Primary ‘5 Secondary Aut corvatves vesicles ‘vesicles ot Wats Cavities auty ovata Lato vertices Telencephaon ee Forebain {preseneophaon) > Thalamic, Th ventric Deencephaon > meran Aqueduct tain > mesencephalon ees Pons Upper ar ot ‘our verte otoncophalon Coram eeoran \Ghombencephaon). | Meda Lower part ot foun verdeEmbryonic Brain Regions in Structures Present in Adults a Mictsrain ———. Mesencephaion ———— Midbrain (part of brainstem) Mesencephalon Metencephalon Midbrain Hindbrain Diencephalon ere raec ‘Spinal Forebrain Telenesfialon ‘cord (@) Embryo one month old (b) Embryo five weeks old‘Table 5- summary of the More Important Openings in the fase of the skull and the Structures That Pass Through Them Anterior Cranial Fossa erfarations in cribriform plate Ethmoid middle Cranial Fossa optic canal Lesser wing of sphenoid Superior orbital Between lessor and greater wing: of fissure sphenaig Faramen ‘ares Sr ietarata aes reater wing of sphenoi Faramen ovale Greater wing of sphenoid Forman spine Greater wing of sphenoid Foramen Between petraus part of temporal lacerum and sphenoie Posterior Cranial Fossa Foramen foe eefpieal Hypoglossal bi ocefpital jatween petraus part of temporal Jugular foramen and condylar part af occipital Internal acoustic mean Patrous part of tempori Olfactory nerves Optic nerve, opthalmic artery Lacrimal, frontal, trochlear aculomator, nacociliary, and abducent nerves; superiar ophthalmic vein maxillary dhision of the trigeminal nene Mandibular division of the trigeminal nerve, lesser petrasal Middle meningeal artery Internal caratid artery medulla oblongata, spinal part of accessory nerve, and right and left vertebral arteries Hypoglossal nerve lossopharyngeal, vagus, and accessory nerves; sigmoid sinus becomes internal jugular vein Vestibulocochlear and facial nervesMeninges 1) Dura mater (outermost) -with endosteal and meningeal layers layers are intimately attached to each other EXCEPT in parts where VENOUS SINUSES are located where they separate 2) Arachnoid mater -below it, SUBARACHNOID SPACE w/c contains CSF. arachnoid and pia separates widely at times to form CISTERNS. *Cistemna magna or Cerebellomedullary cistern = where CSF from foramen of magendie/luschka exits note: a. falx cerebrl - separates two cerebral hemispheres b. tentorium cerebelli - divides CNS between supra-and infre-tentorial regions. falxcerebelli divides corebellar hemispheres .Epidural/Extradural hematoma - mostly arterial (middle meningeal artery) e. Subdural hematoma - mostly venousSuperior sagittal sinus (@) CSF is secreted by choroid seat es ubarachnot plexus in each lateral ventricle. space (2) CSF flows throug ‘Arachnoid interventricular villus . Choroid r plexus adds more CSF. \ Third (@ CSF flows down “SS Wentricle cerebral aqueduct to — Cerebral fourth ventricle. aqueduct © Choroid plexus in fourth Lateral ventricle adds more CSF. ‘ aperture © CSF flows out two lateral apertures \ and one median aperture. Median @) CSF fills subarachnoid space and aperture bathes external surfaces of brain and spinal cord. Central canal @ At arachnoid villi, CSF is resorbed of spinal cord into venous blood of dural venous sinuses. Subarachnoid space of spinal cordVentral aspect of the BrainstemGrantor Tbs Sucturestmnenated Tunaitons olfactory Sensoqy ‘factory epithelium (ia ator Bub) ‘Ofscton, Optic ‘Sensory Retna Vision iNculomator TMctor ‘superior/midaleinfevorrects, Inferioroblique, | Movementofeye bal levatorpalpebrae. Parasympatnetic | Pupllary constrictor, Gary musde of eyebalBoth_| Pupliary constricion | Gculomotornadeus a the allary ganglion _andaccommadetion Wirechiear ator Superior oblique ‘Movementafeyebel | Wachiear nucleus ‘VTrigerinat ‘Sensony Face, cap, cornea, nasaland oralcavies, cranial | Generalsensation | Trigeminal sensory nudeus uramater Tiotor ‘Muscles of matcation ‘Dpening/elonngmeuth | Trigeminal Motor nucleus TensorTymponi muscle TTensionoftympanic | Trigeminal Motor nucleus mamorane Waiocens actor Tate rectus Movementofeyebal | Abducensmudeus ‘ViFaxial Sensoq7 ‘Anteror2/3 oftongue Taste ‘Nucleus Soitarve Motor ‘Muscle of fcial expression Foaal viovement | Facial Metar nace Stapedlus muscle “Tensionofossises | Facul Motor Nucleus Parasympathatic | Salvary and lacrimal lands va submandibular and | Salvation and ‘Superior Slvaroty Nucleus plerygopalatine ganglia Lacimation ‘Vlivestibulocochiear | Sensory Coches Heanag Cochiearnuseus Vestioular apparatus Proseeptionot head, — | vesttularnucous alongs. eGlossopharyngeal | Sensory Estacion tube, mide ear ‘GeneralSensation, | Wigerninal Sensorynudeus (Carona Body. and sus ‘chema/oeroreceotion ‘Pharynx, posterior1/3 of tongue Taste Nudews Somaru TMator ‘Styropharyngeous ‘swallowing Parasyrnpatet | Salivary glands via the oti ganglion Salvation ToferirSaiwatory audeus Kage ‘Sensory Paty larynx, ossophagus,externalear ‘Generalsensation | Trigeminal Sensorynudeus ‘Aoricbedier and arch ‘chema/asroreception “Thoracic and abdominal vicars VisceralSensation | NudewsSoitars Mater Soft palate, laryns, pharynx upper oacephague | speech swallowing | Auccus ambiguus Parasyripalletic | Catdhovascular, respiratory and gasirointestnal | Controlof these ‘Dorsal Motor audeuso? systems, stems Vagus Whecessory Taster ‘Stemomasteld apeaius Movementorheadand | NucelasAmbguus canal shoulders nerves Taypogiosal actor Tatrinsicand extrinsic muncesof tongue Movementoftongue | Hypoglossainucleus‘ery mad ie is fe pe {etme pron hu sae me oe picsSeeman wn a we cope iin a otc 5 Gena CNTR rN A Th oY a NW xl ay nthe + Seance ote crt by tenner eb pence 1 letenal srs ofthe mal ges 9:2 thogh 8) 1 fscening sensory pana od relay mace Trice reins tcc cnet «Tree eal eluant smn each at and me cat, {Tota conde nurs the ral olen dl oma pty. 1 ffenestr rae ths. «itl arena Ee nthe Sa mc a eM a 4, Decmsation uf the weal misc ee Fg) Seta ‘tue doe conn eat he vial pxelatr mcs. Soanat mbes ee 8 teas he ltr aad reba spank ws the spt at 2 Descent pty ‘Pyrumhl excess ee Fe 9-2) Vocal tthe peer nn {cheno eosin conkespina fe 1 Infor trary nce SS carer fey res tar pres eller Abe va the ike ‘acter pede to te conraleal crtarce nderca rack + foes np tro hed ee, Cental sementl ect xen te mrbran 4 the error ake 1 Sis rao ay se ether 1 omit sers 4. Later kadar ens edi winy miles ht profes athe lf cris pada to the Sader ‘cel on the vent suc he pre 5 fe aout en a cme ee Rat ete ‘het anconess pracston Hom the ker etemtes tthe cbt ‘the nice cect podem 1 Nena pinecone ret ‘ine ances preston Hom the ker etemies to the eatin ‘isthe super ctr pe 1h takers prc ‘comes he med the ceo.Table 8-1 Some of the Main Anatomical Connections of the Cerebral Cortex Somatosensory (most to contralateral side of body; oral to same side; pharynx, larynx, and perineum bilateral} Vision Auditory Taste Smelt Motor Fine movements (most to contralateral side of body; extraocular muscles, upper face, tongue, mandible, larynx, bilateral) Ventral posterior lateral and ventral posterior medial nuclei of thalamus Lateral geniculate body Medial geniculate body Nucleus solitarius Olfactory bulb Thalamus from cerebellum, basal ganglia; somatosensory area; premotor area Primary somesthetic area (3, 1, and 2), posterior central eyrus Primary visual area (17) Primary auditory ‘area (Bd and 42) Posterior central gyrus (B43) Primary olfactory area; periamyedaloid and prepiriform areas, Primary motor area (64) Secondary somesthetic area; primary motor area Secondary visual area (@18 and 19) Secondary auditory area (@22) Secondary olfactory area (628) Motor nuclei of brainstem and anterior horn cells of spinal cord; corpus striatumao enw cies) Dr Receptoc Dopamine {Exar Dect top) res cute —" >| isinnbtion) Thales excite (ae to ‘ésinhbtion) Jie) Fa ‘nhpton) Jamon «caudate toe at innit einer TS Semen eh (ahtenata) ron Decreased functionImportant to remember! Cortico-ponto-cerebello-dentato-thalamo-cortical pathway -major pathway from which the cerebral cortex communicates with the contralateral cerebellum, with it gaining control from the cerebellum for coordinated motor activities.The Afferent Cerebellar Pathways PNicoroabr tac Perot Dorsal spinocerebellar ‘Unconseious kinesthetic & ‘cutaneous afferents from trunk & leg Anterior lobe,pyramis,uvula & paramedian lobe via ipsilateral inferior cerebral peduncle Ventral Spinocerebellar Exteroceptive and proprioceptive _| Vermisand anterior lobe via fibres from body ipsilateral superior cerebral peduncle Vestibulocerebellar tract Vestibular impulse from labyrinth | Flocculonadular lobe via ipsilateral direct and via vestibular nuclei —_| inferior cerebral peduncle Cuneocerebellar tract Proprioceptive impulses, especially from arm,head and neck anterior lobe via ipsilateral inferior cerebral pedunele Tectocerebellar ‘Auditory and visual impulses via | Lobulus simplex leclive & tuber inferior and superior colliculi vvia superior cerebral peduncle Carticopontovere bellar Impulses from motor and other | All parts of cerebellar cortex partsof cerebral cortex via pontine nude except floceulonodular lobe via contralateral middle cerebellar peduncle Olivocerebellar Proprioceptive input from whole body via relay in inferior olive All parts of cerebellar cortex via contralateral inferior cerebral peduncleLobe Nucleus Afferent peduncle Efferent peduncle Function Vestibulocerebellum (archicerebellum) Flocculonodular Fastigial & vestibular Inferior Inferior © Equilibrium * Posture * Eye movement Spinocerebellum (paleocerebellum) Anterior Globose & emboliform Inferior & superior ‘Superior * Muscle tone * Movement execution Stretch reflexes Cerebrocerebellum (neocerebellum) Posterior Dentate Middle ‘Superior * Compares planned to actual movement * Smoothness & precision of MovementsThe cerebellar efferent pathways muscle tone Pathway Function Origin Destination 1. Globose — Influence the Globose Via rubro spinal tract to Emboliform ipsilateral nucleus ipsilateral motor neurons —Rubral motor activity in spinal cord Emboliform nucleus . Dentothala Dentate Via corticospinal tract to mic nucleus _| ipsilateral motor neurons in the spinal cord 3. Fastigial Influence the Fastigial Via vestibulospinal tract vestibular ipsilateral nucleus to ipsilateral motor extensor neurons in spinal cord muscle tone 4. Fastigial Influence the Via reticulospinal tract to reticular ipsilateral ipsilateral motor neurons in spinal cordSensation Receptor Spgeadorder Third Order aways Destination Ventral Lateral Pain and Free nene Posterior Substantia Posterolateral, spinothalamic, Posterior temperature endings foot gelatinosa nucleus of spinal central gangtion ‘thalamus lemniscus: gyrus Posterior Ventral Anterior Posterior Light touch and Free nerve Post Sunstone postroliteral —Spnothalaic, Pastor res i in 7 : pressure endings un strom ictus sa centr Discrinathe else's sascicul touch voretory corpuscles, ot Nuclei Ventral oct sense, pacintan esterior — Gractis posterolateral Tai an ester conscious Eorpuseles, oad fucleusof eat, central muscle joint muscle spindles, ganet ‘cuneatus ‘thalamus tenniscus an sense tendon organs Note that all ascending pathways send branches to the reticular activating system.Table 4-3 Muscle Joint Sense Pathways to the Cerebellum Sensation Receptor First Order Neuron Second-Order Neuron Pathways Destination Muscle Unconscious indies, Anterior and tendon Posterior root posterior Cerebellar muscle Nucleus dorsalis vat Saige organs, ganglion spinocere- cortex q joint bellar receptorsFirst-Order ‘Second-Order Site of Crossover ‘rontantromicns Fosceus Fopgoceton tne fares teach presen Maton rominlat ‘suport. SPINOTHALAMICTRACT Lote Pinan tempecture ‘pinathalmic sation: pees cade tovenand sprethuanie perenne, SPINOCEREBELLAR TRACTS Foxever Pooaacetion Ssinocerbatar area oodacetion| Dera ot gana owe toy onsen Sin ‘on rote arden Snes goat Doxsalroat canta of upper boy sons enter Cs ns ‘orto ard ater ‘whines cea Dexa cet canal. ans ‘nto Ch in dl ot indenter poser ay torn hesbow Doxa ot aan mon (cer Chin dal ote pssbowe Macs gras ofa tngatn eons oss ‘ver before etna ‘meat ones uceaseuneausot smeaulaoongtr tons ‘owtovr before rn ‘medi lonets| Inposerer cry hom ‘nonsererstoat Spnovtometaet Inposerer oy home Spinto acon orposte ie Inponerer ayo: Spinola acton Snes Insane soa segrene Spmocerebatrvacton ‘Sime opposte de Vert oserlte uceusoh eure ea poswolacea! acer ‘has vere Bowral fageuset ‘haba nesbove Not present Not present Primer sensory cotecon ide opposte somes ‘soveve Primary sensory ‘artecen tae Sppostesimals erbetrconoxon ‘Sects corte core Direntyen cect ‘rors seconde retro betrearing medal emseus ‘pssbore ‘Irons ot second ce rere Steveloferey peso ‘ore of mos scone ewrons cos bere ern foeane en ess seam win ‘rebelTable 13-4 Functions of the Main Hypothalamic Nuclei Hypothalamic Nucleus Presumed Function Supraoptic nucleus Synthesizes vasopressin (antidiuretic hormone) Paraventricular nucleus ‘synthesizes oxytocin Preoptic and anterior nuclei Control parasympathetic system Posterior and lateral nuclei ‘Control sympathetic system Anterior hypothalamic nuclei Regulate temperature (response to heat) Posterior hypothalamic nuclet Regulate temperature (response to cold) Lateral hypothalamic nuclei Initiate eating and increase food intake (hunger center) Medial hypothalamic nuclei Inhibit eating and reduce food intake (satiety center) Lateral hypothalamic nuclei Increase water intake (thirst center) Suprachiasmatic nucleus Controls circadian rhythms‘Table 13-1 The Main Afferent and efferent Nervous Connections of the Hypothalamus atmay Afferent ‘medial and spinal lemnisci, tractus soltarius, reticular formation ‘visual fibers Medial forebrain bundle auditory fibers (Corticohypothalamic fibers Hippocampohypathalamic fibers; passibly main autput pathway of limbic system _Amygdalohypothalamic fibers ‘Thalamohypothalamic Aber ‘Tegmental fibers efferent Descending fibers in reticular formation to Brainstem and spinal cord Snammnilothalamic tract swammilotegmental tract uttiple pathways \Viscera and somatic structures Retina ‘Olfactory mucous membrane Inner ear Frontal lobe of cerebral cortex, Hippocampus Ampgdaloid complex Dorsomedial and midline nuclei of thalamus Tegrentum of midbrain Preoptic, anterior, posterior, and (ateral nuclet of hypothalamus Nuclei of marrmilary body Nuclet of manmilary body Hypothalamic nuclei Hypothalamic nuclei Suprachtsematic nucleus Hypothalantc nuclei Hypothalamic nuclei Hypothalamic nuclei Nuclei of mamillary body Hypothalamic nuclei Hypothalamic nuclei Hypothalantc nuclei Craniosacral parasympathetic and ‘thoracolumbar sympathetic cutflows anterior nucteus of thatamus; relayed to cingulate ayrus Reticular formation in tegmentumof midbrain Limbic systemCorticospinal vracts Reticulospinal tracts Tectaspinal, eract Rubraspinal tract Reni, skilled, soluntary movements, especially distal end of limbs Inhibit or facittate voluntary movement; controle sympathetic, sympathetic outflows Reflex postural moversents, concerning sight Facittates acthity of flexor muscles and inhibits scthity of extensor muscles Primary motor cortex (area 9), secondary motor cortex (area 6), parietal lobe (arezs 3, 1, and a Reticular formation Superier cotieulus Red nucleus Most cross at decussation of pyramids ‘and descend as lateral corticospinal tracts; some continue a anterior corticospinal ‘acts and cross Over at level of derenation Some cross at various Internuncial {aipha motor Alpha and ews meter ‘Alpha and seme meter ‘Alpha and pews ceter uci, nucteus, olkary reticular formation. muitipie branches theyVestibulospinal Otivospinal tract Descending fibers Facilitates activity of extensor inhibits flexor muscles Contrat sympathetic and pars- sympathetic systems ‘Vestibular nuclei Inferior otivary ruclei Cerebral cortex, hypothalamus, amygdaloid complex, reticular formation Uncrossed Cross in brainstem Alpha and gamma motor 7 Alpha and gamma motor - Sympathetic. and parasympathetic outflows Note that the corticospinal tracts are believed to control the prime mover muscles (especially the highly skilled movements}, whereas the other descending tracts are impartant in contralling the simple basic movements. Far simplicity, the intarnuncial neurons are omitted from this table.Figure 9.11. Corticobultar innervation ofthe fail nerve (CN Vi muckas. Am UMN kesion (eg. ‘aoe invedving the intemal capsule) rez in contralateral weakest. ofthe lower fcr and spams the upper face. A. UMN ston e.g, Hel psy) sults in parlyss of aca muck in beth the opps anu! lower face. (xrawn with permiaion fromm DeMyer WE: Technigar ofthe Newall Examination: ‘A Programmed Tet, 4 ol. New York, MeGram Hil, 994, 63, p. 17)a ra % x Tear wencmae [Execs |awwamase ‘ual oa nacones | R200 oy | Sanatoncetsat | Opicenaem Ootebars) NES pat iebe | Terpertrennaroe iy ‘tomate patway | cates | Fea) ane2 23 Opera fats, |aeateoem~ |e | BGR | Se, TEES | emcee ct, | Sra mr fe pe mee | il, | a Nace aheroes .0ncn romscnin roman encumer | wae romuer |e | tasarecons | eunaaien | eaten SpaaancesStaccpinre sain | Estee Bo eu | RasaarenceStecaar aimee amass | cera ae near eye cera | ay ssommasstin eons Eyosess”” i ome = swingin! teem? aun | AV ZEEE” Tce ecmmemmimnpepes | nome | tte snare? Heme? [SkvemadSmiseuacee™ | Ee Sener eagmtraron tat >nesonst | oat morro [eeeem [yeraon [izes | lites Semmens inet Sues | eae ‘Geese Was SORGRSET aang Soins SSocoueneS” [amie iee Amro ee | cenasecaarFomaccn | ARNE > ee lawrtcne seca secre? | 5 Eo SNE . ‘adamant > 5, ee me ay fe Vertical Gaze ree? “Trochlear Nei 350 == satsars deoneie | meen dear Pir gesaemmae | em SmosthPurcait | limbofinteraleapeole | > ese 9 masala ‘Slow treching movement esau aa immer [EE venue wsTable 1. Audiony Ras Pathways, ianexratway Son aa ea aera a aaa ‘sutiomsacReter | Loudsounds Swpeoronantuces | Oargenvbtonct fororieronma ou roteve ero ee even [wet intonte [ET [cms nn cctemiayrannc | Sone apicisen pisereuiaeisce | rene Tite yeona inc grain