BRAINSTEM (GROSS AND SECTIONAL ANATOMY)

BY Natya Shahi (D 30)

MBBS 2018
Department of Anatomy, KGMU
INTRODUCTION
3 parts-medulla oblongata, pons and midbrain
Present in posterior cranial fossa
Connects spinal cord to expanded forebrain3 broad functions-it serves as conduits for ascending and
descending tracts connecting spinal cord to different part of higher centers in forebrain, important
reflex centers present like respiration cardiac and vasomotor centers,nuclei for CN 3 to 12 also present
MEDULLA OBLONGATA- connects pons with spinal cord. Region between anterior median
sulcus and anterolateral sulcus occupied by an elevation called pyramid. Elevation is caused by
a bundle of fibres that descend from the cerebral cortex to the spinal cord(corticospinal tract).
Some of the fibres cross from one side to the other in lower part of medulla obliterating the
anterior median fissure. These crossing fibres constitute the decussation of pyramids. Some
other fibres emerge from anterior median fissure above the decussation and wind laterally over
the surface of medulla to enter cerebellum. These are anterior external arcuate fibres. In the
groove between pyramid and olive emerge the rootlets of hypoglossal nerve.
Internal structure of Medulla-considered at 4 levels:level of decussation of pyramids, level
of decussation of leminisci,level of olives,level just inferior to pons
PONS-it is anterior to cerebellum and connects medulla with midbrain. Anterior surface has
basilar groove which lodges basilar artery. On either side of lower part of the pons there is
region called cerebello pontine angle. This region lies near lateral aperture of the 4 th ventricle.
Facial, vestibulocochlear and glossopharyngeal nerve and nervus intermedius lie in this region.
It is divisible into two parts-ventral(basilar) and dorsal(tegmentum) part. Among the basilar
fibres are group of pontine nuclei. When traced laterally transverse fibres form middle
cerebellar peduncle
Internal structure of pons-studied at two levels:at the level of facial colliculus(caudal part)
And at the level of trigeminal nuclei(cranial part)
MIDBRAIN-connects pons and cerebellum to forebrain. It is traversed by cerebral aqueduct
filled with CSF. Posterior surface has 4 colliculi-corpora quadrigemina. Superior colliculi (visual)
and inferior colliculi(auditory). In the midline below inferior colliculus trochlear nerve emerge

OBSERVATIONS-
 Medulla oblongata sections

Pons section

Medulla oblongata sections

RELATED STUDIES-
1-Diffusion tensor imaging and axonal tracking in the human brainstem.
2-Mapping the internal antomy of lateral brainstem.
CLINICAL ANATOMY-
• Medulla oblongata-medial medullary syndrome,lateral medullary syndrome,injury to
lower part of medulla,bulbar palsy and pseudobulbar palsy
• Pons-pontine hemorrhage,millard gubler’s syndrome and tumours of pons
• Midbrain-Weber’s syndrome,benedikt’s syndrome and perinaud’s syndrome
REFERENCES-
1-Drake,Vogl,Mitchell.Gray’s anatomy for students:first south asia edition,Churchill
livingstone,2015
2-Anatomy and physiology-Gerard J.Tortora and Bryan Derrickson,2014,Wiley