Outline ♪ Drawing line in center

A. Medulla oblongata † Front is motor

† Posterior is sensory

♪ Mn → FM BS – FM Bullshit.
Video → Medicosis Perfectionalis
† Front → Motor
Notes → transcript of Medicosis
† Back → Sensory
Perfectionalis
♪ Therefore →
† Motor decussation → Anterior of

Medulla Oblongata medulla

† Sensory decussation → in posterior
– Central nervous system medulla
† Brain †
† Spinal cord.
– Ventricles inside Brain
♪ Brain → ♪ Ventricle of Forebrain
† Forebrain
† Lateral ventricle
† Midbrain
† Third ventricle
† Hindbrain brain
♪ Ventricle of Midbrain
♪ Hind brain † Just a duct → cerebral aqueduct of
† Cerebellum
Sylvius.
† Pons
♪ Ventricle for Hindbrain
† Medulla
† Fourth ventricle
♪ Brain stem → made of † Looks like a pyramid
† Midbrain
♪ Fourth ventricle →
† Pons
† Half lies in Pons
† Medulla oblongata
† Half lies in medulla
 Like a stem.
♪ Medulla → means core.
† Core of what? Core of foramen

magnum.
♪ Another word for core → myelo.
† Hence myelencephalon.

♪ Oblong means → rectangle

♪

– Medulla contains
♪ Descending efferent fibers → motor
fibers
♪ Ascending afferent fibers → sensory

fibers
– Medulla follows the rule
 † Secreted by ependymal cells lining
– Embryology choroid plexus which lines lateral
♪ Three primary vesicles of brain → ventricles.
† Prosencephalon †

† Mesencephalon – Origin of cranial nerves

† Rhombencephalon ♪ From Forebrain.
♪ Prosencephalon → give rise to † CN 1 and 2

† Telencephalon on outside  CN 1 → telencephalon

† Diencephalon on inside.  CN 2 → diencephalon.
♪ Mesencephalon give rise to → ♪ From Midbrain
† Mid brain † CN 3 and 4

♪ Rhombencephalon give rise to → ♪ From Pons

 Metencephalon † CN 5, 6, 7, 8

 Myelencephalon ♪ From Medulla

† Metencephalon give rise † CN 9, 10, 11, 12 →

 give rise to → ♪ This is about superficial attachment of

ž Pons cranial nerves, not about deep nuclei.
ž Cerebellum –
† Myelencephalon give rise to medulla – Cranial nerves with autonomic activity
 ♪ CN 3
♪ Telencephalon give rise to → ♪ CN 7
† Cerebral hemisphere and ♪ CN 9
† Slightly inner basal lamina ♪ CN 10
♪ Diencephalon give rise to → ♪ Medulla also house a nucleus of
† Any word that has thalamus trigeminal nerve.
 Thalamus ♪

 Hypothalamus Nuclei of Cranial Nerves in Medulla

 Epithalamus – Include →
 Subthalamus 9 10 11 12
♪

 Meta thalamus, – Note

♪ Ventricle of telencephalon → lateral ♪ Recall Mn → Some Say Money Matter But

ventricles. my Brother says big brains matter more.

† Ventricle of diencephalon → 3rd – Exits
ventricle. ♪ CN 9 10 11 exits from → posterolateral

♪ Ventricle of midbrain → not a ventricle → sulcus

cerebral aqueduct of Sylvius. ♪ CN 12 → exits from → anterolateral

♪ Ventricle of hindbrain → 4th ventricle. sulcus.

†  fourth ventricle related to

 Pons
 Medulla
 Cerebellum
♪ Medulla and 4th ventricle
† Upper portion of medulla has relation

with fourth ventricle posteriorly.

♪ CSF
  Mn 2 → M in ambiguus M in in
medulla
† CN 9 one of nerve of motor activity of
muscles of branchial apparatus (CN 5
7 9 10) → SVE
† Function
 Supplies only 1 muscle of pharynx →
stylopharyngeus
 Recall → All muscles of pharynx
supplied by Recurrent LN except
Stylopharyngeus which is supplied
by Glossopharyngeal nerve.
†

♪ Trigeminal Sensory Nucleus

† Shared nucleus of trigeminal nerve

with CN 7 9 10
† Recall → Principal Sensory nucleus of

CN 5 a/c extends down in medulla +

spinal cord called → c Spinal part of
principal nucleus of CN 5.
† CN 5 → One of nerve for general

sensations from face via skeletal

muscles (CN 5 7 9 10) → GSA
† Function

 General Sensations from face via

skeletal muscles.

♪ Nucleus of Tractus Solitarius
† Shared nucleus with fibers from → CN

7 9 10
 Mn → NTS → 9 10 7
† Purely Sensory
– Glossopharyngeal Nerve – CN 9  Mn → s for solitary s for sensory
♪ Mixed nerve → (Mn → Big) † Aka → Solitary Nucleus / Gustatory
† Sensory + Motor nucleus.
– Nuclei † CN 9 – one of the nerve for special
♪ Nuclei includes sense of taste (7 9 10) → SVA
† Nucleus Ambiguus  Mn → VAT–O
† Spinal Trigeminal Nucleus of CN 5 ž Value Added Taxes → Olper’s-

† Solitary Nucleus Factory

† Inferior Salivary Nucleus ž Taxes → Taste

 Mn → Spin SIN ž Olper’s Factory → Olfaction.

♪ Nucleus Ambiguus
† CN 9 – one of the nerve for general
† Shared nucleus of CN 9 + 10 + 11 Senses from visceral organs (7 9 10) →
 Basically nucleus of CN 10 GVA
† Purely motor nucleus  Chemoreceptors in carotid body
 Mn 1 → M in ambiguus – M in Motor  Baroreceptors in carotid sinus
 ž † Shared nucleus with fibers from → CN
♪ Inferior Salivatory Nucleus 7 9 10
† Parasympathetic nucleus  Mn → NTS → 9 10 7
† CN 9 – One of the nerve of † Purely Sensory
parasympathetic ANS (10 9 7 3 ) →  Mn → S for solitary S for sensory
GVE † Aka → Solitary Nucleus / Gustatory
† Function nucleus.
 Parasympathetic fibers to parotid † CN 10 – one of the nerve for special
gland via Otic ganglion. sense of taste (7 9 10) → SVA
♪ Note  Mn → VAT–O
† Sup Salivatory nucleus → CN 7 ž Value Added Taxes → Olper’s-

† Inferior Salivatory Nucleus → CN 9 Factory

 Mn → CN 7 superior to CN 9 ž Taxes → Taste

ž ž Olper’s Factory → Olfaction.

– Vagus Nerve → mcq fav † CN 9 – one of the nerve for general

♪ Mixed nerve → (Mn → Big) Senses from visceral organs (7 9 10) →
† Sensory + Motor GVA
– Nuclei  Chemoreceptors in carotid body
♪ Nucleus Include  Baroreceptors in aortic arch (GVA)
† Nucleus Ambiguus 
† NTS ♪ Trigeminal Sensory nucleus
† Spinal Trigeminal Nucleus † Shared nucleus of trigeminal nerve

† Dorsal Motor Nucleus of Vagus with CN 7 9 10

 † In medulla is a/c Spinal part of

♪ Nucleus Ambiguus principal nucleus of CN 5

† Shared nucleus of CN 9 + 10 + 11 † CN 5 → One of nerve for general

 Basically nucleus of CN 10 sensations from face via skeletal

† Purely motor nucleus muscles (CN 5 7 9 10) → GSA
 Mn 1 → M in ambiguus – M in Motor † Function

 Mn 2 → M in ambiguus M in in  General Sensations from face via

medulla skeletal muscles.
† CN 10 one of nerve for motor activity  General sensations from upper
of muscles of branchial apparatus (CN thorax
5 7 9 10) → SVE ž Trachea

† Function → ž Oesophagus

 All muscles of pharynx except ž Pharynx

Stylopharyngeus (CN 9) ž Larynx

 All muscles of palate except tensor 

veli palatini (CN V3) ♪ Dorsal Motor Nucleus of Vagus
 All muscles of larynx – no exception † CN 10 – one of the nerve of

ž Cricothyroid supplied by → SLN Parasympathetic ANS → GVE → mcq

ž Remaining laryngeal muscles → † Function

RLN  PANS fibers to

 Some muscles of oesophagus. ž Smooth muscles of bronchi

 ž Thorax → heart

♪ Nucleus of Tractus Solitarius ž Abdomen → GI tract

ž Glands
  † Brainstem communicate POSTERIORLY
– Accessory Nerve with cerebellum via cerebellar
♪ Motor nerve → (Mn → Matter) peduncles.
– Nuclei † 3 cerebellar peduncles.
♪ 2 parts  Midbrain to cerebellum→ superior
† Cranial part (aka Cranial Accessory cerebellar peduncle
nucleus)  Pons to cerebellum → middle
† Spinal part (aka Spinal Accessory cerebellar peduncle
Nucleus) ž Middle cerebellar peduncle aka →

 Cranial root originates from → Intermediate fiber bundle.

medulla.  Medulla to cerebellum → inferior
♪ Cranial Part → Nucleus Ambiguus cerebellar peduncle.
† Shared nucleus with CN 9 10 11 
† Function † Only important points mentioned
 Cranial part of Accessory nerve is a/c ♪ Superficial attachment of cranial nerves.
considered part of Vagus nerve as † We'll see inferior medullary velum ??

contribution is VERY little ♪

 So separate innervation not known. – External Anterior View of Medulla

 We will consider it CN 10 ♪ In anterior midline → anterior median
† CN 10 → one of the nerve for motor fissure
activity of muscles of branchial ♪ Lateral to midline on either sides →
apparatus (5 7 9 10) → SVE pyramids
♪ Spinal Part ♪ Lateral to pyramids on either sides →
† Motor activity to SCM & trapezius anterolateral sulcus
muscle → GSE ♪ Lateral to anterolateral sulcus on either
† sides → olives
– Hypoglossal Nerve CN 12 ♪ Lateral to olives on either sides →
♪ Purely (Mn → More) posterolateral sulcus
– Nuclei ♪ Lateral to posterolateral sulcus →
♪ Hypoglossal Nucleus inferior cerebellar peduncle
† Dedicated neve for motor activity of ♪ Rule →
muscles of tongue → GSE † If nerve is sensory or mixed → nuclei

† Function will lie more laterally → hence the CN

 Supply all Intrinsic + all extrinsic 9 10 11 nucleus are Laterally.
muscles of tongue except † if a nerve is motor → nuclei will lie

palatoglossus muscle (CN 10) close to midline → hence the CN 12

 Palatoglossus muscle is Extrinsic nucleus is in Midline.
muscle. ♪ Nerve that emerges from anterolateral
† sulcus → 12th nerve
– Peduncles ♪ Nerves that emerge from posterolateral
♪ Cerebral Peduncles sulcus → cranial nerves 9 10 and 11
† Brainstem communicate ANTERIORLY ♪ Pyramids → major pathway for motor
with cerebrum via cerebral tracts
peduncles. † Pass via internal capsule to cerebral

♪ Cerebellar peduncles cortex → mcq.

 † Cuneatus nucleus
 These are sensory nuclei
 Both → fasciculi gracilis + fasciculi
cuneatus tracts synapse onto cell
bodies of 2nd order neurons gracilis
nucleus & cuneatus nucleus
 Nuclei gracilis & nuclei cuneatus
give out fibers → internal arcuate
fibers.
 Bundle of internal arcuate fibers →
collectively called medial lemniscus
tract.
 Medial lemniscus tract Decussate &
then ascends upwards.

– External Posterior view of Medulla

♪ Superior medullary velum is visible.
♪ In posterior midline → posterior median
fissure (not very evident in diagram)
♪ Below floor of 4th ventricle → 2
longitudinal elevations on each side →
counterparts of pyramid and olive
posteriorly →
† Fasciculus gracilis → Medial

† Fasciculus cuneatus → lateral to FG

 These are ascending tracts

 Belong to dorsal column medial
lemniscus pathway.
 Fibers are 1st order sensory neuron

♪ Fourth ventricle
† Floor of fourth ventricle → looks like a

diamond
† Superior medullary velum

† Inferior medullary velum

† Horizontal fibers called medullary

stria.
† Triangular structures

 Hypoglossal trigone → closest to

midline
†  Vagus trigone → triangle for vagus

♪ Deep to tract → nerve,

† Gracilis nucleus
  Auditory trigone → triangle for ž Dorsal column medial lemniscus
auditory nerve system
 ž A pyramidal tract
ϫ Transverse sections of medulla (Not imp ž Pyramidal tract runs in pyramid of
mcq wise) medulla.
– TS through upper part of Medulla ž Always motor.
Passing through floor of 4th ventricle ž Includes
♪ ‫ ؞‬Corticospinal → cortex to spinal
♪ Upper medulla Aka → nerves
† rostral medulla ‫ ؞‬Corticobulbar → brainstem to
† open medulla → because opens onto cranial nerves.
fourth ventricle.
♪ In CS Pyramids lies → anteriorly
♪ fourth ventricle → posteriorly
♪ Anteriorly visible →
† Pyramids

† Olives

♪ Posteriorly visible →
† Gracilis tract → medial

† Cuneatus tract → lateral.

† More lateral→ inferior cerebellar

peduncles,
♪ Nucleus visible
† Cranial nerve 8 nuclei – Ts through Middle of medulla passing
 Originally lies in pons through sensory decussation
 Some part extends to medulla ♪ Sensory decussation is in middle of

† Cranial nerve 10 nuclei medulla

 Nucleus ambiguous † Mn → common sense – word common
ž Nuclei of CN 10 but shared by cn 9 → middle
& 11  Sensory decussation – middle.
 Nucleus solitarius ♪ Sensory decussation → means sensory

ž Shared nucleus of 7 9 10 crossing.

† Spinal nucleus and spinal tract of ♪ Decussation includes fibers of

trigeminal nerve † Dorsal column medial lemniscus

 Part of sensory nucleus of trigeminal system,
nerve. † Tractus gracilis → medial
♪ Other imp structures † Tractus cuneatus → lateral
† From posterior to anterior  Gracilis → from lower extremities.
 Medial longitudinal fasciculus or MLF  Cuneatus from → upper extremities.
ž Function → makes your eye look ž Mn 1 → when one do something

medially, closer to nose. cunning they do it with their

 Tectospinal tract hands.
ž From tectum of midbrain to spinal ž Mn 2 → if one stands anatomical

cord. position → upper extremities are

ž One of extra pyramidal tracts. more lateral to your lower
 Medial lemniscus extremities.
 ž Thus, cuneatus more lateral to medulla we call them dorsal column
gracilis. medial lemniscus system because they
† Gracilis nucleus leave dorsal column and they go towards
† Cuneatus nucleus medial lemniscus which is medial in
anatomical location. Let me remind you
that interior we have pyramids and then
olives, posteriorly we have gracilis then
cuneatus. Spinal tract of trigeminal
nerve and spinal nucleus of trigeminal
are located here for pain and
temperature sensation from your face. I
still have spinocerebellar tract from
spinal cord to cerebellum hashtag
equilibrium and this is second slice of
medulla let's go downstairs lower or
caudal medulla at level of motor
– Ts of Lower part of medulla → level of decastation who's crossing here well
pyramidal decussation. –
♪ Motor decussation is in lower medulla
♪ Pyramidal tract include
† Mn → movements is via lower limbs † Corticospinal
  → decussation – lower medulla. † Corticobulbar
♪ Fibers after decussation in pyramids of ♪ Extra pyramidal tract
medulla are called pyramidal tracts → † Only one extra pyramidal tract → rubro
mcq. spinal tract decussate
♪ Motor tracts include † Red nucleus of midbrain to spinal cord.
† Pyramidal tracts ♪ Other structures
† Extra pyramidal tracts † Gracilis tract & nucleus → medial
 Only pyramidal tracts decussate † Cuneatus tract & nucleus → lateral.

♪ Note →
† Sensory decussation → more posterior

† Motor decussation → more anterior.

ϫ Pearls
– In brainstem
♪ Motor nuclei are medially → CN 3 4 6 12
† Mn → All that come in table of 12

♪ Nuclei of 5 7 8 → Laterally
†

– Centres in medulla →
♪ These lovely sensory fibers that belong ♪ Multiple centres
to dorsal column medial lemniscus † 2 vital centres → cannot survive

system will cross like this. I'm crossing to without.

opposite side. Left will become right and † Other non vital centres → survive

right will become left. Since these are without.

sensory fibers we call this crossing ♪ Vitals
sensory decastation. In middle part of
 † Cardiovascular center → essential for †

Heartbeat. – Which nucleus of trigeminal ganglion

† Respiratory center → essential to receives proprioceptive input from
breathe. ♪ Joints

† Together called cardiopulmonary ♪ Muscles of mastication

centres. ♪ Extraocular muscles

 ♪ Teeth

♪ Non vital ♪ Periodontium

† Swallowing centre † Nucleus of tractus solitarius

† Vomiting centres 

† Sneeze reflex centre – Lesion to nucleus gracilis + cuneatus

† Cough reflex centres ♪ Astrogenesis → inability to judge shape &
† Gag Reflex form of objects.
– Gag Reflex – Lesion of Superior olivary nucleus
♪ Afferents → CN 9 ♪ SON of medulla involved in auditory

♪ Efferents → CN 9 + 10 pathway
† CN 9 → stylopharyngeus muscle ♪ Lesion in SON → pt cannot figure out

† CN 10 → pharyngeal muscles. direction form where sound is coming

♪ Mcq → unilateral lesion of vagus nerve from.
will show little or no gag reflex on ♪

affected side. – Thyroidectomy

– Vomiting center ♪ → damage to vocal cords →
♪ Nucleus of tractus solitarius development of hoarseness in voice
♪ Vertigo with nausea and vomiting ♪ Nerve associated – CN X
associated with dorsal vagus nucleus. ♪

♪ Location dorsal vagus nucleus → lateral – Blood supply →

to rhomboid fossa ♪ Vertebral artery gives rise to →
♪ Rhomboid fossa → depression in anterior † ASA

part of 4th ventricle. † PICA

– Lost of taste sensation → † Medullary arteries

♪ Nucleus of tractus solitarius CN 7 9 10 ♪ ASA → spinal cord + ventromedial part

† of medulla
– Sneeze reflex ♪ PICA → cerebellum + dorsolateral part of
♪ Afferents from both CN 1 + CN 5 but CN medulla
5 fibers > CN 1 fibers. ♪ Medullary artery → medulla.
♪ Efferents → Medulla ♪

♪ Pathway → ♪

† Irritation in nasal mucosa → afferent ♪

via olfactory + ethmoidal → sneezing ♪

centres in medulla → ♪

† Efferent → nucleus ambiguus ( Shared ♪

motor nuclei of CN 9 10 11) → somatic ♪

motor nerves to ♪

 Pharyngeal muscles ♪

 Laryngeal muscles ♪

 Respiratory muscles. ♪

† Sneeze ♪
 ♪

† H2o2 Catalase O2 and h2o

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