SUBCORTICAL

STRUCTURES,FUNCTIONS &
ASSESSMENT
 SUBCORTICAL STRUCTURES
• Below the cerebral cortex are a variety of other structures,
called subcortical structures.
• literally "below the cortex“.
THE HINDBRAIN- RHOMBENCEPHALON
• The posterior part of the brain.
• Consists of Pons, medulla, cerebellum.
 THE PONS
• In Latin, the word pons literally means bridge.
Location:
• Directionally, the pons is superior to the medulla oblongata and
inferior to the midbrain. Sagittally, it is anterior to the cerebellum
and posterior to the pituitary gland.
Function:
• Arousal
• Controlling Autonomic Functions(breathing)
• Regulation of muscle tone and cardiac reflexes.
• The pons has also been associated with the control of sleep cycles.
• Lesion of the Pons may cause motor, sensory, and
coordination disorders including disruption of
ocular movements & alterations in consciousness.
 THE MEDULLA
• The medulla or medulla oblongata is just above the spinal cord
– enlarged extension of the spinal cord into the skull.
Functions
• Controls vital body functions
• breathing,
• heart rate,
• vomiting,
• salivation,
• coughing and sneezing through cranial nerves.
• It controls sensations from the head, muscle movements in the
head, and much of the parasympathetic out put to the organs.
• Damage to lateral medullary structures can result in
sensory deficits.
NUMBER& NAME FUNCTIONS

• I. Olfactory • Smell
• II. Optic • Vision
• III. Oculomotor • control of eye
movements:pupil
constriction
• IV. Trochlear • Control of eye movements

• V. Trigeminal • Skin sensations from most

of the face,control jaw
muscles for chewing and
swallowing.
• VI. Abducens • control of eye
movements

• VII. Facial • Taste from the anterior

two thirds of the tongue,
controls of facial
expression, crying,
salivation, dialation of
the head’s blood vessals.
• VIII. Statoacoustic • Hearing & equilibrium

• IX. Glossopharyngeal- • Taste and other sensations

from throat and posterior
third of the tongue; control
of swallowing, salivation,
throat movement during
speech.

• X. Vagus • Sensations from neck and

thorax; control of
throat,esophagus and larynx.
• XI. Accessory • Control of neck and sholder
movements.

• XII. Hypoglossal- • Control of muscles of the

tongue
 RECTICULAR FORMATION
• The medulla and pons also contains recticular formation.
• It has ascending & descending portions.

• AP- sends output to much of the cerebral cortex, selectively

increasing aroual & attention in one or more area.

• DP- Control the motor areas of the spinalcord

 THE CEREBELLUM
• The cerebellum is a large hindbrain structure with many deep folds.

• The cerebellum is located behind the medulla and pons.

• Functions

• Important for “balance and coordination”.

• The cerebellum coordinates voluntary movements such as posture,
balance, coordination, and speech, resulting in smooth and balanced
muscular activity.
• The cerebellum receives information from the sensory systems, the
spinal cord, and other parts of the brain and then regulates motor
movements.
• People with cerebellar damage are clumsy and lose their
balance.
• People with damage to the cerebellam have drouble shifting
their attention back and forth between auditory and visual
stimuli.
• They have difficulty with timing, inluding sensory timing.
• Example- poor at judging whether one rhythm is faster than
another.
THE MIDBRAIN- MESENCEPHALON

• The midbrain is in the middle of the brain.

• It includes tectum, tegmentum & substantia nigra
 TECTUM
• The roof of the midbrain-tectum ( latin word
for “roof”).
• The swellings on each side of the tectum are
• Superior colliculus- vision
• Inferior colliculus-hearing
 TEGMENTUM
• Under the tectum lies the tegmentum,the intermediate level of
the brain.(In latin tegmentum means a “covering”,.)
• It covers several other midbrain structures,although it is
covered by the tectum.
• Tegmentum icludes the nuclei for the third and fourth cranial
nerves,parts of recticular formatiuon and extensions of the
pathways between the forebrain and spinalcord.
 SUBSTANTIA NIGRA
• The substantia nigra is a region of the midbrain which
contains neurons that produce the neurotransmitter
dopamine.
• It is black in appearance,
• ("substantia nigra" is Latin for "black substance".)
 FUNCTIONS
• Neurons in the substantia nigra travel to brain areas
which are important for motor control as well as to
the frontal lobes, which are important for attention
and executive function.
• Parkinson's disease is a disorder that involves
progressive death of neurons in the substantia nigra,
leading to motor and cognitive symptoms.
 FORE BRAIN-BELOW CEREBRUM

• 1-thalamus
• 2-hypothalamus
• 3-Limbic system
• 4-basal ganglia
 THALAMUS
• The thalamus is a pair of structures(left and right) in the center
of forebrain.
• The term derives from a Greek word meaning “anteroom” or
inner chamber.
• It resembles two avocados joined side by side, one in the left
hemisphere and one in the right.
• Most sensory information goes first to the thalamus, which
processes it and sends output to the cerebral cortex.
• An exception to this rule is olfactory information, which
progresses from the olfactory receptors to the olfactory bulbs
and then directly to the cerebral cortex.
• Body sensations lost with damage to specific thalamic
nuclei.
• Inability to make tactile discrimination &
identification of what is felt.(tactile object agnosia)
• Two kinds of memory impairments-anterograde
amnesia, reterograde amnesia
 HYPOTHALAMUS
• Hypothalamus is less than one cubic centimeter in size.

• Location: Above the pituitary gland and below the thalamus.

• Function:
• It regulates autonomic nervous system(sweating, salivating,shedding of
tears)
• Role in homeostasis-the maintenance of the body’s internal environment at
optimal level
• Regulation of eating.
• Role in motivated behavior(mating & agression)
• This part of the brain also controls the pituitary gland, which
is the master gland that controls all the other endocrine glands
in the body.
• Damage to any hypothalamic nucleus leads to abnormalities in
motivated behaviors, such as feeding, drinking, temperature
regulation, sexual behaviour, fighting or activity level.
 PITUITARY GLAND
• The pituitary gland is an endocrine (hormone producing) gland
attached to the base of the hypothalamus by a stalk that
contains neurons, blood vessels, and connective tissue
• In response to message from the hypothalamus, the pituitary
synthesizes hormones that the blood caries to organs
throughout the body.
 LIMBIC SYSTEM
• A number of other interlinked structures known as limbic
system

• form a border( or limbus-the latin word for border) around the

brainstem.

• These structures are important for motivations and emotions,

such as eating, drinking, sexual activity, anxiety and agression.

• The limbic system includes the hippocampus,cingulate gyrus

amygdala,fornix.
• Fornix – connects the hippocampus with the mammilary
bodies, the mammilary bodies with the thalamus and back to
the cerebral cortex via conections through the cingulate gyrus.
• These connects form a loop known as limbic loop.
 HIPPOCAMPUS
• The hippocampus (from the latin word meaning “seahorse”-a
shape suggested by the hippocampus)
• It is a large structure between the thalamus and the cerebral
cortex, mostly toward the posterior of the forebrain.
• Hippocampus is critical for storing certain kinds of memories,
especially memories for individual events.
• People with hippocampal damage have trouble storing new
memories, but they do not lose all the memories they had
before the damage occurred.
 AMYGDALA
• Location: Part of Limbic System, at the end of the
hippocampus.
• It is involved in aspects of emotional control and
formation of emotional memories.
 BASAL GANGLIA
• The basal ganglia are a collection of subcortical nuclei found
in forebrain..

• They include

• the putamen (“shell”),

• the globus pallidus(“pale globe”),

• the caudate nucleus(“tailed nucleus”).

 PUTAMAN
• The putamen is a large structure located within the brain.

• It is involved in a very complex feedback loop that

prepares and aids in movement of the limbs.

• It is closely intertwined with the caudate nucleus, nucleus

accumbens, and globus pallidus, which are together
known as the corpus striatum.

• Signals are transmitted through these structures to the

motor thalamus, brain stem, and motor neocortex, which
helps the body with all aspects of physical movement.
• Lesions on the brain due to Parkinson's disease can
affect the putamen and cause involuntary muscle
movements or tremors.

• Degenerative diseases of the brain, such as

Huntington's disease, can also affect the putamen
and cause jerky, unpredictable movements.
 GLOBUS PALLIDUS
• The globus pallidus is a structure in the brain
involved in the regulation of voluntary movement.

• If the globus pallidus is damaged, it can cause

movement disorders, as its regulatory function will be
impaired
 CAUDATE NUCLEUS
• Each of the brain's hemispheres contains a caudate nucleus,
and both are located centrally and near the basal ganglia.

• The caudate nucleus plays a vital role in how the brain learns,
specifically the storing and processing of memories.

• It works as a feedback processor, which means it uses

information from past experiences to influence future actions
and decisions.

• This is important to the development and use of language.

Specifically, communication skills are thought to be controlled
mostly by the left caudate and the thalamus.
ASSESSMENTS
 TESTS OF BASAL GANGLIA
• The Boston Naming Test (BNT)-Neuropsychological
assessment tool to measure confrontational word retrieval in
individuals with aphasia or other language disturbance caused
by stroke, Alzheimer's disease, or other dementing disorder.
 ASSESSMENT-MEMORY
• Verbal memory test

✓ California Verbal Learning Test- is a well established neuropsychological

test of verbal memory
✓ The Rey Auditory Verbal Learning Test (RAVLT) is a
neuropsychological assessment designed to evaluate verbal memory .
1. The test is designed as a list-learning paradigm in which the patient hears
a list of 15 nouns and is asked to recall as many words from the list as
possible.
2. After five repetitions of free-recall, a second “interference” list (List B) is
presented in the same manner, and the participant is asked to recall as many
words from List B as possible.
3.After the interference trial, the participant is immediately asked to recall
the words from List A, which she or he heard five times previously.
• Visual memory test
✓WMS-III faces
✓Continuous visual memory test

• Visual recall
✓WMS-III family pictures
• PGI-Memory scale
 MOTOR TESTS
• Bender visual motor gestalt test
• Benton visual retension test
• Complex figure test
• Free drawing
 ATTENTION & EXECUTIVE FUNCTIONS
• WCST
• Stroop test
• The Trail Making Test is a neuropsychological test of visual attention and
task switching. It consists of two parts in which the subject is instructed to
connect a set of 25 dots as quickly as possible while still maintaining
accuracy.