LECTURE 17: NS V: BRAIN II

Brain Stem
A. Forms the “core” of the brain
B. Nerve fibers pass cerebral hemispheres to spinal cord and vice versa through brain stem
a. Nuclei of cranial nerves located here
C. Includes:
a. Medulla oblongata
i. Located in foramen magnum
ii. Cardiovascular and respiratory centers
iii. Motor and sensory decussation (cross-over)
b. Pons
i. Located superior to medulla
ii. Part of respiratory center
c. Midbrain
i. Located superior to pons
ii. Auditory and visual reflex centers
Diencephalon
A. Thalamus: synapse in the sensory relay center
a. Superior to midbrain (beneath corpus callosum)
b. Relay centers for all sensations except smell
B. Hypothalamus
a. Located superior to midbrain (inferior to thalamus)
b. Nuclei control sleep/wake cycle, nuclei control eating, ANS, connections w/
pituitary gland (eating disorders, inability to sleep, stay awake)

Reticular Activating Center (RAS)

 Columns of neurons that are located in the middle of the brains tem from thalamus 
medulla
  Maintain a conscious state; when damaged  coma

CEREBELLUM: coordinates movement (e.g. controls flexor and extensor muscles)

BASAL GANGLIA: initiates movements in adults (controls movement of newborn babies)

Substantia Nigra: involved in gross movements; when damaged, Parkinson’s disease
develops

LIMBIC SYSTEM
 Formed by many parts of the brain
 Has many functions: sex drive, major memory center

PATHWAYS (or TRACTS): composed of ascending or descending bundles of nerve fibers, which
conduct info between brain and spinal cord
1. Fasciculus gracilis and cuneatus (sensory pathway)
a. Originates at spinal cord
b. Decussation (cross-over): medulla
c. Destination: area 3,1,2
2. Corticospinal tract (motor pathway)
a. Originates in area 4
b. Decussation in medulla
c. Destination: spinal cord
d. Thalamus—membrane—pons—medulla—spinal cord
** left brain controls right side of body, vice versa**

CLINICAL CONSIDERATIONS
Innervation of skeletal muscle dependent on 2 neurons:
1. upper motor neurons
a. cell body usually located in gray matter of cortex (precentral gyrus)
 b. its axon synapses on a lower motor neuron
2. lower motor neurons
a. cell body is in the brain stem or spinal cord
b. its axon synapses on skeletal muscle fibers
**Damage to either of these 2 neurons can result in paralysis; effect of damage on muscular
activity depends on # of neurons damaged and their precise location – see below

Symptoms of Types of Damages

1. poliomyelitis – lower motor neuron lesion
a. results from viral infection
b. damages lower motor neurons located in ventral gray horn of spinal cord
c. neurons located in lumbar enlargement most frequently affected – resulting in
symptoms associated with lower limb
d. flaccid paralysis
e. reflexes absent
f. muscles atrophy (decrease in size)
g. asymmetrical palsy of muscles supporting vertebral column causes scoliosis
(abnormal lateral curvature of spine); when patient walks, he limps and
“appears” as if one limb is shorter than the other
2. Cerebrovascular Accident (CVA or stroke) – upper motor neuron lesion
a. Blockage or rupture of blood vessels supplying brain
b. May result in ischemia (inadequate blood flow) in regions supplied by these
vessels
c. Neurons in these areas will subsequently die resulting in loss of function
d. If damage has occurred to neurons of motor cortex or corticospinal tract, you
may expect… spastic paralysis (jittery, state of flexion), reflexes are intact,
Babinski Response present (toes flare out, big toe dorsiflexes (should normally
curl)