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Neuro Atlas

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Descending Motor Pathways<br />

NEUROPHYSIOLOGY<br />

Motor<br />

cortex<br />

Internal<br />

capsule<br />

Hip<br />

Knee<br />

Ankle<br />

Toes<br />

Trunk<br />

Shoulder<br />

Elbow<br />

Wrist<br />

Fingers<br />

Thumb<br />

Neck<br />

Brow<br />

Eyelid<br />

Nares<br />

Lips<br />

Tongue<br />

Larynx<br />

Lateral aspect of<br />

cerebral cortex to show<br />

topographic projection<br />

of motor centers on<br />

precentral gyrus<br />

Midbrain<br />

Pons<br />

Medulla<br />

Basis<br />

pedunculi<br />

Basis<br />

pontis<br />

Pyramids<br />

Motor system<br />

Fibers originate in motor cortex and<br />

descend via posterior limb of internal<br />

capsule to basis pedunculi of midbrain<br />

Longitudinal bundles branch upon<br />

entering basis pontis and rejoin to<br />

enter pyramids of medulla<br />

At lower medulla, bulk of fibers cross<br />

median plane to form lateral<br />

corticospinal tract; some fibers<br />

continue downward in ipsilateral<br />

lateral corticospinal tract; others<br />

descending ipsilateral anterior<br />

corticospinal tract<br />

Medulla<br />

Above midthoracic<br />

level<br />

Decussation<br />

of pyramids<br />

Synapse occurs at spinal level: Lateral<br />

corticospinal fibers synapse on<br />

ipsilateral anterior horn cells; anterior<br />

corticospinal fibers synapse on<br />

contralateral anterior horn cells<br />

Motor<br />

endplate<br />

Spinal<br />

cord<br />

Below midthoracic<br />

level<br />

Anterior corticospinal tract<br />

Lateral corticospinal tract<br />

Motor<br />

endplate<br />

©<br />

FIGURE 2.20<br />

CORTICOSPINAL TRACTS •<br />

The corticospinal, or pyramidal, tract is the major motor tract that<br />

controls voluntary movement of the skeletal muscles, especially<br />

skilled movements of distal muscles of the limbs. All structures<br />

from the cerebral cortex to the anterior horn cells in the spinal<br />

cord constitute the upper portion of the system (upper motor neuron).<br />

The anterior horn cells and their associated axons constitute<br />

the lower portion of the system (lower motor neuron).<br />

71

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