Trunk nerves (intercostal, sympathetic, vagus nerve)
Gracile fasciculus (column of Goll)
Fasciculus gracilis
- Origin
- Medial part of the posterior column, built from the ascending branches of the posterior roots from Co1 up to and including T7
- Insertion
- Ends in the gracile nucleus in the medulla oblongata; the pathway then crosses as the medial lemniscus and continues to the thalamus
- Function
- Carries fine touch, vibration sense and conscious proprioception from the lower half of the body upwards, uncrossed
- Innervation
- Somatosensory, uncrossed up to the medulla oblongata
- Movement & chain
- Reports the position of the legs and lower trunk
- Palpation
- Not palpable; tested with a tuning fork for vibration sense, position sense of the toes and the Romberg test
- Clinical
- Posterior column disease with sensory ataxia and a positive Romberg test, in subacute combined degeneration from vitamin B12 deficiency, tabes dorsalis and posterior column compression. Vibration sense is the first to go, and it goes at the feet first.
- Segmental innervation
- Carries the segments below T6, that is T7-Co1
- In clinical practice
- Testing vibration and position sense when B12 deficiency or polyneuropathy is suspected, and fall prevention in sensory ataxia, because the patient falls in the dark or with the eyes closed
- Region in the model
- Trunk nerves (intercostal, sympathetic, vagus nerve)