The initiation and coordination of movement are under the control of an immense network of nerves in the central nervous system (CNS) that originate from the cerebral cortex and course through the internal capsule, brainstem, and spinal cord. The impulses for movement are carried by nerves known as upper motor neurons (UMN). The pyramidal tract is the primary tract that propagates signals necessary for voluntary movement. The pyramidal tract divides into the corticospinal tract and the corticobulbar tract. Injury to UMNs in these tracts is common because of the large areas covered by the motor neuron pathway. Any injury to these tracts is known as UMN lesions. Damage to UMNs results in characteristic clinical manifestations colloquially termed “upper motor neuron signs” or “upper motor neuron syndrome.” The symptoms include muscle weakness, spasticity, hyperreflexia, and clonus. Damage to UMNs of the corticobulbar tract can manifest as dysphagia and dysarthria. Distinguishing upper motor neuron signs from lower motor neuron signs is essential in the neurological physical exam.[1]