The fundamental of neuroanatomy

Muhammad Iqbal Basri

Anatomy Department
Hasanuddin University

1
A. Introduction
 Nervous system consist of:
o CENTRAL NERVOUS SYSTEM (CNS)
o PERIPHERAL NERVOUS SYSTEM (PNS) (Nn. Craniales
+ Nn. Spinales)

 CNS
o Location inside of Cavum Cranii + Canalis Vertebralis
o Consist of ENCEPHALON + MEDULLA SPINALIS
o There are channels in CNS Ventriculi system + Canalis
Centralis
o CNS cover by layer/ MENINGES sheath
o Basic structure / primary CNS  SUBSTANTIA GRISEA +
SUBSTANTIA ALBA

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3
INTRODUCTION 2
 CNS consist by nervous cell :
o NEUROGLIA  - as suporting cell
- consist of Oligodendrosit, Astrosit, Microglia,
Ependym cell
o NEURON
- Is the PRIMARY fuctional unit in nervous system
- The primary part contained nervous sytem (90% on CNS)
- have axon + dendrit  FIBRE NERVE
- Axon enveloped by “myelin”
(CNS  by Oligodendrosit, PNS  by Schwann cell)
- Collection of fibre nerve:
• CNS  tractus / fasciculus / fibrae
• PNS  Nervus
- Neuron size  can reach within 1 m, but still on microscopic size

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 Cellular organization

 Neurons
 Cell body
 Axon
 Dendrites

 Neuroglia －glial cell

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Structural classification
 Bipolar neuron
has an axon and a dendrite
 Pseudounipolar neuron
has a central branch and a
peripheral branch
 Multipolar neuron has an axon
and two or more dendrites

Functional classification
 Sensory (afferent) neuron
 Motor (efferent) neuron
 Association neuron

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INTRODUCTION 3
o Axon + Dendrit  consist of SUBSTANTIA ALBA
o Body cell  consist of SUBSTANTIA GRISEA
o NUCLEUS  a collection of body cell in CNS
o SYNAPS  related between 1 Neuron (axon) to the
next neuron (Dendrit)

 STIMULUS
o SENSORIS STIMULUS
- Exteroceptif
- Interoceptif
- Proprioceptif
o MOTORIS STIMULUS
Fast Stimulus 10 – 120 m/second

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NEUROLOGICAL DIAGNOSIS
1. Clinical Diagnosis
2. Topical Diagnosis NEUROANATOMY

3. Ethiological Diagnosis

FUNCTIONAL NEUROANATOMY

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Basic terminology in nervous system

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In the CNS
 Gray matter : collection of
nerve cell bodies and their
dendrites, gray color during
fresh condition
 Cortex : the outermost layer
of gray matter in cerebrum
and cerebellum
 White matter : collection of
nerve fibers, white color
during fresh condition
 Medulla: a central core of
white matter beneath cortex of
cerebrum and cerebellum
 Nucleus: a collection ( group )
of cell bodies which have the
same shape and function

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 Fasciculus ( tract ): a
bundle of nerve fibers
which have the same
origin, termination,
pathway and function
 Reticular formation: an
admixture of cross-
crossing fibers with
larger or smaller groups
of nerve cells occupying
the meshes

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In the PNS
 Ganglion : a
collection of neuronal
cell bodies outside the
CNS
 Nerve : a bundle of
nerve fibers held
together by connective
tissue sheath

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 Neurons
• Dendrites: carry nerve impulses toward cell body
• Axon: carries impulses away from cell body
• Synapses: site of communication between neurons using chemical
neurotransmitters
• Myelin & myelin sheath: lipoprotein covering produced by glial cells
(e.g., Schwann cells in PNS) that increases axonal conduction velocity
• Demyelinating diseases: e.g., Multiple Sclerosis (MS) in CNS or
Guillain- Barré Syndrome in PNS
dendrites
cell
axon with
body
myelin sheath

Schwann
cell
synapses
Moore’s COA5 2006 13
 Sensory (Afferent) vs. Motor (Efferent)
sensory (afferent) nerve

(pseudo-) unipolar neurons conducting impulses e.g., skin

from sensory organs to the CNS

motor (efferent) nerve

e.g., muscle
multipolar neurons conducting impulses
from the CNS to effector organs (muscles & glands)
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Gray’s Anatomy 38 1999
 Structure of Spinal Nerves: Somatic Pathways
dorsal root dorsal
dorsal root ganglion ramus
spinal
dorsal nerve somatic
horn sensory
nerve
CNS (GSA)
inter-
neuron
ventral ventral somatic
horn ramus motor
nerve
(GSE)
ventral root
white ramus
communicans
Mixed Spinal
sympathetic gray ramus
Nerve ganglion communicans 15
TOPICS
1. Introduction
2. Spinal Cord/ Medulla Spinalis
3. Truncus Cerebri /Brain Stem
4. Diencephalon
5. Cerebellum
6. Cerebrum
7. Nn. Craniales
8. Meninges
9. Ventricle System
10. Liquor Cerebrospinal (LCS)/CSF
11. Blood Supply
12. Stimulus

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REFERENCE
1. Anatomi Susunan Saraf Manusia by Sidharta &
Dewanto
2. Topical Diagnosis by Peter Duus
3. Clinical Neuroanatomy by Richard S.Snell
4. Grant’s Atlas of Anatomy
5. Gray’s Anatomy

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B. Medulla Spinalis
Position
 Lies in vertebral canal

 Continuous above with medulla

oblongata at level of foramen
magnum
 Ends below at lower border of
L1 in adult; at birth at level of
L3

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External Structure
 A long cylindrical structure and
slightly flattened anteroposteriorly,
 Conus medullaris
 Filum terminale
 Cauda equina
 Two enlargements
Cervical enlargement
(intumescentia): corresponds to
the C4 to the T1 segments
Lumbosacral enlargement
(intumescentia): corresponds to
the L2 to the S3 segments

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Fissure and sulci
 Anterior median fissure
 Posterior median sulcus
 Anterolateral sulcus －anterior (motor) roots emerge serially
 Posterolateral sulcus －posterior (sensory) roots enter spinal cord,
each bear a spinal ganglion which constitutes the first cell-station of
the sensory nerves

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Relationship of segments
of spinal cord to vertebrae
 A portion of the cord that gives
rise to a pair of spinal nerve
constitutes a segment.
 There are 31 segments
8 cervical
12 thoracic
5 lumbar
5 sacral
1 coccygeal

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 Internal structures
 Central canal
 Gray matter
 Anterior horn (column)
 Posterior horn (column)
 Intermediate zone
 Lateral horn (column)
 Anterior gray commissures
 Posterior gray commissures
 White matter
 Anterior funiculus
 lateral funiculus
 Posterior funiculus
 Anterior white commisure

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Posterior horn (column):
 Marginal layer
 Substantia gelatinosa Rolandi
 Nucleus proprius
 Nucleus thoracicus
in segments C8~L3

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Intermediate zone
 Intermediaolateral nucleus
(lateral horn or column): lies in
segments T1~L3, containing
sympathetic preganglionic
neurons
 Sacral parasympathetic nucleus:
lies in segments S2~S4,
containing parasympathetic
preganglionic neurons
 Intermediomedial nucleus : for
sensation of viscera

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 Rexed’s lamina

 posterior horn is formed

by lamina Ⅰ to Ⅵ；
 Intermediate zone
corresponding to
lamina Ⅶ；
 Anterior horn is
composed laminae Ⅷ
and Ⅸ；
 lamina Ⅹ is the gray
matter surrounding the
central canal.

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Substantia Alba
White matter contains three kinds of fibers:
ascending, descending, and fasciculus proprius

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 Ascending tracts

Fasciculus cuneatus
Fasciculus gracilis
Posterior spinocerebellar tract

Anterior spinocerebellar tract

Spinothalamic tract

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Ascending tracts
Tract Site of origin Funiculus Termination Function
Fasciculus Spinal ganglia Posterior Gracile Convey
gracilis below segment nucleus proprioceptive
T5 and fine touch
Fasciculus Spinal ganglia Cuneate sensation of
cuneatus above segment nucleus trunk and limbs
T4
Posterior Homolateral Lateral Cerebellum Unconscious
spinocerebellar nucleus proprioception
thoracicus from lower limb
Anterior Contralateral and lower
spinocerebellar Laminae portion of trunk
Ⅴ~Ⅶ
Spinothalamic Laminae Ⅰ, Lateral Dorsal Pain,
Ⅳ~Ⅶ and thalamus temperature and
anterior simple touch
sensation of
trunk and limbs
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Descending tracts

Fasciculus proprius

Lateral corticospinal tract

Rubrospinal tract

Reticulospinal tract

Vestibulospinal tract

Tectospinal tract Medial longitudinal fasciculus

Anterior corticospinal tract

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 Descending tracts
Tract Site of origin Funiculus Termination Function
Lateral Cerebral cortex Lateral Laminae Voluntary movement
corticospinal Ⅳ~Ⅸ
Anterior Cerebral cortex Anterior anterior
corticospinal horn

Rubrospinal Red nucleus Lateral Laminae Excitatory of flexors

Ⅶ~Ⅶ
Vestibulospinal Homolateral Anterior Laminae Excitatory of extensors
vestibular Ⅶ~Ⅷ
nuclei
Reticulospinal Reticular Anterior Laminae Voluntary movement
formation and lateral Ⅶ~Ⅷ

Medial Vestibular Anterior Laminae Coordinate neck with eye

longitudinal nuclei Ⅶ~Ⅷ movement
fasciculus
Tectospinal Superior Anterior Laminae
colliculus Ⅵ~Ⅷ
Fasciculus Spinal cord Anterior, Spinal cord Intrinsic reflex
proprius lateral and mechanism of spinal cord
posterior
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Main functions of spinal cord
 Conduction of excitations
 Reflex activity

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 TRACTUS/FASCICULUS
1. Tractus Spinothalamicus Anterior (touch + press)
2. Tractus Spinothalamicus Lateralis (pain + thermal)
3. Tractus Spinocerebellaris Ant/Ventral (muscle
tones+ tendo)
4. Tractus Spinocerebellaris Post/Dorsal (muscle
tones+ tendo)
5. Tractus Corticospinalis Ant/Lat (motoric)
6. Fasciculus Cuneatus
(position, movement,
7. Fasciculus Gracilis discrimination,vibration)

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C. Truncus Cerebri

Consists of
 Mesencephalon

 Pons

 Medulla oblongata

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 Medulla oblongata
Ventral surface
 Pyramis: contain pyramidal
tract (corticospinal tract)
 Decussatio pyramidalis :
formed by crossing fibers of
corticospinal tract
 Oliva : produced by underlying
nucleus olivarius inferior
 Sulcus anterolateral: rootlets of
hypoglossal nerve emerge from it
 Sulcus retroolivarius: rootlets
of glossopharyngeal, vagus and
accessory nerves emerge from it

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 Medulla oblongata
Dorsal surface
 Lower portion
 Tuberculum gracilis: produced
by underlying gracile nucleus
 Tuberculum cuneatum: marks
the site of cuneate nucleus
 Pedunculus cerebellaris
inferior
 Obex
 Upper portion: forms the lower
half of rhomboid fossa

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 Pons
Ventral surface
 Pars basilaris
 Sulcus basilaris
 Bulbopontine sulcus: from
medial to lateral, the abducent,
facial and vestibulocochlear
nerves appear
 Pedunculus cerebellaris
medius
 Nervus trigeminal
 Trigonum pontocerebellaris :
the junction of medulla, pons and
cerebellum

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 Pons

Dorsal surface
 Pedunculus cerebellaris
superior
 Velum medullaris
superior
 Nervus trochlearis

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 Mesencephalon
Ventral surface
 Crus cerebri
 Fossa interpeduncular
oculomotor nerves emerge
from medial of crus cerebri
 Substantia perforata
posterior

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 Mesencephalon
Dorsal surface
 Colliculus superior
constitute centers for
visual reflexes
 Colliculus inferior
associated with auditory
pathway
 Brachium colliculus
superior
 Brachium colliculus
inferior

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Features
 Sulcus medianus
 Sulcus limitans
 Area vestibularis overlies
vestibular nuclei
 Acoustic tubercle overlying
dorsal cochlear nucleus
 Eminentia medialis
 Striae medullaris

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 Colliculus facialis: overlies
nucleus of abducent n. and genu
of facial nerve
 Trigonum hypoglossum :
overlying hypoglossal nucleus
 Trigonum vagi : overlies
dorsal nucleus of vagus nerve
 Funiculus separans
 Area postrema
 Locus coeroleus

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Roof
 Anterior part: formed by
superior cerebellar peduncle
and superior medullary
velum
 Posterior part: formed by
inferior medullary velum and
choroid plexus of fourth
ventricle
 Three apertures
 Median aperture of fourth
ventricle
 Two lateral apertures of
fourth ventricle

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General somatic motor nuclei

 Nucleus of oculomotor n.
 Nucleus of trochlear n.
 Nucleus of abducent n.
 Nucleus of hypoglossal n.

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 General somatic motor nuclei

Nucleus Site Cranial n. Function

Nucleus of Midbrain Ⅲ Supreior, inferior,and

medial recti, inf. obliquus,
Oculomotor n. levator palpebrae superioris

Nucleus of Midbrain Ⅳ Superior obliquus

trochlear n.
Nucleus of Pons Ⅵ Lateral rectus
abducent n.
Nucleus of Medulla Ⅻ Muscles of tongue
hypoglossal n.

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Special visceral motor nuclei

 Motor nucleus of trigeminal n.

 Nucleus of facial n.
 Nucleus ambiguus
 Accessory nucleus

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 Special visceral motor nuclei
Nucleus Site Cranial n. Function

Motor nucleus of Pons Ⅴ Masticatory muscles

trigeminal n.
Nucleus of facial n. Pons Ⅶ Facial m., platysma,
posterior belly of digastric,
stylohyoid, stapedius

Nucleus ambiguus Medulla Ⅸ,Ⅹ.Ⅺ Skeletal m. of pharynx,

larynx and upper part of
esophagus
Accessory nucleus Medulla- Ⅺ Sternocleidomastoid,
cervical cord trapezius
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General visceral motor nuclei

 Accessory
oculomotor nucleus
 Superior salivatory
nucleus
 Inferior salivertory
nucleus
 Dorsal nucleus of
vagus n.

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 General visceral motor nuclei
Nucleus Site Cranial n. Function

Accessory Midbrain Ⅲ Sphincter pupillae and

oculomotor nucleus ciliary m.

Superior salivatory Pons Ⅶ Submandibular,

nucleus sublingual and lacrimal
glands
Inferior salivertory Medulla Ⅸ Parotid gland
nucleus

Dorsal nucleus of medulla Ⅹ Many cervical,

vagus n. thoracic and abdominal
viscera
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Visceral sensory nuclei ( general and special )

 Nucleus of solitary tract

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Visceral sensory nuclei ( general and special )

Nucleus Site Cranial n. Function

Nucleus of Medulla Ⅶ,Ⅸ,Ⅹ Taste and visceral

solitary tract sensation

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 General somatic sensory nuclei

 Mesencephalic
nucleus of trigeminal
n.
 Pontine nucleus of
trigeminal n.
 Spinal nucleus of
trigeminal n.

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 General somatic sensory nuclei
Nucleus Site Cranial n. Function
Mesencephalic Midbrain Ⅴ Proprioception
nucleus of of head
trigeminal n.
Pontine nucleus Pons Ⅴ Tactile sensation
of trigeminal n. of head

Spinal nucleus of Medulla Ⅴ Pain and

trigeminal n. temperature
sense of head

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 Special somatic sensory nuclei

 Cochlear nuclei

 Vestibular nuclei

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 Special somatic sensory nuclei

Nucleus Site Cranial n. Function

Cochlear Pons and Ⅷ Sense of hearing

nuclei medulla

Vestibular Pons and Ⅷ Sense of

nuclei medulla equilibrium

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 Relay nuclei
 Gracile nucleus
 Cuneate nucleus
 Inferior olivary nucleus
 Superior olivery nucleus
 Pontine nucleus
 Nucleus of inferior colliculus
 Gray matter layers of
superior colliculus
 Nucleus rubra
 Substantia nigra
 Pretectal area

60
 Non-cranial nerve nuclei
Nucleus Site

Gracile nucleus Medulla (underneath gracile tubercle)

Cuneate nucleus Medulla (underneath cuneate tubercle)

Superior olivery nucleus Pons

Pontine nucleus pons
Nucleus of inferior colliculus Midbrain
Gray matter layers of superior Midbrain
colliculus
Red nucleus Midbrain

Substantia nigra Midbrain

Pretectal area Midbrain
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 Substantia Alba
Ascending tracts
 Lemniscus medialis – proprioceptif pathway
 Lemniscus spinalis – sensorik
 Lemniscus trigeminalis – sensorik wajah
 Lemniscus lateralis – auditoric pathway

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Descending tracts

 Corticospinal tract
 Rubrospinal tract
 Tectospinal tract
 Vestibulospinal tract
 Reticulospinal tract

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Reticular formation of brain stem

 Ascending reticular
activating system
(ARAS)
 Motor central and
vital centres
 Reticulospinal tract
 Cardiovascular center
and respiratory center
 Serotonergic rapheal
nuclei

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The characters of internal
structure of brain stem

65
 Pons
 Pars tegmentum
directed upward continuation of
medulla oblongata
 Pars basilaris
contain both longitudinal and
transverse fibers intermixed with
pontine nuclei

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 Mesencephalon
 Tectum of midbrain:
includes superior and inferior
colliculi
 Pedunculus cerebri
 Tegmentum :
contain ascending tracts, central gray
matter, recticular formation and so on
 Substansia nigra
 Crus cerebri :
 Tractus pyramidal－ middle three-
fifths of the crus:
 Tractus frontopontine medial one-
fifth:
 Tractus pariatotempopontine
lateral one-fifth

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D. Diencephalon
 Position: Lies between mesencephalon and cerebrum,
almost entirely surrounded by cerebral hemisphere

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 Subdivision
1. (Dorsal) thalamus
2. Metathalamus
3. Epithalamus
4. Subthalamus
(=thalamus
ventralis)
5. Hypothalamus

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 Thalamus (dorsalis)
External features
 A large egg-shaped
nucleus mass,
 Anterior end called
anterior thalamic tubercle,
 Posterior end called
pulvinar thalami
 Right and left portion of
thalamus are joined by
adhesio interthalamic
 Floor－sulcus
hypothalamic

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72
 Classification of nuclei of dorsal thalamus
Three nuclear group－divided by
internal medullary lamina
 Anterior nuclear group
 Medial nuclear group
 Lateral nuclear group

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 internal medullary lamina
Med. nuclear group
Dorsal tier Ant. nuclear group

Pulvinar

Medial geniculate Ventral anterior

body (MGN)
Ventral intermediate

Ventral posterior nucleus (VP)

Lateral geniculate body (LGN)
Ventral posterolateral (VPL)

Ventral posteromedial (VPM )

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 Subdivision Principal Nuclei Common
abbreviation
Ant. nuclear group
Med. nuclear group
Lat. nuclear group
Dorsal tier Lateral dorsal LD
Lateral posterior LP
Pulvinar
Ventral tier Ventral anterior VA
Ventral intermediate VI
Ventral posterior VP
Ventral posterolateral VPL
Ventral posteromedial VPM

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Special relay nuclei
 Vent. anterior nucleus (VA)
 Vent. intermediate nucleus (VI)
Receiving dentate nucleus, globus pallidus and substantia nigra to
motor cortex
 Vent. posteromedial nucleus (VPM)
－receives lemniscus trigeminus and taste fibers

 Vent. posterolateral nucleus (VPL)

－receives lemniscus medialis and lemniscus spinalis
Projects to first somatic sensory area via central thalamic radiation

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 Hypothalamus
Position－lies ventral to thalamus
Boundaries
 Superiorly: sulcus hypothalamus
 Inferiorly:
 chiasma opticum
 tuber cinereum
 Infundibulum
 corpus mamillaris
 Anterior: lamina terminalis
 Posterior: continues with
mesencephalon tegmentum

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 Subthalamus

 Transition zone
between diencephalons
and tegmentum of
mesencephalon
 Contain subthalamic
nucleus, parts of
nucleus ruber and
substantia nigra

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Subdivisions
 Preoptic region
 Supraoptic region
 Tuberal region
 Mamillary region

79
 Paraventricular nucleus

Paraventriculohypophyeal
tract

Supraoptic nucleus

Supraopticohypophyseal Mamillary nucleus

tract
arcuate nucleus
tuberoinfundibular tract
infundibulum

anterior lobe of hypophsis

posterior lobe of hypophysis

80
 Hypothalamus --connection

 Connects with limbic system

 Connects with brainstem and spinal cord
 Connects with dorsal thalamus
 Connects with hypophysis

81
 Hypothalamus --connection
 Supraoptic nucleus →supraoptic nucleus
(ADH) →supraopticohypophyseal tract
→posterior lobe of hypophysis
 Paraventricular nucleus → paraventicular
nucleus (oxytocin) →paraventriculohypophyseal
tract→posterior lobe of hypophysis

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Metathalamus

Lateral geniculate body (LGN)

Medial geniculate body (MGN)

Metathalamus

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 Metathalamus
 Corpus geniculatum
medialis (MGN)
 Relay station of audition
 Receive fibers from
colliculus inferior
 Projects to auditory area
via radiatio acustica
 Corpus geniculatum
lateral (LGN)
 Relay station of vision
 Receive fibers from
tractus opticus
 Projects to visual area via
radiatio optica

84
E. Cerebrum
 The telencephalon consists of
right and left hemispherium cerebri,
partially separated by fissura
longitudinalis cerebri.
 The fissura transversus cerebri
intervenes between the
hemispheres and the cerebellum
 Each hemisphere has three
surfaces: superolateral, medial
and inferior

85
 Three principal sulci
 Sulcus centralis (Rolandi)
 Fissura cerebri lateralis (Sylvii)
 Sulcus parietooccipitalis

Sulcus centralis
Sulcus parietooccipitalis

Fissura cerebri
lateralis

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Five lobes
 Lobus frontalis
 Lobus parietalis
 Lobus temporalis
 Lobus occipitalis
 Lobus centralis (Insulae)

Parietal lobe
Insular lobe

87
 Sulci and gyri of Superolateral surface
Precentral gyrus
Precentral sulcus Postcentral gyrus
Superior frontal sulcus Postcentral sulcus
Superior parietal lobule
Inferior frontal sulcus

Superior, Supramarginal
middle gyrus
and inferioe Angular gyrus
frontal
gyri

Superior temporal sulcus

Superior temporal gyrus
Inferior temporal sulcus
Middle temporal gyrus
Inferior temporal gyrus

88
 Sulci and gyri of medial surface

Corpus callosum Paracentral lobule

Callosal sulcus Marginal ramus

cingulate gyrus
Parietooccipital sulcus
Cingulate sulcus
Cuneus

Calcarine sulcus

Lingual gyrus

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 Inferior surface
Olfactory bulb

Olfactory tract
Uncus
Olfactory trigone

Occipitotemporal sulcus Anterior perforated

substance
Parahippocampal
gyrus

Medial and lateral

occipitotemporal
gyri

Collateral sulcus

90
Hippocampus
Hippocampal
formation
Dentate gyrus

91
Broadmann’s Area
 The entire surface of cortex cerebri is numbered from 1 to
47 (BROADMANN)
 A few of Area Receptif Primer
1. Area Sensoris Primer (Area 3, 1 & 2)
2. Area Visualis (Area 17)
3. Area Auditoria (Area 41 – 42)
4. Area Gustatoria (Area 43)
5. Area Wernicke (22)
 Some of Area Motoris
1. Area Motoris (Area 4)
2. Area Premotorik (Area 6)
3. Area Supressor (Area 6, 18, 12, 19, 24)
4. Area Broca (Area 44)

92
 First somatic motor area
Position: located in precentral gyrus and anterior
portion of paracentral lobule

93
 First somatic motor area
Characters
 Representation is inverted,
but head and face are upright
 A body part is represented by
a cortical area proportional to
its use rather than its size
 Receiving fibers from
precentral gyrus, VA, VL and
VPL, sending out fibers to
form pyramidal tract,
controlling voluntary
movements
 Homunculus motoris

94
First somatic sensory area

Position－lies in
postcentral gyrus and
posterior portion of
paracentral lobule

95
 First somatic sensory area

Characters
 Sensory representation,
like motor area, is
crossed and inverted
 Receiving and interpret
sensation from opposite
side of body
 Homunculus sensoris

96
 Auditory area

 Located in gyrus
temporalis
tranversalis
 Receive auditory
information from both
ears

97
 Visual area
 Lie on either side of
calcarine sulcus in medial
surface of occipital lobe
 Visual cortex of one
hemisphere receives
impression from temporal
part of retina of same side
and nasal part of opposite
side
 Lesions of visual cortex
produce contralateral
homonymous visual field
defections

98
 Vestibular area: located in front of superior temporal
gyrus
 Olfactory area : located near the uncus
 Taste area : located at frontal operculum

99
 Language area
It is dominant in left hemisphere in
right-handed person
 Motor speech area
 Located in posterior portion of
inferior frontal gyrus
 Damage: motor aphasia
 Auditory speech area
 Located in posterior portion of
superior temporal gyrus
 Lesion: sensory aphasia
 Visual speech area
 Located in angular gyrus
 Lesion: alexia

100
 Substantia Alba
Association fibers
Run between gyri within the
same hemisphere
 Cerebral arcuate fibers

 Superior
longitudinal fasciculi
 Inferior
longitudinal fasciculi
 Uncinate fasciculus

 Cingulum

101
Commissural fibers
－ run between left and
right hemisphere
 Corpus callosum :
rostrum, genu, trunk,
splenium
 Anterior commissure
 Fornix and commissure of
fornix

102
Projection fibers:
connect cortex with lower part of
brain and spinal cord and they
include both ascending and
descending fibers
Capsula interna
 Position: a thick lamina of
white matter lying between
caudate nucleus, thalamus
and lentiform nucleus

103
Ganglia Basalis

 A substantia grisea mass located between

centrum semiovale and Thalamus
 Consist of :
1. NUCLEUS CAUDATUS
2. NUCLEUS LENTIFORMIS
3. CLAUSTRUM
4. CORPUS AMYGDALAE
 Nucleus Caudatus + Nucleus Lentiformis
= CORPUS STRIATUM
 Substantia grisea centralis = GANGLIA
BASALIS

104
 GANGLIA BASALIS

CORPUS CORPUS
CLAUSTRUM
STRIATUM AMYGDALAE

NUCLEUS NUCLEUS
CAUDATUS LENTIFORMIS

GLOBUS
PUTAMEN
PALLIDUS

105
106
HIPPOCAMPUS

 A substantia grisea within lobus temporalis

o From Uncus → Splenium Corporis Callosi
o On basis of Cornu Inf. Of Ventr. Lat
 From Hippocampus
through ALVEUS → Fimbria Hippocampi → Crus
Fornicis
 Hippocampus + Gyrus Dentatus + Gyrus
Parahippocampi → FORMATIO HIPPOCAMPI

107
108
Three parts
 Anterior limb of internal capsule
 Lies between caudate nucleus and
lentiform nucleus
 Containing frontopontine tract and
anterior thalamic radiation
 Genu of internal capsule
 Is angle at which anterior and
posterior limbs meet
 Containing corticonuclear tract
 Posterior limb of internal capsule
 Lies between thalamus and lentiform
nucleus
 Contain corticospinal tract,
corticorubral tract, central
thalamic radiation, parieto-
occipito-temporo-pontine tract,
acoustic radiation and optic
radiation

109
 Limbic system
 Composition
 Limbic lobe: includes septal area, cingulated gyrus, parahippocampal
gyrus, hippocampus, dentate gyrus, temporal pole, anterior part of
insular lobe and so on
 Associated subcortical nuclei: amygdaloid body, septal nuclei,
hypothalamus, epithalamus, anterior nucleus group of thalamus,
tegmentum of midbrain
 Function: concerned with visceral activities, olfaction, emotion
and memory, so this system is called ‘visceral brain’

110
RHINENCEPHALON

 A part of Cerebrum → Olfaction system

 A part of Cerebrum → functionally (NOT have
a separate lobus)
 No developed well in humans
 Consist of:
1. Bulbus + Tractus + Stria Olfactorius
2. Substantia Perforata Anterior
3. Area Paraolfactoria (Gyrus subcallosus)
4. Area prepyriformis
5. Amygdalae

111
112
F. Cerebellum

 Lies above and behind the

medullar and pons and
occupies posterior cranial
fossa

Cerebellum

113
 External features
Consists of two hemispherium cerebelli united in the
midline by the vermis cerebelli

114
 External features
Three peduncles
 Pedunculus cerebellaris
inferior －connect with medulla
and with spinal cord, contain both
afferent and efferent fibers
 Pedunculus cerebellaris
medius －connect with pons,
contain afferent fibers
 Pedunculus cerebellaris
superior －connect with
midbrain, contain mostly efferent
fibers

115
 External features

 Tonsilla cerebelli
two elevated masses
on inferior surface of
hemispheral portion just
nearby foramen
magnum

116
 Lobes
 Two deep fissures
 Fissura prima
 Fissura posterolateral
 Three lobs
 Lobus flocculonodular
flocculus and nodule
 Lobus anterior Corpus
 Lobus posterior cerebellaris

117
 Lobes
Lobus
anterior
Fissura prima corpus
cerebellaris
Lobus
posterior

Lobus flocculonodular
Fissura posterolateral

118
119
120
 Three functional divisions
 Vestibulocerebellum
 Archicerebellum

 Flocculonodular lobe

 Accept vestibular impulse

 Spinocerebellum

Intermediate zone
Vermis
 Paleocerebellum

Lateral zone
 Vermis and intermediate
zone
 Proprioceptif from spinal
cord
 Cerebrocerebellum
 Neocerebellum
Flocculonodular lobe
 Lateral zone

 Lobus posterior (except

pyramis and uvula)
121
 Internal structures
Gray matter
 Cortex cerebelli
 Nuclei cerebelli
 Nucleus dentatus
 Nucleus fastigium
 Nucleus interpositus
 Nucleus emboliformis
 Nucleus globosus

White matter－
Corpus medullaris

122
 Internal structures

Cortex cerebelli Fastigial nucleus

Globose nucleus
Dentate nucleus Emboliform nucleus

Corpus medullaris

123
TABLE OF AFFERENT + EFFERENT FIBRES

PEDUNCULUS AFFERENT EFFERENT

CEREBELLI
1. Tractus Tectocerebellaris 1. Tractus Fastigiobulbaris
SUPERIOR 2. Tractus Spinocerebellaris 2. Tractus Cerebellorubralis
Brachium conjunctivum Anterior 3. Tractus Dentatothalamicus

Tractus Pontocerebellaris --------

MEDIUS
Brachium pontis
1. Trac. Spinocerebellaris post 1. Trac. Cerebellovestibularis
2. Trac. Vestibulocerebellaris 2. Trac. Cerebelloreticularis
INFERIOR 3. Tractus Olivocerebellaris
4. Trac. Arcuatocerebellaris
Corpus restiforme 5. Fibra Trigeminocerebellaris
6. Trac. Reticulocerebellaris
7. Trac. Cuneocerebellaris

=3 = 10 =5
124
G. The Meninges of Brain

 Duramater cerebri
 Arachnoidmater cerebri
 Piamater cerebri

125
 Duramater cerebri
Characters
 A thick and dense
inelastic membrane that
composed of two layers,
an inner or lamina
meningealis and outer
or lamina endostealis
 It is in loose contact with
calvaria, and most
strongly adherent to
base of skull

126
Four septa- Lamina meningealis
 Falx cerebri
 Tentorium cerebelli－in front there is a gap, the incisura
tentorial , for passage of midbrain
 Falx cerebelli
 Diaphragma sellae

127
Sistem sinus venosus
 Sinus sagittalis superior
 Sinus sagittalis inferior
 Sinus rectus
 Confluens sinuum

128
 Sinus transversus
 Sinus sigmoideus
 Sinus petrosus
superior
 Sinus petrosus
inferior

129
Sinus cavernosus
 Position: lies on each side of sella turcica

 Relations of cavernous sinus:

 Arteri carotis interna and abducent nerve run through the sinus
 Oculomotor and trochlear nerves and ophthalmic and maxillary
divisions of trigeminal nerve lie in the lateral wall of the sinus

130
 The flowing of the blood in dural sinus

Sup. sagittal sinus

Inf. sagittal sinus Straight sinus Confluence of sinus Transverse sinus

Sup. petrosal sinus

Sigmoid sinus
Cavernous sinus

Inf. petrosal sinus Internal jugular vein

131
Arachnoidmater cerebri

 Characters: a delicate
membrane covering
brain loosely, passing
over sulci and entering
only cerebral
longitudinal and
transverse fissures
 Consist of : membrana
arachnoidea and
trabecula arachnoidea

132
 Granulatio arachnoidea－ project into sinuses of dura mater,
serve as sites where cerebrospinal fluid diffuses into bloodstream

133
Spatium
subarachnoideum
Position: lies between pia and
arachnoid maters containing
cerebrospinal fluid
Terminal cistern : the largest
part of subarachnoid space
extending from termination of
spinal cord to level of S2, where
it is occupied by nerves of
cauda equina, so it is the best
site for a lumbar puncture

134
 Cisterna subarachnoid c
 Cisterna
cerebellomedullaris
(magna)
 Cisterna
interpeduncularis
(basalis)
 Cisterna pontis
 Cisterna superior
(ambiens)
 Cisterna chiasmatis
 Cisterna lumbalis

135
Cerebellomedullary cistern

136
Lumbar spinal puncture (spinal tap)

137
 Piamater cerebri

 Closely invests brain

surface, in some areas the
pia invaginates into
ventricles to take part in
the formation of choroids
plexus

138
Circulation of cerebrospinal fluid (CSF)
 Cerebrospinal fluid is a
clear colorless fluid, which
acts as a transport medium
for nutrients and vaster
products and provides a
protective fluid cushion for
the central nervous system.
 Production: produced by the
choroids plexuses within the
lateral, third and fourth
ventricles

139
 Circulation of cerebrospinal fluid
CSF drains from lateral ventricle interventricular foramina third ventricle

mesencephalic aqueduct median and two lateral apertures

fourth ventricle

subarachnoid space arachnoid granulations superior sagittal sinus vein

140
H. Arteries of brain
Two sources
 Arteri carotis interna:
supplies anterior 2/3 of
cerebral hemisphere
and parts of
diencephalon
 Arteri vertebralis:
supplies postterior 1/3
of cerebral
hemisphere and parts
of diencephalon, brain
stem and cerebellum

141
 Arteri carotis interna

 Arteri cerebri anterior

 Arteri cerebri media
 Arteri choroidea anterior
 Arteri communicans
posterior

142
Arteri cerebri anterior
 Joined the fellow of the
opposite side by the arteri
communicans anterior
 Cortical branches: supply
all medial surface of the
cerebral cortex as far back
as the parietooccipital sulcus
and superior border of the
suprolateral surface of the
cerebral hemisphere
 Central branches: supply
caudate nucleus, anterior
part of lentiform nucleus and
anterior limb of internal
capsule

143
Arteri cerebri media
 Cortical branches:
supply most of
superolateral surface of
cerebral hemisphere and
insular lobe
 Central branches:
supply lentiform and
caudate nuclei, genu and
posterior limb of internal
capsule (arteri
lenticulostriata )

144
 Arteri choroidea anterior:
passes backward, enters
inferior horn of lateral ventricle,
and ends in choroid plexus. It
supplies lateral geniculate
body, posterior limb of internal
capsule, middle 3/5 of crus
cerebri,and globus pallidus
 Arteri communicans posterior:
runs backward to join posterior
cerebral artery

145
Arteri vertebralis
Cranial branches
 Anterior and posterior spinal
arteries
 Posterior inferior cerebellar
artery
Arteri basilaris
 Anterior inferior cerebellar
artery
 Labyrinthine artery
 Pontine arteries
 Superior cerebellar artery
 Arteri cerebri posterior

146
Arteri cerebri posterior
 Cortical branches:
supply medial and
inferior surfaces of
temporal lobe and
occipital lobe
 Central branches:
supply dorsal thalamus,
medial and lateral
geniculate bodies,
hypothalamus and
subthalamus

147
Cerebral arterial circle ( arteriosus
circulus Willisi)
 Formation: formed by
anterior communicating
artery, both anterior
cerebral arteries, internal
carotid arteries, posterior
communicating arteries,
and posterior cerebral
arteries
 Position: lies on sella
turcica around optic
chiasma, tuber cinereum
and mamillary bodies

148
 Area of oxygendeprives brain

Blockage

Thrombus

Plaque

149
 Microaneurysm

Lenticulostriate arteries

Subarachnoid hemorrhage

150
Intracerebral
hemorhage

Arteriovenous
malformation

151
Blood vessels of spinal cord
Arteries of spinal cord
 Two sources
 Arteri spinalis anterior (1)
and arteri spinalis posterior
(2)
 Branches of segmental
arteries: radicular arteries
of posterior intercostals
arteries, lumbar arteries,
and lateral sacral arteries
 Damage area:
T1~T4,ventral part of L1
 vascular ring
( vasocorona )

152
I. Ventricle system

153
VENTRICULUS ENCEPHALI

 Ada 4 ventriculus Encephali, terdiri dari :

 2 ventriculus lateralis
 1 ventriculus tertius
 1 ventriculus quartus
 Merupakan ruang → berisi LIQUOR
CEREBROSPINALIS (LCS)
 Seluruh permukaan dalamnya → dilapisi
selapis sel EPENDYMA.

154
155
156
DANKE !

157