The gracile and cuneate nuclei, also called the dorsal column nuclei, lie in the lower medulla where the dorsal columns of the spinal cord end. Here fine touch, vibration and position sense fibres make their first synapse. The second-order fibres then cross the midline as the internal arcuate fibres to form the medial lemniscus.
| Location | Dorsal surface of the lower medulla, beneath the gracile and cuneate tubercles on either side of the midline |
|---|---|
| Parts |
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| Connections |
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| Blood Supply | Posterior spinal arteries; Posterior inferior cerebellar artery |
Relay fine touch, vibration and conscious proprioception from the body to the opposite thalamus.
Lesions at or below these nuclei cause loss of vibration and position sense on the same side, while lesions above the crossing cause loss on the opposite side. Chiari malformation and foramen magnum tumours can compress this area, producing numbness and clumsiness of the hands. The accessory cuneate nucleus relays arm proprioception to the cerebellum.
Pressure from tumours or Chiari malformation at the cervicomedullary junction causing sensory loss, clumsy hands and neck pain.
Unsteadiness worse with eyes closed (positive Romberg sign) from loss of proprioceptive relay in the dorsal column-medial lemniscus pathway.
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