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Brainstem & Cranial Nerves

Maryann Martone, Ph. D. NEU 256 October 13, 2005

Review: Levels of the Spinal Cord

Ventricles in brainstem
Mesencephalon cerebral aqueduct Metencephalon 4th ventricle Mylencephalon 4th ventricle

Corpus callosum Fornix Thalamus Anterior commissure Hypothalamus

Posterior commissure

Occipital Lobe Quadrigeminal cistern

vermis Optic nerve 4th ventricle Mammillary body

pyramid

Anterior view of brainstem


basal ganglia internal capsule optic chiasm optic nerve optic tract hypothalamus mammillary body

cerebral peduncle interpeduncular fossa pons flocculus inferior olivary nuclear complex cerebellum pyramidal decussation cerebellar tonsil

pyramid

Lateral view of brainstem


optic tract cerebral peduncle trigeminal nerve

optic nerve middle cerebellar peduncle optic chiasm vestibulocochlear nerve hypothalamus pons flocculus cuneate tubercle inferior olivary nuclear complex

anterior median fissure

pyramid

Posterior view of brainstem

Superior colliculus Cerebral peduncle Superior cerebellar peduncle Middle cerebellar peduncle Inferior colliculus

4th ventricle

Inferior cerebellar peduncle

Medulla

Components of the brainstem


Sensory ascending pathways (dorsal) Motor descending pathways (ventral) Cerebellar pathways Cranial nerve sensory and motor tracts CPGs: rhythmic chewing, respiration, cardiovascular regulation & gain adjustments for reflexes Modulatory systems: locus coeruleus, raphe & substantia nigra

Ascending sensory pathways


Fine discriminitive touch, conscious proprioception Fasciculus gracilis: Terminates in the nucleus gracilis (medulla) Fasciculus cuneatus: Terminates (medulla) in the cuneate and accessory cuneate nuclei Sensations of pain and temperature Lateral Spinothalamic Tract origin dorsal horn cells of the gray matter Fibers cross contralaterally through the anterior commissure and ascend to the VPL nucleus Transmits sensations of touch Ventral Spinothalamic Tract origin cells of the posterior horn Fibers cross to the opposite side in the anterior commissure

Descending motor pathways


Voluntary movement Lateral Corticospinal Tract Originates in large pyramidal cells (precentral gyrus) cross to the opposite side of the cord at the pyramidal decussation & terminate in the dorsal horn cells Ventral Corticospinal Tract Originates in the pyramidal cells (motor area of the cortex) Impulses related to equilibrium and antigravity reflexes Vestibulospinal Tract Fibers originate in the vestibular nuclei of the medulla and terminate at level of the sacral spinal nerves Connects vestibular complex and head and eye movement coordination center in medulla Medial Longitudinal Fasciculus Contains both ascending and descending fibers

Motor Hierarchy
Lateral group (extremities; fine motor control) Corticospinal tract Rubrospinal tract Medial group (axial musculature; rhythmic and postural movements) Vestibulospinal tract Tectospinal tract Reticulospinal tract Final common path: motor pool

Reticular Formation
Core of brainstem (midbrain, pons and medulla) composed of loosely organized neurons, outside of the major nuclear groups of the brainstem. Medial-to-lateral: raphe nuclei, gigantocellular region, small cell region Participate in widespread connections Rostral continuation of interneuronal network found in spinal cord

Cerebellar pathways
Conduct impulses from the leg and trunk muscles for unconscious proprioception Dorsal & Ventral Spinocerebellar Tracts Enter cerebellum via inferior cerebellar peduncle

Brainstem Internal Anatomy

Components of the brainstem


Sensory ascending pathways (dorsal):
Relay nuclei, tracts

Motor descending pathways (ventral)


Tracts, motor nuclei brainstem

Cerebellar pathways
Tracts, cerebellar afferent and efferent nuclei

Cranial nerve sensory and motor tracts


Cranial nerve nuclei, nerve entry and exit points

CPGs: rhythmic chewing, respiration, cardiovascular regulation & gain adjustments for reflexes Modulatory systems: locus coeruleus, raphe & substantia nigra
Chemically coded nuclei

Tracing through the brainstem: Dorsal Column/Medial Lemniscal System

Corticospinal Tract

Caudal Medulla

Closed medulla

Caudal Medulla

Medulla

Rostral Medulla

Rostral Medulla

Medulla-Pons Junction

Mesencephalon

The Cranial Nerves


The head and neck are not innervated by spinal nerves Sensory information is received and motor information is sent via 12 cranial nerves Considered part of the PNS they convey messages to and from the body's muscles and glands.

Each cranial nerve.


Can be referred to by a name or number! Has a general function Has at least a motor, sensory or parasympathetic component Some have more than one component Has associated brainstem nuclei Innervates a structure(s)

Cranial nerves can be identified on the ventral surface of the brain


I I II III IV V VI VIII IX XII

VII

X
XI

Some tricks to learning cranial nerve numbers, names & components


I II III IV V VI VII VIII IX X XI XII
Olfactory Optic Occulomotor Trochlear Trigeminal Abducens Facial Auditory/Vestibulocochlear Glossopharyngeal Vagus Spinal/Accessory Hypoglossal On Old Olympus Towering Tops A Frenchman And German Viewed Some Hops Some Say Marry* Money But My Brother* Says Big* Business* Makes Money
S = Sensory M = Motor B = Both/Mixed Sensory & Motor * = Parasympathetic

Arrangement of brainstem cranial nerve nuclei in columns


Midbrain Pons Medulla

Insert picture with different levels differentiated

General Rules of Thumb


Most motor nuclei are associated with a single cranial nerve

Afferent nuclei often receive fibers from several cranial nerves


All associated with a single function however, e.g., nucleus of solitary tract

Functions of Cranial Nerves

www.neurophys.com/EMG/Cranial_Nerves/

Cranial Nerve I: Olfactory


Component: Function: Tract: Sensory Smell Olfactory cells of nasal mucosa Olfactory Bulbs pyriform cortex

Cranial Nerve II: Optic


Component(s): Function: Sensory Vision

Tract:

retinal ganglion cells optic chiasm thalamus primary visual cortex in occipital lobe

Cranial Nerve III: Oculomotor


Component #1: Motor

Function(s): Structure(s) Innervated:

Movement of eyeball & lens accomodation 4 eyeball muscles & 1 eyelid muscle

Component #2:
Nucleus location: Function: Structure(s) Innervated:

Parasympathetic
midbrain pupil constriction ciliary muscle and pupillary constrictor muscles

Cranial Nerve III: Oculomotor

Cranial Nerve IV: Trochlear


Component: Function: Nucleus location: Structure(s) Innervated: Motor moves eyeball midbrain superior oblique muscles

Cranial Nerve V: Trigeminal


Component #1: Sensory(impulses of touch, pain, heat and cold) pons & medulla (1) sensations; (2) general sensory from tongue; (3) proprioception (1) face, scalp, teeth, lips, eyeballs, nose & throat lining; (2) anterior 2/3 of tonque; (3) muscles of mastication

Locations of nuclei: Function:

Structure(s) Innervated:

Cranial Nerve V: Trigeminal


Component #2: Function: Nucleus location: Structure(s) Innervated: Motor chewing trigeminal motor nucleus in pons muscles of mastication

Cranial Nerve V: Trigeminal

Cranial Nerve VI: Abducens


Component: Function: Nucleus: Structure(s) Innervated: Motor Eyeball movement abducens nucleus in pons lateral rectus muscle of eye

Cranial Nerve VII: Facial


Component #1: Nucleus location: Sensory medulla

Function:
Structure(s) Innervated: Component #2: Nucleus location: Function: Structure(s) Innervated:

(1) taste & (2) proprioception


(1) anterior 2/3 of tongue & (2) face and scalp Motor facial motor nucleus in pons facial expressions muscles of the face

Cranial Nerve VII: Facial


Component #3: Nucleus location: Function: Structure(s) Innervated: Parasympathetic Superior salivatory nucleus in medulla salivation and lacrimation (drooling and tears) salivary and lacrimal glands via submandibular and pterygopalatine gamglia

Cranial Nerve VIII: Vestibulocochlear


(aka acoustic or auditory nerve)
Component: Functions: Nucleus: Structure(s) Innervated: Sensory (1) Balance (2) Hearing In pons and medulla vestibular apparatus of internal ear cochlear of internal ear auditory cortex in the temporal lobes

Cranial Nerve VIII: Vestibulocochlear


(aka acoustic or auditory nerve)

Cranial Nerve IX: Glossopharyngeal


Component #1: Nucleus location: Function: Sensory medulla (1) taste; (2) proprioception for swallowing & (3) blood pressure receptors (1) posterior two thirds of tongue; (2) throat muscles & (3) carotid sinuses

Structure(s) Innervated:

Cranial Nerve IX: Glossopharyngeal


Component #2: Nucleus location: Function: Motor medulla (1) swallowing and gag reflexes & (2) tear production (1) throat muscles and (2) lacrimal glands

Structure(s) Innervated:

Cranial Nerve IX: Glossopharyngeal


Component #3: Function: Structure(s) Innervated: Parasympathetic saliva production parotid glands

Cranial Nerve X: Vagus


Component #1:
Nucleus location: Function:

Sensory
medulla (1) chemoreceptors; (2) pain receptors; (3) sensations; (4) taste (1) blood oxygen concentration, carotid bodies; (2) respiratory & digestive tracts; (3) external ear, larynx & pharynx (4) tongue

Structure(s) Innervated:

Cranial Nerve X: Vagus


Component #2: Nucleus location: Function(s): Motor medulla (1) heart rate & stroke volume; (2) peristalsis; (3) air flow; (4) speech & swallowing (1) pacemaker & ventricular muscles; (2) smooth muscles of the digestive tract (3) smooth muscles in bronchial tubes (4) muscles of larynx a & pharynx

Structure(s) Innervated:

Cranial Nerve X: Vagus


Component #3:
Structure(s) Innervated:

Parasympathetic
smooth muscles and glands of the same areas innervated by motor component, as well as thoracic and abdominal areas

Cranial Nerve XI: Spinal Accessory


Component:
Function: Nucleus location: Structure(s) Innervated:

Motor
head rotation (& shoulder shrugging!) accessory nucleus in medulla trapezius & sternocleidomastoid muscles

Cranial Nerve XII: Hypoglossal


Component: Function: Nucleus location: Structure(s) Innervated: Motor Speech and swallowing In medulla Throat and tongue muscles

Cranial Nerve XII: Hypoglossal