Control pathways

Ascending Pathways

Dorsal column

• Fine touch, vibration, proprioception
• Runs ipsilaterally - decussate in medulla
• Sensations from Cervical neck travel in Cuneate tubercle
• Sensations from Legs (below T6) travel in graciLe tubercle

Spinothalamic

• Runs contralaterally - decussate in spinal cord (+1/2 levels above entry)

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Lateral tract - pain and temperature Anterior tract - crude touch + pressure

Dorsal column

Spinothalamic

Decending pathways

Pyrimidal tracts - voluntary movement

• Lateral corticospinal - 80%

• Voluntary movement of limbs

• Contrallateral

• Descussate at pyramids

• Anterior corticospinal - 20%

  • Movement of axial muscles
  • Bilateral innervation

• Rubrospinal tract - contralateral fine motor control

• Reticulospinal tract

  • Medial - facilitates muscle contraction $\uparrow$ tone
  • Lateral - inhibits contraction $\downarrow$ tone

• Vestibulospinal tract - balance and posture

• Tectospinal tract - coordination of head movements with vision

Trigeminal sensory nucleus

Trigeminal sensory nucleus

• All somatic sensory fibres from the face run within this nucleus to the ventroposteriolateral thalamus

• Mesencephalic nucleus - proprioception

• Pontine - discriminative touch

• Rostral spinal nucleus - simple touch + pressure

• Caudal spinal nucleus - pain and temperature