The brainstem is the stalk-like part of the brain that interconnects the cerebrum and diencephalon with the spinal cord. In the human brain, the brainstem is composed of the midbrain, the pons, and the medulla oblongata. The midbrain is continuous with the thalamus of the diencephalon through the tentorial notch.
The endocardium is the innermost layer of tissue that lines the chambers of the heart. Its cells are embryologically and biologically similar to the endothelial cells that line blood vessels. The endocardium also provides protection to the valves and heart chambers.
The hypoglossal nucleus is a cranial nerve nucleus, found within the medulla. Being a motor nucleus, it is close to the midline. In the open medulla, it is visible as what is known as the hypoglossal trigone, a raised area protruding slightly into the fourth ventricle.
The fourth ventricle is one of the four connected fluid-filled cavities within the human brain. These cavities, known collectively as the ventricular system, consist of the left and right lateral ventricles, the third ventricle, and the fourth ventricle. The fourth ventricle extends from the cerebral aqueduct to the obex, and is filled with cerebrospinal fluid (CSF).
The trigone is a smooth triangular region of the internal urinary bladder formed by the two ureteric orifices and the internal urethral meatus.
In cardiology, the cardiac skeleton, also known as the fibrous skeleton of the heart, is a high-density homogeneous structure of connective tissue that forms and anchors the valves of the heart, and influences the forces exerted by and through them. The cardiac skeleton separates and partitions the atria from the ventricles .The heart's cardiac skeleton comprises four dense connective tissue rings that encircle the mitral and tricuspid atrioventricular (AV) canals and extend to the origins of the pulmonary trunk and aorta. This provides crucial support and structure to the heart while also serving to electrically isolate the atria from the ventricles.
Circumventricular organs (CVOs) are structures in the brain characterized by their extensive and highly permeable capillaries, unlike those in the rest of the brain where there exists a blood–brain barrier (BBB) at the capillary level. Although the term "circumventricular organs" was originally proposed in 1958 by Austrian anatomist Helmut O. Hofer concerning structures around the brain ventricular system, the penetration of blood-borne dyes into small specific CVO regions was discovered in the early 20th century. The permeable CVOs enabling rapid neurohumoral exchange include the subfornical organ (SFO), the area postrema (AP), the vascular organ of lamina terminalis, the median eminence, the pituitary neural lobe, and the pineal gland.
The facial colliculus is an elevated area located in the pontine tegmentum, within the floor of the fourth ventricle. It is formed by fibres from the facial motor nucleus looping over the abducens nucleus. The facial colliculus is an essential landmark of the rhomboid fossa.
The area postrema, a paired structure in the medulla oblongata of the brainstem, is a circumventricular organ having permeable capillaries and sensory neurons that enable its dual role to detect circulating chemical messengers in the blood and transduce them into neural signals and networks. Its position adjacent to the bilateral nuclei of the solitary tract and role as a sensory transducer allow it to integrate blood-to-brain autonomic functions. Such roles of the area postrema include its detection of circulating hormones involved in vomiting, thirst, hunger, and blood pressure control.
The rhomboid fossa is a rhombus-shaped depression that is the anterior part of the fourth ventricle. Its anterior wall, formed by the back of the pons and the medulla oblongata, constitutes the floor of the fourth ventricle.
The subcallosal area is a small triangular field on the medial surface of the hemisphere in front of the subcallosal gyrus, from which it is separated by the posterior parolfactory sulcus; it is continuous below with the olfactory trigone, and above and in front with the cingulate gyrus; it is limited anteriorly by the anterior parolfactory sulcus.
The olfactory trigone is a small triangular area in front of the anterior perforated substance.
The anterior vagal trunk is one of the two divisions into which the vagus nerve splits as it passes through the esophageal hiatus to enter the abdominal cavity. The anterior and posterior vagal trunks represent the inferior continuation of the esophageal nervous plexus inferior to the diaphragm. The majority of nerve fibres in the anterior vagal trunk are derived from the left vagus nerve.
The posterior vagal trunk is one of the two divisions into which the vagus nerve splits as it passes through the esophageal hiatus to enter the abdominal cavity. The anterior and posterior vagal trunks together represent the inferior continuation of the esophageal nervous plexus inferior to the diaphragm.
In the upper part of the medulla oblongata, the hypoglossal nucleus approaches the rhomboid fossa, where it lies close to the middle line, under an eminence named the hypoglossal trigone. It is a slight elevation in the floor of the inferior recess of the fourth ventricle, beneath which is the nucleus of origin of the twelfth cranial nerve.
The hepatic branches of anterior vagal trunk are branches of the anterior vagal trunk that provide parasympathetic innervation the liver, and gallbladder. Each anterior vagal trunk issues 1-2 hepatic branches which pass through the superior part of the omentum minus to reach and join the hepatic (nervous) plexus before proceeding to the porta hepatis. The anterior vagal trunk is the main source of parasymathetic afferents for the hepatic plexus.
The habenular trigone is a small depressed triangular area situated anterior/superior to the superior colliculus. It contains the habenular nuclei.
A vagal maneuver is an action used to stimulate the parasympathetic nervous system by activating the vagus nerve. The vagus nerve is the longest nerve of the autonomic nervous system and helps regulate many critical aspects of human physiology, including heart rate, blood pressure, sweating, and digestion through the release of acetylcholine. Common maneuvers that activate the vagus nerve include the Valsalva maneuver and carotid sinus massage, which can serve diagnostic or therapeutic functions.
Sinus arrhythmia is a commonly encountered variation of normal sinus rhythm. Sinus arrhythmia characteristically presents with an irregular rate in which the variation in the R-R interval vary by more than 0.12 seconds. Additionally, P waves are typically mono-form and in a pattern consistent with atrial activation originating from the sinus node.
