Brainstem

Brainstem is the posterior stalk-like part of the brain that connects the cerebrum with the spinal cord.

The brainstem is very small, making up around only 2.6 percent of the brain’s total weight.

In the human brain the brainstem is composed of the midbrain, the pons, and the medulla oblongata. The midbrain is continuous with the thalamus of the diencephalon through the tentorial notch, and sometimes the diencephalon is included in the brainstem.

©Disaster STS Network

The midbrain is further subdivided into three parts: tectum, tegmentum, and the ventral tegmental area. The tectum forms the ceiling. The tectum comprises the paired structure of the superior and inferior colliculi and is the dorsal covering of the cerebral aqueduct.

The tegmentum which forms the floor of the midbrain, is ventral to the cerebral aqueduct. Several nuclei, tracts, and the reticular formation are contained here.

The ventral tegmental area is composed of paired cerebral peduncles. These transmit axons of upper motor neurons.

The pons lies between the medulla oblongata and the midbrain. It contains tracts that carry signals from the cerebrum to the medulla and to the cerebellum and also tracts that carry sensory signals to the thalamus.

The medulla oblongata is the lower half of the brainstem continuous with the spinal cord. Its upper part is continuous with the pons. The medulla contains the cardiac, dorsal and ventral respiratory groups, and vasomotor centres, dealing with heart rate, breathing and blood pressure. Another important medullary structure is the area postrema whose functions include the control of vomiting.

©Britannica

It has the critical roles of regulating cardiac, and respiratory function, helping to control heart rate and breathing rate. It also provides the main motor and sensory nerve supply to the face and neck via the cranial nerves. Ten pairs of cranial nerves come from the brainstem.

Other roles include the regulation of the central nervous system and the body’s sleep cycle.[3] It is also of prime importance in the conveyance of motor and sensory pathways from the rest of the brain to the body, and from the body back to the brain. These pathways include the corticospinal tract (motor function), the dorsal column-medial lemniscus pathway (fine touch, vibration sensation, and proprioception), and the spinothalamic tract (pain, temperature, itch, and crude touch).

Diseases of the brainstem can result in abnormalities in the function of cranial nerves that may lead to visual disturbances, pupil abnormalities, changes in sensation, muscle weakness, hearing problems, vertigo, swallowing and speech difficulty, voice change, and co-ordination problems.

Localizing neurological lesions in the brainstem may be very precise, although it relies on a clear understanding on the functions of brainstem anatomical structures and how to test them.

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