Brainstem

Overview
Medulla Pons Midbrain

January 12, 2009

Ventral Lateral View

Corticospinal tract descends throughout movement

Midbrain
Cerebral peduncles

Pons
Basis pontis

Reticular formation descends throughout movement

Medulla
Pyramid Olive

ascends throughout arousal

Ventral Dorsal Organization

(anterior - posterior)

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

Ventral Dorsal Organization

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

Ventral Dorsal Organization

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

Cerebellum Cuneatus, gracilis (medulla)

Ventral Dorsal Organization

Tectum

Basis

Tegmentum

Vertical Columns of Cranial Nerves

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

Sensory nuclei
General sensory
lateral to branchial motor Face, sinuses, meninges All modalities CN V mainly Also CN VII, IX, X

Branchial motor
Lateral position Branchial arches: chewing, expression, middle ear, pharynx, larynx, sternomastoic, trapezius CN V, VII, XI N. ambiguus (IX, X)

Visceral sensory
lateral to visceral motor Taste; cardiorespiratory, GI info N. of the solitary tract (CN VII, 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

Special sensory
furthest lateral Balance; hearing CN VIII (vestibular) CN VIII (cochlear)

Brainstem
Overview
Medulla Pons Midbrain

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

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 Medulla

Cross section at three levels
Level of pyramidal decussation

Level of lemniscal decussation

Level of inferior olivary nuclei

Level of Lemniscal Decussation

Gracile nucleus Cuneate nucleus

MLF

Position & vibration sense

Pyramids
Internal arcuate fibers

Medial lemniscus
Carries 2nd order sensory neurons to VPL thalamus

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

Hypoglossal nucleus
CN XII

Vestibular nuclei
Medial Inferior

Inferior cerebellar peduncle = Restiform body

MLF

Inferior olivary nuclei

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

Arcuate nuclei pontine nuclei

Cranial Nerves of the Medulla

Vestibular nuclei CN XII

Cranial Nuclei of the Medulla

N. solitarious
Sensory nucleus for

CN VII, IX, X

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 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 Medulla

N. solitarious Dorsal motor nucleus of X
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 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 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 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 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 Nerve

N. solitarious Inf. salivatory nucleus
Parotid gland, parasympathetic

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 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 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 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 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 Nerve
Wanderer N. solitarious Dorsal motor nucleus of X
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 Nerve
Wanderer N. solitarious Dorsal motor nucleus of X
Parasympathetic, preganglionic

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

Brainstem
Overview
Medulla Pons Midbrain

Pons
Landmarks
Basis pontis 4th ventricle Cerebellum and Middle cerebellar peduncle

Cranial Nerves V, VI, VII, VIII

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

Cross section at three levels
Level of facial nucleus (CN VII)

Level of middle cerebellar peduncle

Level of locus ceruleus

4th Ventricle

Pons
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

Posterior view: Cerebullum cut away

CN VIII Vestibular Nuclei

Pure sensory lateral location Balance

Cranial Nerves of Lower Pons

CN VIII Vestibular Nuclei (Cochlear Nuclei)

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 Pons

CN VII nucleus - Facial nerve Muscles of face

Cranial Nerves of Lower Pons

CN VI nucleus Abducens nerve Abduction of eye

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
4th Ventricle Middle cerebellar peduncle

Corticospinal tract,
Descending fibers corticobulbar tract, corticopontine fibers

Mid Pons
4th Ventricle Middle cerebellar peduncle

Pontine nuclei

in basis

Mid Pons
Lateral lemniscus

from cochlear nucleus

hearing

Pontine nuclei

Trapezoid body transverse fibers in pontine tegmentum

Mid Pons
Lateral lemniscus

Medial lemniscus fibers from dorsal column (position and vibration)

Trigeminal tract pain, temperature, touch from contralateral face

Pontine nuclei
Lemniscal sensory system in tegmentum of the pons

Cranial Nerve of the Mid Pons

4th Ventricle

CN V
Motor trigeminal nucleus

Cranial Nerve of the Mid Pons

4th Ventricle

CN V
Motor trigeminal nucleus

Principal trigeminal sensory nucleus

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 Pons

Cross section at three levels
Level of facial nucleus (CN VII) Level of middle cerebellar peduncle Level of locus ceruleus

Upper Pons
4th ventricle cerebral aqueduct Superior cerebellar peduncle

decussation

Upper Pons
4th ventricle cerebral aqueduc Superior cerebellar peduncle

Transverse ponto-cerebellar fibers

Descending upper motor neurons

Upper Pons
Periaqueductal gray matter 4th ventricle cerebral aqueduc

MLF

Upper Pons
4th ventricle cerebral aqueduc

Locus ceruleus
Primary source of noradrenergic innervation to the brain Neurons contain melanin

MLF

Upper Pons
4th ventricle cerebral aqueduc Parabrachial Nucleus Also release catecholamines Neurons also contain melanin

MLF

Upper Pons
4th ventricle cerebral aqueduc Pediculopontine Nucleus Some neurons release acetylcholine Other neurons release glutamate They assist in learning and voluntary motor control, e.g. locomotion, saccadic eye

MLF

Brainstem
Overview
Medulla Pons Midbrain

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

Cranial Nerves
III, IV

Patterning of the Midbrain

External Structure of Midbrain

1. Optic chiasm 2. Interpeduncular fossa 3. Oculomotor nerve (CN III) 4. Trochlear nerve (CN IV) 5. Pons 6. Cerebral peduncles (crus cerebri)

Ventral surface (anterior)

External Structure of Midbrain

Quadrigeminal Plate
Superior colliculus Inferior colliculus

CN IV
Trochlear nerve

Dorsal surface Cerebellum removed

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

Cross section at two levels
Level of inferior colliculus Level of superior colliculus

Lower Midbrain
Inferior colliculus
hearing
DORSAL

cerebral aqueduct
cerebral peduncles VENTRAL

Lower Midbrain
Inferior colliculus Substantia nigra

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

Lower Midbrain
Inferior colliculus Substantia nigra
Basis peduncularis

Crus cerebri (cerebral peduncle)

Lower Midbrain
Inferior colliculus
CN IV Trochlear nerve

Lower Midbrain
Inferior colliculus
CN IV Trochlear nerve MLF

Lower Midbrain
Inferior colliculus
CN IV MLF

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

Lower Midbrain
Inferior colliculus
hearing

Mesencephalic nucleus of V
analogous to dorsal root ganglion but within CNS

Internal Structure of Midbrain

Cross section at two levels
Level of inferior colliculus Level of superior colliculus

Upper Midbrain
Superior colliculus
vision

Substantia nigra

Crus cerebri (cerebral

Upper Midbrain
Superior colliculus
vision

Medial geniculate body

hearing

Upper Midbrain

Vision
Superior colliculus Lateral geniculate body

Hearing
Inferior colliculus Medial geniculate body

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

Superior colliculus
vision
Edinger Westfal nucleus Parasympathetic to ciliary ganglion Pupillary sphincter ciliary muscles

Red nucleus

CN III Oculomotor nucleus

Cranial Nerves of Upper Midbrain

Superior colliculus
vision
Edinger Westfal nucleus

MLF

Red nucleus

CN III Oculomotor nucleus

Innervation of Eye Muscles

Dorsal view

Cerebellum removed

Innervation of Eyes & Muscles

Lacrimal gland VII) (CN 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

Diencephalon
Thalamus Hypothalamus