94 Cranial Nerves

Pain and Temperature Pathway

Pain and temperature sensation is carried by a much more primitive,
widespread pathway than discriminative touch. In addition to the objective
localization of pain sensation, the central pathways provide for activation of
the limbic system and the activation of the fight or flight response that may be
an appropriate response to pain. The trigeminal pain and temperature pathway
also includes three principal neurons (see Figure V-12).
1.The primary or first-order neuron carries impulses from the periphery to the
central nervous system. The central processes enter the pons along with the
central processes of the discriminative touch neurons. Once they have entered
the brain stem, they turn caudally and descend within the brain stem forming
the tract of the spinal trigeminal nucleus before terminating within the
appropriate parts of the nucleus.
2. Cell bodies of the second-order sensory neuron form the spinal trigeminal
nucleus. Their axons cross the midline and join the spinal lemniscus en route to
the thalamus where they terminate within the intralaminar and ventral posterior
thalamic nuclei medial to the discriminative touch neurons. These axons also
send collateral branches to the reticular formation in the brain stem, providing
for arousal and visceral responses to pain.
3. Axons of third-order (thalamic) neurons project to the appropriate region of
the sensory cortex where the sensory signals are consciously perceived.
Light or simple touch is poorly localized and is probably carried by both
the discriminative touch and pain and temperature pathways.

In both discriminative touch and pain and temperature pathway, a small

number of second-order sensory axons representing the mouth and
perioral region ascends ipsllateraily to the ventral posterior nucleus of the
thalamus providing for a degree of bilateral representation of the face
within the sensory cortex.

BRANCHIAL MOTOR (EFFERENT) COMPONENT

Central Motor Nuclei: Innervation of the Masticator Nucleus
The trigeminal motor (masticator) nuclei are located in the tegmentum of the
pons, medial to the pontine trigeminal nuclei (Figure V—13). They innervate
the muscles of mastication (ie, masseters, temporales, medial and lateral
pterygoid muscles, plus tensores tympani, tensores veli palatini, mylohyoid
muscles, and anterior bellies of the digastric muscles).
In humans, jaw movements have two functions: a primitive function in
masticating food and an important function in articulating speech sounds.
Since chewing is primarily a reflex activity in response to sensory signals from
the mouth, the