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Transcript
‫بسم هللا الرحمن الرحیم‬
The Brainstem
The Brainstem
Consists of
• Midbrain
• Pons
• Medulla oblongata
The brainstem has three broad functions:
(1) it serves as a conduit for the ascending tracts and descending tracts connecting the spinal cord to the different parts of the
higher centers in the forebrain
(2) it contains important reflex centers associated with the control of respiration and the cardiovascular system and with
the control of consciousness
(3) it contains the important nuclei of cranial nerves lll through Xll.
Ventral surface
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•
•
•
•
Medulla oblongata
Pyramid: contain pyramidal tract (corticospinal tract)
Decussation of pyramid: formed by crossing fibers of
corticospinal tract
Olive: produced by underlying inferior olivary
nucleus
Anterolateral sulcus: rootlets of hypoglossal nerve
emerge from it
Retroolivary sulcus: rootlets of glossopharyngeal,
vagus and accessory nerves emerge from it
Medulla Oblongata
Dorsal surface
• Lower portion
– Gracile tubercle: produced by
gracile nucleus
– Cuneate tubercle: marks the site of
cuneate nucleus
underlying
– Inferior cerebellar peduncle
– Obex
• Upper portion: forms the lower
half of rhomboid fossa
Pons
Ventral surface
• Basilar part
• Basilar sulcus
• Bulbopontine sulcus
:
from medial to lateral, the
abducent, facial and
vestibulocochlear nerves
appear
• Middle cerebellar peduncle
• Trigeminal nerve
Pons
Dorsal surface
• Superior cerebellar peduncle
• Superior medullary velum
• Trochlear nerve
Midbrain
Ventral surface
• Crus cerebri
• Interpeduncular fossa
oculomotor nerves emerge
from medial of crus cerebri
• Posterior perforated
substance
Midbrain
Dorsal surface
• Superior colliculus
constitute centers for visual
reflexes
• Inferior colliculus
associated with auditory
pathway
• Brachium of superior
colliculi
• Brachium of inferior
colliculi
Fourth ventricle
Central canal →fourth ventricle →mesencephalic aqueduct→third ventricle
Position
• Situated ventral to
cerebellum, and
dorsal to pons and
cranial half of
medulla
*
*
Boundaries
• Inferolateral: gracile and
cuneate tubercles,
inferior cerebellar
peduncle
• Superolateral: superior
cerebellar peduncle
• Lateral recess
Features
• Median sulcus
• Sulcus limitans
• Vestibular area overlies vestibular
nuclei
• Acoustic tubercle
•
overlying dorsal cochlear nucleus
• Medial eminence
• Striae medullares
• Facial colliculus: overlies
nucleus of abducent n. and
genu of facial nerve
• Hypoglossal triangle
overlying hypoglossal nucleus
• Vagal triangle: overlies
dorsal nucleus of vagus nerve
• Area postrema
• Locus ceruleus
:
Roof
• Anterior part: formed by
superior cerebellar
peduncle and superior
medullary velum
• Posterior part: formed by
inferior medullary velum
and choroid plexus of
fourth ventricle
• Three apertures
– Median aperture of fourth
ventricle
– Two lateral apertures of
fourth ventricle
Tela choroidea and choroid plexus
The characters of internal
structure of brainstem
Medulla oblongata
Lower part (closed part)
• Two decussations–
– Decussations of medial lemniscus
– Decussations of pyramid
Cuneatus n
V nucleuos
Medulla oblongata
Upper part (open part)
• Appearance of inferior
olivary nuculeus and inferior
cerebellar peduncle
• Enlargement of central canal
to form the fourth ventricle
floor
•
•
•
•
•
Spinoolivary
accessory olivary
Cortico olivary
inf. Olivary n.
Central tegmental tract
inf. Olivary n.
Olivocerebellar fibers
Inf. Olivary = center of coordination of
afferents of cerebellum
Internal structures
Gray matter
• Cranial nerve nuclei
• Relay nuclei
Relay nuclei
•
•
•
•
•
•
•
Gracile nucleus
Cuneate nucleus
Inferior olivary nucleus
Superior olivery nucleus
Pontine nucleus
Nucleus of inferior colliculus
Gray matter layers of superior
colliculus
• Red nucleus
• Substantia nigra
• Pretectal area
Non-cranial nerve nuclei
Nucleus
Site
Gracile nucleus
Medulla (underneath gracile tubercle)
Cuneate nucleus
Medulla (underneath cuneate tubercle)
Superior olivery nucleus
Pons
Pontine nucleus
pons
Nucleus of inferior colliculus
Midbrain
Gray matter layers of superior
colliculus
Midbrain
Red nucleus
Midbrain
Substantia nigra
Midbrain
Pretectal area
Midbrain
White matter
Ascending tracts
•
•
•
•
Medial lemniscus
Spinal lemniscus
Trigeminal lemniscus
Lateral lemniscus
Medial lemniscus
Spinal lemniscus
Trigeminal lemniscus
Descending tracts
•
•
•
•
•
Corticospinal tract
Rubrospinal tract
Tectospinal tract
Vestibulospinal tract
Reticulospinal tract
Lateral lemniscus
Reticular formation of brainstem
• Ascending reticular
activating system (ARAS)
• Motor central and vital
centres
– Reticulospinal tract
– Cardiovascular center and
respiratory center
• Serotonergic rapheal
nuclei
• Medial longitudinal fasciculus= medial
vestibolospinal tract
• Dorsal n of vagus =parasympathic part
• Solitarious n= gustatory
• Central tegmental tract