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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