MEDULLA OBLONGATA

Inferior olive
coronal

Human, 10% formalin, Pal-Weigert and carmine stains, 7 x.

Nucleus gracilis: Fully developed at this level. Only a small remnant of the
fasciculus gracilis caps the nucleus.
Cuneate nucleus and tract: Note that a definite portion of the fasciculus cuneatus
caps the nucleus cuneatus as compared to that seen on the adjacent nucleus gracilis.
The lightly stained island in the fasciculus cuneatus represents neurons of the
accessory cuneate nucleus.
Spinal tract and nucleus of nerve V: Continuation of similar structures seen at
more caudal levels (see Plates 324 and 328 ).
Medial longitudinal fasciculus: Note the change of position of the fasciculus in
this figure as compared to a more caudal level (see Plate 328 ). This is a result of
the formation of the medial lemniscus, which displaces the medial longitudinal
fasciculus to a more dorsal location.
Principal and medial accessory inferior olive: This nuclear group distinguishes
sections of the medulla at this level. The principal olive is the larger component
with its hilum directed medially. The medial accessory olive is found along the
border of the medial lemniscus. Inferior olive neurons give rise to olivocerebellar
fibers that project into the cerebellum.
Pyramid: See the same structure at more caudal levels. Plates 324, 325, 326, 328,
and 329.
Internal arcuate fibers: See also Plate 328, Axons of gracile and cuneate neurons.
Spinocerebellar tract: See also Plates 317, 324, 327, and 328. Continuation of the
same tract seen in the spinal cord.
Medial lemniscus: Formed by the decussating internal arcuate fibers. Constitutes
the second-order neurons of the posterior column pathways (fasciculi gracilis and
cuneatus and their nuclei), conveying kinesthetic sense and discriminative touch to
higher levels of the neuraxis.
Nerve XII rootlets: Hypoglossal cranial nerve. Note their characteristic location
medial to the inferior olive and lateral to the pyramid. This proximity to the
pyramid is the anatomical basis for the inferior or hypoglossal alternating
hemiplegia resulting from lesions in this area. This syndrome (also known as
medial medullary syndrome) consists of lower motor neuron paralysis of the
ipsilateral half of the tongue and contralateral (upper motor neuron) hemiplegia.
The hypoglossal nerve supplies all the intrinsic and extrinsic muscles of the tongue
except the palatoglossus muscle.






















MEDULLA OBLONGATA
Inferior olive
coronal


Choroid plexus: Located in the caudal part of the roof of the fourth ventricle.
Inferior vestibular nucleus: One of four vestibular nuclei. Characteristically
located medial and dorsal to the restiform body, and traversed by myelinated
bundles.
Tractus solitarius: Contains general visceral as well as special visceral (taste)
fibers from the vagus, glossopharyngeal, and facial nerves. Fibers project onto
neurons in the nucleus solitarius located in close proximity to the tract.
Nucleus solitarius: Located in close proximity to the tractus solitarius, from which
it receives fibers.
Hypoglossal (CN XII) nucleus: A group of large neurons located dorsal to the
medial longitudinal fasciculus in the floor of the fourth ventricle in a paramedian
position. Rootlets of hypoglossal nerve course in tegmentum of medulla between
the medial lemniscus and inferior olive.
Hypoglossal (CN XII) rootlets: Coursing in the tegmentum of the medulla
oblongata between the medial lemniscus and the inferior olive. Exit from the
ventral surface of the medulla between the pyramid and inferior olive.
Dorsal accessory olive: A component of the inferior olivary complex located
dorsal to the principal olive.
Medial longitudinal fasciculus: Descending portion of a fiber system with
ascending and descending components. Neurons of origin are from various brain
stem nuclei, but with a major vestibular component. The fibers descending in this
fasciculus are destined to synapse on motor neurons in the cervical region of the
spinal cord, which supply neck musculature.
Accessory cuneate nucleus: Receives fibers of the dorsal spinocerebellar tract
entering the spinal cord above the eighth cervical segment. Projects to the
cerebellum via the restiform body.
Restiform body: Also known as the inferior cerebellar peduncle. A compact
bundle of nerve fibers connecting the medulla with the cerebellum. Described first
in 1695 and named by Humphrey Ridley, an English anatomist. Tracts and fibers
forming this bundle originate in the medulla and the spinal cord.
Nucleus of spinal tract of trigeminal (CN V) nerve: Receives exteroceptive
fibers from the ipsilateral side of the face via the spinal tract of the trigeminal
nerve. Lesions result in loss of pain sensation in the ipsilateral face.
Medial lemniscus: Axons of gracile and cuneate nuclei. Forward continuation of
the same structure seen in more caudal sections.
Principal inferior olive: Located dorsal and lateral to the pyramid. Note the
characteristic convoluted appearance. The principal inferior olive is the largest
component of the inferior olivary complex, which includes, in addition, the dorsal
accessory inferior olive and the medial accessory inferior olive.
Pyramid: Heavily myelinated motor fiber system. Represents descending fibers
from the cerebral cortex that pass through the internal capsule, cerebral peduncle,
and pons before reaching the medullary pyramids. Fibers in the pyramid undergo
partial crossing in the motor decussation to give rise to the lateral corticospinal
tract. It is estimated that, in man, about one million fibers are present in each
pyramid.




MEDULLA OBLONGATA
Cochleovestibular and
Glossopharyngeal nerves
coronal

Human, 10% formalin, Pal-Weigert, 3.8 x.

Medial longitudinal fasciculus: Descending portion of a fiber system with
ascending and descending components. Neurons of origin are from various brain
stem nuclei, but with a major vestibular component. This system is concerned with
eye and neck movements. The fibers in the descending component are destined to
synapse on motor neurons in the cervical spinal cord that supply neck musculature.
Medial lemniscus: Continuation of the same system noted in caudal sections.
Glossopharyngeal (CN IX) nerve: A mixed nerve. Characteristically enters the
medulla, inferior and medial to the restiform body.
Amiculurn olivae: A bundle of fibers surrounding the inferior olivary complex.
Contains fibers that terminate on neurons of the olivary complex.
Inferior olive: Convoluted laminae of gray matter dorsal to the pyramid. Receives
fibers from cortical and subcortical sites and projects fibers primarily to the
contralateral but also to the ipsilateral cerebellum via the restiform body.
Concerned with motor control.
Pyramid: Heavily myelinated motor fiber system. Contains descending fibers
from the cerebral cortex that pass through the internal capsule, cerebral peduncle,
and pons before reaching the pyramids. Fibers in the pyramid undergo partial
crossing in the motor decussation caudal to this level.
Arcuate nucleus: Motor neurons ventral to the pyramid. Receives cortical input
and projects to the cerebellum via the stria medullaris and restiform body.
Homologous to pontine nuclei.
Olivocerebellar tract: Axons of neurons in the inferior olivary complex. Fibers
arise from both olivary complexes but primarily from the contralateral complex.
Destined for the cerebellum via inferior cerebellar peduncle (restiform body).
Olivocerebellar fibers constitute the major component of the restiform body.
Cochlear (CN VIII) nerve: Central processes of bipolar neurons in the spiral
ganglion. Enters the lateral surface of the pons lateral and dorsal to the restiform
body. Projects upon the dorsal and ventral cochlear nuclei. Lesions in the cochlear
nerve result in ipsilateral loss of hearing.
Ventral cochlear nucleus: Located ventral and lateral to the restiform body.
Receives axons of the cochlear nerve originating in the upper turns of the cochlea.
Restiform body: Also known as inferior cerebellar peduncle. A compact bundle of
nerve fibers connecting the medulla with the cerebellum. Tracts and fibers forming
this bundle originate in the medulla and the spinal cord.
Dorsal cochlear nucleus: Characteristically located dorsal and lateral to the
restiform body. Receives axons of the cochlear nerve originating in the lower turns
of the cochlea.
Inferior vestibular nucleus: One of four vestibular nuclei. Characteristically
located medial to the restiform body and traversed by myelinated bundles.
Stria medullaris: Axons of arcuate neurons. Courses in the floor of the fourth
ventricle. Joins the restiform body to reach the cerebellum.
Medial vestibular nucleus: One of four vestibular nuclei. Characteristically
located medial to the inferior vestibular nucleus in the floor of the fourth ventricle.
Axons of neurons in this nucleus form the medial vestibulospinal tract.




PONS
Trapezoid body coronal

Human, 10% formalin, Pal-Weigert, 2.5 x.

Vermis of the cerebellum: Overlying the fourth ventricle. Midline portion of
cerebellum.
Medial longitudinal fasciculus: Continuation of the same structure seen at more
caudal levels. Concerned with ocular movement in response to vestibular
stimulation.
Central tegmental tract: Compact fiber bundle located dorsal to the medial
lemniscus. Carries fibers from midbrain tegmenturn, red nucleus, and
periaqueductal gray matter to the inferior olivary complex.
Superior olivary nucleus: One of the tegmental nuclei that belong to the cochlear
system. Receives fibers from the trapezoid body and contributes to the formation
of the lateral lemniscus.
Trapezoid body: Also known as the inferior acoustic stria. Axons of neurons in
the inferior cochlear nucleus form the trapezoid body.
Pontocerebellar tract: Axons of pontine nuclei on their way to the cerebellum via
the brachiurn pontis.
Pontine nuclei: Scattered between the descending corticospinal, corticopontine,
and corticobulbar fibers and the horizontally oriented pontocerebellar fibers.
Receive input from the cerebral cortex via the corticopontine tract and project to
cerebellum via the pontocerebellar tract.
Brachium conjunctivum: Also known as the superior cerebellar peduncle. Most
important efferent fiber system of the deep cerebellar nuclei. Located dorsolateral
to the fourth ventricle. Later in its course, it dips into the tegmenturn of the pons
and midbrain (see Plates 337, 338 and 339). Nerve fibers in this bundle are
destined to reach the contralateral red nucleus and ventrolateral nucleus of the
thalamus.
Restiform body: Also known as the inferior cerebellar peduncle. Continuation of
the same fiber system seen at more caudal levels. The restiform body is shown here
entering the cerebellum.
Brachium pontis: A massive bundle of fibers connecting the basal portion of the
pons with the cerebellum. Also known as the middle cerebellar peduncle. Contains
pontocerebellar tract.
Spinal tract and nucleus of trigerninal nerve: Continuation of the same
structures described at caudal levels.
Medial lemniscus: Continuation of the same fiber system described at more
caudal levels (see Plates 329, 330 and 331). Note change in orientation of fibers
from (previously) vertical in medulla oblongata to horizontal here in the pons.
Corticospinal, corticopontine, corticobulbar tracts: Descending fiber system
sectioned transversely. Destined for the pontine nuclei, cranial nerve nuclei, and
the spinal cord motoneurons.









PONS
Facial and abducens
nerves coronal

Human, 10% formalin, Pal-Weigert, 2.2 x.

Genu of facial (CN VII) nerve: A bundle of facial nerve fibers in the floor of the
fourth ventricle.
Brachium conjunctivum: Also known as the superior cerebellar peduncle. Most
important efferent fiber system of the deep cerebellar nuclei. Located clorsolateral
to the fourth ventricle.
Superior vestibular nucleus: Located dorsal and medial to the restiform body.
One of four vestibular nuclei. Receives fibers from the vestibular component of the
vestibulocochlear (CN VIII) nerve and projects fibers to the cerebellum via the
restiform body and to nuclei of extraocular movement via the medial longitudinal
fasciculus.
Facial (CN VII) nerve: Coursing ventrolaterally to emerge at the lateral border of
the pons.
Facial nucleus: Located medial to the facial nerve. Axons of neurons in the facial
nucleus course medially and dorsally to reach the floor of the fourth ventricle
(genu of facial nerve) before turning laterally and ventrally to exit from the lateral
surface of the pons.
Abducens nerve: Rootlets of the abducens nerve are seen coursing in the
tegmenturn of the pons. They arise from the medial aspect of the nucleus and exit
from the ventral surface at the caudal border of the pons. Supply the lateral rectus
muscle of the eye.
Medial lemniscus: Continuation of the same structure seen at more caudal and
more rostral levels.
Pontocerebellar tract: Continuation of the same structure seen at more caudal
levels. Axons of pontine nuclei destined for the cerebellum.
Pontine nuclei: Scattered between pontocerebellar fibers and the corticospinal,
corticopontine, and corticobulbar fibers. Relay station between the cerebral cortex
and cerebellum.
Corticospinal, corticopontine, corticobulbar tracts: Long descending fiber
system originating in the cerebral cortex. Sectioned transversely as it passes
through the basal portion of the pons.
Abducens nucleus: Located in a paramedian position in the floor of the fourth
ventricle. Axons of neurons in this nucleus emerge from the medial aspect of the
nucleus to form the abducens nerve. Lesions of the abducens nucleus result in
ipsilateral paralysis of lateral gaze. The abducens nucleus and the adjacent genu of
facial nerve together form the facial colliculus, a paramedian elevation in the floor
of the fourth ventricle.
Brachium pontis: A massive bundle of fibers connecting the basal portion of the
pons with the cerebellum. Also known as the middle cerebellar peduncle.
Restiform body: Continuation of the same structure seen at more caudal levels.
Seen entering the cerebellum.
Dentate nucleus: The largest of the deep cerebellar nuclei. Axons of this nucleus
are major components of the brachium conjunctivum.
Facial colliculus: A paramedian elevation in the floor of the fourth ventricle
overlying the abducens nucleus and the genu of the facial nerve.



PONS
Trigeminal nerve coronal

Human, 10% formalin, Pal-Weigert, 2.4 x.

Fourth ventricle: The anterior part of the fourth ventricle overlying the pons.
Brachium conjunctivum: Massive outflow tract from the cerebellum seen at this
level prior to decussation. Lesions in this area will result in a disorder of
coordinated movement. Note the change in position of this structure in more rostral
sections (see Plates 337, 338 and 339).
Principal (main) sensory nucleus of trigerninal (CN V) nerve: Located lateral
to the motor nucleus of the trigeminal. Receives touch sensations from the
ipsilateral face via the trigeminal nerve.
Motor nucleus of trigerninal (CN V) nerve: Located in the dorsal part of the
tegmentum. Axons form the motor root of the trigerninal nerve and supply muscles
of mastication, and the tensor tympani, tensor palati, mylohyoid, and the anterior
belly of the digastric muscles.
Brachium pontis: Also known as the middle cerebellar peduncle. A massive
bundle of fibers connecting the basal portion of the pons with the cerebellum.
Contains pontocerebellar fibers.
Pontocerebellar tract: Axons of pontine nuclei destined for the cerebellum via the
brachium pontis.
Corticospinal, corticopontine, corticobulbar tracts: Long descending fiber
system originating in the cerebral cortex. Sectioned transversely as it passes
through the basal portion of the pons. Note the horizontally oriented
pontocerebellar tract.
Medial lemniscus: Continuation of the same system seen in more caudal levels.
Trigeminal nerve: Sensory-motor cranial nerve. Seen coursing in the lateral part
of the pons.
Central tegmental tract: Compact fiber bundle located in the tegmenturn of the
pons. Carries fibers from midbrain tegmentum, red nucleus, and periaqueductal
gray matter to the inferior olivary complex.
Medial longitudinal fasciculus: Ascending component of a fiber system
originating in vestibular nuclei and destined to synapse with neurons in nuclei of
extraocular movement (CN III, IV, and VI). Concerned with control of eye
movement.
Superior medullary velum: Forms the anterior (superior) part of the roof of the
fourth ventricle.













PONS
Trigeminal nerve coronal

Human, 10% formalin, Pal-Weigert, 2.5 x.

Brachium conjunctivum: Also known as superior cerebellar peduncle. Contains
axons of deep cerebellar nuclei destined for the red nucleus and thalamus. Forms
part of the lateral wall of the fourth ventricle.
Central tegmental tract: A compact fiber bundle located dorsal to the lateral part
of the medial lemniscus. Carries fibers from midbrain tegmentum, red nucleus, and
periaqueductal gray matter to the inferior olivary complex.
Brachium pontis: Also known as the middle cerebellar peduncle. Massive bundle
of fibers connecting the basal portion of the pons with the cerebellum. Contains
pontocerebellar fibers from the contralateral half of the pons. Some pontocerebellar
fibers from the ipsilateral half of the pons are also contained in the brachium pontis.
Trigeminal (CN V) nerve: A mixed nerve with a larger sensory component
(portio major) and a smaller motor component (portio minor).
Pontine nuclei: Located in the basal part of the pons. Continuous caudally with
arcuate nuclei in the medulla oblongata. Receive corticofugal fibers and project
(pontocerebellar tract) mainly to the contralateral cerebellum.
Corticospinal, corticopontine, corticobulbar tracts: A long descending fiber
system sectioned transversely as it courses through the basal part of the pons.
Pontocerebellar tract: Axons of pontine nuclei destined for the cerebellum.
Constitutes the major component of the middle cerebellar peduncle (brachium
pontis).
Medial lemniscus: Continuation of the same fiber system noted in several more
caudal levels. Note the change of orientation of this fiber bundle from a vertical
orientation in the medulla to a horizontal orientation at this level.
Lateral lemniscus: Continuation of trapezoid body. Conveys auditory impulses.
Medial longitudinal fasciculus: The ascending component of this fasciculus.
Contains fibers from the vestibular nuclei destined for the nuclei of extraocular
movement. Lesions of the medial longitudinal fasciculus at this level will result in
a characteristic clinical picture known as internuclear ophthalmoplegia.


















PONS- MESENCEPHALIC JUNCTION
Trochlear nerve coronal

Human, 10% formalin, Pal-Weigert, 2.9 x.

Brachium conjunctivum: Massive outflow tract of the cerebellum. Fibers are
seen just prior to and beginning decussation. Fibers project, after decussation, into
the red nucleus and ventrolateral nucleus of the thalamus. Lesions in this tract
result in a disorder of coordinated movement.
Pontocerebellar tract: The same structure seen at more caudal levels.
Corticospinal, corticopontine, corticobulbar tracts: The same structures seen at
more caudal levels. Cut in cross section as they descend to lower caudal levels.
Pontine nuclei: Scattered between pontocerebellar fibers and the corticospinal,
corticopontine, and corticobulbar tracts.
Brachium pontis: Axons of pontine nuclei on their way to the cerebellum.
Medial lemniscus: Continuation of the same structure seen at more caudal levels.
Spinal lemniscus: Continuation of the same structure seen at more caudal levels.
Contains spinothalamic and spinotectal fibers.
Lateral lemniscus: Contains cochlear fibers. Located laterally and dorsally on its
way to the inferior colliculus and medial geniculate body. Concerned with audition.
Trochlear (CN IV) nerve: Seen exiting from the dorsal aspect of the midbrain
after decussating. The fourth cranial nerve supplies the superior oblique
extraocular muscle. The only cranial nerve to decussate (cross) completely prior to
leaving the neuraxis.
Central tegmental tract: Compact fiber bundle located medial to the brachium
conjunctivum. Carries fibers from the midbrain tegmentum, red nucleus, and
periaqueductal gray matter to the inferior olivary complex. Note change in position
of this tract in more caudal levels.
Medial longitudinal fasciculus: Continuation of same structure seen at more
rostral and more caudal levels.
Decussation of trochlear (CN IV) nerve: Axons of neurons in the trochlear
nucleus seen decussating prior to exit from the dorsal surface of the neuraxis.


















MESENCEPHALON
Inferior colliculus coronal

Human, 10% formalin, Pal-Weigert, 2.7 x.

Aqueduct of Sylvius: Connecting the third and fourth ventricles. Sylvius (Jacques
Dubois) was a sixteenth -century French anatomist.
Trochlear (CN IV) nucleus: Motor neurons located in a paramedian position
dorsal to the medial longitudinal fasciculus. Axons of neurons in trochlear nucleus
decussate prior to leaving the neuraxis (see Plate 337).
Inferior colliculus: Ovoid cellular mass in the tecturn of the mesencephalon.
Belongs to the auditory system.
Lateral lemniscus: Located laterally and dorsally as it enters the inferior
colliculus. Concerned with audition.
Spinal and medial lemnisci: Continuation of the same structures seen at more
caudal levels.
Corticospinal, corticopontine, corticobulbar tracts: Sectioned transversely on
their way to pontine nuclei, cranial nerve nuclei, and motor neurons of the spinal
cord.
Pontocerebellar tract: Axons of pontine nuclei on their way to the cerebellum.
Decussation of brachium conjunctivum: Massive outflow tract of the cerebellum
seen decussating at this level. Fibers project, after decussation, into the red nucleus
and ventral lateral nucleus of the thalamus.
Tract of the mesencephalic nucleus of trigerninal (CN V) nerve: Processes of
pseudounipolar neurons in the mesencephalic nucleus of the trigeminal nerve.
Neurons are sparsely scattered on each side of the tract.
Medial longitudinal fasciculus: Continuation of the same structure seen at more
rostral and more caudal levels.





















MESENCEPHALON
Inferior colliculus coronal

Human, 10% formalin, Pal-Weigert, 3.0 x.

Inferior colliculus: Ovoid cellular mass belonging to the auditory system.
Receives fibers from the lateral lemniscus and is reciprocally connected to the
medial geniculate body.
Central (periaqueductal) gray: An area of gray matter surrounding the aqueduct
of Sylvius. Contains scattered neurons, several nuclei, and some finely myelinated
and unmyelinated fibers. Recent interest in this area has focused on its role in pain.
The neuropeptide enkephalin has been identified in the central gray.
Spinal lemniscus (spinothalamic and spinotectal tracts): Continuation of the
same fiber system seen at more caudal levels.
Medial lemniscus: Continuation of the same fiber system seen at more caudal
levels.
Central tegmental tract: A compact fiber bundle located in the dorsal part of the
mesencephalon dorsal to the decussation of brachiurn conjunctivurn. Carries fibers
from the midbrain tegmentum, red nucleus, and periaqueductal gray matter to the
inferior olivary complex. Note how the position of this tract changes in more
caudal levels (see Plates 333 and 335, 336, 337).
Decussation of brachium conjunctivum: Massive outflow tract of the cerebellum
seen crossing in the tegmenturn of the midbrain. Fibers project, after decussation,
into the red nucleus and the ventral lateral nucleus of the thalamus. Lesion results
in a disorder of coordinated movement.
Basis pontis: Basal part of pons. Contains pontine nuclei as well as corticospinal,
corticobulbar, corticopontine, and pontocerebellar fibers.
Cerebral peduncle: Descending corticofugal fiber system. Lesion results in
weakness (paresis) or paralysis of the contralateral half of the body, including the
face.
Medial longitudinal fasciculus: The ascending component of this bundle.
Connects vestibular nuclei with nuclei of extraocular movement (CN III, IV, VI).
Trochlear (CN IV) nucleus: Lies in the V-shaped ventral part of the central gray.
Axons arch around the central gray, cross in the anterior medullary velum, and
emerge from the dorsal aspect of the mesencephalon. Axons supply the superior
oblique extraocular muscle.
Brachium of inferior colliculus: Also known as inferior quadrigeminal brachium.
A bundle of nerve fibers from the lateral lemniscus and the inferior colliculus on
their way to the medial geniculate body. This fiber bundle conveys auditory
impulses from the midbrain to the thalamus.