Upper motor neurons in the motor cortex and brainstem initiate and direct voluntary movements. Basal ganglia gate proper movement initiation while the cerebellum coordinates sensory and motor signals for ongoing movement. Lower motor neurons in the spinal cord integrate signals and innervate skeletal muscles. There is somatotopy in the spinal cord with more proximal muscles represented medially and distal muscles laterally. Motor units comprise a motor neuron and the muscle fibers it innervates. Slow motor units generate less force slowly while fast units generate more force but fatigue rapidly.