Lateral Motor Systems

Lateral Corticospina l Tract/ Pyramidal

Goal Directed MovementsVoluntary Skilled movements of distal muscles of the limbs Excites Flexor m. Inhibits Extensor M.

-Precentral Gyrus (Area 4, primary motor cortex) -Betz Cells -Premotor (6) -Parietal Lobes (3,2,1)

Entire cord/ Cervical/ lumbosacral enlargements -Distal Muscles

-Corona Radiata - Posterior Limb of internal capsule (Thalamus/striatu m) -middle of cerebral peduncle -medullary pyramids -lateral funniculus Ventral horn -motor efferent

Caudal MedullaPyramidal Deccusati on

Cortex: Contralateral corresponding to area of damage Internal Capsule: Contralateral hemiplegia Webber’s Syndrome: Cerebral Peduncle Medial Medullary Syndrome: Medullary Pyramid Above Pyrimidal Decussation: Contralateral Below Pyrimidal Deccusation: Ipsilateral At Decussation: Bilateral Decortate Posturing/ Rigidity: lesion superior to superior colluculus Benedikt’s Syndrome:Unilateral Lesion of Red Nucleus

Rubriospinal Tract

Goal Directed Movementscerebral cortex and cerebellum indirectly influence spinal cord Proximal M. Excites Flexor M.

Cerebellar Nuclei (contralateral) + Cerebral Cortex (ipsilateral) Rednucleus Midbrain (Tegmentum @sup. Colliculus) Cerebellum Flocconodular lobe)(VIII) Pons: Lateral vestibular nucleus (ipsilateral) Pons:

Lower Motor Neurons (medial)  Proximal Limb muscles (alpha/gamm a LMN)

-Lateral Brainstem -Lateral Spinal Cord -Medial Ventral Horn

Ventral Tegmental Decussati on Midbrain

Medial Motor Systems

Lateral Vestibulospi nal Tract


Maintain upright posture/balan ce by exciting neurons that innervate Extensor muscles of the lower limbs Positioning of

Spinal Cord (Ipsilateral) Alpha motor neurons, gamma motor Neurons Extensor m. trunk/limbs Ventral Horn


Lesion Vestibular Nerve/Nucleus Falling toward side of lesion Lateral Medullary Syndrome of Wallenberg: Vertebral A./PICA Internuclear


Vestibulospi nal Tract

Tectospinal Tracts / Corticotectal Tract

head and neck - adjust head position in changes to posture -coordinates eye movements w/ eachother - coordinates eye movements w/ hear (VOR) Coordinate Eye/Head movements and upward gaze

Medial Vestibular Nucleus

of Spinal Cord/ LMN (inhibit α/γ)w/ Spinal Accessory Nerve (SCM) and axial m. **Bilateral** Superiorly to: CN III, IV, VI (via MLF) Contralater al Cervical Spinal Cord (CN XI nueclus— SCM) Additional axons from superior colliculus pontine maramedial reticular formation upward gaze Also reticularspinal tracts Autonomic information from higher levels respiration, circulation, sweating, shivering, pupil dialation, sphincter GI/urinary -W/ COrticospinal Tract Fibers -Corona Radiata - Internal Capsule (at Genu /area 4) - Cerebral Peduncle Midbrain: Dorsal Tegmentum

Opthalmoplegia: Lesion Medial Logitudinal fasiculus Vestibulo- ocular Reflex: Nystagmus Dolls Head Maneuver: Abnormal (MLF Lesion): Eyes move w/ head

Corticotectal: Retina/ visual cortex/ inferior parietal lobes Superior Colliculus Tectospinal : Superior Colluciuls 1) LRST:mellow Medulla Reticular Bilaterally(later al funiculus) 2)MRST:pump ed Pons Retucular Ipsilaterally (anterior funiculus) Precentral Gyrus

Parinaud’s Syndrome/ Dorsal Midbrain Syndrome/ Collicular Syndrome: LesionSuperior Colliculi/ posterior commisure (pineal gland tumor/hydrocephalus) Decerebrate Postering/Rigidity: Lesion caudal to red nucleus

Reticulospin al Tracts: Lateral Medullary Reticulospin al Medial Pontine Reticulospin al Corticobul bar tracts Corticobulbar tracts

Maintain upright posture by influencing voluntary and reflexive movements : Inhibit LRST Excite MRST

1) All Spinal Cordsuppresses Extensor spinal reflex 2) All Spinal CordExcite axial muscles/leg extensors

LRST ascending fibers Intralamina r/ thalamic nuclei (Arousal/Sl eep)

Controls muscles of head/face and neck

BilateralBrainstem Motor Nuclei: V, IX + X (ambiguous) Contralateral: VII, XII

Cortical/Internal Capsule Lesions: affect Both corticospinal/cotriconucl ear tract contralateral hemiplegia w/ CN VII and XII CNVII- contralateral lower quadrent of face

CNXII- tongue deviates away from lesion Pseudobulbar Palsy: Bilateral lesion of corticobulbar tract: (UMN /Internal Capsule) Dysphagia, dysarrythria, paresis of tongue, loss of emotional control Causes:brainstem stroke, ALS, MS Anterior Corticospinal Tract