CORTICAL CONTROL OF MOTOR FUNCTIONS

The cerebral cortex has an outer grey matter and an

inner white matter. It is made up of 6 layers viz from
outwards in ward
1 Molecular layer
2 External granular layer
3 External pyramidal layer
4 Internal granular layer
5 Internal pyramidal layer
6 Layer of fusiform cells

Cytoarchitechturally it is divided into 47 areas by

Broadmann., specific areas correlate with specific
functions eg area 4 is the primary motor cortex
and area 17 the primary visual cortex
PRIMARY MOTOR AREAS OF THE CEREBRAL
VCORTEX
1 Primary motor cortex (BROADMANN AREA 4)
Located on the anterior wall of the central
sulcus and adjacent portions of the precentral
gyrus.Lesions in the primary motor cortex
cause more marked motor deficits than
 lesions in other areas of the cerebral
cortex.The neurons in this area determine the
direction.They act on the alpha motor neurons
in the anterior horn .There is somatotopic
organization of the primary motor
cortex.amount of force to be exerted and in
what
SENSORY INPUTS TO THE PRIMARY MOTOR
CORTEX
1 From the periphery via the thalamus
2 From the cerebellum via the thalamus
3 From the basal ganglia via the thalamus.
2 SUPPLEMENTARY MOTOR AREA
(SECONDARY MOTOR AREA)
Stimulation of the supplementary motor area
causes bilateral complex postural responses
suggesting that it is concerned the control of
extra pyramidal neurons.
PREMOTOR CORTEX( AREA 6)
This area projects to the primary motor
cortex , subcortical structures and the spinal
cord..
PYRAMIDAL THE EXTRAPYRAMIDAL SYSTEMS
PYRAMIDAL
The pyramidal pathway is the direct pathway
through the cerebral cortex controls the
skeletal muscles.
The fibres originate from the cortex and
descend through the internal capsule. Some of
these fibres terminate in the brainstem
(corticobulbar). While others descend to the
spinal cord as corticospinal tract.
At the level of the pyramids about 80% of
the corticospinal fibres cross over
( decussate) and descend AS lateral
corticospinal tract accompanied by the
rubrospinal tract.The uncrossed fibres descend
as the ventral corticospinal tract., but they
eventually crossover before termination.
Most of the corticospinal fibres end on
interneurons which link them to the ant
horn cells and only a few of them end
directly (less than 10%) and make direct
connection.
FUNCTIONS
The extrapyramidal tracts are responsible for
the control of posture , planning and for the
initiation of voluntary movements eg gross
movts of the trunks and proximal limb
muscles.
Damage to the extrapyramidal systems is
responsible for the spasticity and
exaggeration of reflexes which accompany the
paralysis seen stroke

PYRAMIDAL DAMAGE
There is loss of fine skilled movements like
buttoning of shirts and lasing of shoes.
The commonest damage to the
extrapyramidal system which control posture
and movements is the cerebrovascular
accident , stroke in which there is a rupture
of branches of the middle cerebral artery
which supplies the internal capsule, this
rupture can result from uncontrolled
hypertension
 80-85% of cases of narrowing of the blood
vessels are due to artherosclerosis leading to
thrombosis at the site of blockade by an
embolus,the remaining 20_25%are due to a
rupture in hypertensive patients with bleeding
around the internal capsule,