A stalk of nerve tissue that forms the lowest part of the brain and links with the spinal cord. The brainstem acts partly as a highway for messages travelling between other parts of the brain and spinal cord. It also connects with 10 of the 12 pairs of cranial nerves (which emerge directly from the underside of the brain) and controls basic functions such as breathing, vomiting, and eye reflexes. Brainstem activities are below the level of consciousness, and they operate mainly on an automatic basis. The brainstem is composed of 3 main parts: the midbrain, pons, and medulla. The midbrain contains the nuclei (nervecell centres) of the 3rd and 4th cranial nerves. It also contains cell groups involved in smooth coordination of limb movements. The pons contains nerve fibres that connect with the cerebellum. It also houses the nuclei for the 5th–8th cranial nerves. The medulla contains the nuclei of the 9th–12th cranial nerves. It also contains the “vital centres” (groups of nerve cells that regulate the heartbeat, breathing, blood pressure, and digestion (information on which is relayed via the 10th cranial nerve (see vagus nerve). Nerve-cell groups in the brainstem, known collectively as the reticular formation, alert the higher brain centres to sensory stimuli that may require a conscious response. Our sleep/wake cycle is controlled by the reticular formation. The brainstem is susceptible to the same disorders that afflict the rest of the central nervous system (see brain, disorders of). Damage to the medulla’s vital centres is rapidly fatal; damage to the reticular formation may cause coma. Damage to specific cranial nerve nuclei can sometimes lead to specific effects. For example, damage to the 7th cranial nerve (the facial nerve) leads to facial palsy. Degeneration of the substantia nigra in the midbrain is thought to be a cause of Parkinson’s disease.


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