The Brain Stem

Location and Basic Physiology

is the most inferior portion of the brain, adjoining and
structurally continuous with the brain and spinal cord. The
brainstem gives rise to cranial nerves and provides the
main motor and sensory innervation to the face and neck
via the cranial nerves.
it is important part of the brain, as the nerve connections of
the motor and sensory systems from the main part of the
brain that communicate with the peripheral nervous system
pass through the brainstem.This includes the corticospinal
tract (motor), the posterior column-medial lemniscus pathway
and the spinothalamic tract.
The brain stem also plays an important role in the regulation
of cardiac and respiratory function. It regulates the central
nervous system (CNS) and is pivotal in maintaining
consciousness and regulating the sleep cycle.
Components of the Brainstem
Dorsal aspect of Brainstem
 Brain stem Nuclei
It is composed of many important nuclei:
• Reticular nuclei:
pontile reticular Nn.: are excitatory and receive
excitatory signal from vestibular Nn. , cerebellum. They form
medial reticulospinal tract.
medullary reticular Nn. : are inhibitory and receive
excitatory signal from collateral from CST;RST and send
signal through lateral RST
The excitatory and inhibitory reticular nuclei constitute a
controllable system that manipulated by motor signal from
the cortex and elsewhere to provide necessary muscle
contractions for standing against gravity and inhibit
appropriate group of muscle to perform this function.
Vestibular Nn;
they function with pontile reticular Nn to excite
the antigravity muscle.
They send excitatory signal through med and lat
vestibulospinal tract that pass ant in spinal cord,
which control selectively the contraction of
these muscle to maintain equilibrium in
response to signals from vestibular apparatus.
With out the support of vestibular Nn, pontile
reticular Nn loss much of its antigravity
function.
Locations of the reticular and vestibular nuclei in the brain stem
 Midbrain
Located between diencephalon and pons
Midbrain structures include:
Cerebral peduncles – two structures that
contain descending pyramidal motor
tracts.
Cerebral aqueduct – hollow tube that
connects the third and fourth ventricles
Various nuclei
 Midbrain Nuclei
 Nuclei that control cranial nerves III (oculomotor)
and IV (trochlear).
 Corpora quadrigemina - 4 domelike protrusions of
dorsal midbrain.
 2 Superior colliculi - visual reflex centers;
coordinate head and eye movement when we
follow a moving object (does not have to be a
conscious decision).
 2 Inferior colliculi - auditory relay centers
between hearing receptors to sensory cortex.
○ Reflexive responses to sound – turn head toward
sound.
Substantia nigra ;functionally linked to
basal nuclei, contains melanin pigment
(precursor of dopamine - NT).
Red nucleus ;largest nucleus (rich blood
supply) of the reticular formation; relay
nuclei for some descending motor
pathways.
 Pons
Location: between midbrain and medulla oblongata
Forms part of anterior wall of 4th ventricle
Fibers of the pons:
Connect higher brain centers and spinal cord
Relay impulses between motor cortex and cerebellum
Origin of cranial nerves V (trigeminal), VI (abducens),
and VII (facial)
Contains nuclei of the reticular formation
 Medulla Oblongata
is the lower half of the brainstem. The medulla contains
the cardiac, respiratory, vomiting, and vasomotor centers
and regulates autonomic, involuntary functions such as
breathing, heart rate, and blood pressure..
The medulla is often divided into two parts:
An open or superior part (where the dorsal surface of
the medulla is formed by the fourth ventricle).
A closed or inferior part where the metacoel (caudal
part of fourth ventricle) lies within the medulla
oblongata.
 Most inferior part of brain stem.
 With pons forms ventral wall of 4th ventricle.
 Contains choroid plexus of 4th ventricle.
 Pyramids – two longitudinal ridges formed by
corticospinal tracts descending from motor cortex.
Medulla Nuclei
 Inferior olivary nuclei - gray matter that relays
sensory information regarding stretch of muscle and
joints
 Cranial nerves IX (glosopharyngeal, X (vagus), XI
(accessory; neck muscle), and XII (hypoglossal;
tongue).
 Vestibular nuclear complex - synapses that mediate
and maintain equilibrium
 Ascending sensory tract nuclei, including nucleus
cuneatus and nucleus gracilis
 Serve as relay station for general somatic sensation.
Medulla has an important role in autonomic reflex
centers that maintain homeostasis:
Cardiovascular control center – adjusts force and rate of
heart contraction
Respiratory centers – control rate and depth of
breathing
Additional centers – regulate vomiting, hiccupping,
swallowing, coughing, and sneezing
 Reticular formation
Network of nuclei and nerve fibers in different areas of
brainstem with projection to cerebrum.
Functions as reticular activating system (RAS)
Involved in attention and in transition from sleep to
wakefulness
RAS sends impulses to cortex to arouse it from sleep.
The reticular formation includes ascending pathways to
the cortex in the ascending reticular activating system
(ARAS) and descending pathways to the spinal cord via
the reticulospinal tracts of the descending reticular
formation.
Neurons of the reticular formation, those of the(ARAS)
play a crucial role in maintaining behavioral arousal and
consciousness. The functions of the reticular formation
are modulatory and premotor. The modulatory
functions are primarily found in the rostral sector of the
reticular formation and the premotor functions are
localized in the neurons in more caudal regions.
Divisions of the Reticular Formation

Traditionally, the nuclei are divided into three columns:

Raphe nuclei (medium column)Magnocellular
red nucleus (medial zone)
Parvocellular reticular nucleus (lateral zone)
The raphe nuclei are the place of synthesis of
serotonin, which plays an important role in mood
regulation.
The gigantocellular nuclei are involved in motor
coordination.
The parvocellular nuclei regulate exhalation
dd
Ascending reticular activating system

The ascending reticular activating system (ARAS), also

known as the extra thalamic control modulatory system
or (RAS), is a set of connected nuclei in the brains of
vertebrates that is responsible for regulating
wakefulness and sleep-wake transitions. The ARAS is a
part of the reticular formation and is mostly composed
of various nuclei in the thalamus and a number of
dopaminergic, noradrenergic, serotonergic,
histaminergic, cholinergic, and glutamatergic brain nuclei
Functions of the ARAS
Regulating sleep-wake transitions
Attention
Consciousness
 Clinical significance of the ARAS
Mass lesions in brainstem ARAS nuclei can cause severe
alterations in level of consciousness (coma).
Bilateral damage to the reticular formation of the
midbrain may lead to coma or death.
Direct electrical stimulation of the ARAS produces pain
responses in cats and educes verbal reports of pain in
humans.
Descending reticulospinal tracts
The reticulospinal tracts, also known as the descending
or anterior reticulospinal tracts, are extrapyramidal
motor tracts that descend from the reticular formation
in two tracts to act on the motor neurons supplying the
trunk and proximal limb flexors and extensors.The
reticulospinal tracts are involved mainly in locomotion
and postural control, although they do have other
functions as well
The descending reticulospinal tracts are one of four major
cortical pathways to the spinal cord for musculoskeletal
activity. The reticulospinal tracts works with the other three
pathways to give a coordinated control of movement. The
four pathways can be grouped into two main system
pathways:
The medial system the reticulospinal pathway and the
vestibulospinal pathway, and this system provides control of
posture.
The lateral system The corticospinal and the rubrospinal
tract pathways which provides fine control of movement.
Components of the reticulospinal tracts

The tract is divided into two parts, the medial (or

pontine) and lateral (or medullary) reticulospinal tracts
(MRST and LRST)
 Functions of the reticulospinal tracts

 Integrates information from the motor systems to

coordinate automatic movements of locomotion and
posture
 Facilitates and inhibits voluntary movement;
influences muscle tone
 Mediates autonomic functions
 Modulates pain impulses
 Influences blood flow to lateral geniculate nucleus of
the thalamus.
Clinical significance of the reticulospinal tracts

RST are mostly inhibited by the corticospinal tract; if

damage occurs at the level of or below the red nucleus
(to the superior colliculus), it is called decerebration, and
causes decerebrate rigidity: an unopposed extension of
the head and limbs.
RST also provide a pathway by which the hypothalamus
can control sympathetic thoracolumbar outflow and
parasympathetic sacral outflow