Major divisions of the nervous system Central nervous system (CNS) Peripheral nervous system (PNS)

Somatic (cerebrospinal) nervous system

Visceral (autonomic) nervous system (ANS)

- sympathetic division - parasympathetic division
Satisfactory criterion for this is found only in the PNS. In the CNS we cannot easily make difference between the somatic and autonomic nervous systems.

Cranial cavity

Vertebral canal external layer of dura mater

No free epidural space!

dura mater

epidural space
internal layer of dura mater

subdural space
arachnoid mater

subdural space
arachnoid mater

subarachnoid space
pia mater

subarachnoid space
pia mater

The meninges
Three membranes called meninges envelop the nervous system. At the CNS level they are easily recognized as dura mater (pachymeninx), arachnoid mater and pia mater (the last two forming together so-called leptomeninges). At the level of the PNS these membranes continue as the sheaths of peripheral nerves and ganglions. The dura mater is the outermost and thickest of all meninges. It lines the cranial cavity and the vertebral canal and provides support and protection for the nervous system within. It is made of two layers. The external layer serves as the internal periosteum for bones that built the walls of the cranial cavity and vertebral canal. The internal layer may be a separate structure (as it is in the vertebral canal) or may fuse with external layer (as in the cranial cavity). The real space existing in the vertebral canal between the two layers of the spinal dura mater is called epidural (extradural) space and it contains blood vessels and roots of spinal nerves bathed in fatty tissue. The remnants of epidural space in the cranial cavity are only seen as dural sinuses, trigeminal cavity and pituitary cavity. There is no free epidural space in the cranial cavity in a healthy individual. In pathologic condition however, this space may form again when some contents, especially blood flowing out of torn meningeal arteries, will set the two dural layers apart. The internal layer of cranial dura mater in some places makes infoldings that protrude into the cranial cavity and divide it into smaller compartments. These infoldings include the cerebral falx, the tentorium cerebelli and the cerebellar falx. The two falxes are oriented sagittally and they intervene between the hemispheres (cerebral or cerebellar, respectively). The tentorium cerebelli separates the cerebral hemispheres (occipital lobes) from the cerebellum. The tentorium is attached to the grooves of the transverse and superior petrosal venous sinuses and to the posterior and anterior clinoid processes. It divides the cranial cavity into supratentorial and infratentorial compartments. Anteriorly the tentorium is notched to allow the brainstem to pass between the supratentorial and infratentorial compartments. The supratentorial compartment is further partially divided into two halves by the falx cerebri. Each half houses one cerebral hemisphere. Below the cerebral falx the telencephalon impar passes to connect the two hemispheres. The falx cerebelli is not so prominent and it only marginally separates the cerebellar hemispheres. In addition the internal layer of cranial dura roofs the trigeminal cavity and it also passes above the pituitary gland as the so-called sellar diaphragm (diaphragma sellae). The pituitary stalk pierces sellar diaphragm centrally.

The meninges - continued

The arachnoid mater is a delicate membrane, which lines internal surface of the dura mater. It is pressed to the dura but does not fuse with it. Between the two membranes there is a capillary (hair-like) space moistened with the tissue fluid. This space is called the subdural space or cavity. It can become the true space if something (e.g. blood) will accumulate within. Near the dural sinuses and some veins the arachnoid forms many specialized organs, which serve as the sites of evacuation of the cerebrospinal fluid into the venous blood. These are called arachnoid granulations (granulations of Pacchioni). The pia mater grows together with the tissue of the nervous system. It is very thin but functionally important envelope. It surrounds the vessels, which penetrate the nervous tissue giving them a bit of support. At some places it invaginates deeply in the internal spaces (ventricles) of the brain and takes part in forming the choroid plexuses (the organs which produce the majority of the cerebrospinal fluid). The capacity of the dural envelope is greater than the volume of the nervous system. As pia mater shapes on the nervous system and arachnoid mater shapes on the dura mater, there is quite a distance between them. This space is filled with the cerebrospinal fluid and forms the subarachnoid space or cavity. At some places this space is especially broad and constitutes the subarachnoid cisterns. Through the subarachnoid space tiny fibers of arachnoid mater run, connecting it with pia mater. There are cerebral vessels and roots of cranial nerves suspended in the cerebrospinal fluid in the subarachnoid space.

Major divisions of the brain

ontogenetic point of view clinical point of view

Encephalon - Brain
(prosencephalon - forebrain)
telencephalon
cerebral hemispheres telencephalon impar

Encephalon - Brain
cerebrum
cerebral hemispheres telencephalon impar diencephalon (not included by some authors)

diencephalon
thalamencephalon hypothalamus

mesencephalon - midbrain
tectum of midbrain cerebral peduncles

cerebellum

(rhombencephalon - hindbrain)
metencephalon
pons cerebellum

brainstem
midbrain pons medulla oblongata

myelencephalon
medulla oblongata

Major divisions of the brain - continued Diencephalon

thalamus
thalamencephalon epithalamus hypothalamus - includes subthalamus

Mesencephalon
tectum of midbrain tegmentum cerebral peduncles cerebral crura

Specific sensory pathway:

1) - runs from receptors to cerebral cortex,

2) - conveys only one kind of sensation,

3) - uses as few neurons as possible.

Specific sensory pathways

Somatosensory pathways
Somatosensory pathway of spinothalamic (anterolateral) system Somatosensory pathway of posterior funiculus/medial lemniscus system Somatosensory pathways of trigeminal system
convey information about somatic sensation conveys pain, temperature and imprecise touch information from trunk and limbs conveys body movements and position, pressure, vibration and precise touch information from trunk and limbs

convey all somatic information from head

Olfactory pathway Visual pathway Auditory pathway Gustatory pathway Vestibular pathway

conveys olfactory information conveys visual infomation conveys auditory information conveys gustatory information conveys head movements and position information

Lateral spinothalamic tract Sensory ganglionic cells are the primary neurons. Their dendrites innervate pain and temperature receptors and convey impulses running in spinal nerve towards the spinal ganglion. In spinal ganglion the somata of these cells are found. Then the impulses are conveyed by axons of sensory ganglionic cells. These small-diameter fibers enter the spinal cord in posterior root and end synapsing with the cells of posterior horn. Posterior horn cells are the secondary neurons. Their axons leave the posterior horn and run through the white commissure toward the contralateral lateral funiculus. Then they bend up and ascend through the whole length of spinal cord and brainstem to reach the thalamus. In the spinal cord they run in anterior part of lateral funiculus. In the brainstem they run through tegmentum (forming the so-called spinal lemniscus). After arriving at thalamic level they end synapsing with the cells in ventral posterior lateral nucleus (VPL). Cells of VPL nucleus of thalamus are the tertiary neurons. Their axons ascend in the posterior limb of internal capsule to get to the cortex. The bundle of these axons forms the sensory radiation. The tertiary neurons end synapsing in the somatosensory cortex. For the trunk and limb regions the cortex is in the posterior part of paracentral lobule (lower limb) and superior (trunk) and middle (upper limb) parts of postcentral gyrus. Lateral spinothalamic tract conveys pain and temperature sensations. It comprises three neurons. Secondary neurons decussate in white commissure of spinal cord. Decussation is called low, for the tract reaches the other side of the nervous system almost at the level at which the primary neurons enter the spinal cord.

Lateral spinothalamic tract

somatosensory cortex

III neuron

sensory radiation of posterior limb of internal capsule

cells of ventral posterolateral (VPL) nucleus of thalamus on the other side

tegmentum of brainstem
II neuron cells of posterior horn of spinal cord small-diameter fibers of posterior root of spinal nerve cells of spinal ganglion branches of spinal nerve lateral funiculus of spinal cord white commissure of spinal cord to decussation!

I neuron

on the same side

carries pain and temperature information from

receptors

Anterior spinothalamic tract Sensory ganglionic cells are the primary neurons. Their dendrites innervate imprecise touch receptors and convey impulses running in spinal nerve towards the spinal ganglion. In spinal ganglion the somata of these cells are found. Then the impulses are conveyed by axons of sensory ganglionic cells. These small-diameter fibers enter the spinal cord in posterior root and end synapsing with the cells of posterior horn. Posterior horn cells are the secondary neurons. Their axons leave the posterior horn and run through the white commissure toward the contralateral anterior funiculus. Then they bend up and ascend through the whole length of spinal cord and brainstem to reach the thalamus. In the spinal cord they run in lateral part of anterior funiculus. In the brainstem they run through tegmentum (adding to the spinal lemniscus). After arriving at thalamic level they end synapsing with the cells in ventral posterior lateral nucleus (VPL). Cells of VPL nucleus of thalamus are the tertiary neurons. Their axons ascend in the posterior limb of internal capsule to get to the cortex. The bundle of these axons forms the sensory radiation. The tertiary neurons end synapsing in the somatosensory cortex. For the trunk and limb regions the cortex is in posterior part of the paracentral lobule (lower limb) and superior (trunk) and middle (upper limb) part of postcentral gyrus. Anterior spinothalamic tract conveys imprecise touch sensations. It comprises three neurons. Secondary neurons decussate in white commissure of spinal cord. Decussation is called low, for the tract reaches the other side of the nervous system almost on the level on which the primary neurons enter the spinal cord.

Anterior spinothalamic tract

somatosensory cortex sensory radiation of posterior limb of internal capsule

III neuron

cells of ventral posterolateral (VPL) nucleus of thalamus tegmentum of brainstem

on the other side

II neuron cells of posterior horn of spinal cord

anterior funiculus of spinal cord white commissure of spinal cord to decussation!

I neuron

small-diameter fibers of posterior root of spinal nerve

cells of spinal ganglion branches of spinal nerve

on the same side

carries imprecise touch information from

receptors

Ascending tracts of posterior funiculus Sensory ganglionic cells are the primary neurons. Their dendrites innervate receptors of many kinds of discriminative sensations (limb position and movement, pressure, vibration, precise touch) and convey impulses running in spinal nerve towards the spinal ganglion. In spinal ganglion the somata of these cells are found. Then the impulses are conveyed by axons of sensory ganglionic cells. These large-diameter fibers enter the spinal cord in posterior root and reach posterior funiculus. In posterior funiculus they bend up and ascend through the spinal cord to reach the medulla. Fibers from lower part of the body form gracile fasciculus, fibers from upper part - cuneate fasciculus. In medulla the fibers end synapsing with cells of gracile or cuneate nucleus, respectively. Cells of gracile and cuneate nuclei are the secondary neurons. Their axons cross the midline in lemniscal decussation and then ascend in the brainstem tegmentum, forming the medial lemniscus. They run through the whole length of brainstem to reach the thalamus. After arriving at thalamic level they end synapsing with the cells in ventral posterior lateral nucleus (VPL). Cells of VPL nucleus of thalamus are the tertiary neurons. Their axons ascend in the posterior limb of internal capsule (adding to the sensory radiation) to get to the cortex. The tertiary neurons end synapsing in the somatosensory cortex. For the trunk and limb regions the cortex is in posterior part of the paracentral lobule (lower limb) and superior (trunk) and middle (upper limb) part of postcentral gyrus. Ascending tracts of posterior funiculus convey discriminative kinds of sensations. They comprise three neurons. Secondary neurons decussate in lemniscal decussation. Decussation is called high, for the tracts reach the other side of the nervous system on the level of medulla, which is high above the level of primary neurons entrance.

Ascending tracts of posterior funiculus

somatosensory cortex

III neuron

sensory radiation of posterior limb of internal capsule cells of ventral posterolateral (VPL) nucleus of thalamus
medial lemniscus in tegmentum of brainstem lemniscal decussation to

on the other side

II neuron

decussation!

cells of gracile and cuneate nuclei fascicles of posterior funiculus of spinal cord I neuron cells of spinal ganglion branches of spinal nerve large-diameter fibers of posterior root of spinal nerve

on the same side

carry discriminative information from

receptors

Trigeminothalamic tracts

somatosensory cortex sensory radiation of posterior limb of internal capsule

III neuron

on the other side

cells of ventral posteromedial (VPM) nucleus of thalamus

cells of sensory nuclei of trigeminal nerve roots of cranial nerves

to

II neuron

tegmentum of brainstem

decussation!

I neuron

cells of sensory ganglions of cranial nerves branches of cranial nerves

on the same side

carry somatosensory information from

receptors

Gustatory pathway

gustatory cortex along with sensory radiation of posterior limb of internal capsule

III neuron

on the other side

cells of ventral posteromedial (VPM) nucleus of thalamus

II neuron

tegmentum of brainstem
cells of upper part of solitary nucleus roots of cranial nerves to

decussation!

I neuron

cells of sensory ganglions of cranial nerves branches of cranial nerves

on the same side

carries taste information from

receptors

Visual pathway

visual cortex optic radiation of posterior limb of internal capsule

IV neuron cells of lateral geniculate nucleus (LGN) of thalamus

to

optic tract III neuron ganglion cells of retina II neuron bipolar cells of retina optic chiasma

partial decussation!

optic nerve

intraretinal pathway rods and cones

I carries visual information from neuron

Partial decussation of visual pathway

visual field defects visual field site of lession optical apparatus of the eye retina optic nerve

1 2 3
1 - blindness of left eye

optic chiasma
optic tract lateral geniculate body

optic radiation 2 - hemianopia heteronyma (bitemporalis)

3 - hemianopia homonyma (right)

visual cortex

Auditory pathway

auditory cortex acoustic radiation of sublentiform part of internal capsule

IV neuron

on both sides

cells of medial geniculate nucleus (MGN) of thalamus

brachium of inferior colliculus lateral lemniscus cells of different nuclei of brainstem to on both sides partial decussation! partial decussation!

III neuron

II neuron

lateral lemniscus trapezoid body

cells of cochlear nuclei root of vestibulocochlear nerve

I neuron

bipolar cells of spiral ganglion branches of cochlear part of vestibulocochlear nerve

on the same side

carries auditory information from

receptors

Olfactory pathway
lateral olfactory stria

olfactory cortex

II neuron

olfactory tract
mitral cells of olfactory bulb olfactory nerve olfactory receptor cells in mucous membrane of nasal cavity olfactory cilia to

on the same side

I neuron

carries smell information from

receptors

! Olfactory pathway

has two neurons only does not pass through thalamus does not cross the midline

Cortical areas
Projection areas - get information mainly from one lower center or send information mainly to one lower center, are interconnected with projection thalamic nuclei
Somatosensory (somaesthetic) area Visual area Auditory area Gustatory area Olfactory area Vestibular area

Sensory areas

Motor area

Association cortical areas - exchange information mainly with other cortical areas and also with many lower centers
Unimodal association areas - deal with one functional modality only Multimodal association areas - deal with many functional modalities

Complexes of areas dealing with one functional modality = projection area + unimodal association area

Sensory areas
Somatosensory complex
Projection somatosensory area - postcentral gyrus and posterior part of paracentral lobule Association somatosensory area - superior parietal lobule

Visual complex
Projection visual area - calcarine sulcus and adjacent parts of cuneus and lingual gyrus Association visual area - around (except anteriorly) the projection visual area extending into the temporal and parietal lobes

Auditory complex
Projection auditory area - transverse temporal gyri and middle part of superior temporal gyrus Association auditory area - superior temporal gyrus around the projection auditory area

Olfactory complex
Projection olfactory area - uncus Association olfactory area - enthorhinal area Projection gustatory area - opercular part of postcentral gyrus Projection vestibular area - probably lower part of postcentral gyrus

Association unimodal areas - probably in superior parietal lobule

Motor areas
Motor complex
Primary projection motor area - precentral gyrus and anterior part of paracentral lobule Supplementary projection motor area - posterior part of medial frontal gyrus Association motor area - middle and posterior parts of frontal gyri on the superolateral surface Frontal eye field - middle part of middle frontal gyrus

Motor (anterior) speech area (Brocas area) - unpaired, only in dominant hemispheretriangular and opercular parts of inferior frontal gyrus

Multimodal association areas

Posterior association area - opercular part of the postcentral gyrus, inferior parietal lobule, posterior parts of superior and middle temporal gyri Sensory (posterior) speech area (Wernickes area) - unpaired, only in dominant hemisphere supramarginal and angular gyri and posterior parts of superior and middle temporal gyri Anterior association area - anterior parts of frontal gyri and inferior surface of frontal lobe

Medial association area - cingulate and parahippocampal gyri

Pyramidal motor system

comprises two neurons
Upper motor neuron - cells of primary motor cortex

Lower motor neuron - motor cells of anterior horn of spinal cord or cells of motor nuclei of cranial nerves

is functionaly connected with voluntary movements

Pyramidal motor tracts

Corticospinal tracts - related to the striated muscles innervated by spinal nerves
Lateral corticospinal tract Anterior corticospinal tract

Corticonuclear tracts - related to the striated muscles innervated by cranial nerves

carries motor information from

motor cortex

cells of paracentral lobule and superior and middle parts of precentral gyrus corona radiata of internal capsule anterior part of posterior limb of internal capsule I neuron cerebral crus longitudinal fascicles of pons to pyramid pyramidal decussation lateral funiculus of spinal cord motor cells of anterior horn of spinal cord

decussation!

II neuron

anterior root of spinal nerve branches of spinal nerves

Lateral corticospinal tract

muscles

carries motor information from

motor cortex

cells of paracentral lobule and superior and middle parts of precentral gyrus corona radiata of internal capsule anterior part of posterior limb of internal capsule I neuron cerebral crus longitudinal fascicles of pons to pyramid anterior funiculus of spinal cord white commissure motor cells of anterior horn of spinal cord

decussation!

II neuron

anterior root of spinal nerve branches of spinal nerves

Anterior corticospinal tract

muscles

carry motor information from

motor cortex

cells of lower part of precentral gyrus

corona radiata of internal capsule I neuron genu of internal capsule cerebral crus to (longitudinal fascicles of pons)

tegmentum of brainstem
cells of motor nuclei of cranial nerves roots and branches of cranial nerves muscles

partial decussation!

II neuron

Corticonuclear tracts

Corticonuclear tract
is duplicated for most motor nuclei of cranial nerves, with the exception of the lower part of motor facial nucleus and hypoglossal nucleus.

Motor nuclei of cranial nerves except the two mentioned above

receive crossed and uncrossed cortical fibers.

Lower part of facial motor nucleus and hypoglossal nucleus

receive only crossed cortical fibers.

Thalamic nuclei - anatomical classification

Median nuclei Medial nucleus (medialis dorsalis nucleus) Intralaminary nuclei Anterior nucleus Lateral nucleus
lateral dorsal nucleus Dorsal nucleus

lateral posterior nucleus

pulvinar lateral geniculate body medial geniculate body ventral anterior nucleus ventral lateral nucleus ventral posterior nucleus posterior nuclei

Metathalamus

Ventral nucleus

ventral posterior medial nucleus ventral posterior lateral nucleus ventral posterior inferior nucleus

Reticular nucleus

Thalamic nuclei - functional classification

Specific nuclei - nucleus has precise topographical projection to a limited region of the ipsilateral cortex and this cortical region projects back topographically upon the nucleus
Relay nuclei - nucleus receives a major non-thalamic subcortical input
Sensory nuclei - nucleus is involved in sensory function Motor nuclei - nucleus is involved in motor function Limbic nuclei - nucleus is involved in limbic function

Association nuclei - nucleus receives their main subcortical input from other thalamic nuclei

Nonspecific nuclei - nuclear connections with the cerebral cortex are not of topographically reciprocal type

Sensory thalamic nuclei

spinothalamic tracts, medial lemniscus trigeminothalamic tracts, gustatory pathway optic tract brachium of inferior colliculus ventral posterior lateral (VPL) nucleus ventral posterior medial (VPM) nucleus lateral geniculate nucleus (LGN) medial geniculate nucleus (MGN) somatosensory cortex (trunk and limbs areas) somatosensory cortex (head area) visual cortex auditory cortex

Motor thalamic nuclei

globus pallidus, substantia nigra (cerebellum) cerebellum (globus pallidus, substantia nigra) ventral anterior (VA) nucleus ventral lateral (VL) nucleus premotor cortex motor cortex

Limbic thalamic nuclei

amygdaloid body mamillary body

part of medialis dorsalis (MD) nucleus

anterior nucleus (Ant)

orbitofrontal cortex cingulate cortex

Association thalamic nuclei

other thalamic nuclei, visual pathway collaterals other thalamic nuclei other thalamic nuclei, hypothalamus pulvinar (Pul) lateral posterior (LP) nucleus parietal, occipital and temporal association cortex parietal association cortex

part of medialis dorsalis medial temporal and (MD) nucleus prefrontal association cortices

Hypothalamic nuclei

pre-optic area optic region supra-optic nucleus paraventricular nucleus tuberal region infundibular nucleus mamillary region mamillary nuclei

subthalamus

subthalamus

Function of better known hypothalamic nuclei

pre-optic region belongs to the telencephalon on embryological grounds, secretes factors controling pituitary production of gonadotropins, demonstrates sexual dimorphism optic region supra-optic nucleus - secretes vasopressin (antidiuretic hormone, ADH) paraventricular nucleus - secretes oxytocine tuberal region infundibular nucleus - secretes hormones which control the function of anterior lobe of pituitary gland mamillary region mamillary nuclei - take their part in Papezs circuit, which is related to memory functions subthalamus subthalamic nucleus - belongs to the motor extrapyramidal system

Nuclei of cranial nerves

I, olfactory nerve II, optic nerve True cranial nerves M - motor nucleus projection of telencephalon, no nuclei projection of diencephalon, no nuclei S - sensory nucleus P - parasympathetic nucleus

M - oculomotor nucleus III, oculomotor nerve P - accessory oculomotor nucleus (Westphal-Edinger nucleus)

mesencephalic tegmentum at the level of superior colliculus

IV, trochlear nerve

M - trochlear nucleus

mesencephalic tegmentum at the level of inferior colliculus

M - trigeminal motor nucleus S - mesencephalic nucleus V, trigeminal nerve S - pontine nucleus S - spinal nucleus

midlevel of pontine tegmentum tegmentum in upper pons and mesencephalon midlevel of pontine tegmentum tegmentum in lower pons, medulla and cervical spinal cord tegmentum of lower pons

VI, abducent nerve

M - abducent nucleus

M - facial motor nucleus VII, facial nerve

tegmentum of lower pons

S - sensory nuclei of trigeminal nerve

S - upper (gustatory) part of solitary nucleus P - superior salivatory nucleus

as described above
tegmentum of lower pons tegmentum of lower pons

VIII, vestibular part of vestibulocochlear nerve VIII, cochlear part of vestibulocochlear nerve

S - vestibular nuclei 4 nuclei: superior, inferior, lateral and medial S - cochlear nuclei tegmentum of lower pons and medulla

2 nuclei: dorsal and ventral

M - ambiguus nucleus S - sensory nuclei of trigeminal nerve
(conscious somatic sensation)

tegmentum of pontomedullary junction

tegmentum of medulla as described above tegmentum of lower pons tegmentum of medulla tegmentum of upper medulla

IX, glossopharyngeal nerve

S - upper (gustatory) part of solitary nucleus S - lower part of solitary nucleus

(nonconscious somatic sensation)

P - inferior salivatory nucleus

M - ambiguus nucleus

tegmentum of medulla as described above tegmentum of lower pons tegmentum of medulla tegmentum of medulla

S - sensory nuclei of trigeminal nerve

(conscious somatic sensation)

X, vagus nerve

S - upper (gustatory) part of solitary nucleus

S - lower part of solitary nucleus

(nonconscious somatic sensation)

P - dorsal nucleus of vagus XI, accessory nerve, cranial part XI, accessory nerve, spinal part XII, hypoglossal nerve

M - nucleus ambiguus

tegmentum of medulla

M - spinal accessory nucleus M - hypoglossal nucleus

upper cervical spinal cord tegmentum of medulla