856 NEUROLOGY 





conscious recognition of impulses. The descending fibers in the spinal tract of the 

 trigeminal terminating in the nucleus of the tract probably establish relations 

 through connecting neurons with motor nuclei in the anterior column of the spinal 

 cord and with motor nuclei of the medulla. 



(2) The sympathetic afferent fibers are usually described as terminating in the 

 dorsal nucleus of the vagus and glossopharyngeal. Some authors, however, believe 

 they join the tractus solitarius and terminate in its nucleus. These afferent fibers 

 convey impulses from the heart, the pancreas, and probably from the stomach, 

 esophagus and respiratory tract. Their terminals in the dorsal nucleus come into 

 relation with neurons whose axons probably descend into the spinal cord, conveying 

 impulses to the motor nuclei supplying fibers to the muscles of respiration, i. e., 

 the phrenic nerve and the nerves to the intercostal and levatores costarum muscles. 

 Other axons probably convey vasomotor impulses to certain sympathetic efferent 

 neurons throughout the spinal cord. The dorsal nucleus (nucleus of the ala cinerea) 

 and the posterior continuation of it into the commissural nucleus of the ala cinerea 

 constitute probably the so-called respiratory and vaso-motor center of the medulla. 

 The shorter reflex neurons of the dorsal nucleus probably effect connections 

 either directly or indirectly with motor cells of the vagus itself and other cranial 

 nerves. 



(3) Taste fibers conducting impulses from the epiglottis and larynx are supposed 

 to pass in the vagus and to join the tractus solitarius, finally terminating in the 

 nucleus of the tractus solitarius. It is not certain that this nucleus represents the 

 primary terminal center for taste and some authors maintain that the taste fibers 

 terminate in the dorsal nucleus. The secondary ascending pathways from the 

 primary gustatory nucleus to the cortex as well as the location of the cortical 

 center for taste are unknown. A gustatory center has been described near the ante- 

 rior end of the temporal lobe. The nucleus of the tractus solitarius is connected 

 with motor centers of the pons, medulla and spinal cord for the reactions of mastica- 

 tion and swallowing. 



(4) Somatic motor fibers to the cross striated muscles of the pharynx and larynx 

 arise in the nucleus ambiguus. This nucleus undoubtedly receives either directly 

 or indirectly collaterals or terminals from the opposite pyramidal tract controlling 

 the voluntary movements of the pharynx and larynx. The reflex pathways con- 

 veying impulses from the terminal sensory nuclei are unknown, but probably form 

 part of the intricate maze of fibers constituting the reticular formation. 



(5) Sympathetic efferent fibers arise from cells in the dorsal nucleus (nucleus of 

 the ala cinerea). These are preganglionic fibers of the sympathetic system and all 

 terminate in sympathetic ganglia from which postganglionic fibers are distributed to 

 various organs, i. e., motor fibers to the esophagus, stomach, small intestine, gall- 

 bladder, and to the lungs; inhibitory fibers to the heart; secretory fibers to the 

 stomach and pancreas. The dorsal nucleus not only receives terminals of sym- 

 pathetic afferent fibers for reflexes but undoubtedly receives terminals and collaterals 

 from many other sources, but the exact pathways are at present unknown. 



The Glossopharyngeal Nerve (IX cranial} is similar to the vagus nerve as regards 

 its central connections and is usually described with it. It contains somatic sensory, 

 sympathetic afferent, taste, somatic motor and sympathetic efferent fibers. The 

 afferent sensory fibers arise from cells in the superior ganglion and in the petrosal 

 ganglion. The same uncertainty exists concerning the nuclei of termination and 

 nuclei of origin of the various components as for the vagus. 



(1) The somatic sensory fibers are few in number. Some are distributed with 

 the auricular branch of the vagus to the external ear; others probably pass to the 

 pharynx and fauces. They are supposed to join the spinal tract of the trigeminal 

 and terminate in its nucleus. The connections are similar to those of the somatic 

 sensory fibers of the vagus. 



