BRAINSTEM AND ITS

CONNECTIONS -
NEUROPHYSIOLOGY

Mohammed Jassim K J (28284)

1st Semester MPT
Yenapoya Physiotherapy College
INDEX
1. Introduction to Brainstem
2. Midbrain
3. Pons
4. Medulla oblangata
5. References and co-references
 BRAINSTEM
• Act as a bridge connecting
The Brain to The Spinal cord
and rest of the body

• Contains ascending and

descending tracts between
brain and spinal cord.

• It also contains many centers

for regulation of vital
functions in the body.
The Brainstem consists of
Consists of 3 parts

• Midbrain
• Pons
• Medulla oblangata
 RETICULAR FORMATION
• A crucial component of sleep wake cycle
• Responsible for the transition from a
state of sleep into a state of
conciousnnes
• Plays a vital role in deciding which
sensory signals are sent upward to the
brain for consious processing and which
are considered irrelevant and therefore
ignored
 FUNCTIONS
• Controls sleep wake cycle
• Controls Muscle tone
• Controls Attension
• Controls Arosal
• Controls Awareness
• Influences Circadian rythm
• Influences Learning
• Influences Endrocine secrretions
CLINICAL SIGNIFICANCE
• Schizophrenia
• Post traumatic stress disorder
• Narcolepsy
• REM behavioral disorder
• Sleep disorders
• Coma
MIDBRAIN
• Midbrain is the upper and shortest part of the brainstem
• It consists of two parts:
1. Tectum
2. Cerebral peduncles.
TECTUM
It contains 2 paired structure that are both involved in processing
special sensory information

1. Superior colliculi
• Center for light reflex
• Involved in controlling the eye movements in
response to the visual infromation.
2. Inferior colliculi
• Center for auditory reflexes
• Stimulation produces reflex vocalization

• MEDIAL LONGITUDINAL FASCICULUS

It serves as the connecting point of

3 cranial nerves that control the muscle
around the eye.
PERIAQUEDUCTAL GREY
Contains collection of cell bodies that plays an important part in the
perception,regulation of pain

SUBSTANTIA NIGRA

Forms part of basal ganglia forming

connections with different parts of the
brain.
It produces dopamine ,which controls
movements and muscle tone.
Damage to Substantia nigra results in:

• Balance and coordination problems.

• Muscle weakness and spasms.
• Shakiness and tremors.
• Trouble with focusing, thinking or problem-solving.
• Difficulty controlling eye movements, causing vision problems.
CEREBRAL PEDUNCLE

Consists largely of motor neurons travelling from the motor cortex to

the skeletal muscle known as corticospinal tract and to the muscles of
the face via the cranial nerves which is known as corticobulbar tract
TEGMENTUM

• Upward continuation of the reticular formation

in pons

RED NUCLEUS

Red nucleus is a large oval or round mass of gray

matter
• Functions of red nucleus
1. Control of muscle tone:
Because of its connections with cerebellum, vestibular apparatus and skeletal
muscle, the red nucleus plays an important role in
facilitating the muscle tone.

• 2. Control of complex muscular movements:

Red nucleus controls the complex muscular movements. It plays an important
role in the integration of various impulses received from many important areas
of brain.

3. Control of righting reflex

Red nucleus is the center for all righting reflexes excpet optical righting reflexes
4.Control of movements of eyeball

5. Control of skilled movements:

Red nucleus plays an important role in controlling the skilled muscular
movements by its connections with spinal cord and cerebral cortex.
CRANIAL NERVE

2 cranial nerves branch off the midbrain

Cranial nerve 3- Occulomotor nerve

helps to move eyes and focus on objects , and to
control the size of the pupil in responds to light.

Cranial nerve 4- Trochlear nerve

Controls superior oblique muscle - helps in downward,outward and

inward eye movements.
PONS
• Largest part of the brainstem
• Located between the midbrain and medulla oblangata
• It has the continuation of the
tracks from the midbrain including
the corticospinal tract going to the
muscle and various sensory fibers
going to the parital lobe
FUNCTIONS
• Pontine respiratory center
• 0ccular movements
• Neurotransmitters
• Sleep
 Pontine respiratory center

1. PNEUMOTAXIC CENTER 2.APNEUSTIC CENTER

Stops inspiration when the lungs have Promotes inpiration when the lungs
stretched so far are empty
 Occular movements

• Mediate horizontal eye

movements on their ipsilateral
sides

• Damage here produces weakness

of eye movements known as
Horizontal gaze palsy
 Neurotransmitters

• The pons contains 2 major sites of neurotramsitter production

1. Raphe nuclei
Produces Seratonin - A neurotramsitter involved in mood and
emotion

2. Locus coeruleus
Produces Norepinephrine/Noradrinaline - plays a major role in
sympathetic nerves system and its fight or flight response
 Sleep
Pons contain structures important to the reticular formation - A
major contributer to the sleep cycle
Cranial nerves
4 craial nerves branch off the pons

• Cranial nerve 5-Trigeminal nerve (motor and

sensory)
Skin of face,tongue,teeth,muscle of mastication

• Cranial nerve 6 -Abducens nerve (motor)

Lateral rectus muscle of eye

• Cranial nerve 7 -Fascial nerve (motor and sensory)

Muscles of fascial expression,Taste

• Cranial nerve 8-Vestibulocochlear nerve (sensory)

Hearing
MEDULLA OBLANGATA
• Medulla oblongata or medulla is the
lowermost part of brain. It is situated
below pons and is continued downwards
as spinal cord.

• Medulla forms the main pathway for

ascending and descending tracts of the
spinal cord.

• It also has many important centers which

control the vital functions.
• THE AREA POSTREMA - VOMITING REFLEX
-Induces vomiting during irritation
or inflammation of GI tract

• THE NUCLEUS SOLITARIUS -GAG REFLEX

- Recieves taste inputs
- Maintain arterial blood pressure

LESIONS
-Loss of taste
-Instability of blood pressure and other vital
signs
• THE NUCLUES AMBIGUUS
- Speech and swallowing

LESION/DAMAGE
- Dysphagia
-Dysarthria
-Dysphonia
-Difficulty chewing
-Hoarse voice
 • RESPIRATORY CENTERS

• This area controls the rate and depth of

respiration

from here ,
The nerve impulses pass to the phrenic and
intercostal nerves which stimulate
contraction of the diaphram and intercostal
muscles and initiate inspiration

• It functions in close assosiation with the

pnemotaxic and apneustic centers in the
pons
 • CRANIAL NERVES

• Cranial nerve 9 - Glossopharyngeal nerve

Tastes, salivates,swallows, monitors carotid body and
sinus

• Cranial nerve 10 - Vagus nerve

Tastes, swallows, lifts palate, talks, communication to
and from thoraco- abdominal viscera.

• Cranial nerve 11 -Acessory nerve

Turns head, lifts shoulder

• Cranial nerve 12-Hypoglossal nerve

Moves tongue
 THE PYRAMIDAL DECUSSIATION
Finally at the end of the medulla the
pyramidal decussiation occurs

Here the nerve fibers in the motor

pathway crossover from left to right
and right to left

This is the reason why damage to the

left side of the brain produces
weakness in the right side of the brain.
 DISEASES OF THE BRAINSTEM
• Parkinsons disease - Degeneration or injury to the dopaminergic neurons in
substantia nigra
• Medial pontine syndrome - Damage to abducens nerve,corticospinal
tract,medial lemniscus
• Locked in syndrome - Damage to the corticobulbar,corticopontine and
corticospinal tracts.
• Brainstem stroke - Due to disruption in the blood supply to the brainstem
• Brainstem glioma- specific type of brain tumor that originates in the
brainstem
• Brainstem abcess -Accumulation of pus in the brainstem that is brought by
an infection
• Brainstem Ataxia - Disorder that affects the brainstems capacity to govern
movements,resulting in difficulties walking or coordinating movements
THANK
YOU
ANY DOUBTS?
QUIZ TIME
• Medulla is the ………… part of brain
• Structure in the brain assosiated with auditory pathway?
• Which part of the midbrain produces dopamine?
• Tell a function of reticular formation?
• References:
•Sembulingam - Essentials of Medical Physiology,
https://drive.google.com/file/d/0B7XJwaJHLk3FTE1sOEZ1SHlBcnM/view?usp=drive_link&resourcekey=0-
Hbe5hBYILElEOtXNZpf0ew
•Ross & Wilson-Anatomy & Physiology
https://drive.google.com/file/d/1rS6xysSDcAdSiEMipQfj_5VFFcR2PXgF/view?usp=sharing
•Text of medical physiology https://faculty.ksu.edu.sa/sites/default/files/hall_textbook_of_medical_physiology.pdf
•https://www.ncbi.nlm.nih.gov/books/NBK544297/
•https://www.braininjury-explanation.com/consequences/impact-by-brain-area/brainstem