In contrast, the axons that these pyramidal neurons send out must travel a considerable distance to reach their targets: the motor neurons in the brainstem and the spinal cord. We therefore distinguish two descending pyramidal tracts that are responsible for voluntary movements.
The corticobulbar tract leads to the motor neurons in the nuclei of the brainstem. These nuclei stimulate the muscles of the face, jaw, tongue, and pharynx, via the cranial nerves. The other descending pyramidal tract, the corticospinal tract, stimulates the motor neurons in the spinal cord that are responsible for moving the body's axial muscles, as well as the arms and legs.
The corticospinal tract follows two different pathways to descend into the spinal cord. The first, called the lateral system, contains the axons of the cortical neurons that are responsible for the muscles of the extremities. The fibres in this bundle pass over the ventral surface of the brainstem to form two eminences called the pyramids. Next, at the junction between the medulla and the spinal cord, the fibres of this lateral corticospinal tract cross the midline and continue their descent on the opposite side of the spinal cord. About 80 to 90% of the axons from the motor cortex undergo this crossover, or decussation, before reaching the motor neurons responsible for the movement of the most distal segments of the arms and legs.
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