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Neuroanatomy Notes PDF
Neuroanatomy Notes PDF
Haytham Bayadsi
2011/2012
A. Telencephalon:
Consists of the cerebral hemispheres & the basal ganglia and contains the lateral ventricles.
1. Cerebral hemispheres: separated by the longitudinal cerebral fissure & falx cerebri, interconnected by
the corpus callosum & consist of 6 lobes and the olfactory structures.
For orientation, the best starting point is the central sulcus of Rolando:
A transverse sulcus on the outer surface of the hemispheres, separating the frontal lobe from the
parietal lobe
Bordered by anteriorly by the precentral gyrus (main primary motor cortex, belongs to the
frontal lobe, giving rise to the fibers of the pyramidal tract)
Bordered posteriorly by the postcentral gyrus (main primary sensory cortex, belongs to the
parietal lobe)
Another important sulcus to be located is the lateral sulcus of Sylvius:
o Divides the frontal lobe & parietal lobe above from the temporal lobe below
o Has a number of side branches, but 2 of the most prominent are:
o The ascending (vertical) ramus
o The horizontal ramus, which further subdivide the inferior frontal gyrus into 3 parts
a. Frontal lobe:
i. Extends from the frontal pole to the central sulcus of Rolando, laying above the lateral
surface
paracentral sulcus: forming the anterior border of the paracentral lobule
9. Medial frontal gyrus (the continuation of the superior frontal gyrus on the medial
surface of brain)
10. Parolfactory area (Subcallosal area)
11. Paraterminal gyrus (subcallosal gyrus, peduncle of the corpus callosum)
The subcallosal area and the paraterminal gyrus belong to the frontal lobe
medial surface
Marginal sulcus: separates the posterior paracentral lobule from the
precuneus
2. Precuneus
c. Temporal lobe:
i. Extends from the temporal pole to a line connecting the parieto-occipital sulcus & the
preoccipital notch, lying below the lateral suclus, from which it extends up to the
collateral sulcus
ii. The convex (outer) surface contains:
1. Transverse temporal gyri of Heschl: lie buried within the lateral suclus, extending
from the superior temporal gyrus toward the MGB (Brodmanns area 41,42)
2. Superior temporal gyrus: contains the Wernicke speech are in the dominant
hemisphere
Superior temporal sulcus
3. Middle temporal gyrus
Middle temporal sulcus
4. Inferior temporal gyrus
Inferior temporal sulcus
projects into the medial wall of the occipital horn of the lateral ventricle as
the Calcar avis. (contains the Bordmanns areas 16,17,18 for visual field)
Hippocampal sulcus
3. Hippocampal formation:
Between the choroidal & hippocampal fissures, rolled into the
paraterminal gyri converge anteriorly and continue into the induseum griseum
which is a grey sheet covering the corpus callosum. At the splenium, the
induseum griseum continues as the gyrus fasciolaris, proceeds into the dentate
gyrus and terminates in the limbus Giacomini
i. The fornix: a C-shaped bundle of fibers that carries signals from the hippocampus to the
4. Columns (Anterior Pillars): left & right, ends at the mamillary bodies, has 2 parts,
a. Visibile part (Pars libera): around the interventricular foramen of Monro
b. Hidden part (Pars tecta): between the interventricular formaen and the
mamillary bodies
ii. Putamen
iii. Globus pallidus (Paleostriatum, Pallidum), divided by the medial medullary lamina
into:
1. Internal (Medial) segment (GPi): adjacent to the internal capsule
2. External (Lateral) segment (GPe): adjacent to the putamen
iv. Amygdaloid nuclear complex (Amygdala)
v. Claustrum: located between the putamen & the insular cortex and between the
3. White matter:
a. Cerebral commissures: white matter fibers that inter-connect the cerebral hemispheres,
i. Corpus callosum: the largest commissure of the brain, has four parts:
1. Rostrum
2. Genu
3. Body
4. Splenium
The corpus callosum consists of a mass of transversely travelling commissural fibers that
the superficial ones appear in the form of the transverse striae
The supracallosal gyrus (induseum griseum; gyrus epicallosus) consists of a thin
layer of grey matter in contact with the dorsal surface of the corpus callosum and
continuous laterally with the grey matter of the cingulate gyrus.
It contains two longitudinally directed strands of fibers termed the medial and lateral
longitudinal striae respectively
The supracallosal gyrus is prolonged around the splenium of the corpus callosum as a
delicate lamina, the fasciolar gyrus which is continuous below with the dentate gyrus,
and anteriorly it terminates after the splenu of corpus callosum in the paraterminal gyrus
(see the description of the paraterminal gyrus in the limbic lobe)
ii. Anterior commissure: located in the mid-sagittal section between the lamina
trigones together
triangular lamina, named the psalterium (Lyra of David), ventral to the splenium of the
corpus callosum, between the crura of the fornices
b. Internal capsule: white matter located between the basal ganglia and the thalamus, has 3 parts:
i. Anterior limb: between the caudate nucleus & the putamen
ii. Genu: between the anterior & posterior limbs
iii. Posterior limb: between the thalamus & the lentiform nucleus
c. External capsule: white matter fibers that run between the most lateral segment of the lentiform
nucleus and the claustrum, eventually joining the internal capsule around the lentiform nucleus
d. Extreme capsule: just lateral to the claustrum, beneath the insular cortex
B. Diencephalon:
Located between the telencephalon & mesencephalon and between the interventricular foramen & the posterior
commissure, consists of:
1. Epithalamus:
a. Pineal body (Epiphysis cerebri)
b. Habenular trigone: a small depressed triangular area bordered by,
i. Medially: tenia thalami + habenular commissure
ii. Laterally: thalamus
iii. Posteriorly: Superior colliculus
c. Medullary stria of the thalamus
d. Tela choroidea and choroid plexus of the 3rd ventricle (+ tenia thalami)
2. Thalamus: separated from the hypothalamus by the hypothalamic sulcus
a. Pulvinar
b. Metathalamus:
i. Medial geniculate body (MGB): belongs to the auditory system, communicates with the
bordered by:
i. Anteriorly: Free part of the columns of the fornix (pars libera)
ii. Posteriorly: Anterior tubercle of the thalamus
d. Lamina rostralis: A whitish line appearing on perfectly median sections of the brain as a thin
bridge connecting the rostrum of the corpus callosum with the lamina terminalis; the rostral
lamina contains no commissural fibres; instead, it corresponds to the line along which the pia
mater reflects from the medial surface of one hemisphere to that of the other
e. Recesses of the 3rd ventricle:
i. Optic recess: At the junction of the floor and anterior wall of the third ventricle,
C. Mesencephalon (Midbrain):
Located between the diencephalon & the pons and extending from the posterior commissure to the frenulum of
the superior medullary velum
1. Contains: the cerebral aquaduct of Sylivus (mesencephalic duct) that connects the 3rd ventricle with
peduncle
c. Interpeduncular fossa
i. Oculomotor nerve (CN-III) (see the cranial nerves table for exact location)
ii. Oculomotor sulcus (medial sulcus of the mesencephalon)
iii. Posterior perforated substance: created by the penetrating branches of the posterior cerebral
and posterior communicating arteries
3. Dorsal surface:
a. Quadrigeminal plate (Tectal plate):
i. Superior colliculus
ii. Inferior colliculus
b. Brachium of the superior colliculus (superior brachium)
c. Brachium of the inferior colliculus (inferior brachium)
d. Trochlear nerve (CN-IV): the only cranial nerve that exists the brainstem from the dorsal aspect
e. Lemniscal trigone: a small grayish area bordered by:
i. Anteriorly: inferior brachium (brachium of the inferior colliculus)
ii. Posteriorly + inferiorly: superior cerebellar peduncle
iii. Laterally: the lateral sulcus of the mesencephalon + cerebral peduncle
D. Pons:
Located between the midbrain & the medulla and extends from the superior pontine sulcus (at the pontomesencepahlic junction) up to the inferior pontine sulcus (at the ponto-medullary junction)
1. Ventral surface:
a. Base of the pons (Basis pontis): the anterior part of the pons
b. Basilar sulcus: for the lodgement of the basilar artery; this sulcus is bounded on either side by an
eminence caused by the descent of the cerebrospinal fibers through the substance of the pons
c. Cranial nerves: (see the cranial nerves table for exact location)
i. Trigemnial nerve (CN-V)
ii. Abducent nerve (CN-VI)
iii. Facial nerve (CN-VII)
iv. Vestibulocochlear nerve (CN-VIII)
2. Dorsal surface: is the upper part (or superior pontine portion) of the Rhomboid fossa (above the
medullary striae)
a. Locus ceruleus: a bluish-gray area which owes its color to an underlying patch of deeply
pigmented nerve cells, termed the substantia ferruginea. contains the highest density of norepinephrine secreting neurons in the CNS
b. Facial colliculus: contains the abducent nerve nucleus and the internal genu of the facial nerve
c. Sulcus limitans: separates the alar plate from the basal plate
d. Dorsal median sulcus
e. Medial eminence
f. Superior fovea
g. Vestibular (Acoustic) area: the area lateral to the limiting sulcus & medial to the restiform
body (ICP) on the floor of the rhomboid fossa overlying mainly the vestibular nuclei
h. Acoustic tubercle (Trigone of the acoustic nerve): a small eminence in the lateral recess of the
4th ventricle corresponding to the underlying nuclei of the acoustic & vestibular nerves
i. Striae medullares
most inferior):
1. Glosspharyngeal nerve (CN-IX)
2. Vagus nerve (CN-X)
3. Accessory nerve (CN-XI)
ii. Medial paraolivary suclus (anterior), 1 cranial nerve exits here:
1. Hypoglossal nerve (CN-XII)
2. Dorsal surface:
a. Inferior medullary portion of the Rhomboid fossa:
i. Striae medullares
ii. Sulcus limitans
iii. Vagal trigone (Ala cinerea)
iv. Hypoglossal trigone
v. Area postrema (Vomiting center)
vi. Funiculus Separans: An oblique ridge separating the area postrema from the vagal trigone
vii. Inferior fovea: a small depression in the limiting sulcus below the medullary striae of
angle of the rhomboid fossa and the beginning of the central canal of spinal cord
ix. Taenia of the 4th ventricle
b. Gracile tubercle (Calva): contains the gracile nucleus, continues in the spinal cord as the
F. Cerebellum:
Located in the posterior cranial fossa attaching to the brainstem by three cerebellar peduncles. it forms the roof
of the fourth ventricle and separated from the occipital & temporal lobes by the tentorium cerebelli. The
surface of the cerebellum consists of numerous parallel narrow convolutions, the Folia, on its outer surface and
contain the following structures:
1. Hemispheres: made up of 2 lateral lobes
** Arbor Vita (Tree of life): the appearance of the cerebellar white matter on the mid-sagittal section
(branched, tree-like)
2. Vermis: a mid-line unpaired structure
** Vallecula of the cerebellum: a fossa created between the hemispheres, with the Vermis being its
floor
Morphological Anatomy of the cerebellum:
Superior Vermis
Superior Hemisphere
Lingula
Central lobule
Moticle:
Culmen
Declive
Folium
Inferior Hemisphere
Tuber
Pyramid
Uvula
Tonsil
Nodulus
Flocculus
The cerebellum is sub-divided into 2 main parts separated by the posterolateral fissure:
1. Flocculonodular lobe
2. Cerebellar body, further subdivided by the primary fissure (deepest fissure on the mid-saggital
section) into:
a. Anterior lobe (Rostral to the primary fissure)
b. Posterior lobe (Caudal to the primary fissure)
5. Inferior cerebellar peduncle (ICP, Restiform body): connects the cerebellum to the medulla
6. Inferior medullary velum
Inferolateral trunk: It provides blood supply to the 3rd, 4th, and 6th cranial nerves, as well as to
the Gasserian ganglion. It anastomosis with branches of the internal maxillary artery, providing a
collateral circulation between the ECA and the ICA systems.
body, globus pallidus, tail of caudate nucleus, hippocampus, amygdaloid body, tuber cinereum,
hypothalamic nuclei, thalamic nuclei, substantia nigra, red nucleus, and crus cerebri
Anterior cerebral artery (ACA), a terminal branch: it passes anteriorly, loops around the genu of
the corpus callosum, then posteriorly in the interhemispheric fissure along with its fellow of the
opposite side, and the two being joined by the Anterior Communicating artery. It is divided into 2
segments:
o Precommunicating segment (A1) (before the anterior communicating artery), which gives
the Anteromedial group of central arteries, which enters the most medial part of the
anterior perforated substance, consisting of:
Supraoptic artery
Anterior perforating arteries
Preoptic arteries
o Postcommunicationg segment (A2) (after the anterior communicating artery until the
bifurcation forming the pericallosal and callosomarginal arteries):
Medial striate artery (Recurrent artery of Heubner): runs backward and laterally to
enter the anterior perforated substance supplying the anterior caudate and putamen
and anterior limb of internal capsule
Medial frontobasal (Orbitofrontal) artery: basal part of frontal lobe
Polar frontal (Frontopolar) artery
o Pericallosal artery (A3 segment): forms t he internal parietal arteries (superior, inferior)
and the precuneal artery, gives also:
Callosomarginal artery: gives the paracentral artery for the paracentral lobule
supplying the leg/foot area of the motor and sensory cortices
Middle cerebral artery (MCA), a terminal branch: it passes laterally around the pole of the
temporal lobe, then posteriorly in the depth of the lateral cerebral fissure; has 4 segments:
o Sphenoidal segment (M1): supplying perforating branches to the Internal capsule,
Thalamus (Thalamostriatal branches), and Striate body (Corpus Striatum)
(Lenticulostriatal branches) via:
Anterolateral group of central arteries (Lateral Striate arteries 8-10 branches):
enter the anterior perforated substance, ascend lateral to the lower part of the
Lentiform nucleus, then they turn medially and pass trough the reach the internal
capsule and caudate nucleus. On of these arteries is usually large and called
Charcot's artery or Artery of cerebral haemorrhage
o Insular segment (M2): supplying branches to the insula. In this segment the MCA might
bifurcate or trifurcate into superior, inferior & middle divisions terminating into the
adjacent cortical areas
o Opercular segment (M3): extends laterally from the insula towards the cortex. Sometimes
its grouped with M2 segment (then its called Sylvian segment)
o Terminal or cortical segment (M4): supplying a large part of the central cortical
convexity, lateral frontobasal branches and speech areas of Boca & Wernicke
Posterior Cerebral Artery (PCA): formed by the bifurcation of the basilar artery; it passes around the
cerebral peduncle to reach the medial aspect of the hemisphere; it is divided into three segments:
o Precommunicating segment (P1), branches:
Posteromedial group central (paramedian) arteries: enter the interpeduncular perforated
region, supplying the posterior medial part of the midbrain
Thalamoperforating artery: supplying midbrain and thalamus
Collicular artery: Supplying the Superior and inferior colliculi (corpora quadrigemina) of
tectum of midbrain
o Postcommunicating segment (P2), branches:
Posterolateral group of central arteries (circumflex mesencephalic branches): Supply the
lateral part of midbrain
Posterior medial choroidal branches: supply the choroid plexus of the third ventricle
Posterior lateral choroidal branches: supply parts of the choroid plexus of the lateral
ventricle
Peduncular branches: for the cerebral peduncles
Thalamogeniculate artery: for the pulvinar and the Later & Medial geniculate bodies
E. Anastomoses between the anterior (internal carotid) & the posterior (vertebrobasilar)
systems:
1. Posterior communicating artery: between the internal carotid artery (ICA) and the posterior cerebral
artery (PCA) as part of the arterial circle of Willis, in the interpeduncular fossa
2. Glomus anastomosis: between the anterior choroid artery (branch of ICA, or sometimes MCA) and the
posterior lateral choroid artery (branch of the PCA) inside the choroid glomus in the central part of the
lateral ventricle
3. Parieto-ccipital anastomosis: between the pericallosal artery (ACA terminal branch) and the dorsal
branch to corpus callosum (PCA terminal branch) at the parietooccipital fissure
Hypothalamus:
Anteromedial group of central arteries (of ACA): anterior part of hypothalamus
Posteromedial group of central arteries (of PCA): posterior party of hypothalamus
2) Globus Pallidus:
Anterior choroidal artery: supplies the central part
Posterior communicating artery: supplies the medial most part
Striate arteries: supplies the lateral part
Brian Stem:
Medulla:
Anterior Spinal artery: supplies a triangular area next to the midline including the pyramids, medial
lemniscus and hypoglossal nucleus
Posterior Spinal artery: supplies a small area including the gracile and cuneate nuclei
Posterior Inferior Cerebellar artery: supplies the retro-olivary region (behind the inferior olive)
containing the rubrospinal tract, nucleus ambiguous, the dorsal vagal nucleus and part of the inferior
cerebellar peduncle
Direct bulbar branches from the vertebral arteries
Pons: by branches of Basilar artery,
Paramedian branches: supplying the medial portion of the ventral part of the pons
Short Circumferential branches: supplying the lateral portion of ventral part
Long Circumferential branches: supplying the dorsal portion of Pons
Midbrain: mainly by branches of Basilar artery,
Posterior Cerebral artery: via posteromedial group central arteries, collicular branches
(Quadrigeminal artery)
Superior Cerebellar artery: via paramedian and circumferenial branches winding around midbrain
Posterior Communicating artery
Veins from the upper surface of the cerebellum drain into the straight, transverse and superior petrosal
sinuses.
Veins from the inferior surface of the cerebellum drain into the right and left sigmoid and inferior
petrosal sinuses and occipital sinus
Veins of the midbrain drain into the great cerebral vein or into the basal vein of Rosenthal
The Pons and medulla drain into the superior & inferior petrosal sinuses, the transverse sinus and the
occipital sinus
Inferiorly the veins of the medulla are continuous with the veins of the spinal cord and Basilar plexus
Cranial meninges:
Mesodermal covering that covers the brain and the interior of the cranial cavity and has several functions:
- Protect the brain
- Form a supporting framework of arteries, veins and sinuses
- Enclose a fluid (CSF = Cerebrospinal fluid) filled cavity, in the sub-arachnoidal cavity
It is made out of 3 membranous connective tissue layers forming the Pachy- and Leptomeninx:
- Pachymeninx:
o Dura mater: tough, thick fibrous
- Leptomeninx:
o Arachnoid mater: thin, intermediate
o Pia mater: delicate, internal, vasculated
1. Dura Mater:
A bilaminar membrane that is composed of 2 layers:
1) External periosteal (Endosteal) layer: adherent to the inner surface of the calvaria and continuous on
the exterior cranium through the foramen magnum (as the periostieum of the skull)
2) Internal meningeal (Fibrous) layer: strong fibrous membrane continuous with the spinal dura mater
at the foramen magnum
The 2 layers are fused together and cannot be separated except where the dural sinuses and the infoldings
are formed, the meningeal arteries can be found running between the 2 layers as well.
The dura mater is strongly adherent and attached to the calvaria and skull especially at the base.
Pathologically, any fluid or blood that accumulates between the dura and the skull forms the pathological
Epi-dural space (usually as a result of trauma skull fracture injury to the meningeal arteries)
(Note: in the vertebral canal, the spinal Epi-dural space is a physiological space found there and not
pathological)
A. The dural infoldings (folds) or plates:
Divides the cranial cavity into compartments and provides mechanical support for the brain:
- Cerebral (Major) falx: lies in the longitudinal cerebral fissure separating the 2 cerebral hemispheres
Attachments:
o Crista Gali
o Frontal crest of frontal bone
o Internal occipital protuberance
o Tentorium cerebelli (Upper surface, continuation)
It contains:
o Superior Saggital sinus (at the upper border)
o Inferior Saggital sinus (at the lower free border)
Cerebellar (minor) falx: lies in the Infratentorial compartment attached to the internal occipital crest
and partially separates the Cerebellar hemispheres
Sellar Diaphragm: formed between the Clinoid processes forming the roof of the hypophysial fossa,
it covers the pituitary gland and has an aperture called the diaphragmatic hiatus for the passage of
the hypophysial stalk (infundibulum) and hypophysial veins
Trigeminal cave, Meckel cavity: covers the Gasserian (Semilunar) ganglion or the ganglion of
Trigeminal nerve (CN-V) on both sides of the cavernous sinuses
Superior sagittal sinus: extending from the Crista gali to the internal occipital protuberance, lies
inside the superior margin of the Falx cerebri, then it joins the confluence of sinuses. It receives the
superior cerebral veins and communicates on both sides with the lateral venous lacunae
Inferior sagittal sinus: runs in the inferior concave free border of the falx cerebri, ending up in the
straight sinus
Transverse sinus: passes laterally from the confluence of sinuses forming a groove in the occipital
bones and then becomes The sigmoidal sinus. It drains blood from the confluence of sinuses
Sigmoid sinus: S-shaped, continues inferiorly as the internal jugular vein as passing through the
posterior venous part of the jugular foramen
Occipital sinus: lies in the border of the Cerebellar Falx, connects the confluence of sinuses with the
internal vertebral venous plexus
Cavernous sinus: located on both sides of the Sella turcica, on the body of the sphenoid bone, above
the Sphenoidal sinus. It's divided into a venous plexus by incomplete connective tissue septa. The
double layer of the dura divides and surrounds this sinus, forming:
o Medial lamina: attached to the body of the sphenoid bone (a continuation of the posterior
petroclinoidal fold and the tentorial notch)
o Lateral lamina: between the anterior & posterior clinoid processes (a continuation of the
anterior petro-clinoidal fold)
The 2 cavernous sinuses on both sides are communicating with each other by the inter-cavernous
sinuses, going in front and behind the hypophysis. It receives blood from (inflow):
o Superior ophthalmic vein: this connection is very important clinically in the transmission of
upper lip & face infections.
** The anastomosis of the facial vein branches with the ophthalmic ones (via the angular vein
near the medial corner of the eye) will give the chance to infections in the face, nose and
upper lip areas (in the danger triangle of face area) to ascend in a retrograde fashion and reach
the cavernous sinus and thus infecting the meninges (causing lethal meningitis) or damage to
the nerves in the cavernous sinus or thrombosis (leading to ophthalmoplegia)
o Inferior ophthalmic vein: either directly or via the superior ophthalmic vein
o Sphenoparietal sinus: running along the posterior edge of the ala minor of sphenoid bone
o Superficial middle cerebral vein
o Inferior cerebral vein
The outflow sinuses of the cavernous sinus are:
o Superior petrosal sinus: taking the blood to the junction of transverse & sigmoid sinuses
o Inferior petrosal sinus: taking the blood into the sigmoid sinus
o Emissary veins (via foramen ovale or lacerum): to the pterygoid plexus
The cavernous sinus communicates also with:
o Basilar plexus: connecting the cavernous sinus to the internal vertebral venous plexus
Superior petrosal sinuses: from the posterior end of the cavernous sinus to the transverse
sinuses at the part where it becomes sigmoidal
Inferior petrosal sinuses: runs in the groove between the temporal and basilar bones. It drains
blood from the cavernous sinus directly to the beginning of the internal jugular veins
Basilar plexus: connects the Internal vertebral (Epidural) venous network of the spinal cord with
the cavernous sinus and inferior petrosal sinuses
Emissary veins: channels of communication between the venous sinuses of the dura mater and
the external veins of the diploe and the scalp
Translated &
Modified from Dr.
Milan Sibalin original
work
3. Meningeal spaces:
- Cranial epidural space (between skull and dura, or to be more accurate between the 2 layers of
dura matter): a potential space that normally contains the meningeal vessels.
Can be pathological as a result of trauma leading to the rupture of the middle meningeal arteries
and bleeding between the bone and dura mater separating them from each other and forming an
epidural hemorrhage/hematoma
- Spinal epidural space: which is a physiological (natural) space located between the spinal dural
sac and the vertebral periosteum (Endorachis). It contains loose areolar tissue, internal vertebral
venous plexus and lymphatics
- Subdural space (between dura and arachnoid): also a potential space that trasmitts the superior
cerebral veins to the venous lacunae of the superior sagittal sinus via the bridging veins. It can be
pathological due to the bleeding of the bridging veins do to rapid hydration/dehydration of brain
tissue or acceleration/deceleration injury forming a subdural hemorrhage/hematoma
- Subarachnoid space: is a natural physiological occurring space between the arachnoid and pia
mater, surrounding the entire brain and spinal cord.
It contains CSF (Cerebrospinal spinal fluid), trabecular cells, cerebral arteries and
veins
It can be enlarged at some places in the cranial cavity forming the Subarachnoid
cisterns
Extends in adults below the level of conus medullaris up to the 2nd sacral vertebra as
the lumbar cistern
-
Subarachnoid cisterns: dilation of the subarachnoid space containing CSF. They are names
after the structures over which they lie (e.g. chiasmatic, pontine etc.) (see the Dr. Hanicss
handout about the cisterns)
The walls of the cerebral ventricles (taken from Dr. Altdorfers and Dr. Somogyis handout)
Floor - anterior wall - roof are formed by the radiation of corpus callosum (the radiation of rostrum genu - and body).
B/ Central part (Body): found posteriorly from interventricular foramen to the level of the splenium of corpus
callosum. Walls:
Floor is formed by the dorsal aspect of thalamus, covered by the lamina affixa (lamina affixa thalami
extends from stria terminalis to tenia choroidea).
Medial wall: choroid lamina epithelialis of the lateral ventricle, attached to the fornix (tenia fornicis)
and to the thalamus (tenia choroidea). On the outer aspect of choroid lamina epithelialis the pia mater
(together = choroid tela) and the choroid plexus can be found.
In the medial wall two longitudinal elevations are seen: the bulb of the posterior horn, formed by the
radiation of the corpus callosum (forceps major) and the calcar avis, produced by the calcarine fissure.
On the floor the collateral trigone (caused by the collateral sulcus) is found.
D/ Inferior horn curves ventrally and then rostrally into temporal lobe.
The floor is formed by the hippocampus and the collateral eminence (caused by the collateral sulcus).
The roof and lateral wall is formed by the white substance of the hemisphere (radiation of splenium
corporis callosi: tapetum) and along its medial border are the stria terminalis and tail of caudate nucleus.
Anteriorly: the amygdaloid nucleus bulges into the anterior end of the horn.
Medial wall: the choroid lamina epithelialis (with choroid tela and choroid plexus) is attached to the
fimbria of hippocampus (tenia fimbriae) and to the stria terminalis (tenia terminalis).
THIRD VENTRICLE: small, narrow, midline vertical cleft of diencephalon, bridged by interthalamic
adhesion of thalamus.
Roof is formed by choroid lamina epithelialis of the 3rd venticle (+ choroid tela and choroid plexus).
The attachments of choroid lamina epithelialis: tenia thalami (on stria medullaris thalami), habenulae
and habenular commissure.
Floor is formed by the hypothalamus with the optic chiasm, infundibulum, mamillary bodies, and
subthalamus.
Anterior wall contains anterior commissure, columns of fornix and lamina terminalis.
At posterior end of the ventricle the habenular commissure and the posterior commissure are located
(between them the pineal recess, above the habenular comm. the suprapineal recess).
Choroid plexus locations: found in the roof of the 3rd and 4th ventricles and next to the central part and
inferior horns of the lateral ventricles. (The choroid plexus is enlarged at the junction between inferior horn and
central part; here it is called the choroid glomus). None is found in the anterior or posterior horns. The plexus in
the lateral ventricle is the largest and most important and is continuous with that of the 3rd ventricle above the
interventricular foramina. The lateral openings of the 4th ventricle (foramina of Luschka) also contain choroid
plexus which protrude through them and secrete CSF into the subarachnoid space.
tenia choroidea
tenia terminalis
FOURTH VENTRICLE
The fourth ventricle is best studied on a midsagittal section through the brain stem and cerebellum.
The roof is tent-shaped; formed by the superior medu1lary velum, a thin plate, which extends between
the two superior cerebellar peduncles. (Lingula, a midline part of the cerebellar cortex, is fused to the
outer surface of the sup. medullary velum.) The lower part of the roof is formed by the inferior
medullary velum, the nodule of cerebellum and a thin ependymal membrane, the choroid lamina
epithelialis of the fourth ventricle from which the choroid plexus of the fourth ventricle is suspended.
The inferior medullary velum is continuous with the superio medullary velum at the apex of the fourth
ventricle, the fastigium.
The floor of the fourth ventricie is shaped like a rhombus and is accordingly referred to as the rhomboid
fossa. On each side of the median sulcus is a longitudinaily running ridge, the medial eminence. The
medial eminence is bounded laterally by the sulcus limitans. The small medullary fold that overhangs
the opening of the central canal at the inferior end of the rhomboid fossa is called the obex. Identify the
following structures in the rhomboid fossa:
1. Striae medullares: group of medullated fibers.
2. Facial colliculus is the pronounced elevation on the medial eminence rostral to the striae medullares;
overlies the abducens nucleus and the internal genu of the facial nerve.
3. Locus ceruleus, a bluish gray area rostral to the facial colliculus in the area of the sulcus limitans. The
area overlies the nucleus of the locus ceruleus (its pigmented cells give rise to noradrenergic
pathways).
4. Vestibular area overlies the vestibular and cochlear nuclei in the lateral part of the rhomboid fossa.
5. Hypoglossal trigone - caudally from the striae medullares is formed by the underlying nucleus of the
hypoglossal nerve.
6. Vagal trigone, lateral and posterior to the hypoglossal trigone, overlies the ala cinerea (autonomous
nuclei of the vagus and glossopharyngeal nerves).
7. Area postrema is situated more laterally.
The cerebrospinal fluid leaves the fourth ventricle to enter the subarachnoid space through the median
aperture (foramen Magendie), and the two lateral apertures (foramina of Luschka). The relatively wide median
aperture which opens into the cerebellomedullary cistern, can be seen on the dorsal side of the brain stem in the
angle between medulla oblongata and the cerebellum.
The lateral aperture can be identified on one of the half brain stem-cerebellum preparations by gently
probing in the direction of the tubular lateral recess of the fourth ventricle as it curves over the dorsal aspect of
the brain stem. The lateral aperture, which is located in the cerebellopontine angle, is usually easy to identify
from outside because a part of the choroid plexus of the fourth ventricle projects out into the subarachnoid space
through this opening (forming the flower basket of Bochdalek).
3 dimensional view of the borders of the lateral ventricle, viewing it from a posterior aspect,
6. Cicumventricular organs:
Chemosensetive zones that monitor varying concentrations of circulating hormones in blood & CSF located in
the periphery of the 3rd ventricle and floor of the 4th. These are highly vascularized areas with fenestrated
capillaries and no BBB (except for the sub-commissural organ), include:
a. Organum vasculosum of the lamina terminalis
o Considered to be a vascular outlet of LHR hormone and somatostatin
b. Median eminence of the tuber cinereum
o Contains neurons that elaborate releasing and inhibiting hormones into the hypophyseal portal
system
c. Subfornical organ
o Located on the inferior surface of the fornix at the level of the interventricular foramen of Monro
o Central receptor site for angiotensin II
o Porjects to the supraoptic nuclei and the organum vasculosm
d. Subcommissural organ
o Located below the posterior commissure
o Has BBB
e. Pineal body:
o Contains calcareous granules, in brain sand or acervulus
o Has pinealocytes, innervated by the ANS to sythesize serotonin and melatonin
f. Area postrema
o 2 small subependymal oval areas on either side of the 4th ventricle rostral to the obex
o Chemoreceptor zone that triggers vomiting in response to circulating emetic substances
The exits of cranial nerves (from brain, dura and skull) & their subarachnoid pathway
(Taken from Dr. Altdorfer & Dr. Somogyis handout 2007)
Brain exit
I.
Olfactory nerve
II.
Optic nerve
III.
Oculomotor nerve
IV.
Trochlear nerve
Dural exit
Cribriform plate
Cribriform plate
Optic chiasma
Optic canal
Chiasmatic cistern
Interpeduncular cistern
1. Quadrigeminal
cistern (initial part)
2. Ambiens cistern
(encircling the brainstem)
Oculomotor sulcus
(=medial sulcus of crus
cerebri) in the
interpeduncular fossa;
between post. cerebral a.
and sup. cerebellar a.
Below inferior colliculi;
both sides of the
frenulum of sup.
medullary velum
Note: n. IV. is the only
cranial nerve which exits
ont he DORSAL aspect of
the brain!!
V.
Trigeminal nerve
VI.
Abducent nerve
At the ponto-medullary
junction, on both sides of
foramen cecum
VIII.
Vestibulocochlear
nerve
IX.
Glossopharyngeal
nerve
X.
Vagus nerve
XI.
Accessory nerve
XII.
Hypoglossal nerve
Subarachnoid pathway
(Cistern)
Olfactory bulb
Trigeminal (Meckel's)
cave
V/1.: cavernous sinus
(lateral wall)
V/2.: cavernous sinus
(lateral wall)
V/3.: For. ovale
VII.
Facial nerve*
----
Jugular foramen
(anterior part: pars nervosa)
----
Hypoglossal canal
----
* nervus intermedius exits between n. VII. and n. VIII. but belongs to n. VII. (parasympathetic and taste fibres)
The real cranial nerves (CN III-XII.) originate from the brainstem (=midbrain, pons, medulla). Ist and IInd cranial nerves are not real cranial nerves
because they are extensions of the brain (CNS!).
E. internal morphology:
i. Gray matter:
o In the center of the spinal cord, H or butterfly shaped (varies in different levels)
o Has a central canal and subdivided into 10 cytoarchitectural areas called Rexed Laminae
o Divided into:
a. Dorsal horn (column): receives and processes sensory input, found at all levels
b. Lateral horn (column): recieves viscerosensory input, extends from T1(C8)-L3
c. Ventral horn (column): contains predominantly motor nuclei, found at all levels
ii. White matter:
o Consists of bundles of myelinated fibers that surround the central grey matter and consists of
ascending and descending fiber pahtways called tracts
o Divided bilaterally by sulci into 3 major divisions:
a. Dorsal funiculus (Dorsal column): located between the dorsal median sulcus and the
dorsal lateral suclus, subdivided above T6 into:
1. Fasciculus gracilus (of Golls): located between the dorsal median septum and
the dorsal intermediate sulcus & spetum, found at all levels
2. Fasciculus cuneatus (of Burdachs): located between the dorsal intermediate
sulcus & septum and the dorsal lateral sulcus, only found at the upper thoracic &
cervical cord levels (C1-T6)
b. Lateral funiculus: located between the dorsal lateral and ventral lateral sulci
c. Ventral funiculus: contains the anterior white commissure, which is located between the
central canal and the ventral median fissure
F. Spinal nerves:
Consists of 31 pair of nerves that emerge from the spinal cord: 8 cervical, 12 thoracic, 5 lumbar, 5 sacral and 1
coccygeal containing both motor & sensory fibers
o Spinal nerves are numbered after the vertebra they exist above
o The 1st cervical nerve and the coccygeal nerve usually have no dorsal (sensory) roots and no
corrosponding dermatomes
o The 1st cervical spinal nerve passes between the atlas and the skull
o The 2nd cervical spinal nerve passes between the atlas and the axis
o With the exception of C1, all spinal nerves exit the intervertebral canal via intervertebral or sacral
foramina
o Components & branches of the spinal nerves: formed by the union of dorsal and ventral roots within
the intervertebral foramen, resulting in a mixed nerve:
a. Dorsal root: enters the dorsal lateral suclus as dorsal rootlets, conveying sensory input from the
body via the dorsal root ganglion (DRG)
b. Ventral root: emerges as ventral rootlets from the ventral lateral sulcus, conveying motor output
from visceral and somatic motor neurons
c. Cauda equina: consists of lumbosacral (dorsal & ventral) nerve roots (L2-Co) that descend from
the spinal cord through the subarachnoid space (lumbar cistern) to exit through their respective
intervertebral or sacral foramina (because the spinal cord itself is shorter than the spinal canal!)
d. Spinal nerve rami (branches):
i. Dorsal primary ramus: innervates the skin & muscles of the back
ii. Ventral primary ramus: innervates the ventral lateral muscles and skin of the trunk,
extremities and visceral organs
iii. Meningeal ramus: innervates the meninges and vertebral column
iv. Gray communicating rami: contain unmyelinated postganglionic sympathetic fibers,
associated with all spinal nerves
v. White communicating rami: contain myelinated preganglionic sympathetic fibers and
myelinated GVA fibers (splanchnic nerves), found only in T1-L3
G. Spinal nerve innervation:
1 spinal nerve innervates the derivates from 1 somite, which includes:
o Dermatome: a cutaneous area innervated by the fibers of 1 spinal nerve
o Mytome: a group of muscles innervated by fibers of 1 spinal nerve
o Sclerotome: a group of bones & ligaments innervated by fibers of 1 spinal nerve