tract
And corticobulbar tract
Peculiarities:
Thala.
Corona
radiata
Motor cortex
Post limb
III, IV
Cerebral
peduncles
Internal capsule
C.N.
Mid brain
Post.
V, VI, VII
Long.
fasciculi
Pons
Ant.
IX,XI,XII
Medulla
Pyramids
decussation
Lat. CST
SP.Cord
Ant.CST
Motor cortex
Internal capsule
Corticobulbar fibers
Decussasion of pyramids
Ant. corticospinal
Lat. Cortico spinal
Origin:1. Primary motor cortex (area 4 ) 30% (3% large pyramidal cells- Betz cells )
2. Premotor cortex (area 6 ) & area 8 -30%
3. Somatosensory cortex (SI & SII) (3,1,2 & 40)
parietal lobe association areas (5,7) 40%
Course :-
Lat. CST
Through
interneurons
TO
To
To cerebellum
Reticular n. reticulospinal
Vestibular n. vestibulospinal
Pontine n. pontocerebellar
Olivary n. olivocerebellar
III, IV
Pons
V, VI, VII
Medulla
Functions
control vol. movement of muscles of larynx,
pharynx, palate, face, jaw and eyes.
Clinical picture in Pyramidal tract lesionsLesion above the level of sp. Cord effects on
opposite side of body
Lesion in the spinal cord effects on the same side
Impairment of vol., skilled movements
Increased muscle tone clasp knife rigidity
Exaggerated tendon reflexes and clonus
Extensor planter reflex Babinskis response
loss of superficial reflexes
Toes down
(flexion)
Fanning
of toes
Corticobulbar tract
Facial nerve n.
Facial nerve
Facial paralysis
Functions of E.P.S.
1. Alternative channel for Vol.
and reflex activity
2. Coarse movements of trunk &
whole limb.
3. Changing tone of muscle
4. Background posture
EXTRAPYRAMIDAL TRACTS
Motor fibers arising from subcortical
areas
brain descending outside the corticospinal
tract,
-- reaching sp.cord
-- Ending on or motor neurons
--ipsilat. Or contralat.
--Multichannel system
EPS
1.Rubrospinal
2.Tectospinal
3.Lat. Vestibulospinal
4.Medial vestibulospinal
5.Pontine reticulospinal
6.Medullary reticulospinal
RRTV
Midline
cortex
putamen
C.N.
S.N.
Red n.
cerebellum
S.C.
Vesti. N.
+
-
-
+
Rotation of head
Linear acceleration
Semicircular
canals
Medial vesti. N.
Utricle, saccule
Lat. vesti.
N.
Uncrossed
Uncrossed fibers
fibers
III. Medial vestibulospinal IV. Lat. vestibulospinal
Ant. White
column
Lat White
column
-motor neurons
Through out the length of sp.
cord
Facilitation of extensors and inhibition of
FUNCTIONS OF EPS
Control of tone, posture and equilibrium
Control of complex movements of the
body and limbs
Tonic inhibitory control over lower centers
Monosynaptic
Flexors of hand
and fingers
Functions
Skilled
movements
Effects of
During iu life
polysynaptic
Lower extremity
Postural
muscles
Gross
movements
LMNP
Site of
lesion
- or cranial
motor
neuron
-single muscle
on the same
sidelost
Neurons
forming
descending
Groups of
tracts
muscles
on opposite
side
lost
- flaccidity
Clasp-knife rigidity,
spastic paralysis
Muscle
s
Involve
Vol.
d
movements
Tone of involved
muscles
UMNP
Superficial reflexes
lost
Planter reflex
affected
Tendon jerks
lost
Muscle atrophy
wasting
LMNP
UMNP
lost
lost only if Babinskis +ve
S1 is
marked
Exaggerated,
clonus+
absent
Site of lesion
LMNP
- - or cranial
motor neuron
Muscles Involved -single muscle
on the same side
Voluntary movements - lost
Tone of the muscles - flaccidity
involved
Superficial reflexes
Planter reflex
Tendon jerks
Muscle atrophy
UMNP
Neurons forming
descending tracts
Groups of muscles
on opposite side
lost
Clasp-knife
rigidity,spastic
paralysis
lost
Babinskis +ve
lost
lost only if S1
is affected
lost
Exaggerated,
clonus+
marked wasting absent
paralysis in flexion
CLINICAL CONDITIONS
UMNP
LMNP
Syringomyelia
STROKE
UMNP Due To C.V.A.
SPASTICITY Signs Due To
Involvement of PS & EPS
BABINSKIS SIGN
Superficial reflex
Firm tactile stimulus to lat.
side of sole
Extension of great toe,
fanning of toes
Seen in lesions of CST,
infants, deep sleep, coma
Explanation:- CST
supresses withdrawal reflex.
Damage to CST reveals
withdrawal reflex
# spine
Gunshot injury
Transverse myelitis
Occlusion of blood vessel
Reflexes
MANAGEMENT
management of nutrition, fluid
balance
Use of antibiotics
Proper skin care
Acute administration of large doses of
glucocorticoids
lesion
a) On same
side- Motor UMN lesion
spastic paralysis,
Babinskis,
reflexes
On oppo.
side
Loss of
Left
pain,temp
.
Lat.STT
midlin
e
righ
t
On same
side 1.Loss
of
proprioceptio
Lat.STT
n,vibration
Site of
lesion
2.UMNP
Dorsal column
Dorsal column
Lat.CST
Pain ,temp.
Lat.CST