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Systematic Anatomy
Nervous system
Brain stem (part 1)

Dr.Hongqi Zhang (张红旗)

Email: zhanghq58@126.com
1
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Copy Right- Hongqi ZHANG-Department of Anatomy-Fudan University

External structure
of brain stem

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 CNS and Divisions of the brain
Brain
 Telencephalon
 Diencephalon
 Cerebellum
 Brain stem
1-Midbrain
2-Pons
3-medulla oblongata
Spinal cord
Copy Right- Hongqi ZHANG-Department of Anatomy-Fudan University
Median sagittal section of the brain
1 Frontal lobe of cerebrum
2 Occipital lobe of cerebrum
3 Corpus callosum
4 Ant.commissure
5 Lamina terminalis
6 Optic chiasma
7 Hypothalamus
8 Thalamus and third ventricle
9 Colliculi of the midbrain
10 Midbrain(inf.portion)
11 Cerebellum
12 Pons
13 Fourth ventricle
14 Medulla oblongata
15 Central canal
16 Spinal cord

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Copy Right- Hongqi ZHANG-Department of Anatomy-Fudan University
General description of brain stem
Consititution: midbrain.pons.medulla oblongata
Lower end: connect with spinal cord
Upper end: connect with diencephalon
Anterior:clivus
Posterior:cerebellum
Ventricle:the fourth ventricle
Structure:complicated
Function:important

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Copy Right- Hongqi ZHANG-Department of Anatomy-Fudan University

key point about the brain stem

The landmark of boundary of different portions
The relation between appearance and internal structure
The longitudinal and transverse relation of the nerve fiber
The decussation location of the conducting tract
The clinical symptom after the injury of conducting tract
Learning method: recommendation
Observe appearance and think about internal structure
Observe section,think about the cubic & link sup.& inf.portion
Remember key point,don’t recite all and summary in poem

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 The brain stem

Organization
• Midbrain
• Pons
• Medulla oblongata
Position
• The brain stem and
cerebellum occupies
the post. cranial fossa
of the skull
Gross appearance of the
brain stem
Copy Right- Hongqi ZHANG-Department of Anatomy-Fudan University
the boundary landmark of brain stem in ant. surface

Midbrain
Sup.border of pons
Pons
bulbopontine sulcus
Medulla oblongata

Brain stem connect with 3-12 cranial nerves

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Copy Right- Hongqi ZHANG-Department of Anatomy-Fudan University
Appearance of the brainstem(specimen)

Mid brain

Pons

Medulla abongata

Anterior view posterior view

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Copy Right- Hongqi ZHANG-Department of Anatomy-Fudan University
Ventral surface

Trigerminal motor root

Trigerminal sensory root

Abducent nerve

Facial nerve root (motor)

Nervus intermedius
vestibulocochlear nerve

Glassopharyngeal nerve
vagus nerve
Hypoglassol nerve

Accessory nerve
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Copy Right- Hongqi ZHANG-Department of Anatomy-Fudan University
lateral surface
pons

Trigerminal motor root

Trigerminal sensory root

vestibulocochlear nerve

Facial nerve
Abducent nerve
Nervus intermedius
Glassopharyngeal nerve

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Copy Right- Hongqi ZHANG-Department of Anatomy-Fudan University

Dorsal surface
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Copy Brain and roots

Right- Hongqi of cranial nerves(basilar
ZHANG-Department of Anatomy-Fudanaspect)
University
 Ventral Surface of the Brain Stem
Medulla oblongata
 Pyramid-1
Composed of bundles of nerve
fiber, pyramidal tract
 Decussation of pyramid-2
Formed by crossing fibers of
pyramidal tract
 Olive-3
Produced by underlying inferior
olivary nucleus
 Anterolateral sulcus-4
Emerge the roots of hypoglossal 31
nerve 4
 Retroolivary sulcus-5 2
Emerge the roots of
ⅨⅩ,Ⅺcranial nerve
5
 Ventral Surface of the Brain Stem
1
Pons
Basilar part
Basilar sulcus
basilar artery-1
Bulbopontine
sulcus -2
There emerge, from
medial to lateral, the 2
abducent n, facial n. &
vestibulocochlear n.
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Ventral Surface of the Brain Stem

Pons
Middle cerebellar
peduncle - 2
Trigeminal nerve-1
Emerges from the 1
junction of basilar part & 2
middle cerebellar
peduncles
Pontocerebellar trigone-3
The junction of medulla,
pons and cerebellum 3

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 Ventral Surface of the Brain Stem

Midbrain
1- Crus cerebri 1 1
2
2-Interpeduncular fossa
Oculomotor n.(3) 3
emerges on the medial
side crus cerebri
Post.perforated substance
 Dorsal Surface of the Brain Stem
Medulla oblongata
• Lower portion
– Gracile tubercle-1
produced by underlying gracile
nucleus
– Cuneate tubercle-2
produced by underlying cuneate
nucleus 3
– Inferior cerebellar
peduncle -3
2
• Upper portion: forms the lower 1
half of rhomboid fossa
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Striae medullaris

Trigone of hypoglassol n 2
1
Trigone of vagus n

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 Dorsal Surface of the Brain Stem

Pons
Trochlear nerve
Sup.medullary velum
Sup.cerebellar peduncle
Middle cerebellar peduncle
Inferior cerebellar peduncle
 Dorsal Surface of the Brain Stem

Midbrain 3
 Superior colliculus -1
1
Constitute centers for 4
2
visual reflexes
 Inferior colliculus -2
Associated with auditory
pathway
 Brachium of superior colliculus-3
 Brachium of inferior colliculus -4
 Fourth ventricle
Central canal →fourth ventricle →mesencephalic aqueduct→third ventricle

Position
• Situated ventral to
cerebellum, and dorsal
to pons and cranial half
of medulla
 Floor of the 4th ventricle
— Rhomboid Fossa

Boundaries
Inferolateral:gracile and
cuneate tubercles,
inferior cerebellar
peduncle
Superolateral: superior
cerebellar peduncle
Lateral recess
Floor of the 4th ventricle — Rhomboid Fossa

Features
Median sulcus-1
Sulcus limitans-2
Vestibular area-3
Overlies vestibular nuclei 5
1
2 7 3
Acoustic tubercle-4 4
Overlying dorsal cochlear
nucleus
Medial eminence-5 6
Striae medullares-6
Facial eminence-7
1 2
 Floor of the 4th ventricle — Rhomboid Fossa
 Facial colliculus
Overlies nucleus of abducent n. and
genu of facial nerve
 Hypoglossal triangle-1
Overlies hypoglossal nucleus
 Vagal triangle-2
Overlies dorsal nucleus of vagus nerve 3
 Locus ceruleus-3 蓝斑 1
2
Bluish-gray in color, it owes its color to a
group of deeply pigmented nerve
cells,function related to sleep.
 Roof of the Fourth ventricle

Anterior part:
Formed by sup. cerebellar
peduncle and sup.medullary
velum
Posterior part:
Formed by inferior medullary
velum & choroid plexus of
fourth ventricle
Three apertures Lat.aperture

– Median aperture of
fourth ventricle Median aperture
– Two lateral apertures of
fourth ventricle
1. Posterior medullary velum
2. Choroid plexus
3. Cisterna cerebellomedullaris of subarachnoid cavity
4. Central canal
5. Corpora quadrigemina
6. Cerebral peduncle
7. Anterior medullary velum
8. Ependymal lining of ventricle
9. Cisterna pontis of subarachnoid cavity
Arrow = Flow of cerebrospinal fluid (CSF) through foramen of
Magendie
Internal structure
of the brain Stem
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General description of internal structure of brain stem

Constitution
gray matter,white matter & reticular formation
Opening of central canal to form the 4th ventricle floor
Grey matter is separated into nuclei by nervous fiber
Nuclei types: cranial nuclei and non cranial nuclei
Nuclei are located in the superficial layer near back
surface of brain stem

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Copy Right- Hongqi ZHANG-Department of Anatomy-Fudan University
General description of internal structure of brain stem

Anterior - posterior layout of gray matter in spinal

cord;but medial - lateral layout of gray matter in
brain stem.
Post.view
Post.view Post.view

Ant.view Ant.view Ant.view

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Copy Right- Hongqi ZHANG-Department of Anatomy-Fudan University
Sensory nuclei are in lateral side of sulcus limitans
motor nuclei are in medial side of sulcus limitans
Nuclei related to viscera is close to sulcus limitans
The somatic nuclei is far from the sulcus limitans
Sulcus limitans
SSSN

GSSN

G+S-VSN
GVMN
SVMN
GSMN
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General description of nuclei related to cranial n

Nuclei related to Ⅲ~Ⅻ cranial n.are in brain stem

Nuclei related to Ⅲ~Ⅳ cranial n.are in midbrain,

Ⅴ~Ⅷ in pons, Ⅸ~Ⅻ in medulla oblongata mainly

One cranial n. can connect one nucleus or

more than one nucleus

One cranial nucleus can connect one cranial nerve

or more than one cranial n.

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Copy Right- Hongqi ZHANG-Department of Anatomy-Fudan University
General description of nuclei related to cranial n.

1 cranial n. ---- 1 cranial nuclear

1 cranial n.---- 1
cranial nuclear;
Or more than one
cranial nuclei 1 cranial nuclear maybe
connect to cranial nerve
more than one cranial n.

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Copy Right- Hongqi ZHANG-Department of Anatomy-Fudan University
General description of nuclei related to cranial n.

Cranial nerve nuclei mainly situated in the

superficial layer of the back surface of brain stem.
Nomenclature: according to connecting cranial
nerve mainly, or to the feature of the nucleus.
From medial to lateral ,there are 6 functional
column (not 7), because both special visceral
sensory nuclei and general visceral sensory
nuclei are one nucleus -nucleus ambiguus.
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Copy Right- Hongqi ZHANG-Department of Anatomy-Fudan University
Abbreviation related to cranial nerve nuclei
GSMN-general somatic motor nuclei
SVMN-special visceral motor nuclei
GVMN-general viscera motor nuclei
GVSN- general visceral sensory nuclei
SVSN - special visceral sensory nuclei
GSSN-general somatic sensory nuclei
SSSN-special somatic sensory nuclei

SVSN and GVSN belong to the same nucleus

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Copy Right- Hongqi ZHANG-Department of Anatomy-Fudan University
Feature and function of cranial n.nuclei
GSMN- innervate skeleton muscle from somite

SVMN- innervate skeleton muscle from brachial arch

GVMN-supply cardiac muscle,smooth muscle & glands

GSSN-receive sensory impulse from skin & mucosa

of head and face

V S N (general & special )- receive sensory impulse

taste,olfactory,cardiovascular,viscera & glands

SSSN-receive hearing and equilibrium impulse
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Copy Right- Hongqi ZHANG-Department of Anatomy-Fudan University

Accessory nuclear.of oculomotor n.

nuclear.of oculomotor n.
nuclear.of trochlear n.

Motor nuclear.of trigerminal n.

nuclear.of abducent n.
nuclear.of facial n.
Sup.salivatory nuclear
Inf.salivatory nuclear
Nuclear ambiguus
Dorsal nuclear of vagus n.
Nuclear of hypoglassol n.

Nuclear of accessory n.

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The end!
Good bye!

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