Brainstem
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What is the brainstem?
The brainstem consists of the medulla, pons and midbrain; it excludes the cerebellum.
What are the three regions of the brainstem?
Medulla, pons and midbrain.
What are the main functions associated with the brainstem?
Ascending and descending tracts; cranial nerves; regulation of cardiovascular and respiratory systems; homeostasis; certain reflexes such as vomiting and swallowing; sleep; movement; posture; sensory processing; consciousness; and more.
What are monoaminergic nuclei?
Brainstem nuclei associated with monoamine neurotransmitters including dopamine, noradrenaline and serotonin.
What is the corticospinal tract also known as?
The pyramidal tract.
Where does the corticospinal tract decussate?
At the pyramids in the medulla.
What is motor decussation?
The crossing of the corticospinal tract at the pyramids of the medulla.
Approximately what percentage of the corticospinal tract does not cross?
Approximately 10%.
What does the portion of the corticospinal tract that does not cross form?
The anterior corticospinal tract.
What information is carried in the dorsal columns?
Conscious proprioception, fine touch and vibration.
What are the two dorsal column pathways?
Gracile and cuneate.
What does the gracile pathway carry?
Input from the lower half of the body.
What does the cuneate pathway carry?
Input from the upper half of the body.
Where do first-order sensory neurons in the dorsal column pathway synapse?
On second-order neurons in the dorsal column nuclei: the gracile or cuneate nucleus.
What happens after first-order dorsal column sensory neurons synapse in the dorsal column nuclei?
Decussation occurs before the information projects to the thalamus.
What is sensory decussation in the dorsal column pathway?
The crossing of information carried by the dorsal columns after synapsing in the gracile or cuneate nuclei and before projecting to the thalamus.
Which cranial nerves are visible on the ventral surface of the cerebrum?
CN I (olfactory) and CN II (optic).
Which cranial nerves are visible on the ventral surface of the brainstem?
CN III through CN XII.
What is CN I?
Olfactory.
What is the primary function of CN I (olfactory)?
Smell (olfaction).
What type of cranial nerve is CN I?
Sensory.
What is CN II?
Optic.
What is the primary function of CN II (optic)?
Vision.
What type of cranial nerve is CN II?
Sensory.
What is CN III?
Oculomotor.
What is the primary function of CN III (oculomotor)?
Eye movements, pupils and eyelids.
What type of cranial nerve is CN III?
Motor.
What is CN IV?
Trochlear.
What is the primary function of CN IV (trochlear)?
Downward and inward eye movements.
What type of cranial nerve is CN IV?
Motor.
What is CN V?
Trigeminal.
What is the primary function of CN V (trigeminal)?
Facial sensation and muscles for chewing.
What type of cranial nerve is CN V?
Mixed: sensory and motor.
What is CN VI?
Abducens.
What is the primary function of CN VI (abducens)?
Lateral eye movements.
What type of cranial nerve is CN VI?
Motor.
What is CN VII?
Facial.
What is the primary function of CN VII (facial)?
Taste and muscles of facial expression.
What type of cranial nerve is CN VII?
Mixed: sensory and motor.
What is CN VIII?
Vestibulocochlear.
What is the primary function of CN VIII (vestibulocochlear)?
Hearing and balance.
What type of cranial nerve is CN VIII?
Sensory.
What is CN IX?
Glossopharyngeal.
What is the primary function of CN IX (glossopharyngeal)?
Taste, swallowing and blood pressure.
What type of cranial nerve is CN IX?
Mixed: sensory and motor.
What is CN X?
Vagus.
What is the primary function of CN X (vagus)?
Autonomic function such as blood pressure; sensation from the larynx and pharynx; muscles of the vocal cords; swallowing; and more.
What type of cranial nerve is CN X?
Mixed: sensory and motor.
What is CN XI?
Accessory.
What is the primary function of CN XI (accessory)?
Shoulder and neck muscles.
What type of cranial nerve is CN XI?
Motor.
What is CN XII?
Hypoglossal.
What is the primary function of CN XII (hypoglossal)?
Movements of the tongue.
What type of cranial nerve is CN XII?
Motor.
Which cranial nerves are sensory only?
CN I (olfactory), CN II (optic) and CN VIII (vestibulocochlear).
Which cranial nerves are motor only?
CN III (oculomotor), CN IV (trochlear), CN VI (abducens), CN XI (accessory) and CN XII (hypoglossal).
Which cranial nerves are mixed?
CN V (trigeminal), CN VII (facial), CN IX (glossopharyngeal) and CN X (vagus).
What is the mnemonic for the names and order of the cranial nerves?
Oh Once One Takes The Anatomy Final, Very Good Vacations Are Had.
What does the mnemonic "Oh Once One Takes The Anatomy Final, Very Good Vacations Are Had" represent?
The names and order of cranial nerves I–XII.
What is the mnemonic given for the roles of the cranial nerves?
Some Say Money Matters, But My Brother Says Big Brains Matter More.
What does the mnemonic "Some Say Money Matters, But My Brother Says Big Brains Matter More" represent?
The sensory/motor classification of cranial nerves I–XII.
What is a clinical example given for testing CN I?
Identifying a familiar smell.
What is a clinical example given for testing CN II?
Eye examination for acuity and visual field.
What is a clinical example given for testing CN VIII?
A hearing test.
What is a clinical example given for testing CN III?
Pupil reaction to light.
What is a clinical example given for testing CN IV and CN VI?
Eye movement and control.
What is a clinical example given for testing CN XI?
Shrugging the shoulders or turning the head against resistance.
What is a clinical example given for testing CN XII?
Tongue movements.
What is a clinical example given for testing CN VII?
Observing facial expressions.
What is a clinical example given for testing CN IX and CN X?
Swallowing and voice.
What are the two respiratory groups found in the medulla?
The dorsal respiratory group (DRG) and ventral respiratory group (VRG).
What respiratory centres are found in the pons?
The apneustic centre and pneumotaxic centre.
What does the medulla contain in relation to respiratory control?
The dorsal respiratory group (DRG) and ventral respiratory group (VRG).
What does the pons contain in relation to respiratory control?
The apneustic centre and pneumotaxic centre.
Where are the cardiovascular centres found?
In the medulla.
What type of control do the cardiovascular centres in the medulla exert?
Sympathetic or parasympathetic control of cardiac function.
What example of cardiovascular regulation is given in the lecture?
The baroreceptor reflex.
Where is dopamine mainly synthesised in the brain according to the lecture?
The ventral tegmental area (VTA) and substantia nigra (SN), both located in the midbrain.
What are the major sites of dopamine synthesis mentioned in the lecture?
The ventral tegmental area (VTA) and substantia nigra (SN).
Where is the locus coeruleus located?
In the pons.
What neurotransmitter is associated with the locus coeruleus?
Noradrenaline.
Where are the raphe nuclei found?
In the midbrain, pons and medulla.
What neurotransmitter is associated with the raphe nuclei?
Serotonin.
What are the raphe nuclei part of?
The reticular formation.
What does the reticular formation control according to the lecture?
Arousal, including sleep, attention and consciousness.
Where are the ventral tegmental area and substantia nigra located?
In the midbrain.
Where is the locus coeruleus located?
In the pons.
Where are the raphe nuclei located?
In the midbrain, pons and medulla.
Which neurotransmitter is associated with the VTA and substantia nigra?
Dopamine.
Which neurotransmitter is associated with the locus coeruleus?
Noradrenaline.
Which neurotransmitter is associated with the raphe nuclei?
Serotonin.
What are the three main learning outcomes of this lecture?
Identify major anatomical landmarks of the brainstem; identify the name, number and primary functions of the 12 cranial nerves; and describe sensory, motor and autonomic functions linked to the brainstem.