Fasciculus cuneatus (lateral dorsal column)

First-order neurone / UMN · above T6 ipsilateral lateral

First-order axons from above T6 (upper limb, upper trunk and neck) ascend on the same side lateral to the gracile fasciculus, separated from it by the posterior intermediate sulcus, and synapse in the nucleus cuneatus of the caudal medulla. It exists only above T6, so the dorsal column is widest in the cervical cord.

Traced from the start

  1. Cutaneous mechanoreceptors (Meissner, Pacinian, Merkel, Ruffini)Proprioceptors (muscle spindle, Golgi tendon organ, joint receptors)
  2. Fasciculus cuneatus (lateral dorsal column)

Detail

Input
Above T6: upper limb, upper trunk and neck
Side
Ipsilateral
Position
Lateral dorsal column; present only above T6
Ends in
Nucleus cuneatus, caudal medulla

When it goes wrong

Cervical posterior column lesion (multiple sclerosis plaque, cervical spondylotic myelopathy)

Loss of vibration and joint position sense in the hands with a clumsy 'useless hand', pseudoathetosis, and Lhermitte's phenomenon (electric shock down the spine on neck flexion)

Practise this structure

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