and lobulus paracentralis (Brodmann’s area 4) 1 /3 from the premotor areas (areas 6 and 8) 1 /3 from somatosensory cortex (areas 3, 1 and 2) posterior limb of internal capsule crus cerebri fibrae pontis longitudinales pyramidal decussation – 85% decussate lateral ( crossed ) corticospinal tract to the contralateral side in the medulla oblongata anterior corticospinal tract 15% uncrossed to the ipsi lateral side in the medulla oblongata Prof. Dr. Nikolai Lazarov 11 CNS Pathways Lateral and anterior corticospinal tracts NB: The corticospinal tract terminates predominantly on interneurons , final common pathway, only rarely ––– directly on the large motoneurons! Prof. Dr. Nikolai Lazarov 12 CNS Pathways PyramidalPyramidal motormotor systemsystem corticonuclear (corticobulbar) tract:tract 1 from the lower /3 of gyrus precentralis genu of internal capsule crus cerebri pars ventralis pedunculi cerebri corticonuclear axons innervate cranial motor nuclei bilaterally they directly innervate the nuclei for cranial nerves V, VII, XI and XII indirectly innervate nuclei for nerves III, IV and VI via interneurons NB: The 'bulb' is an archaic term for the medulla oblongata . Prof. Dr. Nikolai Lazarov In clinical usage, it includes the pons as well ! 13 CNS Pathways ExtrapyramidalExtrapyramidal motormotor pathwayspathways Feedback multineuronal and polysynaptic circuits through “subcortical nuclei”: striopallidal system substantia nigra subthalamic nucleus cerebellum Pathways to peripheral motoneurons: cortico -rubro -spinal tract – extremities:extremities tractus frontorubralis nucleus ruber tractus rubrospinalis cerebello -rubro -spinal tract:tract cerebellar cortex deep cerebellar nuclei tractus cerebellorubralis nucleus ruber tractus rubrospinalis cortico -reticulo -spinal tract:tract fibrae corticoreticulares nuclei reticulares fibrae reticulospinales – medial and lateral parts cerebello -reticulo -spinal tract:tract cerebellar cortex nucleus dentatus tractus cerebelloreticularis nuclei reticulares tractus reticulospinalis cerebello -vestibulo -spinal tract:tract flocculo-nodular cerebellar cortex nucleus fastigii tractus cerebellovestibularis nucleus vestibularis lateralis tractus vestibulospinalis Prof. Dr. Nikolai Lazarov 14 CNS Pathways BasalBasal gangliaganglia pathwayspathways Closed reverberating circuits of the basal ganglia: striatum is the main acceptor pallidum is the main effector Prof. Dr. Nikolai Lazarov 15 Meninges MeningesMeninges ofof thethe brainbrain - protective tissue DuraDura matermater (Pachimeninx),(Pachimeninx) dura mater encephali LeptomeninxLeptomeninx (Lepto - from the root meaning thin in Greek): ArachnoidArachnoid matermater , arachnoidea mater encephali PiaPia matermater , pia mater encephali Prof. Dr. Nikolai Lazarov 16 Meninges CerebralCerebral duradura matermater structuresstructures sickle-shaped falx cerebri tentorium cerebelli falx cerebelli diaphragma sellae cavum trigeminale (Meckeli) Prof. Dr. Nikolai Lazarov NB: dura mater (Latin "hard mother" ) 17 Meninges CranialCranial duraldural venousvenous sinusessinuses superior sagittal sinus inferior sagittal sinus transverse sinuses sigmoid sinuses confluence of the sinuses occipital sinus straight sinus (sinus rectus) petrosquamous sinus superior petrosal sinuses inferior petrosal sinuses cavernous sinuses intercavernous sinuses, anterior and posterior Prof. Dr. Nikolai Lazarov 18 Meninges ArachnoidArachnoid matermater Arachnoid granulations (or arachnoid villi) – in the sinuses Pacchioni's granulations or pacchionian bodies Antonio Pacchioni (1665–1726) spiderweb-like layer (hence the name) subarachnoid space filled with cerebrospinal fluid subarachnoid cisterns: cisterna cerebellomedularis posterior et lateralis cisterna pontocerebellaris cisterna ambiens cisterna trigeminalis cisterna cruralis cisterna interpeduncularis cisterna carotidis
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