Brainstem

G.Arveladze
N.malashkhia
 Brainstem
The brainstem is the most caudally situated and phylogenetically
oldest portion of the brain. It is grossly subdivided:

Medulla oblongata (the rostral continuation of the spinal cord),

Pons (middle portion of the brainstem)

Midbrain (mesencephalon)
Brainstem Anatomy
The brainstem contains a large
number of fiber pathways,
including all of the ascending
and descending pathways.
The brainstem also contains many nuclei,
(all of which play an important role in motor regulatory circuits)
nuclei of cranial nerves III through XI

red nucleus

substantia nigra (in midbrain)

pontine nuclei

olivary nuclei of the medulla

the nuclei of the midbrain,
are important relay stations in
the visual and auditory
pathways
brainstem is network of
neurons of the reticular
formation, which contains the
autonomic regulatory centers
for vital bodily functions,
including cardiac activity,
circulation, and respiration.
The reticular formation also
sends impulses to the cerebral
cortex that are necessary for
the maintenance of
consciousness. Descending
pathways from the reticular
formation influence the
activity of the spinal motor
neurons
• Because the brainstem contains many different nuclei and
nerve pathways in such a compact space, even a small
lesion within it can produce neurological deficits of several
different types occurring simultaneously (as in the various
brainstem vascular syndromes).
• A relatively common brainstem finding is so-called crossed
paralysis or alternating hemiplegia, in which cranial nerve
deficits ipsilateral to the lesion are seen in combination
with paralysis of the contralateral half of the body.
In general, cranial nerve deficits can be classified as
1. supranuclear, i.e., caused by a lesion in a descending pathway from
higher centers, usually the cerebral cortex,;
2. nuclear, if the lesion is in the cranial nerve nucleus itself;
3. fascicular, if the lesion involves nerve root fibers before their exit
from the brainstem;
4. peripheral, if the lesion involves the cranial nerve proper after its
exit from the brainstem.
The type of deficit produced depends on the site of the lesion.
 Surface Anatomy of the Brainstem
 Medulla

The  medulla extends

from the site of exit of
the roots of the first
cervical nerve (C1), at
the level of the foramen
magnum, to its junction
with the pons 2.5­- 3 cm
more rostrally.
 Dorsal view

The Medulla Oblongata 

Relay stations
1. nucleus gracilis 
pass sensory info to
the thalamus
2. nucleus cutaneatus 
pass sensory info to
the thalamus
3. olivary nuclei pass
info to the cerebrum,
diencephalon, and
brain stem
 Medull a ob longa ta

 
contains sensory and motor
nuclei of cranial nerve (5)
1. Vestibulocochlear VIII
2. Glossopharyngeal IX 
3. Vagus X
4. Accessory XI  Nuclei of the vestibular n.
5. Hypoglossal XII
Sensory Motor
A c c e s s o r y ( a u t o n o m ic )
n u c le u s = E d in g e r –
W e s tp h a l n u c le u s
M e s e n c e p h a lic n u c le u s a n d
tr a c t o f th e tr ig e m in a l n .
P r i n c i p a l s e n s o r y n u c l e u s of the trigeminal n.
Nucleus of
the cochlear n.

medulla oblongata 
Autonomic nuclei 
major centers include (2) Nucleus of the tractus solitarius Spinal nucleus and tract
of the trigeminal n.

1. cardiovascular centers 
2. Respiratory centers
Pons
 
consists of sensory and motor nuclei of 4
cranial nerves: 
1. nuclei involved with involuntary
control for breathing  
3. nuclei that relay cerebellar commands  
4. ascending, descending, and transverse
tracts
5. Nuclei of trigeminal V
6. Abducens VI 
7. Facial VII
8. Vestibulococochlear VIII 
9. nuclei involved with involuntary
control of breathing
10. Apneustic Center
11. Pneumotaxic center
12. nuclei that relay cerebellar
commands:
Cerebellar peduncle:1. ascending tracts 2.
transverse fibers 
Pons
 Mesencephalon (midbrain)
 
consists of:
1. two pairs of nuclei collectively called corpora
quadrigemina 
2. nuclei of the reticular formination
3. Red nucleus  
2. substantia nigra 
3. cerebral peduncles

responsible for... 
1. processing auditory and visual stimuli 
2. where auditory processing occurs 
3. where visual processing occurs
4. integrates information with the cerebrum and
cerebellum 
5. regulates motor output of the basal nuclei 
6. have ascending fibers that synapse in the
thalamus and descending fibers of the
corticospinal pathway
 Cranial Nerves  Origin,
Components, and Functions
schematic dorsal view of the
brainstem, in which the motor
and parasympathetic cranial
nerve nuclei are shown on the
right and the somatosensory and
special sensory nuclei are shown
on the left.
Sensory Motor
A c c e s s o r y (a u to n o m ic )
n u c le u s = E d in g e r –
M e s e n c e p h a lic n u c le u s a n d W e s tp h a l n u c le u s
tra c t o f th e trig e m in a l n .
P r i n c i p a l s e n s o r y n u c l e u s of the trigeminal n.
Nuclei of the vestibular n.
Nucleus of
the cochlear n.

All 12 cranial nerves are seen in

the figure, from I (olfactory
nerve) to XII (hypoglossal
nerve); it should be borne in
Nucleus of the tractus solitarius Spinal nucleus and tract
mind, of the trigeminal n.
Thanks for Attention!