426 



HANDBOOK OF PHYSIOLOGY 



NEUROPHYSIOLOGY I 



with the frequently performed pain-relieving opera- 

 tions. Unfortunately such problems seem to be seldom 

 of interest to clinical observers. 



In regard to kinesthetic sensations considerable 

 progress has been achieved in recent years. First of 

 all, it is now apparent that the sense of position and of 

 movements of the joints depends solely on the appro- 

 priate receptors in the joints themselves. There is no 

 need to invoke a mysterious ' muscle' sense to explain 

 kinesthetic sensations, and to do so runs contrary to all 

 the known facts concerning the muscle stretch re- 

 ceptors. 



A second point is that kinesthetic activity is relayed 

 in the medial lemniscal system, as could have been 

 expected from clinical experiences in man. Cells con- 

 cerned with kinesthetic activity are intermingled at 

 each synaptic level with the cells concerned with the 

 activity evoked by tactile receptors, and the two 

 groups are arranged in one common representation 



pattern. The individual cells retain, as far as is known, 

 their modality specificity at least to the first stage of 

 cortical activation. 



A third fact of great interest is that receptors from 

 bones, periosteum, deep fascia and sheaths of tendons 

 activate the medial lemniscal system in exactly the 

 same fashion as do the tactile skin and joint receptors. 

 Whether kinesthetic and deep stimuli activate also the 

 spinothalamic system is unknown. 



At present the conclusion must be that touch, pres- 

 sure, kinesthesis and deep sensibility are all very 

 closely related. Yet this is not at all apparent from 

 introspective observations, at least not for touch and 

 kinesthesis. It seems likely that more will have to be 

 known about cortical handling of the neural activity 

 evoked \)y sensory stimuli before one can approach 

 such problems on other than a purely speculative 

 basis. 



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