USTNotesgroup2010
Reviewer by Mau
Board added pics by Ryan Go
Neuroanatomy Practical 2nd Shift
-maueewowee
1. MEDULLA
Lower 1/3-closed medulla *level of pyramidal
decussation
Things to note:
• Fasciculus Gracilis
o Post extension is nucleus gracilis
o Conscious propioception of the
lower extremities
• Fasciculus Cuneatus
o Post extension is the nucleus
cuneatus
o Conscious propioception of the
upper extremities
• Descending Nucleus of the V
o For pain and thermal sense in face,
also some degree of touch and
pressure
• Pyramids
o Motor
o Corticospinal-trunk, extremities
o Corticobulbar-facial, tongue,
extraocular muscles
• Pyramidal decussation
o Crossing fibers
o Descend as lateral corticospinal
tract in lateral funiculus synapsing
at lateral motor neuron which
supplies contralateral extremities
Middle 1/3-closed
Things to note: *bigger size of n. gracilis; Absence
of decussations; Presence of arcuate fibers
• Pyramids
o No decussations yet
o Lesion: contralateral hemiparesis
• Nucleus Gracilis
o Fiber tract: Fasciculus Gracilis
o Conscious Propioception of LE
o Very Big
o Lesion: ipsilateral loss of
propioception
• Nucleus Cuneatus
o Fiber tract: fasciculus cuneatus
o Conscious propioception of UE
• Internal Arcuate Fibers
o Crossed fibers; ascending to the
opposite end forming the Medial
Lemniscus tract
• Medial Lemniscus
o For conscious propioception
o Courses thru thalamus via
ventroposterolateral tract (VPL)
Upper 1/3- open medulla
Take Note: inferior olives; Nucleus of tractus
solitarius; Rhomboid Fossa of 4th ventricle
• Rhomboid Fossa of 4th Ventricle
o 3 eminences overlying the nuclei of
hypoglossal, vagal, vestibular
• Nucleus of Tractus Solitarius
o Sensory modality from alar plate
o Rostral 1/3 taste
 SVA CN 7,9,10
o Caudal 1/3-sensory for viscera
 GVA CN 9, 10
• Pyramids
o Corticospinal/Corticobulbar tracts
o Lesions: contralateral hemiparesis
• Medial Lemniscus
o Conscious Propioception
o Lesion: Contralateral Loss of
Propioception
• Medial Longitudinal Fasciculus
o Congugate Gaze
• Inferior Olivary Nucleus
o Associated with voluntary muscle
movement
o Sends oligocerebellar fibers
medially through inferior cerebellar
peduncle
o Lesion: Contralateral
2. PONS
Lower ½
Take Note: presence of facial colliculus which
overlies the abducens nuclei and genu of the facial
nerve
• 4th ventricle
• Pyramids
o Corticospinal and Corticobulbar
tracts
o Lesion: Contralateral Hemiparesis
• Pontocerebellar tract
o Crossing fibers from pontine nuclei
o Lesion: Contralateral
• Middle cerebellar peduncle
• Medial lemniscus
o Conscious Propioception
o Lesion: Contralateral Loss of
Propioception
• Trapezoid body
o Transverse fibers
• Basilar sulcus
o Basilar Atery passes
• Abducens nuclei
o Supplies the lateral lemniscus;
lateral rectus muscle
o Lesion: Medially deviated eyeball
• Genu of facial motor root
o Supplies the face
o Lesion: Ipsilateral hemifacial palsy
Upper ½
*all structures in lower ½ are also present here
except the genu of facial nerve.
 3. MIDBRAIN- Bell shaped • Rootlets of CN 3
o Courses downwards to
interpeduncular fossa
Lower 1/2- level of inferior colliculus • CN 3
o Supplies:
Take note: no red nucleus; no rootlets; has superior  Lids
peduncle; presence of oculomotor nerve • Lesion: ptosis
 Extraocular Muscles
• Interpeduncular Fossa
• Effect: medial
• Crus Cerebri
• Lesion: Lateral
o Basis of midbrain
 Pupil (Edinger-Westphal n.)
o 3 descending motor tracts
• Effect: Constrict
 Corticospinal
• Lesion: Dilation of
 Corticobulbar
pupil
 Corticopontine
• Corticospinal & Corticobulbar tracts
o Lesion: contralateral *Nice to Know: only fiber tracts absorb the stain…
• Substantia Nigra nuclei appear white
o Does not absorb stain
o Separate tegmentum from basis If the lesion is:
o Has 2 parts
 Pars compacta Above decussation: Contralateral
• Dorsally; source of Below decussation: Ipsilateral
striatal dopamine At decussation: upper-ipsi; lower-contra; CROSS
via nigrostriatal HEMIPLEGIA
pathway
• Deficient in
Parkinson’s
Disease
 Pars reticulata
• Source of GABA
• Cerebral Aqueduct
o Cavity that separates tectum and
tegmentum
• Periaqueductal Gray
o Surrounds the cerebral aqueduct
• MLF
o Conjugate Gaze
o Ventral to PAG
• Decussation of superior cerebellar
peduncle
o Crossed fibers from deep
cerebellar nuclei
• Superior Cerebellar Peduncle
• Inferior Colliculus
o Constitute the tectum
o Important relay for hearing
o Sends fiber to Medial Geniculate
Body (MGB) coursing thru the
Lateral Lemniscus
• Trochlear Nerve (CN 4)
o Supplies the superior oblique
muscle

Upper ½- level of the Superior Colliculus

Take note: Has Red Nucleus, Has rootlets of CN3

• Red Nucleus
o Occupies the ventral aspect of
tegmentum
o Consists of caudal magnocellular
part and rostral parvicelluar part
• Superior Colliculus
o Constitutes the tectum
o Fibers coursing thru the Medial
Lemniscus to the Lateral
Geniculate Body (LGB)