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Transcript
Neuro Objectives 22 1. Cranial nerves: III: Rostral midbrain o Efferents to ocular muscles IV: Caudal midbrain o Efferents to superior oblique V: Midpons o Afferents for face and anterior 2/3 of tongue (touch) o Efferents to muscles of mastication VI: Caudal pons o Efferents to lateral rectus VII: Caudal pons o Afferents for anterior 2/3 of tongue (taste) o Efferents to most facial muscles VIII: Pontomedullary junction o Afferents to the organ of Corti, semicircular canals, saccule, and utricle IX: Rostral medulla o Afferents from posterior 1/3 of tongue (both taste and touch) o Efferents to the parotid gland X: Rostral medulla o Efferents to visceral organs of abdomen o Efferents to skeletal muscle of pharynx, larynx, esophagus XI: Cervical cord o Efferents to trapezius and sternocleidomastoid XII: Middle medulla o Efferents to tongue muscles 2. Midbrain/pons: a. Midbrain: Aqueduct, inferior colliculus, no pontine fibers, cerebral peduncle b. Pons: 4th ventricle, no inferior colliculus, pontine fibers, no cerebral peduncle Pons/medulla: a. Pons: middle cerebellar peduncle, no olivary nucleus, no pyramids, pontine fibers b. Medulla: no peduncle, interior olivary nucleus, pyramids, no cerebral peduncle Superior/inferior colliculi: a. Superior colliculi: rostral medulla, not demarcated well, clear cerebral peduncle, red nucleus b. Inferior colliculi: caudal medulla, clearly demarcated, pontine fibers in cerebral peduncle, decussation of cerebral peduncles Cerebral peduncle: ventral lobes in the midbrain Basal pons: ventral lobe with transverse pontine fibers Middle cerebellar peduncle: connects pons to the cerebellum in the caudal pons Pyramid: ventral lobe in the medulla that will turn into the basal pons Olive: the protrusion resulting from the inferior olivary nucleus in the rostral medulla 3. Superior colliculus: Dorsal to periaqueductal gray in rostral midbrain Periaqueductal gray: Clear staining tissue surrounding aqueduct in the midbrain Red nucleus: Ventromedial in the rostral midbrain where the superior cerebellar peduncles end Substantia nigra: White staining tissue dorsal to the cerebral peduncles in the midbrain 4th ventricle: Cavity running from the rostral medulla to the rostral pons Cerebral aqueduct: Cavity running through the midbrain Reticular formation: Middle area running coronally through brainstem surrounding tracts Inferior olivary nucleus: Dorsolateral to pyramids in the rostral medulla 4. Rostral midbrain: No superior cerebellar peduncles (red nucleus), superior colliculus Caudal midbrain: Decussation of superior cerebellar peduncles, inferior colliculus Rostral pons: Pontine fibers, no middle cerebellar peduncle Caudal pons: Pontine fibers, middle cerebellar peduncle Rostral medulla: Inferior olivary nucleus, prominent inferior cerebellar peduncle Caudal medulla: Nucleus gracilis/cuneatus, ventromedial medial lemniscus 5. Blood supply: Anterior Posterior Midbrain Vertebral a. Anterior spinal a. Posterior spinal a. (caudal) PICA (rostral) Pons Basilar a. AICA (caudal) Superior cerebellar a. (rostral) Medulla Basilar a. Superior cerebellar a. Posterior cerebral a. Superior cerebellar a. (caudal) Posterior communicating a. (rostral) 6. Medial lemniscus (Contralateral touch/position): medial in caudal medulla → medial to inferior olivary nucleus in the rostral medulla → dorsolateral in the basal pons → ventromedial to the spinothalamic tract in the midbrain Spinothalamic tract (Contralateral pain/temperature): lateral in caudal medulla → dorsal to inferior olivary nucleus in rostral medulla → lateral in basal pons → dorsolateral to the medial lemniscus in the midbrain Nuclei gracilis (Ipsilateral proprioception from legs): ventromedial in the caudal medulla Nuclei cuneatus (Ipsilateral proprioception from arms): ventrolateral in the caudal medulla Inferior cerebellar peduncle (Afferent input to the cerebellum): dorsolateral in the medulla Middle cerebellar peduncle (Pontine nuclei → contralateral cortex): connects caudal pons to the cerebellum Superior cerebellar peduncle (Efferent output of the cerebellum): dentate nucleus in the cerebellum at the medullary level → dorsolateral to 4th ventricle in the pons → ventromedial to the aqueduct in the midbrain Cerebral peduncle (Corticospinal, corticopontine, corticobulbar tracts): ventrolateral lobes in the midbrain 7. Medial longitudinal fasciculus: medial throughout brainstem, ventral to the ventricular system Oculomotor nuclei: rostral midbrain, medial, multiple nuclei ventral to periaqueductal gray Trochlear nuclei: caudal midbrain, medial, dorsal to MLF, only cranial nerve that leaves both dorsally and crosses the midline after the nucleus Abducens nuclei: caudal pons, lateral to MLF Hypoglossal nuclei: rostral medulla, medial, dorsal to MLF 8. Abducens nuclei fibers: a. fibers → abducens nerve → lateral rectus to move eye laterally b. interneurons crossing midline → MLF → synapse on oculomotor nuclei → medial rectus to move contralateral eye medially MLF role in eye movements: MLF coordinates the two eyes by providing a pathway for input to the contralateral eye