DESCENDING TRACTS

DR. PRAVESH JAISWAL

MBBS, MD
ASSISTANT PROFESSOR PHYSIOLOGY
UPUMS, SAIFAI, ETAWAH
MOTOR SYSTEM
 Motor Area of CNS
 Cerebellum

 Basal Ganglia

 Spinal Cord

 Muscles
MOTOR AREA OF CNS

 Primary motor cortex

 Pre motor Area

 Supplementary Motor Area

PRIMARY MOTOR CORTEX
 Brodmann’s area 4
 Topographical

representation
PRE MOTOR AREA
 Brodmann’s area 6
 Topographical

representation
 Complex type of

Motor activity
 Mirror Neuron
SUPPLEMENTARY MOTOR AREA
 Near the
longitudinal fissure
 Bilateral movement
OTHER AREA
 Motor Speech Area
 Voluntary eye

movement area
 Head Rotation area

 Area of Hand skills

DESENDING PATHWAY
CLINICAL CLASSIFICATION:
1. The Pyramidal tracts are the descending
tracts that pass through the pyramid in the
medulla.
Usually, they are synonymous with the
corticospinal tract as the corticospinal fibers
pass through the medullary pyramid.
2. Extrapyramidal tracts are the
descending pathways that do not pass
through the pyramid in the medulla.
Extrapyramidal tracts include reticulospinal,
vestibulospinal, rubrospinal, and tectospinal
tracts.
PHYSIOLOGICAL CLASSIFICATION- BASED ON THE TERMINATION OF THE
DESCENDING PATHWAYS ON THE MOTOR NEURONS IN THE SPINAL CORD
AND THE FUNCTION OF THE PATHWAYS

Lateral System Pathways Medial System

Pathways
 Descend down in the lateral column  descend down in the medial
of the spinal cord. and anterior columns of the
1. These include lateral corticospinal spinal cord. These pathways
tract and rubrospinal tract.
include:
2. The fibers of these tracts are placed 1. Reticulospinal tract
in the lateral funiculus in the spinal 2. Vestibulospinal tract
cord and fibers terminate on the
motor neurons that are placed 3. Tectospinal tract
laterally in the ventral horn of the 4. Anterior corticospinal tract.
spinal cord, i.e. on the lateral group
of motor neurons these tracts are involved in the
regulation of posture as the
3. Thus, these tracts are involved in motor neurons of medial group
the regulation of skilled voluntary innervate the proximal limb
movements as lateral group of muscles and the muscles of
motor neurons innervate the distal
the axial skeleton of the
limb muscles.
body.
CORTICOSPINAL TRACT
 Origin
The fibers of corticospinal tract originate from
the primary motor cortex (area 4), especially
from the large motor cells of Betz in the fifth
layer of the precentral gyrus.
1. There are about 30,000 Betz cells in the
cortex, whereas about one million axons are
present in the corticospinal tract, which clearly
indicate that the corticospinal fibers also
originate from other areas in the cortex.
2. The other cortical motor areas include
premotor cortex (lateral part of area 6),
supplementary motor area (medial part of area
6), primary somatosensory cortex (area 3, 1,
and 2), and parietal cortex (area 5 and 7).
3. Motor cortex contributes to 60% of fibers (30%
from area 4 and 30% from area 6) and sensory
cortex contributes to 40% of fibers in the
corticospinal tract.
The lateral corticospinal tract (LCST)
constitutes about 80% of the fibers in the
corticospinal pathway. This is the most
important descending pathway for the control
of skilled voluntary activities.
The anterior or ventral corticospinal tract
constitutes only 20% of the fibers in the
corticospinal pathway and is involved in control
of posture.
 RUBROSPINAL TRACT
Origin
Rubrospinal tract originates from the red nucleus, located in the
midbrain. The red nucleus receives strong excitatory input from the
motor cortex and cerebellum.
Course
Immediately after originating from the red nucleus, fibers cross over to
the opposite side at the same level
• The fibers terminate on the lateral group of motor neurons that
innervate distal limb muscles.
• Rubrospinal tract excites flexor group of muscles and inhibits extensor
muscles.
Functions
The rubrospinal tract controls skilled voluntary movements
Applied Physiology
In experimental animal, lesion of rubrospinal tract produces deficit in the
distal limb muscles, especially in the flexor group of muscles. However, if
the lateral corticospinal tract is intact, the deficit persists temporarily.
EFFECTS OF LESIONS

1. Lesion of lateral corticospinal tract results in impairment of

skilled voluntary activities like writing, painting, etc. But, as
the rubrospinal tract is intact, the subject recovers after few
days or weeks.
• However, isolated lesion of lateral corticospinal tract is very
uncommon in humans.
• In addition, diseases that affect corticospinal tract also affect
the corticobulbar tracts that influence activities of
extrapyramidal systems.
• Thus, a pure corticospinal tract disease is not seen in
humans.
2. Lesion of the anterior corticospinal tract in animals results in
inability to maintain posture while walking, climbing, etc.
• But in human beings, postural deficit following lesion of
anterior corticospinal tract is not prominent because of two
reasons: i. This tract is not well developed in humans ii.
Other major posture regulating pathways, especially the
reticulospinal tract and vestibulospinal tract, are still intact.
Clinical Importance
Corticospinal pathway may be interrupted anywhere along its course.
However, at the internal capsule (capsular lesion) is the most common
pyramidal tract lesion.
CAPSULAR LESION: As the fibers coming from different parts of the
cortex pass through a narrow tunnel in the posterior limb of the
internal capsule, disease of the internal capsule results in complete
interruption of corticospinal fibers.
1. This leads to complete paralysis of opposite half of the body
(contralateral hemiplegia).
2. It should be noted that the ascending fiber systems from the basal
ganglia and cerebellum pass close to the internal capsule.
• Therefore, extrapyramidal systems are also affected in addition to
the involvement of corticospinal fibers.
• Consequently, pyramidal tract disease due to capsular lesion is
often termed as complete upper motor neuron paralysis.
3. The usual cause of capsular lesion is the rupture of Charcot’s
artery, the lenticulostriate branch of the middle cerebral
artery.
• This artery is also called the artery of cerebral hemorrhage as it
accounts for more than 60% of the causes of intracerebral
 MEDIAL SYSTEM PATHWAYS
Vestibulospinal Tracts
Vestibulospinal tracts (VSTs) originate from the vestibular
nuclei.

 There are four vestibular nuclei: lateral, medial, superior, and

inferior.

Vestibular nuclei receive inputs from otolith organs and

semicircular canals.

VSTs maintain body posture in response to change in head

position and acceleration of the body.

Two important vestibulospinal tracts: lateral vestibulospinal

and medial vestibulospinal tracts.
Lateral Vestibulospinal Tract
originates from the lateral vestibular nucleus (Deiter’s nucleus)
in the brainstem
Course
Descends down ipsilaterally through the brainstem and spinal
cord.
 The fibers occupy the ventral funiculus of the spinal cord and
terminate on interneurons and motor neurons in the ventral horn
of spinal cord.
Functions
It excites motor neurons that supply the proximal group of
muscles (especially the extensor muscles of the limb). Thus,
LVST controls posture.
The input to lateral vestibular nucleus comes mainly from
semicircular canals and otolith organs of the inner ear.
Therefore, LVST controls body posture in relation to angular and
linear accelerations of the head.
Medial Vestibulospinal Tract
Origin : from the medial vestibular nucleus
Course
MVST descends down ipsilaterally in the brainstem and ventral
funiculus of the spinal cord. The fibers of MVST terminate on the
medial group of interneurons and motor neurons.
Functions
MVST controls body posture. The input to medial vestibular
nucleus comes mainly from the semicircular canals. Therefore,
MVST adjusts body posture especially the head position in
response to angular acceleration
Reticulospinal Tracts
Core of brainstem contains reticular formation.
Reticular formation receives inputs from the spinal cord,
vestibular nuclei, cerebellum, hypothalamus, tectum, and
cortex, and projects mainly to the cortex, thalamus, and spinal
cord.
1. Two reticular nuclei are important: nucleus reticularis pontis
in pons and nucleus gigantocellularis in medulla.
2. Accordingly, there are two main reticulospinal tracts: the
pontine reticulospinal tract and the medullary reticulospinal
tract.
3. Reticulospinal tracts are most important medial system
pathways for control of posture.
Pontine Reticulospinal Tract
Origin Pontine reticulospinal tract originates from nucleus
reticularis pontis oralis and nucleus reticularis pontis caudalis
located in the pontine reticular formation.
Course This tract descends down ipsilaterally in the Ventral
funiculus of the spinal cord. The fibers terminate on the medial
group of interneurons and motoneurons that innervate the
proximal and axial groups of muscles of the body .
Functions The function of pontine reticulospinal tract is similar
to that of lateral vestibulospinal tract.
It excites the motor neurons of the proximal extensor muscles
that are involved in the regulation of posture.
Medullary Reticulospinal Tract
Origin Medullary reticulospinal tract originates from nucleus
gigantocellularis located in the reticular formation of the
medulla.
Course The tract descends down ipsilaterally in the ventral
funiculus of the spinal cord to terminate on the medial group of
interneurons and motoneurons that innervate the proximal
Functions This tract is mainly inhibitory. It inhibits the activities of
the motor neurons that innervate extensor neurons.
Tectospinal Tract
Origin
Tectospinal tract originates from the tectum or superior colliculus.
Course
Immediately after originating from superior colliculus, fibers
crossover to the opposite side below the periaqueductal gray.
• The fibers then descend down in the ventral funiculus of the
spinal cord to terminate on the medial group of interneurons
and motor neurons.
• This is the smallest of all descending tracts as it extends up to
the midcervical region of the spinal cord.
Functions
Superior colliculus mainly receives visual inputs. Therefore, the
tectospinal tract regulates the contralateral movement of the head
in response to visual stimuli.
 CLINICAL ASPECTS
Patterns of Paralysis
Paralysis or plegia means complete loss of voluntary
movement, whereas paresis refers to the weakness of
muscles (incomplete paralysis).
Monoplegia
Monoplegia refers to paralysis of all the muscles of one limb (leg
or arm).
Crural (leg) monoplegia that occurs due to trauma, myelitis,
disk-prolapse, or tumor of thoracolumbar segments of the spinal
cord.
Brachial (arm) monoplegia that occurs due to diseases affecting
cervical segments.
Hemiplegia
Hemiplegia means paralysis of one half of the body. This is the most
common form of paralysis that involves arm, leg, and sometimes the
face on one side of the body. Usually, it occurs due to lesion of the
corticospinal pathway at the internal capsule that results in
contralateral hemiplegia.
Paraplegia
Paraplegia refers to paralysis of both lower limbs. It usually occurs due
to spinal cord injury or diseases that cause transection of the cord.
Rarely the diseases of motor cortex, cauda equina, or peripheral
nerves cause paraplegia.
Quadriplegia
Quadriplegia or tetraplegia indicates paralysis of all four extremities. It
usually occurs due to transection of the spinal cord in the upper
cervical segments. Disease of the upper motor neurons bilaterally in
the cervical cord, brainstem, or cerebrum can also cause quadriplegia.
Isolated Paralysis
Isolated paralysis of one or more muscle groups occurs due to disease
of a particular nerve or the branch of the nerve