<BRAINSTEM II>

OUTLINE medulla. Fibres from this nucleus are motor, and they
I. BRAINSTEM NUCLEI innervate the muscles of the tongue except
palatoglossus
II. MEDULLA
A. Somatic Motor Nuclei
B. Visceral Motor Nuclei
B. Visceral Motor Nuclei
C. Cranial Nerve Component  Dorsal Motor Nucleus of the Vagus
III. PONS - column of cells lateral to the hypoglossal nucleus and
A. Parabrachial Nucleus extending both rostrally and caudally a
B. Pedunculopontine Nucleus little beyond the hypoglossal nucleus.
C. Cranial Nerve Component - Axons arising from this nucleus are preganglionic
IV. MIDBRAIN parasympathetic fibers that convey general visceral
efferent impulses to the viscera in the thorax and
abdomen.
I. BRAINSTEM NUCLEI - receives fibers from the vestibular nuclei; thus,
excessive vestibular stimulation (e.g., motion
MOTOR sickness) results in nausea, vomiting, and a change in
General somatic Oculomotor heart rate.
efferent nuclei Trochlear
Abducens  Nucleus Ambiguus
Hypoglossal - also known as the ventral motor nucleus of the vagus.
It is a column of cells situated about halfway between
Special visceral Motor nucleus of trigeminal erve
the inferior olive and the nucleus of the spinal tract of
efferent nuclei Nucleus of facial nerve, the trigeminal nerve.
General visceral Nucleus ambiguous - These axons convey special visceral efferent
efferent nuclei Dorsal vagal nucleus impulses to the branchiomeric muscles of the
Accessory oculomotor nucleus/ pharynx and larynx
(Edinger-Westphal nucleus) - contributes efferent fibers to the glossopharyngeal
(CN IX) and accessory (CN XI) nerves.
Salivatory nuclei
SENSORY C. Cranial Nerve Component
General somatic principal sensory nucleus
afferent nuclei spinal nucleus and a. Hypoglossal Nerve (CN XII)
mesencephalic nucleus of CN V
Special somatic cochlear nucleus -contains primarily somatic motor nerve fibers that innervate
afferent nuclei vestibular nucleus the intrinsic and extrinsic muscles of the tongue. It also
General visceral nucleus of the solitary tract contains afferent proprioceptive fibers from the muscle
afferent nuclei commissural nucleus of vagus spindles of tongue muscles.
gustatory nucleus

II. MEDULLA Schematic diagram of the

 contains autonomic centers that regulate respiration,
circulation, and gastrointestinal motility.
 extends from the pyramidal decussation to the
inferior pontine sulcus.
 gives rise to cranial nerves—CN IX to CN XII, the
nuclei of CN V and CN VIII extend caudally into the
medulla.
A. Somatic Motor Nuclei
 Hypoglossal Nucleus
- situated near the midline and below the hypoglossal
trigone (or triangle) in the floor of the fourth ventricle
of the upper medulla. It is an elongated column
extending into both the open and closed parts of the
Trans # 3 Basal Ganglia Part II
origin and intramedullary
course of rootlets of the
hypoglossal nerve.
 A number of nuclear masses in close proximity to the
hypoglossal nerve (CN XII) nucleus are believed to
be reticular neurons; they do not contribute fibers to
the hypoglossal nerve.
 They are known as perihypoglossal or satellite nuclei
(nucleus intercalatus, nucleus prepositus, and
Roller's nucleus).
 They receive input from the (1) cerebral cortex, (2)
vestibular nuclei, (3) accessory oculomotor nuclei,
and (4) paramedian pontine reticular formation.
 The output of these nuclei terminates in
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 (1) cranial nerve nuclei involved in extraocular
movement (oculomotor, trochlear, abducens),
(2) cerebellum, and (3) thalamus.
Clinical Sign:
 A. Lesions in the hypoglossal nerve or nucleus result
in lower motor neuron paralysis of the tongue
musculature homolateral to the lesion
Symptoms:
- Decrease or loss of movement of the homolateral half of
the tongue
 Atrophy of muscles in the homolateral half of the
tongue
 Fasciculations of muscles in the homolateral half of
the tongue
 Deviation of the protruding tongue to the atrophic side
(by action of the normal genioglossus muscle)
 B. Lesions involving the rootlets of the hypoglossal
nerve and the adjacent medial lemniscus within the
medulla result in the signs of hypoglossal nerve
lesion detailed above and contralateral hemisensory
loss of kinesthesia and discriminative touch
 C. Lesions involving the rootlets of the hypoglossal
nerve and the adjacent pyramid within the medulla
are manifested by the signs and symptoms of a
hypoglossal nerve lesion and contralateral upper
motor neuron paralysis
 Jackson's Syndrome- constitute, intramedullary
vascular lesions or tumors that involve the hypoglossal,
cranial accessory, vagus, and glossopharyngeal nerves
and contralateral hemiparesis
 Tapia's Syndrome - Intra- or extramedullary lesions
that involve the hypoglossal, vagus, and
glossopharyngeal nerves
b. Accessory Nerve (CN XI)
Has two roots:
Trans # 3 Basal Ganglia Part II
 Spinal root - arises from the accessory nucleus, a
collection of motor neurons in the anterior horn of the
upper five or six cervical spinal segments and the
caudal part of the medulla. It enters the cranial cavity
through the foramen magnum and leaves it through
the jugular foramen.
- The spinal root contains somatic motor fibers that
supply the sternocleidomastoid and trapezius (upper
part) muscles.
 Cranial root - arises from the caudal pole of the
nucleus ambiguus in the medulla oblongata. This root
emerges from the lateral surface of the medulla, joins
rootlets of the vagus nerve (forming its recurrent
laryngeal branch), and supplies the intrinsic muscles
of the larynx.
Clinical Sign:
 Manifestations of unilateral lesions of the accessory
nerve:
 Due to impaired function of the trapezius muscle
- Downward and outward rotation of the
scapula ipsilateral to the lesion
- Moderate sagging of the ipsilateral shoulder
 Due to impaired function of the sternocleidomastoid
muscle.
- Weakness on turning the head to the side
opposite the lesion
- No observable abnormality of head position in
repose
c. Vagus Nerve (CN X)
- mixed nerve containing both afferent and efferent
fibers, is associated with four nuclei in the medulla
oblongata. The
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 - efferent components of the nerve are related to two
medullary nuclei.
Schematic diagram of the components of the vagus nerve and
the areas they supply.
 Dorsal motor nucleus of the vagus
- This cranial nerve nucleus is long and it lies
vertically in the medulla. Its upper end lies deep to
the vagal trigone in the floor of the fourth ventricle.
- Fibres arising fom this nucleus supply the heart,
lungs, bronchi, esophagus, stomach, small
intestine and large intestine up to the right two-
thirds of the transverse colon.
 Nucleus Ambiguus
- lies in the medulla. It forms an elongated
collumn lying deep in the reticular formation,
both in the open and closed parts of the
medulla. Inferiorly, it is continuous with the
spinal accessory nucleus.
- The nucleus ambiguus is a composite nucleus
and contributes fibres to the glossopharyngeal,
vagus and accessory nerves.
 Afferent components of the vagus nerve are related to
two medullary nuclei:
 Nucleus of the spinal tract of the trigeminal nerve
- receives general somatic afferent fibers from
the external ear, external auditory canal, and
external surface of the tympanic membrane
- The neurons of origin of these fibers are in the
superior (jugular) ganglion of the vagus nerve.
- Somatic afferent fibers in the vagus nerve
descend in the spinal trigeminal tract and
synapse in this nucleus
 Nucleus solitaries
- two solitary nuclei merge to form the commissural
nucleus of the vagus nerve.
- receives two types of visceral afferent fibers.
 General visceral afferent fibers
Trans # 3 Basal Ganglia Part II
- from the glossopharyngeal nerve (CN IX). These
fibers convey general visceral sensations from the
pharynx, larynx, trachea, and esophagus as well as
the thoracic and abdominal viscera.
 Special visceral afferent fibers
- From glossopharyngeal (cranial nerve IX) and
facial (cranial nerve VII) nerves.
- fibers convey taste sensations from the region of
the epiglottis
d. Glossopharyngeal Nerve (CN IX)
- mixed nerve (containing both afferent and efferent
components), is associated with four nuclei in the
medulla.
- EFFERENT component:
 Nucleus Ambiguus
- Axons that travel with the glossopharyngeal nerve
arise from neurons in the rostral part of the
nucleus ambiguus
- Supply special visceral efferent fibers to the
stylopharyngeus muscle, which elevates the
pharynx during swallowing and speech.
- This efferent component of the glossopharyngeal
nerve is small.
 Inferior Salivatory Nucleus
- group of neurons that are difficult to distinguish
from reticular neurons in the dorsal aspect of the
medulla. The axons of neurons in this nucleus
leave the medulla from its lateral surface.
- They are preganglionic general visceral efferent fibers
that convey secretomotor impulses to the parotid
gland.
- They travel via the lesser petrosal nerve to the otic
ganglion, from which postganglionic fibers supply the
parotid gland.
- Dry mouth in response to fear and anxiety, and
salivation in response to food odor reflect inputs to the
inferior salivatory nucleus from the hypothalamus and
olfactory system, respectively
 Afferent components of the glossopharyngeal nerve
are related to the same two nuclei associated with the
vagus nerve:
 Nucleus of the spinal tract of the trigeminal nerve
- nucleus receives general somatic afferent fibers
from the retroauricular region. Neurons of origin
of these fibers are located in the superior ganglion
within the jugular foramen.
 Nucleus solitarius.
- This nucleus receives two types of visceral
afferent fibers.
a. General visceral afferent fibers.
- These fibers convey tactile, pain, and thermal
sensations from the mucous membranes of the
posterior third of the tongue, the tonsils, and the
eustachian tube.
- located in the inferior (petrosal) ganglion.
-Within the medulla, they form the tractus
solitarius and project on the nucleus solitarius in a
manner similar to that described above for the
vagus nerve.
b. Special visceral afferent fibers.
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 - These fibers convey taste sensations from the
posterior third of the tongue.
 Glossopharyngeal nerve also contains a special
afferent branch,
 Carotid sinus nerve
- This branch innervates the carotid body and carotid
sinus, which are chemoreceptor and baroreceptor
centers.
- Elevation of carotid arterial pressure stimulates the
carotid sinus nerve, which upon reaching the medulla
sends collaterals to the dorsal motor nucleus of the
vagus.
- General visceral efferent components of the vagus
nerve then reach ganglion cells in the wall of
the heart to slow the heart rate and reduce blood
pressure. This glossopharyngeal-vagal reflex is
especially sensitive in elderly people.
Clinical Sign:
 Unilateral lesions of the glossopharyngeal nerve are
manifested by the following signs:
- Loss of the pharyngeal (gag) reflex homolateral
to the nerve lesion. This reflex is elicited by
stimulation of the posterior pharyngeal wall, the
tonsillar area, or the base of the tongue.
- Loss of the carotid sinus reflex homolateral to
the nerve lesion.
- Loss of taste in the homolateral posterior third of
the tongue.
- Deviation of the uvula to the unaffected side.
 Glossopharyngeal neuralgia (Reichert syndrome,
Tympanic plexus neuralgia)
- Due to a lesion in the glossopharyngeal nerve is
characterized by paroxysms of severe pain in the
throat, posterior tongue, and ear triggered by
swallowing or tongue movements.
a. Vestibulocochlear Nerve (CN VIII)
Two vestibular nuclei that appear at rostral levels of the
medulla:
 Inferior Vestibular Nucleus
- located medial to the restiform body and is
characterized in histologic preparations by the
presence of dark-staining bundles of fibers
coursing through it.
 Medial Vestibular Nucleus
- which is located medial to the inferior nucleus, is
poorly stained in myelin preparations because of
the relatively few fibers it contains.
Additional Info:
Nucleus Solitarius- divided into two zones
1. Caudal and Medial Zone
- is concerned with general visceral sensation and
primarily cardiorespiratory function.
- receives input via two cranial nerves: the
glossopharyngeal (CN IX) and the vagus (CN X).
- Neurons in this zone project to:
 nucleus ambiguous
 the dorsal motor
 nucleus of the vagus,
Trans # 3 Basal Ganglia Part II
 centers within the medullary reticular formation
concerned with cardiovascular and respiratory
function,
 intermediolateral cell column in the spinal cord
 parabrachial pontine nucleus.
2. Rostral and Lateral Zone
- is concerned with special visceral (taste) function.
- The gustatory (taste) zone receives taste sensations
via three cranial nerves:
 Facial nerve (CN VII) conveys taste sensations from
the anterior two-thirds of the tongue
 Glossopharyngeal nerve (CN IX) conveys taste
sensations from the posterior third of the tongue, and
 Vagus nerve (CN X) conveys taste sensations from
the epiglottis.
 The output of the gustatory zone is to the posterior
thalamus (ventral posterior medial nucleus),which in
turn projects to the primary gustatory cortex.
Schematic diagram showing major inputs and outputs of the
nucleus solitarius.
Clinical Sign:
 Lesions in the nucleus solitarius and their
connections with the area postrema have been
associated with a change in feeding behavior
characterized by early satiety and poor appetite.
 Lesions in the nucleus solitarius have been shown
to result in arterial blood pressure elevation.
I. PONS control center
A. Parabrachial Nucleus
 Is a synaptic station for gustatory (taste) pathways
which is located at the level of the isthmus, in the
dorsolateral pons and plays an important role in
autonomic regulation
 Have neuromelanin-containing catecholamine
neurons which undergo a significant reduction in
number in patients with Parkinson's disease.
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  Nucleus is subdivided into lateral segment, where
pigmented neurons are more abundant and medial
segments.
B. Pedunculopontine Nucleus
 located between the spinal lemniscus, brachium
conjunctivum, and medial lemniscus is the
parabrachial pedunculopontine nucleus
 Is the brain stem control center for somatic motor
and cognitive behaviors, including locomotion,
motor learning, and the reward system.
 It is also responsible for the sleep wake arousal
system and the muscle coordination mechanism as
well as in oculomotor function including initiation of
saccadic eye movements.
 The nucleus contains two populations of neurons,
cholinergic and glutamatergic.
 sends direct excitatory output to the basal ganglia
(mainly to subtha-lamic nucleus and substantia nigra
pars compacta, with a smaller projection to both
segments of globus pallidus) and to the intralaminar
nuclei of thalamus.
 Sends indirect output to the spinal cord
C. Cranial Nerve Component
a. Cochleovestibular Nerve (CN VIII)
 is responsible for both hearing and balance and brings
information from the inner ear to the brain.
 Has two divisions: cochlear and vestibular.
- The two divisions travel together from the peripheral end
organs in the inner ear to the pons, where they separate;
each then establishes its own distinct connections
1. Cochlear Division
- is the larger of the two divisions and is responsible for
transmitting auditory signals from the inner ear to the
cochlear nuclei, within the brainstem, and ultimately to
the primary auditory cortex, within the temporal lobe
- Nerve fibers in the cochlear nerve are central processes
of bipolar neurons in the spiral ganglion located in the
modiolus of the inner ear.
- Cochlear nerve fibers respond to both displacement and
velocity of the basilar membrane of the organ of Corti.
2. Vestibular Division
Trans # 3 Basal Ganglia Part II
- primarily responsible for maintaining body balance and
eye movements
- It relays information related to motion and position.
- The vestibular system involves coordinated
communication between the vestibular apparatus
(semicircular canals, saccule, and utricle), ocular
muscles, postural muscles, brainstem, and cerebral
cortex
b. Facial Nerve (CN VII)
 is a mixed nerve with both sensory and motor
components.
 This nerve is responsible for our individuality, the facial
expressions that characterize each of us.
1. Sensory Components
 facial nerve carries two types of sensory afferents:
 Exteroceptive fibers from the external ear and
 Taste fibers from the anterior two-thirds of the
tongue.
2. Motor Components
 Somatic Motor Fibers
- supply the muscles of facial expression and the
stapedius, the stylohyoid, and the posterior belly of
the digastric.
- These fibers arise from the facial motor nucleus in
the pontine tegmentum.
 Motor nucleus of the facial nerve is organized into
longitudinally oriented motor columns (subnuclei)
concerned with specific facial muscles: the medial,
dorsal, intermediate, and lateral subnuclei.
 Dorsal Subuclei – contain the motor neurons that
supply upper facial muscles
 Lateral Subnuclei – contain the motor neurons that
innervate lower facial muscles
 Medial Subnuclei – contain motor neurons that
supply the platysma and the posterior auricular
muscles
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 The facial motor nucleus receives fibers from the
following sources:
1. Cerebral cortex
- Corticofacial fibers originate from areas of
face representations in the primary motor,
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 supplementary motor, premotor, rostral, and
caudal cingulate cortices.
2. Basal ganglia
- input to the facial motor nucleus explains the
movement of paretic facial muscles in
response to emotional stimulation.
3. Superior olive
- This input is part of a reflex involving the
facial and auditory nerves.
- It explains the grimacing of facial muscles
that occurs in response to a loud noise
4. Trigeminal system
- This input is also reflex in nature, linking the
trigeminal and facial nerves.
- It underlies the blinking of the eyelids in
response to corneal stimulation.
5. Superior colliculus
- This input via tectobulbar fibers is reflex in
nature and provides for closure of the eyelids
in response to intense light or a rapidly
approaching object.
 Secretomotor (Visceral Motor) Fibers
- arise from the superior salivatory nucleus in the
tegmentum of the pons to innervate the lacrimal,
submandibular, and sublingual glands as well as
the mucous membranes of the nose and hard and
soft palate.
Clinical Sign:
 Signs of facial nerve paralysis (Bell's palsy) vary with
the location of the lesion:
i. Lesions of the facial nerve proximal to the
geniculate ganglion result in the following
signs:
- Paralysis of all the muscles of facial expression
- Loss of taste in the anterior two-thirds of the
ipsilateral half of the tongue
- Impaired salivary secretion
- Impaired lacrimation
- Hyperacusis (hypersensitivity to sound as a
result of paralysis of the stapedius muscle)
- Crocodile tears in some patients with aberrant
growth of regenerating fibers
c. Abducens Nerve (CN VI)
 is a purely motor nerve that innervates the
lateral rectus muscle.
 The abducens nucleus is located in a
paramedian site in the tegmentum of the pons,
in the floor of the fourth ventricle and has two
populations of neurons:
 large (motor neurons)
- form the abducens nerve and supply
the lateral rectus muscles
 small (interneurons)
- join the contralateral medial
longitudinal fasciculus and terminate on
neurons in the oculomotor nucleus that
supply the medial rectus muscle
 The abducens nucleus receives fibers from:
- (1) the cerebral cortex
- (2) the medial vestibular nucleus via
the medial longitudinal fasciculus,
- (3) the paramedian pontine reticular
formation (PPRF),
- (4) the nucleus prepositus hypoglossi.
Clinical Sign:
 Lesions of the abducens nerve result in
- paralysis of the ipsilateral lateral rectus
muscle and diplopia (double vision) on
attempted horizontal gaze toward the
side of the paralyzed muscle

ii. Lesions distal to the geniculate ganglion but

proximal to the chorda tympani result in the
following ipsilateral signs:
- Paralysis of all the muscles of facial expression
- Loss of taste in the anterior two-thirds of the
tongue
- Impaired salivary secretion
- Hyperacusis

iii. Lesions of the facial nerve at the sty-lomastoid

foramen results in
- In paralysis of the muscles of facial expression
that are ipsilateral to the lesion

 Lesions of the abducens nucleus

Trans # 3 Basal Ganglia Part II 6 of 13

 - do not result in paralysis of abduction but
instead in paralysis of horizontal gaze ipsilateral
to the lesion;
- This is manifested by the failure of both eyes to
move on attempted ipsilateral horizontal gaze
A. Gross Topography
d. Trigeminal Nerve (CN V)
 Is the largest of the twelve cranial nerves.
 It transmits sensory information from the head and
neck and provides innervation to the muscles of
mastication, the tensor tympani, tensor palati,
myelohyoid, and anterior belly of the digastric.
Trigeminal nerve has two roots:
1. Efferent Root
- efferent root of the trigeminal nerve arises from the
motor nucleus of the trigeminal nerve in the
tegmentum of the pons.
- The efferent root supplies the muscles of mastication
and the tensor tympani, the tensor palati, the
mylohyoid, and the anterior belly of the digastric.
Clinical Sign:
 Lesions affecting the efferent root result in paralysis
of the lower motor neuron type of the muscles
supplied by this root.
2. Afferent Root
- contains two types of afferent fibers.
 Proprioceptive fibers
- are peripheral processes of unipolar neurons in
the mesencephalic nucleus of the trigeminal
nerve
- fibers convey pressure and kinesthesia from the
teeth, periodontium, hard palate, and joint
capsules as well as impulses from stretch
receptors in the muscles of mastication.
 Exteroceptive Fibers
Trans # 3 Basal Ganglia Part II
- are general somatic sensory fibers that convey
pain, temperature, and touch sensations from
the face and the anterior aspect of the head.
III. Mesencephalon (Midbrain)
a.Ventral View
 inferior surface of the mesencephalon (midbrain) is
marked by the divergence of tw o massive bundles of
fibers the cerebral peduncles w hich carry
corticofugal fibers to low er levels
 Caudally, the cerebral peduncles pass into the basis
pontis; rostrally, they continue into the internal
capsule
 Between the cerebral peduncles lies the
interpeduncular fossa, from which exits the
oculomotor nerve (cranial nerve III)
 The trochlear nerve (cranial nerve IV) emerges from
the dorsal aspect of the mesencephalon, curves
around, and appears at the lateral borders of the
cerebral peduncles
 The optic tract passes under the cerebral peduncles
before the peduncles disappear into the substance of
the cerebral hemispheres.
b.Dorsal View
 four elevations (corpora quadrigemina)
 The rostral and larger two are the superior colliculi;
the caudal and smaller two are the inferior colliculi
 The trochlear nerves emerge just caudal to the
inferior colliculi
B. Three Subdivisons
a. Tectum
 is a mixture of gray and w hite matter dorsal to the
central gray matter
 includes the superior and inferior colliculi
(quadrigeminal plates)
b. Tegmentum
 the main portion of the mesencephalon
 lies inferior to the central gray matter and contains
ascending and descending tracts, reticular nuclei, and
w ell-delineated nuclear masses
c. Basal Portion
 includes the cerebral peduncles, a massive bundle of
corticofugal fibers on the ventral aspect of the
mesencephalon
 it also includes the substantia nigra, a pigmented
nuclear mass that lies between the dorsal surface of
the cerebral peduncle and the tegmentum.
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  Basis pedunculi - has been used to refer to
b. Tegmentum
the basal portion of the mesencephalon,
which includes the cerebral peduncle and
substantia nigra.
 Crus cerebri - has been used to refer to the
massive bundle of corticofugal fibers
(cerebral peduncle) on the ventral aspect of
the mesencephalon
inferior colliculus thus is a relay nucleus in the
auditory pathw ay to the cerebral cortex and
cerebellum. In addition, the inferior colliculus plays a
role in the localization of the source of sound.
 At the level of the inferior colliculus, the
tegmentum of the mesencephalon contains
fibers of passage (ascending and
descending tracts) and nuclear groups.

 Cerebral peduncle - is erroneously used to

1. Fibers of Passage
C. Inferior Colliculus Level The following fiber tracts pass through the mesencephalon
a. Tectum
(refer at pg. 308 of the reference book for a clear illustration)
refer to the mesencephalon below the tectum
a. Brachium conjunctivum (superior cerebellar peduncle)
(tegmentum and basal portion)
 The brachium conjunctivum is a massive bundle of
fibers arising in the deep cerebellar nuclei. These
fibers decussate in the tegmentum of the midbrain at
 The nucleus of the inferior colliculus occupies the
this level. A few proceed rostrally to terminate on the
tectum at the level of the inferior colliculus
red nucleus; the others form the capsule of the red
nucleus and continue rostrally to terminate on the
 This nucleus is an oval mass of small and medium-
ventrolateral nucleus of the thalamus.
size neurons organized into three parts:
b. Medial lemniscus
 The medial lemniscus lies lateral to the decussating
main laminated mass of neurons, called the central
brachium conjunctivum and above the substantia
nucleus,
nigra. This fiber system, w hich conveys kinesthesia
a thin dorsal cellular layer, the pericentral
and discriminative touch from more caudal levels,
nucleus,
continues its course tow ard the thalamus. Fibers in
a group of neurons that surround the central nucleus
the medial lemniscus are somatotopically organized,
laterally and ventrally, the external nucleus
with cervical fibers being most medial and sacral
 The central nucleus is the major relay nucleus in the
fibers most lateral.
auditory pathway
c. Trigeminal lemniscus
 The trigeminal lemniscus is composed of the ventral
 Afferent Connections
secondary trigeminal tracts and travels close to the
Fibers come from the follow ing sources.
medial lemniscus on its w ay to the thalamus.
d. Spinothalamic tract
1. Lateral lemniscus. These fibers terminate on the
 The spinothalamic tract conveys pain and
ipsi- and contralateral inferior colliculi. Some lateral
temperature sensations from the contralateral half of
lemniscus fibers bypass the inferior colliculus to
the body and lies lateral to the medial lemniscus.
reach the medial geniculate body.
Mingled with the spinothalamic fibers are the
2. Contralateral inferior colliculus.
spinotectal fibers on their w ay to the tectum. Fibers
3. Ipsilateral medial geniculate body. This connection
in the spinothalamic tract are somatotopically
serves as a feedback mechanism in the auditory
organized, with cervical fibers being most medial and
pathway.
sacral fibers most lateral.
4. Cerebral cortex ( primary auditory cortex).
e. Lateral lemniscus
5. Cerebellar cortex via the anterior medullary velum.
 The lateral lemniscus conveys auditory fibers and
occupies a position lateral and dorsal to the
 Efferent Connections
spinothalamic tract.
The inferior colliculus projects to the follow ing areas
f. Medial longitudinal fasciculus
1. Medial geniculate body via the brachium of the
 The medial longitudinal fasciculus maintains its
inferior colliculus. This pathway is concerned with
position dorsally in the tegmentum in a paramedian
audition.
position.
2. Contralateral inferior colliculus.
g. Central tegmental tract
3. Superior colliculus. This pathw ay establishes
 The central tegmental tract conveys fibers from the
reflexes for turning the neck and eyes in response to
basal ganglia and midbrain to the inferior olive and
sound.
occupies a dorsal position in the tegmentum,
4. Nucleus of the lateral lemniscus and other relay
ventrolateral to the medial longitudinal fasciculus.
nuclei of the auditory system for feedback.
h. Rubrospinal tract
5. Cerebellum. The inferior colliculus is a major
 The rubrospinal tract conveys fibers from the red
center for the transmission of auditory impulses to the
nucleus to the spinal cord and inferior olive and is
cerebellum via the anterior medullary velum. The
located dorsal to the substantia nigra.

Trans # 3 Basal Ganglia Part II 8 of 13


c. Nuclear Groups
The following nuclei are seen at the level of the inferior
colliculus. (refer at pg.308 of the reference book for a clear
illustration)
1. Mesencephalic Nucleus
 The mesencephalic nucleus of the trigeminal nerve is
homologous in structure to the dorsal root ganglion
but is uniquely placed w ithin the central nervous
system.
 It contains unipolar neurons with axons (the
mesencephalic root of the trigeminal nerve) w hich
convey proprioceptive impulses from the muscles of
mastication and the periodontal membranes. As these
fibers approach the nucleus, they gather in a bundle
close to the nucleus: the mesencephalic tract.
2. Nucleus of the Trochlear Nerve (Cranial Nerve IV)
 The nucleus of the trochlear nerve lies in the
V-shaped ventral part of the central gray
matter. Axons of this nerve arch around the
central gray matter, cross in the anterior
medullary velum, and emerge from the
dorsal aspect of the mesencephalon . These
axons supply the superior oblique eye
muscle.
3. Interpeduncular Nucleus
 The interpeduncular nucleus, w hich is
indistinct in humans, is a poorly understood
nuclear group in the base of the tegmentum
betw een the cerebral peduncles. It receives
fibers mainly from the habenular nuclei (in
the diencephalon) through the
habenulointerpeduncular tract and sends
fibers to the dorsal tegmental nucleus
through the pedunculotegmental tract.
4. Nucleus Parabrachialis Pigmentosus
 The nucleus parabrachialis pigmentosus, w
hich lies betw een the substantia nigra and
the interpeduncular nucleus, is a ventral
extension of the ventral tegmental area of
Tsai.
5. Dorsal Tegmental Nucleus
 The dorsal tegmental nucleus lies dorsal to
the medial longitudinal fasciculus (MLF) in
the central gray matter in close proximity to
the dorsal raphe nucleus. It receives fibers
from the interpeduncular nucleus and
projects on autonomic nuclei of the brain
stem and the reticular formation.
6. Ventral Tegmental Nucleus
 The ventral tegmental nucleus lies ventral to
the MLF in the midbrain tegmentum. Cells
Trans # 3 Basal Ganglia Part II
in this nucleus are rostral continuations of
the superior central nucleus of the pons. This
nucleus receives fibers from the mamillary
bodies in the hypothalamus. The dorsal and
ventral tegmental nuclei are part of a circuit
concerned w ith emotion and behavior.
7. Pedunculopontine (Nucleus Tegmenti Pedunculopontis)
and Lateral Dorsal Tegmental Nuclei
 These two cholinergic nuclei lie w ithin the
tegmentum of the caudal mesencephalon
(inferior colliculus level) and rostral pons
dorsolateral to and overlapping the lateral
margin of the rostral superior cerebellar
peduncle, between that peduncle and the
lateral lemniscus. Neurons of the
pedunculopontine nucleus are affected in
patients w ith progressive supranuclear
palsy, a degenerative central nervous system
disease. It projects to the thalamus and the
pars compacta of the substantia nigra. This
nucleus lies in a region from w hich walking
movements can be elicited on stimulation
(locomotor center).
8. Nucleus Supratrochlearis (Dorsal Raphe Nucleus)
 The nucleus supratrochlearis lies in the
ventral part of the periaqueductal (central)
gray matter betw een the tw o trochlear
nuclei. It sends serotonergic fibers to the
substantia nigra, neostriatum (caudate and
putamen), and neocortex.
9. Parabigeminal Area
 The parabigeminal area is an oval collection
of cholinergic neurons ventrolateral to the
nucleus of the inferior colliculus and lateral
to the lateral lemniscus. It receives fibers
from superficial layers of the superior
colliculus and projects bilaterally back into
superficial layers of the superior colliculus.
Cells in this area play a role, along w ith the
superior colliculus, in processing visual
information. They respond to visual stimuli
and are activated by both moving and
stationary visual stimuli.
10. Nucleus Pigmentosus (Locus Ceruleus)
 The nucleus pigmentosus is seen in the
rostral pons and caudal mesencepha-lon. It
contains 30,000 to 35,000 neurons. At the
level of the inferior colliculus it is situated at
the edge of the central gray matter. It is
made up of four subnuclei: central (largest);
anterior (rostral end); ventral (caudal and
ventral), also known as the nucleus
subceruleus; and posterior dorsal (small). Its
pigmented cells contain melanin granules, w
hich are lost in patients w ith Parkinson's
disease.
d. Basal Porion
1. Cerebral Peduncle
 The cerebral peduncle is a massive fiber bundle that
occupies the most ventral part of the mesencephalon.
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  It is continuous w ith the internal capsule rostrally
and merges caudally into the basis pontis.
 This massive fiber bundle carries corticofugal fibers Schematic diagram showing the major afferent
from the cerebral cortex to several subcortical connections of the superior colliculus. pg. 320 (Afifi)
centers.
2. Substantia Nigra
 The substantia nigra is a pigmented mass of neurons
sandw iched betw een the cerebral peduncles and the
tegmentum
 It has 2 zones:
a dorsal zona compacta containing melanin
pigment
and ventral zona reticulata containing iron
compounds
 The neuronal population of the substantia nigra
consists of pigmented and nonpigmented neurons
Pigmented neurons - uses dopamine
Nonpigmented neurons - are either
cholinergic or GABAergic
Schematic diagram showing the major afferent and
efferent connections of the substantia nigra. Pg. 314 (Afifi)

e. Mesencephalic Dopaminergic Cell Groups

 Besides the pars compacta of the substantia nigra,

two other cell groups in the mesencephalic
tegmentum are dopaminergic:
the ventral tegmental area of Tsai - in
close proximity to the medial substantia
nigra
retrorubral cell group (substantia nigra,
pars dorsalis) - in close proximity to the red Schematic diagram showing the major efferent
nucleus connections of the superior colliculus. pg. 322(Afifi)

A.Tectum
a. Superior Colliculus Level

 The nucleus of the superior colliculus occupies the

tectum at the level of the superior colliculus.
 The superior colliculus is a laminated mass of gray
matter that plays a role in visual reflexes and control
of eye movement.
 The laminated appearance results from alternating
strata of white and gray matter.
Trans # 3 Basal Ganglia Part II 10 of 13
 b. Pretectal Area Schematic diagram showing the major afferent
connections of the red nucleus. Pg 326 (Afifi)
 Rostral to the superior colliculus at the
mesencephalic-diencephalic junction is the pretectal
area (pretectal nucleus).
 This area is an important station in the reflex pathway
for the pupillary light reflex and vertical gaze.
 It receives fibers from the retinas and projects fibers
bilaterally to both oculomotor nuclei.
c.Tegmentum

 At the level of the superior colliculus, the tegmentum

contains fibers of passage and nuclear groups.

1. Fibers of Passage

 The fibers of passage include all the fiber tracts

encountered at the level of the inferior colliculus
except the lateral lemniscus, which terminates on
inferior colliculus neurons and is not seen at superior
colliculus levels. Schematic diagram showing the major efferent
 The brachium conjunctivum fibers, w hich decussate connections of the red nucleus. Pg. 328 (Afifi)
at inferior colliculus levels, terminate in the red
nucleus at this level or form the capsule of the red
nucleus on their w ay to the thalamus

2. Nuclear Groups

 The nuclear groups include the red nucleus, the

oculomotor nucleus, and accessory oculomotor nuclei

a. Red nucleus
 The red nucleus, so named because in fresh
preparations its rich vascularity gives it a pinkish hue,
is a prominent feature of the tegmentum at this level
 It is composed of:
rostral, phylogenetically recent small cell
part (parvicellular)
- well developed in humans
caudal, phylogenetically older large cell part
(magnicellular)
 Traversed by the follow ing fiber systems:
(1) the superior cerebellar peduncle (brachium b. Oculomotor nucleus
conjunctivum)  The oculomotor nucleus lies dorsal to the medial
- only system that projects on the red nucleus, the longitudinal fasciculus (MLF) at the level of the
other two system is only related by proximity superior colliculus.
(2) the oculomotor nerve (cranial nerve III) rootlets  It is composed of a lateral somatic motor cell column
(3) the habenulointerpeduncular tract and a medial visceral cell column. It is approximately
10 mm in length.
 This nucleus receives fibers from the following
sources:

(1) Cerebral Cortex

 Corticoreticulobulbar fibers are bilateral but
come mainly from the contralateral
hemisphere.
(2) Mesencephalon
 Mesencephalic projections to the
oculomotor nucleus originate from Cajal's
interstitial nucleus, the rostral interstitial
nucleus of the medial longitudinal fasciculus
(RiMLF), and the pretectal olivary nucleus.
(3) Pons and Medulla
Trans # 3 Basal Ganglia Part II 11 of 13
  Pontine and medullary projections to the
oculomotor nucleus arise from the vestibular
nuclei, the nucleus prepositus, and the
abducens nucleus.
(4) Cerebellum
 Cerebello-oculomotor fibers to the somatic
motor cell column arise from the
contralateral dentate nucleus and are
concerned w ith the regulation of eye
movements.
c. Accessory oculomotor nuclei
 The accessory oculomotor nuclei include the
following nuclei
(1) Interstitial Nucleus of Cajal
 The interstitial nucleus of Cajal is located
rostral to the Edinger-Westphal nucleus and
caudal to the rostral interstitial nucleus of
the medial longitudinal fasciculus.
(2) Rostral Interstitial Nucleus of the Medial Longitudinal
Fasciculus
 The RiMLF is located dorsomedial to the
red nucleus, rostral to the oculomotor
nucleus, and ventral to the periaqueductal
gray matter.
(3) Darkschewitsch's Nucleus
 Darkschew itsch's nucleus lies dorsal and
lateral to the somatic motor cell column of
the oculomotor nerve.
 It projects to the nuclei of the posterior
commissure but does not project to the
oculomotor nuclear complex.
(4) Nucleus of the Posterior Commissure
 This nucleus is located within the posterior
commissure. It has connections with pretectal and
posterior thalamic nuclei
a. CENTRAL (PERIAQUEDUCTAL) GRAY
 The central gray region of the
mesencephalon surrounds the aqueduct of
Sylvius and contains scattered neurons,
several nuclei, and some fine myelinated and
unmyelinated fibers.
 at the edge of this region lies the following nuclei:
The oculomotor,
accessory oculomotor,
trochlear nuclei
mesencephalic nucleus of the trigeminal
nerve

 Inferior Colliculus Level
Trans # 3 Basal Ganglia Part II
 the paramedian branches supply the medial region of
the mesencephalon, including the MLF, the
paramedian reticular nuclei, and the brachium
conjunctivum.
 The superior cerebellar artery supplies the lateral
region of the midbrain, including the inferior
colliculus, the rootlets of the trochlear nerve, the
spinal and medial lemniscus, and the lateral part of
the cerebral peduncle.
 A wedge between these two regions, which includes
the trochlear nucleus, the cerebral peduncle, and the
medial part of the medial lemniscus, has a variable
and inconstant blood supply.
 Superior Colliculus Level
 divided into 3 zones of blood supply
The medial zone, which includes the third cranial
nerve nuclear complex, receives blood from the tip of
the basilar artery.
The tectum (dorsal zone) is supplied by the superior
cerebellar artery.
The rest of the midbrain is supplied by the posterior
cerebral artery.
 Pretectal Level
 At the level of the upper midbrain (the pretectal
level), the medial zone, including the medial part of
the red nucleus, and rootlets of the oculomotor nerve
receive blood from paramedian branches of the
basilar artery
 The rest of the midbrain
 receives blood from the posterior cerebral artery.
Reference:
Functional neuroanatomy text and atlas 2nd edition
by Adel Afifi
B. Blood Supply
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Trans # 3 Basal Ganglia Part II 13 of 13