The Reticular Formation
Introduction
• Reticular formation is a diffuse but highly-
organized network of neurons distributed
through the tegmentum of brainstem
• It plays a central role in the regulation of the
state of consciousness and arousal
• Because of this, it is sometimes referred to as
the reticular activating system
Anatomy
• Not anatomically well-defined because it
includes neurons from diverse parts of brain
• Its name derives from the characteristic
appearance of loosely packed cells of various
sizes and shapes, embedded in a dense
network of axons and dendrites
• Reticulum = small net (Latin)
Anatomy
• Consists of interconnected circuits of neurons
in the tegmentum, the lateral hypothalamic
area, and the medial, intralaminar, and
reticular nuclei of the thalamus
Anatomy
Anatomy
• Many of these neurons are serotonergic, or
noradrenergic
• Axons from these non-specific thalamic nuclei
project to most of the cerebral cortex,
modulating the level of activity of large
numbers of neurons
Anatomy
• Also gives rise to descending axons in the
reticulospinal tract, which may play a role in
modulating:
– Spinal reflex activity
– Sensory input, and
– Autonomic activity in the spinal cord
Anatomy
• Brainstem RF can be subdivided into 3 zones:
– Lateral zone: “afferent zone”, receives
sensory input
– Medial zone: “efferent zone”, forms central
tegmental tract
– Midline zone: nuclei of raphe and
periaqueductal grey
Anatomy
Functions
Arousal
• Excited by sensory stimuli of various
modalities that are conducted by the way of
collaterals from the somatosensory, auditory,
visual, and visceral sensory systems to
reticular formation
• Produces output in a non-specific manner to a
large area of cortex, thereby performs a
generalized regulatory function
Function
• Behavioural arousal: Attention is focused on a
new stimulus is received, and general
alertness increases.
• It is independent of the modality of the
stimulus and is accompanied by EEG changes
over much of cortex
Functions
Consciousness
• Many areas of the cerebral cortex produce
generalized arousal when stimulated
• The cortex and the mecencephalic RAS are
mutually sustaining areas in maintaining
consciousness
• Lesions that destroy large area of cortex
and/or midbrain may produce coma
Functions
Functions
Causes of coma:
• Intracranial: TBI, CVA, infections, tumours, ↑
ICP
• Extracranial: vascular, e.g. shock
metabolic, e.g. DKA, uraemia
intoxication, e.g. narcotics, CO
miscellaneous, e.g. hyperthermia
Glasgow Coma Scale
References
• Waxman SG. Clinical neuroanatomy. 26th ed.
New York: McGraw-Hill; 2010. p 225-228.
• Noback CR, Strominger NL, Demarest RJ,
Ruggiero DA. The human nervous system:
structure and function. 6th ed. Totowa:
Humana Press; 2005. p 387-390.