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Brainstem,[object Object],By,[object Object],Dr Manah Chandra Changmai,[object Object],    IMS,[object Object]
Brainstem,[object Object],[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],[object Object],Midbrain ,[object Object],Pons,[object Object],Medulla,[object Object],obongata,[object Object]
Ventral surface of brain stem,[object Object],Midbrain,[object Object],Pons ,[object Object],Medulla,[object Object],oblongata,[object Object]
Ventral – Lateral  View,[object Object],Midbrain,[object Object],Cerebral peduncles,[object Object],Pons,[object Object],Basis pontis,[object Object],Medulla,[object Object]
Anatomy of brainstem
Vertical  Columns  of  Cranial Nerves,[object Object]
Internal  Columns  of  Nuclei,[object Object]
Subdivisions  of  Vertical  Columns,[object Object],Motor nuclei,[object Object],Somatic motor,[object Object],closest to midline,[object Object],eyes, tongue,[object Object],CN III, IV, VI, XII,[object Object],Branchial motor,[object Object],Lateral position,[object Object],Branchial arches: chewing, expression, middle ear, pharynx, larynx, sternomastoic, trapezius,[object Object],CN V, VII, XI,[object Object],N. ambiguus (IX, X),[object Object],Visceral motor,[object Object],ventral / ventrolateral,[object Object],Parasympathetic: glands, smooth muscle, heart, lungs, GI above splenic flexure,[object Object],Edinger-Westfall (III),[object Object],Sup. & Inf. salivatory,[object Object],Sensory nuclei,[object Object],General  sensory,[object Object],lateral to branchial motor,[object Object],Face, sinuses, meninges,[object Object],All modalities,[object Object],CN V mainly,[object Object],Also CN VII, IX, X,[object Object],Visceral  sensory,[object Object],lateral to visceral motor,[object Object],Taste; cardiorespiratory, GI info,[object Object],N. of the solitary tract   (CN VII,  IX, X),[object Object],Special sensory,[object Object],furthest lateral,[object Object],Balance; hearing,[object Object],CN VIII (vestibular),[object Object],CN VIII (cochlear),[object Object]
Midbrain ,[object Object]
Midbrain,[object Object],Connects pons and cerebrum with forebrain,[object Object],Cruscerebri,[object Object],[object Object],2cm in length,lies in the posterior cranial ,[object Object],Fossa.,[object Object],[object Object],Dorsal tectum and right and left cerebral,[object Object],Peduncles.,[object Object],[object Object],into ventral cruscerebri and a dorsal,[object Object],Tegmentum by a pigmented lamina,[object Object],“ Substantianigra”,[object Object],[object Object],-Descending fibers that go to the   cerebellum via the pons,[object Object],-Descending pyramidal tracts,[object Object],[object Object],[object Object]
Patterning  of  the  Midbrain,[object Object]
Anatomy of brainstem
Superior colliculi,[object Object],The roof of the aqueduct ( the tectum) contains the corpora quadrigemina,[object Object],2 superior colliculithat control reflex movements of the eyes, head and neck in response to visual stimuli,[object Object],2 inferior colliculithat control reflex movements of the head, neck, and trunk in response to auditory stimuli,[object Object],Inferior colliculi,[object Object],Corpora quadregemina,[object Object],Superior and inferior colliculiseperated by cruciform sulcus,[object Object],Superior colliculi larger and darker  ,[object Object],than inferior colliculi,the  difference ,[object Object],In colour due to superficial neurons in,[object Object],Superior colliculi,[object Object]
Internal  Structure  of  Midbrain,[object Object],Cross section at two levels,[object Object],[object Object]
Level of superior colliculus,[object Object]
Substantianigra,[object Object],Cruscerebri,[object Object]
Cerebral aqueduct,[object Object],Basis pedunculi,[object Object],Substantianigra,[object Object],Cruscerebri,[object Object],(cerebral peduncle),[object Object]
Internal  Structure  of  Midbrain,[object Object],Cross section at inferior colliculus,[object Object]
Section at the level of inferior colliculus,[object Object],Inferior colliculus,[object Object],[object Object],    - large mass of grey matter lying in the tectum,[object Object],    - Forms cell station in auditory pathway.,[object Object],[object Object],    - Lies in the ventral part of central grey matter,[object Object],[object Object],    - Lies in lateral part of the central grey matter,[object Object],[object Object],    - Fibres of ventral spinothalamic tract,[object Object],[object Object],    - Fibres of lateral spinothalamic and spinotectal,[object Object],       tract.,[object Object],[object Object],[object Object]
Cross section at,[object Object],[object Object],[object Object]
Section at the level of superior colliculus……contd.,[object Object],[object Object],gray matter,[object Object],[object Object], - Lies in the anterior part of the tegmentum,,[object Object],dorsomedial to the substantianigra,[object Object],- It is called because of reddish colour which  is ,[object Object],   due to the presence of iron pigment in its ,[object Object],       neurons.,[object Object],[object Object],    - Related to the ventral part of central grey matter,[object Object],[object Object],– Vestibular fibres that coordinate eye,[object Object],movements,[object Object],– Interconnects ocular motor CN 3, 4, 6,[object Object],[object Object],[object Object]
Superior colliculus,[object Object],Edingerwestfal,[object Object],nucleus,[object Object],Occulomotor nucleus,[object Object],Red nucleus,[object Object],– relay from cortex and cerebellum to spinal cord, inferior olive, reticular formation, cerebellum,[object Object],Controls arm movement ,[object Object]
[object Object],– Arise from precentral and postcentral,[object Object],Gyri,[object Object],– May synapse directly on motor neurons,[object Object],or indirectly via interneurons,[object Object],(corticoreticular fibers),[object Object],– Innervate sensory relay nuclei,[object Object],– Innervate cranial nerve motor nuclei,[object Object],bilaterally, with the exception of upper,[object Object],face division of the facial nucleus,[object Object],– Innervates the ipsilateral spinal nucleus,[object Object],of CN 11, which supplies the,[object Object],sternocleidomastoid muscle and the,[object Object],contralateral spinal nucleus of CN 11,,[object Object],which innervates the trapezius muscle,[object Object]
Pons,[object Object]
Pons,[object Object],[object Object],     with prominent transversely running fibres.,[object Object],     These fibres collect to form bundles,the,[object Object],     middle cerebellar peduncles.,[object Object],[object Object],surface,at the junction between pons and ,[object Object],     middle cerebellar peduncle.,[object Object],[object Object],     midline by a shallow groove,thesulcusbasilariswhich lodges the basilar artery.,[object Object],Pons,[object Object],s,[object Object],Sulcusbasilaris,[object Object]
Subdivided into ventral and dorsal part,[object Object],Ventral part of the pons contains,[object Object],[object Object]
Recievescorticopontinefibres from frontal,temporal,parietal and occipital lobes of cerebrum,[object Object],[object Object],  of pons.,[object Object],[object Object],  million neurons in pontinenuclei.Most of them ,[object Object],  are glutaminergic.,[object Object],[object Object],fibres.,[object Object],[object Object],Pontine nuclei,[object Object]
Dorsal part of pons,[object Object],Midpons,[object Object],[object Object],    of the part of the medulla behind the pyramids.,[object Object],[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,[object Object],     peduncle in upper part.,[object Object],DORSAL PART,[object Object],Upper pons,[object Object]
Dorsal surface of pons,[object Object],Six ascending tract,[object Object],1 Dorsal and ventral cochlear nuclei,[object Object],    – Receives auditory input from the cochlea,[object Object],       through CN 8,[object Object],2    Trapezoid body,[object Object],    – Formed by decussating fibres of the,[object Object],       ventral cochlear nuclei,[object Object],3    Superior olivary nucleus,[object Object],    – Auditory relay nucleus that receives input,[object Object],      from the cochlear nuclei and contributes,[object Object],      to lateral lemniscus,[object Object],  4   Lateral lemniscus,[object Object],» Auditory pathway that conducts most,[object Object],contralateral cochlear input,[object Object],  5   Medial lemniscus,[object Object],» Spinal afferent pathway,[object Object],  6   Spinal lemniscus,[object Object],» Spinal afferent pathway,[object Object]
4th Ventricle,[object Object],Connection of pons to cerebellum,[object Object],Restiform body (inf. cerebellar peduncle),[object Object],Middle cerebellar peduncle,[object Object],Medial lemniscusAscending 2nd order sensory neurons,[object Object],Descending upper motor neurons,[object Object]
Section through lower part of the pons,[object Object],[object Object],• Lateral gaze,[object Object],[object Object]
Medial, lateral and superior vestibularnuclei of CN 8,[object Object],• Receive proprioceptive input from vestibular,[object Object],systems and cerebellum,[object Object],• Projects to cerebellum and medial longitudinal,[object Object],fasciculus,[object Object],[object Object]
Facial nucleus of CN 7                                   • Gives rise to fibres that innervate the   muscles offacial expression,[object Object],[object Object],– Auditory relay nucleus that receives input,[object Object],from the cochlear nuclei and contributes,[object Object],to lateral lemniscus,[object Object]
Cranial  Nerves  of  Lower  Pons,[object Object],Vestibular Nuclei ,[object Object],Pure sensory  lateral location    ,[object Object],Balance,[object Object]
Cranial  Nerves  of  Lower  Pons,[object Object],At a slightly higher level,[object Object],Abducens N. nucleus,[object Object],Abduction of eye,[object Object],Longest, most vulnerable CN,[object Object],Facial N. nucleus,[object Object],Muscles of face,[object Object]
Mid  Pons,[object Object],4th Ventricle,[object Object],Middle cerebellar peduncle,[object Object],Corticospinal tract,corticobulbar tract, ,[object Object],corticopontine fibers,[object Object],Descending fibers,[object Object]
Mid  Pons,[object Object],Lateral lemniscus,[object Object],Trapezoid body,[object Object],fibers from dorsal column (position and vibration),[object Object],Medial leminiscus,[object Object],fibers from dorsal column (position and vibration),[object Object],Pontine nuclei,[object Object],Trapezoid body :,[object Object],transverse fibers in pontinetegmentum,[object Object]
Mid  Pons,[object Object],Medial lemniscusfibers from dorsal column (position and vibration),[object Object],Motor trigeminal nucleus,[object Object],Trigeminal tractpain, temperature, touch from contralateral face,[object Object],Principal trigeminal sensory nucleus,[object Object],Cranial nerve nuclei and Lemniscal sensory system – in tegmentum of the pons,[object Object]
Section through upper part of pons,[object Object],[object Object]
Principal sensory nucleus of CN 5– Receives discriminative tactile and pressure,[object Object],sensation from face, terminates in thalamus,[object Object],[object Object],» Auditory pathway that conducts most,[object Object],contralateral cochlear input,[object Object],[object Object],– Formed by decussating fibres of the,[object Object],ventral cochlear nuclei,[object Object]
Upper  Pons,[object Object],Periaqueductal gray matter,[object Object],Medial longitudinal fasciculus,[object Object],Superior cerebellar peduncle,[object Object],decussation,[object Object],Transverse ponto-cerebellar fibers,[object Object]
Upper  Pons,[object Object],Pediculopontine Nucleus,[object Object],Locus ceruleus,[object Object],Parabrachial Nucleus,[object Object],Some neurons release acetylcholine  ,[object Object],Other neurons release glutamate,[object Object],They assist in learning and voluntary motor control,             e.g. locomotion, saccadic e,[object Object]
MEDULLA OBLONGATA,[object Object]
External structure of medulla,[object Object],[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],[object Object],    at its upper end,[object Object],[object Object]
Anterior median fissure
Posterior median fissureMedulla oblongata,[object Object],Spinal cord,[object Object]
External surface of medulla,[object Object],Ventral surface of medulla oblongata contains,[object Object],[object Object]
elevation between anterior median    and anterolateralsulcus,[object Object],[object Object],fibres.,[object Object],[object Object]
Oval swelling between anterolateralposterolateralsulcus,half an inch,[object Object],  long,[object Object],[object Object],  matter called inferior olivary,[object Object],  nucleus,[object Object],Olive,[object Object],Pyramid,[object Object]
Pyramid,[object Object],Olive ,[object Object],Anterolateral fissure,[object Object],Anterior median fissure,[object Object]
Posterior part of medulla oblongata,[object Object],The posterior part of medulla contains,[object Object],[object Object],   elevation ,called nucleus gracilis,[object Object],[object Object],elevation,callednucleus cuneatus,[object Object],[object Object],   the floor of the fourth ventricle,[object Object],[object Object],    elevation in the lower part of medulla,[object Object],    lateral to fasciculus cuneatus.,[object Object]
DORSAL SURFACE OF MEDULLA OBLONGATA,[object Object],Floor of fourth ,[object Object],ventricle,[object Object],Obex,[object Object],Gracile tubercle,[object Object],Posterior median sulcus,[object Object],Posterior median fissure,[object Object],Cuneate tubercle,[object Object]

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