Documente Academic
Documente Profesional
Documente Cultură
February 7, 2012
Dr. Melissa Calilao
Pyramidal System
I.
II.
A.
B.
C.
D.
E.
III.
A.
B.
C.
D.
IV.
A.
B.
V.
A.
B.
VI.
A.
B.
OUTLINE
Motor System
Pyramidal Tract
Two Main Pathways
Origin of Fibers
Motor Homunculus
Supplementary Motor Area
Descending
Pathways:
Anatomical
Organization
Corticospinal Tract
Pathway
Lateral Corticospinal Tract
Anterior Corticospinal Tract
Termination of Pyramidal Tract
Upper Motor Neuron vs Lower Motor
Neuron Paralysis
Upper Motor Neuron
Lower Motor Neuron
Corticobulbar Tract
Facial Motor Nucleus
Lower Motor Nucleus
Other Descending Tracts
Midbrain
Pons/Medulla
A.
B.
ORIGIN OF FIBERS
Objectives:
Enumerate the tracts that constitute the pyramidal system
Trace the pathway of the pyramidal tracts
Locate the position of the lateral and anterior corticospinal tracts in a
section of the spinal cord
Differentiate an upper motor vs. a lower motor neuron lesion
Describe briefly the other descending tracts
I. MOTOR SYSTEM
MOTOR SYSTEM
1. Pyramidal system
MOTOR HOMUNCULUS
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PATHWAY
E.
st
1 order of neuron(N1)
o Nerve cell body in the cerebral cortex
nd
2 order of neuron(N2)
o Internuncial neuron (connecting neuron) in
anterior gray column of spinal cord
o Has short axon
rd
3 order of neuron(N3)
o Lower motor neuron
o In the anterior gray column of the spinal cord
o Axon directly innervates the skeletal muscles
through the anterior root of spinal nerves
o Lower Motor Neurons (Alpha motor neuron) the final common pathway
Reflex
o Involuntary response to a stimulus and requires
fast action
o Higher centers of the brain is not needed
Reflex arcs
o Important in maintaining muscle tone for
posture
o Components:
1. Receptor organ
2. Afferent neuron
3. Efferent neuron
4. Effector organ
st
1.
2.
Corona radiata
3.
Internal capsule
4.
5.
6.
7.
8.
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o
o
A.
LMN LESION
Complete paralysis
(complete loss of action,
since main innervations
of muscles are severed)
Flaccidity - due to atonia
Arreflexia
(reflex arc is damaged)
No Clonus
Figure 3. Motor Neurons Lesions
B.
No Babinski sign
rd
Notes:
Notes:
o The pyramidal tract is used by physicians to refer
specifically to the corticospinal tract
UMN LESION
Paresis
(muscle weakness)
Spasticity
due to marked hypertonia
increase in muscle tone
lesion is on extrapyramidal tract
Hyperreflexia
(LMN over discharge
there is an absence of suppressor
action on LMN
related to increase in tone
lesion on extrapyramidal tract)
No muscle atrophy
minor in chronic state
in time, it will have disused
atrophy
Clonus manifested
rapid, strong muscle contraction
when paralyzing limb is grasped
firmly
lesion on extrapyramidal tract
(+) Babinski sign
dorsiflexion of big toe and
fanning out of other toes
lesion on corticospinal tract
Loss of certain superficial
reflexes
lesion on pyramidal tract
a. Superficial abdominal reflex
b. Cremasteric reflex
A.
V. CORTICOBULBAR TRACT
Arise from the face region of the primary motor cortex (BA
4), also from BA 6 and 3, 1, 2
End at the midbrain
Project to:
o Motor nuclei of CN III, IV, V, VI, VII, IX, X, XI and XII
(every CN EXCEPT 1, 2, 8 which are sensory)
o Parts of reticular formation (Corticoreticular fibers) in
pons and medulla for controlling the movements of
emotions such as smiling, laughing
o Sensory relay nuclei (nucleus gracilis, nucleus
cuneatus, sensory trigeminal nuclei, nucleus of
solitary fasciculus) controls the sensory inputs that
arrive at CNS
Projections are bilateral receive innervations from both
contralateral and ipsilateral cortex EXCEPT:
o Facial motor nucleus
o Hypoglossal nucleus
Also pass through the internal capsule, located at the genu
Dorsal part
o Innervates upper half of the face
o Receives innervations from both contralateral and
ipsilateral cerebral cortex
Ventral part
o Innervates lower half of the face
o Only receives innervations from the contralateral
cerebral cortex
Central facial paralysis
o UMN/supranuclear lesion of the corticobulbar tract
o Dorsal part still receives innervations from the same
side of cerebral cortex thus, some functions are still
retained (able to wrinkle forehead muscle)
Peripheral facial paralysis (Bells Palsy)
o LMN lesion of facial nerve or motor nucleus
o Complete paralysis of half of the face on the same
side of the lesion (ipsilateral)
HYPOGLOSSAL NUCLEUS
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B.
RUBROSPINAL TRACT
PRACTICE PROBLEM 3
Interstitiospinal tract
o Origin: Interstitial nucleus of Cajal
o Uncrossed and forms part of the MLF
o Termination: Anterior horn of upper cervical levels of
spinal cord including laminae VII and VIII
o Function: modulates reflex postural movements in
response to visual and vestibular stimuli
PONS/MEDULLA
A.
VESTIBULOSPINAL TRACT
o
o
o
o
B.
Reticulospinal Tract
Tracts enter the anterior grey columns of the spinal cord to gain
access to alpha and gamma motor neurons
Facilitate and inhibit activity of the alpha and gamma motor
neurons in the anterior grey columns, influencing voluntary
movement and reflex activity
Includes the descending motor fiber; allows access from the
hypothalamus to the sympathetic and sacral parasympathetic
outflows
Reticular Formation: groups of scattered nerve cells and nerve
fibres scattered throughout the midbrain, pons, and medulla
oblongata
Example: respiration, circulation, dilation, sweating, shivering,
sphincter control of GIT and urinary tract
1.
ipsilaterally long
1.
2.
2.
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