Cấu trúc bên trong của thân não, gian não, đoan não, màng não và mạch máu

Spinal Trigeminal Nucleus and Tract (SpTN, SpTTr) Medial and Spinal Vestibular Nuclei (MVN, SpVN) Lateral Cuneate Nucleus (LCN). Inferior Cerebellar Peduncle (ICP) Medial Longitudinal[r]

(1)

DEPARTMENT OF ANATOMY

CẤU TRÚC BÊN TRONG CỦA THÂN NÃO

GIAN NÃO, ĐOAN NÃO, MÀNG NÃO VÀ MẠCH MÁU

GIAN NÃO, ĐOAN NÃO, MÀNG NÃO VÀ MẠCH MÁUGIAN NÃO, ĐOAN NÃO, MÀNG NÃO VÀ MẠCH MÁUCẤU TRÚC BÊN TRONG CỦA THÂN NÃO CẤU TRÚC BÊN TRONG CỦA THÂN NÃO

(2)

Các đoạn Các đoạn 8 cổ 8 cổ 12 ngực 12 ngực

5 thắt lưng 5 thắt lưng

5 cùng 5 cùng 1 cụt 1 cuït

Rễ trước TK gai Rễ trước TK gai Rễ sau TK gai Rễ sau TK gai

Ống trung tâm Ống trung tâm

Bó thon Bó thon

Bó chêm Bó chêm

Vách sau trong Vaùch sau trong

Chất xám trung gian Chất xám trung gian Sừng bên Sừng bên Khe giữa Khe giữa Thừng sau Thừng sau Thừng bên Thừng bên Thừng trước Thừng trước Bó thon Bó thon Sừng sau Sừng sau Sừng trước Sừng trước Mép trắng Mép trắng Chất trung gian Chất trung gian trung tâm

(3)

Chất xám trung tâm Chất xám trung tâm

Cống não Cống não Mảnh sing tư

Mảnh sing tư

(4)

Lồi não trên Lồi não trên

Cấu tạo lưới Cấu tạo lưới

Chất đen Chất đen

Bắt chéo cuống Bắt chéo cuống tiểu não trên

(5)

Sợi cầu ngang Sợi cầu ngang

Bó vỏ gai Bó vỏ gai (tháp) (tháp) Cuống tiểu Cuống tiểu não dưới não dưới Cuống tiểu não Cuống tiểu não trên

(6)

Cuống tiểu Cuống tiểu não dưới não dưới Nhân trám Nhân trám Bắt chéo Bắt chéo vận động vận động Bắt chéo Bắt chéo cảm giác cảm giác Bắt chéo Bắt chéo tháp tháp Đường dẫn Đường dẫn truyền gai tiểu truyền gai tiểu não không bắt não không bắt chéo

(7)

Vùng cảm giác

Vùng cảm giác cô

thể thể Liềm Liềm trong trong Vành Vành tia tia Bao Bao trong trong Nhân bèo Nhân bèo Sợi vỏ Sợi vỏ nhân đến nhân đến

các TK sọ

Liềm gai

(8)

VAGUS NERVE TK XTK X Nhân hoài nghi

Nhân hoài nghi Nhân lưng TK X Nhân lưng TK X

Nhân bọt dưới Nhân bọt dưới

Nhân gai dây V Nhân gai dây V

(9)

(10)

(11)

(12)

(13)

(14)

MEDULLA OBLONGATA

VI

XII

VIII VII

IX X

(15)

THE FLOOR OF 4TH VENTRICLE

- Median sulcus

- Stria medullaris

- Trigonum hypoglossi - Trigonum acustici

- Trigonum vagi (ala cinerea) - Fovea inferior

- Eminentia teres

(colliculus facialis + e.medialis)

- Conductor sonorus

- Locus caeruleus

- Fovea superior

(16)

(17)

tectospinal tr.

pontine reticulospinal tr.

medullary reticulospinal tr.

med vestibulospinal tr.

lat vestibulospinal tr.

lat corticospinal tr.

ant corticospinal tr.

central autonomic path.

gracile tr.

cuneate tr.

anterolateral path. (spinothalamic tr.)

spinal n of the trigeminal nerve spinal tr of the trigeminal nerve

(18)

C1 SPINAL CORD

Identify:

Fasciculus Gracilis (FG) Fasciculus Cuneatus (FC)

Dorsal Spinocerebellar Tract (DSCT) Ventral Spinocerebellar Tract (VSCT)

Spinothalamic Tract (STT; also called Anterolateral System)

Corticospinal Tracts (CST for lateral, CSTa for anterior) Rubrospinal Tract (RST)

Medial Longitudinal Fasciculus (MLF) Tectospinal Tract (TST)

Reticulo- and Vestibulospinal Tracts (Rt+VST) Hypothalamic Autonomic Tract (HAT)

Note:

(19)

(20)

(21)

central gray matter med longitudial fas.

spinal lemniscus

spinal tr n of the V nerve pos spinocerebellar tr.

lat corticospinal tr. pyramidal tr.

pyramidal decussation

med lat vestibulospinal tr. somas of the paramedian of reti forma.

medullary reticulospinal tr. central autonomic path.

(22)

PYRAMIDAL DECUSSATION Identify:

Fasciculus Gracilis (FG) and Nucleus Gracilis (NG) Fasciculus Cuneatus (FC)& Nucleus Cuneatus (NC) Spinal Trigeminal Nucleus and Tract (SpTN, SpTTr)

Dorsal and Ventral Spinocerebellar Tracts (DSCT, VSCT) Spinothalamic Tract (STT)

Rubrospinal Tract (RST)

Reticulo- and Vestibulospinal Tracts (Rt+VST) Hypothalamo-Autonomic Tract (HAT)

Solitary Nucleus (SN) Note:

The Pyramidal tract fibers arise in cerebral cortex, descend to the lower medulla, and cross here to the contralateral spinal cord where they form the Corticospinal Tract Although the internal features at this level are similar to those in the spinal cord, some changes, particularly in the arrangement of the gray matter, have taken place

As mentioned previously, the Dorsal Horn is now related primarily to the trigeminal nerve and is called the Spinal Trigeminal Nucleus This nucleus is a rostral continuation of the substantia gelatinosa of the spinal cord; the actual transition occurs at the lower levels of C2-3, below which the substantia gelatinosa becomes much smaller

The medulla retains an oval outline, but notice that the groove of the Posterior

(23)

(24)

(25)

(26)

MID MEDULLA OBLONGATA sensory decussation gracile tr. cuneate tr. cuneate n. gracile n.

internal arcuate fiber medial lemniscus

spinal lem.

spinal tr n of the V nerve solitary tr n

pos spinocerebellar tr accessory cuneate n.

hypoglossal n

hypoglossal ner ambiguus n cranial accessory ner

lat vestibulospinal tr. somas of the paramedian of reti forma.

dorsal n.of vagus

MLF

(27)

UPPER PART OF MEDULLA OBLONGATA

med inf vestibular n

IX ner solitary n spinal tr n V ner

medial lemniscus spinal lem.

inf olivary n.

accessory olivary n. (olivocerebellar tr.)

inf cerebellar ped.

rubro-olivary f. MLF ambiguus n (stylopharyngeus) hypoglossal n hypoglossal ner

magnus raphe n

paramedian of reti form. pontine reticulospinal tr.

retroambiguus n. (expiratory center)

solitary n.

(inspiratory center)

dorsal n.of vagus

(28)

(29)

SENSORY DECUSSATION Identify:

Nucleus Gracilis and Cuneatus (NG, NC)

Lateral Cuneate Nucleus (LCN)

Hypoglossal Nucleus (12) and Nerve Fibers

Dorsal Motor Nucleus (DMN) of the Vagus Solitary Nucleus (SN)

Dorsal & Ventral Spinocerebellar Tracts (DSCT, VSCT) Spinal Trigeminal Nucleus and Tract (SPTT, SPTN) Spinothalamic Tract (STT)

Hypothalamo-Autonomic Tract (HAT)

Inferior Olivary Complex (PO, MAO, DAO) Lateral Reticular Nucleus (LRN)

Pyramidal Tracts (PT)

Internal Arcuate Fibers (IAF) Medial Lemniscus (ML)

Reticulo- and VestibuloSpinal Tracts (Rt+VST) Note:

The Solitary Tract and its surrounding pale staining Nucleus (SN) function in the processing of visceral and sensory information that is carried into the brain by the Vagus (X), Glossopharyngeal (IX), and Facial (VII) nerves

The neurons of the Inferior Olivary Complex (Principal Olive (PO), Medial Accessory Olive (MAO), and Dorsal Accessory Olive (DAO) give rise to axons which cross the

(30)

VAGUS NERVE 1 Identify:

Pyramidal Tract (PT) Medial Lemniscus (ML) Tectospinal Tract (TST)

Medial Longitudinal Fasciculus (MLF)

Spinal Trigeminal Nucleus & Tract (SpTN, SpTTr)

Principal Olive (PO), Dorsal(DAO), (MAO)

Medial and Spinal Vestibular Nuclei (MVN, SpVN)

Inferior Cerebellar Peduncle (ICP)

Hypoglossal Nuclei (12)

Dorsal Motor Nucleus (DMN) Solitary Tract and Nucleus (SN)

Nucleus Ambiguus (NA)

Dorsal and Ventral Spinocerebellar Tracts (DSCT, VSCT) Spinothalamic Tract (STT)

Hypothalamo-Autonomic Tract (HAT) Note:

The Nucleus Ambiguus primarily innervates branchial arch musculature of the pharynx, esophagus, and larynx (SVE) However, it also gives rise to vagal preganglionic parasymp (GVE) projections to the heart, similar to the Dorsal Motor Nucleus

The Vagus Nerve is associated with four nuclei: Dorsal Motor Nuclei - GVE

Nucleus Ambiguus - SVE (brachial arch muscles)

(31)

VAGUS NERVE 2 Identify:

Spinal Trigeminal Nucleus and Tract (SpTN, SpTTr) Medial and Spinal Vestibular Nuclei (MVN, SpVN) Lateral Cuneate Nucleus (LCN)

Inferior Cerebellar Peduncle (ICP) Medial Longitudinal Fasciculus (MLF) Tectospinal Tract (TST)

Hypoglossal Nuclei (12)

Dorsal Motor Nucleus (DMN)

Solitary Tract and Nucleus (ST, SN)

Nucleus Ambiguus (NA)

Reticular Formation (RF) Note:

(32)

GLOSSOPHARYNGEAL NERVE Identify:

Pyramidal Tract (PT) Medial Lemniscus (ML) Tectospinal Tract (TST)

Medial Longitudinal Fasciculus (MLF) Medial Vestibular Nucleus (MVN) Spinal Vestibular Nucleus (SpVN) Inferior Cerebellar Peduncle (ICP)

Spinal Trigeminal Tract and Nucleus (SpTTr, SpTN) Solitary Tract and Nucleus (SN)

Principal Olive (PO)

Central Tegmental Tract (CTT)

Ventral Spinocerebellar Tract (VSCT) Spinothalamic Tract (STT)

Facial Motor Nucleus (7)

Nucleus Prepositus (NPrep)

Dorsal and Ventral Cochlear Nuclei (DCN, VCN) Pontobulbar Body (PBB)

Arcuate Nucleus (ARC)

Note:

The Pontobulbar Body is a caudal extension of Pontine Gray and sends projections to the cerebellum

Another "misplaced piece" of Pontine Gray is the Arcuate Nucleus Like the Pontine Gray, it receives projections from the cerebral cortex and sends efferents to the

(33)

(34)

(35)

(36)

PONTOMEDULLARY J.

pyramidal tr.

transverse f.

cochlear ner ventral cochlear n dorsal cochlear n

trapezoid body lateral lemniscus

sup olivary n lat sup vestibular n

vestibular ner

medial lemniscus trigeminothalamic tr.

trigeminal lemniscus solitary n tr

sup cerebellar ped.

lat vestibulospinal tr.

VII ner.

VI ner.

pontine n.

caudal pontine reticular n.

central tegmental tr.

(37)

GENU OF FACIAL NERVE-PONS Identify:

Basilar Pons and Pontine Gray (PG) Corticospinal Tract fibers (CST) Medial Lemniscus (ML)

Tectospinal Tract (TST)

Superior Olivary Nucleus (SO)

Lateral Lemniscus (LL) Trapezoid Body (TB)

Spinothalamic Tract (STT) Rubrospinal Tract (RST)

Ventral Spinocerebellar Tract (VSCT) Hypothalamo-Autonomic Tract (HAT)

Facial Motor Nucleus (7) and Genu of the Facial Nerve Abducens Nucleus (6) and Abducens Nerve Fibers Facial Colliculus

Spinal Trigeminal Tract and Nucleus (SpT)

Mesencephalic Trigeminal Tract and Nucleus (MesT)

Superior Vestibular Nucleus (SVN) Note:

The Corticospinal Tract fibers which form the Pyramidal Tracts in the medulla can be seen surrounded by the Pontine Gray In addition, Corticopontine Fibers which

terminate in the Pontine Gray are present, as well as Pontocerebellar Fibers that cross and form the Middle Cerebellar Peduncle (MCP)

(38)

(39)

(40)

MID-PONS

facial colliculus.

sup cerebellar ped.

spinal tr n V ner spinal lemniscus

medial lemniscus trigeminothalamic tr.

sup olivary n trapezoid body

lateral lemniscus

VI n.

VI ner. pyramidal tr.

corticopontine f. pontine n.

paramedian of reti form.

sup salivatory n. (secretomotor f.) solitary n tr

gustatory f

nervus intermedius

(41)

(42)

(43)

(44)

(45)

UPPER PONS sup cerebellar ped. spinal lemniscus medial lemniscus lateral lemniscus trigeminothalamic tr. sensory root principal n. mesencephalic n.of V

motor n of V

motor root of V

(46)

TRIGEMINAL NERVE 2-PONS Identify:

Pontine Gray (PG)

Corticospinal Fibers (CST)

Middle Cerebellar Peduncle (MCP)

Medial Lemniscus (ML)

Spinothalamic Tract (STT)

Lateral Lemniscus (LL, best seen on left) Rubrospinal Tract (RST)

Hypothalamo-Autonomic Tract (HAT) Superior Cerebellar Peduncles (SCP, cut) Ventral Spinocerebellar Tract (VSCT) Central Tegmental Tract (CTT)

Medial Longitudinal Fasciculus (MLF)

Trigeminal Motor Nucleus (5)

(47)

TRIGEMINAL NERVE 3-PONS

Identify:

Trigeminal Nerve Root

Principal Sensory Trigeminal Nucleus

Motor Trigeminal Nucleus,

Mesencephalic Trigeminal Nucleus

Superior Cerebellar Peduncle Ventral Spinocerebellar Tract Central Tegmental Tract (CTT) Note:

This is a high power view of the upper right quadrant of the previous slide

(48)

ISTHMUS 1-PONS

Identify:

Pontine Gray (PG)

Corticospinal Tract fibers (CST) Middle Cerebellar Peduncle (MCP)

Lateral Lemniscus (LL)

Hypothalamo-Autonomic Tradt (HAT) Superior Cerebellar Peduncle (SCP) Central Tegmental Tract (CTT)

Rubrospinal Tract (RST) Tectospinal Tract (TST)

Medial Longitudinal Fasciculus (MLF) Raphe nucleus (R, 5HT)

Locus Ceruleus (LC, NA)

Mesencephalic Trigeminal Nucleus (MesT)

Periaqueductal Gray (PAG)

Medial Longitudinal Fasciculus (MLF, just below PAG)

(49)

Identify:

Lateral Lemniscus (LL)

Superior Cerebellar Peduncle (SCP) Central Tegmental Tract (CTT)

Mesencephalic Trigeminal Tract (MesT)

Locus Ceruleus (LC, noradrenergic (NA) neurons)

Medial Longitudinal Fasciculus (MLF) Dorsal Raphe Nucleus (DR)

Superior Central Raphe Nucleus (SCR)

Decussation of the Trochlear Nerves (4DX)

Note:

This is a high power view of the previous slide

The darkly staining, pigmented cells of the Locus Ceruleus (LC) have widespread

noradrenergic (NA) projections

The Dorsal Raphe (DR)and Superior Central Raphe (SCR) Nuclei have widespread serotonergic (5HT) projections

(50)

(51)

LOWER MIDBRAIN cerebral aqueduct PAG compact part (dopaminergic neurons) reticular part (GABAergic neurons) substantia nigra

ventral tegmental n. spinal lemniscus

medial lemniscus

lateral lemniscus

trigeminal lemniscus

inf colliculus

mesencephalic n.of V

decussation of sup cerebellar ped.

trochlear n. decussation of trochlear n.

corticonuclear f. corticospinal f.

corticopontine f. corticopontine f.

interpeduncular n.

(52)

INFERIOR COLLICULUS-MIDBRAIN

Identify:

Crus Cerebri of the Cerebral Peduncles Corticospinal Tract (CST)

Substantia Nigra (SN)

Decussation of the Superior Cerebellar Peduncles (SCPDX)

Medial Lemniscus (shifting dorsolaterally) (ML)

Medial Longitudinal Fasciculus (MLF) Periaqueductal Gray (PAG)

Central Tegmental Tract (CTT)

Inferior Colliculus

Note:

The massive Crus Cerebri of the Cerebral Peduncles contain Corticospinal, Corticobulbar,

and Corticopontine Fibers

The Lateral Lemniscus fans out as it terminates in the Inferior Colliculus (golf ball on tee)

The Inferior Colliculus is a major element of the auditory system

(53)

(54)

UPPER MIDBRAIN PAG compact part (dopaminergic neurons) reticular part (GABAergic neurons) spinal lemniscus medial lemniscus spino-tectal tr. trigeminal lemniscus sup colliculus dentatothalamic f. rubrothalamic f.

oculomotor n. red n. tectospinal tr. corticopontine f. corticopontine f. corticonuclear f. corticospinal f.

midbrain raphe n

cuneiform n.

(55)

Identify:

Superior Colliculus (SC)

Brachium of the Inferior Colliculus (BIC)

Crus Cerebri

Superior Cerebellar Peduncles (SCP)

Oculomotor Nucleus (3)

Edinger-Westphal Nucleus of (EWN) Medial Longitudinal Fasciculus (MLF) Note:

The Superior Colliculus is extremely important in controlling eye-head movements in orienting to a variety of stimuli Its output pathway, the Tectospinal Tract, has been located on many previous sections

The Brachium of the Inferior Colliculus projects from the Inferior Colliculus to the Medial Geniculate Body of the Thalamus located more rostrally

The Crus Cerebri can be divided into thirds such that the medial 1/3 contains the

frontopontine fibers, the middle 1/3 contains the corticobulbar and corticospinal fibers, and the lateral 1/3 contains the parietopontine, occipitopontine, and temporopontine fibers

The Substantia Nigra (SN) is a component of the Basal Ganglia and provides the

dopaminergic innervation of the Caudate and Putamen that is deficient in Parkinson's

Disease

The Superior Cerebellar Peduncles have finished decussating and are continuing on their course to more rostral structures such as the red nucleus and ventrolateral nucleus of the thalamu (VL)

(56)

SUPERIOR COLLICULUS-MIDBRAIN Identify:

Superior Colliculus (SC) Periaqueductal Gray (PAG) Cerebral Aqueduct

Brachium of the Inferior Colliculus (BIC)

Red Nucleus (RN)

Cerebello-thalamic fibers (CBTh) Crus Cerebri

Corticospinal Tract fibers (CST)

Oculomotor Nucleus (3)

Oculomotor Nerve Fibers exiting the brainstem in the Interpeduncular Fossa

Medial Longitudinal Fasciculus (MLF) Interstitial Nucleus Of Cajal (INC) Central Tegmental Tract (CTT) Hypothalamo-Autonomic Tract Note:

(57)

(58)

(59)

MIDBRAIN-THALAMIC J.

thalamus pineal gland

medial forebrain bundle

substantia nigra

VPN

med geniculate body inf brachium

lat G body

corticonuclear f. corticospinal f.

(60)

Diencephalon Diencephalon

Central core of the forebrain surrounded by the cerebral hemispheres

Consists of three paired structures – thalamus, hypothalamus, and epithalamus

(61)

(62)

(63)

Thalamus Thalamus

Paired, egg-shaped masses that form the superolateral walls of the third ventricle

Connected at the midline by the interthalamic adhesion (intermediate mass)

Contains four groups of nuclei - anterior, ventral,

(64)

(65)

(66)

Thalamus – “gateway” to the cerbral cortex Thalamus – “gateway” to the cerbral cortex

1.Afferent impulses from all senses converge and synapse in the thalamus

2.Impulses of similar function are sorted out,

“edited”, and relayed as a group to the appropriate area of the sensory cortex or association areas

3.All inputs ascending to the cerebral cortex pass through the thalamus

(67)

Hypothalamus Hypothalamus

Below the thalamus, it caps the brainstem and forms the inferolateral walls of the third ventricle

Mammillary bodies - small, paired nuclei bulging anteriorly from the hypothalamus - relay stations for olfactory pathways

Infundibulum – stalk of the hypothalamus connecting to the pituitary gland

(68)

(69)

(70)

Hypothalamic Function Hypothalamic Function

1.Regulates blood pressure, rate and force of heartbeat,

digestive tract motility, respiratory rate and depth, pupil

size, and many other visceral activities

2.Center for emotional response - involved in perception of pleasure, fear, rage

3.Regulates body temperature – the body’s “thermostat” 4.Regulates food intake - feelings of hunger and satiety 5.Regulates sleep-wake cycle

(71)

Endocrine Functions of the Hypothalamus Endocrine Functions of the Hypothalamus

1.Releasing hormones control the secretion of hormones by the anterior pituitary

2.Stimulates ADH release from the posterior pituitary

(72)

Epithalamus Epithalamus

Most dorsal portion of the diencephalon; forms roof of the third ventricle

Pineal gland – extends from the posterior border and secretes Melatonin, a hormone involved with sleep regulation, sleep-wake cycles, and mood

(73)

(74)

(75)

(76)

(77)

(78)

TRANSITION TO DIENCEPHALON Identify:

Decussation of the Superior Cerebellar Peduncles (SCPDX)

Medial Longitudinal Fasciculus (MLF) Central Tegmental Tract (CTT)

Periaqueductal Gray (PAG) Superior Colliculus (SC)

Brachium of the Inferior Colliculus (BIC) Medial Geniculate (MG)

Lateral Geniculate (LG) Optic Radiations (OR)

Pulvinar nucleus of thalamus (PUL) Pineal Gland (PIN)

Stria Terminalis Note:

The Optic Radiations are projections from the Lateral Geniculate Body of the Thalamus to the Visual Cortex

The Fornix is continuous with the Alveus of the Hippocampus

The Stria Terminalis is a tract connecting the Amygdala in the temporal lobe with the Hypothalamus

(79)

POSTERIOR COMMISSURE Identify:

Basilar Pons

Crus Cerebri

Superior Cerebellar Peduncles (SCP) Central tegmental tract (CTT)

Spinothalamic tract (STT)

Hypothalamo-Autonomic Tract (HAT) MLF

Periaqueductal Gray (PAG) Posterior Commissure (PC) Pretectal Area (PTA)

Habenular Commissure (HC) Pineal Gland (PIN)

Lateral Geniculate Body (LG) Optic Radiations (OR)

Pulvinar (PUL)

Corpus Callosum, splenium (CCs)

Fornix (F)

Body of Caudate Nucleus (Cb)

Stria Terminalis (ST)

Hippocampal CA fields and dentate gyrus (DG) Alveus (Al)

Fimbria of the Fornix (Fi)

(80)

VPL-VPM 1 Identify:

Basilar Pons

Substantia Nigra (SN) Red Nucleus (RN)

Superior Cerebellar Peduncles (SCP) MLF

Medial Lemniscus (ML) and Spinothalamic Tract (STT)

Ventral Posterolateral (VPL) and Ventral Posteromedial (VPM) nuclei

Periaqueductal Gray IPAG)

Posterior Commissure (PC)

Habenular Commissure (HC) Lateral Geniculate Body (LG) Optic Radiations (OR)

Optic Tract (OT) Pulvinar (PUL) Note:

On the right side the dorsal thalamus is

represented by the Pulvinar On the left side three general thalamic cell groups may be recognized The Pulvinar is still present dorsally Ventrolaterally, the ventral tier thalamic nuclei are appearing; at this level, these include the Ventral Posterolateral Nucleus (VPL) and the caudal end of the

(81)

VPL-VPM 2

Choroid Plexus in roof of third ventricle (CP) Posterior Commissure (PC)

Thalamic Reticular Nucleus (R)

Internal Capsule (IC)

Centromedian Nucleus (CM)

Ventral Posterolateral Nucleus of the Thalamus (VPL) Ventral Posteromedial Nucleus of the Thalamus (VPM)

Pulvinar (PUL)

Red Nucleus (RN) Body of Caudate (C) Stria Terminalis (ST) Optic Tract (OT)

Lateral Geniculate Body (LG) Optic Radiations (OR)

Medial Geniculate (MG) Hippocampus

Alveus (Al) Fimbria (Fi)

Choroid Plexus in Temporal Horn of Lateral Ventricle (CPinTH) Tail of the Caudate (Ct)

Body of Lateral Ventricle (LH) Crus Cerebri

Periaqueductal Gray (PAG) Note:

(82)

HABENULO-INTERPEDENCULAR Identify:

Ventral Posterolateral (VPL) and Ventral Posteromedial (VPM) nuclei

Centromedian nucleus (CM) Mediodorsal nucleus (MD)

Habenulointerpeduncular Tract (HIP) Interpeduncular Nucleus (IN)

Crus Cerebri

Substantia Nigra (SN) Reticular Nucleus (R) Internal Capsule (IC) Zona Incerta (ZI) Body of Caudate (C) Stria Terminalis (ST) Hippocampus

Alveus (Al)

Fimbria of Fornix (Fi)

Choroid Plexus in Temporal Horn of Lateral Ventricle (CPinTH) Optic Tracts (OT)

Lateral Geniculate (LG) Optic Radiations (OR)

Medial Lemniscus (ML) and Superior Cerebellar Peduncle fibers (SCP)

Note:

The Habenulointerpeduncular Tract (HIP, also called the fasciculus retroflexus) courses through another intralaminar nucleus (the Parafascicular Nucleus) and proceeds

(83)

INTERNAL CAPSULE Identify:

Ventral Posteromedial (VPM) and Ventral Posterolateral (VPL) nuclei

Centromedian nucleus (CM)

Mediodorsal Nucleus (MD)

Stria Medullaris Thalami (SMT)

Choroid Plexus forming roof of third ventricle (3V) Substantia Nigra (SN)

Red Nucleus (RN)

Reticular nucleus (R) and Zona Incerta (ZI) Internal Capsule (IC)

Body of Lateral Ventricle (LV) Subthalamic Nucleus (STN) Body of Lateral Ventricle (LV) Body of Caudate (C)

Putamen (P)

Globus Pallidus (GP) Oculomotor Nerves (3) Amygdala

Tail of Caudate (Ct)

Temporal Horn of Lateral Ventricle (TH) Hippocampus

Amygdala Note:

The Stria Medullaris Thalami is a good landmark for the Mediodorsal Nucleus

The fibers streaming laterally from the Red Nucleus are cerebello-thalamic fibers (labeled SCP) on their way to termination within VL

(84)

INTERNAL MEDULLARY LAMINA Identify:

Stria Medullaris Thalami (SMT) Mediodorsal Nucleus (MD)

Lateral Dorsal nucleus (LD)

Choroid Plexus (CP) forming roof of third ventricle (3V) Internal Medullary Lamina (IML)

Ventral Lateral Nucleus (VL)

Thalamic fasciculus (TF, contains cerebello-thalamic and pallido-cerebello-thalamic fibers)

Reticular Nucleus (R) and Zona Incerta (ZI)

Subthalamic Nucleus (STN)

Substantia Nigra (SN) Crus Cerebri

Extreme Capsule (ExmC) Claustrum (Cl)

External Capsule (ExlC) Putamen (P)

Globus Pallidus (GPm, GPl) Amygdala

Mammillary Bodies (MB) Note:

The Mammillary Bodies are the most posterior part of the Hypothalamus

Dorsal to the Subthalamic Nucleus is a thin, darkly stained fiber region Fibers present include Cerebello-Thalamic projections to VL and Lenticular Fasciculus and Thalamic Fasciculus projections from the Globus Pallidus to the Ventral Anterior Nucleus of the Thalamus (VA; not on this slide)

(85)

LENTICULAR FASCICULUS Identify:

Choroid Plexus forming roof of third ventricle (3V) Mediodorsal Nucleus (MD)

Lateral Dorsal Nucleus (LD)

Internal Medullary Lamina (IML) Ventral Lateral Nucleus (VL)

External Medullary Lamina (EML)

Reticular Nucleus (R) and Zona Incerta (ZI) Subthalamic Nucleus (STN)

Internal Capsule (IC) Extreme Capsule (ExmC) Claustrum (Cl)

Globus Pallidus (GPm, GPl) Optic Tract (OT)

Amygdala

Lenticular Fasciculus (LF)

Thalamic Fasciculus (TF, contains pallido-thalamic and cerebello-thalamic fibers) Mammillothalamic Tract (MTT)

Tuber cinereum (TC, contains median eminence of hypothalamo-hypophyseal portal system)

Note:

The Mammillary Bodies receive massive inputs from the Hippocampus via the Fornix The Mammillary Bodies in turn project to the Anterior Nucleus of the Thalamus via the

(86)

ANTERIOR NUCLEUS Identify:

Corpus Callosum (CC) Lateral Ventricle (LV)

Fornix (F, dorsally and ventrally) Body of Caudate (C)

Choroid Plexus (CP) forming roof of third ventricle (3V) Mediodorsal Nucleus (MD)

Anterior Nucleus (A)

Internal Medullary Lamina (IML) Ventral Anterior Nucleus (VA)

Reticular Nucleus (R) and Zona Incerta (ZI)

Internal Capsule (IC) Extreme Capsule (ExmC) Claustrum (Cl)

Globus Pallidus (GPm, GPl) Optic Tract (OT)

Amygdala

Ansa Lenticularis (AL, pallidothalamic projections to VA) Anterior Commissure (AC)

Mammillothalamic Tract (MTT) Massa Intermedia (MI)

Note:

(87)

ANSA LENTICULARIS Identify:

Lateral Ventricle (LV) Fornix (F)

Body of the Caudate (C)

Choroid Plexus forming roof of third ventricle (3V) Stria Medullaris Thalami (SMT)

Mediodorsal Nucleus (MD) Anterior Nucleus (A)

Ventral Anterior Nucleus (VA)

Reticular Nucleus (R) and Zona Incerta (ZI) Extreme Capsule

Putamen (P)

Globus Pallidus (GPl, GPm) Ventral Pallidum (VP)

Nucleus Basalis of Meynert (NBM)

Anterior Perforated Substance) (APS) Optic Chiasm (OX)

Amygdala

Ansa Lenticularis (AL)

Anterior Commissure (AC)

Mammillothalamic Tract (MTT) Note:

Loss of neurons in the Nucleus Basalis of Meynert (NBM), which sends cholinergic

fibers to the cerebral cortex, has been thought to be associated with senile dementia of the Alzheimer type

The ventral pallidum (VP) is the "pallidal element" of the ventral striatal-pallidal

(88)

GENU OF INTERNAL CAPSULE

Identify:

Genu of Corpus Callosum (CCg) Lateral Ventricle (LV)

Head of the Caudate (Ch)

Putamen (P)

Globus Pallidus (GP)

Nucleus Accumbens (NA) Anterior Commissure (AC) Columns of Fornix

Note:

(89)

ANTERIOR LIMB OF IC

Identify:

Genu of Corpus Callosum (CCg) Lateral Ventricle (LV)

Head of Caudate (Ch) Internal Capsule (IC)

Putamen (P)

Nucleus Accumbens (NA) Claustrum (Cl)

Globus Pallidus (GP) External Capsule (ExlC) Extreme Capsule (ExmC) Septum Pellucidum (SP) Septal Nuclei (SN)

Subcallosal Gyrus Note:

(90)

ROSTRUM OF CORPUS CALLOSUM

Identify:

Genu of the Corpus Callosum (CCg) Septum Pellucidum (SP)

Rostrum of the Corpus Callosum (CCr) Head of the Caudate (Ch)

Lateral Ventricle (LV) Internal Capsule (IC) Claustrum (Cl)

(91)

Cerebral Hemispheres Cerebral Hemispheres

Form the superior part of the brain and make up

over 80% of its mass

Hemispheres are separated by the Longitudinal fissure and from cerebellum by the Transverse Cerebral fissure

Surface Features:

(92)

Cerebral Hemispheres - Lobes Cerebral Hemispheres - Lobes

Frontal, Parietal, Temporal, Occipital, and (Insula) Central sulcus – separates the frontal and parietal lobes Parieto-occipital sulcus – separates the parietal and

occipital lobes

(93)

Cerebral Hemispheres – basic regions Cerebral Hemispheres – basic regions

Cortex – superficial gray matter, 1-4.5 mm thick

(94)

Cerebral Cortex Cerebral Cortex

Enables sensation, communication, memory, understanding, and voluntary movements

Each hemisphere controls the opposite (contralateral) side of the body

Hemispheres are not functionally equivalent

(95)

Cerebral Cortex Cerebral Cortex

Three kinds of functional areas:

Motor areas – control voluntary movement Sensory areas – conscious awareness of sensation

Association areas – integrate diverse

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(112)

Cerebral Cortex: Motor Areas Cerebral Cortex: Motor Areas

Primary (somatic) motor cortex Premotor cortex

Broca’s area

(113)

Primary Motor Cortex Primary Motor Cortex

Located in the precentral gyrus of the frontal lobe Allows conscious control of voluntary movements Composed of neurons called pyramidal cells -

axons project to spinal cord and make up the

(114)

Primary Motor Cortex Primary Motor Cortex

(115)

Premotor Cortex Premotor Cortex

Located anterior to the precentral gyrus Controls learned, repetitious, or patterned motor skills

Coordinates simultaneous or sequential actions( directly or indirectly)

(116)

Broca’s Area Broca’s Area

Located anterior to the inferior region of the premotor area

Present in one hemisphere (usually the left)

A motor speech area that directs muscles involved in speech

(117)

Frontal Eye Field Frontal Eye Field

Located anterior to the premotor cortex and superior to Broca’s area

(118)

Sensory Areas Sensory Areas

Primary somatosensory cortex

Somatosensory association cortex Visual and auditory areas

(119)

Primary Somatosensory Cortex Primary Somatosensory Cortex

Located in the postcentral gyrus of the parietal lobe Receives information from somatic sensory receptors in the skin and proprioceptors in skeletal muscles

(120)

Primary Somatosensory Cortex Primary Somatosensory Cortex

Somatosensory homunculus –

(121)

Somatosensory Association Cortex Somatosensory Association Cortex

Located posterior to the primary somatosensory cortex Integrates sensory information coming from the

primary somatosensory cortex to produce an

(122)

Visual Areas Visual Areas

Primary visual (striate) cortex - located on the

posterior tip of the occipital lobe, most of it is buried in the calcarine sulcus - receives visual information from the retinas

(123)

Auditory Areas Auditory Areas

Primary auditory cortex - located in the superior margin of the temporal lobe -receives information related to pitch, rhythm, and loudness

(124)

Other Sensory Areas Other Sensory Areas

Olfactory (smell) cortex – small area of frontal lobe above the orbit and in medial temporal lobe

(piriform lobe and uncus)

(125)

Other Association Areas Other Association Areas

Prefrontal cortex Language areas

(126)

Prefrontal Cortex Prefrontal Cortex

Located in the anterior portion of the frontal lobe

Involved with intellect, cognition, recall, personality, judgment, reasoning, and conscience

(127)

Language Areas Language Areas

Located in a large area surrounding the left (or language-dominant) lateral sulcus

Broca’s area – speech preparation and production

Wernicke’s area – involved in sounding out unfamiliar words

Lateral prefrontal cortex – language comprehension and word analysis Lateral and ventral temporal lobe – coordinate

auditory and visual aspects of language

Broca’s area Wernicke’s

(128)

General (Common) Interpretation Area (?) General (Common) Interpretation Area (?)

Ill-defined region including parts of the temporal, parietal, and occipital lobes

Found in one hemisphere, usually the left

Integrates incoming signals into a single thought Involved in processing spatial relationships

Visceral Association Area (?) Visceral Association Area (?)

Located in the cortex of the insula

(129)

Lateralization of Cortical Function Lateralization of Cortical Function

Lateralization – each hemisphere has abilities not shared with the other hemisphere

Cerebral dominance – designates the hemisphere dominant for language

Left hemisphere – controls language, math, and logic Right hemisphere – controls visual-spatial skills,

(130)

Cerebral White Matter Cerebral White Matter

Consists of myelinated fibers and their tracts

Responsible for communication

between areas of the cerebrum and between the cerebral cortex and

(131)

Cerebral White Matter Fiber Tracts Cerebral White Matter Fiber Tracts

Commissures – connect corresponding gray areas of the two hemispheres (corpus callosum , anterior and posterior commissures)

Association fibers – connect different parts of the same hemisphere

Projection fibers – enter the hemispheres from lower brain or cord centers

(132)

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(134)

Basal Nuclei Basal Nuclei

Masses of gray matter found deep within the cortical white matter

Corpus striatum:

1.Caudate nucleus (amygdala- tail of caudate)

2.Lentiform nucleus – composed of the putamen and the globus pallidus

3.Fibers of internal capsule run between and

(135)

1 CAUDATE N 2 LENTIFORM N

+ PUTAMEN = CORPUS STRIATUM

3 SUBTHALAMIC N.

4 SUBSTANTIA NIGRA

+ GLOBUS PALLIDUS

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(144)

Functions of Basal Nuclei (?) Functions of Basal Nuclei (?)

Possible functions of basal nuclei: 1.Influence muscular activity

2.Regulate attention and cognition

3.Regulate intensity of slow or stereotyped movements

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Middle meningeal artery

Glabella

Inion

Pterion Sec point

Pterion – pos br.: 57.9mm Avascular rg.

STEREOTACTICS STEREOTACTICS STEREOTACTICS

(152)

Third ventricle

5.20

14.00 8.6 0 Ant com Pos com Monro f. Basal line Khoa: 25.6mm

Schaltenbrand & Bailey: 23.0mm Mundinger & Potthof: 24.6mm

Khoa: 24.3mm

Hassler & cs: 24.0mm

Kandel & Tsibulnikov: 23.0mm

(153)

Topographic map (: longitude, : latitude)

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1 Skin

2 Subcutaneous t.

3 Supraspi lig.

4 interspi lig.

5 Flavum lig.

6 Dural matter

8 Subarachnoid space

7 Arachnoid matter

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REFERENCES REFERENCESREFERENCES REFERENCES 1 TEXTBOOKS 1 TEXTBOOKS 1 TEXTBOOKS 1 TEXTBOOKS

1 Fitzgerald M.J.T., Jean Folan-Curran Clinical Neuroanatomy and related neuroscience,

1 Fitzgerald M.J.T., Jean Folan-Curran Clinical Neuroanatomy and related neuroscience, 4thth ed. ed. London : W.B Saunders, 2002

London : W.B Saunders, 2002

2 Williams PL, Warwick R et al

2 Williams PL, Warwick R et al Gray’s Anatomy, 37Gray’s Anatomy, 37thth ed ed NewYork : Churchill Livingstone, 1989, NewYork : Churchill Livingstone, 1989, pp 401-22, 499-16

pp 401-22, 499-16

3 Pick TP & Howden R

3 Pick TP & Howden R Gray’s Anatomy, The Classic Collector’s edGray’s Anatomy, The Classic Collector’s ed NewYork : Gramercy, 1977 NewYork : Gramercy, 1977 Sabiston

4 Sabiston Textbook of Surgery, 15Textbook of Surgery, 15thth ed ed Philadelphia : W.B Saunder Company, 1997. Philadelphia : W.B Saunder Company, 1997.

5

5 Oxford Textbook of Surgery on CD-ROM, ver 1.0Oxford Textbook of Surgery on CD-ROM, ver 1.0 Oxford University Press, 1995 Oxford University Press, 1995

1 Fitzgerald M.J.T., Jean Folan-Curran Clinical Neuroanatomy and related neuroscience,

1 Fitzgerald M.J.T., Jean Folan-Curran Clinical Neuroanatomy and related neuroscience, 4thth ed. ed. London : W.B Saunders, 2002

London : W.B Saunders, 2002

2 Williams PL, Warwick R et al

2 Williams PL, Warwick R et al Gray’s Anatomy, 37Gray’s Anatomy, 37thth ed NewYork : Churchill Livingstone, 1989, ed NewYork : Churchill Livingstone, 1989, pp 401-22, 499-16

pp 401-22, 499-16

3 Pick TP & Howden R

3 Pick TP & Howden R Gray’s Anatomy, The Classic Collector’s edGray’s Anatomy, The Classic Collector’s ed NewYork : Gramercy, 1977 NewYork : Gramercy, 1977 Sabiston

4 Sabiston Textbook of Surgery, 15Textbook of Surgery, 15thth ed Philadelphia : W.B Saunder Company, 1997. ed Philadelphia : W.B Saunder Company, 1997

5 Oxford Textbook of Surgery on CD-ROM, ver 1.0Oxford Textbook of Surgery on CD-ROM, ver 1.0 Oxford University Press, 1995 Oxford University Press, 1995

2 WEBSITES

1.http://www.mednote.co.kr/ANATOMYHNADOUThtm.htmhttp://www.mednote.co.kr/ANATOMYHNADOUThtm.htm

2.http://www.fleshandbones.com/anatomy/fitzgeraldhttp://www.fleshandbones.com/anatomy/fitzgerald

3.http://www.anatomy.tvhttp://www.anatomy.tv

4.Anatomy of the Human Body Henry GrayAnatomy of the Human Body Henry Grayhttp://www.bartleby.com/107/http://www.bartleby.com/107/

1 http://www.mednote.co.kr/ANATOMYHNADOUThtm.htmhttp://www.mednote.co.kr/ANATOMYHNADOUThtm.htm

2 http://www.fleshandbones.com/anatomy/fitzgeraldhttp://www.fleshandbones.com/anatomy/fitzgerald

3 http://www.anatomy.tvhttp://www.anatomy.tv