SUBJECT: PHYSIOLOGY
TOPIC: CONTROL OF POSTURE AND MOVEMENT
LECTURER: DR. GIGI FRANCISCO
DATE: MARCH 2011
REVIEW:
SPINAL MOTOR NEURON (innervates the skeletal muscles)
Stretch Reflex – a spinal reflex triggered by the stretch
receptors or the muscle spindles; stimulus is lengthening of
the muscle. The impulse is carried by the dorsal horn
neuron that then synapses with the a-motor neuron in the
ventral horn and this one will innervate the muscle to cause
an effect. Afferent neuron that innervates the muscle
spindle also innervates an interneuron that is inhibitory to
the antagonistic muscle to allow for the corresponding
sudden movement.
Golgi Tendon Reflex – as your muscle contracts, tension is
built in the muscle. This tension is sensed by the golgi
tendon to which it is stimulated. This is innervated by the
group 1A and group 1B afferents. An inhibitory interneuron
will inhibit the a-motor neuron that inhibits a skeletal
muscle (antagonist like the one in stretch reflex) causing it
to lengthen or relax. The antagonist muscle then will be
stimulated and this muscle will shorten.
NEUROPHYSIOLOGY: POSTURE AND MOVEMENT
**All impulses that you want the skeletal muscle will do will
all have to course the a-motor neuron (lower motor neuron).
This is also the final common pathway (meaning this is the
final neuron that will control the skeletal muscles that is
common to the descending motor tract).
The figure above shows that the motor neuron/fibers are
located in the ventral horn. The arrangement in this section
shows that all efferents or all the motor neuron that
innervates your extensors are arranged alternately with
your flexors. You can also appreciate the arrangement
above wherein it shows that the neurons or fibers located
in the medial side of the ventral horn innervates the
proximal part of the body while the one in the most lateral
innervates the distal parts. An example is the figure above
in the right side where the nerves innervating the arm are
medially located while the one that innervates the hand is
more lateral.
LECTURE PROPER
AXIAL MUSCLES VS DISTAL MUSCLES
 Axial Muscles
o Trunk and proximal extremities
o Function:
 Postural adjustments – you do not
appreciate this but the muscles are rapidly
contracting and relaxing to maintain your
position.
 Gross Movements – movements of
proximal muscles include general
movements that is generally used for
adjustment
 Distal Muscles
o Hands and Digits
o Function:
 Fine, skilled movements like drawing,
writing, sewing, etc.
Control of Voluntary Movement
Page 1
 Primary Motor Area

The figure above shows the pathway of generating a

movement. The idea originates from the cortex. This
involves the cortical association areas which then goes to
the premotoer and motor cortex (vital to the final execution
of your intended movement – it receives regulation from
the basal ganglia and the cerebellum). The movement is
generated with signals coming from the premotor and
motor cortex. The cerebellum also gets input from the
cerebellum for important adjustments the body wants to do
like picking up a fallen object)

Function of Inputs to Spinal Motor Neuron

1. Voluntary Control
2. Adjust Body Posture for movement – integrates
sensory pathways in the body (a good example is
sensing whether the body is in need of
adjustments to maintain the appropriate center of
gravity or not in order not to lose our balance.)
3. Coordinate Action of Muscles to Make movement
smooth and precise The figure above is a recreation of the motor and sensory
homunculus. The sensory cortex or homunculus at the left
THE MOTOR AREAS OF THE CEREBRAL CORTEX is larger compared to the motor homunculus. An example is
the hands which is considerably larger in the sensory cortex
compared to the motor cortex, meaning it has more
neurons or innervation concerning sensory function. The
tongue is also considerably larger in the sensory cortex.
These two figures reflects the level of activity of different
parts of the body.

PRIMARY MOTOR AREA

 Topographic organization of Neurons

o Facial area represented bilaterally, rest of
the body unilateral representation
o Cortex control opposite side of the body
o Representation proportionate in size to
skill involved in use of body part

 PRIMARY motor cortex (area 4) SUPPLEMENTARY MOTOR AREA (SMA)

o Precentral gyrus
 Premotor Area 6 (area 6)
 Supplementary Motor Area (Area 6 and 8)
 Primary Somatosensory Area (Area 1,2 and 3)
o Postcentral Gyrus
 Posterior Parietal Area (Areas 5 and 7)
**Inputs from the sensory area is important in the
generation of movement since this impulses allows the
brain to determine what type of movements is needed by
the body or what is needed by the body to immobilize to
generate a particular action.
 Projection mainly to motor cortex
 In front of the precentral gyrus
 This is where the idea originates
 It was noted there is increased blood supply to this
area when doing a certain movement . Even before
the action is generated, there is already increased
blood supply to the motor neurons here.
 Function:
o Planning of Motor sequences
o Coordination of complex bilateral
movements

PREMOTOR CORTEX

 Inputs mainly from the posterior parietal cortex

 Inferior to supplementary motor area
 Projection to:

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 o Primary Motor Cortex
o Basal ganglia and thalamus
o Spinal Cord via Ventral Corticospinal Tract
 Function:
o Setting posture for planned movement –
harnessess the muscles of individual to
accomplish a move.
o Control of Proximal Limb Muscles

POSTERIOR PARIETAL AREA

 Lies behind the somatic sensory cortex

 Inputs from both sensory and motor areas
 Projects to premotor area
 Function:
o Integration of sensory and motor information,
eg. Hand-eye coordination
o Awareness of body’s position in space and
relationship to objects
 Lesion: “Hemi-neglect syndrome” – if one side is
affected

PARIETAL CORTEX

 Tests
o Graphesthesia
 Ability to identify writing on one’s palm
 Function of the parietal lobe (sensing what
is written on the palm)
o Stereognosis
 Ability to identify objets by touch

OVERALL

From the idea  cortical association areas (supplementary

area)  premotor and motor cortex (also has inputs from
the basal ganglia and cerebellum)  Stimulate motor
neuron (generation of movement) LATERAL CORTICOSPINAL TRACT

 80% of fibers that decussate at the medullary

MAJOR DESCENDING PATHWAYS
 Axons of neuron from motor cortex give rise to
descending fiber tracts
 Pathways are named from the origin to the
termination (example is Corticospinal tract where
the origin is in the cerebral cortex and it terminates
in the spinal cord. Thus, the name corticospinal
tract)
 Lateral Corticospinal Tracts
o 80% cross the midline at medullary pyramids
o Pyramidal Tract
 Ventral Corticospinal Tract
o 20% cross at level of spinal cord instead at the
pyramids
 Corticobulbar tract
o Generally the same as the corticospinal tract
except it ends at the nucleus of the cranial
nerves
o Motor neurons in:
 CN III, IV, VI – controls the extraocular
muscles
 CN V – motor neuron of the trigeminal
nerve
 CN VII – facial nerve
 CN XII – hypoglossal nerve
pyramids
 Most fibers directly terminate to your Lower motor
neuron
 Origin
o 30% primary motor cortex,
o 29% premotor and supplementary motor
cortex
o 40% parietal lobe and sensory cortex
 Termination:
o From Sensory area: Dorsal Horn Interneurons
(some fibers terminate in interneurons)
o From Motor Areas: a- and y- motor neurons
**predominantly to neurons innervating distal muscles,
eg., hand, can directly elicit muscle contraction
 Function:
o Control of skilled, voluntary movements
 Direct control of motor cortex on
contraction of distal limb muscles
 Corticobulbar tract controls muscle
contraction innervated by cranial motor
nerves
**Note: if synapse is with interneuron, effect maybe
inhibitory or facilitatory

VENTRAL CORTICOSPINAL TRACT

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  20% of fibers that cross at the level of the spinal
cord to synapse with the a-motor neuron
 Priojects bilaterally to medial motor neurons and
interneurons in the spinal cord
 Function
o Control of Bilateral postural movements

MAJOR DESCENDING PATHWAYS

 Lateral motor Pathways

o Corticobulbar/Spinal tracts
o Red Nucleus: rubrobulbar/spinal tracts
 The red nucleus can be found at the level
of the brainstem
 Parallel to corticospinal fibers
 Medial Motor Pathways (originates below the
cerebral cortex)
o Vestibulospinal tracts
o Superior Colliculus: Tectospinal Tracts THE MOTOR SYSTEM
o Pontine Reticulospinal tracts
o Medullary Reticulospinal Tracts

RED NUCLEUS

The image above summarizes the major descending

pathways. The Corticospinal pathway comprises the direct
activation pathway while the remaining comprises the
indirect activation pathways.
RED NUCLEUS PATHWAYS

DESCENDING SPINAL PATHWAYS

 Rubrobulbar tract
LOCATION FUNCTION
 Rubrospinal tract
From Cortex:
o Represent an evolutionary older form of the
CORTICOSPINAL
corticobulbar and corticospinal tracts
o Collaterals from descending cortical fibers to  Crossed Lateral Voluntary
Pyramidal Movements
red nucleus
 Direct Ventral Voluntary
o Parallel innervation with corticobulbar/spinal
Pyramidal Movements
tract
From Brainstem:
Extrapyramidal
 Vestibulospinal Vetnromedial Posture and balance
 Tectospinal Ventromedial Motor component to
MAJOR DESCENDING PATHWAYS visual reflexes
 Reticulospinal Ventromedial Muscle tone,
 Medial pathways Regulation of
o Vestibulospinal tract sensory end-organs.
 Lateral Vestibulospinal tract  Rubrospinal Dorsolateral Extrapyramidal
 Medial vestibulospinal tract control of flexor
 Function: Control Posture and balance muscles
o Tectospinal Tract
 Function: Control head and eye movement **All fibers from the pathways in the table terminate in the
o Pontine Reticulospinal tract (postural muscles) a-motor neurin except to some that terminates to
 Function: Excitatory to y-Motor Neurons interneurons (some fibers from the lateral corticospinal
o Medullary Reticulospinal tract (postural pathway)
muscles)
 Function: Inhibitory to y-Motor Neurons

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THE FINAL COMMON PATHWAY  Spinal Shock
o Depression of Spinal reflexes as a result
of transection of the spinal cord
o First there will be flaccidity and after a
while spinal reflexes will become spastic.

UPPER MOTOR vs. LOWER MOTOR NEURON

 Lower motor neuron The figure above shows an example of spinal animal. The
o Spinal and cranial motor neurons that spinal cord was transected (incomplete) – some fiber tracts
directly innervate skeletal muscle are left intact. This animal after recovering from spinal
 Upper motor neuron shock exhibit walking movements with the set-up above.
o Motor Neurons located in the brainstem This shows that there are centers in the spinal cord as well
and cotex that activate the lower motor as the base of the brain that fires regularly and are called
neuron in the spinal cord semiautomaticity of stepping movements – central pattern
Upper motor Lower Motor generators (1 in cervical and 1 in spinal region)
Neuron Neuron
Stretch Reflex Increased (eg. Decreased/ LOCOMOTION
Clonus) Absent
Spastic Flaccid
Tone Rigidity (eg. Decreased/  Graham Brown (1911)
Clasp-knife) Absent o Semiautomaticity of Stepping Movements
Hypertonic Hypotonic  Demonstrated in cats with spinal cord
Fasciculation Absent Present transection
Babinski Present Absent  2 Spinal Locomotor Center
o Cervical Region
o Spinal Region
**Fasciculation – fine muscle contraction because of
 Mesencephalic Locomotor Region  Cuneiform
increase sensitivity of dennervated muscle to cholinergic
Nucleus (where the discharge comes from)
activity; muscle twitching
 Central Pattern Generator in CNS (CPGs)
UPPER MOTOR NEURON LESION
BASAL GANGLIA

 Hyperreflexia
 Function:
 Clonus – involuntary muscular contraction and
o Controls the background tone and posture for
relaxation; unlike fasciclation, clonus involves large
movements initiated in the cerebral cortex
scale movement as opposed to small twitchings of
 Activity:
fasciculation.
o Inhibits the thalamus (mainly inhibitory) –
 Babinski Reflex – primitive reflex; ; hyperextension
thalamus is excitatory to cerebral cortex
of the hands in babies; abnormal if reflex is
 Influence the motor cortex via the thalamus
persistent after age 2
o Inhibitory
 Neurotransmitters
INTERRUPTION OF DESCENDING PATHWAYS o Excitatory: Acetylcholine/ Glutamate
o Inhibitory: GABA
 Decorticate Rigidity
o Removal of the cerebral cortex **There are two pathways in the activation of basal ganglia.
o Rubrospinal excitation of flexors There is an indirect longer pathway which is inhibitory in
o Rubrospinal is the next in hierarchy of the nature and the direct pathway which is excitatory.
descending pathways that is why it is
predominant or stimulated
 Decerebrate Rigidity
o Interruption of Inputs from the cortex
(Corticospinal/ Corticobulbar tracts) and
Red nucleus (rubrospinal tract)
o Dominance of Excitatory Reticulospinal
Pathway to extensions

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 FUNCTIONS

 Regulation of ongoing movements

o Synergy: rate, range, force and direction of
movements
o Lesions: lack of coordination
 Programming of motor sequences
 Regulation of Vestibular reflexes

FUNCTIONAL SUBDIVISIONS

PARKINSON’S DISEASE

 Decreased dopamine levels

 Degeneration of dopaminergic Neurons in
Substanti nigra (pars compacta)
o Excitatory, D1 Receptor
o Inhibitory, D2 Receptor
 Bradykinesia
o Slowing of movement
 Symptoms: VESTIBULOCEREBELLUM
o Rigidity
o Akinesia (slowing of movement)  Flocculonodular Lobe with the vestibular nuclei
o Resting Tremors*  Controls axial musculature and movements of
 Treatment: L-DOPA the head and eyes
 Parkinsonia Gait
 Maintains balance and coordinates eye
o Hypokinetic
o Fenestrating Gait movements with the head position
o Turns “EN BLOC”  Lesions: ataxia, nystagmus
 Some people who have Parkinson’s disease is
Muhhamad Ali, Adolf Hitler, Pope John Paul II, etc. SPINOCEREBELLUM

HUNTINGTON”S DISEASE  Anterior portion

 From dorsal/ventral spinocerebellar tracts to
 Hereditary the vermis and paravermis
 Destruction of cholinergic and inhibitory GABAergic
 Efferents to the motor cortex (via the thalamus)
Neurons
 Symptoms:
to regulate posture and equilibrium
o Chorea (writhing)  Motor execution
o Hyperkinetic Gait o Monitors motor programs as they occur
 Treatment: None  Lesions: “past-pointing”/Dysmetria, Intention
tremors, hypotonia, dysdiadochokinesia
CEREBELLUM
CEREBROCEREBELLUM

 Posterior Lobe
 The lateral portion of the cerebellar hemisphere
 Efferents to the primary motor cortex (via the
dentate nucleus and thalamus)
 Initiation of movement and coordination of muscle
contraction (motor plan: direction, pattern and
intensity)
 Lesions: delayed initiation of movement,
disturbance of coordination, dysmetria, dysphonia
 Afferent Connections:
o Corticopontocerebellar pathway

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  Motor and Premotor Cortices
 Somatosensory Cortex
o Olivocerebellar tract
o Vestibulocerebellar fibers
o Reticulocerebellar fibers
o Dorsal/Ventral Spinocerebellar tracts

CEREBELLUM

 Input neurons (excitatory)

o Mossy fibers
 From:
 Vestibulocerebellar
 Spinocerebellar
 Pontocerebellar
 Afferent to:
 Granule Cell dendrites
CEREBELLAR DYSFUNCTION
o Granule Cells
 Split to form parallel fibers which impinge
on purkinje cells  Symptoms of associated with lesions
o Climbing Fibers o Dysmetria
 From the inferior olive to purkinje cells  Loss of ability to measure range of motion
 1:1, “conditioning of purkinje cell” o Ataxia
 Disturbance of balance with unsteady gait
o Dysdiadochokinesia
 Irregularity in alternate motion
 Difficulty or inability in performing rapid
alternating movements
o Dysphonia
 Slowing and slurred speech
o Postural tremors
o Restin tremors (basal ganglia)
o Difficulty with repetitive movements

**Heel-to-shin test – parang de kwatro

**Romberg’s Test – test for cerebellar function

SUMMARY

MOTOR CORTEX

INTERNEURONS OF CEREBELLUM
 The supplementary motor area and the premotor
Area are involved in the planning of movement
 Inhibitory interneurons  The primary motor area is responsible for the
o Golgi cell, GC execution of the movement
o Basket cell, BC  Descending motor pathways
o Stellate cell o There are 2 major fiber tracts
 Excitatory  The lateral corticospinal tract (pyramidal
o Granule cell, GR tract)
 Output Cell  The medial descending pathways (Extra-
o Purkinje cell pyramidal tract):
o Always inhibitory  Rubrospinal
o Neurotransmitter, GABA  Tectospinal
 Vestibulospinal
 Pontine Reticulospinal Tract
 Medullary Reticulospinal Tract
o Decorticate Rigidity
 Disruption of fibers from the cortex,
predominance of rubrospinal tracts
 Resulting in flexion of upper extremities
o Decerebrate Rigidity
 Disruption of rubrospinal tracts
 Predominance of Reticulospinal tracts
 Hyperextension of both upper and lower
extremities
 Basal Ganglia
o Modulate impulses to the motor cortex via the
thalamus

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 o Involved in the planning and execution of
smooth movement
o Disorders results in hypokinesia (eg.
Parkinson’s disease) or Hyperkinesia END OF TRANSCRIPTION
(Huntington’s disease)
 Cerebellum
o Regulates movements by controlling synergy
o The output from the cerebellar cortex is via the
purkinje cells and is always inhibitory
o Disorder causes ataxia

FIGURE 1: PRIMARY MOTOR CORTEX AND ITS ASSOCIATION CORTICES.

NEUROPHYSIOLOGY: POSTURE AND MOVEMENT Page 8

FIGURE 2: RED NUCLEUS AND OTHER PATHWAYS

FIGURE 3: DESCENDING PATHWAYS IN A SPINAL CROSS-SECTION

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FIGURE 4: BASAL GANGLIA AND CONNECTIONS; DIRECT AND INDIRECT ACTIVATION PATHWAY

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FIGURE 5: CEREBELLUM AND CONTENTS

FIGURE 6: CEREBELLAR PATHWAYS

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