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Cranial Nerves and Brainstem 12 Tribes, 12 Disciples, 12 Eggs/Dozen 12 Cranial Nerves Harvey Karten • Make up your own mnemonic Some Basic Organizational Principles • Alar and Basal Plate • Cranial Nerves: – Sensory – Motor – Sensory and Motor (Mixed) • Motor neurons lie INSIDE the brain (with a notable exception – postganglionic autonomics) • Sensory neurons lie OUTSIDE the brain (with a notable exception – Mesencephalic nuc. Trigem) • FIGURE 13 The early spinal cord and hindbrain are divided into dorsal (alar) and ventral (basal) plates by the limiting sulcus. This morphology reflects early ventral differentiation of the mantle layer (2), which is accompanied by an early ventral thinning of the neuroepithelial or ventricular layer of the neural tube (it remains as the ependymal lining of the adult ventricular system). The mantle layer develops into adult gray matter. This schematic drawing, which was traced from a transverse section of the spinal cord, also shows dorsal (sensory) and ventral (motor) roots of the spinal cord; dorsal root ganglia, which contain the somata of sensory neurons derived from the neural crest; and mixed (sensory and motor) spinal nerves distal to the ganglia. The peripheral area (3) is called the marginal zone and develops into the spinal cord white matter or funiculi, which contain ascending and descending fiber tracts. Sulcus Limitans, Alar and Basal Plate Sulcus Limitans forms a boundary zone Alar Plate: Sensory Inputs Basal Plate: Motor Neurons • FIGURE 13 The early spinal cord and hindbrain are divided into dorsal (alar) and ventral (basal) plates by the limiting sulcus. This morphology reflects early ventral differentiation of the mantle layer (2), which is accompanied by an early ventral thinning of the neuroepithelial or ventricular layer of the neural tube (it remains as the ependymal lining of the adult ventricular system). The mantle layer develops into adult gray matter. This schematic drawing, which was traced from a transverse section of the spinal cord, also shows dorsal (sensory) and ventral (motor) roots of the spinal cord; dorsal root ganglia, which contain the somata of sensory neurons derived from the neural crest; and mixed (sensory and motor) spinal nerves distal to the ganglia. The peripheral area (3) is called the marginal zone and develops into the spinal cord white matter or funiculi, which contain ascending and descending fiber tracts. Alar Plate e.g., Visceral Sensory (Vagal) Cochlear Nuclei Vestibular nuclei Trigeminal sensory nuclei HOW FAR FORWARD? Superior and Inferior Colliculi, Thalamus, Telencephalon, Olfactory Bulb??? Basal Plate e.g., Visceral Motor (Vagal) Hypoglossal Facial Trigeminal sensory nuclei ?Oculomotor? Rhombomeres and Segmentation FIGURE 9 Distribution of neuronal types in the chick embryo hindbrain in relation to rhombomeres. (A). Shown on the right side are branchiomotor neurons, forming in r2+r3 (Vth cranial nerve, trigeminal), r4+r5 (VIIth nerve, facial), and r6+r7 (IXth nerve, glossopharyngeal), and contralaterally migrating efferent neurons of the VIIIth nerve (vestibuloacoustic), which are in the floor plate (fp) of r4 at the stage shown. Shown on the left side are somatic motor neurons, forming in r1 (IVth nerve, trochlear), r5+r6 (VIth nerve, abducens), and r8 (XIIth nerve, hypoglossal). Cranial nerve entry/exit points and sensory ganglia associated with r2 (trigeminal), r4 (geniculate, vestibuloacoustic), r6 (superior), and r7 (jugular) are shown, as is the otic vesicle (ov). Colored bars represent the AP extent of Hox gene expression domains; note that one of these, Hoxb1, is expressed at a high level only in r4. Modified from Lumsden and Keynes, (1989). (B). In addition to branchiomotor neurons, each rhombomere also contains six classes of interneuron, as defined by position and axon trajectory. r4 (as shown here) also contains contralaterally migrating vestibuloacoustic neurons (cva). (C). Later in development, branchiomotor neurons complete their laterally directed migration (arrows) and condense as defined nuclei close to their exit points. Similarly, cva neurons have complete their migration across the midline (arrow) and form a grouping in r4 and r5. Cranial Nerves • Not all cranial nerves are NERVES – Two are brain tracts I & II (Olfactory and Optic) • Sensory • Motor • Mixed (Sensory and Motor) • Alar and Basal Plate • Cranial Nerves: – Sensory – Motor – Sensory and Motor (Mixed) Major Sensory Inputs • • • • • • Olfaction (I) Vision (II) Trigeminal sensation (V) Hearing, Vestibular (VIII) + centrifugals Gustatory (VII, IX-X) Internal visceral sensation (IX-X) Major Motor Outputs • Vision – oculomotor and accessory oculomotor (III, IV, VI, Edinger-Westphal for pupillary control and accommodation) • Trigeminal motor – feeding, expression, hearing control (V motor) • Facial motor (VII) • Hearing, Vestibular – Centrifugal (VIII) • Heart, lungs, GI tract, pancreas, (IX-X) • Spinal Accessory – trapezius, sternocleidomastoid (XI) • Tongue (XII) • Make up your own mnemonic Specialized Polymodal Chemical Systems – Catecholamines • Locus Ceruleus • Substantia Nigra compacta • Nuc. Tractus Solitarius – Serotonin • Raphe nuclei – Acetylcholine • Locus Ceruleus • Nucleus Basalis of Meynert Cerebellum Superior cerebellar peduncle Mesencephalic tract & nuc V Middle cerebellar peduncle Sens nuc V 4th ventricle Motor nuc V MLF Superior olivary nucl. Fascicles of cn. V CN V Trapezoid body Trigeminothalamic tract Corticospinal & corticobulbar fibers Pons: see basis pontis; mid pons: see fascicles of cn V Spinal lemniscus Medial lemniscus Pontine nuclei Basis pontis Choroid plexus Hypoglossal nucl. Inf. cerebell peduncle Dorsal motor nucl. of vagus Solitary tract Solitary nucl. Ventricle IV Spinal trigem. nucl. + tract Nucl. ambiguus cn. X Hypoglossal fascicles Spinal lemniscus Medial longitudinal fasciculus Inf. olivary nucl, cn. XII Pyramidal tracts Open medulla: pyramids, IV ventricle, nucleus of the inferior olive Medial lemniscus Reticular Formation • Medial Reticular Formation – Descending pathways • Lateral Reticular Formation – Local networks • ASCENDING RETICULAR ACTIVATING SYSTEM (ARAS) – sleep, wakefulness, attention Choroid plexus Hypoglossal nucl. Inf. cerebell peduncle Dorsal motor nucl. of vagus Solitary tract Solitary nucl. Ventricle IV Spinal trigem. nucl. + tract Nucl. ambiguus cn. X Hypoglossal fascicles Spinal lemniscus Medial longitudinal fasciculus Inf. olivary nucl, cn. XII Pyramidal tracts Open medulla: pyramids, IV ventricle, nucleus of the inferior olive Medial lemniscus Cerebellum Superior cerebellar peduncle Mesencephalic tract & nuc V Middle cerebellar peduncle Sens nuc V 4th ventricle Motor nuc V MLF Superior olivary nucl. Fascicles of cn. V CN V Trapezoid body Trigeminothalamic tract Corticospinal & corticobulbar fibers Pons: see basis pontis; mid pons: see fascicles of cn V Spinal lemniscus Medial lemniscus Pontine nuclei Basis pontis • Descending inputs – majority of axons in cerebral peduncle of cortical origin end in RF: – Motor cortex largely to Medial RF – Sensory cortex largely to Lateral RF • Ascending spinal inputs: many to Lateral RF • Cerebellar Outputs from deep Cbllar Nuclei Reticular Formation • ASCENDING RETICULAR ACTIVATING SYSTEM (ARAS) – sleep, wakefulness, attention Cranial Nerves • Alar and Basal Plate Cranial Nerves Cranial Nerves Corticospinal tract •Also called pyramidal tract •Arises primarily from primary motor cortex, premotor and supplementary motor cortex •Somatosensory cortex also contributes •70-90% of fibers cross in the lower medulla (decussation of pyramids) •Crossed = lateral corticospinal tract •Uncrossed = anterior/ventral corticospinal tract •Synapses with: •Alpha and gamma motor neurons • Propriospinal neurons • Interneurons Corticospinal tract Cerebral Cortex: precentral gyrus Corona Radiata lnternal Capsule (posterior limb) Crus Cerebri (middle portion) Longitudinal pontine fibers Pyramid - pyramidal decussation Corticospinal Tract - Lateral and Anterior Termination: Spinal Gray (Rexed IV-IX) Midbrain pons medulla decussation spinal cord Dorsal column/medial lemniscus 1. Dorsal Root Ganglion dorsal root - dorsal column 2. Dorsal Column Nuclei (N. gracilis or N.cuneatus) internal arcuate fiber - lemniscal decussation- medial lemniscus 3. Thalamus (VPL) internal capsule -corona radiata 4. Primary sensory cortex (S I) Nucl. Grac & Cuneat.-Arcuate fibers-Medial lemniscus-Thalamus Anterolateral system (spinothalamic) •Pain and temperature on contralateral side of body •Crosses in spinal cord •Thalamus via spinal lemniscus (spinoreticular, spinomesencephalic tracts) Fasciculus gracilus Fasciculus cuneatus Median dorsal sulcus Gracile nucleus Cuneate nucleus Central canal Dorsal motor nucl. of vagus Spinal trigeminal nucleus and tract Hypoglossal nucl. Internal Arcuate Fibers Dorsal spinocerebellar tract (small font) Reticular formation Ventral spinocerebellar tract (small font) Medial lemniscus Pyramidal decussation Spinal lemniscus Nucleus of the Inferior Olive Pyramid Caudal medulla: pyramids, no IV ventricle Vertebral artery Ventral median fissure Spinocerebellar tract Modality: Unconscious Proprioception Receptor: Muscle spindle, Golgi tendon organ 1. Dorsal Root Ganglion dorsal root 2. a. Clarke’s column (C8-L2) Posterior/dorsal Spinocerebellar Tract ipsilaterally project to cerebellum via inferior cerebellar peduncle b. Secondary neuron: dorsal horn crossing- form anterior Spinocerebellar Tract on contralateral side-cross again before entering via superior cerebellar peduncle 3. Cerebellar Cortex on ipsilateral side