Medulla Oblongata (Human Anatomy): Image, Functions, Diseases and Treatments

What is the medulla oblongata? Your medulla oblongata is the bottom-most part of your brain. Your medulla oblongata is a part of your brainstem, which connects your brain to your spinal cord. That makes your medulla a major connection point in your nervous system. It also manages many of the most important functions of your body. It also helps control vital processes like your heartbeat, breathing and blood pressure.

Your medulla oblongata (med-oo-la ob-long-ah-ta), often just called the medulla, is a key part of your nervous system. It’s key not only because of its location but also because of what it controls. Some of its jobs include:Manages heart, circulation and breathing**. Your medulla is where your cardiovascular and respiratory systems link together into a united system that controls your heart rate, breathing, blood pressure and more.Manages other automatic processes. These are things that your body often does without you having to think about them.

Some examples include coughing, sneezing, swallowing, vomiting and maintaining your balance.Nerve connections. The vast majority of major nerves converge at your spine, carrying signals to and from your brain. That means those signals must pass through your medulla. Four of your 12 cranial nerves (which connect areas of your throat and tongue directly to your brain) pass through your medulla.

Crossover point. your medulla is the location of a region called 'the pyramids,' where most of the movement-related nerves in your body crisscross. That crossover is why one side of your brain almost always controls parts on the opposite side of your body.

The medulla and cranial nerves

Your cranial nerves (which come in pairs and use Roman numerals to set them apart) that pass through your medulla include the following:

• Cranial Nerve (CN) IX: Your ninth cranial nerve handles many of the functions of your mouth. These include activating the glands that make saliva (spit) and your ability to taste and feel things inside of your mouth. It also controls your gag reflex, which keeps you from accidentally choking on objects.
• CN X: Your 10th cranial nerve, known as the vagus nerve, is one of the most important nerves in your body. It connects to all the major organs from your neck to the top part of your colon, transmitting signals for your autonomic nervous system. These are signals you don’t think about, and they manage your heart rate, intestinal movements and more. This nerve also carries signals for muscles of your larynx (voice box) and the muscles you use to swallow.
• CN XI: Your 11th cranial nerve controls muscles on your neck and upper back. These muscles help you turn your head or shrug your shoulders.
• CN XII: Your 12th cranial nerve controls the muscles that you use to stick out your tongue. That makes this nerve vital for your ability to speak and swallow.

Your medulla is the bottom-most part of your brain, connecting to your spinal cord through the foramen magnum, an opening at the bottom of your skull. Just above your medulla is your pons, which is just below the central structures in your brain.

Your medulla also separates the nerves that control muscle movement, which are on the left side, and the nerves that control certain sensations like touch, temperature or pain, which are on the right side.

Your medulla is generally tube- or funnel-shaped. It’s widest at the top, where it connects to your pons.

The average adult human brain is between 2.6 and 3.1 pounds, of which your medulla accounts for about 0.5%. That means your medulla weighs between 2 ounces and 2.5 ounces (59grams to 72 grams).

Like all other brain tissue, various types of white and gray brain matter and nerve cells make up your medulla. The tissue of your brain is roughly:

• 77% water.
• 11% lipids (fats).
• 8% proteins.
• 4% other.

• Parkinson’s disease: Progressive neurological and brain dysfunction is the hallmark of Parkinson's disease. Early signs appear gradually. A slight tremor in one hand may be the first sign. Although tremors are characteristic of this illness, it can also cause a person's movements to become rigid or slow.
• Wallenberg syndrome: Lateral medullary syndrome is another name for Wallenberg syndrome. Strokes that occur close to the medulla often cause this condition. A breach in the lateral medulla oblongata is to blame (i.e., the lateral medullary syndrome). Ischemia from an infarction of the posterior inferior cerebellar artery or the vertebral artery is the most common cause of Wernicke's syndrome.
• Dejerine syndrome: Dejerine syndrome, also known as medial medullary syndrome, is a very unusual illness that affects fewer than 1 percent of persons who suffer strokes in the back of the brain.Bilateral medial medullary syndrome: Bilateral medial medullary syndrome is a rare complication from a stroke. Only a fraction of 1 percent of people with strokes in the rear part of their brain develop this condition.
• Reinhold syndrome: A case of Reinhold syndrome, also known as hemi medullary syndrome, is highly unusual. When the posterior inferior cerebellar artery and its anterior spinal artery branches get blocked, this condition is known as occipital lobe epilepsy.
• Stroke of the Medulla: Paralyzing damage to the medulla disrupts life-sustaining nerve signals. Numerous undesirable consequences may arise.
• Brain Aneurysm: When a weak spot in a brain artery enlarges and fills with blood, it is called an aneurysm. The only time you might notice anything is if your aneurysm has ruptured and started leaking blood. In addition to causing a debilitating headache, a ruptured aneurysm can lead to a potentially fatal stroke.
• Brain Cancer: A brain tumour is an unnatural accumulation of cells in or on the brain. Tumors of the brain and spinal cord are often referred to as CNS tumours.
• Moebius Syndrome: The neurological condition known as Moebius syndrome is extremely uncommon. Some of the nerves that flow from the brain to the rest of the body (the cranial nerves) become weak or paralysed as a result.
• Multiple System Atrophy: Rare in the neurological disease spectrum, multiple system atrophy (MSA) leads to the decline of specific brain regions. This causes disruptions in talents and functions controlled by those regions of the brain over time. Unfortunately, this illness is lethal in the long run.
• Progressive Supranuclear Palsy: Symptoms include difficulty walking, thinking, swallowing, and moving the eyes, and the underlying cause is injury to the brain (namely the basal ganglia, substantia nigra, subthalamic nucleus, pars reticulata, and other midbrain structures). To far, no effective treatments for curing or altering the condition have been discovered.
• Hemangioblastoma: Hemangioblastoma is a benign tumour that forms in blood vessels. In most cases, it develops in the brain, spinal cord, or retina in the back of the eye, where it begins as a tumour in the blood vessel lining (retina).
• Brain Herniation Syndrome: When pressure builds up inside the skull and shifts brain tissue, a herniation occurs. The most common causes of this include traumatic brain injury, stroke, and brain tumours, all of which lead to swelling and bleeding in the brain.
• Brain Abscess: Pustules that form in the brain are called brain abscesses. When an infection or traumatic brain injury allows bacteria or fungus to invade brain tissue, this condition develops.

The symptoms of conditions affecting your medulla are most likely to look like symptoms that affect parts of your body with nerves that run through your medulla. A key difference is that with a stroke affecting your medulla, you’ll often have certain symptoms on one side of your body and others on the other side.

Some of the most likely symptoms include:

• Stroke symptoms
• Clumsiness or lack of coordination (symptoms of ataxia).
• Headaches
• Hoarseness (dysphonia)
• Inability to feel temperature or pain in part of your body or face.
• Jerky or uncontrolled eye movements (nystagmus)
• Nausea and vomiting
• Paralysis
• Trouble swallowing (dysphagia)
• Vision problems.

Some of the treatments for conditions in your medulla are specific, as this part of your brain is so specialized. Your medulla’s location also means that surgery can be difficult or even impossible because of the risk of damaging nearby parts of your brain or spinal cord.

Many tests can help diagnose conditions that affect your brain, including your medulla. Common tests include:

• Angiogram: Cerebral angiography employs x-rays and a contrast substance (dye) to visualize blood vessels in the brain. Carotid arteriograms are X-ray examinations used to detect blockages or other abnormalities in the carotid artery, a major blood vessel supplying the brain.
• CT: When compared to traditional head X-rays, brain CT scans are able to reveal more information about brain tissue and brain structures, which can be helpful when diagnosing and treating brain injuries and diseases..
• MRI: Imaging the brain and spinal cord with an MRI is routinely done. Aneurysms of the cerebral vessels are routinely diagnosed using this procedure.
• Calcitonin test: Calcitonin blood tests determine how much of the hormone is circulating in the body. The thyroid, a small, butterfly-shaped gland in front of the throat, produces a hormone called calcitonin. The hormone calcitonin plays a role in regulating calcium homeostasis. Calibrated to detect malignant cells, calcitonin is a tumour marker..
• Electroencephalogram: Electrodes (tiny metal discs) are connected to the scalp to record electrical activity in the brain during an electroencephalogram (EEG). Brain cells are constantly communicating with one another via electrical impulses, even when we sleep. The EEG depicts this activity as irregular lines.
• Electromyogram: Muscle and nerve function can be evaluated with electromyography (EMG), a diagnostic test (motor neurons). The outcomes of an EMG can reveal nerve dysfunction, muscle dysfunction, or issues with nerve-to-muscle signal transmission.
• Positron emission tomography (PET) scan: To observe and quantify metabolic process changes, as well as those in blood flow, regional chemical composition, and absorption, positron emission tomography is a functional imaging technique that uses radioactive compounds known as radiotracers.
• Spinal tap (lumbar puncture): The lumbar puncture, also called a 'spinal tap,' is a diagnostic procedure. The lumbar area of the back is the target. A lumbar puncture is a procedure in which a needle is placed into the gap between two lumbar bones (vertebrae) to withdraw a sample of cerebrospinal fluid.

• Surgical Drainage for brain abscess: A shunt is a small tube used to redirect the flow of cerebrospinal fluid (CSF) from the brain's ventricles to another portion of the body where it can be absorbed. Shunts are typically only 0.3cm (3mm) in diameter and made of plastic. Valve mechanisms allow cerebral fluid to drain, but prevent its reversal.
• Radiation therapy: Radiation therapy involves subjecting cancer cells to high-energy radiation or particles in order to kill them. It is not a common treatment for cancer of the parathyroid gland.
• Chemotherapy: Chemotherapy is the process of destroying cancer cells by using anticancer medications, often known as cytotoxic drugs. It is not a common treatment for cancer of the medulla oblongata.

• Steroids for reducing inflammation of Medulla Oblongata: anti-inflammatory drugs reduce inflammation by limiting the migration of polymorphonuclear leukocytes (PMNs) to regions of cellular and tissue damage. They are beneficial in the treatment of any sort of medullary infection and other infections relating to different regions of brain.
• Analgesics for pain in Medulla Oblongata: Analgesics are medications used to relieve pain and reduce the amount of prostaglandins generated by the body. they are helpful in the treatment of any cerebral disorder.
• Antibiotics for infection in Medulla Oblongata: bacterial illnesses of the parts of the brain are treated with antibiotics. Staining Gram-positive bacteria: Vancomycin resistance with Gram-negative bacteria: Ceftriaxone, in conjunction with either azithromycin or doxycycline.
• Antivirals for treating infection of Medulla Oblongata: Although these drugs are powerful against bacterial and fungal cerebral infections, they have no impact on the virus that causes cerebral edema. Included in this group of medicines are amantadine, ribavirin, acyclovir, ganciclovir, and foscarnet.

You can do several things to help prevent damage to your medulla or avoid conditions that affect it.

Eat a balanced diet. Certain vitamin deficiencies, especially vitamin B12, can affect your brain, including your medulla, and cause major issues.

Stay physically active and maintain a healthy weight. Circulatory and heart problems affect your brain, too. Stroke is an example of this, often happening because of problems in your heart. Staying active and maintaining a healthy weight can help reduce your risk.

Wear safety equipment as needed. Injuries to your head can affect your brain seriously, causing concussions or traumatic brain injuries. Wearing safety equipment during work and play activities can protect your brain from these types of injuries.