Name Medulla Nucleus Gracillis + Fassiculus Gracillis

Input proprioceptive, fine touch and vibratory sense primary afferent fibers from the lower part of the trunk and lower limbs

Location

Notes

Lesion

Nucleus Cuneatus + Fassiculus Cuneatus

Spinal trigeminal nucleus + tract

nucleus = caudal medulla up to the level of the hypoglossal nerve tract continues down spinal At level of hypoglossal nerve, start seeing the deccusation of internal arcuate fibers forming the medial lemniscus cord nucleus = caudal medulla up The fassiculuses both get smaller and both nuclei get larger as you travel rostral up the brainstem proprioceptive, fine touch and to the level of the vibratory sense primary afferent hypoglossal nerve fibers from the upper limb and tract continues down spinal upper trunk. cord Spinal trigeminal is the equivalent of the dorsal horn taking care of the head and a little bit of the neck primary afferent fibers conveying Most of the sensory info coming in here are the pain and temperature sensory caudal medulla up to mid pain & temperature (majority), * Somatotopic organization = upside down head pons, at the level of the facial SOME proprioception, fine touch Opthalmic more ventral, maxillary are internemdiate, mandibular more dorsal and abducens nerve and vibratory sense from the head -replaced rostrally at mid pons by principle trigeminal and motor trigeminal nucleus. Caudally replaced in spinal cord by substatia gelatinosa

ipsilateral loss of modalities

Lesion of the nucleus typically results in variable loss of ipsilateral pain and temperature perception

levels of spinal cord up nonconscious proprioception and posterior rostral medulla at the level of At level of rostral medulla, it is replaced by inferior cerebellar peduncles fine touch for lower trunk and limb spinocerebellar tract the vagus and Located anterolateral to the spinal trigeminal system below C8 glossopharyngeal nerves crossed tract nonconscious proprioception of lower trunk and limb (more complex info) crossed tract conveys pain and temperature (excluding head) fibers to the thalamus. crossed tract conveys pain and temperature and crude touch (excluding head) fibers to the thalamus. levels of spinal cord up to rostral pons at level of principal trigeminal nuclei At level of rostral pons, it is replaced by superior cerebellar peduncle Located ventral to the posterior spinocerebellar tract Fibers go a bit rostral before going down back into the superior cerebllar peduncle

Ipsilateral loss of nonconcious proprioception of lower limb and lower trunk Contralateral loss of nonconcious proprioception if between the two desucations

anterior spinocerebellar tract

lateral spinothalamic

anterior spinothalamic

levels of spinal cord up to caudal medulla at level of hypoglossal nerve

At level of hypoglossal nerve, will merge into the anterolateral system

Corcitocpinal/ corticonuclear

Pyramids - start as decusation at cuadal medulla. Crossed fibers - no longer a decusation at level of hypoglossal nerve. Called pyramid from this level to the rest of the rostral medulla Uncrossed fibers innervate anterior horn neurons Levels of spinal cord to - some fibers terminates on cranial nerve nuclei innervating skeletal muscles at the level of the rostral medulla throughout the length of the spinal rostral midbrain at level of - at caudal pons, no longer see pyramids as corticospinal fibers move dorsally away from surface. Some fibers still cord carrying fibers for major occulamotor nerve. Moves terminate on cranial nerve nucleus of this level concious motor movement dorsally away from pyramids Corticospinal/nuclear tract - now located in bassilar pons. Fibers are dispersed due to pontine nuclei running in between them - will reorganize into singular unit at midbrain, at level of trochlear nucleus --> going to form the cerebral peduncles - Replaced by cerebral peduncle at midbrain level of occulamotor nerve Crossed fibers descending from red nucleus, activating flexor muscles and inhibiting externsors reflexes in postural movement of neck in response to visual stimuli Levels of spinal cord to rostral midbrain at level of occulamotor nerve Levels of spinal cord to rostral midbrain at level of occulamotor nerve Activates flexor muscles and inhibits extensor muscles At level of occulamotor nerve in midbrain, rubrospinal fibers go into their source: the red nucleus

Above the decussation--> paresis or paralysis on contralateral side Below the decussation = ipsilateral paresis/paralysis -hyperreflexia and positive babinski sign

Rubrospinal

Tectospinal

At level of occulamotor nerve in midbrain, tectospinal fibers go into their source: the deep layers of superior colliculus

Name

Input

Location

Notes

Lesion

At caudal medulla - contains mainly medial vestibulospinal fibers innervating axial muscles of the neck and upper thorax. It also contains descending fibers from the reticular formation. The medial longitudinal fasciculus is descends to the spinal cord At rostral medulla - has descending fibers to spinal cord and additionally ascending fibers from vestibular Medial Longitudinal both an ascending and descending and ascends as rostral as the nuclei to organize complex movement and reticular formation that are destined for the extraocular nuclei Fassiculus (MLF) tract that has a mixture of axons midbrain-thalamic junction At cuadal pons - contains a mixture of descending fibers to the spinal cord and ascending fibers to from several different sites. CN VI, CN IV and CN III. Both sets of fibers originate predominately in the vestibular nuclei or reticular formation.

Lateral vestibulospinal

facilitory to extensor/antigravity muscles of trunk and limbs

levels of spinal cord to pons At level of pons, tract merges with its source: lateral vestibulospinal nucleus at level of facial nerve Cell bodies (C1-C4) to small GSE component remnant going all the way up Replaced by nucleus amiguus at cuadal medulla to caudal medulla (before Fibers from precentral gyrus cross at motor decusation seeing hypoglossal nucleus) The lower motor neurons are located in the spinal cord levels C1-4 in the posterolateral margin of the anterior horn. Upper motor neurons are located in precentral gyrus and premotor cortex. They cross in the motor decussation to innervate the contralateral accessory nucleus. Its fibers leave the spinal cord at the level of the denticulate ligament and ascend through the vertebral canal into the foramen magnum to enter the posterior cranial fossa. It joins with the vagus and glossopharyngeal nerves to exit at the jugular foramen. UMN lesion - contralateral shoulder drop and weakness in turning the head to the contralateral side

Accesory nucleus

innervate trapezius and sternocliedomastoid (CN XI)

innervates the sternocleidomastoid and then passes through the Spinal Accesory Nerve posterior triangle of the neck to (CN XI) innervate the trapezius (thru the posterior triangle)

LMN lesion - ipsilateral shoulder droop and weakness in turning the head to the contralateral side.

Medial Lemniscus

crossed tract ascending fibers from nucleus gracillis and cuneatus

caudal medulla at level of hypoglossal nerve to the thalamus

Three stack tract = MLF , tectospinal, medial lemniscus - Relationship will hold thru entire length of the medulla - Medial lemniscus (bottom part of three stack) will move away from other two starting in pons (MLF and tectospinal stays in relatively the same position thru the brainstem) - Caudal levels are more anterior in the medial lemniscus, rostral levels are more posterior As the medial lemniscus move more horizontally, caudal levels become lateral and rostral levels become medial

Lesion of a paramedian artery (provides for medial structures) between caudal medulla and rostral pons --> will loose medial lemniscus = loss of touch, vibration, and pressure sensation for limbs, body on contralateral side

External cuneate nucleus

termination site for the cuneocerebellar tract that conveys seen only in caudal medulla nonconscious proprioception and at level of hypoglossal nerve touch from the upper limb to the cerebellum.
Primary afferent system from GVA and SVAs More caudal portion = respiratory, cardiovascular, digestive system comes in (modulates smooth mm. and cardiac mm. of these sections) Rostral portion = SVAs (taste fibers) This region is heavily involved in autonomic nervous system (sort of equiv of the dorsal horn of spinal cord or trigeminal complex) Tract is totally isolated from the fiber system. Sits in the middle of the nucleus

Nucleus tractus solitarius

caudal medulla at level of termination site for multiple cranial hypoglossal up to pons at the At caudal medulla = termination for baroreceptor fibers, chemoreceptor fibers (CN IX) and CN X (visceral nerves level of the facial nerve afferent fibers from the respiratory, heart and gastrointestinal system)
At caudal pons = termination site of CNVII, CN IX visceral afferent fibers. CN IX - taste for posterior 1/3 of the tounge CN VII - taste from anterior 2/3 of tounge. Go to rostral 1/3 of the nucelus **major afferent site for cardiovascullar and respiratory is nuc tractus solitarius

Name Hypoglossal Nucleus

Input innervates intrinsic and extrinsic muscles of the tongue.

Location caudal medulla to rostral medulla (level of vagus, glossopharyngeal nerve)

Notes GSE component Cell bodies of origin (lower motor neurons) for hypoglossal nerve

Lesion

Hypoglossal Nerve (CN XI)

innervating intrinsic and extrinsic skeletal muscles of the tongue

The fibers exit the brainstem between the pyramids and the olive in the preolivary sulcus and pass to the lateral side of the tongue to innervate its intrinsic and extrinsic muscles. Left cortex innervates more of the right tounge muscle nucleus hypoglossal nucleus or its nerve roots = lower motor neurons/fibers descending corticonuclear fibers = upper motor neuron lesion

LMN lesion Stick out tongue --> tongue deviate to side of lesion, atrophy, fasciculations UPM lesion - Slight preponderance of contralateral. Tongue therefore deviates to the opposite side of the lesion (not always seen)

Inferior cerebellar peduncle

conveys posterior spinocerebellar fibers, olivocerebellar fibers and rostral medulla (level of cuneocerebellar fibers to the glossopharyngeal and vagus Replaces the posterior spinocerebellar tract at rostral pons. cerebellum. nerve) to caudal pons at the Has fibers to medial and inferior vestibular nucleus from the cerebellum Also has efferent fibers from the level of glossopharyngeal and cerebellum to brainstem vestibular vestibulocochlear nerve nuclei

rostral medulla (level of origin for parasympathetic glossopharyngeal and vagus Dorsal motor nucleus preganglionic neurons of the vagus nerve) to caudal pons at the of the vagus nerve nerve level of glossopharyngeal and vestibulocochlear nerve rostral medulla (level of somatomotor innervation for glossopharyngeal and vagus skeletal muscles innervated by CN nerve) to caudal pons at the IX and CN X. level of facial and abducens nerve

GVE component First neuron in two neuron chain that is responsible for the parasympathetic innervation to smooth and cardiac muscle 2nd neurons located in Resp, cardiac, GI up to splenic flexure, in walls of the organs At caudal pons, dorsal motor nucleus is replaced by the iferior salivary nucleus SVE component Innervates stylopharyngeus (CN IX) and pharyngeal, laryngeal, and muscles near the region of the palate (CN X) - Drawing a line from the dorsolateral tip of the inferior olivary nucleus to the hypoglossal nucleus can identify the position of the nucleus ambiguus. The nucleus ambiguus is located at the mid-point of this line. Replaces accesory nucleus at rostral medulla Replaced by facial motor nucleus at caudal pons UMN bilaterally innervates nuc ambiguus, so lesion deficiencies not commonly seen LMN lesion - Unilateral Horseness (unilateral lession of the recurrent laryngeal nerve), dysphasia, dysarthria, uvualla will deviate to unaffected side Soft palate will sink on affected side LMN lesion -Bilateral (ie. an Ependymal lesions from the floor of the 4th ventricle) disruption of respiratory rhythms, cardiovascular rhythms or difficulty in bringing air into the lungs.

Nucleus ambiguus

Vagus Nerve (CN X)

Somatic motor = innervation of skeletal muscles including: pharyngeal constrictors, intrinsic muscles of larynx, muscles elevating/depressing the soft palate SOMATIC MOTOR: Efferents from Visceral motor= parasympathetic innervation of smooth muscle of upper digestive system, respiratory systems and heart. nuc. ambiguus Visceral Sensory from inferior ganglion = sensory innervation of the mucosa of larynx, respiratory system, heart and digestive system - Central processes go into postolivary sulcus and terminat at nucleus tractus of solitarius VISCERAL MOTOR: Efferents from - Somatitopically organized dorsal motor nucleus - Taste fibers go to the rostral third of the nuc. soltarius SENSORY: Central processes from Somatic Sensory from superior ganglion = innervation of external auditory meatus and external surface of tympanic membrane. - Central processes go into postolivary sulcus and terminat at spinal trigeminal nucleus cell bodies of origin in inferior and superior ganglion of vagus nerve Fibers join and go out the dorsolateral side of the medulla at postolivary sulcus

Name

Inferior olivary nucleus

Ventral trigeminothalamic tract

Central tegmental tract

Notes Lesion Acts as a premotor/pre-cerebellar nuclei part of the circuitry involved in Derived from alar plate cerebellar regulation of motor rostral medulla (level of Feedback system = a check on the outflow of another system movements glossopharyngeal) to level Cerebellum controls motor fibers in a major way. Sends fibers up to the cortex to tell it whats happening. It right before pons (at the level also sends fibers to red nucleus --> rostral half of red nucleus will send fibers down to olive (Rubro-olivary Acts as a feedback nucleus for fo the facial and abducens fibers a tract, part of another tract system) --> olive then sends that info back into the cerebellum, telling the cerebellum, sending fibers to the nerve) cerebellum what it just told the cortex to do (feedback check!) contralateral cerebellum Important feature in the extrapyramidal control system Has fibers from spinal trig nucleus conveying proprioception, fine touch, vibratory sense, pain and temperature from the Lesion results in a variable head. --> VPM nuc of thalamus --> post central gyrus loss of contralateral pain and crossed fibers rostral medulla (level of Ascend to the cortex to tell pain and temp of face and part of the neck temperature and crude from the efferents arrising from glossopharyngeal) to At pon (level of facial nerve) organizes into a common tract system, sitting on the horrizontaly oriented medial lemniscus sensation. There may be spinal trigeminal nucleus and few thalamus as its own separate tract some contralateral loss of from principle sensory trig nucleus *Collateral branches terminate throughout the lateral zone of the reticular formation to modulate incoming information fine touch, vibratory sense from the trigeminal nerve. and proprioception. contains descending axons from red nucleus, corpora quadragemina to the inferior olivary nucleus. rostral medulla (level of Second longitudinal tract system (in addition to MLF) that is a multipurpose highway glossopharyngeal) to Used to get rubro-olivary fibers from rostral half of the red nucleus to inferior olive Also contains ascending fibers from thalamic levels More prominent as you go more rostral the reticular formation to the subthalamus and intralaminar thalamic nuclei. receives primary afferent fibers Two most cuadal nuclei appear first medial and inferior from CN VIII Contributes to : Descending medial vestibulospinal tract, Vestibulocerebellar pathway (secondary), Ascending projections travel in the
MLF to extraocular nuclei nuclei and gaze centers.

Input

Location

Medial vestibular nucleus

Sends fibers in the MLF that descend to the spinal cord and ascend to extraocular nuclei And sends fibers by way of the inferior cerebellar peduncle to the cerebellum. receives primary afferent fibers from CN VIII

rostral medulla (level of - Replaces nucleus gracillis glossopharyngeal) to caudal - Replaced rostrally by superior vestibular nucleus pons
Vestibuloccular reflex: Turn hea --> increase frequency on the ipsilateral semicircular canal --> send increased impulses to medial vestibular nuc --> MLF --> excitatory projection to contralateral abducens and PPRF --> ** as head moves, latearl gaze moves to the contralateral direction (head to left, eyes to the right...etc) **

Inferior vestibular nucleus

Sends fibers by way of the inferior cerebellar peduncle to the cerebellum.

Does not have descending fibers Will see lots of dark dots = axons cut in passage from lateral vestibular Salt = cell body of inferior vestibular rostral medulla (level of Pepper = descending tract fibers glossopharyngeal) to caudal More pepper --> inferior vestibular ----Little pepper --> lateral vestibular pons Projects vestibulocerebellar fibers (secondary) to the cerebellum Replaces nucleus cuneatus Replaced rostrally by lateral vestibular nucleus caudal pons (level of glossopharyngeal and vestibulocochlear) to mid pontine level GVE component Replaces dorsal motor nucleus Replaced by superior salivary nucleus at more rostral level of pons (level of facial and abducens nerver) see below

Pons Inferior salivary nucleus contains preganglionic parasympathetic fibers that contribute to the glossopharyngeal nerve.

SOMATIC MOTOR: Efferents from Somatic motor = innervation of skeletal muscles including: stylopharyngeus Visceral motor= first neuron of two neuron parasympathetic chain innervating parotid gland (second is in the otic ganglion) nuc. ambiguus VISCERAL MOTOR: Efferents from Visceral Sensory = barroreception and taste - Central processes from the carotid body and carotid sinus terminating at caudal 2/3 of nucleus tractus of solitarius inferior salivary nucleus SENSORY: Central processes from cell bodies of origin in inferior ganglion of the glossopharyngeal nerve
Somatic Sensory= general sensory from posterior 1/3 of tongue, pharynx, middle ear, auditory tube & mastoid air cells - Central processes terminate at spinal trigeminal nucleus Upper motor neurons are located in the precentral gyrus and descend through the posterior limb of the internal capsule as part of the corticonuclear tract.

Glossopharyngeal nerve (CN IX)

- special sense (taste) from the posterior 1/3 of tongue. Central processes terminate in the rostral 1/3 of nucleus tractus solitarius

LMN lesion Almost impossible to see deficits May see a little bit of loss of gag reflex

Name Posterior/dorsal cochlear nucleus

Input receives afferent fibers from the spiral ganglion of the cochlea for sound descrimination - initially contralateral receives afferent fibers from the spiral ganglion of the cochlea for nonconcious localization - initially bilateral receives primary afferent fibers from the vestibular component of the vestibulocochlear nerve

Location

Notes

Lesion

Anterior/ventral cochlear nucleus

between rostral medulla and Auditory system: caudal pons Primary afferents are coming from spiral ganglia associated w/ the regions of cochlear duct --> region of the ponto medullary junction synapising in the ventral and dorsal cochlear nuclei Ventral cochlear nuclei is just one stop in the entire auditory pathway. between rostral medulla and Second stop (one of multiple second stops) is the superior olivary nucleus caudal pons Associated with middle cerebellar peduncle Contributes a lot of fibers to MLF (which is more and more concerned at this point to take vestibular input up to the visual system controlling centers = occulomotor, abducens, trochlear complexes) pons at level of facial nerve Sends fibers both contralaterally and ipsilaterally to level of principle Not a descending tract system trigeminal nuclei Concerned with movement of visual system It is the rostral continuation of the medial and lateral vestibular nuclei pons from level of facial and Majority of the peduncle is made up of pontocerebellar fibers from contralateral pontine nucleus abducens nerve to level of The peduncle is at greatest prominence at the level of the principal trigeminal nucleus principal trigeminal nuclei

Superior Vestibular nucleus

It projects fibers to the cerebellum and rostrally to the trochlear nucleus and oculomotor nucleus (part that innervates the inferior rectus). contains afferent fibers originating from pontine nuclei.

Middle cerebellar peduncle

Facial motor nucleus

SVE component innervates many skeletal muscles pons at the level of facial and somatomotor innervating: muscles of facial expression, stylohyoid, posterior belly of the digastric and stapedius (dampen see below of the face. (fibers for facial nerve) abducens nerve movement of the stapes) Replaces nucleus amiguus Somatic motor = muscles of facial expression, stylohyoid, posterior belly of the digastric and stapedius Visceral motor= first neuron of two neuron parasympathetic chain innervating lacrimal gland, submandibular gland, sublingual gland, nasal UMN lesion smoothing of face mucous glands and oral mucous glands. in side contralateral to lesion SOMATIC MOTOR: Efferents from Visceral Sensory = taste facial nucleus - special sense (taste) from the anterior 2/3 of tongue. Central processes terminate in the rostral 1/3 of nucleus tractus solitarius
Above eyes, wont see any problems (will still be able to wrinkle forhead) Below eyes, smoothing of face on affected side LMN lesion Causes one side of the face to be paralyzed (bells palsy) - Can have hypercousis = ringing in the ear, hypersensitivity to hearing - Also see crocodile tears

Facial nerve (CN VII)

VISCERAL MOTOR: Efferents from Somatic Sensory= innervating portions of the external auditory meatus superior salivary nucleus - Central processes terminate at spinal trigeminal nucleus SENSORY: Central processes from cell bodies of origin in geniculate ganglion Involved in the efferent loop of the corneal reflex Fiber first moves posteriorly towards the floor of the fourth ventricle and then loops around the abducens nucleus (picks up fibers from superior salivary) before it moves laterally to exit the ventrolateral side of the pons **Upper motor neuron fibers - Muscles of facial expression above the eyes receive a strong bilateral innervation from the cerebral cortex, while muscles of facial expression below the eyes receive a predominate contralateral innervation.**

Abducens nucleus

GSE component It is embraced by the facial tract as it swings around to a posterior medial position(to go by the superior salivary nucleus) pons at the level of facial and Also contains neurons that project - Innervates lateral rectus abducens nerve to the medial rectus neurons in the - like the other two occulamotor nuclei, Innervated from region of frontal cortex, rostral to precentral gyrus = prefrontal contralateral oculomotor nucleus eye fields via the MLF Somatic motor = innervate lateral rectus

Innervates lateral rectus (fibers for abducens nerve)

lateral gaze paralysis of ipsilateral eye both eyes are forcefully directed away from the side of the lesion

Abducens nerve (CN VI)

SOMATIC MOTOR: Efferents from LMN from abducens nucleus passes through the cavernous sinus in the middle cranial fossa to enter the orbit by way of the superior orbital fissure to innervate the extraocular muscle, lateral rectus. abducens nucleus Upper motor neurons are located in the frontal eye fields. Their fibers pass through the anterior limb of the internal capsule.

Paralysis of lateral rectus -> diplopia (double vission) -> nausea

Name Superior Salivary nucleus

Input contains preganglionic parasympathetic fibers that contribute to the facial nerve.

Location

Notes

Lesion

GVE component pons at the level of facial and Source of preganglionic parasympathetic fibers responsible for innervating submandibular and sublingual (submandibular abducens nerve ganglion), lacrimal, nasal, mucosal glands (Pterygopalatine ganglion) Replaces the inferior salivary nucleus (which replaced the dorsal motor nucleus for vagus) pons at level of facial/abducnes nerve to midbrain at the level of the trochlear nerve Fiber tract system used by auditory system to get fibers to the next relay system in the brainstem conveys auditory information to rostral regions From the level of the trigeminal nuclei, see a reverse/normal C shape configuration: consisting of medial lemniscus, anterolateral system, and lateral lemniscus - will terminate in nucleus of lateral lemniscus (located more rostrally), unlinke medial lemniscus, which goes to the thalamus Involved in processing of auditory information from the cochlear nuclei: - Medial SO: uses interaural time differences to localize LF sounds. - Lateral SO: uses intensity differences to localize HF sounds

Lateral lemniscus

Contains fibers from other auditory systems in addition to superior olivary nucleus Receiving fibers that are both crossed and uncrossed from the cochlear nuclei Also contributes fibers to the lateral lemniscus Receive descending corticopontine fibers

Superior olivary nucleus

pons at level of facial/abducens nerve to level of priciple trigeminal nuclei

Pontine Nuclei

They are a large collection of neurons that are precerebeller/premotor nuclei, makes the buldge in pons Receive descending cortical input which mirrors what the corticospinal/nuclear tract is going to tell lower motor neurons pons at level of Going to send their axons contralaterally that form the middle cerebellar peduncles facial/abducens nerve to Correcting or modifying what the corticospinal/nuclear fibers are telling what the lower motor neurons to do to ensure also send their axons midbrain at the level of the they are doing the proper amount of work contralaterally that form the middle trochlear nerve Crossing fibers called pontocerebllar fibers cerebellar peduncles The pontocerebellar fibers are so massive, they get in the way of the coricospinal/corticonucler --> gets spread away and distributed through the basilar pons Contains crossed and uncrossed fibers from principle trigeminal nucleus Crosses as it approaches the thalamus Occupy the region called periaquaductal gray region= The gray matter that immediately surrounds the cerebral aquaduct of the mid brain Eventually do cross (not all, majority will)the uncrossed fibers are not enough to save the general sensation since most of the fibers cross *Collateral branches terminate throughout the lateral zone of the reticular formation to modulate incoming information from the trigeminal nerve.

Dorsal trigeminothalamic

pons at level of principle trigeminal nucleus to thalamus

Superior cerebellar peduncle

conveys the anterior spinocerebellar fibers to the cerebellar cortex. Also a major outflow from the cerebellum to red nucleus and thalamus.

Majority of the sup. Peduncle is a major outflow from cerebellum to brainstem or thalamus = dentatothalamic fibers Dentato = refers to dentate nucleus of the cerebellum How the cerebelleum sends fibers up to the thalamus, and eventually up to the cortex pons at level of principle Also has dentatorubro fibers= dentate nucleus to the red nucleus trigmeinal nucleus to Terminate in the rostral half of the red nucleus --> go down to the inferior olive in the central tegmental tract midbrain at level of trochlear --> back up to cerebellum nucleus At midbrain, the peduncles form the superior cerebellar desucation, where anterior spinocerebellar tract crosses for the second time. The cross happens more rostrally, and then come back down caudally after they cross (overshoot system) GSA component Misplace senesory ganglia - Started as neural crest cells, then pulled back into the cns during development Band of cells that has a tract and a nucleus Interested in stretch receptors associated with muscles of mastication Feed down to the nucleus controlling mastecation (trigeminal motor system) on the force of your bite Go to the periodontal membrane of the teeth (pressure receptor on how much you are clenching down with your jaw) - Most vissible in the rostral parts of the pons and cuadal mid brain Send some fibers to ventral trigeminothalamic. Majority of fibers go into the dorsal trigeminothalamic --> VPM pons at level of principle trigmeinal nucleus Lateral to the trigeminal nerve Replaces the spinal trigeminal nucleus

receives mainly muscle spindle pons at level of principle afferents from the jaw and related trigeminal nucleus to Mesecephalic nucleus areas of the face, which serve as midbrain at level of trochlear afferents for reflex closing of the nucleus jaw

Principle (sensory) trigeminal nucleus

receives primary afferent fibers from the face and stretch receptors from extraocular cranial nerves

Name

Input

Location

Notes

Lesion UPM lesion show no effect

Motor trigeminal nucleus

receives a bilateral innervation from the precentral gyrus that descends through the internal capsule as part of the corticonuclear fibers that terminate in the nucleus

pons at level of principle trigmeinal nucleus

Muscles innervated: Masseter, Temporalis, Medial Pterygoid, Lateral Pterygoid, Mylohyoid, Anterior belly of the Digastric, LMN lesion: Lesion of Tensor Veli Palatini, Tensor Tympani trigeminal, mandibular nerve, - Tensor tympani dampens the movement of the maleus or trigeminal motor nuc = Medial to trigeminal nerve show weakness in Replaces the spinal trigeminal nucleus mastecation and swallowing, and also show some hypersensitivity to sound Lesion of the peripheral nerve: loss of sensation ipsilateral to the lesion.

Somatic motor = innervation of skeletal muscles including: Masseter, Temporalis, Medial Pterygoid, Lateral Pterygoid, Mylohyoid, Anterior belly of the Digastric, Tensor Veli Palatini, Tensor Tympani Somatic Sensory from superior ganglion = innervation of external auditory meatus and external surface of tympanic membrane. - Central processes terminate at principle sensory trigeminal nucleus and some into spinal trigeminal nucleus - sensory fibers enter the pons where most bifurcate into short ascending fibers terminating in the principal sensory nucleus or long descending fibers that terminate throughout the length of the pons and medulla in the spinal trigeminal nucleus SOMATIC MOTOR: Efferents from - fibers form spinal trigeminal tract motor tirgeminal nucleus - All of the senosry nerves have branches. They have peripheral process that are going to stretch receptor or to the skin of the face, mucus membrane of oral cavities, bringing stretch receptor info back from the eyes (all muscles have stretch receptors. The SENSORY: Central processes from stretch info is not brought back by the occulamotor nerves, instead uses the trigemnial sensory fibers) cell bodies of origin in trigeminal - three branches (opthalmic, maxillary, mandibular) ganglion and mesencephalic - involved in the afferent loop for the corneal reflex nucleus of trigeminal nerve Corneal Reflex : Take a wisp of cotton and touch cornea --> nasocilliary branch --> trigeminal ganglion --> send afferents into the principial sensonry trig nuc and spinal trigeminal nuc (thru collaterals) --> nucleus send axons to the ipsilateral and contralateral facial motor nucleus --> The two facial motor nuclei send axons through the internal auditory meatus, facial canal, stylomastoid foramen to the orbicularis oculi (eyelid closer). = NORMAL RESPONSE: touch one eye, both eyelids blink - ALSO- the principal trigeminal sensory nucleus sends ascending axons to the cerebral cortex by way of the ventral trigeminothalamic tract and thalamocortical tracts to the cortical postcentral gyrus (tell brain something is touching eye)

Trigeminal Nerve (CN V)

Lesion of the root (central processes): loss of all sensation from the ipsilateral face and paralysis of muscles innervated by the motor component (lower motor neuron lesion). ----------------------------Lesion on afferent system: no blinking in ipsilateral nor contralateral eye - If the contralateral cornea is touched, both eyes blink. Lesion on ippsilateral facial motor nucleus (efferent system), no blink on ipsilateral side, will still blink on contralateral side -If the contralateral cornea is touched, only the contralateral eye blinks

Midbrain Nucleus of lateral lemniscus

termination of select ascending auditory fibers.

caudal midbrain to level of trochlear nucleus

termination site of lateral lemniscus

Locus (nucleus) ceruleus

involved in both arousal at the level of the forebrain and modulation of sensory perception and motor tone in the brainstem and spinal cord. -Norepinephrine synaptic contacts in the CNS contains large numbers of Rostral pons (as it is merging -Found in region becoming the periaquaductal grey noradrenergic neurons which have with midbrain) to midbrain at -Has highest concentration of NE contating neurons in the CNS extensive rostral and caudal the level of the trochlear -Its axons go both caudally and rostrally, thru the brain and the spinal cord projections throughout the CNS nucleus -Associated with memory consodilation and how we bring up prior experiences -Very localized region found on rostral pons, caudal midbrain that has widespread influences thru entire nervous system -Almost impossible to see in ligar stains -VERY visible in nissil stain

Name

Input composed mainly of tightly packed cells that surround the cerebral aqueduct contains high concentrations of enkephalin have major circuitry associated with control of pyramidal system (becomes part of the extrapyramidal system that controls the pyramidal system) Recieves fibers from cortical input, receives major input from the superior and medial vestibular nuclei (by way of the MLF) and the vertical gaze center located in midbrain/ diencephalon junction.

Location

Notes
In the base of this region we find the dorsal trigeminal thalamic tract system Find locus cerilius, parts of the mesencephalic nucleus and tract, and trochlear nerve in this region Major pain reflex control system for spinal cord control of pain =Has a major influece on how we percieve pain in the levels of the spinal cord Major descending control of pain systems and feedback system that the CNS uses to sharpen the feeling of pain at spinal cord level Part of reticular formation that contains opiod receptors = related to pain perception

Lesion

Periaquaductal/ central grey

caudal midbrain to level of occulamotor nucleus

Substantia Nigra

contains over 80% of the dopamine in the brain midbrain at the level of the involved in modulating movement initiated by the motor cortex. trochlear nucleus to They themselves do not project to the skeletal muscles pyramidal system Responsible for modifying how the motor control to lower motor neurons are carried out Become more prominent as you go more rostral UPM lesion not see since nucleus is bilaterally innervated LMN lesion: see trochlear nerve LMN lesion: cause external rotation of the eye as a result of the unopposed action of the inferior oblique --> diplopia and weakness in downward gaze

Trochlear Nucleus

midbrain at the level of the Innervates superior oblique trochlear nucleus (level of Just like the other occulatmotor nuclei, they are innervated from frontal eye fields of the frontal cortex inferior colliculus) Look for birds nest in the middle of the MLF. Egg = trochlear nucleus

Trochlear Nerve (CN IV)

Somatic motor = innervate superior oblique Leaving the trochlear nuc in a caudal direction (see the nerve before you see the nucleus) SOMATIC MOTOR: Efferents from - see the nerve first in rostral pons (as it is merging with the midbrain) trochlear nucleus Only nerve in brainstem that leaves from the dorsal side of the brainstem Located in region becomig the periaquaductal grey contains descending corticospinal/ corticonuclear tracts origin of tectospinal tract and termination of visual fibers involved in visual reflexes midbrain at the level of the At this level, can also see interpeduncular fossa occulamotor nucleus Part of the corpus quadrigemina (sup and inf colliculus) Visual system nucleus The more superficial layer associated with visual input and control of visual input Deeper layers are source of fibers that form the tectospinal tract Inferior colliculus look like beach balls, superior colliculus look like bumpslike mickey mouse ears location of lower motor neurons that innervate superior rectus, levator palpebra superioris, medial rectus, inferior rectus and inferior oblique extraocular muscles. - fibers passed anteriorly to the interpeduncular fossa between the cerebral peduncles Parasympathetic origin of the first neuron of the two neuron chain that innervates ciliaris(focus/accomodation) and sphincter pupulia (closes iris/constricts pupil) - located medially to occulamotor nucleus Recieves bilateral innervation from pretectum region

Cerebral Peduncle

Superior colliculus

midbrain at level of the occulamotor nucleus

Contains somatic motor fibers from midbrain at level of the Occulamotor nucleus prefrontal eye fields for innervation occulamotor nucleus (level of of eye muscles superior colliculus) location of preganglionic Accesory parasympathetic neurons that are midbrain at level of the occulamotor (Edinger- involved in innervation of sphincter occulamotor nucleus Westphal) nucleus pupillae and ciliaris muscles associated with the eye

Somatic motor = innervate superior rectus, levator palpebra superioris, medial rectus, inferior rectus and inferior oblique extraocular muscles Descend thru the tegmentum of the midbrain --> pass through the bassilar regions --> come out just medial to the cerebral peduncles These nerves along with other cranial nerves innervating eye muscles and V1 and V2 pass through cavernous sinus Occulamotor Nerve (CN III) SOMATIC MOTOR: Efferents from Posible LMN lession: Tumor of internal pituitary or bulging of the internal carotid = irregular eye movement on one side vs. other occulamotor nucleus - compression of LMN (ie temporal lobe herniation, aneurysms) = loose parasympathetics first - vascular problem (ie diabetes) = loose somatic efferents first - aneurysms most often involve the posterior communicating artery

LMN lesion: diplopia when the individual attempts to look laterally to the side opposite of the lesion or when the individual attempts to look up or down, deviated eye to the lateral and inferior position, ptosis, dilated pupil and inability to accommodate.

Name

Input origin of crossed, descending motor fibers that innervate skeletal muscles throughout the body.

Location midbrain at level of the occulamotor nucleus

Notes Origin of the rubrospinal tract, central tegmental tract - Some of the central tegmental tract has nothing to do with red nucleus (has to do with reticular formaiton). Therefore you see both the central tegmental tract and red nuc at this level Proper name should be cerebellorubro and cerebellothalamic fibers One group goes to red nucleus, one group goes to thalamus Also called dentatorubral or dentatothalamic fibers (dentate nucleus in cerebellum) Serves as major ascending and descending axons Ascending fibers join with CTT or MLF --> terminate in intralaminar nuclei of thalamus, hypothalamus, & cortex - responsible for increased awareness in response to sensory stimuli * important for maintaining normal state of conciousness Descending fibers: reticulospinal tracts (which receive input from basal ganglia, substantia nigra, vestibular nuclei, and cerebal corticies by way of the CTT

Lesion

Red Nucleus

Cerebellorubothalami fibers from the superior cerebellar c fibers that terminate in the red nucleus Reticular Formation

midbrain at level of the occulamotor nucleus

MRF

forms fibers for reticulospinal (uncrossed descending tract)

entire brainstem

Reticular formation lateral to superior olivary nucleus Nucleus gigantocellulais

project to nucleus solitarius, dorsal moto nuc of vagus, IML of spinal cord project to nucleus solitarius, dorsal moto nuc of vagus, IML of spinal cord Receive input from apneustic central (+) in caudal pons and pneumotaxic center (-) receive ascending fibers from spinal cord and descending fibers from higher brain regions

lateral to superior olivary nucleus

Related to cardiopressor area

medulla

related to cardiodepressor activity Ventral = reticular formation around nuc ambiguus - controls force of expiration and inspiration Dorsal = reticular formation around nu tractus solitarius - controls timing of inspiration The LRF axons terminate on medial tericular formation or cranial nerve nuclei - receive most afferent collateral branced from major sensory systems and descending inputs from motor cortex helps coordinate activities of multiple cranial nerves (ie: hypoglossal, facial, ambiguus, and trigeminal motor nuclei all together when chewing and swallowing food) Reticular formation does not stop in brainstem. In the thalamus, equivalents of the reticular formation do exist, called interlaminar nuclei - Well organized in the thalamus found within regions (unlike in brainstem) - Will find clusters of cells within them. - Contained within internal medullary lamina - Has ascending inputs into the thalamus, which will modify corticothalamic nuclei - Modify output of thalamus nuclei (ie VPM, VPL) Where we find reticular formation of the brainstem, making us aware of our surroundings Regulate sleep wake transition and attention lesion can result in coma or stupor

Respiratory area

pontine - inspiratory medulla - expiratory

LRF

entire brainstem

Intralaminar nuclei

fibers from Medial reticular formation

In the thalamus

ascending reticular activating system (ARAS)

Pain and reticular formation

Spinothalamics sending fibers to LRF --> MRF Some of the MRF sends fibers up to periaquaductal gray --> send axons cadually to raphe system --> send seratonergic axons down to the spinal cord -->terminating on lamine 1 and 2 which contain interneurons with enkephlin --> turns on interneurons that contain enkephlins (opiate), which synapse on the primary pain afferent nerves coming in (type C fibers) hyperpolarizing (inhbiting) the cells *presynaptic inhibition* - Also can synapse on neurons of nucleus proprius *postsynaptic inhibition* Enkephlin containg internurons also have inputs from prim afferents of touch receptors Rubbing a cut/bruise after you get hurt --> stimulating the enkephlin release Diverting the stimulus to the pain fibers. Quit rubbing on the fiber, pain comes back

Name

Input

Location

Notes Serves as the horizontal gaze center located slightly ventral to the abducens nucleus and has direct connections with the abducens nucleus *Has excitatory inputs to the ipsilateral abducens nucleus and excites interneurons of the abducens nucleus that send axons that cross into the contralateral MLF and synapse on oculomotor neurons that directly innervate the medial rectus. *Has inhibitory to the contralateral abducens nucleus in order to inhibit the opposing lateral rectus and the opposing medial rectus.

Lesion

PPRF

receives connections from the superior colliculus, frontal eye in medial reticular formation fields of the cerebral cortex and the and part of the raphe system vestibular complex.

Interstitial nucleus

It receives connections from the superior colliculus, frontal eye Serve as the verticle gaze center Midbrain among MLF fibers fields of the cerebral cortex and the has bilateral connections via the posterior commissure with the oculomotor nucleus and the trochlear nucleus vestibular complex recieves fibers from optic nerve that fell short to get to superior colliculus bilaterally innervate the edinger westphal (send fibers to both contralateral and ipsilateral edinger westphal) **Pupillary response light --> optic nerve --> chiasm --> tract --> pretectum --> both accesory oculamotor nucleus --> both eye's pupils constrict (normal)

Pretectum

rostral midbrain