Descending motor pathways / tracts:

1) 2) PYRAMIDAL / CORTICO-SPINAL. EXTRA-PYRAMIDAL / EXTRA CORTICOSPINAL. (All the descending motor pathways, other than pyramidal are called extrapyramidal).

PYRAMIDAL TRACTS:
Consist of 1 million fibers. Mostly myelinated fibers, but slow conducting. Tract originates from cerebral cortex. 30% of fibers originate from primary motor area. Another 30% from pre-motor area & supplementary motor area. 40% from somatic sensory area of cerebral cortex. All these fibers converge through corona-radiata towards internal capsule. In internal capsule, the tract occupies the genu (the bent portion) & anterior 2/3 of posterior limb. Then tract passes into midbrain, where it occupies middle 3/5 of cerebral peduncle / crus cerebri. When tract passes through the internal capsule, fibers for cervical parts of body are in genu & fibers for lower parts of body are in posterior limb of internal capsule.

Fibers converge through

Corona radiata towards internal capsule

Ant. 2/3 of post. Limb of int. cap has fib for Lower parts of body Genu of int. capsule has fibers for cervical parts of body

MID BRAIN In cerebral peduncle, fibers for lower parts are lateral PONS

In cerebral peduncle, fibers for cervical parts are medial Transverse pontocerebellar fibers break the tract into small bundles

PONS

MEDULLA PYRAMID

LOWER MEDULLA 80% fibers cross MOTOR DECUSSATION

SPINAL CORD
Lat cortico-spinal tract

Ant cortico-spinal tract

BETZ CELLS

45% CERVICAL

3% fibers, no inter-neurons

Other fibers, inter-neurons

20%

THORACIC

Alpha / gamma motor neuron

35%
LUMBAR

SPINAL CORD

SPINAL CORD

CORTEX

CORTICO BULBAR FIBERS

CORTICO SPINAL TRACT

SPINAL CORD

BRAIN STEM CRANIAL NERVE NUCLEI

 In cerebral peduncle, fibers for cervical parts of body are medial & fibers for lower parts are lateral. From midbrain, tract enters the pons, where tract is broken into small bundles by transverse pontocerebellar fibers. When these bundles enter medulla, these gather / unite along the anterior border of medulla to form the pyramid (a swelling). The tract is named pyramidal because of pyramid formation along anterior border of medulla. In lower part of medulla, 80% of fibers cross over to opposite side, to form MOTOR DECUSSATION. (Sensory decussation: fibers from nucleus gracilus & cuneatus).

Fig 55-4, Guyton

 After motor decussation, crossed fibers enter lateral white columns of spinal cord to form lateral corticospinal tract. Fibers of tract which remain uncrossed, enter anterior white column of spinal cord to form anterior corticospinal tract. Fibers of anterior cortico-spinal tract terminate in ventral horn of cervical & upper thoracic segments of spinal cord. These fibers terminate onto motor neurons ( aplha & gamma). It is thought that these fibers are from supplementary motor area, for control of attitudinal or positional movements,e-g, in climbing posture.

Fig 55-4, Guyton

 Fibers of lateral cortico-spinal tract terminate onto the motor neurons in ventral horn of spinal cord at various levels. From cortico-spinal tract as a whole, 45% fibers terminate in cervical segments, 35% in lumbar & 20% in thoracic segments of spinal cord.

 Most of cortico-spinal fibers for their termination first synapse with interneurons which in turn synapse with motor neurons (alpha & gamma). Only fibers which arise from Betz cells (Giant pyramidal cells), which form only 3% fibers, terminate directly into motor neurons.

 Certain branches of cortico-spinal tract go to different brain parts: To caudate & lentiform nuclei. To red nucleus. To olivary nuclei & reticular formation. There are also cortico-bulbar fibers which come along cortico-spinal tract. In the brain stem these fibers cross over to opposite side to terminate with motor neurons in nuclei of cranial nerves.

Fig 55-5, Guyton