Pons Medulla
Pons Medulla
Pons Medulla
Pons
basilar groove
cerebral peduncle of
midbrain
transverse fibers
6
middle cerebellar
peduncle
medulla
cerebellum
substantia ferruginea
midbrain
superior cerebellar peduncle
median sulcus
sulcus
limitans
medial eminence
vestibular area
facial colliculus
inferior cerebellar peduncle
medulla
spinal lemniscus
transverse fibers
medial lemniscus
trapezoid body
Bundles of corticospinal
and corticonuclear fibers
medial vestibular n.
inferior cerebellar
peduncle
facial colliculus
nucleus of abducent
middle cerebellar
peduncle
trapezoid body
pontine nuclei
Medulla
medulla
pons
(9)
(10)
hypoglossal
nerve
(11)
central canal
central canal
cuneate tubercle
gracile tubercle
corticospinal tract
anterior spinocerebellartract
level of decussation
of the pyramid
anterior median
fissure
posterior median
sulcus
spinal nucleus of trigeminal
nerve
fasciculus gracilis
nucleus gracilis
fasciculus cuneatus
nucleus cuneatus
central canal
anterior median
fissure
level of decussation
of the pyramid
nucleus gracilis
nucleus cuneatus
spinal nucleus of
trigeminal nerve
hypoglossal nucleus
nucleus cuneatus
spinal root of
accessory nerve
spinal nucleus of
trigeminal nerve
decussation of medial lemnisci
pyramid
reticular formation
tectospinal tract
medial lemniscus
pyramids
olives
hypoglossal nerve
nucleus ambiguus
1.
.
2. Vestibular nuclear complex:
a. medial vestibular
b. inferior vestibular
c. lateral vestibular
d. superior vestibular
3. Cochlear nuclei: the anterior and posterior
4. Nucleus ambiguus
5. Nucleus of tractus solitarius
6. Dorsal nucleus of the vagus
7. Hypoglossal nuclei
8. Arcuate nuclei
reticular formation
medial lemniscus
pyramid
Rule of four
1. There are 4 structures in the midline beginning with M
1. Glossopharyngeal (CN9):
2. Vagus (CN10)
3. Spinal accessory (CN11):
4. Hypoglossal (CN12):
Trigeminal (CN5
Abducent (CN6)
Facial (CN7)
Vestibulocochlear (CN8)
1. Olfactory (CN1):
2. Optic (CN2):
3. Oculomotor (CN3):
4. Trochlear (CN4):
Affected Structures
1. Nucleus ambiguus
2. Spinal nucleus of trigeminal
3. Vestibular nuclei
4. Inferior cerebellar peduncle
5. Spinal lemniscus/spinothalamic
tract
Affected Structures
1. Nucleus ambiguus (dysphagia and dysarthria)
2. Spinal nucleus of trigeminal (analgesia and
thermoanesthesia on the ipsilateral side of the face)
3. Vestibular nuclei (vertigo, nausea, vomiting, nystagmus)
4. Inferior cerebellar peduncle ipsilateral cerebellar signs gait and limb ataxia
5. Spinal lemniscus/spinothalamic tract (contralateral loss of
sensation of pain and temperature)
6. Descending sympathetic fibers - ipsilateral Horner Syndrome
Affected structures:
1. facial nerve nucleus
weakness of facial muscles
2. abducent nerve nucleus
weakness of the lateral rectus muscle
3. vestibular nucleus
nystagmus
4. trigeminal nerve
weakness of the jaw muscles
5. cochlear nucleus
impairment of hearing
6. corticospinal fibers
contralateral hemiparesis
7. medial and spinal lemniscus
contralateral sensory defects of the trunk and
limbs