Pain Tutorial

Ascending and descending pathways of the spinal cord

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Metastasis of secondary tumours via the lymphatic system and venous pathways (e.g. from breast and prostate) can occur easily to locations close to the spinal cord because the pelvic and thoracic veins are connected to the internal vertebral venous plexuses via Batson's veins - a system of valveless veins. So the scenario described in this exercise reflects a situation that occurs commonly.

You should have learned from this exercise how different types of information travel to and from the brain via the spinal cord and, in particular, learned how pathways are arranged in the spinal cord and where they decussate. The phenomena described in the case study display some of the characteristics of 'Brown-Sequard' syndrome which occurs when there is unilateral hemisection of the spinal cord such that there is ipsilateral loss of motor function and non-noxious mechanosensation with contralateral loss of nociception and thermal sensitivity.