Trigeminal System.

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Trigeminal System

Useful animations: Readings: https://www1.columbia.edu/sec/itc/hs/medical/neruoanatomy/neuroanat/ Somatic sensory: A007 Sensory cranial: F003 Sensory cranial: F004 Somatic sensory: AN01 Somatic sensory: A006 Readings: Principles of NS General somatic sensory organization: 447-449 Brain stem/cranial nerve review: 873-880 Sensory nuclei : 880-882, Fig 44-6

Nociceptors, thermoreceptors, & itch receptors are bare nerve endings Mechanoreceptors are encapsulated Bare nerve ending Merkel’s receptor Meissner’s corpuscle Pacinian corpuscle

Dorsal horn Anterolateral system: spino-thal spino-retic spino-mesen

Components of the trigeminal system Spinal nucleus Caudal nucleus Pain/temp/itch Interpolar nucleus Pain/reflexes, etc, ??? Oral nucleus Reflexes, etc, ??? Main sensory nucleus Mechanosensation Mesencephalic nucleus Jaw proprioception Motor nucleus Jaw muscles

Mesencephalic Trigeminal motor Main sensory Spinal trigeminal nuc: oral interpolar caudal

Organization of the spinal trigeminal nucleus: caudal nucleus

3 2 1 Interpolar nucleus 3 Caudal nucleus 2 1 Upper spinal cord Ophthalmic division Maxillary division Mandibular division 7, 9, & 10 3 C2 2 1 C2 Interpolar nucleus 3 Caudal nucleus 2 1 C2 Upper spinal cord

Input: Small-diameter fibers Marginal zone Substantia gelatinosa Spinal trigeminal tract Caudal nucleus Output: Marginal zone-->Thalamus, midbrain Substantia gelatinosa-->interneurons

Spinal trigeminal tract Caudal nucleus Anterolateral system

Main sensory Anterolateral/ trigeminothal Trigeminal motor lemniscus Medial Main sensory Anterolateral/ trigeminothal Trigeminal motor Medial/ trigeminal lemniscus

Mesencephalic Nucleus &tract

Mesencephalic Nucleus &tract

Somatic Sensory Thalamus Medial dorsal Ventral posterior (VMpo) Ventral posterior medial-VPM (trigem) Ventral posterior lateral-VPL (spinal) Touch Pain

Anterolateral and Trigeminal Systems Ventral posterior-->Postcentral gyrus •localization

Anterolateral System Ventral medial post-->Insular •behavioral & •autonomic responses •“Limbic” Amygdala

Anterolateral and Trigeminal Systems Medial dorsal-->Cingulate gyrus •emotional (-valence…) •“Limbic”

Pain suppression path - Limbic cortex Periaqueductal gray matter Raphe nuclei (5-HT) - Caudal nucleus

Trigeminal System Separate components for pain and touch Brain stem nuclei: Caudal nucleus (pain) Interpolar nucleus (caudal part for pain-mouth) Oral nucleus (???) Main sensory nucleus 3 Separate thalamic pain nuclei & 1 for touch: Pain (VPM, VMpo, MD) Touch (VPM) 3 Separate cortical representations: Postcentral gyrus (localization) Insular (important for pain) Cingulate (emotions, esp. for pain) Pain suppression system PAG-->Raphe nuclei (5-HT)-->Caudal nucleus

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