BRAINSTEM

External and Internal Features

Brainstem

 Occupies posterior
cranial fossa

 Stalk-like in shape

 Connects spinal cord

with forebrain
Brainstem
 3 Broad Functions:
Conduit for ascending and descending tracts

Contains important reflex centers:

○ Control of respiration and cardiovascular system
○ Control of consciousness

Contains important nuclei of CNs III - XII

Brainstem
 Transverse
Subdivisions:
· Midbrain Midbrain

· Pons
· Medulla
oblongata
 Brainstem
 Longitudinal
Subdivisions:
· Tectum Midbrain

· Basis
· Tegmentum
 Tectum (Roof)

 Definition: plate of brainstem tissue

dorsal to the aqueduct

 Components:
Midbrain level: Quadrigeminal plate
Pontine level: Supr. medullary velum
Medullary level: Infr. medullary velum
(Tela choroidea & choroid plexus)
Basis
 Consists of descending
cortical motor tracts:

a) Pyramidal tracts
1. Corticobulbar tract
2. Corticospinal tract

b) Corticopontine tracts
Tegmentum (tegmen “covering”)
 Definition: plate of neurons and tracts
between tectum and basis
 Complicated part of the brainstem:
contains both gray and white matter
Tegmental Gray Matter:
1. Motor/Sensory nuclei of CNs III – XII
(except CN XI)
2. Reticular formation
3. Supplementary motor and sensory nuclei
Tegmental White Matter:
1. All long sensory tracts (ascend from
spinal cord or cranial nerve nuclei to
cerebellum, brainstem, and thalamus)
2. Medial longitudinal fasciculus
3. Cerebellar afferent and efferent
pathways
4. Central Tegmental tract
(interconnects tegmentum, diencephalon,
and basal forebrain gray matter)
5. Profuse unnamed pathways in the
Reticular formation
 MEDULLA
OBLONGATA
Gross Appearance

 Junction between
medulla and spinal cord:
origin of anterior/
posterior roots of C1
spinal nerves (level of
foramen magnum)

 Conical-shaped
Anterior Surface
 Pyramids: swelling on each
 Anterior median side of fissure
fissure: at midline  Inferiorly, fibers cross over:
Decussation of the Pyramids

Anteromedian fissure
 Lateral Surface
 Anterolateral sulcus:  Olives: oval elevations
bet. Pyramids and olives posterolateral to pyramids
 Rootlets of Hypoglossal  Elevation due to Inferior
nerve (CN XII) emerge here olivary nuclei

Anterolateral
Sulcus
 Lateral Surface
 Restiform bodies: connect
 Posterolateral sulcus: medulla to cerebellum
bet. Olives and Inferior
cerebellar peduncles  In the sulcus arise the roots of
(Restiform body) Glossopharyngeal n. (IX),
Vagus n. (X), and cranial
roots of accessory n. (XI)

Posterolateral Sulcus
  Gracile tubercle: elongated
Posterior Surface swelling on each side of sulcus
○ Swelling due to gracile
nucleus
 Posterior median sulcus:
 Cuneate tubercle: elongated
from spinal cord to obex swelling lateral to gracile
(central canal opens and tubercle
expands to form 4th ventricle) ○ Swelling due to cuneate
nucleus
Internal Structure
 Considered at 2 levels:

1. Lower medulla (caudal half)

o Level of Decussation of Pyramids
o Level of Decussation of Lemnisci

2. Upper medulla (rostral half)

o Level of the Olives
o Level just inferior to the Pons
 Lower Medulla
(Level of Decussation of Pyramids)
1. Pyramidal tracts: 80- 3. Fasciculii gracilis &
90% decussate forming the cuneatus: ascend behind
Lat. Corticospinal tract central gray matter

2. Nucleus of Spinal tract 4. Nuclei gracilis & cuneatus:

of Trigeminal nerve appear as dorsal extensions of
central gray matter
 Lower Medulla
(Level of Decussation of Lemnisci)
2. Lat./Ant. Spinothalamic
1. Decussation of tracts & Spinotectal
Lemnisci: posterior to tracts: Spinal lemniscus
pyramids
3. Spinocerebellar,
• Medial Lemnisci: formed
Rubrospinal and
from Internal Arcuate
Vestibulospinal tracts
fibers (came from Nuclei
gracilis & cuneatus)
 Upper Medulla
(Level of the Olives)

1. Infr. Olivary nucleus: 2. Nucleus Ambiguus: large

motor neurons w/in reticular
like a crumpled bag
formation
o Sends fibers to cerebellum o fibers join CNs IX, X, XI
o Spino-olivary tract o Supply voluntary skeletal ms.
3. Central Gray matter:
beneath floor of 4th ventricle c. Nucleus of Tractus
- Structures here (med. to lat.): Solitarius: come from
CNs VII, IX, and X
a. Hypoglossal nucleus
d. Med. & Infr. Vestibular
b. Dorsal nucleus of Vagus
nuclei
4. Med. Longitudinal fasciculus
- form connections between CNs III, 4. Infr. cerebellar
peduncle: located
IV, & VI postero-lateral
- receives input from vestibular
nuclei, cerebellum, proprioceptive
fibers from cervical region
PONS
Gross Appearance
 Anterior to cerebellum
 Connects medulla to
midbrain
 1 in. (2.5 cm.) long
 Anteriorly, seen as a
bridge connecting the
(R) & (L) cerebellar
hemispheres
Anterior Surface
 Basilar groove: shallow
 Convex, w/ many groove in the midline
transverse fibers  For Basilar artery
 Fibers form the Middle
Cerebellar peduncle  Abducens nerve (VI):
in groove between pons
and medulla

Basilar Groove
 Lateral Surface
 Middle cerebellar
 Pontocerebellar angle:
formed by rostral medulla,
peduncle (Brachium
caudal pons and adjacent
pontis): connect pontine cerebellum
nuclei to cerebellum  Facial (VII) & Vestibulo-
 Trigeminal n. (V) found
cochlear (VIII) nerves
here attached here
 Posterior Surface
 Dorsal Median
 Supr. cerebellar peduncle sulcus at midline
(Brachium  Medial eminence:
conjunctivum): limits post.
elongated elevation on
surface laterally
each side of sulcus
 Main Cerebellar Efferent
 Facial colliculus:
pathway
inferior continuation of
eminence
 Sulcus limitans: lateral
to medial eminence  Area vestibuli: lateral
 Substantia ferruginea: floor to sulcus limitans
○ (+) vestibular nuclei
of superior part of sulcus
underneath
limitans
○ Bluish-gray in color

Substantia ferruginea
Internal Structure
 Studied at 2 levels:
1. Transverse section passing through the Facial
colliculus (Caudal part)
2. Transverse section passing through the
Trigeminal nuclei (Cranial part)

 Each section is divided into 2 regions:

1. Anterior basal part divided by the
2. Posterior part, the tegmentum Trapezoid
body
 Transverse Section through the
Caudal part: Tegmentum
 Medial lemniscus: w/  Trapezoid body: made of
spinal & lateral lemnisci
Lat. Lemniscus: carries
fibers from trapezoid body &
auditory fibers to inferior cochlear nuclei
colliculus of midbrain Auditory relay station
  Medial Longitudinal
 Nerve Fibers of fasciculus: beneath 4th
Facial nucleus wind ventricle at midline
around Abducens  Connects Vestibulocochlear
nucleus: forming nuclei w/ nuclei controlling
Facial colliculus extraocular ms. (CNs III, IV,
& VI)
 Vestibular nuclei:
 Spinal nucleus of
lateral to Abducens nucleus Trigeminal nerve &
and close to Inferior tract: lie anteromedial
cerebellar peduncle to Inferior Cerebellar
peduncle
 Transverse Section through the
Caudal part: Basal Part
 Pontine nuclei: small masses  Corticospinal & Corticobulbar
of nerve cells
tracts intersect with these fibers
 Corticopontine fibers from
 Transverse pontine fibers enter
midbrain terminate in the cerebellum through the Middle
pontine nuclei (give rise to cerebellar peduncle
transverse fibers)
 Transverse Section through the Cranial
part: Tegmentum
 Motor nucleus of CN V:  Supr. cerebellar
under lat. part of 4th ventricle peduncle: posterolateral
 Principal Sensory nucleus to Motor nucleus
 Joined by Ant.
of CN V: lat. to Motor nucleus
 Continues inferiorly w/ nucleus Spinocerebellar tract
of Spinal tract
 Raphe nuclei of Reticular
formation: lie in midline  Locus ceruleus: lat. to
tegmentum central gray matter
 Synthesize Serotonin  Synthesize Norepinephrine
(important in production of (implicated in REM or
slow wave or non-REM sleep) paradoxical sleep)
 Transverse Section through the Cranial
part: Basal Part

 Corticospinal,
corticobulbar and
corticopontine
tracts

 Pontine nuclei
MIDBRAIN
Gross Appearance
 Connects pons &
cerebellum with the
forebrain

 0.8 in. (2 cm.) long

 Traversed by a narrow
channel, the Cerebral
aqueduct, which is
filled w/ CSF
Anterior Surface
 Posterior perforated
 Interpeduncular
fossa: deep depression substance: small
perforations at floor of the fossa
in the midline

 Crus cerebri: on each

 Oculomotor n.: emerge
from groove at medial side of
side of fossa
crus cerebri

Interpeduncular fossa
 Lateral Surface
 Superior brachium:  Inferior brachium:
passes from superior connects inferior
colliculus to lateral colliculus to medial
geniculate body and geniculate body
optic tract
Posterior Surface
 Corpora Quadrigemina:
4 rounded eminences
 Supr. colliculi: centers for Trochlear n.: emerge
visual reflexes below infr. colliculi
 Infr. colliculi: lower
auditory centers
Internal Structure
 Comprises 2 levels:
1. Lower Midbrain (Transverse section at the level of
the Inferior colliculi)

2. Upper Midbrain (Transverse section at the level of

the Superior colliculi)

 2 Lateral halves: Cerebral peduncles

1. Crus cerebri: anterior part divided by the
2. Tegmentum: posterior part Substantia nigra
(pigmented gray matter)
 Lower Midbrain
(Level of the Inferior colliculi)
 Nucleus of Infr. colliculus:  Trochlear nucleus: lie in
part of auditory pathway
 Receives fibers from Lateral
central gray matter at
lemniscus
midline
 Fibers pass lat. & post. to exit
 Central gray matter: surrounds midbrain below infr. colliculi
aqueduct
 Mesencephalic nuclei  Decussation of Supr.
of CN V: lat. to aqueduct Cerebellar peduncle:
central part of tegmentum
 Medial longitudinal
fasciculus: near midline
 Reticular formation:
lateral to decussation
 Medial lemniscus:  Substantia nigra: large
behind Substantia nigra motor nucleus thruout
 Spinal & Trigeminal midbrain
lemnisci: lateral to  Made of medium-sized
Med. lemniscus multipolar neurons w/ melanin
 Lat. lemniscus: behind granules in their cytoplasm
Trigeminal lemniscus  Concerned w/ muscle tone
 Crus Cerebri: contains  Frontopontine fibers
descending tracts occupy medial part
 Corticospinal & Cortico-  Temporopontine fibers
bulbar tracts occupy occupy lateral part
middle 2/3
 Upper Midbrain
(Level of the Superior colliculi)
 Nucleus of Supr.  Oculomotor nucleus:
colliculus: forms part lie in central gray matter
of visual reflexes near midline
 Med., Spinal, & Trigeminal  Reticular formation:
lemnisci: curved band in tegmentum, lat.
posterior to Substantia nigra
& post. to Red nucleus
 Red nucleus: rounded  Crus cerebri:
mass of gray matter (+) descending tracts:
 Reddish due to vascularity Corticospinal, Corticobulbar,
& iron-containing Corticopontine
pigment in cytoplasm
of its neurons
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