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Brain stem section
國防醫學院生解科
授課教師: 黃雍協
Brain stem components
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Ascending tract
Descending
Fiber connecting with the cerebellum
Cranial nuclei and nerve
Integrative center---reticular formation
(monoaminergic neuron)
dopamine, catecholamine, and serotonin
Ascending tracts
spinothalamic tract (STT)
Medial lemniscus system
Spinocerebellar tract (dorsal and ventral) ICP and SCP
spinal trigeminal tract
Descending tracts
Tectospinal tract
Rubrospinal tract
Reticulospinal tract
Vestibulospinal tract; Medial longitudinal fasciculus
Corticospinal tract
Central tegmental tract
Fibers connecting with cerebellum
cerebellar peduncles (superior, middle and inferior)
superior cerebellar peduncle decussation
Cranial nuclei and nerve
7個功能模組 延腦包括全部
•一般體感覺(GSA) (from skin and muscle)
•一般內臟感覺(GVA)(頸部以下的內臟)
•特殊體感覺(SSA)(視聽平)
•特殊內臟感覺(SVA) (嗅味)
•一般體運動(GSE) (CN 3,4,6,11,12)
•一般內臟運動(GVE) (CN 3,7,9,10)
•特殊內臟運動(SVE)(咽弓發育而來的頭頸部骨骼
肌) (CN 5, 7, 9, 10)
Cranial nuclei
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7個運動核
oculomotor nu.and trochlear nu. in the midbrain
trigeminal motor nu. in the pons
facial motor nu and abducens nu. at the potomedullary junction
ambiguus and hypoglossal nu. in the medulla
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4個副交感神經核(CN3,7,9,10)
Edinger-Westphal nu. Superior salvatory nu. Inferior salvatory nu. and
Dorsal nu. of vagus
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4種感覺核(主要在延腦)
Trigeminal nu. (GSA)
Solitary nu.(GVA) (rostal part is the gustatory nu. (SVA)) in the medulla
two cochlear nu. (SSA) in the medulla
Four vestibular nu. (SSA) in the potomedullary junction
Blue—sensory nu.
Red---motor nu.
Cranial nuclei and nerve
Anatomy of the brain stem (external features and larger internal structures).
1.Spinomedullary junction: S5N, pyramidal descussion
2. Closed medulla: Pyramidal decussation
(at the most caudal level)
Internal arcuate fibres
(at a more rostral level)
3.Open medulla:
Inferior olivary nucleus
4. Lower pons:
Abducens nucleus
Fibres of facial nerve
5. Mid-pontine level: Trigeminal nerve, Pontine nuclei
Medial lemniscus
6. Upper pons:
SCP, locus ceruleus, M5T
7. Caudal midbrain(下丘): Decussation of superior
cerebellar peduncles
8. Rostral midbrain(上丘): Red nucleus
Oculomotor nerve
23
Close medulla (Caudal medulla)
Sensory nu. and tract
Nucleus gracilis (2)
Nucleus cuneatus(3)
Fasciculus gracilis(23)
Fasciculus cuneatus(4)
Internal arcuate fibers(19)
Lateral (accessory) cuneate nucleus (5)
S5N(6) and S5T(7)
Solitary tract and nucleus(21)
Tracts
Pyramid(13)
Other
MLF(16)
Posterior spinocerebellar tract (8)
Anterior spinocerebellar tract (11)
Inferior olivary nu.(12)
Motor nu.
Hypoglossal nucleus(17) and nerve(18)
Dorsal motor nucleus of X (1)
vagus nerve fibers(20)
Nucleus ambiguus(10)
Ascending tract
ML(15)
ALS(9)
Reticular formation
Raphe nu.(14)
Open medulla (Rostal medulla)
Sensory nu. and tract
Nucleus cuneatus (7)
Lateral cuneate nucleus (8)
Internal arcuate fibers(14)
S5T(24) and S5N (25)
Solitary nucleus(5) and solitary tract (6)
Inferior vestibular nucleus (26)
Medial vestibular nucleus(27)
Motor nu
Hypoglossal nucleus (3) and nerve (15)
Dorsal motor nucleus of X (4) and
fiber(13)
Nucleus ambiguus(11)
Ascending tracts
Other:
Medial lemniscus(18)
Raphe magnus nu. (17)
Inferior olivary nu.(medial accessory nu. ALS(12)
(19), (principal nu. 20, dorsal accessory PSCT entering the ICP(10)
ASCT(23)
nu. 22)
Tract: pyramid(16)
Olivocerebellar fibers
Central tegmental tract (21)
Inferior cerebellar peduncle(9)
Medial longitudinal fasciculus (MLF) (2)
(includes dorsal spinocerebellar and
cuneocerebellar trs.)
Lower pons
Other:
MLF(3)
CTT(21)
SCP (6)
MCP (2)
ICP (7)
pontine nu, (18)
Sensory nu.
Solitray nu. and tract(9)
Spinal trigeminal nu. (11)
Superior olivary nu.(22)
Lateral vestibular nu.(26)
Medial vestibular nu.(28)
Motor nu.
abducens nu.(5) and fiber (8)
facial motor nu. (23) and nerve(25)
internal genu of facial n.(29)
Reticular formation
raphe magnus nu. (4)
Ascending tracts
Spinal trigeminal nu. and tract(10 and 11)
(S5N & S5T, 10,11)
ML(20)
ALS(14)
LL(13)
Trapezoid body(19)
Tract
CST, CBT, CPT(16)
22
Mid-pons
SCP
Sensory nu.
Trigeminal main sensory nu. (6)
and trigeminal nerve(10)
M5N and M5T(5)[mesencephalic]
Superior vestibular nu.(20)
Superior olivary nu.(16)
Motor nu.
Trigeminal motor nu.(7)
Other:
SCP(3)
MCP (18)
Anterior spinocerebellar tract(4)
Pontine nu.(13)
Superior medullary velum (22)
Reticular formation
Superior central nu.(19)
Ascending tracts:
ML(9)
ALS(8)
Trapezoid body(14)
LL(17)
ASC(4)
Tract:
MLF(2), CTT(15), Pyramidal(12)
Pontocerebellar fiber(11)
1
5
4
2
3
12
13
14
11
10
9
7
6
8
Ascending tracts:
Medial lemnicus (9)
spinal lemnicus (10)
lateral lemnicus(11)
Other tracts:
MLF (12)
SCP (13)
central tegmental tract (14)
Upper pons
Motor:
Trochlear decussation (1)
Sensory:
M5N and M5T
(mesencephalic nu. and
tract)(2)
Reticular formation
Locus ceruleus (3)
Dorsal raphe nu. (4)
PAG (periaqueductal gray)(5)
around 4th ventricle
Basal pons:
Pontine nu. (6)
Pontocerebellar fibers (7)
Descending system (8)
Corticospinal, corticobulbar,
cortireticular, cortiopontine
Caudal midbrain--inf.
colliculus level
Other:
Central tegmental tract(13)
MLF(14)
decussation of SCP(11)(cerebello-rubro
thalamic pathway)
Pontine nu. (12)
Cerebral aqueduct(1)
Sensory nu:
Inferior colliculus (5)
M5N and M5T (15)
Motor nu.:
Trochlear nu (3) and fiber (4)
Substantia nigra (10)
Reticular formation
Dorsal raphe nu(2)
PAG (16)
Ascending tract
ML (8)
ALS (7)
LL (6)
Cerebral peduncle: (9)
descending tract:
corticospinal,
corticobulbar(and
corticoreticular)
Corticopontine(位在兩側)
Rostal midbrain—sup. colliculus level
Sensory nu:
Superior colliculus (3)
M5N and M5T(4)
Motor nu:
Oculomotor nu.(18) and nerve(11)
EW nu.
Substantia nigra(compact part,9)
(reticular part, 10)
Red nu.(15)
Ascending tract
ML(7)
ALS(6)
Brachium of inferior colliculus (5)
Other:
Ventral tegmental area(13)
Cerebral peduncle(8)
MLF(16)
CTT(17)
Reticular formation
PAG(2)
Special somatic sensory nu.
Four vestibular nu.
Two cochlear nu.
The level of Cranial Nerve VIII and IX looks a lot like a butterfly.
“Neuroanatomy: An Atlas of Structures, Sections, and Systems.” (Haines 117).
The level of Cranial Nerve VIII and IX looks a lot like a butterfly.
“Neuroanatomy: An Atlas of Structures, Sections, and Systems.” (Haines 117).
Reticular formation
• Monoamergic system
dopamine, serotonin and noradrenalin
• Pain inhibitory center
periaqueductal gray
Dopaminergic neurons
Serotonergic
neurons
Noradrenergic neurons
Pain inhibitory
pathway