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Brainstem. Overview Medulla Pons Midbrain. January 12, 2009. Ventral – Lateral View. Corticospinal tract descends throughout  movement Reticular formation descends throughout  movement ascends throughout  arousal. Midbrain Cerebral peduncles. Pons Basis pontis. Medulla

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brainstem
Brainstem

Overview

Medulla

Pons

Midbrain

January 12, 2009

ventral lateral view
Ventral – Lateral View

Corticospinal tract descends throughout  movement

Reticular formation descends throughout  movement

ascends throughout  arousal

Midbrain

Cerebral peduncles

Pons

Basis pontis

Medulla

Pyramid Olive

ventral dorsal organization anterior posterior
Ventral – Dorsal Organization(anterior - posterior)

Basis

Large anterior fiber tracts: cerebral peduncles, crossing pontine fibers, pyramids

ventral dorsal organization
Ventral – Dorsal Organization

Tegmentum

Anterior cell body-rich areas, floor of brainstem: red nuclei, substantia nigra, reticular formation

ventral dorsal organization5
Ventral – Dorsal Organization

Tectum

Roof of the brainstem: superior colliculi, inferior colliculi: corpus quadrigemina

Cerebellum

Cuneatus, gracilis (medulla)

internal columns of nuclei
Internal Columns of Nuclei

III, IV, VI, XII

V, VII, N. ambiguus, XII

EW, Salivatory, DMN X

V, VII, IX, X

N. Solitary tract

VIII

subdivisions of vertical columns
Motor nuclei

Somatic motor

closest to midline

eyes, tongue

CN III, IV, VI, XII

Branchial motor

Lateral position

Branchial arches: chewing, expression, middle ear, pharynx, larynx, sternomastoic, trapezius

CN V, VII, XI

N. ambiguus (IX, X)

Visceral motor

ventral / ventrolateral

Parasympathetic: glands, smooth muscle, heart, lungs, GI above splenic flexure

Edinger-Westfall (III)

Sup. & Inf. salivatory (VII)

Dorsal motor nucleus of X

Sensory nuclei

General sensory

lateral to branchial motor

Face, sinuses, meninges

All modalities

CN V mainly

Also CN VII, IX, X

Visceral sensory

lateral to visceral motor

Taste; cardiorespiratory, GI info

N. of the solitary tract (CN VII, IX, X)

Special sensory

furthest lateral

Balance; hearing

CN VIII (vestibular)

CN VIII (cochlear)

Subdivisions of Vertical Columns
brainstem10
Brainstem

Overview

Medulla

Pons

Midbrain

.

internal structure of medulla
Internal Structure of Medulla

Cross section at three levels

  • Level of pyramidal decussation
  • Level of lemniscal decussation
  • Level of inferior olivary nuclei
level of pyramidal decussation
Level of Pyramidal Decussation

Lateral corticospinal tract

75 – 90%

Gracile nucleus

Spinal nucleus of V

From pons to C4

Contralateral movement

Pyramidal tract

Anterior corticospinal tract -- fibers to innervate muscles of trunk

internal structure of medulla13
Internal Structure of Medulla

Cross section at three levels

  • Level of pyramidal decussation
  • Level of lemniscal decussation
  • Level of inferior olivary nuclei
level of lemniscal decussation
Level of Lemniscal Decussation

Gracile nucleus

Cuneate nucleus

MLF

Position & vibration sense

Pyramids

Medial lemniscus

Carries 2nd order sensory neurons to VPL thalamus

Internal arcuate fibers

internal structure of medulla15
Internal Structure of Medulla

Cross section at three levels

  • Level of pyramidal decussation
  • Level of lemniscal decussation
  • Level of inferior olivary nuclei
level of inferior olives
Level of Inferior Olives

Vestibular nuclei

Medial Inferior

Hypoglossal nucleus CN XII

Inferior cerebellar peduncle = Restiform body

Inferior olivary nuclei

MLF

Relay between cortex, vestibular nuclei, cerebellum, basal ganglia, and dorsal column nuclei

Arcuate nuclei  pontine nuclei

cranial nerves of the medulla
Cranial Nerves of the Medulla

Vestibular nuclei

CN XII

cranial nuclei of the medulla
Cranial Nuclei of the Medulla

N. solitarious

Sensory nucleus for CN VII, IX, X

cranial nuclei of the medulla19
Cranial Nuclei of the Medulla

N. solitarious

Sensory nucleus for CN VII, IX, X

Spinal trigeminal tract

CN V, VII, IX, X

cranial nuclei of the medulla20
Cranial Nuclei of the Medulla

N. solitarious

Sensory nucleus for CN VII, IX, X

Spinal trigeminal tract

CN V, VII, IX, X

N. ambiguus

Motor nucleus for CN IX, X & XI

cranial nuclei of the medulla21
Cranial Nuclei of the Medulla

N. solitarious

Sensory nucleus for CN VII, IX, X

Dorsal motor nucleus of X

Spinal trigeminal tract

CN V, VII, IX, X

N. ambiguus

Motor nucleus for CN IX, X & XI

cn ix glossopharyngeal nerve
CN IX: Glossopharyngeal Nerve

N. solitarious

Sensory nucleus for CN VII, IX, X

Spinal trigeminal tract

CN V, VII, IX, X

N. ambiguus

Motor nucleus for CN IX, X & XI

cn ix glossopharyngeal nerve23
CN IX: Glossopharyngeal Nerve

N. solitarious

Sensory nucleus for CN VII, IX, X

Posterior 1/3 of the tongue

Spinal trigeminal tract

CN V, VII, IX, X

N. ambiguus

Motor nucleus for CN IX, X & XI

cn ix glossopharyngeal nerve24
CN IX: Glossopharyngeal Nerve

N. solitarious

Sensory nucleus for CN VII, IX, X

Posterior 1/3 of the tongue

Spinal trigeminal tract

CN V, VII, IX, X

Sensation behind ear

N. ambiguus

Motor nucleus for CN IX, X & XI

cn ix glossopharyngeal nerve25
CN IX: Glossopharyngeal Nerve

N. solitarious

Sensory nucleus for CN VII, IX, X

Posterior 1/3 of the tongue

Spinal trigeminal tract

CN V, VII, IX, X

Sensation behind ear

N. ambiguus

Motor nucleus for CN IX, X & XI

Stylopharyngeus (lifts pharynx)

cn ix glossopharyngeal nerve26
CN IX: Glossopharyngeal Nerve

N. solitarious

Sensory nucleus for CN VII, IX, X

Posterior 1/3 of the tongue

Inf. salivatory nucleus

Parotid gland, parasympathetic

Spinal trigeminal tract

CN V, VII, IX, X

Sensation behind ear

N. ambiguus

Motor nucleus for CN IX, X & XI

Stylopharyngeus (lifts pharynx)

cn x vagus nerve
CN X: Vagus Nerve

“Wanderer”

N. solitarious

Sensory nucleus for CN VII, IX, X

Spinal trigeminal tract

CN V, VII, IX, X

N. ambiguus

Motor nucleus for CN IX, X & XI

cn x vagus nerve28
CN X: Vagus Nerve

“Wanderer”

N. solitarious

Sensory nucleus for CN VII, IX, X

Taste, epiglottis Cardiorespiratory

Spinal trigeminal tract

CN V, VII, IX, X

N. ambiguus

Motor nucleus for CN IX, X & XI

cn x vagus nerve29
CN X: Vagus Nerve

“Wanderer”

N. solitarious

Sensory nucleus for CN VII, IX, X

Taste, epiglottis Cardiorespiratory

Spinal trigeminal tract

CN V, VII, IX, X

Ear

N. ambiguus

Motor nucleus for CN IX, X & XI

cn x vagus nerve30
CN X: Vagus Nerve

“Wanderer”

N. solitarious

Sensory nucleus for CN VII, IX, X

Taste, epiglottis Cardiorespiratory

Spinal trigeminal tract

CN V, VII, IX, X

Ear

N. ambiguus

Motor nucleus for CN IX, X & XI

Pharynx Larynx

cn x vagus nerve31
CN X: Vagus Nerve

“Wanderer”

N. solitarious

Sensory nucleus for CN VII, IX, X

Taste, epiglottis Cardiorespiratory

Dorsal motor nucleus of X

Spinal trigeminal tract

CN V, VII, IX, X

Ear

N. ambiguus

Motor nucleus for CN IX, X & XI

Pharynx Larynx

cn x vagus nerve32
CN X: Vagus Nerve

“Wanderer”

N. solitarious

Sensory nucleus for CN VII, IX, X

Taste, epiglottis Cardiorespiratory

Dorsal motor nucleus of X

Parasympathetic, preganglionic

Spinal trigeminal tract

CN V, VII, IX, X

Ear

N. ambiguus

Motor nucleus for CN IX, X & XI

Pharynx Larynx

slide33

Brainstem

Overview

Medulla

Pons

Midbrain

slide34

Pons

Landmarks

Basis pontis 4th ventricle Cerebellum and Middle cerebellar peduncle

Cranial Nerves

V, VI, VII, VIII

pontine nuclei
Pontine Nuclei

Input (ipsilateral)

Motor cortex

Sensory cortex

Association cortex

Cingulate cortex

Output (contralateral)

Transverse crossing via middle cerebellar peduncle to cerebellum

Pontine nuclei

Project to cerebellum

Continuation of arcuate nuclei (over pyramids)

internal structure of the pons
Internal Structure of the Pons
  • Cross section at three levels
  • Level of facial nucleus (CN VII)
  • Level of middle cerebellar peduncle
  • Level of locus ceruleus
slide37
Pons

4th Ventricle

Connection of pons to cerebellum

Restiform body (inf. cerebellar peduncle)

Middle cerebellar peduncle

Medial lemniscus Ascending 2nd order sensory neurons

Descending upper motor neurons

cranial nerves of lower pons
Cranial Nerves of Lower Pons

Posterior view:

Cerebullum cut away

CN VIII – Vestibular Nuclei Pure sensory  lateral location Balance

cranial nerves of lower pons39
Cranial Nerves of Lower Pons

CN VIII –

Vestibular Nuclei

(Cochlear Nuclei)

cranial nerves of lower pons40
Cranial Nerves of Lower Pons

At a slightly higher level

CN VI nucleus – Abducens nerve

Abduction of eye

Longest, most vulnerable CN

CN VII nucleus – Facial nerve

Muscles of face

cranial nerves of lower pons41
Cranial Nerves of Lower Pons

CN VII nucleus - Facial nerve

Muscles of face

cranial nerves of lower pons42
Cranial Nerves of Lower Pons

CN VI nucleus – Abducens nerve

Abduction of eye

internal structure of the pons43
Internal Structure of the Pons
  • Cross section at three levels
  • Level of facial nucleus (CN VII)
  • Level of middle cerebellar peduncle
  • Level of locus ceruleus

Anterior view

mid pons
Mid Pons

4th Ventricle

Middle cerebellar peduncle

Corticospinal tract, corticobulbar tract, corticopontine fibers

Descending fibers

mid pons45
Mid Pons

4th Ventricle

Middle cerebellar peduncle

Pontine nuclei in basis

mid pons46
Mid Pons

Lateral lemniscus

from cochlear nucleus

hearing

Pontine nuclei

Trapezoid body –transverse fibers in pontine tegmentum

mid pons47
Mid Pons

Medial lemniscus fibers from dorsal column (position and vibration)

Lateral lemniscus

Trigeminal tract pain, temperature, touch from contralateral face

Pontine nuclei

Lemniscal sensory system – in tegmentum of the pons

cranial nerve of the mid pons
Cranial Nerve of the Mid Pons

4th Ventricle

CN V

Motor trigeminal nucleus

cranial nerve of the mid pons49
Cranial Nerve of the Mid Pons

4th Ventricle

CN V

Motor trigeminal nucleus

Principal trigeminal sensory nucleus

cranial nerve of the mid pons50
Cranial Nerve of the Mid Pons

4th Ventricle

CN V

Motor trigeminal nucleus

Trigeminal fascicles

Trigeminal nerve

Principal trigeminal sensory nucleus

internal structure of the pons51
Internal Structure of the Pons
  • Cross section at three levels
  • Level of facial nucleus (CN VII)
  • Level of middle cerebellar peduncle
  • Level of locus ceruleus
upper pons
Upper Pons

4th ventricle  cerebral aqueduct

Superior cerebellar peduncle

decussation

upper pons53
Upper Pons

4th ventricle  cerebral aqueduct

Superior cerebellar peduncle

Transverse ponto-cerebellar fibers

Descending upper motor neurons

upper pons54
Upper Pons

4th ventricle  cerebral aqueduct

Periaqueductal gray matter

MLF

upper pons55
Upper Pons

4th ventricle  cerebral aqueduct

Locus ceruleus

MLF

Primary source of noradrenergic innervation to the brain

Neurons contain melanin

upper pons56
Upper Pons

4th ventricle  cerebral aqueduct

Parabrachial Nucleus

MLF

Also release catecholamines

Neurons also contain melanin

upper pons57
Upper Pons

4th ventricle  cerebral aqueduct

Pediculopontine Nucleus

MLF

Some neurons release acetylcholine

Other neurons release glutamate

They assist in learning and voluntary motor control, e.g. locomotion, saccadic eye

slide58

Brainstem

Overview

Medulla

Pons

Midbrain

slide59

Midbrain

Landmarks

Cerebral peduncles Optic chiasm Interpeduncular fossa (Superior colliculi) (Inferior colliculi) (Superior cerebellar peduncle)

Cranial Nerves

III, IV

external structure of midbrain
External Structure of Midbrain
  • Optic chiasm
  • Interpeduncular fossa
  • Oculomotor nerve (CN III)
  • Trochlear nerve (CN IV)
  • Pons
  • Cerebral peduncles (crus cerebri)

Ventral surface

(anterior)

external structure of midbrain62
External Structure of Midbrain
  • Quadrigeminal Plate
  • Superior colliculus
  • Inferior colliculus

CN IV

Trochlear nerve

Dorsal surface

Cerebellum removed

cranial nerves of the midbrain
Cranial Nerves of the Midbrain

Anterior exit

CN III (1)

CN VI (5)

Posterior exit

CN IV (2)

MLF - Medial longitudinal fasciculus (7)

Vestibular nuclei (6)

Pons (3)

internal structure of midbrain
Internal Structure of Midbrain
  • Cross section at two levels
  • Level of inferior colliculus
  • Level of superior colliculus
lower midbrain
Lower Midbrain

Inferior colliculus

hearing

cerebral aqueduct

DORSAL

VENTRAL

cerebral peduncles

lower midbrain66
Lower Midbrain

Inferior colliculus

Substantia nigra

Melanin-containing cells that produce dopamine Project to the basal ganglia

lower midbrain67
Lower Midbrain

Inferior colliculus

Substantia nigra

Crus cerebri

(cerebral peduncle)

Basis peduncularis

lower midbrain68
Lower Midbrain

Inferior colliculus

CN IV Trochlear nerve

lower midbrain69
Lower Midbrain

Inferior colliculus

CN IV Trochlear nerve

MLF

lower midbrain70
Lower Midbrain

Inferior colliculus

CN IV

MLF

Dorsal raphe nucleus – projects serotonergic fibers to basal ganglia and throughout cortex

lower midbrain71
Lower Midbrain

Inferior colliculus

hearing

Mesencephalic nucleus of V

analogous to dorsal root ganglion but within CNS

internal structure of midbrain72
Internal Structure of Midbrain
  • Cross section at two levels
  • Level of inferior colliculus
  • Level of superior colliculus
upper midbrain
Upper Midbrain

Superior colliculus

vision

Substantia nigraCrus cerebri

(cerebral peduncle)

upper midbrain74
Upper Midbrain

Superior colliculus

vision

Medial geniculate body

hearing

upper midbrain75
Upper Midbrain

Vision

Superior colliculus  Lateral geniculate body

Hearing

Inferior colliculus  Medial geniculate body

upper midbrain76
Upper Midbrain

Superior colliculus

vision

Red nucleus – relay from cortex and cerebellum to spinal cord, inferior olive, reticular formation, cerebellum

Controls arm movement

cranial nerves of upper midbrain
Cranial Nerves of Upper Midbrain

Superior colliculus

vision

EdingerWestfal nucleus

Parasympathetic to ciliary ganglion

Pupillary sphincter ciliary muscles

Red nucleus

CN III Oculomotor nucleus

cranial nerves of upper midbrain78
Cranial Nerves of Upper Midbrain

Superior colliculus

vision

EdingerWestfal nucleus

MLF

Red nucleus

CN III Oculomotor nucleus

innervation of eye muscles
Innervation of Eye Muscles

Dorsal view

Cerebellum removed

innervation of eyes muscles
Innervation of Eyes & Muscles

Lacrimal gland (CN VII)

Superior rectus Inferior rectus Medial rectus Inferior Oblique (CN III)

Superior oblique (CN IV)

Lateral rectus (CN VI)

Parasympathetic: Edinger-Westfal (CN III) Sympathetic: Superior Cervical Ganglion

tuesday
Tuesday

Diencephalon

Thalamus

Hypothalamus

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