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D. MEDULLA OBLONGATA INTERNAL STRUCTURE. BRAIN STEM. DORSAL SURFACE. VENTRAL SURFACE. CAUDAL MEDULLA ( LEVEL OF PYRAMIDAL DECUSSATION). FG. DMS. FC. GN. ST5. Central grey matter. CN. SN5. Central canal. DSC. PD. VSC. P. VMF. CAUDAL MEDULLA ( LEVEL OF PYRAMIDAL DECUSSATION).
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D MEDULLA OBLONGATA INTERNAL STRUCTURE
BRAIN STEM DORSAL SURFACE VENTRAL SURFACE
CAUDAL MEDULLA(LEVEL OF PYRAMIDAL DECUSSATION) FG DMS FC GN ST5 Central grey matter CN SN5 Central canal DSC PD VSC P VMF
CAUDAL MEDULLA(LEVEL OF PYRAMIDAL DECUSSATION) • DMS: Dorsal median sulcus • FG: fasciculus gracilis • GN: Gracile nucleus • FC: Fasciculus cuneatus • CN: Cuneate nucleus • SN5: Spinal nucleus of trigeminal nerve • ST5: Spinal tract of trigeminal nerve • P: Pyramid • PD: Pyramidal decussation • DSC: Dorsal spinocerebellar tract • VSC: Ventral spinocerebellar tract • VMF: Ventral median fissure
CAUDAL MEDULLA(LEVEL OF PYRAMIDAL DECUSSATION) • GREY MATTER: • Sensory nuclei: Gracile, cuneate, spinal nucleus of trigeminal • WHITE MATTER: • Ascending tracts: Gracile, cuneate, spinal tract of trigeminal, dorsal & ventral spinocerebellar, spinal leminiscus • Descending tracts: Pyramidal & extrapyramidal tracts
CAUDAL MEDULLA(LEVEL OF PYRAMIDAL DECUSSATION) • Pyramidal decussation:Most of the fibers of pyramid decussate then pass laterally & dorsally to form the lateral corticospinal tract that descend in the lateral white column of spinal & terminate in ventral horn cells of opposite side • Spinal nucleus of trigeminal:It lies in the lower part of pons, the whole medulla & extends to the 2nd cervical segment of spinal cord where it is continuous with substantia gelatinosa. It receives pain & temperature sensations from the face along trigeminal nerve
CAUDAL MEDULLA(LEVEL OF PYRAMIDAL DECUSSATION) • Dorsal & ventral spinocerebellar tracts: They carry proprioceptive fibers to the cerebellum through inferior cerebellar peduncle (dorsal) & superior cerebellar peduncle (ventral) • Gracile &Cuneate tracts: They carry proprioceptive & fine touch sensations & end in Gracile & Cuneate nuclei (2nd order neurones in dorsal column tract)
MID MEDULLA(LEVEL OF SENSORY DECUSSATION) DMS Central grey matter FG FC GN CN Central canal ST5 SN5 Internal Arcuate Fibers DSC M L VSC Sensory Decussation P VMF
MID MEDULLA(LEVEL OF SENSORY DECUSSATION) • GREY MATTER: • Sensory nuclei: Gracile, cuneate, spinal nucleus of trigeminal • WHITE MATTER: • Ascending tracts: gracile, cuneate, spinal tract of trigeminal, dorsal & ventral spinocerebellar, spinal leminiscus • Descending tracts: Pyramidal & extrapyramidal tracts
MID MEDULLA(LEVEL OF SENSORY DECUSSATION) • Gracile & cuneate nuclei: They are more prominent. Axons of cells of gracile & cuneate nuclei curve around the central canal as internal arcuate fibers then decussate forming the sensory decussation & ascend in the brain stem as medial leminiscus that end in the ventral posterolateral nucleus of thalamus • Pyramid: They are more prominent
BRAIN STEM VENTRAL SURFACE DORSAL SURFACE
ROSTRAL MEDULLA DCN 4TH V MV LV V H S ICP VCN M L F A D Vagus Nerve I.O. ML M Hypoglossal Nerve P VMF
ROSTRAL MEDULLA • H: Hypoglossal nucleus • V: Dorsal vagal nucleus • S: Nucleus solitarius • A: nucleus ambiguus • MV: Medial vestibular nucleus • LV: Lateral vestibular nucleus • DCN: Dorsal cochlear nucleus • VCN: Ventral cochlear nucleus • ICP: Inferior cerebellar peduncle • I.O.: Inferior olive • D: Dorsal accessory olive • M: Medial accessory olive • MLF: Medial longitudinal fascisulus • ML: Medial leminiscus • P: Pyramid • VMF: Ventral median fissure
ROSTRAL MEDULLA • GREY MATTER: • Motor nuclei: Hypoglossal, dorsal vagal, nucleus ambiguus • Sensory nuclei: Nucleus solitarius, medial & lateral vestibular nuclei, dorsal & ventral cochlear nuclei, spinal nucleus of trigeminal • Extrapyramidal nuclei: Inferior olive, medial & dorsal accessory olive
ROSTRAL MEDULLA • WHITE MATTER: • Ascending tracts: Medial leminiscus, spinal leminiscus, spinal tract of trigeminal, ventral spinocerebellar tract • Descending tracts: Pyramidal & extrapyramidal tracts • Both ascending & descending tract: Medial longitudinal fasciculus • Inferior cerebellar peduncle: fibers connecting medulla to cerebellum
ROSTRAL MEDULLA • Hypoglossal nucleus: It lies in the medial part of floor of 4th ventricle. It contains motor neurones innervating muscles of tongue (except palatoglossus) through hypoglossal nerve • Dorsal vagal nucleus:It lies in the floor of 4th ventricle , lateral to hypoglossal nucleus. It contains preganglionic parasympathetic neurones running in the vagus nerve • Nucleus Solitarius:It lies ventrolateral to dorsal vagal nucleus. It receive taste fibers from facial, glossopharyngeal & vagus nerves
ROSTRAL MEDULLA • Nucleus ambiguus:It lies dorsal to inferior olivary nucleus. It contains motor neurones innervating muscles of pharynx, palate & larynx through glossopharyngeal, vagus & cranial part of accessory nerves • Medial & lateral vestibular nuclei:They lie in the floor of 4th ventricle, lateral to dorsal vagal nucleus. They receive afferent fibers from vestibular nerve • Dorsal & ventral cochlear nuclei:They lie dorsal (dorsal nucleus) & lateral (ventral nucleus) to ICP. They receive afferent fibers from cochlear nerve
ROSTRAL MEDULLA • Olivary nuclear complex:It is formed of a large nucleus (inferior olive) & 2 smaller nuclei (medial & dorsal accessory olive). • Afferents: From cerebral cortex & spinal cord • Efferents: To cerebellum through ICP • Function: They are concerned with control of movement
ROSTRAL MEDULLA • Medial longitudinal fasciculus:It consists of both ascending & descending fibers: • Ascending fibers: connect vestibular nuclei to nuclei supplying extraoccular muscles (occulomotor, trochlear & abducent nuclei). It coordinates movements of head & eyes • Descending fibers: connect vestibular nuclei to nuclei of ventral horn of spinal cord (medial vestibulospinal tract). It control body posture & balance
ROSTRAL MEDULLA • Spinal leminiscus: It carries pain, temperature & touch sensations from the opposite side of body to ventral posterolateral nucleus of thalamus • Inferior cerebellar peduncle: It is formed of fibers connecting medulla to cerebellum