The brain stemThe brain stem

脑 干

The brain stemThe brain stem

midbrain midbrain 中脑中脑 pons pons 脑桥脑桥 medulla oblongata medulla oblongata 延髓延髓

Bulbopontine sulcus 延髓脑桥沟

ventral surfaceventral surface of the brain stemof the brain stem

PyramidPyramid 锥体锥体 : contain pyramidal tract : contain pyramidal tract (corticospinal tract) (corticospinal tract)

Decussation of pyramidDecussation of pyramid 锥体交叉锥体交叉 formed by crossing fibers of corticospinaformed by crossing fibers of corticospina

l tractl tract

emerge from retroolivary sulcus橄榄后沟

Medulla oblongataMedulla oblongata

hypoglossal nerve 舌下神经 emerge from anterolateral sulcus Glossopharyngeal n. vagus n. accessory n.

Olive 橄榄 : overlying inferior

olivary nucleus 下橄榄核

Basilar partBasilar part 基底部基底部 Basilar sulcusBasilar sulcus 基底沟基底沟

ventral surfaceventral surface of the brain stemof the brain stem

PonsPons

Bulbopontine sulcus 延髓脑桥沟 : from medial to lateral,

abducent, n 展神经 facial n. vestibulocochlear n. 前庭蜗神经

ventral surfaceventral surface of the brain stemof the brain stem

PonsPons

Middle cerebellar peduncle 小脑中脚 Trigeminal nerve 三叉神经 Pontocerebellar trigone 脑桥小脑三角 :

the junction of medulla, pons and cerebellum

Crus cerebri Crus cerebri 大脑脚底大脑脚底Interpeduncular fossaInterpeduncular fossa 脚间窝 脚间窝 oculomotor nerves oculomotor nerves 动眼神经动眼神经 emerge from medial of crus cerebriemerge from medial of crus cerebri

ventral surfaceventral surface of the brain stemof the brain stem

MidbrainMidbrain

Posterior perforated substance 后穿质

Gracile tubercle Gracile tubercle 薄束结节薄束结节 :: overlying gracile nucleusoverlying gracile nucleus

Cuneate tubercle Cuneate tubercle 楔束结节楔束结节 :: overlying cuneate nucleus overlying cuneate nucleus

Inferior cerebellar peduncle Inferior cerebellar peduncle 小脑下脚小脑下脚

dorsal surface of the brain stemdorsal surface of the brain stem脑干背面脑干背面Medulla oblongataMedulla oblongata

Superior cerebellar Superior cerebellar peduncle peduncle 小脑上脚小脑上脚

Superior medullary Superior medullary velum velum 上髓帆上髓帆

dorsal dorsal surface surface of the brain stemof the brain stem脑干背面脑干背面PonsPons

Superior colliculusSuperior colliculus 上丘 上丘 centers of visual flexescenters of visual flexes 视觉反射中枢视觉反射中枢Inferior colliculusInferior colliculus 下丘下丘 conduct auditory sensation conduct auditory sensation 传导听觉传导听觉Trochlear nerveTrochlear nerve 滑车神经滑车神经

dorsaldorsal surface surface of the brain stemof the brain stem脑干背面脑干背面MidbrainMidbrain

Brachium of superior colliculus 上丘臂 Brachium of inferior colliculus 下丘臂

Inferolateral: Inferolateral: gracile tubercles gracile tubercles 薄束结节薄束结节 cuneate tubercles cuneate tubercles 楔束结节楔束结节 inferior cerebellar peduncleinferior cerebellar peduncle 小脑下脚小脑下脚

BoundariesBoundaries

rhomboid fossa rhomboid fossa 菱形窝菱形窝Superolateral: superior cerebellar peduncle 小脑上脚

Lateral recess 外侧隐窝

dorsaldorsal surface surface of the brain stemof the brain stem

Median sulcus Median sulcus 正中沟正中沟Sulcus limitans Sulcus limitans 界沟界沟Vestibular area Vestibular area 前庭区前庭区 overlies vestibular nucleioverlies vestibular nucleiAcoustic tubercle Acoustic tubercle 听结节听结节 overlying dorsal cochlear nucleusoverlying dorsal cochlear nucleus

Medial eminence Medial eminence 内侧隆起内侧隆起Striae medullares Striae medullares 髓纹髓纹

rhomboid fossarhomboid fossa

Facial colliculus 面神经丘 : overlies nucleus of abducent n. and genu of facial nerve

dorsaldorsal surface surface of the brain stemof the brain stem

dorsaldorsal surface surface of the brain stemof the brain stemrhomboid fossarhomboid fossa Hypoglossal triangle Hypoglossal triangle 舌舌下神经三下神经三角角 : overlying hypoglossal nucleus: overlying hypoglossal nucleus

Vagal triangle Vagal triangle 迷走神经三角迷走神经三角 : ove: overlies dorsal nucleus of vagus nervrlies dorsal nucleus of vagus nervee

Area postrema 最后区： lies between the vagal triangle and gracile tubercles

Locus ceruleus 蓝斑 at the upper end of Sulcus limitans 界沟上端

Fourth ventricleFourth ventricle 第四脑室第四脑室

Lie between theLie between thePons( Pons( 脑桥脑桥 )), medulla , medulla Oblongata( Oblongata( 延髓延髓 ))and cerebellum and cerebellum

(in front of cerebellum and (in front of cerebellum and posterior to theposterior to the pons pons and and medulla oblongatamedulla oblongata ).).

position

Fourth ventricleFourth ventricle

FloorFloor-- -- rhomboid fossarhomboid fossa

Anterior part superior cerebellar peduncle

小脑上脚 superior medullary velum

上髓帆

RoofRoof ：：

Fourth ventricleFourth ventricle

choroid plexuses of fourth Ventricle 第四脑室脉络丛 produce the cerebrospinal Fluid (CSF) 产生脑脊液。

Posterior part inferior medullary velum 下髓帆 tela choroidea of fourth Ventricle 第四脑室脉络组织

RoofRoof ：：

Tela choroidea and choroid plexusTela choroidea and choroid plexus脉络丛和脉络组织脉络丛和脉络组织

Fourth ventricleFourth ventricle

(1) (1) Median aperture of fourth venMedian aperture of fourth ventricletricle 第四脑室正中孔第四脑室正中孔

(2) (2) lateral apertures of fourth velateral apertures of fourth ventricle ntricle 第四脑室外侧孔：第四脑室外侧孔： a pair.a pair.

Subarachnoid space 蛛网膜下隙

Communication 交通

(3) mesencephalic aqueduct （ cerebral aqueduct ）中脑水管（大脑导水管）

Third ventricle 第三脑室

Internal structuresInternal structures –– gray mattergray matter

■ Cranial nerve nuclei 脑神经核 ■ Non- Non- Cranial nerve nuclei ( relay nucleirelay nuclei)) 非脑神经核 非脑神经核 (( 传导束中继核传导束中继核 ))

Nuclei Nuclei 神经核神经核

The arrangments of Cranial nerve nuclei :

Cranial nerve nuclei 脑神经核General Somatic motor nucleiGeneral Somatic motor nuclei 一般躯体运动核一般躯体运动核Special visceral motor nucleiSpecial visceral motor nuclei 特殊内脏运动核特殊内脏运动核General visceral motor nucleiGeneral visceral motor nuclei 一般内脏运动核一般内脏运动核

The Cranial nerve nuclei may be divided into 7 kinds:

Visceral afferentVisceral afferent （（ sensorysensory ）） nuclei nuclei ( general and special )( general and special ) 内脏感觉核（一般与特殊）内脏感觉核（一般与特殊）General somatic afferent General somatic afferent （（ senssensoryory ）） nuclei nuclei 一般躯体感觉核一般躯体感觉核 Special somatic afferent （（ sensorsensoryy ）） nuclei 特殊躯体感觉核躯体感觉核

Nucleus of oculomotor n.Nucleus of oculomotor n. 动眼神经核动眼神经核 Nucleus of trochlear n.Nucleus of trochlear n. 滑车神经核滑车神经核 Nucleus of abducent n. Nucleus of abducent n. 展神经核 展神经核 Nucleus of hypoglossal n. Nucleus of hypoglossal n. 舌下神经核舌下神经核

Cranial nerve nuclei 脑神经核General Somatic motor nucleiGeneral Somatic motor nuclei 一般躯体运动核一般躯体运动核

NucleusNucleus SiteSite Cranial n.Cranial n.

FunctionFunction

Nucleus of Nucleus of

Oculomotor n.Oculomotor n. MidbrainMidbrain

Ⅲ Ⅲ Supreior, inferior,and mediSupreior, inferior,and medi

al rectus, inf. obliquus, levaal rectus, inf. obliquus, levator palpebrae superioristor palpebrae superioris

Nucleus ofNucleus oftrochlear n.trochlear n. MidbrainMidbrain

Ⅳ Ⅳ Superior obliquusSuperior obliquus

Nucleus of abNucleus of abducent n.ducent n. PonsPons

Ⅵ Ⅵ Lateral rectusLateral rectus

Nucleus of Nucleus of hypoglossal n.hypoglossal n. MedullaMedulla

Ⅻ Ⅻ Muscles of tongueMuscles of tongue

GeneralGeneral Somatic motor nuclei

Special visceral motor nuclei 特殊内脏运动核 Motor nucleus of trigeminal n.

三叉神经运动核 Nucleus of facial n. 面神经 Nucleus ambiguus 疑核 Accessory nucleus 副神经核

Cranial nerve nuclei 脑神经核

Special visceral motor nuclei

Nucleus Site Cranial n. Function

Motor nucleus of trigeminal n.

Pons Ⅴ Masticatory muscles

Nucleus of facial n.

Pons Ⅶ Facial m., platysma, p

osterior belly of digastric, stylohyoid, stapedius 镫骨肌

Nucleus ambiguus

Medulla Ⅸ, .Ⅹ Ⅺ Skeletal m. of pharynx,

larynx and upper part of esophagus

Accessory nucleus

Medulla-cervical cord

Ⅺ Sternocleidomastoid, trapezius

General visceral motor nucleiGeneral visceral motor nuclei 一般内脏运动核一般内脏运动核Accessory oculomotor nucle

us 动眼神经副核Superior salivatory nucleus 上泌涎核Inferior salivatory nucleus 上泌涎核Dorsal nucleus of vagus n. 迷走神经背核

Cranial nerve nuclei 脑神经核

●General visceral motor nuclei

Nucleus Site

Cranial n. Function

Accessory oculomotor nucleus Midbrain Ⅲ Sphincter pupillae

and ciliary m.

Superior salivatory nucleus Pons

Ⅶ Submandibular, su

blingual and lacrimal glands

Inferior salivatory nucleus Medulla

Ⅸ Parotid gland

Dorsal nucleus of vagus n. medulla Ⅹ Many cervical,

thoracic and abdominal viscera

Visceral afferent nuclei ( general and special )

Nucleus of solitary tNucleus of solitary tractract 孤束核孤束核

Cranial nerve nuclei 脑神经核

Function ：Taste and visceral sensation

Lies in the Medulla obongataSend out the fibers to form ,Ⅶ

, cranial nⅨ Ⅹ .

General somatic afferent nuclei一般躯体感觉核Mesencephalic nucleus of trig

eminal n. 三叉神经中脑核Pontine nucleus of trigeminal

n. 三叉神经脑桥核Spinal nucleus of trigeminal n.

三叉神经脊束核

Cranial nerve nuclei 脑神经核

General somatic afferent nuclei

Nucleus Site Cranial n.

Function

Mesencephalic nucleus of trigeminal n.

Midbrain ⅤProprioception of head

Pontine nucleus of trigeminal n.

Pons Ⅴ

Tactile(touch) sensation of head

Spinal nucleus of trigeminal n.

Medulla Ⅴ

Pain and temperature sense of head

Special somatic afferent nuclei特殊躯体感觉核Cochlear nucleiCochlear nuclei 蜗神经核蜗神经核 Ventral cochlear nucleusVentral cochlear nucleus 蜗神经腹侧核蜗神经腹侧核 Drsal cochlear nucleusDrsal cochlear nucleus 蜗神经背侧核蜗神经背侧核

Cranial nerve nuclei 脑神经核

Vestibular nuclei

前庭神经核

Special somatic afferent nuclei

Nucleus Site Cranial n.

Function

Cochlear nuclei

Pons and medulla Ⅷ

Sensation of hearing

Vestibular nuclei

Pons and medulla Ⅷ

Sensation of equilibrium

■ In medulla oblongata

Gracile nucleus 薄束核 Cuneate nucleus 楔束核 Inferior olivary nucleus 下橄榄核

non- non- Cranial nerve nuclei 非脑神经核 非脑神经核

■ In pons Pontine nucleus 脑桥核

■■ in midbrainin midbrain

inferior colliculus inferior colliculus 下丘下丘 Gray matter layers of sGray matter layers of s

uperior colliculus uperior colliculus 上丘灰质 上丘灰质 Red nucleusRed nucleus 红核红核 Substantia nigraSubstantia nigra 黑质黑质

non- non- Cranial nerve nuclei 非脑神经核 非脑神经核

Nucleus positionGracile nucleus Medulla (underneath gracile tu

bercle)Cuneate nucleus Medulla (underneath cuneate t

ubercle)Pontine nucleus Pons

Nucleus of inferior colliculus

Midbrain

Inferior colliculus superior colliculus

Midbrain

Red nucleus Midbrain

Substantia nigra Midbrain

Non- Non- Cranial nerve nuclei

White matter White matter

Medial lemniscus 内侧丘系 Spinal lemniscus 脊髓丘系 Trigeminal lemniscus 三叉丘系 Lateral lemniscus 外侧丘系

Ascending tracts

Descending tracts Pyramidal tract 锥体束 Corticospinal tract 皮质脊髓束 Corticonuclear tract 皮质核束

White matterWhite matter — — ascending tractsascending tracts

Medial lemniscus 内侧丘系 decussation of medial le

mniscus 内侧丘系交叉

White matterWhite matter — — ascending tractsascending tracts

Spinal lemniscusSpinal lemniscus 脊髓丘系脊髓丘系

White matterWhite matter — — ascending tractsascending tracts

Trigeminal lemniscusTrigeminal lemniscus 三叉丘系三叉丘系

White matterWhite matter — — ascending tractsascending tracts

Lateral lemniscus 外侧丘系

White matterWhite matter —— descending tractsdescending tracts

Corticospinal tract Corticospinal tract 皮质脊髓束皮质脊髓束 Corticonuclear tractCorticonuclear tract 皮质核束皮质核束

Pyramidal tract 锥体束

Corticonuclear tractCorticonuclear tract 皮质核束皮质核束

White matterWhite matter —— descending tractsdescending tracts

Others: rubrospinal tract 红核脊髓束 tectospinal tract 顶盖脊髓束 vestibulospinal tract 前庭脊髓束 reticulospinal tract 网状脊髓束

Reticular formationReticular formation of brain stemof brain stem脑干网状结构脑干网状结构The reticular formation is recognized as the extensive area outside the more conspicuous fiber bundles and nuclei of the brain stem, in which the grey were intermingled with whiter matter. Its major function may sum up as follows:

Reticular formationReticular formation of brain stemof brain stem

■■ Viscceromotor controViscceromotor control-l-----vital centresvital centres 生命中生命中枢枢

Cardiovascular center and rCardiovascular center and respiratory center in medulla obespiratory center in medulla oblongata.longata.

■ Ascending reticular activating system 上行网状激动系统 maintenance of the conscious stateof cerebral cortex. 维持大脑觉醒状态

■ somatomotor control 调节躯体运动 : reticulospinal tract

Medulla oblongataMedulla oblongataLower part (closed part) Two decussations–

– Decussations of medial lemniscus 内侧丘系交叉– Decussations of pyramid 锥体交叉

The transverse section of brain stem----The transverse section of brain stem----

Medulla oblongataMedulla oblongataUpper part (open part) inferior olivary nuculeus and inferio

r cerebellar peduncle Enlargement of central canal to for

m the fourth ventricle floor

Tracts: pyramidal tracy medial lemniscus inferior cerebellar peduncleNuclei: nucleus of hypoglossal n. dorsal nucleus of vagus n. nucleus ambiguus. solitary nucleus, spinal nucleus of trigeminal n.

The transverse section of brain stem----The transverse section of brain stem----

contains a number of new cranial nerve nucontains a number of new cranial nerve nu

clei ,Such as : clei ,Such as : nucleus of abducent n. nucleus of abducent n. nucleus of facial n. nucleus of facial n. vestibular nuclei ,vestibular nuclei , spinal nucleus of trigeminal n.spinal nucleus of trigeminal n.

longitudinal fibers(pyramidal tract)

transverse fibers arised from the pontine nuclei.

The transverse section of brain stem----The transverse section of brain stem----

Middle cerebellar peduncle 小脑中脚

ponspons

■ Tegmentum of pons 背盖部

■ Basilar part 基底部

■ tectum of midbrain 中脑顶盖 ■ Cerebral peduncle 大脑脚：

may be divided into 3 parts● Tegmentum 被盖 :

Ascending tracts:

medial lemniscus,

spinal lemniscus,

trigeminal lemniscus.

nuclei: red nucleus, nucleus of oculomotor n. and troclear n.

includes superior and inferior colliculi

The transverse section of brain stem----The transverse section of brain stem----midbrain

■ Cerebral peduncle 大脑脚 ● Tegmentum 被盖

The transverse section of brain stem----The transverse section of brain stem----midbrain

● Substentia nigra 黑质● Crus cerebri 大脑脚底 : frontopontine Tract 额桥束 , pyramidal tract, tempo-occipito-pontine tract 颞枕桥束

Lateral corticospinal tract Anterior corticosp

inal tract

superior cerebellar peduncle

its fibres arises from theits fibres arises from the cerebellum,cerebellum, and passe and passes to the opposite s to the opposite thalathalamusmus and the opposite and the opposite rred nucleus ed nucleus of the midbof the midbrain. rain.

Ventral cochlear nuclei

Dorsal cochlear nuclei