Anatomy of the Brainstem

Neuroanatomy block-Anatomy-Lecture 5
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 Objectives
At the end of the lecture, students should be able to:

01 List the components of brain stem.

02 Describe the site of brain stem
03 Describe the relations between components of brain stem & their
relations to cerebellum.
04 Describe the external features of both ventral & dorsal surfaces of
brain stem
05 List cranial nerves emerging from brain stem Color guide
06 Describe the site of emergence of each cranial nerve ● Only in boys slides in Green
● Only in girls slides in Purple
● important in Red
● Notes in Grey
 Development of Brain Brain stem
● The brain develops from the cranial part of neural tube. ● The brainstem is the region of the brain that connects the
● The cranial part is divided into 3 parts: cerebrum with the spinal cord.
● Site: It lies on the basilar part of occipital bone (clivus).
- Subdivided into:
● Parts from above downwards :
1. Telencephalon: (cavities: 2 lateral ventricles)
Two cerebral hemispheres.
1. Midbrain
Forebrain 2. Pons
2. Diencephalon: (cavity: 3rd ventricle) 3. Medulla oblongata
thalamus, hypothalamus, epithalamus & subthalamus ● Connection with cerebellum:
Each part of the brain stem is connected to the
Midbrain - (cavity: cerebral aqueduct) cerebellum by cerebellar peduncles (superior, middle &
inferior).
- (cavity: 4th ventricle)
- Subdivided into:
Hindbrain 1. Pons
2. Cerebellum
3. Medulla oblongata

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Sagittal section of Brain

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Functions of the Brain Stem
Pathway of tracts between cerebral cortex & spinal cord
(ascending and descending tracts).
1
Site of origin of nuclei of cranial nerves (from 3rd to 12th).

2
Site of emergence of cranial nerves (from 3rd to 12th).

3
Contains groups of nuclei & related fibers known as reticular
formation responsible for:
4 -
-
Control of level of consciousness
Perception of pain
- Regulation of cardiovascular & respiratory systems
- A vehicle for sensory information

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 Medulla oblongata
Ventral surface Dorsal surface
Ventral surface
● Continuation of ventral median Cudal part (Closed medulla)
Ventral fissure of spinal cord. Divides the
medulla into 2 halves.
median Cavity: Central canal.
● Its lower part is marked by ●
fissure decussation of most of pyramidal ● Composed of:
(corticospinal) fibers (75 % -90%). 1. Dorsal median sulcus: divides the closed medulla
into 2 halves.
2. Fasciculus gracilis: on either side of dorsal median
● An elevation, lies on either side of sulcus.
ventral median fissure. 3. Gracile tubercle: an elevation produced at the upper
Pyramid Ventral median
● Produced by corticospinal tract fissure part of fasciculus gracilis, marks the site of gracile
(descending motor tract). Dorsal surface nucleus.
4. Fasciculus cuneatus: on either side of fasciculus
gracilis.
● An elevation, lies lateral to the 5. Cuneate tubercle: an elevation produced at the
pyramid. upper part of fasciculus cuneatus, marks the site of
Olive
● Produced by inferior olivary nucleus cuneate nucleus
(important in control of movement).
Fasciculus cuneatus
Fasciculus Cranial part (open medulla)
gracilis
1. Hypoglossal (12th):
Nerves - From sulcus between pyramid & olive. ● Cavity: 4th ventricle.
2. Glossopharyngeal ( 9th), vagus (10th) ● On either side, an inverted V-shaped sulcus divides
emerging
& cranial part of accessory (11th): the area into 3 parts (from medial to lateral):
(4) - From sulcus dorsolateral to olive 1. Hypoglossal triangle: overlies hypoglossal nucleus.
(from above downwards). 2. Vagal triangle: overlies dorsal vagal nucleus.
3. Vestibular area: overlies vestibular nuclei.

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 Pons
Transverse pontine
Basilar sulcus (pontocerebellar) Nerves emerging (4)
fibers
Ventral surface

1. Trigeminal (5th):
- From the middle of ventrolateral aspect of
pons, as 2 roots: a small medial motor root & a
Ventral Originate from pontine
large lateral sensory root.
2. Abducens (6th):
surface Divides the pons
nuclei, cross the midline &
pass through the
- At the junction between the pons & pyramid.
into 2 halves, 3. Facial (7th) & Vestibulocochlear (8th):
contralateral middle
occupied by - At cerebellopontine angle (junction between
cerebellar peduncle to
basilar artery. medulla, pons & cerebellum). Both nerves
enter the opposite
emerge as 2 roots (from medial to lateral):
cerebellar hemisphere.
motor root of 7th, sensory root of 7 th ,
vestibular part of 8th & cochlear part of 8th. Dorsal surface

Schwannomas can compress this angle (CN VIII in particular)

● Separated from open medulla by an imaginary line passing between the margins of middle
cerebellar peduncle.
Dorsal ●
1.
On either side of median sulcus, it divides into 2 parts (from medial to lateral) :
Medial eminence & facial colliculus: overlies abducens nucleus.
surface 2. Vestibular area: overlies vestibular nuclei.
● The dorsal surfaces of open medulla and pons lie in the caudal 1/3rd
and the rostral 2/3rd of the floor of the 4th ventricle respectively.

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 Midbrain
Ventral surface

● Large column of descending fibers (crus cerebri or basis

Crus
pedunculi), on either side, separated by a depression called cerebri

the interpeduncular fossa.

Ventral surface
● Nerve emerging from Midbrain (one):
1. Oculomotor (3rd):
- From medial aspect of crus cerebri.

Dorsal surface
● Marked by 4 elevations:
1. Two superior colliculi: concerned with visual reflexes.
2. Two inferior colliculi: forms part of auditory pathway.
Dorsal surface ● Nerve emerging from Midbrain (one):
1. Trochlear (4th):
- Cudal to the inferior colliculus (The only cranial nerve
emerging from the dorsal surface of brainstem).

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Practice
Q5: The cavity of the closed medulla is?
Q1: Basilar sulcus of the pons is occupied by?
A. 4th ventricle
A. basilar nerve
B. Median sulcus
B. basilar artery
C. Central canal
C. basilar vein
D. Dorsal median sulcus
D. basilar nucleus
Q6: The only cranial nerve emerging from the dorsal surface of brainstem is?
Q2: the basilar sulcus is a part of which of the following?
A. Trochlear (4th)
A. dorsal surface of medulla
B. Oculomotor (3rd)
B. ventral surface of medulla
C. Vagus (10th)
C. dorsal surface of pons
D. Facial (7 th)
D. ventral surface of pons
Q7: The two superior colliculi are concerned with?
Q3: The cranial nerve that emerges from ventral surface of midbrain is?
A. Auditory pathway
A. Trochlear (4th)
B. Facial reflexes
B. Oculomotor (3rd)
C. Sensory pathway
C. Vagus (10th)
D. Visual reflexes
D. Facial (7th)
Q8: Regarding the medulla oblongata, which one of the following is correct?
Q4: Which one of the following is the site of the inferior colliculus?
A. The pyramid is lateral to olive.
A. In the ventral surface of medulla, lateral to the olive.
B. The cuneate tubercle is lateral to gracile tubercle.
B. In the dorsal surface of medulla, medial to the vagal triangle.
C. The hypoglossal nerve is the most lateral nerve emerging from it.
C. In the ventral surface of midbrain, lateral to the medial eminence.
D. The cerebellum is connected to it by middle cerebellar peduncle.
D. In the dorsal surface of midbrain, above the trochlear nerve.

Answers: Q1(B) Q2(D) Q3(B) Q4(D) Q5(C) Q6(A) Q7(D) Q8(B) 9

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