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in: Pain, Nociception, Sensory system, Central nervous system pathways

Anterolateral system

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In the nervous system, the anterolateral system is an ascending pathway that conveys pain, temperature (protopathic sensation), and crude touch from the periphery to the brain. It comprises three main pathways:

Name Destination Function
spinothalamic tract (lateral and anterior) thalamus important in the localization of painful or thermal stimuli
spinoreticular tract reticular formation causes alertness and arousal in response to painful stimuli
spinotectal tract tectum orients the eyes and head towards the stimuli

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v·d·e
Pain and nociception
Head and neck

Jaw and mouth (Odynophagia )  • Ear (otalgia, otitis media, otitis externa)  • Eye (glaucoma)
Head (headache, migraine, tension headache, cluster headache, cerebral aneurysm,
sinusitis, meningitis) Neck (atypical myocardial infarction)

Thorax

Back (upper back, lower back, spinal disc herniation, degenerative disc disease, coccydynia)
Breast (perimenstrual, breast cancer)  • Chest (myocardial infarction, gastroesophageal reflux disease,
pancreatitis, hiatus hernia, aortic dissection, asymptomatic pulmonary embolism, Tietze's syndrome)
Shoulder (right side - cholecystitis)

Abdominal

Left and right upper quadrant (peptic ulcer disease, gastroenteritis, hepatitis, pancreatitis,
cholecystitis, atypical myocardial infarction, abdominal aortic aneurysm,
asymptomatic gastric cancer)  • Left and right lower quadrant (appendicitis, ulcerative colitis,
Crohn's disease, ectopic pregnancy, endometriosis, pelvic inflammatory disease, diverticulitis,
urolithiasis, pyelonephritis, colorectal cancer)

Limbs

Arm (myocardial infarction, left arm)  • Leg (deep vein thrombosis,
peripheral artery occlusive disease, claudication, spinal disc herniation, sciatica)

Joints (arthralgia)

Small joints (osteoarthritis, rheumatoid arthritis, systemic lupus erythematosus, gout, pseudogout  •
Large joints (osteoarthritis, septic arthritis, hemarthrosis, osteonecrosis)  •
Back joints (ankylosing spondylitis, inflammatory bowel disease)  • Other (psoriatic arthritis,
reactive arthritis)

Musculoskeletal

Delayed onset muscle soreness, myalgia, physical trauma

Other/unspecified

cold pressor test, congenital insensitivity to pain, dolorimeter,
HSAN (Type I, II congenital sensory neuropathy, III familial dysautonomia,
IV congenital insensitivity to pain with anhidrosis,
V congenital insensitivity to pain with partial anhidrosis), neuralgia, pain asymbolia, pain disorder,
paroxysmal extreme pain disorder  • Allodynia, breakthrough pain, chronic pain, hyperalgesia,
hypoalgesia, hyperpathia, phantom pain, referred pain

Related concepts

Anterolateral system, gate control theory of pain, pain management (anesthesia, cordotomy),
pain scale, pain threshold, pain tolerance, posteromarginal nucleus, substance P, suffering, OPQRST

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