Spinal Cord Tracts (8).pdf atf

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TABLE OF CONTENTS
Spinal Cord
1. Overview of Spinal Cord and Spinal tracts
2. Two neuron chain - UMN vs LMN
3. Two neuron chain - Stretch Reflex Arch
Tracts 4.
5.
Pyramidal Tracts - Anterior and Lateral Corticospinal Tracts
Pyramidal Tracts - Corticobulbar Tracts and Trigeminal
Motor Pathway
6. Pyramidal Tracts - Facial Nerve Pathway
7. Pyramidal Tracts - Nucleus Ambiguus and Hypoglossal
Nerve Pathways
8. Extrapyramidal Tracts - Rubrospinal Tract
9. Extrapyramidal Tracts - Reticulospinal Tracts
10. Extrapyramidal Tracts - Vestibulospinal Tracts
11. Extrapyramidal Tracts - Tectospinal Tracts
12. Overview of Sensation and First, Second, and Third Order
Neurons
13. Dorsal Column Medial Lemniscus Pathway
14. Anterior and Lateral Spinothalamic Pathways
15. Spinocerebellar Pathways
REVIEW OUTLINE
1. White Matter vs Grey Matter
Overview of 2. Ascending Vs Descending Tracts

○ Motor vs Sensory
Spinal Cord 3. Ascending Sensory Tract Localization

○ Anterolateral Pathways - Spinothalamic Tracts
and Spinal ○ Dorsal Column Medial Lemniscal Tracts

○ Spinocerebellar Tracts
Tracts 4. Descending Motor Tract Localization

○ Anterior Corticospinal Tract
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○ Lateral Corticospinal Tract
○ Rubrospinal Tract
○ Reticulospinal Tract
○ Vestibulospinal Tract
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White Matter vs Grey Matter Bootcamp.com
Grey Matter:
● Location of neuron cell bodies
● Point of communication between neurons
White Matter
● Location of Axons bundles
● Serves to transmit signals to other regions of
the brain, spinal cord, and body
Ascending vs Descending White Matter Tracts Bootcamp.com
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Ascending Sensory Tract Localization Bootcamp.com
Dorsal Column Medial Lemniscal Pathways

○ Fasciculus Gracilis
○ Fasciculus Cuneatus
Anterolateral Pathways
○ Anterior Spinothalamic Tract
○ Lateral Spinothalamic Tract
Spinocerebellar Pathways
○ Dorsal/Posterior Spinocerebellar Tract
○ Ventral/Anterior Spinocerebellar Tract
Descending Motor Tract Localization Bootcamp.com
Pyramidal Tracts
Extrapyramidal
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References Bootcamp.com
References:
● Page 2: <a href="https://commons.wikimedia.org/wiki/File:1313_Spinal_Cord_Cross_Section.jpg">OpenStax</a>, <a
href="https://creativecommons.org/licenses/by/4.0">CC BY 4.0</a>, via Wikimedia Commons
● Page 3: <a href="https://commons.wikimedia.org/wiki/File:Spinal_cord_tracts_-_English.svg">Polarlys and Mikael Häggström</a>, <a
href="https://creativecommons.org/licenses/by-sa/3.0">CC BY-SA 3.0</a>, via Wikimedia Commons
● Page 4-5: <a href="https://commons.wikimedia.org/wiki/File:Medulla_spinalis_-_tracts_-_English.svg">Polarlys (File:Medulla spinalis -
Querschnitt - Bahnen - German.svg), translation by Selket</a>, <a href="http://creativecommons.org/licenses/by-sa/3.0/">CC BY-SA 3.0</a>,
via Wikimedia Commons
REVIEW OUTLINE
1. White Matter vs Grey Matter
Overview of 2. Ascending Vs Descending Tracts

○ Motor vs Sensory
Spinal Cord 3. Ascending Sensory Tract Localization

○ Anterolateral Pathways - Spinothalamic Tracts
and Spinal ○ Dorsal Column Medial Lemniscal Tracts

○ Spinocerebellar Tracts
Tracts 4. Descending Motor Tract Localization

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REVIEW OUTLINE
1. Upper Motor Neurons (UMN)

Two-Neuron 2. Lower Motor Neurons (LMN)
3. Stretch Reflex Arch
Chain 4. LMN Lesions
5. UMN Lesions
6. Babinski Sign
Upper Motor Neurons vs Lower Motor Neurons Bootcamp.com
Upper Motor Neurons (UMN):

● Cell bodies are located in higher cortical areas
○ Motor cortex & brainstem
● Axons will synapse with a LMN in the brainstem or
spinal cord
Lower Motor Neurons (LMN):
● Cell bodies are located in the
○ ventral horn of the spinal cord
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○ brainstem motor nucleus
● Axon terminate at NMJ and stimulates Skeletal
muscle
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Lower Motor Neurons Bootcamp.com
Lower Motor Neurons (LMN):

In the brainstem:
• LMN cell bodies form cranial nerve nuclei
• axons form cranial nerves which travel to their target muscles in the
face
In the spinal cord:

• LMN cell bodies are located in the ventral horns
• axons travel out the ventral root, spinal nerve, dorsal or ventral ramus,
peripheral nerve to reach their target muscle
Stretch Reflex Arch: Bootcamp.com
• Purpose is to maintain muscle length
• Muscle stretch is sensed by muscle spindles (A)
• Stretch provides feedback to activate the LMN, which

triggers active muscle contraction
• LMN lesion abolishes reflex arch
• The stretch reflex is suppressed by input from UMNs

• UMN lesion enhances reflex
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Important spinal levels tested with a

reflex hammer:
• C6 = biceps
• C7 = triceps
• L4 = patellar
• S1 = achilles
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Lower Motor Neuron Lesions Bootcamp.com
• Atrophy: loss of neurotransmitter signaling to stimulate

muscle resulting in muscle fiber deterioration and
decrease muscle mass.
• Ipsilateral weakness: results in muscle weakness, or
paralysis if ALL its LMN are damaged.
• Hyporeflexia: reduced or absent reflex due to lack of
LMN stimulating muscle fibers.
• Fasciculations: damage causes spontaneous firing of
action potentials leading to twitching of the muscles
fibers
• Hypotonia: Decreased muscle tone due to the lack of
stimulation from LMN efferents.
Upper Motor Neuron Lesions Bootcamp.com
• No atrophy: no atrophy because of intact LMN (may

result over time from disuse)
• Weakness: graded weakness of movement (paresis)can
be ipsilateral or contralateral (depending on location)
• Hyper-reflexia: increased reflexes due to lack of
inhibition from UMN
• No fasciculations: no fasciculations because of intact
LMN
• Hypertonia/ Spastic paralysis: affected limb will have
increased muscle tone, tested by passive stretchAfraTafreeh.com
of the
limb
• Babinski’s sign
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Babinski Sign Bootcamp.com
Plantar Reflex / Babinski Sign

• Reflex arch: L5-S1
• Normally, this stimulus results in plantar flexion of

ankle and flexion (curling) of toes.
• In an UMN lesion, firm stroking of the sole of the foot

causes dorsiflexion of the ankle, extension and
spreading of the toes.
• In infants this presents reverse
NORMAL
ABNORMAL
References:
● Page 5 & 6: https://assets.coursehero.com/study-guides/lumen/images/cuny-csi-ap-1-2/reflexes/Nerv_151.jpg
● Page 8:
○ Babinski’s demonstration: <a
href="https://commons.wikimedia.org/wiki/File:Babinski%27s_sign_(de).png">derivative work:
Roxbury-de (talk)Objaw_babinskiego.png: The original uploader was Malki at Polish Wikipedia.</a>, <a
○ Foot: <a href="https://commons.wikimedia.org/wiki/File:Human_Right_Sole.png">Bosgewa</a>, <a
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REVIEW OUTLINE
1. Upper Motor Neurons (UMN)

Two-Neuron 2. Lower Motor Neurons (LMN)
3. Stretch Reflex Arch
Chain 4. LMN Lesions
5. UMN Lesions
6. Babinski Sign
REVIEW OUTLINE
1. Anterior Corticospinal Pathway

Pyramidal Tracts: 2. Lateral Corticospinal Pathway
Corticospinal & 3. Corticobulbar Pathway
4. Trigeminal Motor Pathway
Corticobulbar 5. Facial Nerve Pathway
tracts 6. Nucleus Ambiguus Pathway

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7. Hypoglossal Nerve Pathway
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Corticospinal Pathways Bootcamp.com
Lateral Corticospinal Pathway:

● cortex → corona radiata → internal capsule → crus
cerebri → medullary pyramids (Decussation) → lateral
corticospinal tract → ventral horn LMN → skeletal muscle
● Controls muscles of the distal limbs (hands and feet)
● Responsible for precise, highly skilled movements
○ Ie. playing a piano
Anterior Corticospinal Pathway:

● cortex → corona radiata → internal capsule → crus
cerebri → medullary pyramids ( not decussation) →
anterior corticospinal tract → ventral horn LMN → skeletal
muscle
● Controls muscles neck, trunk, and proximal limbs
90% of corticospinal axons decussate at pyramids (LCS tract)

10% of corticospinal axons do NOT decussate (ACS tract)
Corticospinal Tract Lesions Bootcamp.com
LMN Lesions
● In the CST have ipsilateral effects
● This is including lesions of LMN axons/spinal
nerves and ventral horn cell bodies
● Note: in CBT this is not always the case
UMN lesions
● In the CST, UMN lesions can have ipsilateral or
contralateral effects
● This depends on location of lesion relative to
point of decussation AfraTafreeh.com
● It's important to understand decussations
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Corticobulbar Pathway Bootcamp.com
Corticobulbar pathway:
● Pathway: cortex → corona radiata → internal capsule → crus cerebri
→ some decussate, some don’t → motor nuclei (LMN) → cranial
nerve → skeletal muscle
● Note that CBT decussation occurs at the level of the target nucleus.
Direct CBT LMN nuclei:

● Trigeminal (V)
● Facial (VII)
● Glossopharyngeal (IX)
● Vagus (X)
● Hypoglossal (XII)
Indirect CBT LMN nuclei:

● Oculomotor (III)
● Trochlear (IV)
● Abducens (VI)
Trigeminal Nerve (motor) Pathway - Bilateral UMN Innervation Bootcamp.com
● UMNs originate in the facial region of the PMC and

BI-laterally innervate the LMNs
● LMNs in the masticator nuclei of the Pons control the

ipsilateral muscles of mastication
○ via the mandibular division of the trigeminal N CN V3
● Function test: patient protrudes their jaw

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What happens with an UMN lesion vs LMN lesion?
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Facial Nerve Pathway - Unilateral and Bilateral UMN Innervation Bootcamp.com
● UMNs originate in the facial region of the PMC and BI-laterally AND
UNI-laterally innervate the LMNs
● LMNs in the facial nucleus of the pons control the ipsilateral muscles
of facial expression
○ Motor nucleus is divided into the:
■ Rostral subnucleus - bilateral UMN innervation
● Frontalis muscle - forehead
■ Caudal subnucleus - contralateral UMN Innervation
● Lower facial muscles - around the mouth
● Function test: patient raises their eyebrows and show their teeth
What happens with an UMN lesion vs

LMN lesion?
*UMN facial lesion vs Bell's Palsy

Nucleus Ambiguus Pathway - Bilateral UMN Innervation Bootcamp.com
● UMNs originate in the facial region of the PMC and BI-laterally

innervate the LMNs
● LMNs in the nucleus ambiguus of the medulla control the ipsilateral

muscles of the soft palate, larynx and pharynx
○ Via the glossopharyngeal nerve (CN IX) and Vagus nerve
(CN X)
● Function test: test patients gag-reflex, speech, or say “Ahhh”

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Hypoglossal Nerve Pathway - Contralateral UMN Innervation Bootcamp.com
● UMNs originate in the facial region of the PMC and

CONTRA-laterally innervate the LMNs
● LMNs in the hypoglossal nucleus of the medulla control the

ipsilateral genioglossus muscle (tongue)
● Function test: patient sticks out tongue

REVIEW OUTLINE
1. Anterior Corticospinal Pathway

Pyramidal Tracts: 2. Lateral Corticospinal Pathway
Corticospinal & 3. Corticobulbar Pathway
4. Trigeminal Motor Pathway
Corticobulbar 5. Facial Nerve Pathway
tracts 6. Nucleus Ambiguus Pathway

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7. Accessory Nerve Pathway
8. Hypoglossal Nerve Pathway
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REVIEW OUTLINE
Extrapyramidal 1. Rubrospinal Pathway

2. Reticulospinal Pathway
Tracts: 3. Vestibulospinal Pathway
Rubrospinal, 4. Tectospinal Pathway
Reticulospinal,
Vestibulospinal &
Tectospinal
Pathways
Rubrospinal Tract Pathway Bootcamp.com
Pathway: Function: maintains muscle

red nucleus → decussate at tone of flexors and counteracts
VTA → rubrospinal tract → extensor muscles. Also thought
ventral horn → skeletal muscle to play a role in fine motor
control of the upper limb and
Input: hand.
motor cortex, globose and
emboliform nuclei of the Provides contralateral
cerebellum innervation
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Reticulospinal Tract Pathway Bootcamp.com
Medial Reticulospinal Tract: Lateral Reticulospinal Tract:
Pathway: pontine reticular Pathway: medullary reticular

formation → MRT → ventral horn formation → LRT → ventral horn
→ skeletal muscle → skeletal muscle
Input: ascending sensory tracts Input: cortex via corticoreticular

(DCML/STT) fibers, and ascending sensory
tracts
Function: facilitates voluntary
movement and increases muscle Function: inhibits voluntary
tone, specifically extensor movement and reduces muscle
muscles (ipsilateral) tone, specifically extensor muscles
(ipsilateral)
Medial and Lateral Vestibulospinal Tract Pathway Bootcamp.com
Pathway:
● LVST: lateral vestibular nuclei (CN VIII) → vestibulospinal tract → ventral
horn → limbs muscles (ipsilateral)
● MVST: Medial vestibular nuclei (CN VIII) → vestibulospinal tract →
ventral horn → neck muscles (Bilateral)
Inputs:
● Macula and crista ampullaris via the vestibulocochlear nerve.
● Fastigial nucleus of the deep cerebellar nuclei
Function: increase antigravity muscle tone in accordance with head

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movements to maintain posture and balance. These are extensor muscles in
the limbs
Lesion: results in a continuous state

of contraction of the extensor muscles
of the limbs, a condition known as
decerebrate rigidity.
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Tectospinal Tract Pathway Bootcamp.com
Pathway: superior colliculus →

decussates immediate → tectospinal
tract → ventral horn → skeletal muscle
Input: visual information from the optic

nerve (CN II)
Function: reflexive movements of the

head, eyes, and trunk in response to
visual or auditory stimuli
REVIEW OUTLINE
Extrapyramidal 1. Rubrospinal Pathway

2. Reticulospinal Pathway
Tracts: 3. Vestibulospinal Pathway
Rubrospinal, 4. Tectospinal Pathway
Reticulospinal,
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Vestibulospinal &
Tectospinal
Pathways
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REVIEW OUTLINE
1. Overview of Sensory Modalities

Overview of 2. Somatotopic Organization
3. Ascending Sensory Tract Localization
Sensation and 4. Three Neuron Chain
1st, 2nd & 3rd

Order Neurons
The 5 Sensory Modalities Bootcamp.com
Generally Humans have 5 senses

1. Smell
2. Vision
3. Taste
4. Sound
5. Touch
All sensory information, with the exception of smell,

passes through the Thalamus before reaching the
somatosensory cortex.
Touch sensation is broken down into 6 different

types of touch:
● Nociception
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● Temperature Spinothalamic Pathway
● Crude touch
● Discriminative touch Dorsal Columns/

● Vibration + Pressure Medial Lemniscus
● Proprioception Pathway
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Somatotopic Organization Bootcamp.com
Remember:
● The primary somatosensory cortex displays

somatotopic organization
● The LEFT primary somatosensory cortex

receive information from the RIGHT side of
the body
● The RIGHT primary somatosensory cortex

receives information for the LEFT side of the
body

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Organization of Somatosensory Pathways Bootcamp.com
● Three neuron chain, 1°, 2°, 3°
● The 1° neuron is pseudounipolar with its cell body

located in the DRG of the PNS
○ Cell body is in the trigeminal ganglion for
the face
● The 2° neuron cell body located in the dorsal horn of

the spinal cord OR a brainstem nucleus, it then
decussates and its axon projects to the
contralateral thalamus.
● The 3° neuron cell body is located in the VP nucleus

of the thalamus and projects to the somatosensory
cortex
References:
● Page 3: <a href="https://commons.wikimedia.org/wiki/File:1421_Sensory_Homunculus.jpg">OpenStax College</a>, <a
href="https://creativecommons.org/licenses/by/3.0">CC BY 3.0</a>, via Wikimedia Commons
● Page 4: <a href="https://commons.wikimedia.org/wiki/File:Medulla_spinalis_-_tracts_-_English.svg">Polarlys (File:Medulla spinalis -
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REVIEW OUTLINE
1. Overview of Sensory Modalities

Overview of 2. Somatotopic Organization
3. Ascending Sensory Tract Localization
Sensation and 4. Three Neuron Chain
1st, 2nd & 3rd

Order Neurons
REVIEW OUTLINE
1. Three Neuron Chain

Dorsal Columns/ 2. DCML Tracts of the Lower Limb
3. DCML Tracts of the Upper Limb
Medial 4. Somatotopic organization of the DC
Lemniscus
Pathways AfraTafreeh.com
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Organization of DCML Neurons Bootcamp.com
Three Neuron Chain
● The 1° neuron is pseudounipolar with its cell body

located in the DRG of the PNS
○ Cell body is in the trigeminal ganglion for
the face
● The 2° neuron cell body located in a brainstem

nucleus, it then decussates and its axon projects to
the contralateral thalamus.
● The 3° neuron cell body is located in the VPL

nucleus of the thalamus and projects to the AfraTafreeh.com
somatosensory cortex
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DCML Tracts of the Lower Limbs Bootcamp.com
Three Neuron Chain
1° neurons:
• cell bodies in DRG, axons enter CNS via dorsal roots
• axons ascend ipsilaterally in the fasciculus gracilis (FG)
2° neurons:
• cell bodies in the nucleus gracilis (NG) of the posterior
medulla
• axons decussate, ascend contralaterally in the medial
lemniscus (ML)
3° neurons:
• cell bodies in the VPL thalamus
• axons project to primary somatosensory cortex in the
postcentral gyrus.
DCML Tracts of the Upper Limbs Bootcamp.com
Three Neuron Chain
1° neurons:
• cell bodies in DRG, axons enter CNS via dorsal roots
• axons ascend ipsilaterally in the fasciculus cuneatus (FC)
2° neurons:
• cell bodies in the nucleus cuneatus (NG) of the posterior
medulla
• axons decussate, ascend contralaterally in the medial
lemniscus (ML)
3° neurons:
• cell bodies in the VPL thalamus AfraTafreeh.com
• axons project to primary somatosensory cortex in the
postcentral gyrus.
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Somatotopic organization of the DC Bootcamp.com
As the ascend the spinal cord, the dorsal

column accumulates more and more axons,
first starting with the FG from the lower body
and ending with the addition of the FC from the
upper body dermatomes
What happens when we have a

lesion in this region?
Somatotopic organization of the DC Bootcamp.com
As the ascend the spinal cord, the dorsal

column accumulates more and more axons,
first starting with the FG from the lower body
and ending with the addition of the FC from the
upper body dermatomes
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What happens when we have a

lesion in this region?
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References:
● Page 3: <a href="https://commons.wikimedia.org/wiki/File:Medulla_spinalis_-_tracts_-_English.svg">Polarlys (File:Medulla spinalis -
REVIEW OUTLINE
1. Three Neuron Chain

Dorsal Columns/ 2. DCML Tracts of the Lower Limb
3. DCML Tracts of the Upper Limb
Medial 4. Somatotopic organization of the DC
5. Nucleus Gracilis and Cuneatus in Cross Section
Lemniscus
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REVIEW OUTLINE
1. Anterior Vs Lateral Spinothalamic Tracts

Anterior and 2. Spinothalamic Tract
3. Somatotopic organization of the STT
Lateral
Spinothalamic
Pathways
Anterior Vs Lateral Spinothalamic Tracts Bootcamp.com
Anterior Spinothalamic Tract

● Carries information involving crude touch sensation
Lateral Spinothalamic Tract

● Carries information involving pain and temperature
sensation
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Spinothalamic Tract Bootcamp.com
Three Neuron Chain
1° neurons:
• Cell bodies are located within the DRG
• Axons project into the spinal cord via the dorsal roots
2° neurons:
• Cell bodies are located in the dorsal horn of the spinal
cord
• Axons will then decussate to the contralateral side and
ascend in the spinothalamic tract of the anterolateral
funiculus
• Once these tracts reach the brainstem they turn into the
spinal lemniscus tract.
3° neurons:
• Cell bodies are located in the VPL thalamus
• Axons travel within the internal capsule (posterior limb)
and project to the primary somatosensory cortex.
Somatotopic Organization of the Spinothalamic Tract Bootcamp.com
As the spinothalamic tract ascends

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the spinal cord, more and more
axons are added from each
dermatome
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Somatotopic Organization of the Spinothalamic Tract Bootcamp.com
How would a slow-growing cervical

intramedullary vs extramedullary
lesion present over time?
References:
● Page 2: Spinal Section: <a
href="https://commons.wikimedia.org/wiki/File:Medulla_spinalis_-_tracts_-_English.svg">Polarlys
(File:Medulla spinalis - Querschnitt - Bahnen - German.svg), translation by Selket</a>, <a
href="http://creativecommons.org/licenses/by-sa/3.0/">CC BY-SA 3.0</a>, via Wikimedia Commons
AfraTafreeh.com
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REVIEW OUTLINE
1. Anterior Vs Lateral Spinothalamic Tracts

Anterior and 2. Spinothalamic Tract
3. Somatotopic organization of the STT
Lateral
Spinothalamic
Pathways
REVIEW OUTLINE
1. Dorsal vs Ventral Spinocerebellar Tracts

Dorsal and 2. Dorsal Spinocerebellar Pathway
3. Ventral Spinocerebellar Pathway
Ventral 4. Cuneocerebellar Pathway
5. Summary
Spinocerebellar
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Dorsal vs Ventral Spinocerebellar Tracts Bootcamp.com
Spinocerebellar tracts are involved in unconscious

proprioception
Cuneospinocerebellar Tract
● Carries information involving proprioception
from C1-C7 (upper limbs, head and neck)
Dorsal Spinocerebellar Tract

from C8-L3 (lower limbs and trunk)
Ventral Spinocerebellar Tract

from L4-Co1 (lower limbs)
Dorsal Spinocerebellar Tract Bootcamp.com
1° neurons:
2° neurons:
• Cell bodies are located in Clarke’s column (dorsal
horn) of the spinal cord
• Axons ascend ipsilaterally in the dorsal
spinocerebellar tract
• Axons will enter the cerebellum via the inferior
cerebellar peduncles AfraTafreeh.com
• Synapses in the cerebellar cortex
C8
C8
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Ventral Spinocerebellar Tract Bootcamp.com
1° neurons:
2° neurons:
• Cell bodies are located in Clarke’s column (dorsal
horn) of the spinal cord
• Axons decussate to the contralateral side and
ascend in the ventral spinocerebellar tract
• Axons will enter the cerebellum via the superior
cerebellar peduncles and pass contralaterally
AGAIN to the opposite cerebellar hemisphere
• This double decussation results in ipsilateral
perception
• Synapse in the cerebellar cortex
C8
C8
Cuneocerebellar Tract Bootcamp.com
1° neurons:
• Pass through the dorsal horn of the spinal cord
(doesn’t synapse)
• Axons ascend ipsilaterally in the fasciculus cuneatus
2° neurons:
• Cell bodies are located in the accessory cuneate
nucleus of the medulla (close to the cuneatus
nucleus)
• Axons pass through the inferior cerebellar AfraTafreeh.com
peduncles
• Synapses in the cerebellar cortex
C8
C8
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Summary of Spinocerebellar Tracts Bootcamp.com
Dorsal spinocerebellar tract

● Carries unconscious proprioceptive information
from spinal cord segments C8-L3 (lower limbs and
trunk)
Ventral spinocerebellar tract

from spinal cord segments L4 - Co1 (lower limbs)
Cuneocerebellar tract
from spinal cord segments C1-C7 (head and neck
structures)
C8
C8
References:
● Page 2:
○ Spinal Section: <a
href="https://commons.wikimedia.org/wiki/File:Medulla_spinalis_-_tracts_-_English.svg">Polarly
s (File:Medulla spinalis - Querschnitt - Bahnen - German.svg), translation by Selket</a>, <a
href="http://creativecommons.org/licenses/by-sa/3.0/">CC BY-SA 3.0</a>, via Wikimedia
Commons
○ Dermatomes: <a
href="https://commons.wikimedia.org/wiki/File:Dermatoms_(re-labeled).svg">©
AfraTafreeh.com User:Mono /
Wikimedia Commons, a sister project of Wikipedia</a>, <a
href="https://creativecommons.org/licenses/by-sa/3.0">CC BY-SA 3.0</a>, via Wikimedia
Commons
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REVIEW OUTLINE
1. Dorsal vs Ventral Spinocerebellar Tracts

Dorsal and 2. Dorsal Spinocerebellar Pathway
3. Ventral Spinocerebellar Pathway
Ventral 4. Cuneocerebellar Pathway
5. Summary
Spinocerebellar
Pathways

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AfraTafreeh.

1. White Matter vs Grey Matter

Overview of 2. Ascending Vs Descending Tracts

Spinal Cord 3. Ascending Sensory Tract Localization

and Spinal ○ Dorsal Column Medial Lemniscal Tracts

Tracts 4. Descending Motor Tract Localization

Dorsal Column Medial Lemniscal Pathways

1. White Matter vs Grey Matter

Overview of 2. Ascending Vs Descending Tracts

Spinal Cord 3. Ascending Sensory Tract Localization

and Spinal ○ Dorsal Column Medial Lemniscal Tracts

Tracts 4. Descending Motor Tract Localization

1. Upper Motor Neurons (UMN)

Upper Motor Neurons (UMN):

Lower Motor Neurons (LMN):

In the spinal cord:

• Purpose is to maintain muscle length

• Muscle stretch is sensed by muscle spindles (A)

• Stretch provides feedback to activate the LMN, which

• The stretch reflex is suppressed by input from UMNs

Important spinal levels tested with a

• Atrophy: loss of neurotransmitter signaling to stimulate

• No atrophy: no atrophy because of intact LMN (may

Plantar Reflex / Babinski Sign

• Normally, this stimulus results in plantar flexion of

• In an UMN lesion, firm stroking of the sole of the foot

• In infants this presents reverse

1. Upper Motor Neurons (UMN)

1. Anterior Corticospinal Pathway

tracts 6. Nucleus Ambiguus Pathway

Lateral Corticospinal Pathway:

Anterior Corticospinal Pathway:

90% of corticospinal axons decussate at pyramids (LCS tract)

Direct CBT LMN nuclei:

Indirect CBT LMN nuclei:

● UMNs originate in the facial region of the PMC and

● LMNs in the masticator nuclei of the Pons control the

● Function test: patient protrudes their jaw

What happens with an UMN lesion vs

*UMN facial lesion vs Bell's Palsy

● UMNs originate in the facial region of the PMC and BI-laterally

● LMNs in the nucleus ambiguus of the medulla control the ipsilateral

● Function test: test patients gag-reflex, speech, or say “Ahhh”

● UMNs originate in the facial region of the PMC and

● LMNs in the hypoglossal nucleus of the medulla control the

● Function test: patient sticks out tongue

What happens with an UMN lesion vs LMN lesion?

1. Anterior Corticospinal Pathway

tracts 6. Nucleus Ambiguus Pathway

Extrapyramidal 1. Rubrospinal Pathway

Rubrospinal, 4. Tectospinal Pathway

Pathway: Function: maintains muscle

Medial Reticulospinal Tract: Lateral Reticulospinal Tract:

Pathway: pontine reticular Pathway: medullary reticular

Input: ascending sensory tracts Input: cortex via corticoreticular

Function: increase antigravity muscle tone in accordance with head

Lesion: results in a continuous state

Pathway: superior colliculus →

Input: visual information from the optic

Function: reflexive movements of the

Extrapyramidal 1. Rubrospinal Pathway

Rubrospinal, 4. Tectospinal Pathway

1. Overview of Sensory Modalities

1st, 2nd & 3rd