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ANATOMY OF BRAINSTEM AND ASSOCIATED LESIONS - MIDBRAIN:

MIDBRAIN:

At the end of the lecture the student should be able to know:

• External features of midbrain

• Cranial Nerves of the Midbrain

• Internal structure of midbrain

• Lesions of midbrain

MIDBRAIN:

• LANDMARKS

• Cerebral peduncles

• Optic chiasm

• Interpeduncular fossa

• (Superior colliculi)

• (Inferior colliculi)

• (Superior cerebellar peduncle)

MIDBRAIN:

• Cranial Nerves III, IV

• Midbrain is divided at the level of cerebral aqueduct


into:

• Dorsal portion called tectum which largely consists of


inferior and superior colliculi
• Ventral portion, known as tegmentum

EXTERNAL STRUCTURE OF MIDBRAIN:

1. Optic chiasm

2. Interpeduncular fossa

3. Oculomotor nerve (CN III)

4. Trochlear nerve (CN IV)

5. Pons

6. Cerebral peduncles (crus cerebri).

CRANIA NERVES OF THE MDBRAIN:

• Anterior exit

• CN III (1)

• CN VI (5)

• Posterior exit

• CN IV (2)

• MLF - Medial longitudinal fasciculus (7)

• Vestibular nuclei (6)

• Pons (3)
INTERNAL DIVISIONS OF MIDBRAIN:

• Tegmentum is bounded ventrally by the


massive fibre system of the crus cerebri

• The term cerebral peduncle is sometimes used


as a synonym for crus cerebri

• Cerebral peduncle refers to the whole


midbrain on either side excluding the tectum.

INTERNAL DIVISIONS OF MIDBRAIN:

• Ventral to the colliculi the cerebral aqueduct runs the length of the midbrain

• Surrounding the aqueduct is a pear shaped arrangement of grey matter called Periaqueductal
grey matter.

SUBSTANTIA NIGRA:

• These neurons project to the caudate nucleus and putamen of the basal ganglia in the forebrain

• Degeneration of the pars compacta of the substantia nigra is associated with Parkinson’s disease

SUBSTANTIA NIGRA:

• Other non pigmented subdivision of the substantia nigra is called the pars reticulata

• Pars reticulata is considered to be a functional homologue of the medial segment of the globus
pallidus which is also part of the basal ganglia.
INTERNAL STRUCTURE OF MIDBRAIN:

• Cross section at the level of inferior colliculus

• CN IV Trochlear nerve

• MLF

• Dorsal raphe nucleus

• Substantia nigra

• Mesencephalic nucleus of V

LOWER PART OF MIDBRAIN:

• CAUDAL PART OF MIDBRAIN:

• In the caudal part of the midbrain the


inferior colliculus constitutes part of the
ascending acoustic projection

• Ascending auditory fibres run in the lateral


lemniscus which terminates in the inferior
colliculus

CAUDAL PART OF MIDBRAIN:

• Efferent fibres from the


colliculus terminate in the
medial geniculate nucleus of the thalamus

• This nucleus projects to the auditory cortex of the temporal lobe.

INTERNAL STRUCTURE OF MIDBRAIN:

Cross section at the level of superior colliculus:

• Medial geniculate body

• Superior colliculus

• Crus cerebri (cerebral peduncle)

• Red nucleus –Controls arm movement

• Substantia nigra

• Upper midbrain

• Cranial Nerves of Upper Midbrain

ROSTRAL PART OF MIDBRAIN:

• The superior colliculus of the


rostral area of the midbrain is
part of the visual system

• Its main afferents are


corticotectal fibres originating
from the visual cortex of the
occipital lobe and from the
frontal eye field of the frontal
lobe

• These inputs are concerned


with controlling movements of the eyes.
BLOCKAGE OF CEREBRAL AQUEDUCT:

• Cerebral aqueduct is one of the narrowest parts of ventricular system.

• In congenital hydrocephalus, or tumors of midbrain, aqueduct may be blocked which blocks the
flow of CSF.