Anatomy of

Sensory Tract &

Motor Tract
Nabilla Rizky
PRETEST
1. Which Rexed laminae that arrow A is pointing?
2. Arrow A is pointing at structure….
3. What is the function of the structure?
4. Arrow B is pointing at structure….
5. What is the function of the structure?
6. What is the name of the structure A?
7. What is the name of structure B?
8. What is the function of structure B?
9. Someone comes with the weakness of the limbs, increased of the reflexes and
muscle tone. Where does the lesion locate?
10. If someone comes with the loss of proprioception, vibration, and pressure on both
side of the body without any disturbed motor function, what is the most probable
diagnose?
Anatomy of Sensory
Tract & Motor Tract
 Medulla Spinalis
● Continuation of medulla oblongata
● Start from foramen magnum to L1-L2, L3-Coccygeus is also called the cauda
equina
● Main structure of the spinal cord is substansia grisea (gray matter) and
substansia alba (white matter)
● Substansia grisea is filled with cell bodies and become a place for synapses
● Substansia alba is filled with axons for carrying signals either ascending or
descending
 Substansia grisea
● The dorsal horns are the site of termination of primary afferent fibres, which
enter via the dorsal roots of spinal nerves.
● The ventral horns contain efferent neurones whose axons leave the spinal
cord in ventral nerve roots. A small intermediate lateral horn is present at the
thoracic and upper lumbar levels and contains the cell bodies of preganglionic
sympathetic neurones.
● At any particular spinal level (as seen in transverse section), the spinal grey
matter is considered to consist of 10 layers, called Rexed’s laminae, which are
defined on the basis of neuronal size, shape, cytological features and density.
The laminae are numbered sequentially in a dorsoventral sequence.
● Laminae I to IV correspond to the head of the dorsal horn and are the main
receiving areas for cutaneous primary afferent terminals and collateral
branches. Many complex polysynaptic reflex paths (ipsilateral, contralateral,
intrasegmental and intersegmental) start from this region, and many long
ascending tract fibres that pass to higher levels arise from it.
● Laminae V and VI receive most of the terminals of proprioceptive primary
afferents and profuse corticospinal projections from the motor and sensory
cortex and subcortical levels.
● Lamina VII includes much of the intermediate (lateral) horn. It contains
prominent neurones of Clarke’s column (nucleus dorsalis, nucleus thoracicus,
thoracic nucleus) and intermediomedial and intermediolateral cell groupings.
The lateral part of lamina VII has extensive ascending and descending
connections with the midbrain and cerebellum (via the spinocerebellar,
spinotectal, spinoreticular, tectospinal, reticulospinal and rubrospinal tracts).
● Lamina VIII is a mass of propriospinal interneurones. It receives terminals from
the adjacent laminae, many commissural terminals from the contralateral lamina
VIII and descending connections from the interstitiospinal, reticulospinal and
vestibulospinal tracts and the medial longitudinal fasciculus.
● Lamina IX is a complex array of cells consisting of α and γ motor neurones and
many interneurones.
● Lamina X surrounds the central canal and consists of the dorsal and ventral
grey commissures.
 Substansia alba

● They are arranged in three large masses—the dorsal, lateral and ventral
funiculi—on either side of the cord. Fibres of related function and those with
common origins or destinations are grouped to form ascending and descending
tracts within the funiculi.
● Here, the tracts are considered under three main headings: ascending,
descending and propriospinal.
● Ascending tracts contain primary afferent fibres, which enter by dorsal
roots, and fibres derived from intrinsic spinal neurones, which carry afferent
impulses to supraspinal levels.
● Descending tracts contain long fibres, which descend from various
supraspinal sources to synapse with spinal neurones.
● Propriospinal tracts, both ascending and descending, contain the axons of
neurones that are localized entirely to the spinal cord and link nearby and
distant spinal segments.
 Overview of Ascending Pathway
● Ascending sensory projections related to the general senses consist of a
sequence of three neurones
● These are often referred to as primary, secondary and tertiary sensory
(afferent) neurones or first-, second- and third-order neurones, respectively.
● First-order neurones in dorsal root ganglia → terminate ipsilateral to the cell
bodies of second order neurones in the gray matter → ascends to the dorsal
column nuclei → decussate in the medulla ascend as the medial lemniscus →
within the thalamus, ascending second-order sensory neurones terminate in the
ventral posterior nucleus, making synaptic contact with the cell bodies of
third-order neurones → axons of third-order neurones pass through the internal
capsule to reach the cerebral cortex, where they terminate in the postcentral
gyrus of the parietal lobe, also known as the primary somatosensory cortex.
 Sensory Tract (Ascending)

● Columna dorsalis → touch-pressure, position, vibration

● Tract. spinothalamicus lateralis → pain & temperature
● Tract. spinothalamicus anterior → crude touch
● Tract. spinocerebellaris posterior → fine coordination of lower extremity
muscles
● Tract. spinocerebellaris anterior → lower extremity movements
● Tract. cuneocerebellaris → movement coordination of the upper extremity
● Tract. spinoolivarius → lower extremity proprioception
 Columna dorsalis
● The dorsal funiculus on each side of the cord consists of two large ascending
tracts: the fasciculus gracilis and fasciculus cuneatus.
● The dorsal columns contain a high proportion of myelinated fibres carrying
proprioception (position sense and kinaesthesia) and exteroceptive
(touch-pressure) information, including vibratory sensation, to higher levels.
● These fibres come from several sources:
1) Long primary afferent fibres from the dorsal roots of spinal nerves → dorsal
column nuclei in the medulla oblongata
2) Shorter primary afferent fibres → neurones of Clarke’s column
3) Other spinal neurones and axons from secondary neurones → the dorsal
column nuclei.
● Fasciculus gracilis (starts from caudal): sensory impulse → dorsal spinal roots
(ganglia) → ascending axons of secondary neurones in laminae IV to VI of the
ipsilateral dorsal horn → terminate in the nucleus gracilis of the medulla
oblongata → decussation of medial lemniscus → nucleus ventral posterolateral
thalamus → somatosensory cortex (gyrus postcentralis lobus parietalis → area
3, 1, and 2)

● Fasciculus cuneatus (starts from mid-thoracic): sensory impulse → dorsal

spinal roots (ganglia) → ascending axons of secondary neurones in laminae IV to
VI of the ipsilateral dorsal horn → terminate in the nucleus cuneatus of the
medulla oblongata → decussation of medial lemniscus → nucleus ventral
posterolateral thalamus → somatosensory cortex (gyrus postcentralis lobus
parietalis → area 3, 1, and 2)
 Tractus spinocerebellaris
● There are two principal spinocerebellar tracts: dorsal or posterior, and ventral
or anterior. They occupy the periphery of the lateral aspect of the spinal white
matter and carry proprioceptive and cutaneous information to the
cerebellum for the coordination of movement. Both tracts contain
large-diameter myelinated fibres, but there are more in the posterior tract.
● The dorsal spinocerebellar tract carries information from the trunk and lower
limb.
● The ventral spinocerebellar tract carries information from the lower limb.
Axons forming the tract mostly decussate; a few remain ipsilateral.
● The cuneocerebellar tract is therefore functionally allied to the dorsal
spinocerebellar tract and is its upper limb equivalent.
● Tractus spinocerebellaris posterior (starts from L2/L3): sensory impulse →
dorsal spinal roots (ganglia) → ascending axons of secondary neurones in
laminae VII (Clarke’s column) → pass through pedunculus cerebellum inferior in
medulla oblongata → terminate ipsilaterally in the rostral and caudal parts of
vermis cerebellum

● Tractus spinocerebellaris anterior (starts from upper lumbar): sensory

impulse → dorsal spinal roots (ganglia) → synapses secondary neurones in
laminae V to VII of the ipsilateral dorsal horn → decussation on the gray matter
commisure → ascends through the medulla oblongata → pudenculus
cerebellum superior → terminates in vermis cerebellum anterior
 Tractus spinothalamicus
● The spinothalamic tracts consist of second-order neurones that convey pain,
temperature, coarse (non-discriminative) touch and pressure information to
the somatosensory region of the thalamus.
● The lateral spinothalamic tract subserves pain and temperature sensations.
● The ventral spinothalamic tract subserves coarse tactile and pressure
modalities.
● Tractus spinothalamicus lateralis: sensory impulse → dorsal spinal roots
(ganglia) → synapses secondary neurones in diverse laminae → decussation in
the ventral white commisure → ascends → nucleus ventral posterolateral
thalamus
● Tractus spinothalamicus anterior: sensory impulse → dorsal spinal roots
(ganglia) → synapses secondary neurones in diverse laminae → decussation in
the ventral white commisure → ascends → nucleus posterior posterolateral
thalamus
 Tractus spinoolivarius
● The spinoolivary tract is described in animals as arising from neurones in the
deeper laminae of grey matter.
● The tract carries information from muscle and tendon proprioceptors and
from cutaneous receptor of the lower extremity.
 Overview of Descending Pathway
● The term ‘lower motor neurones’ refers to the alpha motor neurones that
innervate the extrafusal muscle fibres of skeletal muscle.
● The term ‘upper motor neurones’ in theory refers collectively to all the
descending pathways that impinge on the activity of lower motor neurones.
● This pathway originates from the cerebral cortex, including the primary motor
cortex of the frontal lobe → corticospinal fibres descend through the brain stem
→ majority of them cross to the contralateral side in the pyramidal decussation
of the medulla → lateral corticospinal tract → terminates in association with
interneurones and motor neurones of the spinal grey matter → ventral root →
designated muscle
 Motor Tract (Descending)

● Tract. corticospinalis → voluntary movements

● Tract. reticulospinalis lateralis → control pain perception & motor function
● Tract. reticulospinalis medialis → inhibits & facilitates contraction
● Tract. vestibulospinalis → balance & posture
● Tract. tecnospinalis → coordination of the head & vision
● Tract. rubrospinalis → fine control of the motoric
 Tractus corticospinalis
Precentral motor cortex (area 4) and premotor cortex (area 6) → descend through
the subcortical white matter → posterior limb of the internal capsule → pass through
the ventral part of the midbrain in the pedunculus cerebri or crus cerebri → continue
caudally through the pons → separated from its ventral surface by transversely
running pontocerebellar fibres → in the medulla oblongata they form a discrete
bundle, the pyramid, which forms a prominent longitudinal column on the ventral
surface of the medulla → decussatio pyramidum → tractus corticospinalis lateral

*tracts that didn’t cross at decussatio pyramidum will be tractus corticospinalis

anterior
*most of the tracts will synapses in laminae V to VIII
 Tractus rubrospinalis
● The origin, localization, termination and functions of rubrospinal connections are
poorly defined in humans, and the tract appears to be rudimentary.
● Rubrospinal fibres cross in the ventral tegmental decussation and descend in
the lateral funiculus of the cord, where they lie ventral to, and intermingled with,
fibres of the lateral corticospinal tract. In humans it appears to project only to
the upper three cervical cord segments.
● Rubrospinal fibres are distributed to the lateral parts of laminae V and VI and the
dorsal part of lamina VII of the spinal grey matter. The terminal zones of the tract
correspond to those of corticospinal fibres from the motor cortex.
 Tractus tecnospinalis
● The tectospinal tract arises from neurones in the intermediate and deep layers
of the superior colliculus of the midbrain.
● It crosses ventral to the periaqueductal grey matter in the dorsal tegmental
decussation and descends in the medial part of the ventral funiculus of the
spinal cord. Fibres of the tract project only to the upper cervical cord segments,
ending in laminae VI to VIII.
● They make polysynaptic connections with motor neurones serving muscles in
the neck, facilitating those that innervate contralateral muscles and inhibiting
those that innervate ipsilateral ones.
 Tractus vestibulospinalis
● Lateral vestibulospinal tract arises from small and large neurones of the lateral
vestibular nucleus (Deiters’ nucleus) → descends ipsilaterally, initially in the
periphery of the ventrolateral spinal white matter but subsequently shifting into
the medial part of the ventral funiculus at lower spinal levels → lateral
vestibulospinal fibres end ipsilaterally in the medial part of the ventral horn in
lamina VIII and the medial part of lamina VII.
● Medial vestibulospinal tract arises from neurones in the medial vestibular
nucleus → descends in the medial longitudinal fasciculus into the ventral
funiculus of the spinal cord → fibres of the medial tract project mainly to the
cervical cord segments → ending in lamina VIII and the adjacent dorsal part of
lamina VII.
 Tractus reticulospinalis
● Medial reticulospinal tract: oral and caudal pontine reticular nuclei and the
gigantocellular reticular nucleus in the medulla → pontine fibres descend, mainly
ipsilaterally, in the ventral funiculus of the cord — medullary fibres descend
ipsilaterally and contralaterally, in the ventral funiculus and ventral part of the
lateral funiculus → the terminals of reticulospinal fibres are distributed to lamina
VIII and the central and medial parts of lamina VII.
● Lateral reticulospinal tract: neurones of the ventrolateral tegmental field of the
pons → the fibres cross in the rostral medulla oblongata and project, with a high
degree of collateralization, throughout the length of the spinal cord → axons of
this tract terminate in laminae I, V and VI and also bilaterally in the lateral
cervical nucleus.
 Summary of major descending
brainstem tracts
● Group A (ventromedial brain stem pathways) consists of both vestibulospinal
tracts, with the medial reticulospinal, and tecnospinal all of which pass
through the medial and ventral parts of the lower brain stem tegmentum to
descend in the ventral and ventrolateral funiculi of the spinal cord.
● Functionally, this system is concerned with the maintenance of posture, the
integration of movements of the body and limbs and synergistic whole limb
movements, but it also subserves the orientation movements of the body and
head.
● Group B (lateral brain stem pathways) consists of the rubrospinal tract and
the lateral reticulospinal tract. These tracts descend through the ventrolateral
part of the lower brain stem tegmentum and continue in the dorsolateral
funiculus of the spinal cord.
● Group B pathways provide the capacity for independent, flexion-biased
movements of the limbs and shoulders, and especially of the elbows and
hands. They supplement the motor control mediated by group A pathways.
 Tractus propriospinalis
(Fasciculi proprii)
● Propriospinal neurones are confined to the spinal cord; that is, their ascending
and descending fibres begin and end within the spinal grey matter.
● The majority of spinal neurones are propriospinal neurones, most of which lie in
laminae V to VIII.
● The system mediates all those automatic functions that continue after
transection of the spinal cord, including sudomotor and vasomotor activities
and bowel and bladder functions.
● Long propriospinal neurones distribute their axons throughout the length of
the cord, mainly via the ventral and lateral funiculi; their cell bodies are in lamina
VIII and the dorsally adjoining part of lamina VII → axons from the long
propriospinal neurones of the cervical cord descend bilaterally, whereas those
from the corresponding lumbosacral neurones ascend mainly contralaterally.
● Intermediate propriospinal neurones occupy the central and medial parts of
lamina VII and project mainly ipsilaterally.
● Short propriospinal neurones are found in the lateral parts of laminae V to VIII,
and their axons run ipsilaterally in the lateral funiculus.
 Lesions of the Spinal Roots, Nerves,
and Ganglia
● Root compression usually presents acutely with pain, which may be severe. The
pain, paraesthesia and numbness occur in a dermatomal distribution. It may be
difficult to demonstrate sensory loss on the trunk because of the overlap of the
dermatomes.
● It is important to distinguish anatomically among radicular (‘nerve root’) pain,
referred pain and radiating pain.
● Radicular pain occurs in a spinal nerve (dermatomal) distribution, is well
localized and results from involvement of the spinal nerve in the pathological
process, such as when it is compressed by a disc prolapse.
● Referred pain is not strictly of spinal origin. The source of the pain is
usually a visceral structure whose afferent innervation shares an
interneuronal pool in the posterior horn of the spinal cord with the
somatic structure where the pain is felt.
● Radiating pain does not adopt any particular anatomical distribution. It is
often vaguely localized, and the patient may use the whole hand to
indicate the affected area. The extent of its area of distribution often
relates directly to the severity of the pain. Spinal pain of this type
commonly radiates around the hip and down into the thigh.
 Lesions of the Conus and Cauda
Equina
● Lesions of the conus and cauda equina, such as tumours, cause bilateral
deficits, often with pain in the back extending into the sacral segments
and to the legs. Loss of bladder and erectile function can be early
features.
● There are lower motor neurone signs in the legs, with fasciculation and
muscle atrophy.
● Sensory loss usually involves the perineal or ‘saddle area’ as well as other
lumbar and sacral dermatomes.
 Source

● Sherwood Introduction to Human Physiology 8th Ed

● Netter’s Neurology 2nd Ed
● Gray’s Clinical Neuroanatomy
● Neuroanatomy Through Clinical Cases 2nd Ed