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Brainstem Anatomy
General Organization
General organization



Sensory cranial nerve nuclei are lateral
Motor cranial nerve nuclei are medial
Visceral motor and visceral sensory nuclei
are intermediate
4th
Inferior
olive
CN IX
CN X
CN XII
ventricle
Obex
Medullary
pyramid
Pyramidal
decussation
Tubercuum
cuneatus
Tubercuum
gracilis
Tracts


Depending on
direction of fibers,
cut in long section
or cross section.
Most tracts are in
cross section
because they run
from rostral to
caudal
(“descending”) or
caudal to rostral
(“ascending”).
Image of the brainstem of a Brainbow mouse,
by Jean Livet of Harvard University
Sympathetics to eye
*Damage will
produce
Horner’s
syndrome:
anhidrosis,
meiosis (small
pupil); minor
ptosis
(drooping of
the upper lid)
Hypothalamospinal tract
Superior cervical ganglion
Sympathetic chain
T1
T2
T3
Pyramidal
Decussation
Pyramidal Decussation
Fasciculus
cuneatus
Fasciculus gracilis
Nucleus
gracilis
Spinal tract
of trigeminal
Spinal nucleus
of trigeminal
Lateral
corticospinal
tract
Central
canal
Pyramidal
decussation
Anterolateral
system
Spinal accessory
motor neurons
Cervical motor
neurons
Pyramid
Pyramidal
Decussation
Pyramidal Decussation
Fasciculus
cuneatus
Nucleus
cuneatus
Fasciculus gracilis
Nucleus
gracilis
Spinal tract
of trigeminal
Spinal
nucleus of
trigeminal
Central
canal
Lateral
corticospinal
tract
Pyramidal
decussation
Anterolateral
system
Spinal accessory
motor neurons
Cervical motor
neurons
Pyramid
Caudal Medulla
Caudal Medulla
Fasciculus
cuneatus
Nucleus gracilis
Nucleus
cuneatus
Spinal tract
of trigeminal
Central
gray mater
Spinal
nucleus of
trigeminal
Central
canal
Internal
arcuate fibers
Medial
Longitudinal
fasciculus
Anterolateral
system
Medial
lemniscus
Pyramid
Caudal Medulla
Caudal Medulla
Fasciculus
cuneatus
Nucleus gracilis
Nucleus
cuneatus
Central
gray mater
Spinal tract
of trigeminal
Central
canal
Spinal
nucleus of
trigeminal
Hypoglossal
nucleus
Internal
arcuate fibers
Medial
longitudinal
fasciculus
Anterolateral
system
Medial
lemniscus
Inferior olivary
nucleus
Pyramid
Mid-Medulla
Mid-Medulla
Fasciculus
cuneatus
Nucleus
cuneatus
Nucleus gracilis
Obex
Solitary
nucleus & tract
Dorsal motor
nucleus of vagus
Ext. cuneate n.
Spinal tract of
trigeminal
Hypoglossal
nucleus
Spinal nucleus
of trigeminal
Medial
longitudinal
fasciculus
Internal
arcuate fibers
Anterolateral
system
Medial
lemniscus
Inferior olivary
nucleus
Pyramid
Mid-Medulla
Mid-Medulla
Nucleus
cuneatus
Ext. cuneate n.
Solitary nucleus
& tract
Dorsal motor
nucleus of vagus
Obex
Inf cerebellar
peduncle
Hypoglossal
nucleus
Spinal tract of
trigeminal
Spinal nucleus
of trigeminal
Medial
longitudinal
fasciculus
Internal
arcuate fibers
Anterolateral
system
Inferior olivary
nucleus
Medial
lemniscus
Pyramid
Mid-Medulla
Mid-Medulla
Vestibular
Solitary
nucleus
Ext. cuneate n.
nucleus & tract
Dorsal motor
nucleus of vagus
Hypoglossal
nucleus
Inf cerebellar
peduncle
Spinal tract
of trigeminal
Medial
longitudinal
fasciculus
Spinal nucleus
of trigeminal
Anterolateral
system
Inferior olivary
nucleus
Medial
lemniscus
Pyramid
Rostral Medulla
Vestibular
nucleus
Rostral Medulla
Choroid plexus
4th ventricle
Cerebellar
cortex
Inf cerebellar
peduncle
Spinal tract
of trigeminal
Medial
longitudinal
fasciculus
Spinal nucleus
of trigeminal
Anterolateral
system
Inferior olivary
nucleus
Medial
lemniscus
Pyramid
Rostral Medulla
Rostral Medulla
Vestibular
nucleus
4th ventricle
Dentate
nucleus
Inf cerebellar
peduncle
Dorsal cochlear n
Spinal nucleus &
tract of trigeminal
Medial
longitudinal
fasciculus
Anterolateral
system
Inferior olivary
nucleus
Pyramid
Medial
lemniscus
Caudal Pons
Caudal Pons
Facial nerve
4th ventricle
Middle
cerebellar
peduncle
Facial
nucleus
Abducens nucleus
Medial
longitudinal
fasciculus
Abducens nerve
Anterolateral system
Medial lemniscus
Raphe nucleus
Corticofugal fibers
Trapezoid
body
Pontine nuclei
Mid to Rostral Pons
Mid to Rostral Pons
Superior cerebellar peduncle
Trigeminal nuclei
Trigeminal nerve
Middle
cerebellar
peduncle
Anterolateral
system
Medial
lemniscus
Corticofugal fibers
Pontine nuclei
4th ventricle
Medial
longitudinal
fasciculus
Mid to Rostral Pons
Mid to Rostral Pons
Superior cerebellar peduncle
Medial
longitudinal
fasciculus
Raphe nuclei
Middle
cerebellar
peduncle
Anterolateral
system
Medial
lemniscus
Corticofugal fibers
Pontine nuclei
Rostral Pons
Rostral Pons
Superior cerebellar peduncle
Lateral
lemniscus
Cerebral aqueduct
Medial
longitudinal
fasciculus
Raphe nuclei
Anterolateral system
Medial lemniscus
Corticofugal fibers
Pontine nuclei
Pontomesencephalic
Junction
Pontomesencephalic Junction
Cerebral aqueduct
Inferior colliculus
Medial
longitudinal
fasciculus
Lateral
lemniscus
Superior
cerebellar
peduncle
Anterolateral
system
Medial
lemniscus
Corticofugal fibers
Pontine nuclei
Pontomesencephalic
Junction
Pontomesencephalic Junction
Inferior
colliculus
Superior
cerebellar
peduncle
Anterolateral
system
Medial
lemniscus
Corticofugal fibers
Pontine nuclei
Cerebral aqueduct
Periaqueductal
gray
Medial
longitudinal
fasciculus
Mesencephalon
Mesencephalon
Superior colliculus
Cerebral aqueduct
Periaqueductal
gray
Medial
geniculate
Oculomotor
nucleus and
nerve
Anterolateral
system
Medial
lemniscus
Red nucleus
Cerebral peduncle
Substantia nigra
Superior
cerebellar
peduncle
Rostral Mesencephalon
Rostral Mesencephalon
Pineal
Anterolateral
system
Cerebral aqueduct
Periaqueductal gray
Pretectal n
Thalamus
Medial
lemniscus
Red
nucleus
Substantia nigra
Cerebral peduncle
Superior
cerebellar
peduncle
Oculomotor
nerve
Atlas of brain stem anatomy
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