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Pyramidal tracts
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The pyramidal tracts include both the corticobulbar tract and the corticospinal tract. These are
aggregations of efferent nerve fibers from the upper motor neurons that travel from the cerebral
cortex and terminate either in the brainstem (corticobulbar) or spinal cord (corticospinal) and are
involved in the control of motor functions of the body.

The corticobulbar tract conducts impulses

Pyramidal tracts
from the brain to the cranial nerves.[1] These
nerves control the muscles of the face and
neck and are involved in facial expression,
mastication, swallowing, and other motor
functions.

The corticospinal tract conducts impulses from

the brain to the spinal cord. It is made up of a
lateral and anterior tract. The corticospinal
tract is involved in voluntary movement. The
majority of fibres of the corticospinal tract
cross over in the medulla oblongata, resulting
in muscles being controlled by the opposite
side of the brain. The corticospinal tract
contains the axons of the pyramidal cells, the
largest of which are the Betz cells, located in
the cerebral cortex.

The pyramidal tracts are named because they

pass through the pyramids of the medulla
oblongata. The corticospinal fibers converge to Deep dissection of brain-stem. Lateral view.
("pyramidal tract" visible in red, and "pyramidal
a point when descending from the internal
decussation" labeled at lower right.)
capsule to the brain stem from multiple
directions, giving the impression of an inverted
pyramid. Involvement of the pyramidal tract at
any level leads to pyramidal signs.

The myelination of the pyramidal fibres is

incomplete at birth and gradually progresses in
Spinal cord tracts, with pyramidal tracts labeled at
cranio-caudal direction and thereby
upper left
progressively gaining functionality. Most of the
myelination is complete by two years of age Details
and thereafter it progresses very slowly in
cranio-caudal direction up to twelve years of Decussation Many fibres in pyramids

age. of Medulla oblongata

From cerebral cortex

Contents
To spinal cord
Structure (corticospinal) or
Corticospinal tract brainstem
(corticobulbar)
Corticobulbar tract

Function Identifiers

Clinical significance Latin tractus pyramidalis

tractus corticospinalis
Additional images

In popular culture MeSH D011712

References NeuroNames 1320

External links
NeuroLex ID birnlex_1464

TA98 A14.1.04.102
Structure A14.1.06.102

TA2 6040
The term pyramidal tracts refers to upper
motor neurons that originate in the cerebral FMA 72634
cortex and terminate in the spinal cord
(corticospinal) or brainstem (corticobulbar). Anatomical terms of neuroanatomy
[edit on Wikidata]
Nerves emerge in the cerebral cortex, pass
down and may cross sides in the medulla
oblongata, and travel as part of the spinal cord until
they synapse with interneurons in the grey column
of the spinal cord.[2]

There is some variation in terminology. The

pyramidal tracts definitively encompass the
corticospinal tracts, and many authors also include
the corticobulbar tracts.[3]

Pyramidal tracts

Corticospinal tract
Further information: Corticospinal tract

Nerve fibres in the corticospinal tract originate from pyramidal cells in layer V of the cerebral cortex.
Fibres arise from the primary motor cortex (about 30%), supplementary motor area and the premotor
cortex (together also about 30%), and the somatosensory cortex, parietal lobe, and cingulate gyrus
supplies the rest.[2] The cells have their bodies in the cerebral cortex, and the axons form the bulk of
the pyramidal tracts.[4] The nerve axons travel from the cortex through the posterior limb of internal
capsule, through the cerebral peduncle and into the brainstem and anterior medulla oblongata. Here
they form two prominences called the medulla oblongatary pyramids. Below the prominences, the
majority of axons cross over to the opposite side from which they originated, known as decussation.
The axons that cross over move to the outer part of the medulla oblongata and form the lateral
corticospinal tract, whereas the fibres that remain form the anterior corticospinal tract.[2] About 80%
of axons cross over and form the lateral corticospinal tract; 10% do not cross over and join the tract,
and 10% of fibres travel in the anterior corticospinal tract.[citation needed]

The nerve axons traveling down the tract are the efferent nerve fibers of the upper motor neurons.
These axons travel down the tracts in the white matter of the spinal cord until they reach the vertebral
level of the muscle that they will innervate.[5] At this point, the axons synapse with lower motor
neurons. The majority of axons do not directly synapse with lower motor neurons, but instead synapse
with an interneuron that then synapses with a lower motor neuron. This generally occurs in the anterior
grey column.[2] Nerve axons of the lateral corticospinal tract that did not cross over in the medulla
oblongata do so at the level of the spinal cord they terminate in.[6]

These tracts contain more than 1 million axons and the majority of the axons are myelinated. The
corticospinal tracts myelinate largely during the first and second years after birth. The majority of
nerve axons are small (<4µm) in diameter. About 3% of nerve axons have a much larger diameter
(16µm) and arise from Betz cells, mostly in the leg area of the primary motor cortex. These cells are
notable because of their rapid conduction rate, over 70m/sec, the fastest conduction of any signals
from the brain to the spinal cord.[2]

Corticobulbar tract
Further information: Corticobulbar tract

Fibres from the ventral motor cortex travel with the corticospinal
tract through the internal capsule, but terminate in a number of
locations in the midbrain (cortico-mesencephalic tract), pons
(Corticopontine tract), and medulla oblongata (cortico-bulbar
tract).[6] The upper motor neurons of the corticobulbar tract Horizontal section through the lower part
of the pons, showing the fibers of the
synapse with interneurons or directly with the lower motor corticospinal tract (#19) passing through
neurons located in the motor cranial nerve nuclei, namely the pontine nuclei
oculomotor, trochlear, motor nucleus of the trigeminal nerve,
abducens, facial nerve and accessory and in the nucleus ambiguus to the hypoglossal, vagus and
accessory nerves.[6] These nuclei are supplied by nerves from both sides of the brain, with the
exception of the parts of the facial nerve that control muscles of the lower face. These muscles are
only innervated by nerves from the contralateral (opposite) side of the cortex.[6]

Function

The nerves within the corticospinal tract are involved in movement of muscles of the body. Because of
the crossing-over of fibres, muscles are supplied by the side of the brain opposite to that of the
muscle.[2] The nerves within the corticobulbar tract are involved in movement in muscles of the head.
They are involved in swallowing, phonation, and movements of the tongue.[6] By virtue of involvement
with the facial nerve, the corticobulbar tract is also responsible for transmitting facial expression.[5]
With the exception of lower muscles of facial expression, all functions of the corticobulbar tract
involve inputs from both sides of the brain.[5]

The extrapyramidal system refers to tracts within the spinal cord involved in involuntary movement but
not part of the pyramidal tracts.[2] Their functions include the control of posture and muscle
tone.[citation needed]

Clinical significance

Further information: Pyramidal signs

1. Damage to the fibres of the corticospinal tracts, anywhere along their course from the cerebral cortex
to the lower end of the spinal cord, can cause an upper motor neuron syndrome.

2. A few days after the injury to the upper motor neurons, a pattern of motor signs and symptoms
appears, including spasticity, hyperactive reflexes, a loss of the ability to perform fine movements, and
an extensor plantar response known as the Babinski sign.[7]

3. Symptoms generally occur alongside other sensory problems.

4. Causes may include disorders such as strokes,[8] cerebral palsy,[9][10] subdural hemorrhage,
abscesses and tumours, neurodegenerative diseases such as multiple system atrophy, inflammation
such as meningitis and multiple sclerosis, and trauma to the spinal cord, including from slipped
discs.[4]

5. If the corticobulbar tract is damaged on only one side, then only the lower face will be affected,
however if there is involvement of both the left and right tracts, then the result is pseudobulbar palsy.
This causes problems with swallowing, speaking, and emotional lability.[4]

6. Severe disabling involuntary movements such as hemiballismus or severe chorea might exhaust the
patient and become a life-threatening situation.

7. In the past, this condition was treated by partial section of the pyramidal tract either at the primary
motor cortex or at the cerebral crus (pedunculotomy).[11]

Additional images

Dissection of brain-stem. Superficial dissection of The motor tract.

Lateral view. brain-stem. Ventral view.

Diagram of the principal

fasciculi of the spinal
cord, from Gray's
anatomy

In popular culture

In National Lampoon's European Vacation, the Griswold family wins a vacation on a game show called
Pig in a Poke when their opponents fail to correctly answer a question about the pyramidal tracts,
despite Clark Griswold (played by Chevy Chase) mistakenly answering that they are a housing
development outside Cairo.[12]

References

1. ^ Chapter 9 of "Principles of Physiology" (3rd 7. ^ Neuroscience (2. ed.). Sunderland, Mass:

edition) by Robert M. Berne and Mathew N. Levy. Sinauer Assoc. 2001. pp. Damage to Descending
Published by Mosby, Inc. (2000) ISBN 0-323- Motor Pathways: The Upper Motor Neuron
00813-5. Syndrome. ISBN 0-87893-742-0. Archived from
the original on 2018-05-03.
2. ^ a b c d e f g
Hall, Arthur C. Guyton, John E. (2005).
Textbook of medical physiology (11th ed.). 8. ^ Topcuoglu, MA; Saka, E; Silverman, SB;
Philadelphia: W.B. Saunders. pp. 687–690. Schwamm, LH; Singhal, AB (1 September 2017).
ISBN 978-0-7216-0240-0. "Recrudescence of Deficits After Stroke: Clinical
and Imaging Phenotype, Triggers, and Risk
3. ^ Anthoney, Terence R. (1994). Neuroanatomy and
Factors" . JAMA Neurology. 74 (9): 1048–1055.
the neurologic exam : a thesaurus of synonyms,
doi:10.1001/jamaneurol.2017.1668 .
similar-sounding non-synonyms, and terms of
PMC 5710180 . PMID 28783808 .
variable meaning . Boca Raton: CRC Press.
pp. 458–460. ISBN 9780849386312. Archived 9. ^ Vitrikas, K; Dalton, H; Breish, D (15 February
from the original on 2018-05-03. 2020). "Cerebral Palsy: An Overview". American
Family Physician. 101 (4): 213–220.
4. ^ a b c
Fauci, Anthony S.; Harrison, T. R., eds.
PMID 32053326 .
(2008). Harrison's principles of internal medicine
(17th ed.). New York: McGraw-Hill Medical. 10. ^ Farag, Sara M.; Mohammed, Manal O.; EL-Sobky,
pp. 147–149. ISBN 978-0-07-147692-8. Tamer A.; ElKadery, Nadia A.; ElZohiery, Abeer K.
(March 2020). "Botulinum Toxin A Injection in
5. ^ a b c
Arslan, Orhan (2001). Neuroanatomical Basis
Treatment of Upper Limb Spasticity in Children with
of Clinical Neurology . CRC Press. p. 368.
Cerebral Palsy" . JBJS Reviews. 8 (3): e0119.
ISBN 1439806136. Archived from the original on
doi:10.2106/JBJS.RVW.19.00119 . PMC 7161716 .
2018-05-03.
PMID 32224633 .
a b c d e
6. ^ Young, Paul A. (2007). Basic clinical
11. ^ DeMyer, William (1998). Neuroanatomy .
neuroscience (2nd ed.). Philadelphia, Pa.:
Williams & Wilkins. ISBN 9780683300758.
Lippincott Williams & Wilkins. pp. 69–70.
Archived from the original on 2018-03-03.
ISBN 9780781753197. Archived from the original
on 2017-03-13. 12. ^ "Quotes from "National Lampoon's European
Vacation" " . Archived from the original on 25
March 2017. Retrieved 3 May 2018 – via
www.imdb.com.

External links

McGill

Stained brain slice images which include the "Corticospinal tract" at the BrainMaps project

Last edited on 18 February 2024, at 16:40

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