DESCENDING PATHWAYS

Ngwazi Dr. K.O AWORI

 CORTICOSPINAL
ORIGIN
• Cerebral cortex
– Primary motor area (30%)

– Premotor area (30%)

– Primary sensory area (40%)

• From layer 5 (inner pyramidal) and especially
from the giant pyramidal cells of Betz
INTO THE CORONA RADIATA
Through posterior limb of INTERNAL
CAPSULE
- Occupies centre of the CRUS CEREBRI
- Some corticonuclei to CIII & CIV leave
 Through the BASE of the PONS
Corticonuclei to Cn V, Cn VI, VII, VIII
leave
 Enter the PYRAMIDS
Corticonuclei to IX, X XI & XII leave
In medulla, decussation of (about 85-
90%) fibres occurs
DECUSSATION
 TERMINATION
• Fibres exit in order: Cervical, thoracic, Lumbar
then sacral.

• Uncrossed cross via an interneuron

• Crossed fibres synapse on the anterior horn

cell directly
 LESIONS
upper motor neuron
• MUSCLE BULK: slightly reduced due to disuse

• MUSCLE TONE: High (Hypertonic- clasp knife

rigidity)
• TENDON REFLEXES: Exaggerated

• PLANTAR REFLEX: Up-going/extensor

(Babinski’s sign positive)
 RUBROSPINAL
• From red nucleus

• Decussate in ventral tegmental decussation

• Descend as rubrospinal in lateral funiculus

• Terminate on anterior horn cells

RUBROSPINAL
 others
Tectospinal
• from the colliculi
• decussate in the dorsal tegmental decussation
• Descend as tectospinal
• Terminate on cervical anterior horn cells
 Reticulospinal
• From the reticular formation

• Raphe nuclei, Locus ceruleus

• Terminate on Substantia gelatinosa, AHC etc

• Regulation of pain mechanisms, truncal balance

 Vestibulospinal
• From the vestibular nuclei in the pons

• In anterior funiculus

• Control of truncal balance in response to

vestibular and cerebellar output
 SUMMARY
Motor systems
CEREBRAL MOTOR CORTEX

THALAMUS
• DT
BASAL GANGLIA
CEREBELLUM

DR RED RETICULAR FORMATION

NUCLEUS TECTUM

FV VESTIBULAR
NUCLEI
VS RS TS CS RS

SPINAL CORD
 DESCENDING PATHWAYS
Influences
• Voluntary movements

• Reflex modulation

• Gamma bias
 LOWER & UPPER MOTOR NEURON
LESIONS
LOWER MOTOR UPPER MOTOR
MUSCLE YES NO
WASTING
MUSCLE TONE LOW (HYPERTONIA
(HYPOTONIA) Clasp-knife)
DEEP TENDON REDUCED/ABSENT HYPERREFLEXIA
REFLEXES
• GRACIAS