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
  CN 3
Lower 1/2- level of inferior colliculus o Supplies:
 Lids
Take note: no red nucleus; no rootlets; has superior  Lesion: ptosis
peduncle; presence of oculomotor nerve  Extraocular Muscles
 Effect: medial
 Interpeduncular Fossa  Lesion: Lateral
 Crus Cerebri  Pupil (Edinger-Westphal n.)
o Basis of midbrain  Effect: Constrict
o 3 descending motor tracts  Lesion: Dilation of
 Corticospinal pupil
 Corticobulbar
 Corticopontine
 Corticospinal & Corticobulbar tracts *Nice to Know: only fiber tracts absorb the stain…
o Lesion: contralateral nuclei appear white
 Substantia Nigra
o Does not absorb stain If the lesion is:
o Separate tegmentum from basis
o Has 2 parts Above decussation: Contralateral
 Pars compacta Below decussation: Ipsilateral
 Dorsally; source of At decussation: upper-ipsi; lower-contra; CROSS
striatal dopamine HEMIPLEGIA
via nigrostriatal
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)
 Rootlets of CN 3
o Courses downwards to
interpeduncular fossa