SOMATOMOTORIC SYSTEM

BRAIN (GSE system: General Somatic Efferent

E system)
B F
(efferent
F EFFECTOR
)
CNS
M E (skeletal muscle)
S C
T
O
R
BRAIN CONTROL OF MOVEMENT
B: Bulbus
The central motor system is arranged as a
MS: medulla spinalis
hierarchy, normally split into three
levels:
I. Motor cortex and other association
cortex
II. Descending spinal tract
 SOMATOMOTORIC
SYSTEM ( )

Motor cortex
(motoric homunculus) (L)

(crossing)

Brain stem : bulbus (R)

(motor nuclei of cran.nerves)

Spinal cord (ant. horn) (R)

NMJ (skeletal m.) (R)

(R: right; L:left;

NMJ:neuromusc. junct.)
 SOMATOMOTORIC SYSTEM
(GENERAL SOMATIC EFFERENT (GSE) SYSTEM)
EFF.
EFFECTOR
1. PYRAMIDAL COORDINATED
SYSTEM (INFO.) (SKELETAL (CONTRACTION)
MUSCLE) MOVEMENT
(instruction:
CONSCIOUS)
CNS
(BRAIN) GSE SYST.

1. PYR. SYST.
2. EXTRAPYRA-
CIRCUIT (direct)
MIDAL
SYSTEM
2. EXTRAPYR. SYST.
BASAL GANGLIA/ (indirect, through circuit)
CEREBELLUM/
THALAMUS/
CORTEX
Pyramidal system Extrapyramidal
system
 THREE LEVELS IN
HIERARCHY
OF MOTOR CONTROL

1. CEREBRAL Corticobulbospinal
CORTEX (primary tract (INDIRECT)
motor area)(UMN)
Corticobulbar tract
s Corticospinal tract
k
e (DIRECT)
2. BRAIN STEM l UMN: upper motor
(BULBUS) e neuron
(LMN) t
a LMN: lower motor
l neuron

3. SPINAL CORD m BULBUS: PONS + MED.

u OBL.
(and cranial motor s
nuclei) (LMN) c
SOMATOMOT. CORTEX:
UMN
Corticobulbar tract
CST Somatomotoric cortex
BULBUS
LMN
SKELETAL
MUSCLE
SKELETAL
MUSCLE MOTOR
LCS
UMN HOMUNCULUS

(Area 4/motor strip/

ACS motor homunculus)
SKELETAL
LMN MUSCLE
SKELETAL
MUSCLE
ANT. HORN
CST: CORTICOSPIN. TRACT
1. LCS: LAT. CORTICOSPIN. TRACT
2. ACS: ANT. CORTICOSPIN. TRACT
MIDLINE
 Primary motor cortex
(precentral gyrus: area
Brodmann 4; motor strip; motor
homunculus)

Homunculus motoris
 MOTOR UNIT
One motor neuron
together with muscle
fibers (myofibers) it
innervates:
1. Small MU

Muscle 2. Large MU
fibers

In humans:
A single motor unit
causes the contraction of
6-30 fibers (small MU: in
some eye muscles) to
over 1,000 fibers (large
MU: in powerful leg
muscles)
CHARACTERISTICS & TYPES OF MOTOR UNIT (MU)
SMALL MU:
Fast movement
Weak movement
Easily fatigue
(e.g., external eye muscles)
LARGE MU:
Slow movement
Strong movement
Not easily fatigue
(e.g., muscles of upper arm and upper leg/thigh)
 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)
 Synaptic end bulb

Sarcolemm
a

MEP
 ELCTRONMICROGRAPH OF
NEUROMUSCULAR JUNCTION (NMJ)

Synaptic end
bulb

MEP
 Electrochemical process

Action potential NT release interaction of NT + receptor

MEP
MOTOR AREA (4,6+8,
3,1,2, 5,7)
Cerebral cortex efferent
(descendens) pathways

1.Corticobulbar tract
2. - Corticorubral
- Corticonuclear
3. Corticospinal tract

Cerebral cortex

1
2 Bulbus
3
Nuc. ruber
Nuc. cran.
Pyr.
decuss.
Ant. horn of
MIDLINE the spin. cord
CORTICOBULBAR
TRACT

Cerebral cortex

Bulbus

Pons
Med.oblongata
 1.CORTICOSPINAL TRACT:
A. Anterior corticospinal
tract (10% of fibers):
directly to the spinal cord
B. Lateral corticospinal
tract (pyramidal tract)
(90% of fibers):
Crossing at the pyramidal
decussation

1
Pyramis: anterior
part of med. obl.,
lateral to the ant.
sulcus medianus
pyramis
Pyramidal
1B 1A decussation
 Bulbus: medulla oblongata + pons

Part of the brain stem

(truncus cerebri)
contains important motor
Pons
nuclei:
-Reticula formation
-Vestibular nuclei
Med. obl.
-Nuclei of motor cranial
nerves

N III, IV, VI extrabulbar muscles

NV mastication muscles
N VII facial/mimic muscles
N IX, X, XI Branchiogenic muscles
Branchial arches I, II,
III
 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 MOTONEURONS (LMNs)*

SKELETAL MUSCLES
* e.g.,
extensors,
COORDINATED MOVEMENT
flexors
(* LMN: Motoric neuron which axon directly innervate the effector/skeletal muscle)
EXTRAPYRAMIDAL COMPONENT: BASAL
GANGLIA

2B BASAL
2A 1 GANGLIA/NUCLEI
2C
1. Lenticular nuc.:
3 2C
Globus pallidus
Putamen
2. Caudate nuc.:
A. Caput
B. Corpus
C. Caudate
3. Amygdala
 R L
PYRAMIDAL SYSTEM
PART OF
SOMATOMOTORIC
SYST. ORIGINATED
FROM SPECIAL
AREAS* OF THE
CEREBRAL CORTEX
WHICH DESCENDS
THROUGH THE
PYRAMID/PYRAMIS OF
THE MEDULLA
OBLONGATA AND
TERMINATES ON
MOTOR NEURON

* Pyramidal areas/cortex
(motor stript)
(4, 3,1,2,6,8, 5,7)
 THE COMPONENTS OF THE PYRAMIDAL
SYST.

SOMATOMOTORIC CORTEX CONTRIBUTION

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)
 CONCEPT OF
UPPER MOTONEURON (UMN)
&
LOWER MOTONEURON (LMN)

CEREBRAL CORTEX
UMN
MESENCEPHALON
BRAIN STEM
THE LOCATION OF ITS CELL BODY (SOMA)

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

Corticospinal Corticobulbar
tract 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
LMN LOWER MOTONEURON (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 MN

Gamma MN

EXTRAFUSAL MUSCLE FIBERS

INTRAFUSAL MUSCLE FIBERS

 SOMATOMOTORIC (DESCENDENT) SYSTEM

MOTOR CORTEX (UMN)

B
LMN
A MUSCL
BULBUS E

C UMN

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(CST) CORTOCOBULBAR
TRACT
(PYRAMIDAL TRACT)

LATERAL CST ANTERIOR CST

(90%) (10%)
 PYRAMIDAL
PYRAMIDAL CORTEX
SYSTEM
CRUS CEREBRI
CORTICOSPINAL (MIDBRAIN)
TRACT
PONS
X
I PYRAMIS
II (MED. OBLONGATA)
III
IV PYR. DECUSSATION
V
VI LATERAL
CORTICOSPINAL
VII
IX TRACT (90%)
VIII
ANTERIOR
REXED LAMINA
CORTICOSPINAL
TRACT (10%)

LMN (ANTERIOR HORN

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

UMN PYR. CORTEX

CORTICOBULBAR TRACT

PONS
BULBUS

1 MED. OBL.

2
LMN Characteristics of the bulbar
nuclei innervation
1 & 2: nuclei in the bulbus In general: crossed + uncrossed
 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
LARYNGEAL MUSCLES (caudal
PHARYNGEAL MUSCLES part)
N XII TONGUE MUSCLES
 CLINICAL CORRELATION

PARALYSIS/PLEGI PARESIS
A A B
A B (PARTIAL PARALYSIS)
(TOTAL
PARALYSIS) Severed Severed

MUSCLE

PLEGIA

MONOPLEGIA HEMIPLEGIA
PARAPLEGIA
(one limb) (half of the body: TETRAPLEGI
(right + left
one upper + lower limbs) (four limbs)
one lower;
the same side)
 PARALYSIS / PLEGIA PYRAMIDAL TRACT LESION

RIGHT (DEXTER) LEFT (SINISTER)

A CORTICOSPINAL TRACT
Lat.
Med.
PYRAMIDAL DECUSSATION

C
LATERAL
CORTICOSPINAL TRACT
B D
SUPERIOR EXTREMITY
Pyr. Tract: Lateral part inferior
exteimity
Medial part Superior
INFERIOR EXTREMITY
extremity
LESION: (CONTRALATERAL !)
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

Hemisection: half of the spinal

cord
ipsilateral: the same side
Contalateral: the opposite side
HEMISECTION OF THE
SPINAL CORD

BROWN-SEQUARD
SYNDROME:
-Paralysis (ipsilat.)
- Deep anesthesia
& cutaneous
hyperesthesia (ipsilat.)
- Cutaneous anesthesia
(contralat.)
LESION AT THE LATERAL
PART OF PYR.
DECUSSATION

Hemiplegia cruciata
Hemiplegia
 EXTRAPYRAMIDAL SYSTEM

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 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)

CIRCUIT MODULATION

LMN

Pyramidal & extrapyramidal

systems interact in harmony
NORMAL & COORDINATED
to produce normal and
MOVEMENT
coordinated movement
 AMYGDALA:
Anatomically: part of basal ganglia
Functionally: part of the limbic
system

GANGLIA BASALIA

NUC. LENTICULARIS

PUTAMEN
GLOBUS PALLIDUS
NUC. CAUDATUS

CAPUT CORPUS CAUDA

 Head of
caudate nuc.
Putamen
Claustrum

Globus
pallidus

Internal
capsule

Thalamus
 DOMAINS OF THE EXTRAPYRAMIDAL SYSTEM

ROUGH SYNERGIC MOVEMENT

POSTURAL ADAPTATION
LOCOMOTION
SEMIAUTOMATIC 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 (via pyramidal cortex)
2. DIRECT (to LMN)

PYRAMIDAL EXTRAPYRAMIDAL
SYSTEM SYSTEM

PYRAMIDAL CORTEX
PYRAMIDAL CORTEX EXTRAPYRAMIDAL CORTEX
EXTRAPYR. CORTEX
1 c
CIRCUIT a
THALAMUS
LMN BASAL GANGLIA
2 b -------------------------
SUBCORTICAL NUC.

VOLUNTARY EXTRAPYRAMIDAL CIRCUIT

(a, b and c)
MOTORIC
RIGIDITY
ACTIVITY
DISORDER
(LESION) DYSKINESIA
 CLINICAL CORRELATION

RIGIDITY
DISORDER OF
EXTRAPYR. SYST.
DYSKINESIA

RIGIDITY INCREASED TONUS

OF AGONIST & ANTAGONIST
MUSCLES

PLASTIC COGWHEEL

RESISTANCE: + RESISTENCE: +
SMOOTH AND JERKY
CONTINUOUS (DISCONTINUOUS)
 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
Parkinsons disease
 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
*Dopamine cannot pass
through blood-brain
barrier (BBB)
ATHETOSIS
LESION: PUTAMEN
(birth trauma)

SYMPTOMS

Slow, sinuous, aimless movements

of distal musculatures of extremities
(hands, feet)
Alternate adduction-abduction (shoulder joints)
Alternate flexion-extention (wrist, fingers)
Hyperextension of fingers
(* Javanese dance)
CHOREA (* Balinese
(dance) 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

Congenital cho- Spasmodic
dyskinesia
reoathetosis

Paralysis
CONGENITAL Agitans
CHOREOATHETOSIS
PARKINSONS
(Parkinsons
DISEASE
Disease)

ATHETOTIC
MOVEMENT

Athetosis
ATHETOSIS
 BALLISMUS
(ballistic: throwing)
SUDDEN, FLAILING* AND
GROSS MOVEMENTS

LESION: SUBTHALAMIC NUC.

(CONTRALATERAL)

(* memukul/mencambuk)

ABNORMAL INVOLUNTARY MOVEMENT

SYMPTOMS
(STRONG AND RAPID)
PROXIMAL MUSCULATURES OF THE LIMBS

DECREASED MUSCLE TONUS

DISAPPEARS WHEN SLEEP
UNILATERAL USUALLY CALLED: HEMIBALLISMUS