Brainstem pathway

Brainstem 2

Dr Shittu LAJ

Development

Ventricles in brainstem

• Mesencephalon cerebral aqueduct• Metencephalon 4th ventricle• Mylencephalon 4th ventricle

vermis

Occipital LobeThalamus

Corpus callosum

Hypothalamus

Fornix

Anterior commissure

Optic nerve

4th ventricle

Posterior commissure

pyramid

Mammillary body

Quadrigeminal cistern

internal capsulebasal ganglia

optic nerveoptic tract

hypothalamus mammillary body

cerebral peduncle

interpeduncular fossa

flocculusinferior olivary

nuclear complex

cerebellum

cerebellar tonsil

pyramid

pyramidal decussation

pons

optic chiasm

Anterior view of brainstem

optic tract

optic nerve

hypothalamus

optic chiasmmiddle cerebellar peduncle

trigeminal nerve

vestibulocochlear nerve

flocculuscuneate tubercle

inferior olivary nuclear complex

anterior median fissure pyramid

pons

cerebral peduncle

Lateral view of brainstem

Middle cerebellar peduncle

Superior colliculus

Inferior colliculusCerebral peduncle

Superior cerebellar peduncle

Inferior cerebellar peduncle

Medulla

4th ventricle

Posterior view of brainstem

Components of the brainstem• Sensory ascending pathways (dorsal):

– Relay nuclei, tracts• Motor descending pathways (ventral)

– Tracts, motor nuclei brainstem• Cerebellar pathways

– Tracts, cerebellar afferent and efferent nuclei• Cranial nerve sensory and motor tracts

– Cranial nerve nuclei, nerve entry and exit points• CPGs: rhythmic chewing, respiration, cardiovascular regulation

& gain adjustments for reflexes• Modulatory systems: locus coeruleus, raphe & substantia nigra

– Chemically coded nuclei

Brain Stem• Located between the

cerebrum and the SC– Provides a pathway for

tracts running between higher and lower neural centers.

• Consists of the midbrain, pons, and medulla oblongata.– Each region is about an inch

in length.• Microscopically, it consists of

deep gray matter surrounded by white matter fiber tracts.

• Produce automatic behaviors necessary for survival.

Brainstem: 3 major divisions

•Midbrain

•Pons

•Medulla

Midbrain

• Located between diencephalon and pons.– 2 bulging cerebral peduncles on

the ventral side. These contain:• Descending fibers to the

cerebellum via the pons• Descending pyramidal tracts

– Running through the midbrain is the hollow cerebral aqueduct, which connects the 3rd and 4th ventricles of the brain.

– The roof of the aqueduct (the tectum) contains the corpora quadrigemina

• 2 superior colliculi - control reflex movements of the eyes, head and neck in response to visual stimuli

• 2 inferior colliculi - control reflex movements of the head, neck, and trunk in response to auditory stimuli

•Cranial nerves 3&4 (oculomotor and trochlear) exit from the midbrain

•Midbrain also contains the headquarters of the reticular activating system

Midbrain• On each side, the midbrain

contains a red nucleus and a substantia nigra– Red nucleus

- numerous blood vessels; - receives info from the cerebrum and cerebellum; - issues subconscious control of muscle tone & posture

– Lateral to the red nucleus is the melanin-containing substantia nigra ,which secretes dopamine to inhibit the excitatory neurons of the basal nuclei.

• Damage to the substantia nigra causes Parkinson disease?

Pons• Literally means “bridge”• Wedged between the midbrain &

medulla. • Contains:

– Sensory and motor nuclei for 4 cranial nerves

• Trigeminal (5), Abducens (6), Facial (7), and Auditory/Vestibular (8)

– Respiratory nuclei:

• Apneustic & pneumotaxic centers work w/ the medulla to maintain respiratory rhythm

– Nuclei & tracts that process and relay info to/from the cerebellum

– Ascending, descending, and transverse tracts that interconnect other portions of the CNS

Medulla Oblongata• Most inferior region of

the brain stem.• Becomes the spinal

cord at the level of the foramen magnum.

• Ventrally, 2 ridges (the medullary pyramids) are visible. – These are formed by

the large motor corticospinal tracts.

– Right above the medulla-SC junction, most of these fibers cross-over (decussate).

Medulla Oblongata• Nuclei in the medulla are

associated w/ autonomic control, cranial nerves, and motor/sensory relay.

• Autonomic nuclei:– Cardiovascular centers

• Alter the rate and force of cardiac contractions

• Alter the tone of vascular smooth muscle

– Respiratory rhythmicity centers• Receive input from the

pons– Additional Centers

• Emesis, deglutition, coughing, hiccupping, and sneezing

Medulla Oblongata

• Sensory & motor nuclei of 5 cranial nerves:

– Auditory/Vestibular (8), Glossopharyngeal (9), Vagus (10), Accessory (11), and Hypoglossal (12)

• Relay nuclei– Nucleus gracilis and nucleus

cuneatus pass somatic sensory information to the thalamus

– Olivary nuclei relay info from the spinal cord, cerebral cortex, and the brainstem to the cerebellar cortex.

Ascending sensory pathwaysFine discriminitive touch, conscious proprioception• Fasciculus gracilis: Terminates in the nucleus gracilis (medulla)• Fasciculus cuneatus: Terminates (medulla) in the cuneate and accessory cuneate nuclei

Sensations of pain and temperature• Lateral Spinothalamic Tract

– origin dorsal horn cells of the gray matter– Fibers cross contralaterally through the anterior commissure and ascend to the VPL

nucleus

Transmits sensations of touch• Ventral Spinothalamic Tract

– origin cells of the posterior horn– Fibers cross to the opposite side in the anterior commissure

Descending motor pathwaysVoluntary movement • Lateral Corticospinal Tract

– Originates in large pyramidal cells (precentral gyrus) – cross to the opposite side of the cord at the pyramidal decussation & terminate in the dorsal

horn cells• Ventral Corticospinal Tract

– Originates in the pyramidal cells (motor area of the cortex)

Impulses related to equilibrium and antigravity reflexes• Vestibulospinal Tract

– Fibers originate in the vestibular nuclei of the medulla and terminate at level of the sacral spinal nerves

Connects vestibular complex and head and eye movement coordination center in medulla• Medial Longitudinal Fasciculus

– Contains both ascending and descending fibers

Motor Hierarchy•Lateral group (extremities; fine motor control)

•Corticospinal tract

•Rubrospinal tract

•Medial group (axial musculature; rhythmic and postural movements)

•Vestibulospinal tract

•Tectospinal tract

•Reticulospinal tract

•“Final common path”: motor pool

Reticular Formation• Extensive network of neurons that

runs thru the medulla and projects to thalamic nuclei that influence large areas of the cerebral cortex.– Midbrain portion of RAS most likely

is its center• Functions as a net or filter for

sensory input.– Filter out repetitive stimuli. Such

as?– Allows passage of infrequent or

important stimuli to reach the cerebral cortex.

– Unless inhibited by other brain regions, it activates the cerebral cortex – keeping it alert and awake.

How might the “sleep centers” of your brain work? Why does alcohol make you tired?

Reticular Formation

• “Core” of brainstem (midbrain, pons and medulla) composed of loosely organized neurons, outside of the major nuclear groups of the brainstem.

• Medial-to-lateral: raphe nuclei, gigantocellular region, small cell region

• Participate in widespread connections

• Rostral continuation of interneuronal network found in spinal cord

Dorsal Column/Medial Lemniscal system

•Secondary neuron is in brainstem: nucleus gracilis and cuneatus=dorsal column nuclei

•Output of dorsal column nuclei crosses midline and forms recognizable bundle: medial lemniscus

•Medial lemniscus fibers synapse in the thalamus in the ventroposterior nuclei

•Thalamic axons synapse in primary somatosensory cortex in several somatotopic maps with some segregation of submodalities

Tracing through the brainstem: Dorsal Column/Medial Lemniscal

System

Corticospinal Tract

Cerebral cortex(MI and SI)

Thalamus

Cerebellarnucleus

Pontinenuclei

Rednucleus

Cerebellarcortex

Fromspinal cordRubrospinal

tract

Involvement of the cerebellum and pontine nuclei

Overview of motor pathways

Arterial supply to the brain

Blood supply to the brain