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Neural Mechanisms of Cardiac Pain
Author Biography
Introduction
Anterolateral System
Somatic vs. Visceral Nociceptive Processing
Angina Pectoris
ympathetic Sensory Innervation
Referred Pain
Currently selected section: SVagal Sensory Innervation
Other Ascending Pathways
Central Sensitization
Thalamus and Cerebral Cortex
Neurophysiology of Angina Pectorsis
Nausea and Vomiting

Dyspnea
Summary

 

Chapter 25:Neural Mechanisms of Cardiac Pain: Vagal Sensory Innervation
         Vagal influences on upper cervical neurons

The specific anatomical connections that allow vagal afferents to affect upper cervical neurons are not established (Figure 5)

The vast majority of vagal afferents terminates in the region of the nucleus of the solitary tract (NTS). Projections from NTS to the upper cervical spinal segments have not been described.

There are some direct vagal projections to the upper cervical segments; these could be either branches of vagal afferents that terminate in NTS or sensory fibers that terminate in the spinal cord rather than NTS (McNeil et al., 1991).

Another possibility is a relay through the parabrachial and subcoeruleus regions in the dorsolateral pons, because vagal stimulation excites neurons in these pontine regions, and the dorsolateral pons has known spinal projections (Ren et al., 1990).

Any or all of these projections could account for vagal influences on upper cervical spinothalamic tract neurons.

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