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PONS: Neuroanatomy

The pons is located between the midbrain and medulla oblongata and connects the cerebellum to the midbrain. It contains nuclei that control various motor and sensory functions. A hemorrhage in the pons can cause paralysis of the face on one side and limbs on the opposite side. Tumors of the pons often manifest as cranial nerve paralysis on one side and weakness of the limbs on the other side.

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Hassan Ilyas
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215 views20 pages

PONS: Neuroanatomy

The pons is located between the midbrain and medulla oblongata and connects the cerebellum to the midbrain. It contains nuclei that control various motor and sensory functions. A hemorrhage in the pons can cause paralysis of the face on one side and limbs on the opposite side. Tumors of the pons often manifest as cranial nerve paralysis on one side and weakness of the limbs on the other side.

Uploaded by

Hassan Ilyas
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PPTX, PDF, TXT or read online on Scribd
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PONS

Gross Appearance of the Pons

• Pons is anterior to the cerebellum and connects the


medulla oblongata to the midbrain.
• It is about 1 inch (2.5 cm) long and owes its name to the
appearance presented on the anterior surface, which is
that of a bridge connecting the right and left cerebellar
hemispheres.
• The anterior surface is convex from side to side and
shows many transverse fibers that converge on each side
to form the middle cerebellar peduncle.

• There is a shallow groove in the midline, the basilar


groove, which lodges the basilar artery.

• On the anterolateral surface of the pons, the trigeminal


nerve emerges on each side. Each nerve consists of a
smaller, medial part, known as the motor root, and a
larger, lateral part, known as the sensory root.
• In the groove between the pons and the medulla
oblongata, there emerge, from medial to lateral, the
abducent, facial, and vestibulocochlear nerves
• The posterior surface of the pons is hidden from view by
the cerebellum.
• It forms the upper half of the floor of the fourth ventricle
and is triangular in shape.
• The posterior surface is limited laterally by the superior
cerebellar peduncles and is divided into symmetrical
halves by a median sulcus.
• Lateral to this sulcus is an elongated elevation, the medial
eminence, which is bounded laterally by a sulcus, the
sulcus limitans.
• The inferior end of the medial eminence is slightly
expanded to form the facial colliculus, which is produced
by the root of the facial nerve winding around the nucleus
of the abducent nerve.
• The floor of the superior part of the sulcus limitans is
bluish-gray in color and is called the substantia
ferruginea; it owes its color to a group of deeply
pigmented nerve cells.
• Lateral to the sulcus limitans is the area vestibuli
produced by the underlying vestibular nuclei
LEVEL CAVITY NUCLEI MOTOR TRACTS SENSORY
TRACTS

FACIAL 4TH VENTRICLE Facial nucleus, Corticospinal and Spinal tract of


COLLICULUS abducent nucleus, corticonuclear cranial nerve V;
medial vestibular tracts, lateral, spinal, and
nucleus, transverse pontine medial lemnisci
spinal nucleus of fibers,
cranial nerve V, medial longitudinal
pontine nuclei, fasciculus
trapezoid nuclei

TRIGEMMINAL 4TH VENTRICLE Main sensory and Corticospinal and Lateral, spinal, and
NUCLEI motor nucleus of corticonuclear medial lemnisci
cranial nerve V, tracts,
pontine nuclei, transverse pontine
trapezoid nuclei fibers,
medial longitudinal
fasciculus
Pontine Hemorrhage

• The pons is supplied by the basilar artery and the anterior,


inferior, and superior cerebellar arteries.
• If the hemorrhage occurs from one of those arteries and is
unilateral
• facial paralysis on the side of the lesion (involvement of
the facial nerve nucleus and, therefore, a lower motor
neuron palsy)
• paralysis of the limbs on the opposite side (involvement of
the corticospinal fibers as they pass through the pons and
will cross in medulla)
• often paralysis of conjugate ocular deviation (involvement
of the abducent nerve nucleus and the medial longitudinal
fasciculus)
• When the hemorrhage is extensive and bilateral, the
pupils may be “pinpoint” (involvement of the ocular
sympathetic fibers); there is commonly bilateral paralysis
of the face and the limbs.
• The patient may become poikilothermic because severe
damage to the pons has cut off the body from the heat-
regulating centers in the hypothalamus
Tumors of the Pons
Astrocytoma of the pons occurring in childhood is the most
common tumor of the brainstem. The symptoms and signs
are those of
• Ipsilateral cranial nerve paralysis and contralateral
hemiparesis
• Weakness of the facial muscles on the same side (facial
nerve nucleus)
• Weakness of the lateral rectus muscle on one or both
sides (abducent nerve nucleus)
• Nystagmus (vestibular nucleus)
• Weakness of the jaw muscles (trigeminal nerve nucleus)
• Impairment of hearing (cochlear nuclei)
• Contralateral hemiparesis, quadriparesis (corticospinal
fibers)
• Anesthesia to light touch with the preservation of
appreciation of pain over the skin of the face (principal
sensory nucleus of trigeminal nerve involved, leaving
spinal nucleus and tract of trigeminal intact)
• Contralateral sensory defects of the trunk and limbs
(medial and spinal lemnisci).
• Involvement of the corticopontocerebellar tracts may
cause ipsilateral cerebellar signs and symptoms.
• There may be impairment of conjugate deviation of the
eyeballs due to involvement of the medial longitudinal
fasciculus, which connects the oculomotor, trochlear, and
abducent nerve nuclei
Infarctions of the Pons

• Usually, infarction of the pons is due to thrombosis or


embolism of the basilar artery or its branches

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