II Sem Lecture Pysiotherapy, BS, SS, 8.05.2020
II Sem Lecture Pysiotherapy, BS, SS, 8.05.2020
II Sem Lecture Pysiotherapy, BS, SS, 8.05.2020
Science!
dr Ivonka 8.05.2020
The cerebrum is the largest part of the brain, located superiorly and
anteriorly in relation to the brainstem. It consists of two cerebral
hemispheres (left and right), separated by the falx cerebri of the dura
mater. Embryologically, the cerebrum is derived from the
prosencephalon.
The cerebrum is located within the bony cranium. It extends from the
frontal bone anteriorly to the occipital bone posteriorly. Within the
skull, the cerebrum fills the anterior and middle cranial fossae, and is
located above the tentorium cerebelli inferoposteriorly.
Internal Structure
The cerebrum is comprised of two different types of tissue – grey
matter and white matter:
External Structure
Externally, the cerebrum has a highly convoluted appearance,
consisting of sulci (grooves or depressions) and gyri (ridges or
elevations). It is divided into two anatomically symmetrical
hemispheres by the longitudinal fissure – a major sulcus that runs in
the median sagittal plane. The falx cerebri (a fold of dura mater)
descends vertically to fill this fissure. The two cerebral hemispheres
are connected by a white matter structure, called the corpus
callosum.
Lateral sulcus – groove separating the frontal and parietal lobes from
the temporal lobe.
1.Frontal Lobe
The frontal lobe is located beneath the frontal bone of the calvaria
and is the most anterior region of the cerebrum. It is separated from
the parietal lobe posteriorly by the central sulcus and from the
temporal lobe inferoposteriorly by the lateral sulcus.
The association areas of the frontal lobe are responsible for: higher
intellect, personality, mood, social conduct and language (dominant
hemisphere side only).
2.Parietal Lobe
The parietal lobe is found below the parietal bone of the calvaria,
between the frontal lobe anteriorly and the occipital lobe posteriorly,
from which it is separated by the central sulcus and parieto-occipital
sulcus, respectively. It sits superiorly in relation to the temporal lobe,
being separated by the lateral sulcus.
3.Temporal Lobe
The temporal lobe sits beneath the temporal bone of the calvaria,
inferior to the frontal and parietal lobes, from which it is separated
by the lateral sulcus.
4.Occipital Lobe
The occipital lobe is the most posterior part of the cerebrum situated
below the occipital bone of the calvaria. Its inferior aspect rests upon
the tentorium cerebelli, which segregates the cerebrum from the
cerebellum. The parieto-occipital sulcus separates the occipital lobe
from the parietal and temporal lobes anteriorly.
The primary visual cortex (V1) is located within the occipital lobe and
hence its cortical association area is responsible for vision.
5.Limbic Lobe
Vasculature
The blood supply to the cerebrum can be simply classified into 3
distinct paired arterial branches:
Forebrain (prosencephalon)
Midbrain (mesencephalon)
Hindbrain (rhombencephalon)
.Anatomical Location
It lies at the same level of and posterior to the pons, from which it is
separated by the fourth ventricle.
Anatomical Lobes
Zones
Functional Divisions
Vasculature
The cerebellum receives its blood supply from three paired arteries:
The SCA and AICA are branches of the basilar artery, which wraps
around the anterior aspect of the pons before reaching the
cerebellum. The PICA is a branch of the vertebral artery.
Ataxia
Nystagmus (coarse)
Intention tremor
Scanning speech
Hypotonia
The meninges
The meninges refer to the membranous coverings of the brain and
spinal cord. There are three layers of meninges, known as the dura
mater, arachnoid mater and pia mater.
These coverings have two major functions:
Iwe shall look at the anatomy of the three layers, and their clinical
correlations.
Dura Mater
The dura mater is the outermost layer of the meninges, lying directly
underneath the bones of the skull and vertebral column. It is thick,
tough and inextensible.
Within the cranial cavity, the dura contains two connective tissue
sheets:
Periosteal layer – lines the inner surface of the bones of the cranium.
Between these two layers, the dural venous sinuses are located. They
are responsible for the venous vasculature of the cranium, draining
into the internal jugular veins.
In some areas within the skull, the meningeal layer of the dura mater
folds inwards as dural reflections. They partition the brain, and divide
the cranial cavity into several compartments. For example, the
tentorium cerebelli divides the cranial cavity into supratentorial and
infratentorial compartments.
The dura mater receives its own vasculature; primarily from the
middle meningeal artery and vein. It is innervated by the trigeminal
nerve (V1, V2 and V3).
Haematomas
A haematoma is a collection of blood. As the cranial cavity is
effectively a closed box, a haematoma can cause a rapid increase in
intra-cranial pressure. Death will result if untreated.
Arachnoid Mater
Pia Mater
Bacteria are the most common infective cause. The most common
organisms are Neisseria meningitidis and Streptococcus pneumoniae.
Part of the brain can be forced out of the cranial cavity – this is
known as cranial herniation.