The Motor System

BIMBO P. DICCION, M.D., FPNA

 Motor System
 By means of our motor system, we move our bodies in
space and the various parts of the body in relation to
one another
 It maintains posture and attitude in opposition to
gravity and other external forces
 All movements are effected by contractions of striated
muscles through the control of the nervous system
 All parts of the peripheral and central nervous systems
participate in motor activity
 Level of the motor system
 1. Spinomuscular level  3. Corticospinal level
 Motor impulses arise in  Has its origin in the
the ant. horn cells of the motor nuclei of the
spinal cord and the cerebral cortex
motor nuclei of the  4. Cerebellar level
brainstem to the  The coordinating
myoneural junctions to mechanism
the muscle  5. Psychomotor level
 2. Extrapyramidal level  Has to do with memory,
 Has its nuclei of origin initiative, and conscious
in the basal ganglia and and unconscious
their complex control of motor activity
connections
 Components of the motor system
 Direct activation pathway

 Control circuits

 Indirect activation pathway

 Final common pathway

 Direct activation pathway
 Largest, best-defined motor pathway

 It is a “single neuron” pathway, extending from the cerebral

cortex to the spinal cord (corticospinal tract or pyramidal
tract) and brainstem (corticobulbar tract)
 Provides a direct route by which information can travel from
the cerebral cortex to the brainstem and spinal cord without
an intervening synapse
 Major function: to effect voluntary activity, particularly
skilled movements under conscious control
 Direct activation pathway
 3 Origins:
 Primary motor cortex
 Premotor cortex
 Supplementary motor cortex
 Major neurotransmitters: glutamate (excitatory) and GABA
(inhibitory)
 Damage results in weakness, with loss of voluntary
movements especially fine, skilled movements, but
preservation of other forms of movements including
segments reflexes
 Direct activation pathway
 Primary Motor Cortex = Brodmann’s area 4
 Occupies the anterior lip of the central sulcus of Rolando
 Integrates input from multiple sources and has a
somatotopic organization, with the contralateral body
represented upside down called the motor homunculus
 The size of the cortical representation varies with the
functional importance of the part represented
 There are more neurons in the areas subserving delicate
and complex function
 Direct activation pathway
 Premotor Cortex = Brodmann’s area 6
 May be considered areas of cortical programming of
voluntary activity particularly proximal muscles
 Area controlling the performance of background activity
in support of the direct activation initiated by the cell
columns in area 4
 Direct activation pathway
 Supplementary Motor Cortex
 Transmits signals from other areas of cortex and the basal
ganglia to primary motor cortex as part of the planning of
voluntary movement
 Two Fibers of the Direct Pathways
 Corticospinal Tract
 also called the Pyramidal Tract
 From the cerebral motor cortex to the spinal cord

 Corticobulbar Tract
 From the cerebral motor cortex to the brainstem nuclei

 Upper motor neurons = the neurons from which these

tracts arises
 Two Fibers of the Direct Pathways
 Corticospinal Tract or Pyramidal Tract
 Arises from large motor cells of Betz in the fifth layer of the
primary motor cortex and premotor cortex; and in the
supplementary motor cortex, in the primary somatosensory
cortex (areas 3,1,& 2), and in the superior parietal lobule (areas 5
& 7)
 Data concerning the origin of the pyramidal tract in humans are
scanty, but in the monkey, Russell and De Myer found that
 40 % of the descending axons arose in the parietal
lobe
 31% in motor area 4
 29 % in premotor area 6
 Two Fibers of the Direct Pathways
 Corticospinal Tract or Pyramidal Tract
 The pyramidal tract, strictly speaking, designates only
those fibers that course longitudinally in the pyramid of
the medulla oblongata.
 It descends from the cerebral cortex; traverses the
subcortical white matter (corona radiata), internal
capsule, cerebral peduncle, basis pontis (ventral pons),
and pyramid of the upper medulla; decussates in the lower
medulla (75-80 %); and continues its caudal course in the
lateral funiculus of the spinal cord, named as the lateral
corticospinal tract.
 This is the only direct long-fiber connection between the
cerebral cortex and the spinal cord
 Two Fibers of the Direct Pathways
 Corticobulbar Tract

 Tract that originates from the cortex to the different

brainstem nuclei
 Areas where the Direct Pathway passes
through
 Corona radiata

 Internal Capsule = posterior limb

 Brain Stem

 a. Midbrain = at the middle third cerebral peduncle

 b. Pons = at the basis pontis

 c. Medulla = pyramid or medullary pyramid

 Spinal Cord = lateral corticospinal tract

Lateral Corticospinal Tract
 Control Circuits
 2 parallel pathways

 the cerebellar pathway

 the basal ganglia pathway

 They both receive input from several motor and sensory cortical
areas and project back to the cerebral cortex via the thalamus. They
integrate and modulate motor activity primarily through the
cerebral cortex and direct activation pathways.

 control and modify motor activity

 Consist of several million neurons more that the direct activation

pathways
 Control Circuits
 They also send information to the brainstem and the indirect
activation pathways.
 Basal ganglia
 Concerned with motor programs, the maintenance of background
activity for posture and the performance of automatic motor actions
(Neurotransmitters: dopamine, glutamate, serotonin, Achetylcholine
and GABA)

 Cerebellum
 Coordinates muscle activity during movement for smooth directed
movements and participate in initiating movement.
(Neurotransmitters: glutamate and GABA = gamma-aminobutyric
acid)
 Control Circuits
 Basal ganglia

 Consist of caudate nucleus, lentiform nucleus (putamen,

globus pallidus), substantia nigra, subthalamic nucleus
 Striatum or neostriatum =caudate nucleus + putamen
 Pallidum or Paleostriatum =Globus pallidus (interna &
Externa)
 Striatum neurotransmitters: acetylcholine, dopamine
(Dopamine is produced in the substantia nigra and
transported to striatum via the nigrostriatal pathway)
 Striatum receives the afferent input to the basal ganglia and
inhibits the globus pallidus through axonal projections
containing GABA
 Control Circuits
 Basal gangila neurotransmitters
 Glutamate = the neurotransmitter of the excitatory projections
from the cortex to the striatum and of the excitatory neurons of
the subthalamic nucleus.
 Acetylcholine (ACh) = the neurotransmitter at the
neuromuscular junction and the autonomic ganglia.
The highest concentration of ACh and its enzymes (choline acetyl
transferase and acetylcholinesterase) is in the striatum.
It has a mixed but mainly excitatory effect on the more numerous
spiny neurons within the putamen
 Control Circuits
 Basal gangila neurotransmitters
 Dopamine = has both inhibitory and excitatory effects on the
spiny neurons within the putamen
Within the basal ganglia, the areas richest in dopamine are the
substantia nigra, where it is synthesized in the nerve cell bodies of
the pars compacta, and the termination of these fibers in the
striatum
 GABA = the inhibitory neurotransmitter of striatal, pallidal, and
substantia nigra (pars reticulata) projection neurons.
 Control Circuits
 CEREBELLUM
 coordination and correction of
movement errors of muscles
during active movements
 neurotransmitters:
 glutamate, GABA
 Aspartate,
Control Circuits: Cerebellum
 3 Functional subdivisions
 Vestibulocerebellum
 Spinocerebellum
 Pontocerebellum
 Functional Subdivision of the Cerebellum
 Vestibulocerebellum

 Also called the flocculonodular lobe

 the oldest portion of the cerebellum (archicerebellum)
 separated from the main mass of the cerebellum, or
corpus cerebelli, by the posterolateral fissure
 Receives special proprioceptive impulses from the
vestibular nuclei through the inferior cerebellar peduncle
 it is concerned essentially with equilibrium
 Controls and coordinates axial musculature and
movements of the head and eyes
 Functional Subdivision of the Cerebellum
 Spinocerebellum
 Also called the paleocerebellum
 Consist of the anterior vermis and part of the posterior
vermis and paravermian cortex
 Its primary input is from dorsal spinocerebellar tract from
the lower limbs (via the inferior cerebellar peduncle) and
the ventral spinocerebellar tract from the upper limbs(via
the superior cerebellar peduncle) which provide
information about motor performance and motor neuron
excitability, respectively.
 The main influence appears to be on posture and muscle
tone
 Functional Subdivision of the Cerebellum
 Pontocerebellum
 Also called the posterior lobe, or neocerebellum,
Cerebrocerebellum, consisting of the middle divisions of
the vermis and their large lateral hemisphere
 largest subdivision
 receives inputs from pontine nuclei via the middle
cerebellar peduncle
 The output is from the dentate nucleus through the
superior cerebellar peduncle
 concerned primarily with the coordination of skilled
movements that are initiated at a cerebral cortical level
CEREBELLAR CORTEX
The three layers of the cerebellar cortex
(1) an outer = molecular layer
(2) a middle = Purkinje layer
(3) an inner = granular layer
Molecular Layer
 the outermost layer
 has the least cellular density
 consists of two types of neurons, stellate cells and
basket cells
 Stellate cells have relatively short dendrites and make
contact with the dendrites of a small number of
Purkinje cells
 Basket cells have more extensive dendritic processes
and make contact of a much large number of Purkinje
cells
 Both the stellate and basket cells exert inhibitory
influences on the Purkinje cells
Purkinje Layer
 The middle layer
 relatively thin but consists of the densely packed cell
bodies of the Purkinje cells
 The axons of the Purkinje cells descend through the
granular layer and synapse on the deep cerebellar
nuclei, upon which they have an inhibitory influence
(GABA)
 Purkinje cell axons provide the sole output of
cerebellar cortex
Granular Layer
 The innermost layer
 consists of densely packed granular cells and Golgi
type II cells .
 Granule cells are the only excitatory cells
 Golgi type II cells ( “Golgi cells”) exert inhibitory
effects
Afferent input to the Cerebellum
 3 types
 Mossy fibers
 Climbing fibers
 Aminergic fibers
Afferent input to the Cerebellum
• Mossy fibers
 the main afferent input to the cerebellum, utilize
aspartate
 are axons of the spinocerebellar tracts and the
projections from pontine, vestibular and reticular
nuclei.
 They enter through all three cerebellar peduncles,
mainly the middle (pontine input) and inferior
(vestibulocerebellar)
 They ramify in the granule layer and excite Golgi and
granule neurons through special synapses termed
cerebellar glomeruli
Afferent input to the Cerebellum
• Climbing fibers
 are the axons of cells in the inferior olivary nucleus and
project to the Purkinje cells of the opposite cerebellar
hemisphere.
 The neurotransmitter is unknown
Afferent input to the Cerebellum
• Aminergic fibers
 project through the superior cerebellar peduncle and
terminate on the Purkinje and granule cells in all parts of
the cerebellar cortex
 two types:
 dopaminergic fibers, which arise in the ventral
mesencephalic tegmentum and project to the
interpositus and dentate nuclei and to the granule and
Purkinje cells throughout the cortex
 serotonergic neurons, which are located in the raphe
nuclei of the brainstem and project diffusely to the
granule cell and molecular layer.
CEREBELLAR NUCLEI
 4 pairs of Cerebellar Nuclei
1. Fastigial Nucleus = most medial
2. Globose Nucleus
3. Emboliform Nucleus
2 & 3 = Nucleus interpositos
4. Dentate Nucleus = most lateral
Fastigial Nuclei
 lie just over the roof of the 4th ventricle and receive
fibers from the flocculonodular lobe and send fibers
back to the vestibular and reticular nuclei
 The primary projections to these nuclei come from
those areas of the cerebellar cortex that receive heavy
inputs from the spinal cord, though they also receive
collateral inputs directly from these fibers as well as
from other sources of cerebellar afferents, including
the reticular nuclei, olivary nuclei, and probably some
fibers from the red nuclei
 Regulates body posture
Nucleus Interpositus
(Globose and Emboliform Nuclei)
 functionally related
 these nuclei receive afferent collaterals from many of
the sources of input to the cerebellar cortices and, with
the exception of a few fibers that proceed directly to
the vestibular nuclei, they are the source of all
cerebellar efferents
 Collectively, they are the recipient of the efferent fibers
of the Purkinje cells
 Regulate movements of ipsilateral extremity
Dentate Nuclei
 the largest and most recently developed nuclei
 located most laterally in the white matter of the cerebellar
hemispheres
 Input is primarily from the cerebellar hemispheres, as well
as some from the anterior lobe of the cerebellum
 they also receive direct collateral input from outside the
cerebellum, probably from the same sources as the
interposed nuclei
 Together with the globose and emboliform nuclei, the
dentate nuclei are the primary source of projections via the
superior cerebellar peduncle to the red nucleus and to the
cortex by way of the ventral lateral nuclei of the thalamus
 Coordinates limb movements with motor cortex and basal
ganglia
 Indirect activation pathways
 The older, more diffuse motor pathways, sometimes called
extrapyramidal pathways
 These pathways mediate the enormous number of
automatic activities involved in normal motor function.
For example, the maintenance of erect posture when
sitting or standing and requires the coordinated
contraction of many muscles.
 Major components are the descending brain stem
pathways
 Receives input from the premotor cortex that is less well-
defined than the input to the direct pathway
 Less affected by the control circuits
 Indirect Activation Pathways
 Two major pathways based on function and
termination
A. Medial Pathways
B. Lateral Pathways
 Indirect Activation Pathways
A. Medial Indirect Pathways
 Includes the medullary reticulospinal,
vestibulospinal, and tectospinal tracts
 Located in the ventral and ventrolateral white
matter of the spinal cord
 They end bilaterally in the ventromedial part of
the gray matter that contains long and
intermediate-projecting propiospinal neurons
 They synapse directly on motor neurons of
neck, back and proximal extremity muscles
 Indirect Activation Pathways
A. Medial Indirect Pathways
 They show a high degree of collateralization,
with axons spreading widely in the area of
termination
 They receive input from premotor cortical areas
 Their distribution overlaps that of the ventral
corticospinal tract
 Control posture, synergistic whole-limb
movements and orienting movements of the
head and body
 Indirect Activation Pathways
A. Medial Indirect Pathways
1. Medullary Reticulospinal tract
 Arises from an inhibitory area of the reticular
formation in the ventromedial part of the caudal
medulla
 Descends crossed and uncrossed in the ventral part of
the lateral funiculus of the spinal cord
 Produces mixed effects, most frequently inhibition of
the extensor motor neurons and excitation of flexors
 Also inhibits tendon reflex
 Indirect Activation Pathways
A. Medial Indirect Pathways
2. Vestibulospinal Tract
 Arises from the vestibular nuclei, majority from the
lateral vestibular nuclei
 Descends mostly uncrossed in the ventral funiculus
of the spinal cord
 Activity in the nucleus produces excitation of
extensor motor neurons and flexor motor neurons
 Indirect Activation Pathways
A. Medial Indirect Pathways
3. Tectospinal Tract
 Originates from cells in the superior colliculus, crosses
in the midbrain and descend near the medial
longitudinal fasciculus
 Travels in the ventral funiculus of the spinal cord and
does not extend below the cervical level
 Important in mediating reflex movements of the head
in response to visual and auditory stimuli
 Indirect Activation Pathways
B. Lateral Indirect Pathways
 Include the rubrospinal and the pontine reticulospinal
tracts
 They descend in the contralateral dorsolateral fasciculus
of the spinal cord
 They terminate in the dorsal and lateral part of the
intermediate gray matter which contains short-projecting
propriospinal neurons
 They have monosynaptic connections with motor
neurons innervating distal extremity muscles
 Indirect Activation Pathways
B. Lateral Indirect Pathways
 Their axons have little collateralization
 They receive input from primary motor cortex
 Their termination overlaps that of the lateral
corticospinal tract
 Provide capacity for independent flexor movements, esp.
of the arm
 Indirect Activation Pathways
B. Lateral Indirect Pathways
1. Pontine Reticulospinal Tract
 Originates in the pontine reticular formation
 Produces excitation of extensor motor neuron and inhibition
of flexor motor neuron and is manifested as postural tone

2. Rubrospinal tract
 Originates in the red nucleus and the fibers immediately
decussate in the ventral tegmental decussation to descend on
the opposite side
 It facilitates activity in arm flexors but has little effect on leg
muscles
 Final Common Pathway
 Is the peripheral effector mechanism by which all motor
activity is mediated
 It includes interneurons and motor neurons in the ventral
horn of the spinal cord and the axons of the motor
neurons that extend peripherally via nerves to innervate
muscles
 Consists of many motor units through which all activities
in the motor system must act
 Motor unit = the basic functional component of the final
common pathway
 Consists of the cell body of a motor neuron (alpha motor
neuron) located in the ventral horn of the spinal cord, its single
axon which leaves the spinal cord as the ventral root, and all the
muscle fibers innervated by the terminal axons
Motor Unit
Ventral Horn Cells
 Three types
1. Alpha motor neuron
 Relatively large cells and are arranged in well-defined
columns that extend through many spinal segments
 Innervates muscle fiber (extrafusal muscle fibers)
2. Gamma motor neuron
 Innervates muscle spindles (intrafusal muscle spindle)
3. Interneuron
 Integrate the activity from the direct and indirect
pathways and sensory input
Movement can be generated from:
- sensory signals in the muscle spindle like
the stretch reflex
- sensory signals from skin as in the pain
withdrawal response
- involuntary signals from the brainstem for
posture, keeping us upright without
conscious attention
- signals from the brain for voluntary
movement
But, regardless of where the signal
originates, all movement is the result
of activity in the alpha motor neuron
– making this the Final Common Path
NEUROMUSCULAR JUNCTION
 a specialized synapse designed to transmit electrical
impulses from the nerve terminal to the skeletal muscle via
the chemical transmitter, acetylcholine
 It has 3 major structural elements:
1. presynaptic nerve terminal that is capped by a
terminal Schwann cell
2. the synaptic cleft
3. postsynaptic membrane of the muscle
 All 3 parts contain organelles and molecules not found in
extrasynaptic regions
1. PRESYNAPTIC REGION
 Synaptic vesicle = the
hallmark ultrastructural
feature of the nerve terminal
which contains
acetylcholine
 are located precisely across
the AChR-rich synaptic folds
and are aligned near release
sites called active zone
 Calcium channels are
arranged in parallel double
rows along with a large
macromolecular complex
designed to accomplish
release of vesicle contents.
Terminal Schwann cells
 At the NMJ, 3 – 5 Schwann
cells form a cap in close
apposition to the nerve
terminal, with processes
that extend into the
synaptic cleft that may
come within a few microns
of the active zone.
 Its roles are:
 Modulation of synaptic
transmission
 Nerve terminal growth and
maintenance
 Axonal sprouting
 Nerve regeneration
2. SYNAPTIC CLEFT
 space of 50 nm that
separates nerve and muscle-
fiber plasma membranes
and is comprised of basal
lamina.
 Constituents of basal
lamina:
 Collagen IV
 Entactin
 Laminin
 Perlecan
 Fibronectin
 Others – agrin, AChE, laminin
ά4 & 5, collagen ά3,4 & 5 and
neuregulin
Acetylcholinesterase
 concentrated at the basal lamina, and it is the most
important protein in the synaptic cleft
 It catalyses acetylcholine into acetyl and choline
 Drugs that inhibit AChE, prolong the duration of
action of Ach on the postsynaptic membrane and
are useful therapies for neuromuscular disorders
3. Postsynaptic surface
 The structures located on the
postsynaptic surface are designed
to optimize transmission of a
chemical signal, Ach, to produce
End Plate Potential.
 Secondary synaptic folds =
most striking ultrastructural
feature
= deep infoldings of the
sarcolemma, at the crests of
which are the acetylcholine
receptors (AChRs)
 AChRs = are the most important
protein in the post synaptic
surface
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