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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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