Thebrainstem

1、山东大学医学院山东大学医学院 解剖教研室解剖教研室李振华李振华学习方法学习方法n看外形，想内部，内外结合。n看断面，想立体，上下串联。n记重点，莫贪多，整理表格。The brain stem 脑干脑干Consists of nMidbrain 中脑中脑 nPons 脑桥脑桥nMedulla oblongata 延髓延髓 The brain stem 脑干脑干Position nThe brain stem occupies the posterior cranial fossa of the skullGross Appearance of the Brain StemVentral Surf

2、ace of the Brain Stem Medulla oblongatanPyramid 锥体锥体: Composed of bundles of nerve fiber, pyramidal tract 锥体束锥体束 nDecussation of pyramid 锥体交叉锥体交叉: Formed by crossing fibers of pyramidal tract nOlive 橄榄橄榄: Produced by underlying inferior olivary nucleus 下橄榄核下橄榄核nAnterolateral sulcus 前外侧沟前外侧沟: Emerge

3、the roots of hypoglossal nerve nRetroolivary sulcus 橄榄后沟橄榄后沟: Emerge the roots of glossopharyngeal, vagus and accessory nervesVentral Surface of the Brain StemPonsnBasilar part 基底部基底部nBasilar sulcus 基底沟基底沟nBulbopontine sulcus 延髓脑桥沟延髓脑桥沟: There emerge, from medial to lateral, the abducent, facial and

4、 vestibulocochlear nervesnMiddle cerebellar peduncle 小脑中脚小脑中脚nTrigeminal nerve 三叉神经三叉神经 Emerges from the junction of basilar part and middle cerebellar pedunclesnPontocerebellar trigone 脑桥小脑三角脑桥小脑三角: The junction of medulla, pons and cerebellumVentral Surface of the Brain StemMidbrain nCrus cerebri

5、大脑脚底大脑脚底nInterpeduncular fossa 脚间窝脚间窝 Oculomotor nerve emerges on the medial side crus cerebrinPosterior perforated substance 后穿质后穿质Dorsal Surface of the Brain Stem Medulla oblongatanLower portionqGracile tubercle 薄束结节薄束结节: produced by underlying gracile nucleus 薄束核薄束核qCuneate tubercle 楔束结节楔束结节: pro

6、duced by underlying cuneate nucleus 楔束核楔束核qInferior cerebellar peduncle 小脑下脚小脑下脚qObex 闩闩nUpper portion: forms the lower half of rhomboid fossaDorsal Surface of the Brain StemPonsnSuperior cerebellar peduncle 小脑上脚小脑上脚nSuperior medullary velum 上髓帆上髓帆nTrochlear nerve 滑车神经滑车神经Dorsal Surface of the Brain

7、 StemMidbrainnSuperior colliculus 上丘上丘 Constitute centers for visual reflexesnInferior colliculus 下丘下丘 Associated with auditory pathwaynBrachium of superior colliculus 上丘臂上丘臂nBrachium of inferior colliculus 下丘臂下丘臂Fourth ventricle 第四脑室第四脑室Position nSituated ventral to cerebellum, and dorsal to pons a

8、nd cranial half of medullaCentral canal fourth ventricle mesencephalic aqueductthird ventricleFloor of the Fourth ventricle Rhomboid Fossa 菱形窝菱形窝Boundaries nInferolateral: gracile and cuneate tubercles, inferior cerebellar pedunclenSuperolateral: superior cerebellar pedunclenLateral recessFloor of t

9、he Fourth ventricle Rhomboid Fossa 菱形窝菱形窝Features nMedian sulcus 正中沟正中沟nSulcus limitans 界沟界沟nVestibular area 前庭区前庭区 Overlies vestibular nucleinAcoustic tubercle 听结节听结节 Overlying dorsal cochlear nucleusnMedial eminence 内侧隆起内侧隆起nStriae medullares 髓纹髓纹Floor of the Fourth ventricle Rhomboid Fossa 菱形窝菱形窝

10、nFacial colliculus 面神经丘面神经丘 Overlies nucleus of abducent n. and genu of facial nervenHypoglossal triangle 舌下神经三角舌下神经三角 Overlies hypoglossal nucleus nVagal triangle 迷走神经三角迷走神经三角 Overlies dorsal nucleus of vagus nervenFuniculus separans 分隔索分隔索nArea postrema 最后区最后区nLocus ceruleus 蓝斑蓝斑 Bluish-gray in co

11、lor, it owes its color to a group of deeply pigmented nerve cellsRoof of the Fourth ventriclenAnterior part: Formed by superior cerebellar peduncle小脑上脚小脑上脚 and superior medullary velum 上髓帆上髓帆nPosterior part: Formed by inferior medullary velum 下髓帆下髓帆 and choroid plexus of fourth ventricle 第四脑第四脑室脉络丛室

12、脉络丛nThree aperturesqMedian aperture of fourth ventricle 第四脑室正中孔第四脑室正中孔qTwo lateral apertures of fourth ventricle 第四脑室外侧孔第四脑室外侧孔Tela choroidea and choroid plexus脉络丛和脉络组织脉络丛和脉络组织Internal structure of the brain StemInternal structure of the brain StemnCentral canal nGray matterqCranial nerve nuclei 脑神经

13、核脑神经核 qRelay nuclei 传导中继核传导中继核nWhite matternReticular formation of brain stem General somatic motor nucleiSpecial visceral motor nucleiGeneral visceral motor nucleiVisceral sensory nuclei ( general and special )General somatic sensory nucleiSpecial visceral motor nucleiCranial nerve nuclei General s

14、omatic motor nuclei 一般躯体运动核一般躯体运动核nNucleus of oculomotor n.动眼神经核动眼神经核nNucleus of trochlear n. 滑车神经核滑车神经核nNucleus of abducent n. 展神经核展神经核nNucleus of hypoglossal n.舌下神经核舌下神经核 General somatic motor nuclei 一般躯体运动核一般躯体运动核nNucleus of oculomotor n.动眼神经核动眼神经核nNucleus of trochlear n. 滑车神经核滑车神经核nNucleus of ab

15、ducent n. 展神经核展神经核nNucleus of hypoglossal n.舌下神经核舌下神经核 NucleusSiteCranial n.FunctionNucleus of oculomotor n.MidbrainSupreior, inferior,and medial recti, inf. obliquus, levator palpebrae superiorisNucleus oftrochlear n.MidbrainSuperior obliquusNucleus of abducent n.PonsLateral rectusNucleus of hypogl

16、ossal n.MedullaMuscles of tongueGeneral somatic motor nuclei Special visceral motor nuclei 特殊内脏运动核特殊内脏运动核nMotor nucleus of trigeminal n. 三叉神经运动核三叉神经运动核nNucleus of facial n. 面神经核面神经核nNucleus ambiguus 疑核疑核nAccessory nucleus 副神经核副神经核 Special visceral motor nuclei 特殊内脏运动核特殊内脏运动核nMotor nucleus of trigemi

17、nal n. 三叉神经运动核三叉神经运动核nNucleus of facial n. 面神经核面神经核nNucleus ambiguus 疑核疑核nAccessory nucleus 副神经核副神经核Special visceral motor nucleiNucleusSiteCranial n.FunctionMotor nucleus of trigeminal n.PonsMasticatory muscles, anterior belly of digastric, mylohyoid Nucleus of facial n.PonsFacial m., platysma, pos

18、terior belly of digastric, stylohyoid, stapediusNucleus ambiguusMedulla, Skeletal m. of pharynx, larynx and upper part of esophagusAccessory nucleusMedulla-cervical cordSternocleidomastoid, trapeziusGeneral visceral motor nuclei 一般内脏运动核一般内脏运动核nAccessory oculomotor nucleus 动眼神经副核动眼神经副核nSuperior saliv

19、atory nucleus 上泌涎核上泌涎核nInferior salivertory nucleus 下泌涎核下泌涎核nDorsal nucleus of vagus n. 迷走神经背核迷走神经背核General visceral motor nucleiNucleusSiteCranial n.FunctionAccessory oculomotor nucleusMidbrainSphincter pupillae and ciliary m.Superior salivatory nucleusPonsSubmandibular, sublingual and lacrimal gla

20、ndsInferior salivertory nucleusMedullaParotid glandDorsal nucleus of vagus n.medullaMany cervical, thoracic and abdominal visceraVisceral sensory nuclei ( general and special ) nNucleus of solitary tract 孤束核孤束核Visceral sensory nuclei ( general and special )NucleusSiteCranial n.FunctionNucleus of sol

21、itary tractMedulla,Taste and visceral sensationGeneral somatic sensory nuclei一般躯体感觉核一般躯体感觉核nMesencephalic nucleus of trigeminal n. 三叉神经中脑核三叉神经中脑核nPontine nucleus of trigeminal n. 三叉神经脑桥核三叉神经脑桥核nSpinal nucleus of trigeminal n. 三叉神经脊束核三叉神经脊束核General somatic sensory nucleiNucleusSiteCranial n.FunctionM

22、esencephalic nucleus of trigeminal n.MidbrainProprioception of headPontine nucleus of trigeminal n.PonsTactile sensation of headSpinal nucleus of trigeminal n.MedullaPain and temperature sense of headSpecial somatic sensory nuclei特殊躯体感觉核特殊躯体感觉核nCochlear nuclei 蜗神经核蜗神经核nVestibular nuclei 前庭神经核前庭神经核Sp

23、ecial somatic sensory nucleiNucleusSiteCranial n.FunctionCochlear nucleiPons and medulla Sense of hearingVestibular nucleiPons and medullaSense of equilibriumnSuperior colliculus 上丘nNucleus of inferior colliculus下丘核nRed nucleus 红核nSubstantia nigra 黑质nPretectal area 顶盖前区nSuperior olivery nucleus 上橄榄核

24、nPontine nucleus 脑桥核nNucleus ceruleus 蓝斑核nGracile nucleus 薄束核nCuneate nucleus 楔束核nInferior olivary nucleus 下橄榄核 Relay nuclei 中继核中继核Non-cranial nerve nucleiNucleusSiteSuperior colliculusMidbrain Nucleus of inferior colliculusMidbrain Red nucleusMidbrain Substantia nigraMidbrain Pretectal areaMidbrain

25、 Superior olivery nucleusPons Pontine nucleusponsNucleus ceruleus ponsGracile nucleusMedulla (underneath gracile tubercle)Cuneate nucleusMedulla (underneath cuneate tubercle)Inferior olivary nucleus MedullaWhite matterAscending tractsnMedial lemniscus 内侧丘系内侧丘系nSpinothalamic tract 脊髓丘脑束脊髓丘脑束 （Spinal

26、lemniscus 脊髓丘系）nTrigeminothalamic tract 三叉丘脑束三叉丘脑束 （Trigeminal lemniscus 三叉丘系）nLateral lemniscus 外侧丘系外侧丘系 Ascending tractsSpinal ganglion 1neuron Fasciculus gracilis Fasciculus cuneatus Gracile and cuneate nuclei2neuron Decussation of medial lemniscusMedial lemniscusVPL 3neurons Central thalamic rad

27、iation T4Medial lemniscus 内侧丘系内侧丘系Spinal ganglia1neuron Lamina, 2neuron Lateral spinothalamic tract anterior spinothalamic tract Spinal lemniscusVPL 3neurons Central thalamic radiationAscending tractsSpinothalamic tract 脊髓丘脑束脊髓丘脑束 （Spinal lemniscus脊髓丘系脊髓丘系） Trigeminal ganglion1neuron Pontine nucleus

28、 of V 2neuronSpinal nucleus of V 2neuronTrigeminal lemniscus Spinal tract of trigeminal n. VPM 3neurons Central thalamic radiation Ascending tractsTrigeminothalamic tract 三叉丘脑束三叉丘脑束 （Trigeminal lemniscus三叉丘系三叉丘系） Ascending tractsLateral lemniscus外侧丘系外侧丘系Descending tractsnPyromidal tract 锥体束锥体束qCorti

29、cospinal tract 皮质脊髓束皮质脊髓束qCorticonuclear tract 皮质核束皮质核束nRubrospinal tract 红核脊髓束红核脊髓束nTectospinal tract 顶盖脊髓束顶盖脊髓束nVestibulospinal tract 前庭脊髓束前庭脊髓束nReticulospinal tract 网状脊髓束网状脊髓束 Reticular Formation of Brain StemnAscending reticular activating system (ARAS) 上行网状激动系统上行网状激动系统nMotor central and vital c

30、entresqReticulospinal tractqCardiovascular center qRespiratory centernSerotonergic rapheal nuclei The characters of internal structure of brain stemMedulla oblongataLower part (closed part)nTwo decussations qDecussations of medial lemniscus qDecussations of pyramid Medulla oblongataUpper part (open part) nAppearance of inferior olivary nuculeus and inferior cerebellar peduncle nEnlargement of central canal to form the fourth ventricle floorPons nTeg