GENERAL SOMATIC

AFFERENTS
Luis Emmanuel O. Esguerra, MD
Department of Anatomy
UERM Memorial Medical Center

Review of Terms

Functional Components of Peripheral

Nerves

General and Special

Somatic and Visceral
Afferent and Efferent

Neuron = nerve cell body

Nucleus vs. Ganglion

Objectives

Describe the components of the pathways for

general somatic sensation:

Sensory receptors.
Peripheral fiber tracts.
Ascending fiber tracts within the CNS.
Thalamus and Primary Sensory Cortex.

Describe the pathways for general somatic

sensation from the body.

Describe the general pattern.

Trace the pathways:

Anterolateral (Spinothalamic) Tract System

Dorsal Column (Medial Lemniscal) System

Objectives

Describe the pathways for unconscious

proprioception.
Describe the pathways for general somatic
sensation from the face region.

Describe the general pattern.

Trace the pathways for different general somatic
sensations from the face region.

Dorsal Trigeminothalamic Tract

Ventral Trigeminothalamic Tract
Trace the pathway involved in the direct and
consensual corneal blink reflexes.

SOMATIC SENSORY
(ASCENDING) PATHWAYS
Sensory Receptors

Peripheral somatic afferent fibers
(cranial and spinal nerves)

Fiber tracts and their nuclei of origin

Thalamus (relay center)

Primary sensory cortex (post-central
gyrus)

MODALITIES OF
SOMATIC SENSATION

PAIN:

THERMAL:

First fast, sharp

Second slow, dull/burning
Warmth
Cold

POSITION SENSE (PROPRIOCEPTION):

Unconscious or conscious
Static limb position and kinesthesia

MODALITIES OF
SOMATIC SENSATION

TOUCH-PRESSURE:

Simple or crude or light touch

Tactile discrimination

2-point discrimination
Stereognosis
Graphesthesia

VIBRATION SENSE

CLASSIFICATION OF
SENSORY RECEPTORS

Based on source of stimuli

Exteroceptive receptors (exteroceptors)

Interoceptive receptors (interoceptors)

Based on adequate stimuli

Mechanoreceptors
Thermoreceptors
Photoreceptors [rods and cones (retina)]
Chemoreceptors

MECHANORECEPTORS

Tactile [touch-pressure, vibration]

Non-encapsulated
Nerve endings around hair follicles

Merkels discs (expanded tip)

Encapsulated
Meissners corpuscles

Pacinian corpuscles

Ruffinis corpuscles

Krauses end bulbs

Golgi-Manzoni

Meissners corpuscle

Nerve endings
of hair follicle
Pacinian
corpuscle
Sensory nerves

MECHANORECEPTORS

Proprioception

Golgi tendon organs

Neuromuscular spindles
Encapsulated receptors

Auditory

Organ of Corti (cochlea)

THERMORECEPTORS
Respond to temperature differences ~2C

Warmth

Not yet identified, probably naked endings

of small unmyelinated nerve fibers

Cold

Naked endings of myelinated nerve fibers

branching into skin

Free nerve endings

Sensory nerves

CHEMORECEPTORS

Pain

Taste

Naked/free nerve endings

Taste buds (tongue)

Olfaction

Olfactory epithelium (nasal cavity)

SOMATIC AFFERENT FIBERS

Fiber Specific Theories

Different receptors and their fibers each

detect a particular quality of sensation
[Doctrine of Specific Nerve Energies]
Separate neural channels carry this
information from the specific receptors to
the place in the brain specific to the
sensation [Labeled Line Principle]

CLASSIFICATION OF PERIPHERAL
SOMATIC AFFERENT FIBERS
MYELINATED

UNMYELINATED

largest; fastest
Ia

smallest; slowest
II (A)

Ib

MUSCLE Annulospiral
Golgi Flower spray endings
endings of
NM spindles

tendon

of NM spindles

A
-

(Ib & II)

NONMUSCLE
[skin/deep]

none

2-point
discrimination
Vibration
Conscious
proprioception

A
(III)
Fast (first,
sharp) pain
Cold
Crude touch

C (IV)
Slow (second,
burning) pain
Warmth

ASCENDING FIBER TRACTS

Spinothalamic (Anterolateral) System

Pain
Thermal sense
Crude touch

Dorsal Column (Medial Lemniscal) System

Conscious proprioception
Vibration sense
Pressure deep touch
Tactile discrimination

Brain component
Cerebral cortex

Cerebral cortex
Basal nuclei
(lateral to thalamus)

Basal nuclei
Thalamus
(medial)

Thalamus

Hypothalamus

Hypothalamus
Cerebellum

Cerebellum

Midbrain
Brain stem

Brain stem
(midbrain, pons,
and medulla)

Pons
Medulla
Spinal cord

Sherwood Human Physiology 5 2004

THE THALAMUS

Dorsal portion of
the diencephalon
(largest)
Functions:

Relay center
Modifies &
integrates afferent
impulses
Adds emotional
tone
Regulates cortical
activity

DIVISIONS OF
THE THALAMUS

Intralaminar group

Centromedian (CM)
Intralaminar nuclei

Anterior nuclear group

Medial nuclear group

Median
Medial
Medial dorsal (MD) or
dorsomedial (DM)

DIVISIONS OF
THE THALAMUS

Lateral nuclear group

Lateral (dorsal) nuclear

Lateral dorsal (LD)

Lateral posterior (LP)

Pulvinar
Ventral nuclear

Ventral anterior (VA)

Ventral lateral (VL)

Ventral posterior



Ventral posterolateral
(VPL)
Ventral posteromedial
(VPM)

PRIMARY SENSORY CORTEX

Located in the post-central gyrus

Somesthetic Center or Somatosensory Area I
Brodmann areas 3, 1 & 2

PRIMARY SENSORY CORTEX

Snell Clin Neuroana 6 2006

Sherwood Human Physiology 5 2004

GENERAL PATTERN
(EXCLUDING FACE REGION):
Receptors
Neuron 1 [N1]: DRG (no synapse)
Neuron 2 [N2]: (decussation)

1.
2.
3.

Neuron 3 [N3]: VPL of the thalamus

4.

5.

Dorsal horn of spinal cord (anterolateral system)

Nucleus gracilis or nucleus cuneatus of medulla (dorsal
column system)
thru posterior limb of internal capsule
forming corona radiata

Sensory cortex: post-central gyrus

GENERAL PATTERN:
IMPORTANT POINTS

The System is crossed. Sensory info from

one side of the body projects to the opposite
thalamus & cortex
N1 in DRG
N2 in dorsal horn or homologous nuclei
N3 in thalamus [VPL]

SPINOTHALAMIC
(ANTEROLATERAL) SYSTEM

Lateral Spinothalamic Tract

Anterior (Ventral) Spinothalamic Tract

For pain and thermal sensation

For light touch, itch, tickle, sexual sensation

Spinotectal Tract
Spinoreticular Tract

Manter & Gatz 10 2003

Manter & Gatz 10 2003

Lateral
Spinothalamic Tract

Subserves:

Pain
Thermal sensation

Pathway for fast

sharp pain

Snell Clin Neuroana 6 2006

Lateral
Spinothalamic Tract
1. Receptors

Free nerve endings

Snell Clin Neuroana 6 2006

Lateral
Spinothalamic Tract
2. N1: Dorsal Root
Ganglion

Axons enter spinal

cord via lateral division
of dorsal root
Enter at zone of
Lissauer with fibers
running 1 to 2
segments up or down

Snell Clin Neuroana 6 2006

Lateral
Spinothalamic Tract
3. N2: Dorsal horn cells

Substantia gelatinosa
(internuncial neurons)
Rexed laminae I-V
(tract cells)
Axons cross to
contralateral side in
ventral commissure &
ascend at lateral
funiculus
Fibers from lower cord
located dorsolaterally,
higher levels
ventromedially
Snell Clin Neuroana 6 2006

Lateral
Spinothalamic Tract
4. N3: VPL of the
thalamus

Thalamic radiations in
the posterior limb of
the internal capsule
Axons form corona
radiata to sensory
cortex

5. Postcentral gyrus
(Brodmann areas 3,
1, & 2)
Snell Clin Neuroana 6 2006

Spinoreticular Tract

Fibers to reticular
formation
For general alertness and
arousal in response to
painful stimuli
to intralaminar thalamic
nuclei (for dull aching
pain)

Spinotectal Tract

Fibers to superior
(rostral) colliculus [for eye
and head orientation]
For orientation toward
potentially harmful painful
stimuli
Snell Clin Neuroana 6 2006

PAIN THEORIES
Intrinsic Pain Suppression Mechanism

Neurons in substantia gelatinosa secrete

substance P for pain sensation
Brain secretes morphine-like substances
(enkephalins, endorphins) to act on opiate
receptors in Lamina II

Gate Control Theory of Pain

Stimulation of myelinated fibers with rubbing

of pain-stimulated area suppress fine pain
fibers

Anterior
Spinothalamic Tract

Subserves:

Light (crude) touch

Itch
Tickle
Sexual sensation

Some authors do not

differentiate from
lateral spinothalamic
tract and group them
all together as
Anterolateral System
Snell Clin Neuroana 6 2006

Anterior
Spinothalamic Tract
1. Receptors

Hair follicle nerve

endings
Merkels discs
Meissners corpuscles
Pacinian corpuscles

Snell Clin Neuroana 6 2006

Anterior
Spinothalamic Tract
2. N1: Dorsal Root
Ganglion

Axons enter spinal

cord via lateral division
of dorsal root
Enter at zone of
Lissauer with fibers
running 1 to 2
segments up or down

Snell Clin Neuroana 6 2006

Anterior
Spinothalamic Tract
3. N2: Dorsal horn cells

Substantia gelatinosa
Axons cross to
contralateral side in
ventral commissure
(some do not) &
ascend at anterior
funiculus
Fibers from lower cord
located dorsolaterally,
higher levels
ventromedially
Join LST at medulla as
spinal lemniscus
Snell Clin Neuroana 6 2006

Anterior
Spinothalamic Tract
4. N3: VPL of the
thalamus

Thalamic radiations in
the posterior limb of
the internal capsule
Axons form corona
radiata to sensory
cortex

5. Postcentral gyrus
(Brodmann areas 3,
1, & 2)
Snell Clin Neuroana 6 2006

IN CASE OF UNILATERAL SPINAL

CORD TRANSECTION:
Light touch sensation may never be
completely lost because it has bilateral
representation by the Anterior
Spinothalamic Tract.

Dorsal Column
Pathway

Also known as Medial

Lemniscal System
For conscious
proprioception, vibration,
deep pressure, deep
touch and tactile
discrimination
Proprioception includes
joint position sense,
kinesthetic sense and
vibratory sense

Snell Clin Neuroana 6 2006

Dorsal Column
Pathway
1. Receptors

Meissners corpuscles
Pacinian corpuscles
Ruffinis corpuscles
(pressure)
Golgi tendon organs

Snell Clin Neuroana 6 2006

Dorsal Column
Pathway
2. N1: Dorsal Root
Ganglion

Axons enter ipsilateral

dorsal funiculus via
medial division of
dorsal root
fasciculus gracilis:
fibers from sacral,
lumbar and lower 6
thoracic
fasciculus cuneatus:
fibers from upper 6
thoracic and all
cervical
Snell Clin Neuroana 6 2006

Dorsal Column
Pathway
3. N2: Nucleus gracilis
and n. cuneatus in
medulla

Axons cross to
opposite side as
internal arcuate fibers
Form the medial
lemniscus in the
contralateral side

Snell Clin Neuroana 6 2006

Dorsal Column
Pathway
4. N3: VPL of the
thalamus

Thalamic radiations in
the posterior limb of
the internal capsule
Axons form corona
radiata to sensory
cortex

5. Postcentral gyrus
(Brodmann areas 3,
1, & 2)
Snell Clin Neuroana 6 2006

IN CASE OF UNILATERAL SPINAL

CORD TRANSECTION:
Light touch sensation may never be
completely lost because it may be
mediated also by the Dorsal Column
System.

Ataxia

Unsteady, awkward and poorly coordinated

movement
Sensory Ataxia - unsteady gait due to a
lesion in the Dorsal Column Pathway
Romberg sign

With eyes closed, patient sways or falls to one

side when asked to stand with feet placed close
together
Used to detect dorsal column ataxia

PATHWAYS FOR UNCONSCIOUS

PROPRIOCEPTION
LOWER LIMBS

UPPER LIMBS

General aspects Anterior/ventral

of movement
spinocerebellar
[ASCT]

Rostral
spinocerebellar
[RSCT]

Fine
coordination of
individual
muscles

Cuneocerebellar

Posterior/dorsal
spinocerebellar
[PSCT]

[CCT]

GENERAL PATTERN OF PATHWAYS

FOR UNCONSCIOUS PROPRIOCEPTION
ASCT*

PSCT

RSCT

CCT

1. Receptor: NM spindle, Golgi tendon, touch endings

(via fasciculus
cuneatus) [C1-T5]

2. N1: DRG
3. N2:
Dorsal horn

SPINAL CORD
Nucleus
Nucleus
dorsalis of Clark centrobasalis
L-VII (medial
intermediate
horn) [T1-L2]

MEDULLA
Accesory cuneate
nucleus

L-VI (dorsal
horn at cervical
enlargement)

Lateral funiculus
Ext. arcuate fibers
4. Cerebellum and Vermis
* with crossed fibers (caudal midbrain superior cerebellar peduncle)
Note: 2-neuron linkage

TRIGEMINOTHALAMIC TRACT
GENERAL PATTERN (FACE REGION):
1.
2.

3.

4.

5.

Receptors
Neuron 1 [N1]: equivalent to DRG (no synapse)
Gasserian ganglion [CN V]
Geniculate ganglion [CN VII]
Superior ganglia [CN IX & X]
Mesencephalic nucleus of CN V (proprioception only)
Neuron 2 [N2]: sensory nuclei of CN V at brainstem
Fibers cross to form Ventral Trigeminothalamic Tract
Some fibers do not cross and form Dorsal Trigeminothalamic
Tract
Neuron 3 [N3]: VPM of the thalamus
Also known as arcuate nucleus or semilunar nucleus
Sensory cortex: post-central gyrus

Trigeminal
Nuclear
Complex

Sensory nuclei

Main sensory
Spinal
Mesensephalic

Motor nucleus of
CN V

Trigeminothalamic
Tract [TTT]
for pain, temperature
and light touch

Pattern:
1. Receptors
2. N1: Gasserian,
geniculate & superior
ganglia

fibers enter brainstem
at appropriate level
for each nerve

descend and enter
ipsilateral spinal tract
of V

Trigeminothalamic
Tract [TTT]
for pain, temperature
and light touch

Pattern (contd):
3. N2: spinal nucleus of V
mainly

fibers cross to
contralateral side of
brainstem & enter
Ventral TTT
4. N3: VPM of thalamus

Fibers enter posterior
limb of internal
capsule
5. Postcentral gyrus (face
area of Brodmann
areas 3, 1, & 2)

Trigeminothalamic
Tract [TTT]
for tactile sensation
and vibratory sense

Pattern:
1. Receptors
2. N1: Gasserian,
geniculate & superior
ganglia
3. N2: main sensory n. of
V & rostral part of spinal
n. of V

most fibers cross

some do not cross
and form Dorsal TTT

Trigeminothalamic
Tract [TTT]
for tactile sensation
and vibratory sense

Pattern (contd):
3. N3: VPM of thalamus

Fibers enter posterior
limb of internal
capsule
4. Postcentral gyrus (face
area of Brodmann
areas 3, 1, & 2)

Trigeminothalamic
Tract [TTT]
for conscious
proprioception

Pattern:
1. Receptors
2. N1: mesencephalic
nucleus of V
3. N2: main sensory n. of
V or reticular formation

fibers ascend
ipsilateral brainstem
in Dorsal TTT
4. N3: VPM of thalamus
5. Postcentral gyrus

* for unconscious proprioception,

N2 fibers pass into
cerebellum

DIRECT CORNEAL BLINK

REFLEX
LEFT

RIGHT
Touch Cornea
CN V1 (ophthalmic
div)
Gasserian ganglion
Spinal tract of V
Spinal nucleus of V

Motor nucleus of VII

orbicularis
oculi

CONSENSUAL CORNEAL
BLINK REFLEX
LEFT

RIGHT
Touch Cornea
CN V1 (ophthalmic
div)
Gasserian ganglion

orbicularis
oculi

Spinal tract of V
Spinal nucleus of V

Motor nucleus of VII

medial
longitudinal
fasciculus
Motor nucleus of VII

REFERENCES

Snell, R.S. Clinical Neuroanatomy, 7th ed.,

Lippincott Williams & Wilkins, 2010.
Carague-Lansang, E.N., et al. Lansang Notes:
Modules in Neuroanatomy, 4th ed., UERMMMC:
Quezon City, 2006.
Moore, K.L. and Dalley, A. F. Clinically Oriented
Anatomy, 6th ed., Lippincott Williams & Wilkins,
2010.
Gilman, S. and Newman, S.W. Manter and
Gatzs Essentials of Clinical Neuroanatomy and
Neurophysiology, 10th ed., F.A. Davis Co., 2003.
Netter, F.H. Atlas of Neuroanatomy and
Neurophysiology, Icon Custom Comm., 2002.