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The anterolateral system (ALS) is an ascending bundle of fibers in the spinal cord, carried in three main pathways or tracts. [1] The tracts convey pain, [6] temperature (protopathic sensation), and crude touch from the periphery to the brain. The most important of these is the spinothalamic tract. [2]
The tract transmits slow nociceptive/pain information (but thermal, and crude touch information as well) from the spinal cord to reticular formation which in turn relays the information to the thalamus via reticulothalamic fibers as well as to other parts of the brain (as opposed to the spinothalamic tract - the direct pathway of the ...
Cordotomy is performed as for patients with severe intractable pain, usually but not always due to cancer.Being irreversible and relatively invasive, cordotomy is used exclusively for pain where treatment to level 3 of the World Health Organization pain ladder (i.e., use of major opiates such as morphine) has proved inadequate.
Descending tracts are pathways by which motor signals are sent from upper motor neurons in the brain to lower motor neurons which then directly innervate muscle to produce movement. The anterior corticospinal tract is usually small, varying inversely in size with the lateral corticospinal tract , which is the main part of the corticospinal tract .
The first-order neurons from the trigeminal ganglion enter the pons and synapse in the principal (chief sensory) nucleus or spinal trigeminal nucleus.Axons of the second-order neurons cross the midline and terminate in the ventral posteromedial nucleus of the contralateral thalamus (as opposed to the ventral posterolateral nucleus, as in the dorsal column medial lemniscus (DCML) system).
The dorsal column–medial lemniscus pathway (DCML) (also known as the posterior column-medial lemniscus pathway (PCML) is the major sensory pathway of the central nervous system that conveys sensations of fine touch, vibration, two-point discrimination, and proprioception (body position) from the skin and joints.
Noxious stimuli activate the endings of nociceptive C and A delta nerve fibers, which carry the signal to neurons in the dorsal horn of spinal cord. DNIC refers to the mechanism by which dorsal horn wide dynamic range neurons responsive to stimulation from one location of the body may be inhibited by noxious stimuli (such as heat, high pressure or electric stimulation) applied to another ...
"Pain ladder", or analgesic ladder, was created by the World Health Organization (WHO) as a guideline for the use of drugs in the management of pain. Originally published in 1986 for the management of cancer pain , it is now widely used by medical professionals for the management of all types of pain .