Hrain sonal cord Stem Root oang 0 NOdose Ganglion sympathetic Ganglion Intrinsic Prmary nna Afferent Neurons Pnmary AMeren Afferent Neurons Neurons LM c Mucosal Chemical 8 Intestinofuga Mechano- Stretch Neuron sC15.NC sens tve CM Neuron Neurone SM
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1. Pathway to the central nervous system (1) Vagus Afferent(迷走神经传入纤维) Medulla Cell body: superior and Filter to overt pain perception inferior jugular and Cental amy Modulation of pain perception nodose) vagal ganglia Hypothalamus interpretation of extemal stimuli Vagal afferent Atitude ☆ Direct input: Mood >nucleus tracuts solitarius (nTS);(孤束核) Non-perceptional aspects of pain Emotionak-affective responses >dorsal motor nucleus of Sickness behaviour Nausea the le vagus (DMV);(迷走 Cytokines Hormones Regulation of digestive function 神经背核) Transmitters Energy and fluid balance Autonomic reflexes the area postrema(最 Food stimuli Neuroendocrine reflexes Distension 后区) v Peripheral trigger for vomitin
17 1. Pathway to the central nervous system (1) Vagus Afferent （迷走神经传入纤维） ❖Cell body: superior and inferior (jugular and nodose) vagal ganglia ❖Direct input: ➢nucleus tracuts solitarius (nTS); （孤束核） ➢dorsal motor nucleus of the vagus (DMV); （迷走 神经背核） ➢the area postrema （最 后区） ✓Peripheral trigger for vomiting
☆ Projection from nTS Reflex connection with other brain stem nuclei: vago-vagal reflex V To pregangl inoic neurons √DMV Nuclues ambiguus Intermediolateral column(中间外侧柱) of the spinal cord Motorneurons supply the face and salivary glands Through the midbrain中脑 and reticular nuclei网状核团 to higher centers: processing of afferent information, mechanism unknown Hypothalamus √ Limbic system
18 ❖Projection from nTS ➢Reflex connection with other brain stem nuclei: vago-vagal reflex ✓To preganglinoic neurons ✓DMV ✓Nuclues ambiguus ➢Intermediolateral column （中间外侧柱）of the spinal cord ➢Motorneurons supply the face and salivary glands ➢Through the midbrain 中脑 and reticular nuclei 网状核团 to higher centers: processing of afferent information, mechanism unknown. ✓Hypothalamus ✓Limbic system
2)Spinal afferent Cell body: dorsal root postsynaptic receptors at Lh. a Presynaptic receptors at dorsal horn level: dorsal horn level: ganglia NMDA AMPA - CCK GABAA >Input: to the cord CGRP SST 5-HT 5-HT. 5-HT through the dorsal roots 6.K H opioid (u, 8, K) adrenergic a, adrenergic Visceral convergence gaba and referred pain(牵涉 痛) d Mediators contained in visceral Projection to the brain primary afferents: glutamate, aspartate Via spinothalamic tract SP NKA NKB CGRP spinoreticular tract and somatostatin dorsal columns VIP galanin >Generally nociceptive
19 (2) Spinal Afferent ❖Cell Body: dorsal root ganglia ➢Input: to the cord through the dorsal roots ➢Visceral convergence and referred pain （牵涉 痛） ❖Projection to the brain: ➢Via spinothalamic tract, spinoreticular tract and dorsal columns. ➢Generally nociceptive
2. Gastrointestinal receptors free naked endings situated at different levels within and outside the wall of the viscera ☆ Mucosal Receptors(粘膜受体) >Lie in or immediately below the mucosal epithelium > Detect the physical and chemical nature of luminal contents ☆ Muscle receptors(肌肉受体) > Deep in the muscularis externae area >Influenced by changes in muscle tension ☆ Serosal and mesenteric receptors(浆膜和肠系膜受体) >Lie beneath the serosa or in the mesenteric attachments Sensitive to movements and distortion of the viscera
20 2. Gastrointestinal Receptors: free naked endings situated at different levels within and outside the wall of the viscera ❖Mucosal Receptors （粘膜受体） ➢Lie in or immediately below the mucosal epithelium ➢Detect the physical and chemical nature of luminal contents ❖Muscle Receptors （肌肉受体） ➢Deep in the muscularis externae area ➢Influenced by changes in muscle tension ❖Serosal and Mesenteric Receptors （浆膜和肠系膜受体） ➢Lie beneath the serosa or in the mesenteric attachments ➢Sensitive to movements and distortion of the viscera