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1、Systematic Anatomy,Dept of Anatomy, Medical College, Qingdao University,1,THE NERVOUS PATHWAYS (神经传导路),A. The Sensory (Ascending) Pathways(感觉传导通路) B. The Visual and Pupillary Reflexes Pathways (视觉传导通路和瞳孔对光反射通路) C. The Acoustic Pathway (听觉传导通路) D. The Equilibratory Pathway (平衡觉传导通路) E. The Motor (Des
2、cending) Pathways (运动传导通路),Systematic Anatomy,Dept of Anatomy, Medical College, Qingdao University,2,A. The Sensory (Ascending) Pathways,1. Deep & discriminatory sensation Proprioceptive (deep) sense (本体感觉): body posture, movement, vibration and pressure.discriminatory sense (精细触觉): size, shape, tex
3、ture and two point discrimination.,Systematic Anatomy,Dept of Anatomy, Medical College, Qingdao University,3,Receptors muscle spindles tendon spindles Pacinis corpuscles (肌梭,腱梭,P小体),I,II,Med. Lemniscus (内侧丘系),III,丘脑皮质束(丘脑中央辐射,cerebral centersCortex of the sup. and middle parts of postcentral gyrus.P
4、osterior part of paracentral lobule (中央后回上中部皮质,中央旁小叶后部),Spinal nn.(脊N) (薄束T4,楔束T4),(内侧丘系交叉),(薄束核,楔束核),(脊神经节),(丘脑腹后外侧核),(内囊后肢),(内弓状纤维),1) Conscious proprioceptive sensory pathways (意识性本体感觉传导通路),Systematic Anatomy,Dept of Anatomy, Medical College, Qingdao University,4, 1) Conscious proprioceptive sens
5、ory pathways,Systematic Anatomy,Dept of Anatomy, Medical College, Qingdao University,5,Receptors muscle spindles tendon spindles Pacinis corpuscles (肌梭,腱梭,P小体),(脊N) (后根),I (脊神经节),II (后角核层),cerebellar centercortex ofcerebellum (小脑皮质),ant. white commissure(脊髓白质前连合) ,thoracic nucleus (胸核),sup. cerebell
6、ar peduncle (小脑上脚),脊 髓 小 脑 前 束,(小脑下脚) (脊髓小脑后束),2) unconscious proprioceptive sensory pathway (非意识性本体感觉传导通路),Systematic Anatomy,Dept of Anatomy, Medical College, Qingdao University,6,Receptors free n. endings (痛) Krauses endbulbs (冷) Ruffini endorgans (热),I,II,(脊髓丘系) (脊髓丘脑侧束),III,丘脑皮质束 (丘脑中央辐射),cereb
7、ral centersCortex of the sup. and middle parts of postcentral gyrus.Posterior part of paracentral lobule (中央后回上中部皮质,中央旁小叶后部),Spinal nn.(脊N) 上升1-2节后外侧束,(脊髓前白连合),(脊髓后角固有核),(脊神经节),(丘脑腹后外侧核),(内囊后肢),2. Superficial sensation 1) Pathway of Pain & Thermal sensation of the Trunk & Limbs (躯干和四肢痛温觉传导通路),System
8、atic Anatomy,Dept of Anatomy, Medical College, Qingdao University,7,1) Pathway of Pain & Thermal sensation of the Trunk & Limbs,Systematic Anatomy,Dept of Anatomy, Medical College, Qingdao University,8,Receptors free n. endings (痛) Krauses endbulbs (冷) Ruffini endorgans (热),I,II,trigeminal lemniscus
9、 (三叉丘系),III,int. cap.内 囊 后 肢,cerebral centerscortex of the inferior part of postcentral gyrus.(中央后回下部皮质),(三叉神经脊束核) ,(V神经节),(丘脑腹后内侧核),(三叉神经) (三叉神经脊束),丘脑中央辐射(丘脑皮质束), 2) Pain & Thermal Sensation of Head and Face (头面部痛温觉),Systematic Anatomy,Dept of Anatomy, Medical College, Qingdao University,9, 2) Pain
10、 & Thermal Sensation of Head and Face (头面部痛温觉),Systematic Anatomy,Dept of Anatomy, Medical College, Qingdao University,10,(损伤部位),感觉障碍表现,Peripheral NS (周围神经),Spinal Cord (脊髓),Internal capsule (内囊),Centers(中枢),Thalamus(丘脑),(脑干延髓),subcutaneous nerve (皮神经): 全部感觉消失,无汗 mixed nerve (混合神经): 全部感觉消失,支配肌肉软瘫 po
11、sterior root 后根): 节段性全部感觉消失,(交叉性痛温觉消失:同侧面部,对侧躯体),(偏身,多伴有自发性痛疼),(对侧三偏: 硬瘫,痛、温、 本体、精细触觉消失, 视觉同向消失),(对侧相应区感觉消失),posterior horn (后角): 同侧节段低1-2节痛温觉消失, Ant. commissure (白质前连合): 对称节段性痛温觉消失 Tract (传导束): 分离性感觉消失),Summary of Sensory Disturbance (感觉障碍小结),Systematic Anatomy,Dept of Anatomy, Medical College, Qin
12、gdao University,11,RECEPTORS free n. endings (毛囊周围神经末梢 tactile corpuscles(触觉小体),I,II,III,丘脑中央辐射(丘脑皮质束),内 囊 后 肢,CEREBRAL CENTERScortex of the sup. and middle parts of postcentral gyrus.Posterior part of paracentral lobule (中央后回上中部皮质,中央旁小叶后部),spinal nn.(脊N),(脊髓白质前连合),(脊髓后角固有束核),(脊神经节),(丘脑腹后外侧核),(脊髓丘系)
13、 (脊髓丘脑前束),3) Tactile Pathway of Trunk and Limbs (躯干四肢触觉),Systematic Anatomy,Dept of Anatomy, Medical College, Qingdao University,12,RECEPTORS free n. endings (毛囊周围神经末梢 tactile corpuscles(触觉小体),I,II,trigem. lemniscus(三叉丘系),III,丘脑中央辐射(丘脑皮质束),CEREBRAL CENTERScortex of the inferior part of postcentral g
14、yrus.(中央后回下部皮质),trigeminal n.(三叉N),(脑桥内交叉),(三叉神经脑桥核),(V神经节),(丘脑腹后内侧核),内 囊 后 肢,4) Tactile Pathway of Head and Face (头面部触觉),Systematic Anatomy,Dept of Anatomy, Medical College, Qingdao University,13,RECEPTORS rod cells (视杆细胞) cone cells (视锥细胞),II,鼻 侧,optic tract (视束),III,视辐射(膝距束),CEREBRAL CENTERSbanks
15、 of the calcarine sulcus( lingual gyrus & cuneus)(距状沟两侧皮质) (舌回和楔叶),bipolar c. (双极细胞),(视交叉),(节细胞),(双极 细胞),(外侧膝状体) ,颞 侧,I,optic n. (视N) ,内 囊 后 肢 后部,3. Visual & pupillary reflexes 1) The visual pathway (视觉传导通路),Systematic Anatomy,Dept of Anatomy, Medical College, Qingdao University,14,3. Visual & pupil
16、lary reflexes 1) The visual pathway,Systematic Anatomy,Dept of Anatomy, Medical College, Qingdao University,15,视觉传导通路及瞳孔对光反射通路：,双极细胞,外侧膝状体,距状沟两侧,节细胞,视束,视锥细胞视杆细胞,视神经,颞 侧,鼻 侧,顶盖前区,动眼神经副核 （双侧）,动眼神经,睫状神经节（双侧）,瞳孔括约肌睫状肌（双侧）,Systematic Anatomy,Dept of Anatomy, Medical College, Qingdao University,16,视觉传导通路及
17、瞳孔对光反射通路： 1. 视觉传导通路： 视网膜中光感受器细胞视锥、视杆细胞，第一级神经元为双级细胞、第二级神经元节细胞，轴突成视神经、经视神经管入颅、经视交叉（视网膜鼻侧半交叉、视网膜颞侧半不交叉），入同侧视束，终止外侧膝状体、外侧膝状体内第三级神经元组成视辐射经内囊后肢投射到端脑距状沟两侧视区，产生视觉。2. 瞳孔对光反射通路：视束纤维经上丘臂于顶盖前区、由此到双侧动眼神经副核，动眼神经副核到睫状神经节换元，节后纤维支配瞳孔括约肌收缩，瞳孔缩小 。 Wilbrand前袢：其中来自视网膜鼻侧半下象限的纤维，向腹侧经视交叉前缘至对侧视神经，向前可达3mm作袢状弯曲，沿视交叉外侧缘后行至对视束。 Wilbrand后袢：其中来自视网膜鼻侧半上象限的纤维，经视交叉向后至同侧视束吻端，作袢状弯曲，经视交叉后缘上方交叉至对侧视束。,
