These two ridge-like structures travel along the length of the medulla oblongata and are bordered medially by the anterior median fissure.

Fibers of the posterior column, which transmit sensory and proprioceptive information, are located behind the pyramids on the medulla oblongata.

These tracts transport motor signals that originated in the precentral gyrus and travelled through the internal capsule to the medulla oblongata and 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.

Whiplash as a result of a car accident can lead to brainstem injuries that affect the pyramids at the medulla oblongata.

Injuries to the pyramids of the medulla oblongata can also be caused by the quick hyperextension of the neck (cervical region of the spine).