Neuroanatomy UNIB 2013-1

7/30/2019 Neuroanatomy UNIB 2013-1

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dr. Isabella Kurnia Liem, MBiomed, PhD, PA

Department of Anatomy

Faculty of Medicine, Universitas Indonesia

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Gross Anatomy of

Human Nervous System


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Topics

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Central nervous system

Peripheral nervous system

Basic neuroanatomical pathways


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Division of Nervous System

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Functions of Nervous System

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Sensory receptors --tomonitor changes inside and

outside the body

Integration -- processes and

interprets the sensoryinput, and make decision

Motor outputdictates a

response by activating the

effector organs


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Central Nervous System

Protection of the brain

Cerebrum

Brain stem: mid brain, pons and medulla oblongata

Cerebellum

Spinal cordVascularisation

Ventricle system and Cerebrospinal fluid

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PROTECTION OF THE BRAIN

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Skull (cranium)

Covered by SCALP: Skin, Connective tissue,Aponeurotic

Galea, Loose connective tissue and Pericranium

Meninges

Cerebro-Spinal Fluid

Blood-brain barrier


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Loose connective tissue (areolar tissue)

=Dangerous area


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Meninges

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Three membranous connective tissue layers: Dura mater: though, thick external fibrous layer

Arachnoid mater: thin intermediate layer

Pia mater: delicate internal vasculated layer

Dura mater = pachymeninx

Arachnoid + pia mater; continuous = leptomeninx


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Dura mater

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two layered membrane

adherent to the internal surface of canium

external --periosteallayer

internal -- meningeallayer

Reflection or reduplication of the meningeal layer:

Falx cerebri

Tentorium cerebelli

Falx cerebelli Diaphragma sellae

Blood suply: middle meningeal arteries.


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Dural sinuses

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Superior sagittal sinus

Inferior sagittal sinus

Straight sinus

Transverse sinusOccipital sinus

Confluence of sinuses

Cavernous sinus

Intercavernous sinus

Superior petrosal sinus

Inferior petrosal sinusBasilar plexus sinus


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Meningeal spaces

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The dura-cranium interface (Extradural space or Epidural space )

not natural/pathologic

between cranium and external periosteal layer

The dura-arachnoid junction or interface (Subdural space) not natural/pathologic

between the dura and the arachnoid.

Subarachnoid space:

real space between arachnoid mater and pia mater.

contains CSF, trabecular cells, cerebral arteries and superior cerebral

veins.


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Intracranial hemorrhage

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Meningeal spaces

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Cisterns : areas of subaracnoid space where the brain countour isgreatly changed such that the pia and arachnoid diverge from

each other.

Major subarachnoid cistern include the:

Posterior cerebellomedullary cistern (Cisterna Magna)

Lateral cerebellomedullary cistern

Pontocerebellar cistern (cisterna pontis)

Quadrigeminal cistern Chiasmatic cistern

Interpeduncular cistern (cisterna basalis)

Lumbal cistern


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Lumbal cistern

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CEREBRUM (TELENCEPHALON)

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2 hemispheres, separated by longitudinal fissure.

Macrostructure: gyry, sulci and fissures on the surface of

cerebral hemisphere.

5 lobes: Frontal lobe

Parietal lobe

Occipital lobe

Temporal lobe

Insula


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CEREBRUM

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Special features on the lateral view of the cerebrum: Precentral gyrus the primary motor cortex

Postcentral gyrus the rimary sensory cortex

Superior temporal gyrus the primary auditory cotex

Occipital pole the primary visual cortex

Triangular part and opercular part of inferior frontal gyryBrocas speech area

Angular gyrus and suramarginal gyrusWernickes speech

area


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Functional areas of cerebral cortex

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Outstanding landmarks on the medial view of cerebrum: Corpus callosum

The fornix

The septum pellucidum

Anterior commisure

Principal fissures and sulci on the medial view of cerebrum:

Calcarine fissure

Cingulate sulcus

Parieto-occipital fissure

Inferior temporal sulcus


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Lobes on the medial view of cerebrum: Frontal lobe cingulate gyrus and paracentral lobule

Parietal lobe rostrally: frontal lobe, posteriorly: parieto-

occipital fissure

Occipital lobe is divided into cuneus and lingual gyrus bycalcarine sulcus.

Temporal lobe


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Functional areas of cerebral cortex

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Body maps in the primary motor cortex and somatosensory

cortex of the cerebrum.

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White fiber tracts of cerebral hemispheres

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Deep gray matter of cerebrum

(Basal Ganglia)

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Caudate nucleus Lentiforme nucleus:

Putamen

Globus palidus

Claustrum

Amigdala


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DIENCHEPALON

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3 structures Epithalamus

Thalamus

hypothalamus


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Epithalamus contains the pineal gland, which secretes a hormone called

melatonin that is involved in the nighttime stage of the sleep-

wake cycle


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Thalamus a paired egg-shaped group of brain nuclei

Gateway to the cerebral cortex

Major relay station for sensory impulses (ascending pathway)

and impulses from all brain regions that communicate withcerebral cortex


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Hypothalamus a series of brain nuclei, is the brains most important visceral

control center

regulates sleep cycles, hunger, thirst, body temperature,

secretion by the pituitary gland, the autonomic nervous system,and some emotions and behaviors.


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Thalamus

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BRAIN STEM

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The three basic subdivision of brain stem are: Mid brain (Mesencephalon )

Pontine (Pons)

Medulla oblongata


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Ventral of the brain showing the three parts of the brain stem:

medulla olblongata, pons and midbrain

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Mesenchepalon

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Mesenchepalon is divided into a tectum and paired cerebralpeduncles, crus cerebri (containing the pyramidal motortracts).

In the tectum, the superior and inferior colliculi mediatevisual and auditory reflexes.

The red nucleus and substantia nigra participate in motorfunctions.

The periaqueductal gray matter elicits the fear response. contains motor nuclei of cranial nerves III and IV; control

eye muscles


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Pons

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In the pons, nuclei of cranial nerves VVII lie near the fourthventricle.

The ventral region of the pons contains the pyramidal tracts

plus the pontine nuclei that project to the cerebellum.


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Pons

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Medula oblongata

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Contains the pyramids and their decussation, all formed bythe pyramidal tracts. The olives contain relay nuclei to the

cerebellum.

Nuclei of cranial nerves VIIIXII lie near the fourth ventricle.

Centers in the medullary reticular formation regulate

respiration, heart rate, blood pressure, and other visceral

functions.


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Medula oblongata

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CEREBELLUM

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The cerebellum smooths and coordinates body movements

and helps maintain posture and equilibrium.

Its main divisionsthe paired cerebellar hemispheres and the

vermisare divided transversely into three lobes: anterior,

posterior, and flocculonodular.

The cerebellar surface is covered with folia (ridges) and

fissures.


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CEREBELLUM

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From superficial to deep, the main regions of the cerebellumare the cortex, the arbor vitae, and the deep cerebellar

nuclei.

The cerebellum connects to the brain stem by the superior,

middle, and inferior cerebellar peduncles, thick fiber tractsthat carry information to and from the cerebellum. All these

fibers are ipsilateral.


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CEREBELLUM

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THE SPINAL CORD


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THE SPINAL CORD

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THE SPINAL CORD

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Function Sensory and motor innervation

Conduction pathwaysto and from the brain

Major center for reflexes

extends from the foramen magnum to VL 1 or 2.

terminal end = conus medullaris; filum terminale


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THE SPINAL CORD

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Thirty-one pairs of spinal nerve roots issue from the spinalcord.

The most inferior bundle of roots resembles a horses tail

(cauda equina).

The spinal cord is enlarged in its cervical and lumbar regions,

reflecting the innervation of the limbs.


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THE SPINAL CORD

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Spinal cord has 31

segment 31 pairs

of spinal nerve


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THE SPINAL CORD

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The white matter of the cord is divided into dorsal, lateral, andventral funiculi containing ascending and descending fibers.

The H-shaped gray matter of the spinal cord has two ventral horns

containing motor neurons and two dorsal horns containing

interneurons. The dorsal horns are subdivided into somatic and visceral sensory

regions; the ventral horns, into visceral and somatic motor

regions.

The roots of the spinal nervesdorsal sensory roots and ventralmotor rootsare PNS structures that attach to the spinal cord.


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THE SPINAL CORD

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THE SPINAL CORD (Protection of the


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THE SPINAL CORD (Protection of the

spinal cord)

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Three connective-tissue membranes, the meninges, encloseand protect both the brain and the spinal cord: the tough

outer duramater, the arachnoid, and the inner vascularized

pia mater.

Cerebrospinal fluid both floats and cushions the structures ofthe CNS.

It fills the subarachnoid space and the central cavities of the

brain and spinal cord.


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THE SPINAL CORD

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THE SPINAL CORD

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THE SPINAL CORD

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VASCULARIZATION

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The blood supply to the brain is from the internal carotid andvertebral arteries.

The internal carotid arteries arise in the neck from the

common carotid arteries and enter the cranial cavity with the

carotid plexus of sympathetic nerves through the carotidcanals.

The terminal branches of the internal carotids are the

anterior and middle cerebral arteries.


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Circle of Willis

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Circle of Willis

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A circular anastomosis formed by: posterior communicating arteries

posterior cerebral arteries

internal carotid artery

anterior cerebral arteries anterior communicating arteries


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VENTRICULAR SYSTEM ANDCEREBROSPINAL FLUID

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4 ventricles:

lateral ventricles (1 and 2) in the cerebral hemispheres

third ventricle in the diencephalon; cerebral aqueduct in midbrain fourth ventricle in the pons and medulla regions of the brain stem.


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Ventricles of the brain

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Neuroanatomy UNIB 2013-1