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Brain: Corticospinal tract
Deep dissection of brain-stem. Lateral view. ("pyramidal tract" visible in red, and "pyramidal decussation" labeled at lower right.)
Diagram of the principal fasciculi of the spinal cord.
Gray's	subject #185 759
NeuroNames	ancil-373
MeSH	Pyramidal+Tracts

The corticospinal or pyramidal tract is a massive collection of axons that travel between the cerebral cortex of the brain and the spinal cord.

The corticospinal tract mostly contains motor axons. It actually consists of two separate tracts in the spinal cord: the lateral corticospinal tract and the medial corticospinal tract. An understanding of these tracts leads to an understanding of why for the most part, one side of the body is controlled by the opposite side of the brain.

Also the corticobulbar tract is considered to be a pyramidal tract. The corticobulbar tract carries signals that control motor neurons located in cranial nerve brain nuclei rather than motor neurons located in the spinal cord.^[1]

The neurons of the pyramidal tracts are pyramidal neurons, but that is not how the pyramidal tract got its name, as most of the pyramidal neurons send their axons elsewhere.^[2] Instead, it got its name from the shape of the corticospinal axon tracts; when the pyramidal tract passes the medulla, it forms a dense bundle of nerve fibres that is shaped somewhat like a pyramid.^[3]

Contents 1 The motor pathway 1.1 Upper motor neurons 1.1.1 Decussation and synapses 1.1.2 From cerebral to motor neurons 1.2 Lower motor neurons 2 Sensory pathways 3 Corticospinal tract damage 4 Extrapyramidal motor pathways 5 Additional images 6 References 7 External links

The corticospinal tract originates from cells in layer V of the motor cortex.

The motor neuron cell bodies in the motor cortex, together with their axons that travel down the brain stem and spinal cord, are referred to as upper motor neuron.

The neuronal cell bodies in the motor cortex send long axons to the motor cranial nerve nuclei mainly of the contralateral side of the midbrain (cortico-mesencephalic tract), pons (cortico-pontine tract), medulla oblongata (cortico-bulbar tract); the bulk of these fibers, however, extend all the way down to the spinal cord (corticospinal tract).

• Most of the cortico-spinal fibers (about 90%) cross over to the contralateral side in the medulla oblongata (pyramidal decussation). Those that cross in the medulla oblongata travel in the lateral corticospinal tract.
• The remainder of them (10%) cross over at the level that they exit the spinal cord, and these travel in the anterior corticospinal tract.

Whichever of these two tracts it travels in, a cortico-spinal axon will synapse with another neuron in the ventral horn. This ventral horn neuron is considered a second-order neuron in this pathway, but is not part of the corticospinal tract itself.

The motor axons move closer together as they travel down through the cerebral white matter, and form part of the posterior limb of the internal capsule.

The motor fibers continue down into the brainstem. The bundle of corticospinal axons is visible as two column-like structures ("pyramids") on the ventral surface of medulla oblongata - this is where the name pyramidal tract comes from.

After the decussation, the axons travel down the spinal cord as the lateral corticospinal tract. Fibers that do not cross over in the medulla oblongata travel down the separate anterior corticospinal tract, and most of them cross over to the contralateral side in the spinal cord, shortly before reaching the lower motor neurons.

In the spinal cord, the axons of the upper motor neuron connect (most of them via interneurons, but to a lesser extent also via direct synapses) with the lower motor neurons (LMNs), located in the ventral horn of the spinal cord.

In the brain stem, the lower motor neurons are located in the motor cranial nerve nuclei (occulomotor, trochlear, motor nucleus of the trigeminal nerve, abducens, facial, accessory, hypoglossal). The lower motor neuron axons leave the brain stem via motor cranial nerves and the spinal cord via anterior roots of the spinal nerves respectively, end-up at the neuromuscular plate and provide motor innervation for voluntary muscles.

• Spinothalamic tract
• Spinocerebellar tract
• Visual pathway
• Olfactory system
• Posterior column pathway

see upper motor neuron.

These are motor pathways that lie outside the corticospinal tract and are beyond voluntary control. Their main function is to support voluntary movement and help control posture and muscle tone. See extrapyramidal motor system.

Dissection of brain-stem. Lateral view.

Superficial dissection of brain-stem. Ventral view.

The motor tract.

• 959774759 at GPnotebook
• Brainstem at UWisc 01Pyramid
• McGill
• BrainMaps at UCDavis Corticospinal tract

v • d • e Brain: mesencephalon (midbrain)
Tectum	Corpora quadrigemina (Inferior colliculi, Superior colliculi) • Subcommissural organ • Pretectum
Peduncle tegmentum	Periaqueductal gray (Cerebral aqueduct, Dorsal raphe nucleus) • Ventral tegmentum • Pedunculopontine nucleus • Red nucleus • MLF (riMLF)  • lemnisci (Medial, Lateral) • cranial nuclei (III: Oculomotor nucleus, III: Edinger-Westphal nucleus, IV: Trochlear nucleus, V: Mesencephalic)
Peduncle base	Substantia nigra • Cerebral crus (Corticospinal tract, Corticobulbar tract, Corticopontine tract/Frontopontine fibers/Temporopontine fibers)

v • d • e Brain: rhombencephalon (hindbrain)
Myelencephalon/medulla	anterior/ventral: Arcuate nucleus of medulla • Pyramid (Decussation) • Olivary body • Inferior olivary nucleus • Anterior median fissure • Ventral respiratory group posterior/dorsal: VII,IX,X: Solitary/tract • XII, X: Dorsal • IX,X,XI: Ambiguus • IX: Inferior salivatory nucleus • Gracile nucleus/Cuneate nucleus/Accessory cuneate nucleus • Area postrema • Posterior median sulcus • Dorsal respiratory group raphe/reticular: Sensory decussation • Reticular formation (Gigantocellular nucleus, Parvocellular reticular nucleus, Ventral reticular nucleus, Lateral reticular nucleus, Paramedian reticular nucleus) • Raphe nuclei (Obscurus, Magnus, Pallidus) tracts: Corticospinal tract (Lateral, Anterior) • Inferior cerebellar peduncle • Olivocerebellar tract • Spinocerebellar (Dorsal, Ventral) • Spinothalamic tract • PCML (Posterior external arcuate fibers, Internal arcuate fibers, Medial lemniscus) • Extrapyramidal (Rubrospinal tract, Vestibulospinal tract, Tectospinal tract)
Metencephalon/pons	anterior/ventral: Superior olivary nucleus • Basis pontis (Pontine nuclei, Middle cerebellar peduncles) posterior/dorsal: Pontine tegmentum (Trapezoid body, Superior medullary velum, Locus ceruleus, MLF, Vestibulocerebellar tract, V Principal Spinal & Motor, VI, VII, VII: Superior salivary nucleus) • VIII-c (Dorsal, Anterior)/VIII-v (Lateral, Superior, Medial, Inferior) raphe/reticular: Reticular formation (Caudal pontine reticular nucleus, Oral pontine reticular nucleus, Tegmental pontine reticular nucleus, Paramedian pontine reticular formation) • Median raphe nucleus Apneustic center • Pneumotaxic center
Metencephalon/cerebellum	Vermis • Flocculus • Arbor vitae • Cerebellar tonsil • Inferior medullary velum Molecular layer (Stellate cell, Basket cell, Parallel fiber) • Purkinje cell layer (Purkinje cell) • Granule cell layer (Golgi cell) • Mossy fibers • Climbing fiber Deep cerebellar nuclei (Dentate, Emboliform, Globose, Fastigial)
Fourth ventricle	apertures (Median, Lateral) • Rhomboid fossa (Vagal trigone, Hypoglossal trigone, Obex, Sulcus limitans, Facial colliculus, Medial eminence) • Lateral recess

v • d • e Anatomy of torso (primarily): the spinal cord
Spinal nerve	Dorsal (Root, Ganglion, Ramus) • Ventral (Root, Ramus) • Sympathetic trunk • rami communicantes (Gray, White)
Gray matter/Rexed laminae	Posterior horn (Column of Clarke, Substantia gelatinosa of Rolando, Nucleus proprius) • Lateral horn • Anterior horn • Central canal/Substantia gelatinosa centralis
White matter: somatic/ascending (blue)	Posterior/PCML: Gracilis • Cuneatus Lateral: Spinocerebellar (Dorsal, Ventral) • Spinothalamic (Lateral, Anterior) • Spinotectal • Posterolateral (Lissauer)
White matter: motor/descending (red)	Lateral: Corticospinal (Lateral) • Ep (Rubrospinal, Olivospinal) Anterior: Corticospinal (Anterior) • Ep (Vestibulospinal, Tectospinal, Reticulospinal)
Layers	Epidural space • Dura mater • Subdural space • Arachnoid mater • Subarachnoid space • Pia mater
Other structures	Denticulate ligaments • Conus medullaris • Cauda equina • Filum terminale • Cervical enlargement • Lumbar enlargement • Anterior median fissure