Medulla Oblongata

The Medulla Oblongata

◼ The medulla oblongata is a cone-shaped neuronal mass responsible for
autonomic (involuntary) functions ranging from vomiting to sneezing. The
medulla contains the cardiac, respiratory, vomiting and vasomotor centers
and therefore deals with the autonomic functions of breathing, heart rate
and blood pressure.

◼ The medulla oblongata is the lowest part of the brainstem, about 3 cm

long, that extends between the pons superiorly and the spinal cord inferiorly
at the level of foramen magnum.

◼ The upper half of the medulla oblongata (open medulla) contains the
lower part of fourth ventricle, while its lower half (closed medulla)
contains the central canal.

◼ The anterior surface of medulla oblongata has the anterior median

fissure separated from the anterolateral fissure by the pyramid.

◼ The pyramid is formed by the pyramidal fibers, consisting of the crossed

lateral corticospinal tracts and the uncrossed anterior corticospinal tracts.
 The Medulla Oblongata
◼ Attaching to the
anterolateral fissure are the
rootlets of hypoglossal
nerve.
◼ Lateral to the pyramid is the
olive which is formed by
the inferior olivary
nucleus.
◼ Lateral to olive is the
posterolateral fissure to
which the rootlets of IX, X
& XI cranial nerves are
attached.
◼ The upper end of medulla
is separated from the pons
by a fissure from which the
VI cranial nerves emerge
near the midline while the
VII & VIII cranial nerves
emerge from its lateral
ends.
 The Medulla Oblongata
◼ The lateral surface of medulla
oblongata has the bulging of the
spinal tract of trigeminal
nerve (tuberculum cinereum)
below and the bulging of
inferior cerebellar peduncle
above.

◼ The posterior surface of medulla

oblongata has the posterior
median sulcus in the lower
half and the floor of the lower
half of 4th ventricle above.

◼ Lateral to the posterior median

sulcus are the fusciculus
gracilis medially and
fusciculus cuneatus laterally
which terminate above in the
gracile and cuneate
tubercles or nuclei.
 The Medulla Oblongata
◼ The internal structures of the medulla must be viewed in cross
section to understand the layout. Three levels of the medulla are
typically discussed from inferior to superior:
◼ Level of decussation of the pyramids
◼ Level of decussation of the medial lemnisci
◼ Level of the olives
◼ The medulla itself is typically divided into two regions: the open and
the closed medulla. The medulla becomes open when the central
canal opens into the fourth ventricle.
◼ Some features are seen in all three cross sections.
◼ Anteriorly we can see the paired lumps representing the pyramids
which are separated by the anterior median fissure.
◼ Centrally, the central canal can be seen as it rises to form the
fourth ventricle.
 Level of the Decussation of the Pyramids

◼ This is the major

decussation point of the
descending motor fibres.
Roughly 75% of motor
fibres housed within the
pyramids cross diagonally
and posteriorly, and
continue down the spinal
column as the lateral
corticospinal tracts.
◼ At this level, the central
portion of the medulla
contains gray matter, while
the outer portion consists
of white matter.
 Level of the Decussation of the Pyramids
•The posterior white matter contains the fasiculus gracilis and the
more lateral fasiculus cuneatus. Corresponding portions of gray
matter extend to these regions and are the nucleus gracilis and
nucleus cuneatus respectively.

• Unchanged from the spinal cord, the spinocerebellar tracts

(posterior and anterior) are located laterally, with the lateral
spinothalamic tract situated between them. The large spinal
trigeminal nucleus and tracts can be found posterior to these
tracts.

•The spinal trigeminal nucleus is a nucleus in the medulla that

receives information about deep/crude touch, pain, and temperature
from the ipsilateral face. In addition to the trigeminal nerve (CN V), the
facial (CN VII), glossopharyngeal (CN IX), and vagus nerves (CN X)
also convey pain information from their areas to the spinal trigeminal
nucleus. Thus the spinal trigeminal nucleus receives input from cranial
nerves V, VII, IX, and X.
• The spinal trigeminal nucleus projects to the ventral posterior medial
nucleus in the dorsal thalamus.

•The medial longitudinal fasciculus (MLF) is one of a pair of crossed fiber

tracts (group of axons), on each side of the brainstem. These bundles of
axons are situated near the midline of the brainstem and are composed of
both ascending and descending fibers that arise from a number of sources
and terminate in different areas. The medial longitudinal fasciculus carries
information about the direction that the eyes should move. It correlates the
movements of eyes, face, tongue, neck in relations to visual, hearing, and
vestibular stimuli.

• It receives fibers from:

1. Vestibular nuclei (Equilbrium).
2. Lateral lemniscus (Hearing).
3. Superior colliculus (Vision).

• It gives fibers to the III, IV, VI, VII, XII, and spinal part of the IX nerves
and the anterior horn cells of the spinal cord.
 Level of Decussation of the Medial Lemniscus
◼ This level marks the location
where the sensory
decussation of the medial
lemniscus occurs . Purple
lines have been used to
represent the internal
arcuate fibres as they run
from the nucleus gracilis and
nucleus cuneatus around and
anterior to the central gray
matter to form the medial
lemniscus.
◼ Lateral to the medial
lemniscus, the trigeminal
nucleus and spinal tract
can once again be seen, as
can the spinocerebellar
tracts and the lateral
spinothalamic tract.
 Level of Decussation of the Medial Lemniscus

◼ Centrally, the hypoglossal nucleus and medial longitudinal

fasciculus are seen.

◼ Moving laterally, the nucleus ambiguous can be seen. Between this

structure and the pyramids is the inferior olivary nucleus.

◼ The inferior olivary nucleus which is a part of the olivo-cerebellar

system and is mainly involved in cerebellar motor-learning and
function. This nucleus is involved in motor control. It is a major source
of input to the cerebellum.

◼ For deacades, cerebellar research has been guided by the central

hypophysis that plasticity in synapses at the cerebellar cortex
mediates learning.
 Level of the Olives

◼ This level shows significant

change in structure both
externally and internally
when compared with
previous levels. The central
canal has now expanded into
the fourth ventricle and as
such makes this region the
open medulla.

◼ The large inferior olivary

nucleus is responsible for
the external expansion of the
olives. The related medial
and dorsal accessory
olivary nuclei can be seen
medial and posterior to this
structure respectively.
 Level of the Olives

◼ The olivary bodies (Olive) are composed of

nerve tissue and measure about 1.25 cm in
length.

◼ The inferior olivary nucleus is the part of

the olivary body that assists in cerebellar
motor learning and function.

◼ The superior olivary nucleus is the part of

the olivary body that belongs to the auditory
system and assists with sound perception.
 Level of the Olives
◼ The large inferior cerebellar peduncles come into view and are
surrounded by multiple nuclei. The two vestibular nuclei (medial
and inferior) are both found towards the midline while the two
cochlear nuclei are found somewhat above and below the
peduncles. Now a much smaller structure, the trigeminal tract and
nucleus is seen adjacent to the peduncle.

◼ The nucleus ambiguous remains as it was previously, while the

hypoglossal nucleus has migrated with the central canal
posteriorly, joined by the medial longitudinal fasciulus. An
additional cranial nucleus comes into view lateral to the hypoglossal –
the dorsal vagal nucleus. Moving further lateral, the nucleus of
tractus solitarius comes into view.

◼ Centrally, the medial lemniscus hugs the midline posterior to the

pyramids, as does the tectospinal tract.

◼ Between the peduncle and the olivary nuclei resides the lateral
spinothalamic tract and the more lateral anterior spinocerebellar tract.
 Level of the Olives

◼ the arcuate nucleus is a group of neurons located on the anterior

surface of the medullary pyramids. These nuclei are the extension of
the pontine nuclei. They receive fibers from the corticospinal tract and
send their axons through the anterior external arcuate fibers and
striae medullares to the cerebellum via the inferior cerebellar
peduncle.

◼ The Arcuate nuclei are capable of chemosensitivity and have a proven

role in controlling respiratory frequency.

◼ The trigeminal lemniscus, also called the trigeminothalamic

tract, is a part of the brain that conveys tactile, pain, and
temperature impulses from the skin of the face, the mucous
membranes of the nasal and oral cavities, and the eye, as well as
proprioceptive information from the facial and masticatory muscles.
It carries sensory information from the trigeminal system to the
ventral posteromedial (VPM) nucleus of the thalamus.