Neuroanatomy: Pyramidal Tract Functions

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Questions and Answers

What is the primary function of the pyramidal tract?

  • Connecting the spinal cord to the peripheral nervous system
  • Transmitting sensory information to the brain
  • Regulating reflex movements
  • Conveying efferent signals for voluntary muscular control (correct)

Where do upper motor neurons (UMNs) originate in relation to the corticospinal tract?

  • In the anterior horn of the spinal cord
  • In the primary motor cortex (correct)
  • In the peripheral nervous system
  • In the brainstem

Which structure is located between the thalamus and the basal ganglia and is significant for UMN pathways?

  • Spinal cord
  • Medulla oblongata
  • Cerebellum
  • Internal capsule (correct)

What type of movements is primarily controlled by the corticospinal tract?

<p>Voluntary movements of the limbs and trunk (C)</p> Signup and view all the answers

What occurs at the anterior horn of the spinal cord in relation to lower motor neurons (LMNs)?

<p>UMNs make synaptic contact with LMNs (D)</p> Signup and view all the answers

Which structure do the axons of upper motor neurons pass through after the primary motor cortex?

<p>Internal capsule (D)</p> Signup and view all the answers

How are the corticobulbar and corticospinal tracts primarily differentiated?

<p>Based on the regions they innervate (brainstem vs spinal cord) (A)</p> Signup and view all the answers

Which part of the body does the corticospinal tract specifically target for voluntary movement?

<p>Limbs and trunk (D)</p> Signup and view all the answers

Where does the decussation of the corticospinal tract occur?

<p>In the lower medulla oblongata (C)</p> Signup and view all the answers

Which structure is primarily responsible for the synapse of upper motor neurons (UMNs) in the corticospinal tract?

<p>Anterior horn of the spinal cord (D)</p> Signup and view all the answers

Which of the following correctly describes the course of impulses conveyed by lower motor neurons (LMNs)?

<p>They travel through the anterior root of the spinal nerves to the skeletal muscles. (B)</p> Signup and view all the answers

In the corticonuclear tract, where do the bodies of upper motor neurons (UMNs) originate?

<p>In the motor cortex (D)</p> Signup and view all the answers

Which anatomical structure is associated with the decussation of the corticonuclear/corticobulbar tract?

<p>Brainstem (D)</p> Signup and view all the answers

What type of body structures do lower motor neurons (LMNs) innervate?

<p>Skeletal muscles of the limbs and trunk (D)</p> Signup and view all the answers

Which of the following best describes the function of the corticospinal tract?

<p>To control voluntary movements of the body (C)</p> Signup and view all the answers

What is the path of corticospinal tract impulses after passing through the anterior horn?

<p>They move along peripheral nerve plexuses to the limbs. (D)</p> Signup and view all the answers

What is the clinical presentation associated with damage to the ventral root or plexus?

<p>Monoplegia affecting individual muscles (A)</p> Signup and view all the answers

Which symptom indicates damage to the lower motor neurons (LMN) affecting muscle tone?

<p>Hypotonia without extrinsic factors (C)</p> Signup and view all the answers

Which clinical manifestation is associated with hyporeflexia?

<p>Damage to stretch reflex pathways (D)</p> Signup and view all the answers

What is a distinguishing feature of lower motor neuron syndrome compared to upper motor neuron syndrome?

<p>Occurrence of muscle fasciculations (A)</p> Signup and view all the answers

Which condition is characterized by muscle atrophy and is distinct for presenting with reflex disorders?

<p>Loss of muscle mass with fasciculations (C)</p> Signup and view all the answers

What is the primary function of essential structures in motor function?

<p>They are necessary for the movement to take place. (D)</p> Signup and view all the answers

Which of the following is classified as an auxiliary structure in motor function?

<p>Extrapyramidal system (C)</p> Signup and view all the answers

Which neuron type specifically denotes voluntary movement functions?

<p>Upper motor neuron (UMN) (C)</p> Signup and view all the answers

Which structure is NOT considered essential for motor movement?

<p>Praxis system (D)</p> Signup and view all the answers

The sequence of movements leading to a goal is primarily driven by which component?

<p>Lower motor neuron (LWN) (B)</p> Signup and view all the answers

Which of the following contributes to movement quality without being essential for movement?

<p>Cerebellum (B)</p> Signup and view all the answers

Which motor neuron is directly involved at the neuromuscular junction?

<p>Lower motor neuron (LWN) (B)</p> Signup and view all the answers

Which of the following structures is integral in the proprioception aspect of motor function?

<p>Cerebellum (D)</p> Signup and view all the answers

Which structure primarily impacts the coordination of movements?

<p>Extrapyramidal system (C)</p> Signup and view all the answers

Which neuron type integrates signals to modulate both essential and auxiliary structures of motor function?

<p>Upper motor neuron (UMN) (A)</p> Signup and view all the answers

What characterizes the normal plantar reflex?

<p>Flexion of the big toe and adduction of the other toes (D)</p> Signup and view all the answers

What reflex occurs normally in infants under 2 years of age?

<p>Babinski reflex (A)</p> Signup and view all the answers

Which type of paralysis is characterized by limited movement in one limb?

<p>Monoplegia (A)</p> Signup and view all the answers

In which area of the motor cortex does affection lead to contralateral motor symptoms?

<p>Corticospinal tract (D)</p> Signup and view all the answers

Which of the following is NOT a symptom associated with upper motor neuron syndrome?

<p>Muscle atrophy (A)</p> Signup and view all the answers

What type of paralysis results from a lesion affecting both sides of the spinal cord?

<p>Paraplegia (C)</p> Signup and view all the answers

Which tract lesion would likely lead to a central facial palsy?

<p>Corticobulbar tract (D)</p> Signup and view all the answers

What type of paralysis occurs due to lesions in the corticospinal tract at the midbrain?

<p>Contralateral hemiplegia (B)</p> Signup and view all the answers

What is a distinguishing feature of upper motor neuron lesions in the spinal cord?

<p>Motor symptoms are ipsilateral (A)</p> Signup and view all the answers

What reflex is associated with a physiological response until the age of 2?

<p>Babinski reflex (D)</p> Signup and view all the answers

What is the primary effect of lesions in the corticoreticulospinal tract?

<p>Increase in muscle tone and spasticity (B)</p> Signup and view all the answers

Which of the following best describes spasticity?

<p>A velocity-dependent increase in muscle resistance (B)</p> Signup and view all the answers

What clinical feature is associated with hemiparetic gait?

<p>Hip extension and adduction with knee extension (A)</p> Signup and view all the answers

Which reflex disorder is characterized by rhythmic involuntary muscle contractions in response to stretch stimuli?

<p>Clonus (B)</p> Signup and view all the answers

What type of muscle tone disorder can result from upper motor neuron syndrome?

<p>Hypertonia (C)</p> Signup and view all the answers

Which condition is indicated by an abnormally brisk deep tendon reflex?

<p>Hyperreflexia (B)</p> Signup and view all the answers

What kind of muscle atrophy is associated with lower motor neuron syndrome?

<p>Neurogenic atrophy from nerve lesions (B)</p> Signup and view all the answers

Which anatomical pathway is primarily affected in reflex disorders related to upper motor neuron lesions?

<p>Corticoreticulospinal tract (B)</p> Signup and view all the answers

Flashcards

What is the role of the Upper Motor Neuron (UMN)?

The upper motor neuron (UMN) is responsible for the voluntary movement of muscles.

What is the role of the Lower Motor Neuron (LMN)?

The lower motor neuron (LMN) carries signals from the UMN to the muscles, causing them to contract.

What structures are involved in coordinating movement?

The cerebellum, proprioception, and vestibular system are essential for coordinating smooth and accurate movements.

What system regulates the speed and quantity of movement?

The extrapyramidal system regulates the quantity and speed of movement.

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What structures plan movement sequences?

The praxis system plans and coordinates the sequence of movements required to achieve a goal.

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What is a Neuromuscular Junction?

A neuromuscular junction is the point of contact between a motor neuron and a muscle fiber, where signals are transmitted to cause muscle contraction.

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What are the effects of Upper Motor Neuron damage?

Damage to the upper motor neuron can lead to weakness, spasticity, and hyperreflexia.

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What are the effects of Lower Motor Neuron damage?

Damage to the lower motor neuron can cause muscle weakness, atrophy, fasciculations, and hyporeflexia.

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What is the difference between essential and auxiliary structures?

Essential structures are necessary for the movement to occur. Auxiliary structures contribute to the quality of movement but aren't strictly required for it.

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What type of muscle is responsible for voluntary movement?

Striated muscle is the type of muscle responsible for voluntary movements such as walking and talking.

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Corticospinal Tract

A motor pathway that carries signals from the cerebral cortex to the spinal cord. It is responsible for voluntary limb and trunk movements.

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Upper Motor Neuron (UMN)

A neuron in the brain that initiates voluntary movement. It sends signals to lower motor neurons in the spinal cord.

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Lower Motor Neuron (LMN)

A neuron in the spinal cord that directly controls muscle contraction. UMNs send signals to them.

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Primary Motor Cortex

The region in the brain where the cell bodies of upper motor neurons are located. It is responsible for planning and initiating voluntary movement.

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Internal Capsule

A white matter structure in the brain that connects different areas of the brain. Upper motor neurons pass through it.

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Anterior Horn of Spinal Cord

The region in the spinal cord where lower motor neurons are located. It receives signals from upper motor neurons.

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Neuromuscular Junction

The connection between a nerve and a muscle fiber where a signal is transmitted to initiate muscle contraction.

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Skeletal Muscle

The type of muscle that is responsible for voluntary movement. It is controlled by lower motor neurons.

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Spasticity

An increase in muscle resistance to passive movement, especially noticeable when a muscle is stretched quickly.

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Clasp-knife response

A neurological sign characterized by an abrupt increase in muscle tone, followed by a decrease with continued movement.

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Hemiparetic gait

A gait pattern caused by a combination of muscle weakness and spasticity, often affecting one side of the body.

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Hyperreflexia

Abnormal briskness of the stretch reflex, elicited by tapping a tendon.

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Babinski sign

A neurological sign that indicates damage to the corticospinal tract. It is characterized by the extension of the big toe and splaying of the other toes when the sole of the foot is stimulated.

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Clonus

A series of rhythmic, involuntary muscle contractions that occur in response to a sudden stretch.

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Lower Motor Neuron Syndrome

A cluster of symptoms resulting from damage to lower motor neurons, affecting the spinal cord or peripheral nerves.

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Muscle atrophy

Wasteing away of muscle tissue, often due to disuse or nerve damage.

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What is the corticospinal tract?

The corticospinal tract is a major descending motor pathway responsible for initiating voluntary movements of the limbs and trunk. It originates in the motor cortex of the brain and travels down through the spinal cord, where it synapses with lower motor neurons that directly control muscle contraction.

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What is the role of the Upper Motor Neuron (UMN) in the corticospinal tract?

The UMNs (Upper Motor Neurons) in the motor cortex initiate voluntary movement by sending signals through the corticospinal tract down to the spinal cord. These signals can influence the speed and intensity of the movement.

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What is the role of the Lower Motor Neuron (LMN) in the corticospinal tract?

The LMNs receive signals from the UMNs in the spinal cord and relay these signals to skeletal muscles, causing them to contract and produce movement.

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Where does the decussation in the corticospinal tract occur?

The decussation is the point where the corticospinal tract fibers cross over from one side of the brain to the opposite side of the spinal cord. This is why damage to one side of the brain often affects the opposite side of the body.

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What is the Corticonuclear/Corticobulbar tract?

The Corticonuclear or Corticobulbar tract is similar to the corticospinal tract, but it controls voluntary movements of the face, head and neck, instead of the limbs and trunk. It also starts in the motor cortex and synapses with LMNs in the brainstem.

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Where does the decussation in the Corticonuclear/Corticobulbar tract occur?

The Corticonuclear/Corticobulbar tract decussates at the brainstem, not the medulla. This is important because damage to the brainstem can affect facial and head movements on the same side of the body.

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Where are the LMNs in the corticospinal tract located?

The anterior horn of the spinal cord is the location where the cell bodies of the LMNs reside. These neurons receive signals from the UMNs in the corticospinal tract and send them to the skeletal muscles, initiating movement.

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Where does the corticospinal tract originate?

The primary motor cortex is the region in the brain responsible for planning and initiating voluntary movements, sending signals through the corticospinal tract to the spinal cord.

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Plantar Reflex

A reflex that is triggered by stroking the sole of the foot. It is characterized by flexion of the big toe and the adduction and flexion of the other toes. It is normal in children over 2 years of age.

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Babinski Reflex

An abnormal reflex that indicates a possible upper motor neuron lesion. It is characterized by extension of the big toe and abduction of the other toes when the sole of the foot is stroked. It is normal in children under 2 years of age.

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Upper Motor Neuron Syndrome

A neurological condition characterized by weakness or paralysis, increased muscle tone, reflex abnormalities, and muscle atrophy. It arises from damage to the upper motor neurons within the brain.

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Upper Motor Neuron Syndrome: Motor Cortex

A condition affecting the motor cortex of the brain. The corticospinal tract is affected resulting in either monoplegia (affecting one limb) or hemiplegia (affecting one side of the body). The symptoms are contralateral to the lesion.

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Upper Motor Neuron Syndrome: Internal Capsule

A condition affecting the internal capsule in the brain, where upper motor neuron axons converge. Results in hemiplegia - paralysis affecting one side of the body. Symptoms are contralateral to the lesion.

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Upper Motor Neuron Syndrome: Midbrain

A condition affecting the brainstem, specifically the midbrain. Results in contralateral hemiplegia and central facial palsy - weakness of the facial muscles on the opposite side of the body. The corticospinal tract is affected.

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Upper Motor Neuron Syndrome: Pons

A condition affecting the brainstem, specifically the pons. Results in contralateral hemiplegia and peripheral facial palsy. The corticospinal tract is affected.

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Upper Motor Neuron Syndrome: Medulla Oblongata

A condition affecting the brainstem, specifically the medulla oblongata. Results in hemiplegia - paralysis affecting one side of the body, and dysphagia and dysarthria - difficulty swallowing and speaking. The corticospinal tract, as well as cranial nerves IX, X, XI, and XII are affected.

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Upper Motor Neuron Syndrome: Spinal Cord

A condition affecting the spinal cord. Depending on the level of the lesion, it can cause hemiplegia, monoplegia, tetraplegia, or paraplegia. The symptoms are ipsilateral (affecting the same side) to the lesion.

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Upper Motor Neuron Syndrome: Motor Cortex

A condition affecting the motor cortex, the area responsible for initiating movement. It can cause either monoplegia - paralysis of a single limb, or hemiplegia - paralysis of one side of the body. The symptoms are contralateral (affecting the opposite side) to the lesion.

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Hypotonia

A decrease in muscle tone (resistance to passive stretch) caused by damage to the lower motor neuron (LMN). The LMN is responsible for carrying signals from the brain to the muscles.

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Hypertonia

An abnormal increase in muscle tone, usually caused by damage to the upper motor neuron (UMN). This can lead to spasticity, clasp-knife response, and other abnormal movements.

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Myotome Weakness

Muscle weakness or paralysis (complete loss of strength) affecting a specific group of muscles supplied by a single nerve root or plexus.

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Study Notes

Motor Neuron Diseases

  • Neurology Lectures: General Pathology, 3rd year of Medicine, Academic Year 2024/2025
  • Motor Neuron Disease – Index: Neuroanatomy Basis, Upper Motor Neuron Syndrome, Lower Motor Neuron Syndrome
  • Neuroanatomy Basis (Motor Function): Integrity of various structures is crucial for voluntary and involuntary movements with appropriate quality. Essential structures are necessary for movement. Auxiliary structures, like coordination, quantity, and speed, influence the quality of movement but are not essential.
  • Essential Structures: Upper motor neuron (UMN), Lower motor neuron (LMN), Neuromuscular junction, Skeletal muscle
  • Auxiliary Structures: Cerebellum, proprioception, vestibular system, extrapyramidal system, and praxis system (sequence of movements to a goal).
  • Pyramidal Tract: Upper and lower motor neurons grouped. The pyramidal tract originates from the primary motor cortex and conveys efferent signals to the spinal cord or brainstem. This is the key pathway for voluntary muscle control.
    • Corticospinal Tract: Primary motor cortex to spinal cord (controls limbs and trunk).
    • Corticobulbar Tract: Primary motor cortex to brainstem (controls head, face, and neck).
  • Corticospinal Tract (A): UMN originates from primary motor cortex affecting the anterior horn of the spinal cord synapses with LMN (lower motor neuron). LMN descends from the anterior horn to skeletal muscle.
  • Path of Corticospinal Tract (A): UMN axons converge and travel through the internal capsule, a white matter structure between the thalamus and basal ganglia. Then, they descend through the midbrain, pons, and into the medulla oblongata. In the medulla oblongata, fibers cross (decussate) to the opposite side. LMNs descend to the anterior horn, travel through spinal and peripheral nerve plexuses then to skeletal muscles.
  • Corticobulbar Tract (B): UMN originates from the primary motor cortex and travels to the brainstem, where it synapses with LMNs. LMNs carry information directly to muscles of the face, head & neck without crossing to the opposite sides.
  • Cranial Nerves (Mnemonic): On Occasion Our Trusty Truck Acts Funny Very Good Vehicle Any How.
  • Cranial Nerves (Mnemonic): I-XII Breakdown Sensory(S)/ Motor(M)/Both(B).
  • Facial Nerve (Important Remark): The axons of the UMNs travel through the corticonuclear tract and decussate at the pons to synapse with the LMNs. Facial motor nuclei (LMNs) in the pons are divided into two subnuclei, superior and inferior. The superior subnucleus innervates the ipsilateral upper face and receives corticonuclear inputs from both hemispheres. The inferior subnucleus innervates the ipsilateral lower face and receives corticonuclear input only from the opposite hemisphere.
  • Facial Palsy (Two Types): Central Facial Palsy (UMN lesion - affects lower face). Peripheral Facial Palsy (LMN lesion - affects entire side of face).

Upper Motor Neuron Syndrome

  • Etiology: Ischemic or hemorrhagic cerebrovascular disease (stroke)
  • Clinical Presentation: Paralysis (paresis), muscle tone disorder, reflex disorder, muscle atrophy
  • Paralysis: Monoplegia (1 limb), hemiplegia (1 side), paraplegia (lower limbs), tetraplegia (all 4 limbs)
  • Muscle Tone Disorder (Hypertonia): Lesions in the corticoreticulospinal tracts can cause hypertonia. Pathological conditions include spasticity, clasp-knife response (abrupt increase then decrease in resistance during movement), and hemiparetic gait (characteristic gait pattern with hip extension, knee extension, and ankle inversion).
  • Reflex Disorder (Hyperreflexia): Lesions in descending inhibitory pathways (like the corticoreticulospinal tract) can lead to hyperreflexia (abnormally brisk stretch reflexes), Babinski sign (big toe extends), and clonus (rhythmic muscle contractions).
  • Muscles Atrophy: Muscle weakness and wasting due to prolonged or severe nerve damage.

Lower Motor Neuron Syndrome

  • Etiology: Spinal cord compression by trauma, Spinal cords ischaemia or haemorrhage, Spinal cord tumour
  • Clinical Presentation: Paralysis (paresis), muscle tone; reflex, muscle atrophy
  • Paralysis (Paresis): Depending on the level of the lesion. Ventral root or plexus affects homolateral (same side) myotome (group of muscles with similar functions). Spinal/cranial peripheral nerve affects individual muscles on the same side of the lesion (homolateral).
  • Muscle Tone Disorder (Hypotonia): If the efferent signal of the stretch reflex is damaged, hypotonia will result.
  • Reflex Disorder (Hyporeflexia): When the efferent signal of the stretch reflex is damaged, hyporeflexia will result, where reflexes are abnormally diminished or absent.
  • Muscle Atrophy: Muscle wasting due to damage to LMNs, often accompanied by fasciculations (muscle twitches) because of sporadic discharges of motor units.

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