Sunday, 20 August 2017

The Medulla

Medulla

1. Surface anatomy

Ventral:

















Gracilis (lower limb- graceful-) medial to cuneatus (upper limb). Generally when standing straight your legs are medial to arms. 


Floor of 4th ventricle:




Cranial nerves:


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Axial views through medulla

1. At level of pyramidal decussation (most caudal)


2. At level of sensory decussation (of medial lemnisci). 
Purple lines represent the internal arcuate fibres as they form the medial lemniscus  


3.  At level of olives (most cranial) NB Open Medulla i.e. above obex of 4th ventricle 


Vasculature:

Vessels that supply the medulla include: the anterior spinal, the posterior spinal, the PICA, AICA, and vertebral arteries


From the above it is possible to surmise the effects of lateral medullary (PICA) syndrome: 


Features are ipsilateral except for loss of contralateral pain and sensation over the body. Also NB Picachew i.e. dysphagia mnemonic. 



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