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Brainstem By Dr Manah Chandra Changmai     IMS
Brainstem ,[object Object]
Consists of the midbrain, pons, andmedulla oblongata.
Each region is about an inch in length.Microscopically, it consists of deep gray matter surrounded by white matter fiber tracts. ,[object Object],Midbrain  Pons Medulla obongata
Ventral surface of brain stem Midbrain Pons  Medulla oblongata
Ventral – Lateral  View Midbrain Cerebral peduncles Pons Basis pontis Medulla
Vertical  Columns  of  Cranial Nerves
Internal  Columns  of  Nuclei
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 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)
Midbrain
Midbrain Connects pons and cerebrum with forebrain Cruscerebri ,[object Object],2cm in length,lies in the posterior cranial  Fossa. ,[object Object],Dorsal tectum and right and left cerebral Peduncles. ,[object Object],into ventral cruscerebri and a dorsal Tegmentum by a pigmented lamina “ Substantianigra” ,[object Object],-Descending fibers that go to the   cerebellum via the pons -Descending pyramidal tracts ,[object Object],[object Object]
Patterning  of  the  Midbrain
Superior colliculi The roof of the aqueduct ( the tectum) contains the corpora quadrigemina 2 superior colliculithat control reflex movements of the eyes, head and neck in response to visual stimuli 2 inferior colliculithat control reflex movements of the head, neck, and trunk in response to auditory stimuli Inferior colliculi Corpora quadregemina Superior and inferior colliculiseperated by cruciform sulcus Superior colliculi larger and darker   than inferior colliculi,the  difference  In colour due to superficial neurons in Superior colliculi
Internal  Structure  of  Midbrain Cross section at two levels ,[object Object]
Level of superior colliculus,[object Object]
Substantianigra Cruscerebri
Cerebral aqueduct Basis pedunculi Substantianigra Cruscerebri (cerebral peduncle)
Internal  Structure  of  Midbrain Cross section at inferior colliculus
Section at the level of inferior colliculus Inferior colliculus ,[object Object],    - large mass of grey matter lying in the tectum     - Forms cell station in auditory pathway. ,[object Object],    - Lies in the ventral part of central grey matter ,[object Object],    - Lies in lateral part of the central grey matter ,[object Object],    - Fibres of ventral spinothalamic tract ,[object Object],    - Fibres of lateral spinothalamic and spinotectal        tract. ,[object Object],[object Object]
Cross section at ,[object Object],[object Object]
Section at the level of superior colliculus……contd. ,[object Object],gray matter ,[object Object], - Lies in the anterior part of the tegmentum, dorsomedial to the substantianigra - It is called because of reddish colour which  is     due to the presence of iron pigment in its         neurons. ,[object Object],    - Related to the ventral part of central grey matter ,[object Object],– Vestibular fibres that coordinate eye movements – Interconnects ocular motor CN 3, 4, 6 ,[object Object],[object Object]
Superior colliculus Edingerwestfal nucleus Occulomotor nucleus Red nucleus – relay from cortex and cerebellum to spinal cord, inferior olive, reticular formation, cerebellum Controls arm movement
[object Object],– Arise from precentral and postcentral Gyri – May synapse directly on motor neurons or indirectly via interneurons (corticoreticular fibers) – Innervate sensory relay nuclei – Innervate cranial nerve motor nuclei bilaterally, with the exception of upper face division of the facial nucleus – Innervates the ipsilateral spinal nucleus of CN 11, which supplies the sternocleidomastoid muscle and the contralateral spinal nucleus of CN 11, which innervates the trapezius muscle
Pons
Pons ,[object Object],     with prominent transversely running fibres.      These fibres collect to form bundles,the      middle cerebellar peduncles. ,[object Object],surface,at the junction between pons and       middle cerebellar peduncle. ,[object Object],     midline by a shallow groove,thesulcusbasilariswhich lodges the basilar artery. Pons s Sulcusbasilaris
Subdivided into ventral and dorsal part Ventral part of the pons contains ,[object Object]
Recievescorticopontinefibres from frontal,temporal,parietal and occipital lobes of cerebrum ,[object Object],  of pons. ,[object Object],  million neurons in pontinenuclei.Most of them    are glutaminergic. ,[object Object],fibres. ,[object Object],Pontine nuclei
Dorsal part of pons Midpons ,[object Object],    of the part of the medulla behind the pyramids. ,[object Object]
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 Upper pons
Dorsal surface of pons Six ascending tract 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   4   Lateral lemniscus » Auditory pathway that conducts most contralateral cochlear input   5   Medial lemniscus » Spinal afferent pathway   6   Spinal lemniscus » Spinal afferent pathway
4th Ventricle Connection of pons to cerebellum Restiform body (inf. cerebellar peduncle) Middle cerebellar peduncle Medial lemniscusAscending 2nd order sensory neurons Descending upper motor neurons
Section through lower part of the pons ,[object Object],• Lateral gaze ,[object Object]
Medial, lateral and superior vestibularnuclei of CN 8 • Receive proprioceptive input from vestibular systems and cerebellum • Projects to cerebellum and medial longitudinal fasciculus ,[object Object]
Facial nucleus of CN 7                                   • Gives rise to fibres that innervate the   muscles offacial expression ,[object Object],– Auditory relay nucleus that receives input from the cochlear nuclei and contributes to lateral lemniscus
Cranial  Nerves  of  Lower  Pons Vestibular Nuclei  Pure sensory  lateral location     Balance
Cranial  Nerves  of  Lower  Pons At a slightly higher level Abducens N. nucleus Abduction of eye Longest, most vulnerable CN Facial N. nucleus Muscles of face
Mid  Pons 4th Ventricle Middle cerebellar peduncle Corticospinal tract,corticobulbar tract,  corticopontine fibers Descending fibers
Mid  Pons Lateral lemniscus Trapezoid body fibers from dorsal column (position and vibration) Medial leminiscus fibers from dorsal column (position and vibration) Pontine nuclei Trapezoid body : transverse fibers in pontinetegmentum
Mid  Pons Medial lemniscusfibers from dorsal column (position and vibration) Motor trigeminal nucleus Trigeminal tractpain, temperature, touch from contralateral face Principal trigeminal sensory nucleus Cranial nerve nuclei and Lemniscal sensory system – in tegmentum of the pons
Section through upper part of pons ,[object Object]
Principal sensory nucleus of CN 5– Receives discriminative tactile and pressure sensation from face, terminates in thalamus ,[object Object],» Auditory pathway that conducts most contralateral cochlear input ,[object Object],– Formed by decussating fibres of the ventral cochlear nuclei
Upper  Pons Periaqueductal gray matter Medial longitudinal fasciculus Superior cerebellar peduncle decussation Transverse ponto-cerebellar fibers
Upper  Pons Pediculopontine Nucleus Locus ceruleus Parabrachial Nucleus Some neurons release acetylcholine   Other neurons release glutamate They assist in learning and voluntary motor control,             e.g. locomotion, saccadic e
MEDULLA OBLONGATA
External structure of medulla ,[object Object]
Becomes the spinal cord at the level of the foramen magnum.
Medulla is broad above ,joins with pons    narrow below, continous with spinal cord ,[object Object],    at its upper end ,[object Object]
Anterior median fissure
Posterior median fissureMedulla oblongata Spinal cord
External surface of medulla Ventral surface of medulla oblongata contains ,[object Object]
elevation between anterior median    and anterolateralsulcus ,[object Object],fibres. ,[object Object]
Oval swelling between anterolateralposterolateralsulcus,half an inch   long ,[object Object],  matter called inferior olivary   nucleus Olive Pyramid
Pyramid Olive  Anterolateral fissure Anterior median fissure
Posterior part of medulla oblongata The posterior part of medulla contains ,[object Object],   elevation ,called nucleus gracilis ,[object Object],elevation,callednucleus cuneatus ,[object Object],   the floor of the fourth ventricle ,[object Object],    elevation in the lower part of medulla     lateral to fasciculus cuneatus.
DORSAL SURFACE OF MEDULLA OBLONGATA Floor of fourth  ventricle Obex Gracile tubercle Posterior median sulcus Posterior median fissure Cuneate tubercle

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Anatomy of brainstem

  • 1. Brainstem By Dr Manah Chandra Changmai IMS
  • 2.
  • 3. Consists of the midbrain, pons, andmedulla oblongata.
  • 4.
  • 5. Ventral surface of brain stem Midbrain Pons Medulla oblongata
  • 6. Ventral – Lateral View Midbrain Cerebral peduncles Pons Basis pontis Medulla
  • 7.
  • 8. Vertical Columns of Cranial Nerves
  • 9. Internal Columns of Nuclei
  • 10. 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 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)
  • 12.
  • 13. Patterning of the Midbrain
  • 14.
  • 15. Superior colliculi The roof of the aqueduct ( the tectum) contains the corpora quadrigemina 2 superior colliculithat control reflex movements of the eyes, head and neck in response to visual stimuli 2 inferior colliculithat control reflex movements of the head, neck, and trunk in response to auditory stimuli Inferior colliculi Corpora quadregemina Superior and inferior colliculiseperated by cruciform sulcus Superior colliculi larger and darker than inferior colliculi,the difference In colour due to superficial neurons in Superior colliculi
  • 16.
  • 17.
  • 19. Cerebral aqueduct Basis pedunculi Substantianigra Cruscerebri (cerebral peduncle)
  • 20. Internal Structure of Midbrain Cross section at inferior colliculus
  • 21.
  • 22.
  • 23.
  • 24. Superior colliculus Edingerwestfal nucleus Occulomotor nucleus Red nucleus – relay from cortex and cerebellum to spinal cord, inferior olive, reticular formation, cerebellum Controls arm movement
  • 25.
  • 26. Pons
  • 27.
  • 28.
  • 29.
  • 30.
  • 31. Occupied predominately by reticular formation
  • 32. Posterior surface help to form floor of fourth ventricle
  • 33. 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 Upper pons
  • 34. Dorsal surface of pons Six ascending tract 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 4 Lateral lemniscus » Auditory pathway that conducts most contralateral cochlear input 5 Medial lemniscus » Spinal afferent pathway 6 Spinal lemniscus » Spinal afferent pathway
  • 35. 4th Ventricle Connection of pons to cerebellum Restiform body (inf. cerebellar peduncle) Middle cerebellar peduncle Medial lemniscusAscending 2nd order sensory neurons Descending upper motor neurons
  • 36.
  • 37.
  • 38.
  • 39. Cranial Nerves of Lower Pons Vestibular Nuclei Pure sensory  lateral location Balance
  • 40. Cranial Nerves of Lower Pons At a slightly higher level Abducens N. nucleus Abduction of eye Longest, most vulnerable CN Facial N. nucleus Muscles of face
  • 41. Mid Pons 4th Ventricle Middle cerebellar peduncle Corticospinal tract,corticobulbar tract, corticopontine fibers Descending fibers
  • 42. Mid Pons Lateral lemniscus Trapezoid body fibers from dorsal column (position and vibration) Medial leminiscus fibers from dorsal column (position and vibration) Pontine nuclei Trapezoid body : transverse fibers in pontinetegmentum
  • 43. Mid Pons Medial lemniscusfibers from dorsal column (position and vibration) Motor trigeminal nucleus Trigeminal tractpain, temperature, touch from contralateral face Principal trigeminal sensory nucleus Cranial nerve nuclei and Lemniscal sensory system – in tegmentum of the pons
  • 44.
  • 45.
  • 46. Upper Pons Periaqueductal gray matter Medial longitudinal fasciculus Superior cerebellar peduncle decussation Transverse ponto-cerebellar fibers
  • 47. Upper Pons Pediculopontine Nucleus Locus ceruleus Parabrachial Nucleus Some neurons release acetylcholine Other neurons release glutamate They assist in learning and voluntary motor control, e.g. locomotion, saccadic e
  • 49.
  • 50. Becomes the spinal cord at the level of the foramen magnum.
  • 51.
  • 53. Posterior median fissureMedulla oblongata Spinal cord
  • 54.
  • 55.
  • 56.
  • 57. Pyramid Olive Anterolateral fissure Anterior median fissure
  • 58.
  • 59. DORSAL SURFACE OF MEDULLA OBLONGATA Floor of fourth ventricle Obex Gracile tubercle Posterior median sulcus Posterior median fissure Cuneate tubercle
  • 60. Internal Structure of Medulla Cross section at three levels Level of pyramidal decussation
  • 61. Level of Pyramidal Decussation Lateral corticospinal tract 75 – 90% Gracile nucleus spinal nucleus of V From pons to C4 Pyramidal tract Anterior corticospinal tract -- fibers to innervate muscles of trunk
  • 62. Internal Structure of Medulla Cross section at level of lemniscaldecussation
  • 63. Level of LemniscalDecussation Gracile nucleus Medial longitudinal fasciculus Cuneate nucleus Medial lemniscus Carries 2nd order sensory neurons to VPL thalamus Internal arcuate fibers
  • 64. Cross section at level of Level ofinferior olivary nuclei
  • 65. Level of Inferior Olives Vestibular nuclei Medial Inferior Hypoglossal nucleus CN XII Inferior cerebellar peduncle= Restiform body Inferior olivary nuclei Relay between cortex, vestibular nuclei, cerebellum, basal ganglia, and dorsal column nuclei
  • 66. Cranial Nerves of the Medulla N. solitarious Sensory nucleus for CN VII, IX, X Vestibular nuclei Posterior 1/3 of the tongue Dorsal motor nucleus of X N. ambiguus Motor nucleus for CN IX, X & XI Spinal trigeminal tract CN V, VII, IX, X Stylopharyngeus (lifts pharynx) Sensation behind ear
  • 67. 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 N. ambiguus Motor nucleus for CN IX, X & XI Stylopharyngeus (lifts pharynx) Spinal trigeminal tract CN V, VII, IX, X Sensation behind ear
  • 68. CN X: Vagus Nerve Dorsal motor nucleus of X Parasympathetic, preganglionic N. solitarious Sensory nucleus for CN VII, IX, X Taste, epiglottis Cardiorespiratory N. ambiguus Motor nucleus for CN IX, X & XI Pharynx Larynx Spinal trigeminal tract CN V, VII, IX, X Ear
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