Ascending and Descending

Tracts

Prof. Dr. Asma’ Hassan

Anatomy Unit
UniSZA

Strictly for instructional use only

 Objectives
1. Describe major ascending and descending
tracts in the central nervous system.

2. Discuss the clinical aspects.

 Neuron and Tracts
3 parts of a neuron:
Dendrites, Cell body, Axon
Tract / Pathway
• a bundle of nerve fibres
(axons) having the same
function, origin and
termination Anatomy of a Neuron

Location of tract:
• long tracts - peripheral
• short tracts - near gray
matter

White matter of spinal cord:

Tracts of myelinated axons
 Definition of Tract
Sensory / Ascending Tract Motor / Descending Tract
• begins in the spinal cord or • begins in the cortex or
brainstem brainstem
• ends in thalamus or cortex • ends in spinal cord
 Ascending tracts Descending tracts

1. Anterolateral system A. Pyramidal tract

(ALS) 1. Corticospinal tract
2. Corticobulbar tract
2. Posterior column-medial
lemniscus pathway B. Extrapyramidal tract
(PCML)
i. Reticulospinal tract
ii. Rubrospinal tract
3. Somatosensory pathways
to cerebellum iii. Tectospinal tract
- Spinocerebellar tracts iv. Vestibulospinal tract
 Anterolateral System (ALS)
The system contains 2 tracts:
1. Lateral spinothalamic tract (LST): Third order
neurons
- pain and temperature

2. Anterior spinothalamic tract (AST):

- light/ crude touch and pressure

Each tract has 3 orders of neurons: Second order

neurons
1) First order neurons
2) Second order neurons
3) Third order neurons First order
neurons
First order neurons
of ALS
• Begin at the receptors i.e.
1) LST – Pain & temperature
: free nerve endings
2) AST – Light / crude touch
(non-discriminative)
: Meissner corpuscle
AST – Pressure
: Pacinian corpuscle
• The peripheral process
transmits input to cell body
which lies in the dorsal root
ganglion
 Anterolateral System (ALS)
Lateral Anterior
spinothalamic spinothalamic
tract tract

Pain Temperature Light touch Pressure

central
CB
process

peripheral
process
 First order neurons of ALS
• Its central process enters spinal cord through the dorsal
root of spinal nerve
• Ascend / descend 1 or 2 segments
– dorsolateral fasciculus (tract of Lissauer)
(a thin column of white matter; contain collateral branches)
- present at all spinal cord levels

Lissauer
tract
 First order neurons of ALS
• 1st order neuron terminates by synapsing with 2nd order
neuron at dorsal gray horn of spinal cord:
1. Lateral spinothalamic tract:
- Substantia gelatinosa (I - II) : pain and temperature
2. Anterior spinothalamic tract:
- Nucleus proprius (III - IV): light touch and pressure

LST
AST
• Cell bodies of 2nd order neurons
are in dorsal gray horn of spinal Second order neurons
cord
• Axons cross obliquely to
opposite side through:
1. Anterior gray commissure
2. Anterior white commissure

• Axons carrying pain and

temperature sensation ascend
as lateral white column
(Lateral spinothalamic tract)

• Axons carrying light touch and

pressure sensation ascend as
anterior white column
(Anterior spinothalamic tract)
 Second order neurons of ALS
• The somatotopic organisation of axons:
– fibres are added to the internal side of white matter

PCML: S – sacral, L – lumbar, T – thoracic, C – cervical

LST & AST:

C – cervical
LST T – thoracic
Anterior L – lumbar
S – sacral
Second order neurons:
• Continue to ascend as
anterior & lateral
spinothalamic tracts in the
tegmentum of brainstem

• At medulla oblongata, they

are joined by spinotectal
tract to form spinal
lemniscus
Second order neurons:
• Continue to ascend as
spinal lemniscus
through tegmentum
of pons & midbrain
 Second & Third order neurons of ALS
• Terminate at ventral
posterolateral (VPL)
nucleus of thalamus by
synapsing with the 3rd order
neurons cell bodies

• Third order neurons fibres

later pass ipsilaterally through
the posterior limb of
internal capsule internal
thalamus capsule
 Third order neurons of ALS
• Third order neurons fibres
pass through the corona
radiata

• Its axon terminates in the

primary somatosensory
area in the postcentral
gyrus of cerebral cortex

• Cerebral cortex will then

interpret the sensory
information
Sensory Homunculus
• Physical representation of the
somatosensory area

• It is scaled according to the

amount of cortex that receive
sensation from body parts

• Sensory from genitalia &

lower limb will be interpreted
by cortical area near the
midline (longitudinal fissure)

• Sensory from head and neck

will be interpreted by cortical
area near the lateral sulcus
 Posterior Column-Medial Lemniscal
Pathway (PCML)
• Sensory pathway that conveys discriminative (fine) touch
and conscious proprioception (vibration & conscious
muscle joint sense) sensation from periphery to the brain
• First order neurons:
 Its peripheral process transmits sensory information to its
cell body in dorsal root ganglion
 Its central process enters spinal cord through dorsal root
 The central process then travels
directly to ipsilateral posterior
white column
 First order neuron of DCML:
- The dendrites of its peripheral process act as sensory
receptors that receive sensation:
a) Free nerve endings (touch, pressure in muscles & joint
capsule)
b) Meissner’s corpuscle
c) Pacinian corpuscle
d) Merkel disks
e) Ruffini corpuscle
 First order neurons of PCML:
– In the posterior white column, the central process
divides into long ascending & short descending
branches (they are NOT tract of Lissauer)

– The short descending branches synapse with

internuncial neurons for intersegmental reflexes
 First order neurons of PCML
• The long fibres ascend
ipsilaterally through posterior
column of spinal cord as 2
fasciculi, i.e.:
1) Fasciculus gracilis (medial)
2) Fasciculus cuneatus (lateral)
First order neurons of PCML:
1) Fasciculus gracilis:
- contains long ascending fibres
from sacral, lumbar & lower
6 (T7 – T12) thoracic spinal
nerves
- i.e. present throughout the
length of spinal cord
2) Fasciculus cuneatus:
- contains long ascending fibres
from upper 6th thoracic (T1-
T6) & cervical spinal nerves
(absent below T6)
- separated from fasciculus
gracilis by a septum
 First order neurons of PCML
• These 2 fasciculi terminate and synapse in the lower
medulla in 2 nuclei:
1. Nucleus gracilis (medial)
2. Nucleus cuneatus (lateral)
which are second order neurons

Note: First order neurons

of ALS fibres terminate in
the spinal cord
 Second order neurons of PCML
• In lower medulla, axons of the
second order neurons sweep
anteromedially to the opposite
side
• These fibres are called
internal arcuate fibres
• This crossing over is commonly
referred to as sensory
decussation
• These fibres ascend as the
medial lemniscus to the
thalamus
 Somatotopic organisation of 2nd order neuron of PCML
• In medulla oblongata:
– Fibres are arranged vertically Midbrain
– Fibres from lower limb are most
anterior
– Fibres from upper limb are most
posterior
• In pons: Pons
– These fibres rotates 90°
– Fibres from lower limb are most medial
lateral lemniscus

– Fibres from upper limb are most

medial Medulla
oblongata
• In midbrain:
– Fibres from lower limb stay at the
same place Blue : Fibres from upper limb
Red: Fibres from lower limb
– fibres from upper limb move laterally
 Third order neurons of PCML
• Second order neurons terminate
and synapse in thalamus
• Cell bodies of 3rd order neurons
are located in VPL nucleus of
thalamus
• Fibres pass through posterior
limb of internal capsule
(posterior 1/3 of posterior limb)
• Fibres course in corona radiata
Internal
capsule
• Terminates in primary
somatosensory area in the
postcentral gyrus of cerebral
cortex
 Clinical Application of the Ascending tracts
PCML
• If lesion occurs in spinal cord, loss of proprioception and
fine touch will be ipsilateral (decussation occurs in medulla
oblongata)
ALS
• Contralateral loss of pain and temperature (decussation
occurs within spinal cord)
Brown-Sequard syndrome (Hemicord lesion)
• DCML – ispilateral loss of proprioception and fine touch
• ALT – contralateral loss of pain and temperature
 Descending Tracts
A. Pyramidal tract:
: originate from the internal pyramidal layer (layer 5) of
cerebral cortex
1. Corticospinal tract
2. Corticonuclear tract

B. Extrapyramidal tract:
: originate from the brainstem
i. Reticulospinal tract
ii. Rubrospinal tract
iii. Tectospinal tract
iv. Vestibulospinal tract
 Descending
Tracts

Pyramidal Extrapyramidal
Tracts Tracts

Corticospinal Corticonuclear 1) Reticulospinal tract

tract tract 2) Rubrospinal tract
3) Tectospinal tract
4) Vestibulospinal tract

Pyramidal tracts: originate from the internal pyramidal layer

(layer 5) of cerebral cortex
Extrapyramidal tracts: originate from the brainstem
 Descending Tracts
• Motor pathways that carry information
from brain to the skeletal muscle
• Composed of 3 neurons:
1) First order neurons:
- Cell body in cerebral cortex
- Synapse with 2nd order neurons
at anterior horn of spinal cord
2) Second order neurons:
- Short internuncial neuron
- Synapse with 3rd order neuron
at anterior horn of spinal cord
3) Third order neurons:
- Innervates the skeletal muscle
- Known as lower motor neuron
 Pyramidal Tracts: Corticospinal Tract

• Motor pathway that

carry input from
cerebral cortex to
spinal cord

• Controls voluntary
action (skilled, precise,
speedy movements) of
skeletal muscles of
the trunks and limbs
 Pyramidal tracts: Corticospinal Tract
1) First order neurons:
– They are axons of the
pyramidal cells in the
internal pyramidal layer
(layer 5) of cerebral cortex

– 2/3 of the axons arise from

precentral gyrus:
 Primary motor cortex
(area 4)
 Secondary motor cortex
(area 6)

– 1/3 of the axons arise from

postcentral gyrus
(somatosensory areas)
• First order neurons of corticospinal tract:
- Axons from precentral gyrus
(motor areas):
 known as upper motor neuron (UMN)
 UMN from different parts of the gyrus
innervates different parts of the body
(can be represented by motor
homunculus)
- Axons from postcentral gyrus
(somatosensory areas):
 They are not UMN
 They influence motor activity by
modulating transmission of sensory
information to higher centre
 Corticospinal tract
• Fibres converge in corona
radiata
• Pass through posterior limb
of internal capsule
– near genu: cervical part /
upper limb
– posterior limb: lower limb

• Pass through middle third of

basis pedunculi of midbrain:
– medial: cervical part / UL
– lateral: lower limb
 Corticospinal (CS) tract

• In pons (basilar part): CS

fibres are broken into many
bundles by transverse
pontocerebellar fibres

• Upper medulla: CS bundles

are group together again to
form pyramid

• At junction of medulla and

spinal cord: most fibres cross
the midline at decussation of
pyramids
 Lateral Corticospinal tract
• Fibres which decussate enter
the lateral white column of
spinal cord

• They form the lateral

corticospinal tract (80-90%)

• Fibres descend the whole

length of lateral white column
of spinal cord

• Fibres terminate mainly in

cervical, lumbar and sacral
spinal cord levels
 Anterior Corticospinal tract
• Remaining 10-20% of fibres do
not decussate
• Fibres descend ipsilateral in
anterior white column of spinal
cord
• These uncrossed fibres are
called anterior corticospinal
tract
• These fibres eventually cross to
opposite side before synapsing
• Fibres termination mainly in the
anterior gray matter of cervical and
upper thoracic spinal cord levels
 Corticospinal tract
Axons descend to synapse in
gray matter of spinal cord with:
• interneurons; which then
synapse with motoneurons
• α motoneurons: skeletal
muscle fibres
• γ motoneurons: muscle stretch
receptors

• Lesions of corticospinal tract

above the pyramidal
decussation will give rise to
paralysis of the body on the
opposite side
Arterial supply of different parts of brain and spinal
cord containing corticospinal tract

Parts Arterial supply

Motor cortex:
Leg area Anterior cerebral artery
Face, trunk and arm areas Middle cerebral artery
Internal capsule Branches of middle cerebral
artery
Midbrain (basis pedunculi) Posterior cerebral artery
Pons Pontine branches of basilar
artery
Medulla oblongata Medullary branches of vertebral
artery
Spinal cord Segmental branches of anterior
spinal artery
 Pyramidal Tracts:
Corticonuclear (Corticobulbar) Tract
(bulbar: brainstem = Cerebral
medulla oblongata + pons) cortex

• Motor pathway that carry

input from cerebral
cortex to cranial nerve
nuclei in the brainstem

• Controls voluntary
action of the skeletal
muscles of the face, Skeletal
muscles
head & neck Brainstem
 Pyramidal Tracts:
Corticonuclear (Corticobulbar) Tract
• It follows the pathway of
corticospinal tract except:
– It does not reach the
spinal cord

– First order neuron

terminates at cranial
nerve nuclei in the
brainstem

– Innervates skeletal
muscle of face, head
and neck
 Descending
Tracts

Pyramidal Extrapyramidal
Tracts Tracts

Corticospinal Corticonuclear 1) Reticulospinal tract

tract tract 2) Rubrospinal tract
3) Tectospinal tract
4) Vestibulospinal tract

Pyramidal tracts: originate from the internal pyramidal layer

(layer 5) of cerebral cortex
Extrapyramidal tracts: originate from the brainstem
 Extrapyramidal Tracts
• Lie outside corticospinal & corticonuclear tracts
• Motor pathways that arise from the brainstem to spinal cord
• Involves with involuntary control of skeletal muscle
• Main function:
- support voluntary movement
- help control posture and muscle tone

Tracts Origin Fibres Function

Reticulospinal Reticular Both Facilitate or inhibit voluntary
formation movement
Rubrospinal Red nucleus Crossed Facilitate flexor & inhibit
extensor muscles
Tectospinal Superior Crossed Reflex postural movements in
colliculus response to visual stimuli
Vestibulospinal Vestibular Uncrossed Facilitate extensor & inhibit
nuclei flexor muscles in
maintenance of balance
Ascending & Descending Tracts of Spinal Cord
 SEQ
With the help of diagram/s, briefly describe
the origin, course and termination of:
A) Anterior spinothalamic tract
B) Lateral spinothalamic tract
C) Posterior column medial meniscal
pathway
D) Lateral corticospinal tract

(each question 10 marks)

 References
1. A textbook of neuroanatomy
M.A. Patestas & L.P. Gartner
2. Clinical neuroanatomy for medical
students
R.S. Snell
3. Clinical neuroanatomy
Vishram Singh