SOMATOMOTORIC SYSTEM

(GENERAL SOMATIC EFFERENT / GSE SYSTEM)

Prof. S. Aswin, MD, PhD

info EFFECTOR
CNS (SKELETAL MOVEMENT
MUSCLE)
PYRAMIDAL, EXTRAPYRAMIDAL &
NEUROMUSCULAR SYSTEM
SKELETAL MUSCLES GENERALLY FUNCTION TO ALLOW
MOVEMENT, ADJUST POSTURE, AND PRODUCE BODY HEAT
THE CRUCIAL PROPERTIES OF THE MUSCLE TISSUE:
- ITS ABILITY TO CONTRACT
- BE EXCITED BY A STIMULUS
- BE STRETCHED (RETURN TO ITS ORIGINAL SHAPE
AFTER STRETCHING OR CONTRACTING)
- GIVES SKELETON THE POWER TO MOVE, IS USUALLY
CONTRACTED VOLUNTARILY AND CONSCIOUSLY
THE CONTRACTION OF SKELETAL MUSCLE IS UNDER
NERVOUS CONTROL, i.e., THE MUSCLE TISSUE ALONE
CANNOT CONTRACT
ITS CONTRACTION IS INITIATED BY A CHEMICAL
(NEUROTRANSMITTER) RELEASED FROM A NERVE
(NEURON)
STRUCTURAL & FUNCTIONAL
ASPECTS OF THE GSE SYSTEM
THE BRAIN EXERTS ACTIVE AND SUBTLE INFLUENCE ON THE
ACTIVITY OF SKELETAL MUSCLES THROUGH DESCENDING
MOTOR PATHWAYS THAT MAKE UP THE UPPER MOTOR NEURONS
(UMN)

UMN: ORIGINATING FROM CELL BODIES IN THE

CEREBRAL CORTEX AND BRAINSTEM
Regulates
FUNCTION: LMN (cranial/spinal nerves)
Modulates

LMN: ALPHA MN EXTRAFUSAL MUSCLE FIBERS

GAMMA MN INTRAFUSAL MUSCLE FIBERS
(see Fig. 14.7)
Fig.10.7 NEUROMUSCULAR SPINDLE

SENSORY RECEPTOR THAT MONITORS THE EXTENT

AND RATE OF MUSCLE LENGTHENING
(STRETCHRECEPTOR)
NEUROMUSCULAR SYSTEM
CONTRACTION OF SKELETAL MUSCLE IS
UNDER NERVOUS CONTROL - THAT IS, THE
MUSCLE TISSUE ALONE CANNOT
CONTRACT
ITS CONTRACTION IS INITIATED BY A
CHEMICAL (NEUROTRANSMITTER:
ACETYLCHOLINE/Ach) RELEASED FROM A
NERVE CELL (NEURON)
MOTOR UNIT (Fig.10.4)

A MOTOR NEURON TOGETHER WITH THE

MUSCLE FIBERS IT INNERVATES

(IN HUMANS: A SINGLE MOTOR UNIT

CAUSESTHE CONTRACTION OF 6 - 30
FIBERS (IN SOME EYE MUSCLES)
TO OVER 1000 FIBERS (IN POWERFUL
LEG MUSCLES)
NEUROMUSCULAR JUNCTION
(NMJ) (Fig.10.5)
THE JUNCTION BETWEEN A MOTOR NEURON
ENDING ON A MUSCLE FIBER
THE END BRANCHES OF THE MOTOR NEURON
(AXON TERMINALS) GAIN ACCESS TO THE
MUSCLE FIBER THROUGH THE ENDOMYSIUM
AT THE JUNCTION BETWEEN THE MUSCLE FIBER
AND THE AXON TERMINALS, THE MUSCLE FIBER
MEMBRANE FORMS A MOTOR END PLATE (MEP)
(MEP:
THE SPECIALIZED PORTION OF THE SARCOLEMMA
(PLASMA MEMBRANE) OF A MUSCLE FIBER
IT SURROUNDS THE SYNAPTIC END BULBS OF THE
AXON)
Fig.10.6 STIMULATION OF MUSCLE
CONTRACTION BY A NERVE IMPULS
13-6B
 SOMATOMOTORIC SYSTEM
PYRAMIDAL SYST. EXTRAPYRAMIDAL SYST.
INITIATION BODY POSITION (rough)
VOLUNTARY TONUS
NONSTEREOTYPIC INHIBITION/ACTIVATION
(specific, smooth, precise,
skilled)
INDIVIDUAL MUSCLE GROUP OF MUSCLES
MOVEMENT MOVEMENT

LOWER MOTONEURON (LMN)*

COORDINATED MOVEMENT

(* LMN: Motoric neuron which axon directly innervate the effector/skeletal muscle)
PYRAMIDAL SYSTEM

PARTOF SOMATOMOTORIC SYST.

ORIGINATED FROM SPECIAL AREA OF THE
CEREBRAL CORTEX WHICH DESCENDS
THROUGH THE PYRAMID/PYRAMIS OF THE
MEDULLA OBLONGATA AND TERMINATES
ON MOTONEURON
THE COMPONENTS OF THE PYRAMIDAL SYST.
CONTRIBUTION
1. SOMATOMOTORIC CORTEX
AREA 4 40%
(MOTOR STRIPT)
HOMUNCULUS MOTORIS
AREA 3,1,2 20%
(SOMAESTHETIC AREA)
AREA 6,8
(PREMOTORIC AREA) 40%
AREA 5,7
(PARASENSORIC AREA)

CORTICOSPINAL TRACT
2. TRACTS
CORTICOBULBAR TRACT

3. MOTORIC NUCLEI
CRANIAL NERVES IN
- BULBUS (PONS + MEDULLA OBLONGATA)
- MESENCEPHALON
SPINAL CORD (ANTERIOR HORN)
(The numbers of area are according to Brodmann)
UPPER MOTONEURON (UMN)
&
LOWER MOTONEURON (LMN)
UMN

THE LOCATION OF ITS CELL BODY (SOMA)

1. CEREBRAL CORTEX (Area 4; 6,8; 3,1,2;5,7)

Corticospinal tract Corticobulbar tract

Bulbus
Spinal cord
(Anterior horn)
 2. MESENCEPHALON
RUBER NUC. TECTAL NUC. INTERSTITIAL NUC.

Rubrospinal Tectospinal Interstitiospinal

tract tract tract

SPINAL CORD (Anterior horn)

3. BRAIN STEM (truncus cerebri)

BULBUS
(PONS + MED. OBL.)
RETICULAR NUC. VESTIBULAR NUC.

Reticulospinal Vestibulospinal
tract tract
SPINAL CORD
 LOWER MOTONEURON (LMN)
LMN THE LOCATION OF ITS CELL BODY

1. BRAIN STEM
MOTORIC NUCLEI OF CERTAIN CRANIAL NERVES
(N III, N IV, N V, N VI, N VII, N IX, N X, N XII)

N III
N IV EXTRAOCULAR MUSCLES
N VI

NV
N VII BRANCHIOGENIC MUSCLES*
N IX VISCERAL ARCH I, II and III
NX

N XII TONGUE MUSCLES

(* BRANCHIOGENIC MUSCLES:
- Facial/mimic muscles - Sternocleidomastoid
- Platysma - Laryngeal muscles
- Trapezius - Pharyngeal muscles)
2. ANTERIOR HORN OF THE SPINAL CORD

ALPHA
MOTONEURON
EXTRAFUSAL MUSCLE
FIBRES

GAMMA
MOTONEURON
INTRAFUSAL MUSCLE
FIBERS
 MOTOR CORTEX (UMN)

A B
LMN
UMN
BULBUS

MUSCULAR
LMN SPINAL CORD ACTIVITY
(Anterior horn) D (MOVEMENT)

A: CORTICOSPINAL TRACT D: SPINAL NERVES

B: CORTICOBULBAR TRACT
C: RETICULOSPINAL TRACT
VESTIBULOSPINAL TRACT
INTERSTITIOSPINAL TRACT
 PYRAMIDAL SYSTEM

CORTICOSPINAL TRACT CORTICOBULBAR TRACT

(PYRAMIDAL TRACT)

LATERAL ANTERIOR
(CROSSED
90%) (10%)
 PYRAMIDAL CORTEX

CRUS CEREBRI
CORTICOSPINAL (MIDBRAIN)
TRACT
PONS
X
I PYRAMIS
II (MED. OBLONGATA)
III
IV PYR. DECUSSATION
V
VI LATERAL
CORTICOSPINAL
VII
IX TRACT
VIII
ANTERIOR
REXED LAMINA
CORTICOSPINAL
TRACT

LMN (ANTERIOR HORN

OF
THE SPINAL CORD)
Lamina Rexed IV, V, VI,
VII, IX
LMN
CORTICOBULBAR TRACT

UMN PYR. CORTEX

CORTICOBULBAR TRACT

PONS
BULBUS

MED. OBL.

LMN
LMN IN THE BULBUS
MOTORIC NUCLEI OF:

N III, N IV, N VI EXTRAOCULAR MUSCLES

NV MASTICATORY MUSCLES
N VII FACIAL (MIMIC) MUSCLES
N IX, N X PALATUM MOLLE MUSCLES
PHARYNGEAL MUSCLES (cranial
LARYNGEAL MUSCLES part)
ESOPHAGUS
N XI TRAPEZIUS
STERNOCLEIDOMASTOID (caudal
LARYNGEAL MUSCLES part)
PHARYNGEAL MUSCLES
N XII TONGUE MUSCLES
CORTICOBULBAR TRACT

CEREBRAL CORTEX CEREBRAL CORTEX

(UMN) (UMN)

IPSILAT.
(uncrossed)

A: BILATERAL
A
CONTRALAT.
(crossed)
B
B: UNCROSSED
(UNILATERAL)

Innervation of nuclei
in the bulbus
CHARACTERISTICS OF CORTICOBULBAR TRACT

IN GENERAL: CRANIAL NERVE NUCLEI RECEIVE

BILATERAL INNERVATION FROM
THE CEREBRAL CORTEX
EXCEPTIONS:

- N VI: CROSSED ONLY (CONTRALATERAL)

CRANIAL
- N VII: 2 NUCLEI
CAUDAL

N VI NUCLEUS
Upper facial muscles

Lower facial muscles

N VII NUCLEI
CLINICAL CORRELATION

PARALYSIS/PLEGIA PARESIS
(TOTAL PARALYSIS) (PARTIAL PARALYSIS)

Severed A B Severed A B

PLEGIA

MONOPLEGIA HEMIPLEGIA PARAPLEGIA TETRAPLEGIA

(One limb) (Half of the (Right + left (Four limbs)
body: one lower limbs)

upper limb
(the same side) +
one lower limb
 PARALYSIS / PLEGIA PYRAMIDAL TRACT LESION

RIGHT (DEXTER) LEFT (SINISTER)

A CORTICOSPINAL TRACT

PYRAMIDAL DECUSSATION

C
LATERAL
CORTICOSPINAL TRACT
B D
SUPERIOR EXTREMITY

INFERIOR EXTREMITY
LESION:
A LEFT HEMIPLEGIA LEFT SUPERIOR EXTREMITY
(HEMIPLEGIA SINISTRA) / CONTRALATERAL
LEFT INFERIOR EXTREMITY
B RIGHT HEMIPLEGIA / IPSILATERAL D TETRAPLEGIA
C LEFT INFERIOR EXTREMITY PARALYSIS
RIGHT SUPERIOR EXTREMITY PARALYSIS RIGHT SUPERIOR EXTREMITY
(HEMIPLEGIA CRUCIATA)
RIGHT INFERIOR EXTREMITY
BROWN-SEQUARD SYNDROME

HEMISECTION OF THE SPINAL CORD

IPSILATERAL PARALYSIS
DEEP ANESTHESIA
+ CUTANEOUS IPSILATERAL
HYPERESTHESIA
CONTRALATERAL CUTANEOUS ANESTHESIA
EXTRAPYRAMIDAL S Y S T E M
A SYSTEM CONSISTS OF TRACTS (SUPRASPINAL
DESCENDENS), NUCLEI AND FEEDBACK CIRCUITS
WHICH PRODUCES SIGNIFICANT INFLUENCES ON
THE VOLUNTARY MUSCLES ACTIVITIES, OUTSIDE
OF THE PYRAMIDAL SYSTEM

THE COMPONENTS OF THE EXTRAPYRAMIDAL SYSTEM

EXTRAPYRAMIDAL CORTEX TELENCEPHALON

BASAL GANGLIA
THALAMUS DIENCEPHALON
SUBTHALAMUS
RUBER NUCLEUS
SUBSTANTIA NIGRA BRAIN STEM
RETICULAR FORMATION
CEREBELLUM
FEEDBACK CIRCUITS
EXTRAPYRAMIDAL SYSTEM PYRAMIDAL SYSTEM

POSTURAL ACTIVITY NONPOSTURAL ACTIVITY

GROUP OF LARGE INDIVIDUAL MUSCLE

MUSCLES ADAPTATION SKILLED MOVEMENTS
(Smooth, precise, specific,
learned)

MODULATION

CIRCUIT
LMN

NORMAL MOVEMENT
(COORDINATED)
DOMAINS OF THE EXTRAPYRAMIDAL SYSTEM

ROUGH SYNERGIC MOVEMENT

POSTURAL ADAPTATION
LOCOMOTION
SEMIAUTTOMATIC MOVEMENT
(WALKING: THE SWAY OF ARMS AND LEGS)
FACE EXPRESSION

EXTRAPYRAMIDAL CORTEX:
OVERLAPS WITH THE CORTEX OF THE PYRAMIDAL SYSTEM
THE INFLUENCE OF THE EXTRAPYRAMIDAL
SYSTEM ON LMN ACTIVITY

1. INDIRECT
2. DIRECT

PYRAMIDAL SYSTEM EXTRAPYRAMIDAL SYSTEM

PYRAMIDAL CORTEX EXTRAPYRAMIDAL CORTEX

1 c
a
THALAMUS
LMN BASAL GANGLIA
2 b -------------------------
SUBCORTICAL NUC.
VOLUNTARY MOTORIC
ACTIVITY
EXTRAPYRAMIDAL CIRCUIT
(a, b and c)
RIGIDITY
DISORDER
DYSKINESIA
TWO DIFFERENT PATHWAYS THROUGH THE BASAL
GANGLIA: DIRECT & INDIRECT
CORTEX
GABA/Enkephalin (glutamate)
GLOBUS STRIATUM
PALLIDUS (Ach) Dopamin
GABA/
Subst. P SUBST. NIGRA
(p. compacta)
GABA Glutamate

SUBTHALAMICGLOBUS SUBST. NIGRA

NUC. PALLIDUS (p. reticularis)
Glutamate (GABA)
THALAMUS SUPPLEMENTARY
SUPPLEMENTARY
MOTOR AREA
MOTOR AREA
CLINICAL CORRELATION
RIGIDITY
DISORDER OF
THE EXTRAPYRAMIDAL SYST.
DYSKINESIA

RIGIDITY INCREASED OF THE TONUS

OF AGONIST AND ANTAGONIST
MUSCLES

PLASTIC COGWHEEL

RESISTANCE: + RESISTANCE: +
SMOOTH AND JERKY
CONTINUOUS (DISCONTINUOUS)

PASSIVE MOVEMENT
TEST
 DYSKINESIA (ABNORMAL INVOLUNTARY MOVEMENT,
WITHOUT PARALYSIS)

RHYTHMIC ARHYTHMIC

ATHETOSIS BALLISMUS
CHOREA

PARKINSONS DISEASE
(PARALYSIS AGITANS)

LESION: - SUBSTANTIA NIGRA

- STRIATUM/GLOBUS PALLIDUS

SYMPTOMS

COGWHEEL RIGIDITY WALKING/GAIT:

DIFFICULTY IN THE INITIATION - SHORT STEPS
OF MOVEMENT - HEAVILY
POVERTY OF MOVEMENT FINE TREMOR
(BRADYKINESIA)/SLOW - RESTING
MASK FACE - PILL ROLLING
THERAPY

SURGICAL LESION OF DECREASED OF TREMOR

GLOBUS PALLIDUS/ AND RIGIDITY
VENTRAL THALAMIC NUC.

DRUG

L-DOPA LOW DOSE RIGIDITY

(Precursor of dopamine)
HIGH DOSE TREMOR
 ATHETOSIS

LESION: PUTAMEN
(Birth trauma)

SYMPTOMS

SLOW, SINUOUS AND AIMLESS

MOVEMENT OF THE DISTAL
MUSCULATURE OF THE EXTREMITIES
(HANDS, FEET)
ALTERNATING ADDUCTION ABDUCTION
(SHOULDER JOINTS)
ALTERNATING FLEXION EXTENTION
(WRIST, FINGERS)
HYPEREXTENTION OF THE FINGERS
CHOREA
(dance)
LESION: STRIATUM
CEREBRAL CORTEX
SYMPTOMS

THE MOVEMENT OF THE EXTREMITIES

(THE AXIAL AND PROXIMAL LIMBS
MUSCULATURES)
- SINUOUS - PURPOSELESS
- JERKY - RAPID
- IRREGULAR
(OCCURS WHEN ALERT DISAPPEARS WHEN SLEEP)

EX. : HUNTINGTONS CHOREA

HEREDITARY
BEGINS AT THE AGE OF 30
AGE GETTING WORSE AND WORSE
FATAL
CHOREOATHETOSIS: COMBINATION OF CHOREA & ATHETOSIS
BALLISMUS
(ballistic: throwing)
SUDDEN, FLAILING AND
GROSS MOVEMENTS

LESION: SUBTHALAMIC NUC.

(CONTRALATERAL)

SYMPTOMS
ABNORMAL INVOLUNTARY MOVEMENT
(STRONG AND RAPID)
PROXIMAL MUSCULATURES OF
THE LIMBS
DECREASED MUSCLE TONUS
DISAPPEARS WHEN SLEEP
UNILATERAL USUALLY CALLED: HEMIBALLISMUS