Cranial Nerve Nuclei

In
Medulla Oblongata

By

Hassan Mohammad Al-Shehri

ID#2051040006
 Cranial nerve nuclei in
Medulla Oblongata

Introduction:

The 'medulla oblongata' is the lower portion of the brainstem. By anatomical

terms of location, it is rostral to the spinal cord and caudal to the pons, which is in turn
ventral to the cerebellum.

Controls autonomic functions and relays nerve signals between the brain and spinal cord.

The medulla is often thought of as being in two parts, an open part (close to the pons),
and a closed part (further down towards the spinal cord). The 'opening' referred to is on
the dorsal side of the medulla, and forms part of the fourth ventricle of the brain.

Running down the ventral aspect of the medulla are the pyramids which contain
corticospinal fibers. On the open medulla, there is a slight bulge just behind the pyramids
called the olive or olivary nuclei.

In Medulla Oblongata we have many nuclei:

• Vestibulocochlear Nucleus (VIII) - Which found in pons and medulla

• Hypoglossal nucleus (XII) - motor
• Dorsal motor nucleus of vagus nerve (X) - visceromotor
• Nucleus ambiguous (IX, X, XI) - motor
• Solitary nucleus (VII, IX, X) - sensory
• Spinal trigeminal nucleus (V) - sensory
• Inferior olivary nucleus afferent fibers to cerebellum
Vestibulocochlear Nucleus
Vestibular nerve:

The 'Vestibulocochlear nerve' is the eighth of twelve cranial nerves and also known as the
auditory nerve or acoustic nerve. It is the nerve along which the sensory cells (the hair
cells) of the inner ear transmit information to the brain. It consists of the cochlear nerve,
carrying information about hearing, and the vestibular nerve, carrying information about
balance. It emerges from the medulla oblongata and enters the internal acoustic meatus in
the temporal bone, along with the facial nerve.

Axons of the vestibular nerve synapse in the vestibular nucleus on the lateral floor and
wall of the fourth ventricle in the pons and medulla. The vestibular nerve goes to the
semicircular canals via the vestibular ganglion. It receives positional information.

The eighth nerve runs through the internal auditory meatus together with the facial nerve.
The primary afferent vestibular neurons project
to four nuclei that comprise the vestibular
nuclear complex in the floor of the medulla
beneath the fourth ventricle.

The four nuclei of the vestibular nuclear

complex are the lateral vestibular nucleus (also
called Deiter's nucleus), the medial vestibular
nucleus, the superior vestibular nucleus, and the
inferior vestibular nucleus.

The vestibular nuclei receive afferent fibers from

the utricle and saccule and the semicircular canals through the vestibular nerve and fibers
from the cerebellum through the inferior cerebellar peduncle. The efferent fibers come
from the nuclei and it will pass to the cerebellum through the inferior cerebellar peduncle.
Efferent fibers also descend uncrossed fibers to the spinal cord from the lateral vestibular
nucleus and from the vestibulospinal tract. In addition, efferent fibers pass to the nuclei of
the occulomotor, trochler, and abducent nerves through the medial longitudinal
fasciculus.
Cochlear nuclei:

The cochlear nuclei consist of:

• (a) the dorsal cochlear nucleus, corresponding to the tuberculum acusticum on the
dorso-lateral surface of the inferior peduncle; and
• (b) The ventral or accessory cochlear nucleus, placed between the two divisions of
the nerve, on the ventral aspect of the inferior peduncle.

The cell groups related to the other division of C.N. VIII, the vestibular nuclei, lie medial
to the inferior cerebellar peduncle.

They receive afferent fibers from the cochlea through the cochlear nerve.
The primary input to both cochlear nuclei is from the auditory portion of C.N. VIII. The
axons making up this division of C.N. VIII consist of the central processes of neurons
that lie in the spiral or cochlear ganglion.

Glossopharyngeal Nerve Nuclei

The IX nerve has no real nucleus to itself. Instead it shares nuclei with VII and X and
these nuclei are main motor, parasympathetic and sensory nucleus.

Main motor nucleus:

It lies deep in the reticular formation of the medulla oblongata and is formed by the
superior end of the nucleus ambiguus. It receives corticonuclear fibers from both cerebral
hemispheres. The efferent fibers supply the stylopharyngeus muscle.

Parasympathetic nucleus:
This nucleus is also called the inferior salivary nucleus. It lies in the medulla just medial
to the nucleus ambiguus.
It receives afferent from hypothalamus, olfactory system, and from nucleus of solitary
tract. Preganglionic parasympathetic axons arising from cells in the inferior salivatory
nucleus end within the OTIC GANGLION. Postganglionic axons then pass to the parotid
gland where they stimulate secretion.

Sensory nucleus:
It’s a part of the nucleus of the TRACTUS SOLITARIUS.
Sensation of taste travel through the peripheral axon of the nerve cells situated in the
ganglion on glossopharyngeal nerve. Afferent impulse from the carotid baroreceptors are
sent via the glossopharyngeal nerve. They terminate in the nucleus of tractus solitarius.
Vagus nerve nuclei
The vagus nerve (also called pneumogastric nerve or cranial nerve X), and it’s the only
nerve that starts in the brainstem (within the medulla oblongata).

The vagus nerve has three associated nuclei, the dorsal motor nucleus, the nucleus
ambiguus and the solitary nucleus.

Nucleus ambiguus:
It’s a motor nucleus. It lies deep in the reticular formation of the medulla oblongata. It
receives corticonuclear fibers from both cerebral hemispheres. It innervates striated
muscle throughout the neck and thorax. This includes some muscles of the palate and
pharynx, muscles of the larynx, and the parasympathetic innervations of the heart.

Dorsal nucleus of the vagus:

This nucleus arises from the floor of the fourth ventricle. It nucleus lies slightly dorsal
and lateral to the hypoglossal nucleus. It receives afferent from hypothalamus and from
glossopharyngeal. the efferent fibers is going to the involuntary muscle of bronchi , heart
, esophagus , stomach , small intestine , and the large intestine until one third of the
transverse colon. This is secretomotor parasympathetic nucleus. Secretomotor primarily
means that it stimulates glands - including mucus glands of the pharynx, lungs, and gut,
as well as gastric glands in the stomach.

Solitary nucleus:
It receives taste information, sensation from the back of the throat, and also visceral
sensation. Visceral sensation includes blood pressure receptors, blood-oxygen receptors,
sensation in the larynx and trachea, and stretch receptors in the gut. Most information
goes from the solitary nucleus to the thalamus and hypothalamic nuclei. Afferent
information concerning general sensation enters the brain stem through the superior
ganglion of the vagus nerve but end the spinal nucleus of the trigeminal nerve.
Accessory nerve
Traditional descriptions distinguish two parts to the accessory nerve:

• A spinal part, formed from axons of spinal nucleus. It receives corticospinal

fibers from both cerebral hemispheres. That innervates the muscles around the
neck -- specifically, the sternocleidomastoid muscle (sternomastoid) and trapezius
muscle on the ipsilateral side.

• A cranial part, formed from the axons of nucleus ambiguus. The afferents from
corticonuclear fibers from both cerebral hemispheres. The efferents emerge from
the anterior surface of the medulla oblongata between the olive and inferior
peduncle.

Hypoglossal nucleus

This nucleus lies just off the midline beneath the floor of the fourth ventricle. It receives
corticonuclear fibers from both cerebral hemispheres. Axons from cells within the
hypoglossal nucleus course ventrally to exit the medulla between the pyramid and the
inferior olive. The hypoglossal nerve then passes through the hypoglossal foramen to
emerge from the base of the skull. Each nerve innervates the ipsilateral intrinsic and
extrinsic muscles of the tongue.

Examination of lesion in cranial nerves

Vestibule cochlear nerve :

Vestibular: Lesions involving the vestibular nerve, nuclei, and descending

pathways will result in problems such as stumbling or falling toward the side of the
lesion. Vestibular function can be investigated with caloric tests. These involve the rising
and lowering of the temperature in the external auditory meatus which induce convection
currents in the endolymph of the semicircular canals (principally the lateral semicircular
canal) and stimulates the vestibular nerve endings.
Cochlear: Lesions involving the cochlear nerve will manifest in deafness and
tinnitus. Its function can be investigated by a tuning fork.

Glossopharyngeal nerve :
The gag reflex is absent in patients with damage to the glossopharyngeal nerve as it is
responsible for the afferent limb of the reflex.

Vagus nerve:
Check for hoarseness, and asking the patient to say "AH"

Accessory nerve :
Getting a person to raise and lower their shoulders while you push down tests trapezius.
When a person turns their head, especially against force, sternocleidomastoid should be
prominent.

Hypoglossal
Problem with the hypoglossal nerve can be detected by asking the patient to stick out his
tongue. The tongue will deviate towards the weak side, towards the side of the lesion.

Nerve Function How to test

VIII hearing a tuning fork
balance look for vertigo
IX pharynx sensation gag reflex
muscles of larynx  check for hoarseness, 
X and pharynx,  open wide and say 
parasymp. "AH"
trapezius and  test shoulder raise or 
XI
sternocleidomastoid turning the head
XII tongue muscles stick out the tongue