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The motor neuron cell bodies in the motor cortex, together with their axons that travel down through the brain stem and spinal cord,
are referred to as upper motor neurons.
Decussation and synapses
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), and medulla oblongata (cortico-bulbar tract). The bulk of
these fibers, however, extend all the way down to the spinal cord (corticopinal tract).
Most of the cortico-spinal fibers (about 80%) 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.
10% enter the lateral corticospinal tract on the same side.
The remainder of them (10%) cross over at the level where they exit the spinal cord, and travel in the anterior corticospinal
tract.
Whichever or 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.
All these usually occurs in the internal capsule
Upper motor neuron problems usually happen before decussation, and lower motor neuron problems, after decussation.
This can explain why we treat patients’ extremities problem using acupuncture points on the contralateral side
Acute pain
Luozheng: search points with fingers for sensitivity, puncture contralaterally, and ask patient to move neck
Yaotongxue (2 points in each hand): same procedure, and ask patient to move, which will send signal to CNS and stimulate
the cortex, which will make new signals (release neurotransmitters) to send to organs
Extrapyramidal motor pathways 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.
Stimulus
Sensory systems code for 4 aspects of a stimulus: type (modality), intensity, location, and duration. Arrival time of a sound pulse
and phase differences of continuous sound are used for localization of sound sources
Certain receptors are sensitive to certain types of stimuli (fro example, different mechanoreceptors respond best to different kinds
of touch stimuli, like sharp or blunt objects).
Receptors send impulses in certain patterns to send information about the intensity of a stimulus (for example, sound volume)
The location of the receptor stimulated gives the brain information about the location of the stimulus (for example, stimulating a
mechanoreceptor in a finger will send information to the brain about that finger)
The duration of the stimulus (how long it lasts) is conveyed by firing patterns of receptors
Modality
A stimulus modality (sensory modality) is a type of physical phenomenon that can be sensed (ex: temperature, taste, sound, and
pressure. The type of sensory receptor activated by a stimulus plays the primary role in coding the stimulus modality.
In the memory-prediction framework, Jeff Hawkins mentions a correspondence between the 6 layers of the cerebral cortex and
the 6 payers of the optic tract of the visual system. The visual cortex has areas labeled V1, V2, V3, V4, V5, MT, IT, etc. Thus
Area V1 is meant to signify only 1 class of cells in the brain, for which there can be many other cells which are also engaged in
vision.
Hawkins lays out a scheme for the analogous modalities of the sensory system. Note that there can be many types of senses. In
particular, for humans, there will be cells which can be labeled as belonging to V1, V2, A1, A2, etc
Auditory system (ear): Auditory Area 1 (A1) is for hearing, via the auditory system, the primary auditory cortex
Somatosensory system consists of the receptors, transmitters (pathways) leading to S1, and S1 that experiences the sensations
labeled as touch and pressure, temperature (warm or cold), pain (including itch and tickle), and the sensations of muscle
movement and joint position including posture, movement, and facial expression (collectively also called proprioception)
Somatosensory Area 1 (S1) is for touch and proprioception in the somatosensory system
Feeds the Brodmann Areas 1-3 of the primary somatosensory cortex, but there are also pathways for proprioception (via
the cerebellum) and motor control (via Broadmann Area 4)
Gustatory system (tongue): Gustatory Area 1 (G1) is used for tasts
Olfactory system: Olfactory Area 1 (O1) is used for smell. In contrast to vision and hearing, the olfactory bulbs are not cross-
hemispheric: the right bulb connects ot eh right hemisphere and the left bulb connects to the left hemisphere.
Human sensory receptors are chemosensor, mechanoreceptor, nociceptor, photoceptor, and thermoceptor.