anatomy of brainstem
TRANSCRIPT
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Brainstem By Dr Manah Chandra Changmai IMS
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Located between the cerebrum and the spinal cord Provides a pathway for tracts running between higher and lower neural centers.
Consists of the midbrain, pons, and medulla oblongata.
Each region is about an inch in length.Microscopically, it consists of deep gray matter surrounded by white matter fiber tracts.
Produce automatic behaviors necessary for survival.
Brainstem
Midbrain
Pons
Medullaobongata
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Midbrain
Pons
Medullaoblongata
Ventral surface of brain stem
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MidbrainCerebral peduncles
PonsBasis pontis
Medulla
Ventral – Lateral View
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Vertical Columns of
Cranial Nerves
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Internal Columns of Nuclei
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Motor nucleiSomatic motor
closest to midlineeyes, tongueCN III, IV, VI, XII
Branchial motorLateral positionBranchial arches: chewing, expression, middle ear, pharynx, larynx, sternomastoic, trapeziusCN V, VII, XIN. ambiguus (IX, X)
Visceral motorventral / ventrolateralParasympathetic: glands, smooth muscle, heart, lungs, GI above splenic flexureEdinger-Westfall (III)Sup. & Inf. salivatory
Sensory nucleiGeneral sensory
lateral to branchial motorFace, sinuses, meningesAll modalitiesCN V mainlyAlso CN VII, IX, X
Visceral sensorylateral to visceral motorTaste; cardiorespiratory, GI infoN. of the solitary tract (CN VII, IX, X)
Special sensoryfurthest lateralBalance; hearingCN VIII (vestibular)CN VIII (cochlear)
Subdivisions of Vertical Columns
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Midbrain
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Shortest brain stem,not more than2cm in length,lies in the posterior cranial Fossa.For descriptive purpose,divided intoDorsal tectum and right and left cerebralPeduncles.Each cerebral peduncles divide furtherinto ventral crus cerebri and a dorsalTegmentum by a pigmented lamina“ Substantia nigra”
Cerebral peduncles contains:-Descending fibers that go to the cerebellum via the pons-Descending pyramidal tracts
Running through the midbrain is the hollow cerebral aqueduct which connects the 3rd and 4th ventricles of the brain.
Connects pons and cerebrum with forebrain
MidbrainCrus cerebri
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Basis Tegmentum
Tectum
Ventral – Dorsal Organization
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Patterning of the Midbrain
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The roof of the aqueduct ( the tectum) contains the corpora quadrigemina
2 superior colliculi that control reflex movements of the eyes, head and neck in response to visual stimuli2 inferior colliculi that control reflex movements of the head, neck, and trunk in response to auditory stimuli
Corpora quadregemina
Superior colliculi larger and darker than inferior colliculi,the difference In colour due to superficial neurons inSuperior colliculi
Superior and inferior colliculi seperated by cruciform sulcus
Superior colliculi
Inferior colliculi
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Internal Structure of Midbrain
Cross section at two levels
• Level of inferior colliculus
• Level of superior colliculus
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Internal structure Transverse section of midbrainCommon to both at inferior and superior colliculus:Crus cerebri (or basis pedunculi): - Consists of fibres descending from cerebral cortex. - Its medial one-sixth is occupied by coticopontine fibres from frontal lobe,lateral one-sixth fibres from temporal,occipital and parietal lobes,the intermediate two third by corticospinal and cortico- nuclear fibres.
Substantia nigra : - Present immediately behind and medial to basis pedunculi. - It appears dark as neuron within it contain pigment. ( neuromelanin )
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Crus cerebri
Substantia nigra
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Basis pedunculiSubstantia nigra
Crus cerebri(cerebral peduncle)
Cerebral aqueduct
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Cross section at inferior colliculus
Internal Structure of Midbrain
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Section at the level of inferior colliculus
Inferior colliculus
- large mass of grey matter lying in the tectum - Forms cell station in auditory pathway.
Trochlear nucleus: - Lies in the ventral part of central grey matter
Mesencephalic nucleus of trigeminal nerve: - Lies in lateral part of the central grey matter
Medial leminiscus: - Fibres of ventral spinothalamic tract
Spinal leminiscus: - Fibres of lateral spinothalamic and spinotectal tract.
Trigeminal leminiscus
Inferior colliculus
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Inferior colliculus
Mesencephalic nucleus of V cranial nerve
Trochlear nerve(N)
Medial longitudinal fasciculus
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Cross section at
• Level of superior colliculus
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Section at the level of superior colliculus
Two large masses of grey matter seen at this level
Superior colliculus in the tectum
– Receives visual input from retina and frontaland occipital eye fields– Receives auditor input from inferior colliculus– Mediates audiovisual refflexes
Commissure of superior colliculus– Connects two superior colliculus
Brachium of superior colliculus– Pathway for fibres from superior colliculus toCortex
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Red nucleus in the tegmentum - Lies in the anterior part of the tegmentum, dorsomedial to the substantia nigra- It is called because of reddish colour which is due to the presence of iron pigment in its neurons.
Oculomotor nucleus - Related to the ventral part of central grey matter
Cerebral aqueduct and periaqueductalgray matter
Medial longitundinal fasciculus– Vestibular fibres that coordinate eyemovements– Interconnects ocular motor CN 3, 4, 6
Central tegmental tract
Section at the level of superior colliculus……contd.
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Medial lemniscus– Spinal afferent tract
Spinal lemniscus– Spinal afferent tract
Substantia nigra– Receives GAGAergic input from caudate putamen– Projects dopaminergic fibres to caudate putamen– Projects nondopminergic fibres to thalamus
Crus cerebri
Section at the level of superior colliculus……contd.
Superior colliculus
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Edinger westfalnucleus
Red nucleus
Occulomotor nucleus
Superior colliculus
– relay from cortex and cerebellum to spinal cord, inferior olive, reticular formation, cerebellum
Controls arm movement
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Corticobulbar Fibers– Arise from precentral and postcentralGyri
– May synapse directly on motor neuronsor indirectly via interneurons(corticoreticular fibers)
– Innervate sensory relay nuclei– Innervate cranial nerve motor nucleibilaterally, with the exception of upperface division of the facial nucleus
– Innervates the ipsilateral spinal nucleusof CN 11, which supplies thesternocleidomastoid muscle and thecontralateral spinal nucleus of CN 11,which innervates the trapezius muscle
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Pons
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Pons
The pons shows a convex anterior surface with prominent transversely running fibres. These fibres collect to form bundles,the middle cerebellar peduncles.
Trigeminal nerve emerges from the anterior surface,at the junction between pons and middle cerebellar peduncle.
The anterior surface of pons is marked in the midline by a shallow groove,the sulcus basilaris which lodges the basilar artery.
Pons
s
Sulcus basilaris
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Subdivided into ventral and dorsal part
Ventral part of the pons contains
Pontine nuclei:•Recieves corticopontine fibres from frontal, temporal,parietal and occipital lobes of cerebrum•The efferent fibres form the transverse fibres of pons.•It has been estimated that there are about twenty million neurons in pontine nuclei.Most of them are glutaminergic.
Vertically running corticospinal and corticopontine fibres.
Transversely running fibres arising in pontine nuclei
Pontine nuclei
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The dorsal part of the pons may be regarded as continuation of the part of the medulla behind the pyramids.
Superiorly continous with the tegmentum of the midbrain.
Occupied predominately by reticular formation
Posterior surface help to form floor of fourth ventricle
The dorsal part is bounded laterally by inferior cerebellar peduncle in the lower part of the pons and superior cerebellar peduncle in upper part.
Dorsal part of pons
DORSAL PART
Midpons
Upper pons
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4 Lateral lemniscus » Auditory pathway that conducts most contralateral cochlear input 5 Medial lemniscus » Spinal afferent pathway 6 Spinal lemniscus » Spinal afferent pathway
1 Dorsal and ventral cochlear nuclei – Receives auditory input from the cochlea through CN 8 2 Trapezoid body – Formed by decussating fibres of the ventral cochlear nuclei 3 Superior olivary nucleus – Auditory relay nucleus that receives input from the cochlear nuclei and contributes to lateral lemniscus
Six ascending tract
Dorsal surface of pons
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Medial lemniscus Ascending 2nd order sensory neurons
Descending upper motor neurons
Middle cerebellar peduncle
Restiform body (inf. cerebellar peduncle)
Connection of pons to cerebellum
4th Ventricle
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Section through lower part of the pons
Abducent nucleus of CN 6• Lateral gazeDorsal and ventral cochlear nuclei of CN8Medial, lateral and superior vestibularnuclei of CN 8• Receive proprioceptive input from vestibularsystems and cerebellum• Projects to cerebellum and medial longitudinalfasciculusSpinal trigeminal tract of CN 5Facial nucleus of CN 7 • Gives rise to fibres that innervate the muscles offacial expressionSuperior olivary nucleus– Auditory relay nucleus that receives inputfrom the cochlear nuclei and contributesto lateral lemniscus
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Vestibular Nuclei Pure sensory lateral location Balance
Cranial Nerves of Lower Pons
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Abducens N. nucleus
Facial N. nucleus
Abduction of eye
Longest, most vulnerable CN
Muscles of face
At a slightly higher level
Cranial Nerves of Lower Pons
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Mid Pons
Middle cerebellar peduncle
4th Ventricle
Corticospinal tract, corticobulbar tract,
corticopontine fibers
Descending fibers
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Lateral lemniscus
Pontine nuclei
Trapezoid body
Mid Pons
Trapezoid body : transverse fibers in pontine tegmentum
Medial leminiscus
fibers from dorsal column (position and vibration)
fibers from dorsal column (position and vibration)
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Medial lemniscus fibers from dorsal column (position and vibration)
Trigeminal tract pain, temperature, touch from contralateral face
Mid Pons
Cranial nerve nuclei and Lemniscal sensory system – in tegmentum of the pons
Principal trigeminal sensory nucleus
Motor trigeminal nucleus
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Section through upper part of pons
Superior cerebellar peduncle
Principal sensory nucleus of CN 5– Receives discriminative tactile and pressuresensation from face, terminates in thalamus
Lateral lemniscus» Auditory pathway that conducts mostcontralateral cochlear input
Trapezoid body– Formed by decussating fibres of theventral cochlear nuclei
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decussationSuperior cerebellar peduncle
Transverse ponto-cerebellar fibers
Periaqueductal gray matter Medial longitudinal fasciculus
Upper Pons
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Locus ceruleus
Parabrachial Nucleus
Pediculopontine Nucleus
Upper Pons
Some neurons release acetylcholine
Other neurons release glutamate
They assist in learning and voluntary motor control, e.g. locomotion, saccadic e
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MEDULLA OBLONGATA
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Medulla is broad above ,joins with pons narrow below, continous with spinal cord
Length is about 3cm, width is about 2cm at its upper end
Surfaces shows series of fissuresAnterior median fissurePosterior median fissure
Spinal cord Medulla oblongata
Most inferior region of the brain stem.
Becomes the spinal cord at the level of the foramen magnum.
External structure of medulla
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Ventral surface of medulla oblongata containsPyramid•elevation between anterior median and anterolateral sulcus•Formed due to decussation of corticospinal fibres.
Pyramid
Olive
Olive •Oval swelling between anterolateral posterolateral sulcus,half an inch long•Produced by large mass of gray matter called inferior olivary nucleus
External surface of medulla
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Anterior median fissure
Pyramid
Anterolateral fissure
Olive
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The posterior part of medulla containsFasciculus gracilis medially ending in rounded elevation ,called nucleus gracilis
Fasciculus cuneatus laterally ending in rounded elevation,called nucleus cuneatus
Posterior part of the medulla forms the floor of the fourth ventricle
Tuberculum cinereum, longitudinal elevation in the lower part of medulla lateral to fasciculus cuneatus.
Posterior part of medulla oblongata
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Posterior median sulcusPosterior median fissure
Obex Gracile tubercle
Cuneate tubercle
Floor of fourth ventricle
DORSAL SURFACE OF MEDULLA OBLONGATA
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Cross section at three levels
Level of pyramidal decussation
Internal Structure of Medulla
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Pyramidal tract
Lateral corticospinal tract
75 – 90%
spinal nucleus of VFrom pons to C4
Gracile nucleus
Anterior corticospinal tract -- fibers to innervate muscles of trunk
Level of Pyramidal Decussation
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Cross section at level of lemniscal decussation
Internal Structure of Medulla
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Medial lemniscus
Carries 2nd order sensory neurons to VPL thalamus
Internal arcuate fibers
Cuneate nucleus
Gracile nucleus Medial longitudinal fasciculus
Level of Lemniscal Decussation
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Cross section at level of Level of inferior olivary nuclei
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Inferior olivary nucleiRelay between cortex, vestibular nuclei, cerebellum, basal ganglia, and dorsal column nuclei
Inferior cerebellar peduncle = Restiform body
Hypoglossal nucleus CN XII
Vestibular nuclei Medial Inferior
Level of Inferior Olives
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Vestibular nucleiN. 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
Dorsal motor nucleus of X
Sensation behind ear
Posterior 1/3 of the tongue
Stylopharyngeus (lifts pharynx)
Cranial Nerves of the Medulla
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N. solitarious
Sensory nucleus for CN VII, IX, X
Posterior 1/3 of the tongue
N. ambiguus
Motor nucleus for CN IX, X & XI
Stylopharyngeus (lifts pharynx)
Inf. salivatory nucleus
Parotid gland, parasympathetic
Spinal trigeminal tract
CN V, VII, IX, X
Sensation behind ear
CN IX: Glossopharyngeal Nerve
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Dorsal motor nucleus of X
Parasympathetic, preganglionic
N. solitarious
Sensory nucleus for CN VII, IX, X
Taste, epiglottis CardiorespiratoryN. ambiguus
Motor nucleus for CN IX, X & XI
Pharynx Larynx
Spinal trigeminal tract
CN V, VII, IX, X
Ear
CN X: Vagus Nerve
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Out On Our Table Top Are Fruits, Very Green Veggies And Hamburgers
Mnemonic
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The End