Medulla Oblongata

Presented by : Kritika Juneja

Enrollment no : 210243101037
Parul Institute of Ayurved & Research
 MEDULLA OBLANGATA
❑The medulla oblangata(medulla) is one of the three
regions that make up the brainstem.
❑It is the most inferior of the three and is
continuous above with the pons and below with spinal
cord.
❑Lies in the anterior part of posterior cranial fossa,
extending down to the foramen magnum.
❑LENGTH= 3 cm
WIDTH=2cm, at its upper end.
RELATIONS:-Anterior: to clevius and meninges.
Posterior:to vallecula of cerebellum.
❑ The medulla is conical in shape, decreasing in width
as it extends inferiorly.
 DIVISIONS:-
Open/Superior part Closed/inferior part
 EXTERNAL FEATURES
The surface of the medulla is marked by a series of fissures
or sulci that divide it into number of regions by certain
fissures.
❖ The Anterior median fissure and the Posterior median
sulcus are upward continuations of the corresponding
features seen on the spinal cord.
❖ On each side the anterolateral sulcus lies in line with
the ventral roots of spiral nerves, rootlets of hypoglossal
nerve emerge from this sulcus.
❖The posterolateral sulcus lies in the line with the dorsal
nerve roots of spinal nerves, and gives attachment to roots
of glossopharyngeal, vagus, and accessory nerves.
❖The anterolateral and posterolateral sulci with nerve roots
divide the surface of each half of the medulla oblangata
into number of regions.
 Anterior(ventral) aspect
⮚Pyramid:- The anterior region on either side of the
fissure is formed of a longitudinal elevation called the
pyramid.(region between the anterior median sulcus and the
anterolateral sulcus)
▪ The pyramid is made up of corticospinal and corticobulbar
fibres. In the lower part of the medulla, many fibres of the
right and left pyramids cross in midline forming the
pyramidal decussation.
▪
 ❖ Olive
▪ In the upper part of the medulla, the region between the
anterolateral and posterolateral sulci shows a prominent,
elongated, and oval swelling , called olive.
▪ This swelling is about half an inch long.
▪ It is produced by a large mass of grey matter called inferior
olivary nucleus.
❖Rootlets of the hypoglossar nerve: These emerge
from the anterolateral sulcus between the pyramid and the
olive.
❖Inferior cerebellar peduncles: of the left and right
side attach the medulla with the cerebellum, forms
the inferolateral boundaries of the lower half of fourth
ventricle.
❖Rootlets of the 9th, 10th and 11th
cranial nerves:These emerge through posterolateral
sulcus.
 Posterior (dorsal) aspect
▪ The posterior surface of the lower part (closed part) medulla,
between the posterior median sulcus and the posterolateral
sulcus, contains tracts that enter from the posterior funiculus of
the spinal cord.
▪ These are the fasciculus gracilis, next to the midline, and
the fasciculus cuneatus, placed laterally. These fasciculi end in
rounded elevations called gracile and cuneate tubercles.
▪ These tubercles are produced by masses of grey matter
called nucleus gracilis and nucleaus cuneatus.
▪The posterior surface of the upper medulla (open part)
forms the lower part of the floor of the fourth ventricle.
This fossa is bounded on either side by the inferior
cerebellar peduncles.
▪ The lower part of the medulla, immediately lateral to
the fasciculus cuneatus, is marked by another
longitudinal elevation called tuberculum cinerum.This
elevation is produced by an underlying collection of
gray matter of the spinal nucleus of trigeminal nerve.
Internal structure
The internal structure of the medulla is
generally studied by observing the
sections at following level:-
❖At the level of the pyramidal decusstation.
❖At the level of the sensory decussation.
❖At the level of the olivary nucleus.
Transverse section- lower part of medulla-
PYRAMIDAL DECUSSATION
GREY MATTER
• Decussating pyramidal fibres
seperate

Anterior horn from Central grey matter

⮚ Seperated anterior horn- Spinal nucleus of the
accessory nerve ( LATERALLY)
Supraspinal nucleus for motor
fibres of 1st cranial nerve (MEDIALLY).

⮚ The central grey matter- pushed Backwards.

⮚ Nucleus gracilis
Nucleus cuneatus continue with grey matter
• Laterally- central grey matter , continue with the
Nucleus of the spinal tract of the trigeminal nerve.
White Matter
1) Pyramids- anteriorly
2) The fibres(each pyramid)
Runs
Backwards & laterally lateral corticospinal tract
To reach
Lateral white column(spinal cord)
• The fasciculus gracilis and the fasciculus cuneatus-
occupy Broad Posterior white column.
• {Other features are similar to those of
spinal cord}.
Transverse section through the Middle of Medulla
passing through sensory decussation.
GREY MATTER

1) Cuneate nucleus
Lateral
Accessory cuneate nucleus(relays unconscious
proprioreceptive fibres - from upper limbs.)
2)The nucleus of the spinal tract of the trigeminal
nerve is also separate from the central grey matter.

3) The lower part of the inferior olivary nucleus is

seen.

4)The central grey contains:-

a) Hypoglossal nucleus- elongated nucleus (2cm)
--supplies muscles of tongue.

b)Dorsal nucleus of vagus

smooth muscles respiratory &

Preganglionic alimentary
Parasympathetic fibres system(glands)
Of heart.
 WHITE MATTER
❖Nucleus gracilis & cuneatus – gives Internal arcuate fibres.
{ these fibres cross to opposite side and forms
Paramedian band – MEDIAL LEMNISCUS }.
❖Pyramidal tracts - anteriorly.
❖Medial longitudinal bundle- posterior to medial
lemniscus.
❖Spinocerebellar, lateral spinothalamic and
other tracts – in anterolateral area.
❖Emerging fibres of 12th nerve.
Transverse section through the upper part of
Medulla passing through floor of fourth
ventricle/open part
 GREY MATTER
• Nuclei of several cranial nerves are seen in the floor of fourth
ventricle:
a) Hypoglossal nucleus- paramedian position
b) Dorsal nucleus of the vagus-XII nerve nucleus(lateral).
c) Nucleus of tractus solitarius-dorsal nucleus of
vagus(venterolateral).
d) Inferior and medial vestibular nuclei- medial to inferior
cerebellar peduncle.
❖Nucleus ambiguus
Origin to

Motor fibres of cranial nerve IX, X and XI

❖ Dorsal and ventral cochlear nuclei( on surface of inferior
cerebellar peduncle)- fibres of cochlear nerve(receive).
❖ Nucleus of spinal tract(Trigeminal nerve)- dorsolatral part.
• INFERIOR OLIVARY NUCLEUS—largest mass of grey
matter seen at this level.{Responsible for producing the
elevation of the olive.}
• Medial and dorsal accessory olivary nuclei lie close to inferior
olivary nucleus.
• Arcuate nucleus - anteromedial to pyramidal tract.
• Visceral centres are:-

• Respiratory centre cardiac centre vasomotor centre

 WHITE MATTER
• Inferior cerebellar peduncle – posterolateral part( lateral
to 4th ventricle)
• Olivocerebellar fibres- acute sections.(prominent).
• Striae medullaris(external arcuate fibres)-floor of
4th ventricle.
• Emerging fibres of IX, X, XI nerves.
 BLOOD SUPPLY

• Anterior spinal artery(medial part).

• Posterior inferior cerebellar artery(potsterolateral

part).
 CLINICAL ANATOMY
● Medial medullary/Dejerine syndrome
Medial medullary syndrome is a form of stroke that
affects the medial medulla of the brain. It is usually
caused by atherothrombotic occlusion of paramedian
branches of the anterior spinal artery, the vertebral artery,
or the basilar artery.
Features are :
-Contralateral hemiplagia due to pyramid damage
of medulla
-Loss of sense of vibration and position due to
damage to medial lemniscus
-Paralysis of muscle of tongue on same side due to
injury to 12th cranial
nerve
● Lateral medullary / Wallenberg syndrome
occurs due to blockage of posterior inferior cerebellar
artery
It supplies areas behind the inferior ovliary nucleus

Features are :
- Ipsilateral paralysis of most of muscles of soft
palate,pharynx and larynx due to injury to nucleus
ambiguus which gives fibres to 9th,10th and 11th
cranial nerves
- Loss of pain and temperature on same side
of face due to involvement of spinal
nucleus
and spinal tract of trigeminal nerve
- Loss of pain and temperature on opposite
side of body due to involvement of lateral
spinothalamic tract
- Giddiness due to involvement of vestibular
nuclei
Damage to inferior cerebellar peduncle,spinocerebellar tracts and part of
cerebellum results in loss of equilibrium i.e. ataxia of limbs on same
side