The Midbrain 2

The Midbrain
Josephine M. Lumitao MD, MHPED, FPOGS

Section of Neuroanatomy
Department of Anatomy
USTFMS
8/20/2014 Free PowerPoint Template from www.brainybetty.com 2
Functions of the Midbrain
Conduit for ascending and descending fiber
tracts
Contains nuclei of cranial nerves III and IV and
midline nuclei with diverse functions
Center for pupillary light reflex

Developmental Features of the
Midbrain
Dorsoventral orientation of alar-basal plates
Neural cavity- Cerebral aqueduct
Alar plate derivatives :
Inferior colliculus
Superior colliculus
Substantia nigra
Red nucleus
Basal plate derivatives :
Trochlear nucleus
Oculomotor nucleus
Edinger-Westphal nucleus
Marginal zone invaded by fibers that form crus
cerebri/cerebral peduncles
Boundaries of the midbrain
Ventral surface:
Caudal boundary- Superior pontine sulcus where
crus cerebri enters the pons
Rostral boundary exit of crura cerebri from
cerebral hemispheres and mammillary bodies
Dorsal surface:
- Caudal boundary Exit of trochlear nerves
- Rostral boundary- midbrain-diencephalic
boundary formed by posterior commissure
External Features Dorsal Surface
Caudal boundary: Exit of
trochlear nerves
Rostral boundary:
Posterior commissure
Four elevations- Corpora
quadrigemina
Inferiorcolliculus(caudal)
Superior colliculus
(rostral)
Pineal gland extends
posteriorly above and
between the superior
colliculus
External Features Ventral Surface
Caudal boundary: Superior
pontine sulcus
Rostral boundary:
Mammillary bodies
Crura cerebri pair of
large axon bundles from
cerebral hemisphere
caudal to the optic tract
Oculomotor nerves exit at
interpeduncular fossa
Lateral View of Midbrain

Internal Anatomy of Midbrain
Tectum area posterior to
cerebral aqueduct; contains
the superior and inferior
colliculus

Tegmentum extends from
base of tectum; does not
include substantia nigra;
contains ascending and
descending fiber tracts and
cranial nerve nuclei

Basis pedunculi
Anterolateral portion of
midbrain on each side made
up of Substantia nigra and
Crus cerebri
Caudal Midbrain Level of the Inferior Colliculus
-TECTUM:
Inferior colliculus made up of a
large central nucleus, dorsal
nucleus and lateral nucleus;
auditory relay nuclei receiving
fibers of the lateral lemniscus
Brachium of the inferior colliculus
projects to medial geniculate body

Inferior Colliculus
Central nucleus- egg shaped core of the inferior
colliculus at the base of afferent fibers of the lateral
lemniscus; consist of parallel shaped layers of cells
with disc shaped dendritic fields; receives and
integrates information from multiple hindbrain
auditory sources and projects to medial geniculate
nucleus; ascending projections converge in a point-
to-plane order, low frequencies posterolaterally and
high frequencies anteromedially
Paracentral nuclei made up of pericentral nucleus
(posterior) and external (lateral) nucleus; receive input
from central nucleus, cerebral cortex and non-auditory
input from spinal cord and superior colliculus;
projects to MGN, superior colliculus and reticular
formation; involved in functions related to attention,
multisensory integration and auditory-motor reflex
Inferior Colliculus receives auditory input from
Lateral lemniscus; projects to medial geniculate body
TEGMENTUM:
- Periaqueductal gray collection of
nerve cell bodies that surround the
cerebral aqueduct; opiate receptors;
receives spinomesencephalic tract and
projects to nucleus raphe magnus; for
modulation of pain transmission
-Trochlear nucleus supplies superior
oblique muscle
-Medial longitudinal fasciculus
-Mesencephalic nucleus and tract
-Decussation of superior cerebellar
peduncle- crossed fibers from deep
cerebellar nuclei to red nucleus and/or
thalamus
-Anterolateral system and medial
lemniscus; Central tegmental tract

Trochlear Nerve
Only motor cranial nerve formed by axons that
cross the midline before their exit
Longest intracranial course
Trochlear nucleus provides GSE fibers to
superior oblique which functions to direct the
eyeball down when turned inwards (intorsion,
depression)
Receives projections from neurons in frontal
eye field via the rostral interstitial nucleus of
the MLF (medial longitudinal fasciculus)
-BASIS PEDUNCULI:
-Substantia nigra pars compacta
(dopamine rich) and pars
reticulata (GABA)
-Crus cerebri middle 3/5
Corticospinal and corticobulbar;
medial 1/5 frontopontine (Arnolds
bundle); lateral 1/5 temporo-
parieto-occipito pointine fibers
(Turcks bundle)

Substantia Nigra
Functionally associated with the basal nuclei
Made up of pars compacta and pars reticulata
Pars compacta large number of neuromelanin
containing cells rich in dopamine; project to
neostriatum(caudate nucleus and putamen) as part of
nigrostriatal pathway
Pars reticulata- loose aggregations of medium to large
sized neurons rich in GABA; project to superior
colliculus, thalamus and pontine reticular formation
Parkinson disease- associated with loss of dopamine ;
resting tremors, akinesia, bradykinesia , blank stare,
paucity of movement
Parkinsons Disease
TECTUM:
Superior Colliculus- made up of
alternating gray matter and white matter;
layers I-III receive input from retina and
visual cortices and project to thalamus;
layers IV-VII subserve gaze changes
including eye movement and project to
thalamus, brain stem and spinal cord
-Detection of movements in visual fields
for visual orientation, searching and
tracking
-For audiovisual reflexes as it receives
input from inferior colliculus
-Connects with the lateral geniculate
nucleus via brachium of superior
colliculus
Features of Rostral Midbrain Level of
Superior Colliculus
TEGMENTUM:
Red nucleus Magnocellular division
send axons which cross the midline at
ventral tegmental decussation of Forel to
form the rubrospinal tract that innervates
the proximal limb flexors
Parvocellular division (rostral)
axons form the rubroolivary tract that
descends in the central tegmental tract
and terminates in the ipsilateral inferior
olives
Receives afferents from the
contralateral deep cerebellar nuclei and
ipsilateral cerebral cortex
Superior Colliculus
TEGMENTUM:
Dorsal tegmental decussation of
Meynert crossed projections of
superior colliculus to brain stem areas
(tectoreticular, tectoolivary and
tectospinal cervical spinal cord)
Tectobulbospinal system of brain stem
MLF
Medial lemniscus
Anterolateral system
Central tegmental tract
Ventral tegmental decussation of
Forel-crossed axons from red nucleus
that form ruprospinal tract
Superior Colliculus
Oculomotor Nucleus
Composed of:
- central nucleus of Perlia that supplies the
ciliary muscle for convergence and accommodation
- lateral dorsal somatic cell column that innervates all extraocular muscles
except the lateral rectus and superior oblique
- Midline dorsal subnucleus(caudal central subdivision) supply the levator
palpebrae superioris
- midline dorsal visceral cell column (Edinger-Westphal nucleus) , origin of
preganglionic parasympathetic fibers to the ciliary ganglion, postganglionic
fibers of which innervate sphincter pupillae and ciliary muscles
Does not receive direct cortical projections via corticobulbar pathway; cortex of
frontal eye field exerts its control over oculomotor neurons via projections to
rostral interstitial nucleus of the MLF (riMLF, the vertical gaze center) and the
superior colliculus
Accessory nuclei: interstitial nucleus of Cajal, nucleus of Darkschewtisch,
nucleus of posterior commissure and riMLF
Oculomotor nerve emerge at interpeduncular fossa medial to crus cerebri
Ipsilateral lesion will result in an abducted and depressed eye, diplopia (double
vision), mydriasis (dilated pupil) non reactive to light and cannot accommodate
and drooping of eyelids (ptosis)
Reticular and Raphe Nuclei of
Midbrain
Reticular Nuclei are
cuneiform and
subcuneiform nuclei
which forms part of
ARAS for maintaining
alertness and
wakefulness
Dorsal raphe nucleus
serotonergic neurons
that modulate neuronal
activity involved in
sleep/dream cycles
Midbrain-Diencephalic junction
Pretectal Area consist of groups of cells related to visual
system; brainstem center for pupillary light reflex; receives input
from superior colliculus and project bilaterally to Edinger-
Westphal nucleus mediating direct and consensual pupillary light
reflex
Posterior commissure rostral boundary of midbrain;
functionally, contains fibers from the pretectal nuclei that project
to contralateral Edinger Westphal nucleus and upgaze fibers
from riMLF; important in consensual pupillary light reflex and
upward vertical gaze
Ventral tegmental area of Tsai- diffuse cell group
ventromedial to red nucleus and continuous with lateral
hypothalamic area; contains dopaminergic neurons that project
to cortical and subcortical structures of limbic system (emotional
behavior); fibers directed to nucleus accumbens that constitute
the mesolimbic or reward pathway
Pupillary Light Reflex
Four neuron reflex arc:
Ganglion cells of retina
forms the OPTIC
NERVE
Pretectal area
Edinger-Westphal
nucleus (bilateral) of
OCULOMOTOR
NERVE
Ciliary Ganglion to
sphincter pupillae to
produce pupillary
constriction

BLOOD SUPPLY OF
MIDBRAIN:
Superior cerebellar
artery supply the
tectum
Quadrigeminal artery
supply the posterior
midbrain and
ventrolateral regions
Posteromedial group
of branches from circle
of Willis (P1 and P2)
from posterior
cerebral artery supply
ventromedial region of
midbrain
Vascular Syndromes of the Midbrain
Webers syndrome ipsilateral
paralysis of extraocular
muscles except superior
oblique and lateral rectus,
dilated pupil ipsilaterally,
contralateral paralysis of
extremities
Claude syndrome Ipsilateral
paralysis of all extraocular
muscles except LR and SO;
ipsilateral dilated pupil,
contralateral ataxia, tremor
and incoordination
Benedikt syndrome
ipsilateral paralysis of
extraocular muscles except
SO and LR; ipsilateral dilated
pupil; contralateral paralysis
of extremities and
contralateral tremor and ataxia
1. Which of the ff. serves as caudal
boundary of dorsal midbrain?
A. Superior pontine sulcus
B. Exit of trochlear nerve
C. Mammillary body
D. Posterior commissure
2. Which of the ff. forms the tectum in
rostral midbrain?
A. Superior colliculus
B. Inferior colliculus
C. Cerebral peduncles
D. Cerebral aqueduct
3. Which of the ff. is center for
pupillary light reflex?
A. Dorsal raphe nucleus
B. Pretectal area
C. Posterior commissure
D. Ventral tegmental area of Tsai
4. Which of the ff. nuclei of the inferior colliculus
shows plane-to-order convergence of
projections?
A. Central nucleus
B. Pericentral nucleus
C. Lateral nucleus
D. Paracentral nuclei
5. The pars compacta of the
substantia nigra is rich in _____.
A. GABA
B. Serotonin
C. Dopamine
D. Norepinephrine
6. What is the functional significance
of posterior commissure?
A. Direct pupillary light reflex
B. Consensual pupillary light reflex
C. Upward vertical gaze
D. Both B and C
7. Which of the ff. is a manifestation of
a lesion of R oculomotor nerve?
A. Ptosis of L eye
B. Medially deviated R eye
C. Dilated R pupil
D. Dilated L pupil
8. Where do the superior colliculus
fibers project?
A. Medial geniculate body
B. Lateral geniculate body
C. Red nucleus
D. Both A and B
9. Which of the ff. structures is found
in caudal midbrain?
A. Superior colliculus
B. Red nucleus
C. Oculomotor nucleus
D. Decussation of superior cerebellar
peduncle
10. Which of the. ff. occupies the
middle 3/5 of the crus cerebri?
A. Frontopontine fibers
B. Corticospinal fibers
C. Occipitopontine fibers
D. Temporopontine fibers

The Midbrain 2

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The Midbrain

Josephine M. Lumitao MD, MHPED, FPOGS

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