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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 l.jpg
Brainstem

Overview

Medulla

Pons

Midbrain

January 12, 2009


Ventral lateral view l.jpg
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 l.jpg
Ventral – Dorsal Organization(anterior - posterior)

Basis

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


Ventral dorsal organization l.jpg
Ventral – Dorsal Organization

Tegmentum

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


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Ventral – Dorsal Organization

Tectum

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

Cerebellum

Cuneatus, gracilis (medulla)


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Ventral – Dorsal Organization

Tectum

Tegmentum

Basis


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Vertical Columns of Cranial Nerves


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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 l.jpg

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


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Brainstem

Overview

Medulla

Pons

Midbrain

.


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Internal Structure of Medulla

Cross section at three levels

  • Level of pyramidal decussation

  • Level of lemniscal decussation

  • Level of inferior olivary nuclei


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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


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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 l.jpg
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


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Internal Structure of Medulla

Cross section at three levels

  • Level of pyramidal decussation

  • Level of lemniscal decussation

  • Level of inferior olivary nuclei


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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


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Cranial Nerves of the Medulla

Vestibular nuclei

CN XII


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Cranial Nuclei of the Medulla

N. solitarious

Sensory nucleus for CN VII, IX, X


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Cranial Nuclei of the Medulla

N. solitarious

Sensory nucleus for CN VII, IX, X

Spinal trigeminal tract

CN V, VII, IX, X


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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


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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 l.jpg
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


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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 l.jpg
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 l.jpg
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 l.jpg
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 l.jpg
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 l.jpg
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 l.jpg
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 l.jpg
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 l.jpg
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 l.jpg
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 l.jpg

Brainstem

Overview

Medulla

Pons

Midbrain


Slide34 l.jpg

Pons

Landmarks

Basis pontis 4th ventricle Cerebellum and Middle cerebellar peduncle

Cranial Nerves

V, VI, VII, VIII


Pontine nuclei l.jpg
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 l.jpg
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 l.jpg
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 l.jpg
Cranial Nerves of Lower Pons

Posterior view:

Cerebullum cut away

CN VIII – Vestibular Nuclei Pure sensory  lateral location Balance


Cranial nerves of lower pons39 l.jpg
Cranial Nerves of Lower Pons

CN VIII –

Vestibular Nuclei

(Cochlear Nuclei)


Cranial nerves of lower pons40 l.jpg
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 l.jpg
Cranial Nerves of Lower Pons

CN VII nucleus - Facial nerve

Muscles of face


Cranial nerves of lower pons42 l.jpg
Cranial Nerves of Lower Pons

CN VI nucleus – Abducens nerve

Abduction of eye


Internal structure of the pons43 l.jpg
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 l.jpg
Mid Pons

4th Ventricle

Middle cerebellar peduncle

Corticospinal tract, corticobulbar tract, corticopontine fibers

Descending fibers


Mid pons45 l.jpg
Mid Pons

4th Ventricle

Middle cerebellar peduncle

Pontine nuclei in basis


Mid pons46 l.jpg
Mid Pons

Lateral lemniscus

from cochlear nucleus

hearing

Pontine nuclei

Trapezoid body –transverse fibers in pontine tegmentum


Mid pons47 l.jpg
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 l.jpg
Cranial Nerve of the Mid Pons

4th Ventricle

CN V

Motor trigeminal nucleus


Cranial nerve of the mid pons49 l.jpg
Cranial Nerve of the Mid Pons

4th Ventricle

CN V

Motor trigeminal nucleus

Principal trigeminal sensory nucleus


Cranial nerve of the mid pons50 l.jpg
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 l.jpg
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 l.jpg
Upper Pons

4th ventricle  cerebral aqueduct

Superior cerebellar peduncle

decussation


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Upper Pons

4th ventricle  cerebral aqueduct

Superior cerebellar peduncle

Transverse ponto-cerebellar fibers

Descending upper motor neurons


Upper pons54 l.jpg
Upper Pons

4th ventricle  cerebral aqueduct

Periaqueductal gray matter

MLF


Upper pons55 l.jpg
Upper Pons

4th ventricle  cerebral aqueduct

Locus ceruleus

MLF

Primary source of noradrenergic innervation to the brain

Neurons contain melanin


Upper pons56 l.jpg
Upper Pons

4th ventricle  cerebral aqueduct

Parabrachial Nucleus

MLF

Also release catecholamines

Neurons also contain melanin


Upper pons57 l.jpg
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 l.jpg

Brainstem

Overview

Medulla

Pons

Midbrain


Slide59 l.jpg

Midbrain

Landmarks

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

Cranial Nerves

III, IV



External structure of midbrain l.jpg
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 l.jpg
External Structure of Midbrain

  • Quadrigeminal Plate

  • Superior colliculus

  • Inferior colliculus

CN IV

Trochlear nerve

Dorsal surface

Cerebellum removed


Cranial nerves of the midbrain l.jpg
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 l.jpg
Internal Structure of Midbrain

  • Cross section at two levels

  • Level of inferior colliculus

  • Level of superior colliculus


Lower midbrain l.jpg
Lower Midbrain

Inferior colliculus

hearing

cerebral aqueduct

DORSAL

VENTRAL

cerebral peduncles


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Lower Midbrain

Inferior colliculus

Substantia nigra

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


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Lower Midbrain

Inferior colliculus

Substantia nigra

Crus cerebri

(cerebral peduncle)

Basis peduncularis


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Lower Midbrain

Inferior colliculus

CN IV Trochlear nerve


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Lower Midbrain

Inferior colliculus

CN IV Trochlear nerve

MLF


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Lower Midbrain

Inferior colliculus

CN IV

MLF

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


Lower midbrain71 l.jpg
Lower Midbrain

Inferior colliculus

hearing

Mesencephalic nucleus of V

analogous to dorsal root ganglion but within CNS


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Internal Structure of Midbrain

  • Cross section at two levels

  • Level of inferior colliculus

  • Level of superior colliculus


Upper midbrain l.jpg
Upper Midbrain

Superior colliculus

vision

Substantia nigraCrus cerebri

(cerebral peduncle)


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Upper Midbrain

Superior colliculus

vision

Medial geniculate body

hearing


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Upper Midbrain

Vision

Superior colliculus  Lateral geniculate body

Hearing

Inferior colliculus  Medial geniculate body


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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 l.jpg
Cranial Nerves of Upper Midbrain

Superior colliculus

vision

EdingerWestfal nucleus

Parasympathetic to ciliary ganglion

Pupillary sphincter ciliary muscles

Red nucleus

CN III Oculomotor nucleus


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Cranial Nerves of Upper Midbrain

Superior colliculus

vision

EdingerWestfal nucleus

MLF

Red nucleus

CN III Oculomotor nucleus


Innervation of eye muscles l.jpg
Innervation of Eye Muscles

Dorsal view

Cerebellum removed


Innervation of eyes muscles l.jpg
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 l.jpg
Tuesday

Diencephalon

Thalamus

Hypothalamus


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