neuroanatomy Neuroanatomy is the study of the structure and organization of the nervous system. In contrast to animals with radial symmetry, whose nervous system consists of a distributed network of cells, animals with bilateral symmetry have segregated, defi ...

, the medullary pyramids are paired

white matter White matter refers to areas of the central nervous system (CNS) that are mainly made up of myelinated axons, also called tracts. Long thought to be passive tissue, white matter affects learning and brain functions, modulating the distributi ...

structures of the brainstem's medulla oblongata that contain motor fibers of the

corticospinal The pyramidal tracts include both the corticobulbar tract and the corticospinal tract. These are aggregations of efferent nerve fibers from the upper motor neurons that travel from the cerebral cortex and terminate either in the brainstem (''co ...

and

corticobulbar In neuroanatomy, the corticobulbar (or corticonuclear) tract is a two-neuron white matter motor pathway connecting the motor cortex in the cerebral cortex to the medullary pyramids, which are part of the brainstem's medulla oblongata (also called ...

tracts – known together as the

pyramidal tracts The pyramidal tracts include both the corticobulbar tract and the corticospinal tract. These are aggregations of efferent nerve fibers from the upper motor neurons that travel from the cerebral cortex and terminate either in the brainstem (''cort ...

. The lower limit of the pyramids is marked when the fibers cross ( decussate).

Structure

The

ventral Standard anatomical terms of location are used to unambiguously describe the anatomy of animals, including humans. The terms, typically derived from Latin or Greek roots, describe something in its standard anatomical position. This position prov ...

portion of the medulla oblongata contains the medullary pyramids. These two ridge-like structures travel along the length of the medulla oblongata and are bordered medially by the anterior median fissure. They each have an anterolateral sulcus along their lateral borders, where the

hypoglossal nerve The hypoglossal nerve, also known as the twelfth cranial nerve, cranial nerve XII, or simply CN XII, is a cranial nerve that innervates all the extrinsic and intrinsic muscles of the tongue except for the palatoglossus, which is innervated by ...

emerges from. Also at the side of each pyramid there is a pronounced bulge known as an olive. Fibers of the

posterior column Posterior may refer to: * Posterior (anatomy), the end of an organism opposite to its head ** Buttocks, as a euphemism * Posterior horn (disambiguation) * Posterior probability The posterior probability is a type of conditional probability that r ...

, which transmit sensory and

proprioceptive Proprioception ( ), also referred to as kinaesthesia (or kinesthesia), is the sense of self-movement, force, and body position. It is sometimes described as the "sixth sense". Proprioception is mediated by proprioceptors, mechanosensory neurons ...

information, are located behind the pyramids on the medulla oblongata. The medullary pyramids contain motor fibers that are known as the

and

tracts. The corticospinal tracts are on the anterior surface of the pyramids. These tracts transport motor signals that originated in the precentral gyrus and travelled through the internal capsule to the medulla oblongata and pyramids. Extrapyramidal tracts are those motor tracts that do not traverse the medullary pyramids. At the pyramids' most caudal end, the corticospinal axons decussate (or cross over) the midline and continue down the spinal cord on the contralateral side. The fibers that decussated will go down the lateral corticospinal tract while the fibers that did not decussate will travel down the

anterior corticospinal tract The anterior corticospinal tract (also called the ventral corticospinal tract, "Bundle of Turck", medial corticospinal tract, direct pyramidal tract, or anterior cerebrospinal fasciculus) is a small bundle of descending fibers that connect the cer ...

. Nearly 90 percent of the fibers decussate and travel down the lateral corticospinal tract while the other 10 percent travels down the

Decussation

The two pyramids contain the

motor fibers A motor neuron (or motoneuron or efferent neuron) is a neuron whose cell body is located in the motor cortex, brainstem or the spinal cord, and whose axon (fiber) projects to the spinal cord or outside of the spinal cord to directly or indirectl ...

that pass from the

brain A brain is an organ that serves as the center of the nervous system in all vertebrate and most invertebrate animals. It is located in the head, usually close to the sensory organs for senses such as vision. It is the most complex organ in a ve ...

to the medulla oblongata and

spinal cord The spinal cord is a long, thin, tubular structure made up of nervous tissue, which extends from the medulla oblongata in the brainstem to the lumbar region of the vertebral column (backbone). The backbone encloses the central canal of the sp ...

. These are the

and

fibers that make up the

pyramidal tract The pyramidal tracts include both the corticobulbar tract and the corticospinal tract. These are aggregations of efferent nerve fibers from the upper motor neurons that travel from the cerebral cortex and terminate either in the brainstem (''co ...

s. About 90% of these fibers leave the pyramids in successive bundles and decussate (cross over) in the anterior median fissure of the medulla oblongata as the ''pyramidal decussation'' or ''motor decussation''. Having crossed over at the middle line, they pass down in the posterior part of the

lateral funiculus The most lateral of the bundles of the anterior nerve roots is generally taken as a dividing line that separates the anterolateral system The spinothalamic tract is a part of the anterolateral system or the ventrolateral system, a sensory path ...

as the

lateral corticospinal tract The lateral corticospinal tract (also called the crossed pyramidal tract or lateral cerebrospinal fasciculus) is the largest part of the corticospinal tract. It extends throughout the entire length of the spinal cord, and on transverse section appe ...

. The other 10% of the fibers stay uncrossed in the

. The pyramidal decussation marks the border between the spinal cord and the medulla oblongata.

Function

The medullary pyramids contain the motor fibers of the

– the corticospinal and corticobulbar tracts.

Clinical significance

Whiplash as a result of a car accident can lead to brainstem injuries that affect the pyramids at the medulla oblongata. These pyramid injuries are usually a result of a dislocation at the occiput or spinal level C1. Injuries to the pyramids of the medulla oblongata can also be caused by the quick hyperextension of the neck (cervical region of the spine). Hyperextension of the neck can pull and tear the pyramids, leading to a variety of symptoms such as weakness in all four limbs, difficulty swallowing, and difficulty speaking. A bilateral infarction in the pyramids of the medulla can result in motor quadriplegia. This is rare, however, as there have only been four cases of this reported.

Additional images

File:Gray679.png, Medulla oblongata and

pons The pons (from Latin , "bridge") is part of the brainstem that in humans and other bipeds lies inferior to the midbrain, superior to the medulla oblongata and anterior to the cerebellum. The pons is also called the pons Varolii ("bridge of Va ...

. Anterior surface. (Pyramid visible at center.) File:Gray684.png, Sketch of the brainstem, with the

visible in red, and pyramidal decussation labeled at lower right. File:Gray688.png, Section of the medulla oblongata at the level of the decussation of the pyramids.

References

Saladin, Kenneth (2012). Anatomy & Physiology: The Unity of Form and Function, Sixth Edition. New York: McGraw-Hill.

External links

Diagram at csus.edu

Whiplash Injuries: The Cervical Acceleration/Deceleration Syndrome book

Neurology Journal article

{{Authority control Brainstem