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Dr. John Vincent Estrada
DESCENDING PATHWAYS Two clinically most important descending fiber tracts: 1. Corticospinal Tract 2. Corticobulbar tract Areas in the cerebral cortex that are involved in the descending pathways: 1. Primary Motor Area (Brodman area 4 in the Precentralgyrus) 2. Premotor Area (Brodman area 6; rostral/ anterior to area 4) y Supplementary Motor Area most medial aspect of Brodman area 6 3. Some motor neurons of the Postcentralgyrus (Brodman areas 3, 1, 2)
CORTICOSPINAL TRACT Concerned with skilled movements of the distal muscles of the limbs/ extremities. Origin: 1. One-third (1/3) of fibers originate from Brodman area 4 2. Another third from area 6 and Supplementary Motor area 3. Remaining third from area 312 of Postcentralgyrus
Upper motor neurons that influence the head are represented in the lateral part of the motor areas while the lower extremities are represented in the superomedian part of the motor areas. More upper motor neurons that influence the head than in the lower extremity y Perineum and abdomen and Lower extremities are small compared to representation of the head
MOTOR NEURONS Lower Motor Neurons y Motor neurons in the anterior (ventral) gray horn of the spinal cord. y Also refer to the motor component of the cranial nerve nuclei(ex: Occulomotor nuclei). Upper Motor neurons y Found in cerebral cortex and basal ganglia. y Referred to as the corticospinal and corticobulbar tracts.
Fibers of the corticospinal tract arise as axons of pyramidal cells situated in the fifth layer of the cerebral cortex (Fig. 4-21). About one-third of the fibers originate from the primary motor cortex (area 4), one-third originate from the secondary motor cortex (area 6), and one-third originate from the parietal lobe (areas 3, 1, and 2); thus, two-thirds of the fibers arise from the precentralgyrus, and one-third of the fibers arise from the postcentralgyrus.
CORTICOSPINAL TRACT PATHWAY Basal motor neurons, specifically Pyramidal cells (Betz cells) in layer 5
The motor neurons situated in the anterior gray columns of the spinal cord send axons to innervate skeletal muscle through the anterior roots of the spinal nerves. These motor neurons are sometimes referred to as the lower motor neurons and constitute the final common pathway to the muscles The lower motor neurons are constantly bombarded by nervous impulses that descend from the medulla, pons, midbrain, and cerebral cortex as well as those that enter along sensory fibers from the posterior roots. The nerve fibers that descend in the white matter from different supraspinal nerve centers are segregated into nerve bundles called the descending tracts. These supraspinal neurons and their tracts are sometimes referred to as the upper motor neurons, and they provide numerous separate pathways that can influence motor activity.
Arises the fibers of the corticospinal tract Posterior limb of the Internal Capsule in the Basal ganglia Crus cerebri of the midbrain Anterior part of the pons In the medulla, the fibers form the pyramids in the anterior aspect * The pyramids of the medulla are composed of fibers of the corticospinal tract. * This is why the corticospinal tract is also called the Pyramidal tract.
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9. 11 and 12 y Cranial nerve nuclei are innervated bilaterally. y Hypoglossal nucleus Both receive fibers from the opposite side that are heavier or more in amount in the same side. they decussate to the opposite side. y Example: movement of the buccinator muscle. 5. 4. 6. the fibers take a different route: They synapse to nuclei cranial nerves 3. Synapse with motor neurons in lamina 9 Quote for the night (dahilgabikoitoginawa) Sa akinkanakahawakperosakanyakanamannakatingin -. y Hematoma will exert pressure in the corticospinal tract. Page | 2 11 January 2011 TRANSER GROUP NAME . 10. 6. they can still move their eyeballs because of the bilateral innervation. nagseselossa monitor CLINICAL SIGNIFICANCE OF CORTICOSPINAL TRACT y It controls the skilled movements of the extremities.then the entire contralateral side will be paralyzed. y Lesions of the 2 nuclei will be manifested on the opposite side because of heavier innervations. VENTRAL CORTICOSPINAL TRACT Lower part of medulla: 10% will not crossover in the pyramids. 7.mouse. When damage is at and above thedecussation it is contralateral. Along the descent. 7 and 8 Interneurons will synapse with motor neurons in lamina 9 Motor neurons in lamina 9. y In patients with stroke. controls the distal muscles of the extremities NEUROANATOMY | Descending Pathways CORTICOBULBAR TRACT Fibers arise from the Frontal Eyefield (Brodman area 4 and 8 in the Middle Frontal gyrus that controls eye movement) Fibers also pass posterior limb of the internal capsule In the brainstem. y Any damage in this will cause paralysis in the body part. they just descend ipsilaterally in the anterior funiculus Ventral Corticospinal tract [Supplies upper limbs only (reaches only up to cervical and upper thoracic)] At their levels of termination. How does paralysis occur about? y Occur because of stroke or cerebral hemorrhage Example: rupture of the Lateral Striate artery (artery of cerebral hemorrhage) y Passes very close through the posterior limb of internal capsule.LATERAL CORTICOSPINAL TRACT Lower part of medulla: 90% of fibers crossover/decussate to the opposite side (Decussation of pyramids= gross manifestation) Lateral Corticospinal tract Descends in the lateral funiculus of the white matter. Below the decussation. fibers synapse with interneurons in Laminae 4. especially alpha fibers. Two exemptions: y Lower facial nucleus Controls the muscles below the eyelids. 5. manifestation is ipsilaterally.
NEUROANATOMY | Descending Pathways CORTICOSPINAL TRACT Page | 3 11 January 2011 TRANSER GROUP NAME .