The medulla oblongata is the lowest part of the brainstem, continuous with the spinal cord at the foramen magnum. It contains the centres that control breathing, heart rate and blood pressure, as well as nuclei of cranial nerves IX to XII. The motor pathways cross over in the medulla, which is why each side of the brain controls the opposite side of the body.
| Location | Between the pons above and the spinal cord below (at the level of the foramen magnum and C1 rootlets), in front of the cerebellum and lower fourth ventricle |
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| Blood Supply | Vertebral arteries; Anterior spinal artery; Posterior inferior cerebellar artery; Posterior spinal arteries |
Maintains vital functions including breathing, heart rate and blood pressure; controls swallowing, coughing, vomiting and tongue movement; and conveys all ascending and descending pathways between brain and spinal cord.
Lateral medullary (Wallenberg) syndrome from vertebral or PICA occlusion causes vertigo, difficulty swallowing, hoarseness, ipsilateral facial and contralateral body pain-temperature loss and Horner syndrome. Medial medullary syndrome causes contralateral hemiplegia and ipsilateral tongue weakness. Herniation of the cerebellar tonsils through the foramen magnum compresses the medulla and can stop breathing.
Infarction of the lateral medulla causing vertigo, ataxia, dysphagia, hoarseness, Horner syndrome and crossed loss of pain and temperature sensation.
Infarction of the medial medulla causing contralateral hemiplegia, contralateral loss of position sense and ipsilateral tongue weakness.
Downward displacement of the cerebellar tonsils through the foramen magnum compressing the medulla, causing respiratory arrest.
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