[2] The system is called "extrapyramidal" to distinguish it from the tracts of the motor cortex that reach their targets by traveling through the "pyramids" of the medulla.

The pyramidal pathways, such as corticospinal and some corticobulbar tracts, may directly innervate motor neurons of the spinal cord or brainstem.

Whereas the extrapyramidal system centers around the modulation and regulation through indirect control of anterior (ventral) horn cells.

The primary role of the vestibular system is to maintain head and eye coordination, upright posture and balance, and conscious realization of spatial orientation and motion.

Then the nuclei receiving these signals project out to the extraocular muscles, spinal cord, and cerebral cortex to execute these functions.

[2][7] Fibers run down the total length of the spinal cord and terminate at the interneurons of laminae VII and VIII.

[2] The medial vestibulospinal tract is a group of descending extrapyramidal motor neurons, or efferent fibers found in the anterior funiculus, a bundle of nerve roots in the spinal cord.

[2][7] Fibers run down to the anterior funiculus to the cervical spinal cord segments and terminate on neurons of laminae VII and VIII.

[2] The vestibulospinal reflex uses the vestibular organs as well as skeletal muscle in order to maintain balance, posture, and stability in an environment with gravity.

The term vestibulospinal reflex, is most commonly used when the sensory input evokes a response from the muscular system below the neck.

Increased muscle tone, development of the proprioceptive and vestibular senses and opportunities to practice with balance are all consequences of this reflex.

During early childhood, the TLR matures into more developed vestibulospinal reflexes to help with posture, head alignment and balance.