1. Desc ending Pathways Dr Haji Khan Khoharo

3. Origin : Cerebral Cortex Area 4 (Primary Motor Area) Area 6 (Premotor Area, PM ) Area 3,1,2 (Primary Sensory area) Area 5 ( Parietal Lobule) Corona Radiata lnternal Capsule _ Posterior Limb Crus Cerebri , Middle Portion Longitudinal Pontine Fiber Pyramid - pyramidal decussation Corticospinal Tracts: - Lateral (crossed) - 85% - Anterior (Not crossed) - 15% Termination : Spinal cord_ anterior motor neurons Corticospinal Tract

5. Corticospinal Tract Corona Radiata lnternal Capsule, Posterior Limb Crus Cerebri, Middle Portion Longitudinal Pontine Fiber Pyramid Pyramidal Decussation Corticospinal Tract - Lateral and Anterior CR IC LPF Pyr PD LCST ACST

7. ventromedial pathway dorsolateral pathway Extrapyramidal Tracts from Brain Stem Spinal Cord Tracts

8. upper motor neuron UMN SOMATIC MOTOR SYSTEM lower motor neuron LMN Brain Stem Descending Pathway Final Common Pathway EFFECTORS skeletal muscle Pyramidal Tract VOLUNTARY CONTROL AUTOMATIC CONTROL Rubrospinal Tract Tectospinal Tract Vestibulospinal Tract MLF Reticulospinal Tract REFLEX

9. UMN vs. LMN Syndrome Type of Paralysis Spastic Paralysis Flaccid Paralysis Atrophy No Atrophy Severe Atrophy Deep Tendon Reflex Increase Absent DTR Pathological Reflex +ve Babinski Sign Absent Superficial Reflex Absent Present Fasciculation and Absent Could be Fibrillation Present UMN syndrome LMN Syndrome