2024 Brainstem - External Features (Lab)

OLFU MEDICINE MHSB - FINALS | Dr. Gironella| May 27, 2021

EXTERNAL FEATURES OF THE BRAINSTEM

BRAINSTEM

MIDBRAIN

• Consists of short segment of brainstem between the pons and nuclei of

diencephalon

ITER /CEREBRAL AQUEDUCT space in the middle of midrain and

communication between the 3d ventricle and 4th ventricle

ANTERIOR

monami | 1 of 6

 PONS

CRUS CEREBRI OF THE bag of fibers

MIDBRAIN / CEREBRAL PEDUNCLE

space that separates two cerebra

INTERPEDUNCULAR FOSSA peduncles

exits on the sides of interpeduncular

fossa and emerge on the surface of
OCULOMOTOR NERVE (CN 3)
transverese groove betwen pons and
midbrain

POSTERIOR

a large tissue that is located above the medulla and on the ventral surface of
brainstem, cerebral peduncles will pass through the pons and caudally it will
emerge towards the pyramid (pathway of fibers)

ANTERIOR

• occupying the anterior aspect

• extending along the midline and
BASAL SULCUS / BASILAR SULCUS coincides with the course of basilar
artery

• exits form the inferior pontine

rostral pair
which will connect through the
SUPERIOR COLLICULUS brachium of superior colliculus to
lateral geniculate for vision
(visual pathway)
through brachium of inferior colliculi
INFERIOR COLLICULUS will connect to medial geniculate
which is part of the auditory pathway
MIDDLE CEREBELLAR PEDUNCLE /
PINEAL BODY part of epithalamus
• smallest of all cranial nerve
• emerges from posterior surface just
TROCHLEAR NERVE behind the inferior colliculus
(emerges posteriorly and goes
anteriorly)
CEREBELLUM PONTINE ANGLE
ADBUCENS NERVE (CN 6)
BRACHIUM PONTIS
sulcus on the caudal end of the
pons— very close to the pyramid
• when viewing it on a lateral side,
the transverse fibers of pons
converge to form a compact lateral
bundle known as middle
cerebellar peduncle (brachium
pontis) that attach the pons on the
overlying cerebellum
compact lateral bundle formed by
converging of transverse fibers of
pons that attach the pons to the
overlying cerebellum
• on the lateral side
• formed between caudal border of
middle cerebellar peduncle the
adjoining cerebellum, upper part of
medulla
• Facial nerve and vestibulocochlear
nerves are found here ( CN 7 & 8)

• penetrate brachium pontis near the

middle of lateral surface of pons
TRIGEMINAL NERVE (CN 5) • sensory portion is larger as
compared to the motor portion

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 MEDULLA OBLONGATA / BULB

• Constitutes the most caudal part o f the brain stem and continues with the
spinal cord at the foramen magnum
• extends rostrally about 2.5 cm caudal to the pons
• central canal of spinal cords is continues through the 4th ventricle at the
point called obex
• rostral part of the medulla forms the oor of 4th ventricle

ANTERIOR

• formed by pyramidal tracts of

corticospinal and corticobulbar
tracts
• forms 2 longitudinal ridges on
eother side of ventral median
PYRAMID ssure / antero-median ssure
• there is a decussation or crossing
over of the pyramids and
obliterating the anteromedian
fissure at the extreme caudal end of
medulla oblongata

VENTROLATERAL SULCUS where rootlets of hypoglossal nerve

(12) emerge

• cranial nerves are seen

• radicalsof cranial portion of
accessory nerve (11)
DORSOLATERAL SULCUS
• vagus nerve (10)
• glossopharyngeal nerve (9)

POSTERIOR POSTERIOR

posterior surface of the pons forms the rostral part of the 4th ventricle
red triangle - behind of ponds
yellow broken lines - behind medulla oblongata

at its widest point, this triangle area contains ponto-medullary junctions and
the lateral recesses of the ventricles
medial eminence and facial colliculus are also seen here

• is actually made up of the fibers of

the facial nerve and nucleus of
FACIAL COLLICULUS
abducens nerve

• bundles of fibers
• forms the walls of 4th ventricle
SUPERIOR CEREBELLAR
• together with the cerebellar vermis
PEDUNCLE
and anterior medullary bellum
forms the roof of the 4th ventricle

DORSAL MEDIAN SULCUS space in between / middle

SULCUS LIMITANS space lateral to the median emience

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 REVIEW USING ACTUAL SLIDES

FASCICULUS GRACILIS & FASCICULUS CUNEATUS - which for an eminence cerebral peduncle
or elevation known as gracile tubercle or clava and cuneate tubercle interopeduncular
fossa
communication between 4th
OBEX ventricle and central canal of spinal pons
cord
basilar sulcus CN V
vagal trigon
LATERAL ELEVATION contains dorsal motor nucleus of the
vagus (black circle)
antrolateral sulcus
hypoglossal trigon
MEDIAL ELEVATION contains hypoglossal nucleus (white ventral median
circle) pyramid
ssure

bun of fibers which are ridges formed

by fibers passing through the
cerebellum
STRIA MEDULLARIS proceed laterally (lateral portion is in
pink squares) and opening of
foramen of Lusca to allow CSF to
flow to the subarachnoid space

drain the CSF towards the

FORAMEN OF MAGENDI
subarachnoid space
superior colliculus

inferior colliculus

superior medullary
velum
middle cerebral
peduncle
superior cerebral
peduncle

inferior cerebral
medial peduncle
eminence

facial
dosro median
folliculus
sulcus

vestibular
clava cuneate tubercle
area

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fi

 superior colliculus

ANTERIOR VIEW:
RED PIN - interpeduncular fossa POSTERIOR VIEW:
GREEN PIN - crus cerebri / cerebral peduncle PINK PIN - inferior colliculus
PURPLE PIN - pons
WHITE PIN - anteromedian fissure

PURPLE PIN - Pyrami

POSTERIOR VIEW: RED PIN - olive
BLUE PIN - vestibular area
PINK PIN - medial elevation / hypoglossal trigon
PURPLE PIN - lateral elevation / vaga trigon
RED PIN - inserted towards stria medullaris

GREEN PIN - dorso lateral sulcus

PURPLE PIN - dorsal median sulcus / posteromedian sulcus
RED PIN - dorsal intermediate sulcus
DIS & DMS LIMITS FASCICULUS GRACILIS
DIS & DSL LIMITS FASCICULUS CUNEATUS
monami
POSTERIOR VIEW:
GREEN PIN - clava (elevation of fasciculus gracilis) | 5 of 6
PURPLE PIN - cuneate tubercle (elevation of fasciculus cuneatus)
RED PIN - obex

 pontomedullary junction (space between pons & medulla oblongata)

posterolateral sulcus

anteromedian sulcus

anterolateral sulcus

superior cerebellar peduncle

middle cerebellar peduncle

inferior cerebellar peduncle

monami | 6 of 6