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NEURO ANATOMY & PHYSIOLOGY 1

Brain and Spinal Cord

BRAIN
 Part of the central nervous system (CNS) that lies within
the cranial vault—the encephalon
 Its surface is convoluted and exhibits gyri and sulci
 Covered by three connective tissue membranes, the
meninges.
 Surrounded by cerebrospinal fluid (CSF)
 One of the largest organs in body
 Weight
 New-born: 350 g
 Men: 1,600 g (3.5 lbs)
 Women: 1,450 g (3.2 lbs)
 One of most metabolically active organs in body
comprises only 2% of total body weight it yet
 Gets 15% of blood
 Consumes 20% of our oxygen need at rest (more
BRAIN: CEREBRUM/CEREBRAL HEMISPHERES
when mentally active)
 Blood flow and O2 increase to active brain areas  Largest portion of brain - Constitutes 60% of brain mass
 1 – 2 mins interruption of blood flow may impair brain  Takes part in: thought, creativity, communication
cells  It is formed of two cerebral hemispheres by a median
 > 4mins without oxygen  permanent brain damage longitudinal fissure, connected to each other by
 Corpus callosum
 Right and left cerebral peduncles: connected to
DIVISIONS OF BRAIN
upper part of the brain stem
ANATOMICAL DIVISIONS
 Anterior, posterior & habenular commissures
I. Cerebrum
 Made up mostly of grey matter
 Right Hemisphere
 Left Hemispheres
FUNCTIONS OF CEREBRAL CORTEX
II. Diencephalon
1. Consciousness: brain stem-reticular formation,
III. Cerebellum
frontal, temporal and deep structures of cerebrum
IV. Brainstem
2. Use of language: speech center present in frontal
 Midbrain
and temporal lobes
 Pons
3. Emotions: frontal and temporal lobes (limbic
 Medulla
system)
4. Memory: frontal and temporal lobes
FUNCTIONAL AREAS
5. Orientation, thinking and intelligence: frontal lobe
I. Motor Areas
II. Sensory Areas
EXTERNAL FEATURES
III. Higher Functions
 Each cerebral hemisphere has
 Three Surfaces
1. Lateral (superolateral) surface
2. Medial surface
3. Inferior surface
 Three Poles
1. Frontal Pole: at the anterior end of the
frontal lobe
2. Temporal Pole: at the anterior end of the
temporal lobe

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Brain and Spinal Cord

3. Occipital Pole: at the posterior end of the Basal Nuclei


occipital lobe  There are several groups of nuclei situated at
 Five Borders various levels within the white mater (Caudate
nucleus, Putamen, Globus pallidus, Subthalamic
nucleus)

Lateral Ventricle
 The cavity of the cerebral hemisphere
 Communicate with the third ventricle via the two
interventricular foramina (of Monro)

INTERNAL CAPSULE
 Thick lamina of white matter made up of projection
fibers which pass to and from the cerebral cortex
 It is continuous superiorly with the corona radiata,
and inferiorly with pedunculi of midbrain
INTERNAL STRUCTURE/COMPONENTS  Parts
Gray Mater (Outer) 1. Anterior limb
 Composed of nerve cells (cerebral cortex). The cells 2. Genu
of each area have specific functions 3. Posterior limb

White Mater (Inner) LOBES OF EACH CEREBRAL HEMISPHERE


 Composed of nerve fibers conducting impulses to  The surface is not smooth, it’s convoluted
and from the cortex  Each bump on the surface of the cerebrum is called
 Three types of nerve fibers a Gyrus, and each shallow groove on the surface of
1. Projection fibers  connect the cerebral cortex the cerebrum is called a Sulcus
with the lower subcortical centres  Sulci and Gyri increase the surface area
2. Association fibers  connect different areas of  Surface of each cerebral hemisphere is divided by
the same cerebral hemisphere three main sulci or fissures into four lobes (which
3. Commissural fibers  connect similar areas of have been given the names of the skull bones under
both hemispheres. They are Corpus callosum, which they lie)
Anterior commissure, Posterior commissure,  These four lobes are
Habenular commissure, Hippocampal 1. Frontal
commissure 2. Parietal
3. Temporal
4. Occipital

MAJOR SULCI OF CEREBRAL HEMISPHERE

Sulcus Separates

Central Sulcus frontal lobe (in front) from parietal


(Roland Sulcus) lobe (behind)
Lateral Sulcus frontal and parietal lobes (above) and
(Sylvian Sulcus) temporal lobe (below)
found mainly on the medial surface
Parieto-Occipital
of the hemisphere between parietal
Sulcus
and occipital lobes

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Conjugate (8) gyrus conjugate


deviation of eyes to
opposite side

Inferior frontal
gyrus in Motor center of
Area (45)
dominant writing.
hemisphere

Inferior frontal
Brocca's Area gyrus in Motor center of
(44) dominant speech
hemisphere

Higher center of
Prefrontal memory,
FRONTAL LOBE Areas (9, 10, Anterior pole orientation,
Sulci 11 & 12) thinking and
Sulci Location intelligence

Precentral Sulcus In front of the central sulcus


PARIETAL LOBE
Superior part of the frontal
Superior Frontal Sulcus Sulci
lobe
Sulci Location
Inferior Frontal Sulcus Inferior part of the frontal lobe
Postcentral sulcus Behind the central sulcus

Gyri Intraparietal sulcus


Gyri Location

Between the central and Gyri


Precentral Gyrus
precentral sulci Gyri Location
Above the superior frontal
Superior Frontal Gyrus Between the central and
sulcus Postcentral gyrus
postcentral sulci
Between the superior and
Middle Frontal Gyrus Superior parietal gyrus Above the intraparietal sulcus
inferior frontal sulci
Below the inferior frontal
Inferior Frontal Gyrus Inferior parietal gyrus Below the intraparietal sulcus.
sulcus
Small gyrus surrounding the
Supra marginal gyrus
upper end of lateral sulcus
Important Functional Areas
Small gyrus surrounding the
Area Site Function
Angular upper end of the superior
Primary Voluntary motor temporal sulcus
Motor Area Precentral gyrus activity of opposite
(4) half of the body Important Functional Areas

Area Site Function


Secondary
Gives
Motor Anterior part of Perception of
extrapyramidal Primary
(Premotor) precentral gyrus cortical sensation
fibers sensory area Post central gyrus
Area (6) from opposite 1/2
(1,2,3)
of the body
Frontal Eye Middle frontal Voluntary

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Brain and Spinal Cord

Knowing the 22)


meaning of the
Uncus and
Superior parietal sensations felt Uncus: sense of
Areas 5 & 7 Hippocampus in
gyrus (steriognosis) in Limbic smell
the medial and
absence of sensory system Hippocampus:
inferior surface of
loss mood & memory
the temporal lobe
Surround the
upper end of Visual psychic area OCCIPITAL LOBE
Angular
superior temporal for speech Sulci
gyrus,
sulcus in (recognition of
area (39) Sulci Location
dominant letters & numbers).
hemisphere Lies on the medial surface of
Calcarine sulcus the occipital lobe and extends
Supra Associative area
Surround the backwards to the occipital pole
marginal and center for
upper end of Short horizontal sulcus
gyrus, area complex
lateral sulcus running on the middle of the
(40) movement Lateral occipital sulcus
superolateral surface of the
occipital lobe
TEMPORAL LOBE
Sulci Gyri
Sulci Location Gyri Location
Superior temporal Above the lateral occipital
Below the lateral sulcus. Superior occipital gyrus
sulcus sulcus
Inferior temporal sulcus Below the lateral occipital
Inferior occipital gyrus
sulcus

Gyri
Important Functional Areas
Gyri Location
Area Site Function
Lies between the lateral sulcus
Superior temporal Posterior medial
and the superior temporal Primary Visual sensory area
gyrus part of occipital
sulcus visual sensory (perception of
Lies between the superior and lobe (surrounds
Middle temporal gyrus area (17) visual impulses)
inferior temporal sulcus calcarine sulcus)
Lies below the inferior Secondary
Inferior temporal gyrus Anterior to area Visual association
temporal sulcus (psychic)
17 in dominant area (Recognition
visual area
Important Functional Areas hemisphere & recall of image)
(18, 19)
Area Site Function

Primary
Superior temporal Auditory sensory
auditory (area
gyrus area
41,42)

Sensory Auditory
Superior temporal
speech area or association area
lobe of dominant
Wernicke's (recognition &
hemisphere
center (area recall of sounds)

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 Interspersed are granule cells and cells of


Martinotti, and horizontal fibers forming the
internal band of Baillarger
6. Multiform or Fusiform Layer
 Contains spindle-shaped cells, granule cells,
Martinotti cells, and stellate cells
 The layer is pervaded by fiber bundles

HISTOLOGY
1. Molecular or Plexiform
 Composed of horizontal cells of Cajal& Golgi
type II
2. Outer / External Granular Layer
 Small pyramidal or triangular cells whose BRAIN: DIENCEPHALON
dendrites terminate on the molecular layer  Paired structure
3. Outer / External Pyramidal Layer  Located between the telencephalon and mesencephalon
 Composed of typical well-formed pyramidal and between the interventricular foramina and the
neurons posterior commissure
 Two sub layers  Continuous with the rostral part of the midbrain
 Superficial layer of medium sized  Forms the lateral wall of the 3rd ventricle
pyramidal cells: horizontal Myelinated  Receives the optic nerve (CN II)
fibers  Contains dozens of nuclei of gray matter
 Deep layer of large pyramidal cells
4. Internal Granular Layer DIVISIONS
 Composed of stellate cells  On the medial surface, the diencephalon is
 Interspersed within the layer are horizontal subdivided, by hypothalamic sulcus into
myelinated fibers forming external band of I. Dorsal part
Baillarger (thalamo-cortical ramifications) 1. Epithalamus
5. Internal Pyramidal or Ganglion Layer 2. Thalamus
 Giant Pyramidal cells of Betz (origin of the II. Ventral part
pyramidal tract) 1. Hypothalamus
2. Subthalamus

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1. EPITHALAMUS Functions
 Relatively small part, located in most caudal and 1. Autonomic function
dorsal region  ANS is regulated by hypothalamic nuclei.
 Lies immediately rostral to superior colliculus o Anterior hypothalamus  excitatory
 Consists of effect on the parasympathetic nervous
 Pineal gland system
 Habenular nuclei o Posterior hypothalamus  excitatory
effect on the sympathetic nervous
Pineal Gland system
 An endocrine organ 2. Temperature regulation
 Synthesizes melatonin  Anterior hypothalamus
 Controls o Helps regulate and maintain body
o Sleep/awake cycle temperature
o Regulation of onset of puberty o Destruction causes hyperthermia
 Posterior hypothalamus
Habenular Nuclei o Helps produce and conserve heat
 Located in habenular triangle (area in the o Destruction causes the inability to
posterior part of the diencephalon, just anterior thermoregulate
to pineal gland) 3. Water balance regulation
 Have connections with limbic system  ADH controls water excretion by the
 Serves autonomic function and emotional kidneys
drives 4. Food intake regulation
 Ventromedial nucleus
2. THALAMUS  Lateral hypothalamic nucleus
 Egg shaped, large mass of grey matter o Hunger or feeding center
 Two large lobes of gray matter (over a dozen o Destruction causes starvation and
nuclei) emaciation
 Laterally enclose the 3rd ventricle
 Separated from hypothalamus by hypothalamic 4. SUBTHALAMUS
sulcus  Most of the subthalamus is just a rostral extension
 Gateway to cerebral cortex: every part of brain that of the midbrain
communicates with cerebral cortex relays signals  It contains one nucleus, subthalamic nucleus
through a nucleus in the thalamus (e.g. Certain  Plays a role in motor control and is interconnected
nucleus for info from retina, another from ears, etc.) with the basal ganglia

Boundaries
 Anterior: interventricular foramen BRAIN: CEREBELLUM
 Posterior: free pole of the pulvinar  Largest part of hind brain
 Dorsal: free surface underlying the fornix and  Called “silent area”
the lateral ventricle  Weight: 150 g
 Ventral: plane connecting the hypothalamic  Develops from the alar plates (rhombic lips) of the
sulci metencephalon
 Medial: third ventricle  Located infratentorially within the posterior fossa and
 Lateral: posterior limb of the internal capsule lies between the temporal and occipital lobes and the
brainstem
3. HYPOTHALAMUS
 Forms inferolateral wall of 3rd ventricle ANATOMICAL DIVISIONS
 Many named nuclei  Two Hemispheres
 Vermis

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FUNCTIONS
Fissures 1. Maintenance of posture and balance
1. Primary fissure 2. Maintenance of muscle tone
2. Horizontal fissure (pre-pyramidal fissure) 3. Coordination of voluntary motor activity
3. Posterior fissure (posterolateral fissure)
CEREBERLLAR NUCLEI
Lobes  Masses of grey scattered in white matter
1. Anterior lobe Cerebellar
Location Features
2. Posterior lobe Nuclei
3. Flocculo-nodular lobe Most prominent
Fastigial Near the
Largest in primates
nucleus middle line
Notches Nucleus of Neocerebellum
1. Anterior cerebellar notch: Pons and Medulla Lateral to Nucleus of
Globose
2. Posterior cerebellar notch: lodges the Falx cerebelli Fastigial Paleocerebellum
nucleus
nucleus Flexor muscle tone
Below the Oval shaped
Emboliform
Fastigial Nucleus of
nucleus
nucleus paleocerebellum
Nucleus of
Dentate Lateral to all
Archicerebellum
nucleus other nuclei
Extensor muscle tone

PHYSIOLOGICAL OR FUNCTIONAL DIVISIONS


1. Vestibulocerebelllum (Archecerebellum)
2. Spinocerebellum (Paleocerebellum)
3. Corticocerebellum (Neocerebellum)

HISTOLOGY
 Has three layers
1. Molecular layer
 Most superficial, underlying the pia mater
 Contains stellate cells, basket cells, and the
dendritic arbor of the Purkinje cells
2. Purkinje cell/Ganglionic layer
 Lies between the molecular and the
granule cell layers
 Conspicuous cell body and their dendrites
are highly developed, assuming the aspect
of a fan
3. Granule layer
 Deepest layer overlying the white matter

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 Contains granule cells, Golgi cells, and  Formed by the Cerebral Peduncles (Crus
cerebellar glomeruli Cerebri)
 A cerebellar glomerulus consists of a  These consist of the converging cerebral crura
mossy fiber rosette, granule cell dendrites, (the most anterior parts of the cerebral
and a Golgi cell axon peduncles), which are separated from each
other by the interpeduncular fossa
 Each peduncle consists of three parts - Crus
Cerebri, Substantia Nigra and Tegmentum
 Oculomotor (III) nerves emerge from the walls
of the interpeduncular fossa

2. Posterior/Dorsal Surface (Tectum)


 Consists of two pairs of swellings, the Inferior
and Superior Colliculi (also called as Corpora
Quadrigemina)
 Trochlear (IV) nerve emerge caudal to the
Inferior Colliculi
 The small area rostral to the Superior Colliculi
is the Pretectum

INTERNAL ANATOMY
CEREBELLAR DYSFUNCTION
 Includes the following triad
 Hypotonia - loss of the resistance
 Dysequilibrium - loss of balance characterized
by gait and trunk dystaxia
 Dyssynergia - loss of coordinated muscle
activity

BRAIN: MID BRAIN (MESENCEPHALON)

 Uppermost part of the Brainstem


 Located between the diencephalon and the pons
 Contains the Cerebral Aqueduct that connects the third
and fourth ventricles
 Contains the nuclei of the Oculomotor (III) and
Trochlear (IV) cranial nerves as well as centers
associated with auditory, visual, and pupillary reflexes

PARTS
 An imaginary line passing from side to side
through the Cerebral Aqueduct divides the
midbrain into,
1. Anterior/Ventral Surface (Tegmentum)
2. Posterior/Dorsal Surface (Tectum)

1. Anterior/Ventral Surface

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CAUDAL MIDBRAIN AT THE LEVEL OF INFERIOR  It has extra-pyramidal motor function, concerned
COLLICULUS with movements
Inferior Colliculus  Lesion of pars compacta leads to Parkinson’s
 Amass of grey matter which receives ascending disease. It is due to absence of dopamine into basal
auditory pathway, that run in lateral lemniscus to ganglia, this is manifested by a mask face, resting
end in inferior colliculus. Its the centre of hearing tremors, rigidity of muscles and a shuffling gait
reflex
Crus Cerebri
Cerebral Aqueduct  Lies ventral to Substantia Nigra
 Runs ventral to colliculi, and surrounding by area  Consists entirely of descending cortical efferent
of grey matter, the peri-aqueductal (or central grey) fibers
 50% of Crus consists of pyramidal tract, consists of
Trochlear Nucleus cortico-bulbar + cortico-spinal fibres which traverse
 Lies ventral to peri-aqueductal grey pons, down to medullary pyramid and spinal cord
 On either side of corticobulbar & corticospinal
CAUDAL MIDBRAIN AT THE LEVEL OF INFERIOR fibres, crus cerebri contains cortico-pontine,
COLLICULUS temporo-pontine + fronto-pontine fibres
Medial Longitudinal Fasciculus
 A well-defined bundle of fibres lies on each side of ROSTRAL MIDBRAIN AT THE LEVEL OF SUPERIOR
median plane in midbrain tegmentum COLLICULUS
 It extends throughout the brain stem, and descends Superior Colliculus
into spinal cord  Lies in upper part of tectum of midbrain
 It helps in control of gaze by coordination of eye,  It is a Centre of visual reflexes
head & neck movements
Pretectal Nucleus
Decussation of Superior Cerebellar Peduncles (Brachium  Lies close to superio-lateral part of Superior
Conjunctivum) Colliculus
 Fibres of each peduncle cross to opposite side,  It has connections with parasympathetic nucleus of
forming decussation in the central part of Oculomotor nerve (Edinger-Westphal nucleus) to
tegmentum control smooth muscles of eye (sphincter pupillae)
and to mediate pupillary light reflex
Medial Lemniscus
 It is a band of ascending fibers carrying Oculomotor Nucleus
proprioceptive & fine touch sensation from  Lies ventral to peri-aqueductal grey
opposite side of body  Efferent fibers emerge from the medial surface of
 It is the upward continuation of gracile & cuneate Crus Cerebri as Oculomotor nerve to supply
tracts of opposite side extraocular muscles of eye (except SO + LR)
 It lies in tegmentum, posterior to substantia nigra
Red Nucleus
Substantia Nigra  It is a large mass of grey matter lies in tegmentum
 It is a large motor nucleus, lies at the most ventral of rostral midbrain
part of midbrain tegmentum  It is involved in motor control
 It contains subdivision part, the pars compacta,
which consists of pigmented, melanin-containing
neurons that synthesize dopamine as their BRAIN: PONS
transmitter
 Situated between the medulla (below) and midbrain
 It projects to caudate nucleus + putamen of basal
(above)
ganglia in the forebrain
 Lies in the posterior cranial fossa on the clivus, anterior
to the cerebellum
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 It is Centre of Respiration  Consists of acoustic fibres responsible for hearing,


 Nuclei of the cranial nerves, V (trigeminal), VI arising from cochlear nuclei
(abducent), VII (facial), and VIII (vestibulocochlear) are  These acoustic fibres crossing opposite side of pons
present in the Pons forming decussation of trapezoid body, then the
axons ascend into rostral pons & midbrain as lateral
DIVISIONS lemniscus and terminate in inferior colliculus
 Divided into 2 main divisions by the transversely  It lies in the anterior part of tegmentum
running fibres of trapezoid body
1. Basilar part (Basis pontis) Abducent Nerve Nucleus
 It is the ventral part of pons  Lies in posterior aspect of caudal pons near floor of
 Contents are constant at all levels 4th ventricle
 It is encircled by fibres of Facial nerve. forming
2. Tegmentum elevation in the floor of 4th ventricle called facial
 It is the dorsal part of pons colliculus
 Superiorly, tegmentum of pons is  Its efferent fibres pass downwards traversing
continuous with tegmentum of midbrain medial lemniscus & pyramidal tract bundles to
 Contents vary in the 3 levels of pons emerge anteriorly at junction between pons &
pyramid of medulla, supplying lateral rectus
muscle

Facial Motor Nucleus


 Lies in posterior part of caudal pons
 Its efferent fibres encircle Abducent nucleus, then
pass anterolaterally to emerge at the junction
between pons & olive of medulla, (supplying
muscles of facial expression)

Medial Longitudinal Fasciculus or Bundle


 It is an association tract, lies close to midline
 Found throughout the brain stem, and descend into
spinal cord
 It links vestibular nuclei with motor ocular nuclei in
VENTRAL (BASILAR) PART OF PONS IN ALL LEVELS the brain stem, supplying extraocular muscles
 It is marked by numerous transverse (oculomotor, trochlear & abducent nuclei) to serve
Pontocerebellar fibres which arise from pontine coordination of head and eye movements
nuclei
 These Pontocerebellar transverse fibres cross the Vestibular Nuclei
midline to pass to contralateral cerebellum, forming  They are four nuclei lie near to vestibular area of
middle cerebellar peduncle (brachium pontis), floor of 4th ventricle
where trigeminal nerve (V) pierces it  They receive afferent fibres for unconscious deep
 Corticospinal & Corticobulbar fibres (pyramidal sensation (equilibrium), from the Vestibular nerve
tract) appear as small, separate bundles running  They send efferent fibres as vestibulo-ocular fibres
longitudinally between fascicles of transverse through medial longitudinal fasciculus
pontine fibres
Spinal tract & Nucleus of Trigeminal Nerve
DORSAL (TEGMENTAL) PART OF CAUDAL PONS AT  Lie on the anteromedial aspect of inferior cerebellar
LEVEL OF FACIAL COLLICULUS peduncle
Trapezoid body  Carrying pain & temperature sensations from the
face & scalp

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DORSAL (TEGMENTAL) PART OF MID-PONS AT DORSAL (TEGMENTAL) PART OF ROSTRAL PONS AT

LEVEL OF TRIGEMINAL NERVE LEVEL OF 4 LEMNISCI

Trigeminal Motor Nucleus Lateral Lemniscus

 Medial in position  The most lateral lemniscus

 Its axons form the motor root of Trigeminal nerve  It is a band of ascending fibres carrying hearing

which passes along Mandibular nerve sensation from both ears (mainly from opposite
side)

Trigeminal Sensory Nucleus  Ends in auditory area in temporal lobe

 Lateral in position
 It receives afferent touch sensation from face & Spinal Lemniscus

scalp  Just medial to lateral lemniscus

 It sends efferent fibres, cross to opposite side to join  It is a band of ascending fibers

axons of spinal nucleus of trigeminal, forming  Carrying pain, temperature & light touch from

trigeminal lemniscus in rostral pons – midbrain - opposite side of body

thalamus
Trigeminal Lemniscus

Superior Cerebellar Peduncle  Just medial to Spinal Lemniscus

 Lies in the rostral part of pons, forming lateral walls  It is a band of ascending fibers carrying superficial

of 4th ventricle sensation, from opposite side of face & scalp

 Lies posterolateral to motor nucleus of trigeminal


Medial Lemniscus
 The most medial lemniscus
 Marks the boundary between ventral & tegmental
portions of pons
 It is a band of ascending fibres carrying
proprioceptive sensation from opposite side of
body

BRAIN: MEDULLA
 Most inferior part of Brain Stem
 Become Spinal cord at the level of Foramen Magnum
 Contains autonomic centres that regulate respiration,
circulation, and gastrointestinal motility

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 Extends from the pyramidal decussation to the inferior  Another elevation lateral to cuneate tubercle;
pontine sulcus Tuber Cinereum is formed by the spinal nucleus
 Gives rise to cranial nerves—CN IX to CN XII of the trigeminal nerve
 The nuclei of CN V and CN VIII extend caudally into
the medulla Upper Open Part
 Connected to the cerebellum by the inferior cerebellar  Forms the lower part of the floor of the 4th
peduncle ventricle
 Presents many features - median sulcus,
EXTERNAL FEATURES hypoglossal and vagal triangles, vestibular
 Divided into right and left symmetrical halves by areas, area postrema, stria medullaris
the anterior median fissure and posterior median
sulcus INTERNAL STRUCTURE
 Studied at three levels
Ventral Part
 Pyramids 1. At the Level of Decussation of Pyramids
 Are two elongated elevations, one on either  Passes through the inferior half of the medulla
side of the anterior median fissure  Nucleus Gracilis and Nucleus Cuneatus appear as
 Formed by the underlying corticospinal narrow strip-like projections from the posterior
(pyramidal) fibres aspect of the central grey matter
 Olives  Apex of posterior horn form the nucleus of the
 Are oval elevations, posterolateral to the spinal tract of the trigeminal nerve
Pyramids  Decussation of Pyramidal tracts
 Formed by an underlying mass of grey matter  Most important feature of medulla at this level
called Inferior Olivary Nucleus  About 75% fibres of pyramidal tract cross the
 Inferior Cerebellar Peduncles midline to get to the lateral white column of
 Are thick bundles of fibres lying posterolateral the other side of the spinal cord in the place
to the Olive where they run downward as the lateral
 Attach the medulla with the cerebellum corticospinal tract. In doing this, the anterior
 Rootlets of the Hypoglossal nerve horns are detached from the central grey
 Seen between the pyramid and the olive matter
 Rootlets of the 9th, 10th and 11th (cranial part)  Every detached anterior horn breaks up to
cranial nerves create the spinal nucleus of the accessory nerve
 Seen between olive and inferior cerebellar and the supraspinal nucleus of the 1st cervical
peduncle. nerve
 Reticular formation - Diffuse zone with a network
Dorsal Part of fibres and scattered nerve cells in the lateral
 Divided into two parts white column adjacent to the nucleus of the spinal
1. Lower Closed tract of the trigeminal nerve
2. Upper Open

Lower Closed Part


 Three longitudinal elevations are seen
i. Fasciculus Gracilis
ii. Fasciculus Cuneatus
iii. Inferior Cerebellar Peduncle
 Upper ends of the fasciculus gracilis and
fasciculus cuneatus expand to form the gracile
and cuneate tubercles, respectively, due to
underlying nuclei of the same name

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2. At the Level of Sensory Decussation


 Passes through the middle of medulla
 More pronounced Nucleus Gracilis and Nucleus
3. At the Level of Olives
Cuneatus
 Passes across the floor of the 4th ventricle and
 Internal Arcuate Fibres arise from the nucleus
through the middle of olives
gracilis and nucleus cuneatus and form the
 Central grey matter is spread over the floor of the
contralateral medial lemniscus
4th ventricle and includes the nuclei of several
 Decussation of the medial lemniscus, formed by
cranial nerves. From medial to lateral, these are:
decussating internal arcuate fibers
hypoglossal nucleus, nucleus intercalatus, dorsal
 Spinal nucleus and tract of trigeminal nerve are
nucleus of vagus and vestibular nuclei (inferior and
located ventrolateral to the cuneate nucleus
medial)
 The lower part of inferior olivary nucleus is seen
 Nucleus of tractus solitarius is located ventral to
 Pyramids are located on each side of the anterior
vestibu-lar nuclei
median fissure
 Nucleus ambiguous, located deep inside the
 Central grey matter includes - hypoglossal nucleus,
reticular formation and supplies origin to the motor
dorsal nucleus of vagus and nucleus of tractus
fibres of 9th, 10th and 11th cranial nerves
solitarius
 On either side of the midline, medial longitudinal
 Medial longitudinal bundle/fasciculus fasciculus -
fasciculus (MLF), tectospinal, medial lemniscus
located posterior to the medial lemniscus
and pyramidal (corticospinal) tracts are located
 Spinocerebellar and lateral spinothalamic tracts
 Arcuate nuclei are situated on the anteromedial
are in the anterolateral area of lateral white column
aspect of the pyramids
 Lateral and anterior spinothalamic tracts are close
 Laterally, from dorsal to ventral, inferior cerebellar
to each other and together form spinal lemniscus
peduncle and inferior olivary nucleus are found
 Inferior cerebellar peduncle lies in posterolateral
part
 Inferior olivary nucleus (largest mass of grey
matter) is in the portion via the upper part of
medulla. It presents crumpled bag-like structure
 Transverse section of medulla just inferior to the
pons presents the same features as those observed
in the transverse section of medulla at the level of
the olives, except for that:
 Lateral vestibular nucleus replaces the inferior
vestibular nucleus
 Cochlear nuclei are now visible

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laminae and ligamenta flava. On each side, it is bounded


by the pedicles of vertebrae with intervening large
intervertebral foramen
 Vertebral canal is continuous above with the cranial
cavity and below with the sacral canal

CONTENTS
1. Epidural space
2. Spinal meninges
3. Spinal cord with its nerve roots

Epidural Space
 Lies between the spinal dura and the periosteum
lining the vertebral canal
 Filled with loose areolar tissue, semiliquid fat,
BRAIN: RETICULAR FORMATION spinal arteries and a network of veins—the internal
 A diffuse ill-defined mass of nerve cell clusters and vertebral venous plexus
interlacing nerve fibres occupying the entire core of the
brainstem Spinal Arteries
 Formed by neurons & processes left over after well-  These are segmental arteries
defined named nuclei & pathways  Arise from ascending cervical and deep
 Phylogenetically, old system cervical arteries in the cervical region, from
 Located in the brain stem posterior intercostal arteries in the thoracic
 Comprises of medullary, pontine & midbrain region, from lumbar arteries in the lumbar
 Poly synaptic region, and lateral sacral arteries in the sacral
 Has both ascending and descending components region
 Extends cranially to the diencephalon and caudally to  They enter the vertebral canal through
the spinal cord intervertebral foramina along the spinal nerve
 Receives data from most of the sensory systems of the roots
body and relay them to all the levels of the neuraxis  They supply spinal cord, its nerve roots,
 Has important role in maintenance of sleep–wake cycle, meninges, and the surrounding bones and
level of consciousness, and alertness or mutism ligaments
 Has localized cell groups called reticular nuclei in
certain regions Internal Vertebral Venous Plexus
 It is a network of veins extends throughout the
Functional Components length of the vertebral canal
1. Ascending Reticular Activating System (ARAS)  These veins correspond to the dural venous
2. Descending Reticular System (DRS) sinus within the cranial cavity and are
continuous with them through the foramen

VERTEBRAL CANAL magnum


 Drained by four subordinate longitudinal
 It is an elongated cavity inside the vertebral column
channels: two posterior and two anterior
 Vertebral canal is a collective name given to the whole
 Also receives veins from spinal meninges and
series of vertebral foramina lying one above the other
spinal cord
when the vertebrae are held together in the vertebral
 Devoid of valves
column
 It is a smooth-walled space bounded anteriorly by the
External Vertebral Venous Plexus
vertebral bodies, intervertebral discs, and the posterior
 Lies outside the vertebral column
longitudinal ligament; and posteriorly by the vertebral

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 Consists of anterior vessels lying in front of  Filum Terminale


vertebral bodies and posterior vessels lying on o It is a delicate thin thread-like
the back of the vertebral arches. These vessels prolongation of pia mater beyond the
communicate with each other and with the conus medullaris
internal vertebral venous plexus o Extends from tip of conus medullaris to
 Devoid of valves the base of the coccyx
o It is divided into two parts,
Spinal Meninges 1. Filum Terminale Internum - lies
 Spinal cord is surrounded by three coverings called within the dural sac
meninges 2. Filum Terminale Externum – lies
 From superficial to deep, outside the dura mater
1. Spinal dura mater  Ligamenta Denticulate
2. Spinal arachnoid mater o Are narrow ribbon-like transparent bands
3. Spinal pia mater of pia mater on each side between the
 The potential space between the dura and dorsal and ventral nerve roots
arachnoid maters is termed as Subdural Space, while o Helps to anchor the spinal cord in the
the large space between the arachnoid mater and middle of the subarachnoid space
pia mater is known as Subarachnoid Space o The first tooth of ligamentum
denticulatum is at the level of the foramen
Spinal Dura Mater magnum, while the last tooth lies between
 It is the prolongation of the inner meningeal T12 and L1 spinal nerves
layer of cranial dura mater and extends from  Linea splendens
foramen magnum to the lower border of S2 o It is a thickened band of pia mater along
vertebra the anterior median fissure of the spinal
 It is attached firmly to the foramen magnum, cord
the tectorial membrane and the posterior  Subarachnoid Septum
longitudinal ligament on the body of axis o It is a fenestrated pial septum in the
vertebra midsagittal plane, which connects the pia
 It is pierced segmentally by dorsal and ventral mater with arachnoid mater posteriorly
roots of the spinal nerves and prolonged over o Posteriorly, the pia mater is also attached
these roots as sleeve-like projections, which to the posterior median septum of the
enter the intervertebral foramina and ends by spinal cord
fusing with the epineurium of the spinal nerves

Spinal Arachnoid Mater


 It is a thin transparent vascular membrane that
loosely invests the spinal cord
 Above it is continuous with the arachnoid
mater surrounding the brain and below it
extends up to the lower border of second sacral
vertebra
 It is separated from pia mater by the
subarachnoid space

Spinal Pia Mater


 It is a vascular membrane that closely invests
the spinal cord
 The pia mater is modified at some places, that
are called processes of pia mater

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Brain and Spinal Cord

 Found between the posterior lateral and


posterior median sulci but only rostral to T6
 Separates the fasciculus gracilis from the
Fasciculus Cuneatus

5. Posterior Median Sulcus


 Shallow posterior midline groove that is
continuous with the posterior median septum

Cauda Equina
 Leash of lumbar (except L1), sacral, and coccygeal
nerve roots around the filum terminale in the pool
of CSF
 It is so named because the lower end of the spinal
cord along with the afore mentioned structures
resembles the tail of a horse (cauda = tail, equina =
SPINAL CORD horse)

 It’s the long lower cylindrical part of the central nervous


Enlargements of Spinal Cord
system occupying the upper two-thirds of the vertebral
1. Cervical Enlargement
canal
 In the region of C5–T1 spinal segments
 Begins at the foramen magnum as the continuation of
 Nerves arising from these segments form
medulla oblongata and usually terminates opposite the
Brachial Plexus
intervertebral disc between the L1 and L2 vertebrae
 In the fetus, it extends up to the level of the lower
2. Lumbar Enlargement
border of S2 vertebra
 In the region of L2–S3 spinal segments
 Nerves arising from these segments form the
FUNCTIONS
Lumbar Plexus
1. Transmission of information between body and
brain
Vertebral levels of Spinal Segments
2. Execution of simple reflexes

EXTERNAL FEATURES
Fissures and Sulci
1. Anterior Median Fissure
 Deep anterior midline groove in which the
anterior spinal artery is found superficially

2. Anterior Lateral Sulcus


INTERNAL STRUCTURE
 Shallow groove from which the anterior
 In transverse sections, neural substance of the
rootlets emerge
spinal cord is divided into central gray matter and
peripheral white matter
3. Posterior Lateral Sulcus
 Shallow groove into which the posterior
White Matter
rootlets enter
 Surrounds the gray matter
 Formed by the bundles of both myelinated
4. Posterior Intermediate Sulcus
(predominant) and nonmyelinated fibers
 Shallow groove that is continuous with the
posterior intermediate septum

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 Anterior median fissure and posterior median  Divided into symmetrical right and left comma
septum divide the entire mass of white matter into shaped masses, which are connected across the
two lateral halves midline by a transverse grey commissure
 The band of white matter lying in front of anterior  Divided into cytoarchitectural areas called Rexed
gray commissure is called Anterior White laminae, expressed with Roman numerals
Commissure  Divided into three horns or cell columns on each
 Each half of the white matter is divided by the side
fibers of anterior and posterior nerve roots into 1. Anterior horn
three white columns or funiculi 2. Lateral horn
Lies between the anterior 3. Posterior horn
Anterior or Ventral median fissure on one side  Part of grey matter anterior to spinal canal 
White Column / Anterior and anterior nerve root and Anterior grey commissure
or Ventral Funiculus anterior gray horn on the  Part to grey matter posterior to spinal canal 
other side Posterior grey commissure.
Lies between the anterior  Part of white matter between the anterior median
nerve root and anterior gray sulcus and the anterior grey commissure 
Lateral White Column / horn on one side and Anterior white commissure
Lateral Funiculus posterior nerve root and
posterior gray horn on the
other side
Posterior or Dorsal Lies between the posterior
White Column / nerve root and posterior gray
Posterior or Dorsal horn on one side and
Funiculus posterior median septum on
the other side

Nuclei in Grey Matter

Gray Matter
 Found toward the center of the spinal cord
 Butterfly or H-shaped that varies according to spinal
cord level
 Contains a central spinal canal

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Brain and Spinal Cord

 Name of the tract indicates the origin and destination of


its fibers
 Axons within each tract are grouped according to the
body region innervated

NAMING THE TRACTS


 If the tract name begins with “spino” (as in
spinocerebellar), the tract is a sensory tract
delivering information from the spinal cord to the
cerebellum (in this case)
 If the tract name ends with “spinal” (as in
vestibulospinal), the tract is a motor tract that
delivers information from the vestibular apparatus
(in this case) to the spinal cord

ANATOMICAL ORGANIZATION
 Ascending pathway consists of 3 neurons
Neuron Origin Supply

Carries the sensory


First Cell body is in the impulse from the
Order dorsal or cranial root sensory receptor to
Neuron ganglion the central nervous
system
Cell bodies in the Carry the sensory
Second
grey matter of the information from the
Order
brain stem or spinal substantia gelatinosa
Neuron
cord to the thalamus
Sensory signals from
Located in the
Third the thalamus to the
Ventral Posterior
Order ipsilateral primary
(VP) nucleus of the
SPINAL CORD: TRACTS Neuron sensory cortex of the
thalamus
 There is a continuous flow of information between the brain
brain, spinal cord, and peripheral nerves. This
information is relayed by sensory (ascending) and
motor (descending) ‘pathways’ CLASSIFICATION OF TRACTS
 General pathways I. Short Tracts (Intersegmental or Propriospinal)
 Consists of a chain of tracts, associated nuclei and  Fibers occupy narrow band peripheral to the
varying number of relays (synapses) grey matter (fasiculus proprius)
 Consist of two or three neurons  They interconnect adjacent or distant spinal
 Exhibit somatotopy (precise spatial relationships) segments
 Decussate  Permit intersegmental coordination
 Involve both the brain and spinal cord
 Are paired (bilaterally and symmetrically) II. Long Tracts
 Tract is a bundle of nerve fibers (within CNS) having the  They serve to join the brain to the spinal cord
same origin, course, destination & function 1. Ascending/Sensory/Afferent
 They are sometimes referred to as fasciculi (= bundles)  Carry impulses from pain, thermal,
or lemnisci (= ribbons) tactile, muscle and joint receptors to
the brain

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Brain and Spinal Cord

2. Descending/Motor/Efferent
 Deliver information to the periphery

ASCENDING / SENSORY / AFFERENT TRACTS

White Funiculus Tract

Anterior funiculus 1. Anterior spinothalamic tract

1. Lateral spinothalmic tract


2. Ventral spinocerebellar tract
3. Dorsal spinocerebellar tract
4. Spinotectal tract
Lateral funiculus
5. Spinoreticular tract
6. Spino-olivary tract
7. Spinovestibular tract
8. Fasiculus dorsolateralis

1. Fasiculus gracilis
Posterior
2. Fasiculus cuneatus
funiculus
3. Comma Tract of Schultze

DESCENDING / MOTOR / EFFERENT TRACTS


 These tracts are formed by motor nerve fibers
arising from brain and descend into the spinal cord

Types

Type Tract

Pyramidal tracts
First tracts to be
found in man 1. Anterior corticospinal tract
Concerned with 2. Lateral corticospinal tract
voluntary motor
activities

1. Medial longitudinal fasiculus


2. Anterior vestibulospinal tract
3. Lateral vestibulospinal tract
Extrapyramidal
4. Reticulospinal tract
tracts
5. Tectospinal tract
6. Rubrospinal tract
7. Olivospinal tract

ASCENDING / SENSORY / AFFERENT TRACTS

Sensory Tract Origin Course Termination Functions Lesion


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Crossed fibers
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cord
(VP) nucleus of Crude touch OPPOSITE SIDE
Spinothalamic nucleus Forms spinal
the Thalamus below the lesion
lemniscus
level
NEURO ANATOMY & PHYSIOLOGY 20
Brain and Spinal Cord

Anterior and Lateral Spinothalamic Tracts

Ventral and Dorsal Spinocerebellar Tracts

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DESCENDING / MOTOR / EFFERENT TRACTS

Sensory Tract Origin Course Functions Lesion

Anterior Upper Motor Lesion


Anterior Betz cells and other Uncrossed
white  Loss of voluntary
corticospinal cells of motor area fibers
column movements
Control of voluntary  Spastic paralysis
movements  Superficial reflexes
Lateral Form upper motor are lost
Lateral Betz cells and other
white Crossed fibers neurons  Deep reflexes are
corticospinal cells of motor area
column exaggerated.
 Positive Babinski’s
sign
Uncrossed Coordination of reflex
Vestibular nucleus
Medial Anterior fibers ocular movements
Reticular formation
longitudinal white Extend up to Integration of Loss of function
Superior colliculus
fasciculus column upper cervical movements of eyes and
and cells of Cajal
segments neck
Uncrossed
Anterior fibers
Anterior Medial vestibular
white Extend up to Maintenance of muscle
vestibulospinal nucleus
column upper thoracic tone and posture
Fasiculus Tracts
segments Maintenance of position Loss of function
Mostly of head and body
Lateral
Lateral Lateral vestibular uncrossed during acceleration
white
vestibulospinal nucleus Extend to all
column
segments
Coordination of
voluntary and reflex
Mostly
movements
Lateral Reticular formation uncrossed
Control of muscle tone
Reticulospinal white of pons and Extend up to Loss of function
Control of respiration
fasciculus medulla thoracic
and
segments
diameter of blood
vessels
Crossed fibers Control of movement of
Anterior
Extend up to head in response to
Tectospinal white Superior colliculus Loss of function
lower cervical visual and auditory
Spino tectal etc column
segments impulses
Crossed fibers
Lateral
Extend up to Facilitatory influence on
Rubrospinal white Red nucleus Loss of function
thoracic flexor muscle tone
column
segments
Lateral Mostly crossed
Inferior olivary Control of movements
Olivospinal white Extent – not Loss of function
nucleus due to proprioception
column clear

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Brain and Spinal Cord

Pyramidal Tracts

Extrapyramidal tracts

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Brain and Spinal Cord

SPINAL REFLEXES Ans: A. Purkinje cells


Ref: Gray’s Anatomy 38/e, p. 1141-42

2. Pattern of efferent fibers from cerebral cortex to sub


cortical area
A. Summation
B. Projection
C. Association
D. Collateral

Ans: B .Projection
Ref: Gray’s Anatomy 38/e, p. 1176

BRAIN 3. Which of the following is true


1. Maximum growth of brain takes place in A. Hypothalamus is part of brainstem
A. Infancy B. Occipital lobe is part of cerebrum
B. Preschool C. Medulla is part of Limbic system
C. School D. All of the above
D. Puberty

Ans: A. Infancy Ans: B. Occiptal lobe is part of cerebrum


Ref: Snell’s 9/e p 686-88
Ref: Ghai’s, Pediatrics, 7/e, p. 3
Explanation:
Occipital lobe is part of cerebrum, whereas medulla
DIVISIONS OF BRAIN is a part of brain stem and hypothalamus and
limbic cortex oribito frontal cortex, cingulated
gyrus, parahippocampal gyrus, uncus & subcallosal
1. Forebrain consists of gyrus is a part of limbic system.
A. Cerebrum and diencephalon
B. Cerebrum only
4. During Sx for meningioma, the left paracentral lobule
C. Diencephalon only
was injured. It would lead to paresis of
D. Crus cerebri and cerebrum
A. Rt.Leg and perineus
B. Left face
C. Right face
Ans: A. Cerebrum and diencephalon
D. Right shoulder and trunk
Ref: Gray’s Anatomy 38/e, p. 974

Ans: A. Rt. Leg and Perineus


Ref: Ganong 21/e p 208
BRAIN: CEREBRUM/CEREBRAL HEMISPHERES Explanation:
- Paracentral lobule is on medial surface of
cerebral hemisphere around central sulcus
1. All are the cells of the cerebral cortex EXCEPT
- Motor area is located in precentral gyrus and
A. Purkinje cells
anterior part of paracentral lobule
B. Cajal cells
- Sensory area is located in post central gyrus
C. Pyramidal cells
and posterior part of paracentral lobule
D. Stellate cells
- In motor & sensory area body is represented
upside down.

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- Right side of motor cortex control left side of B. Putamen


body and vise versa. C. Thalamus
D. Globus-pallidus
5. Superior cerebellar peduncle carries
A. Sensory impulses form spinal cord
B. Motor impulses form cerebellum to thalamus Ans: C. Thalmus
C. Sensory impulses from cortex
11. Functions of basal ganglia include
D. None of the above
A. Planning and voluntary movements
B. Sensory integration
Ans: B. Motor impulses form cerebellum to thalamus C. Short term memory
Ref: Gray’s Anatomy 38/e, p. 1035 D. Coordination of motor function
E. Pain perception

6. The sylvian’s sulcus divides


Ans: A. Planning and voluantry movements
A. Temporal from parietal lobe
Ref:- Snells Neuroanatinny 6/e p. 310-33
B. Parietal from frontal lobe
C. Temporal from frontal lobe Explanation:
D. Motor form sensory cortex
- Subtiutimic nucleus not thalamus is part of basal
ganglia. Dentate nucleus is found in cerebellums.
Ans: A. Temporal from parietal lobe - Function of basal ganglia i.e. (caudate nucleus, putamen,
Ref: Gray’s Anatomy 38/e, p. 1109-10 globus pallidus, substantia nigra, subthalmic nucleus,
amygdaloid nucleus, striatum, & lenticular nucleus) is
planning & programming of voluntary movements.
7. Cortical representation of body in cerebrum is
A. Horizontal 12. Broca’s area is localized in
B. Vertical A. Superior temporal gyrus
C. Tandem B. Parietal lobe
D. Oblique C. Inferior frontal lobe
D. Angular gyrus

Ans: B. Vertical
Ans: C. Inferior frontal lobe
8. Lesion of medial temporal lobe is associated with
A. Auditory amnesia 13. Auditory area is situated in
B. Agnosia A. Middle frontal gyrus
C. Visual amnesia B. Inferior frontal gurus
D. Alexia C. Superior parietal lobule
D. Superior temporal gyrus

Ans: A. Auditory amnesia


Ans: D. Superior temporal gyrus
9. All are nuclei of the basal ganglia except Ref: Essentials of Human Anatomy, 3/e, A.K Datta vol
A. Caudate nucleus 4, p. 61
B. Amygdaloid nucleus
C. Lentiform nucleus 14. Visual cortex is present in the
D. Dentate nuclei A. Occipital lobe
B. Temporal lobe
Ans: D. Dentate nucleus C. Frontal lobe
D. Parietal lobe
10. Basal ganglia consist of all of the following except
Ans: B. Temporal lobe
A. Caudate nucleus

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Ref: Gray’s Anatomy 38/e, p. 1158-59 Ans: A 44 & 45

20. Motor area of Brodman’s is area


15. Broca’s motor speech area is situated in
A. 1
A. Inferior frontal gyrus
B. 4
B. Middle frontal gyrus
C. 5
C. Superior temporal gyrus
D. 7
D. Post central gyrus
Ans: B. 4

Ans: A. Inferior frontal gyrus 21. Frontal eye motor area is


Ref: Essentials of Human Anatomy, 3/e, A.K Datta vol A. 9
4, p. 62 B. 2
C. 6
D. 8
16. Precentral gyrus is Ans: B. 2
A. Sensory cortex Ref:- Ganong 23rd/e p 243,175
B. Motor cortex Explanation:-
C. Proprioceptive cortex
D. Pain centre - Cortical representation of body in cerebrum is
vertical and upside down, and is known as

Ans: B. Motor cortex homunculus

Ref: Gray’s Anatomy 38/e, p. 1164 - Medial temporal lobe lesion is a/w auditory
amnesia
- Broca’s area is localized in inferior frontal lobe,
17. Visual area (are 17) lies in the frontal eye motor field is 6,8,9, pre or
A. Temporal lobe secondary motor area is 4
B. Occipital lobe
C. Parietal lobe 22. Following is true about hippocampus except
D. Frontal lobe A. It forms a projection in the inferior horn of lateral
ventricle of brain
Ans: B. Occipital lobe B. Its ventricular surface is covered by a layer of nerve
Ref: Essentials of Human Anatomy, 3/e, A.K Datta vol fibres called as alvenus
4, p.59-61 fig 6.11 C. Microscopically hippocampal cortex is made up of
six layers
18. Wernicke’s speech area is present in the D. Efferent fibres of hippocampus are called as
A. Superior temporal gyrus formnix
B. Middle frontal gyrus
C. Inferior frontal gyrus
D. Superior parietal lobule Ans: C. Microscopically hippocampal cortex is made up
of six layers

Ans: A. Superior temporal gyrus Ref: Essentials of Human Anatomy, 3/e, A.K Datta vol 4,

Ref: Essentials of Human Anatomy, 3/e, A.K Datta vol p.91-93

4, p.62 fig 6.11

23. Forceps major starts from


19. Broca’s area is A. Body of corpus callosum
A. 44 and 45 B. Splenium of corpus callosum
B. 40 and 42 C. Rostrum of corpus callosum
C. 43 and 44 D. Genu of corpus callosum
D. None
Ans: B. Splenium of corpus callosum

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Ref: Gray’s Anatomy 38/e, p. 1178 connects


hippocampal
formation or
crura of
24. Forceps minor starts from fornix of two
sides.
A. Indusium griseum
Habenular
B. Body of corpus callosum
commissure
C. Genu of corpus callosum connects
D. Splenium of corpus callosum habenular
nuclei
Ans: A. Superior temporal gyrus
Ref: Essentials of Human Anatomy, 3/e, A.K Datta vol 26. Corpus callosum consists of
4, p.70 A. Association fibres
B. Arcuate fibres
C. Commissural fibres
D. Projection fibres
25. True about Corpus callosum
A. Unite far area of two sides of brain
Ans: C. Commissural fibres
B. Connect two frontal lobe
Ref: Essentials of Human Anatomy, 3/e, A.K Datta vol
C. Unite two hemisphere
4, p.69
D. Superiorly related to –Indusium griseum
E. Unite adjacent and widespread separated gyri in
27. Following sulcus is called as a complete sulcus
the same lobe
A. Central sulcus
Ans: A,B,C,D
B. Calcarine sulcus
Ref:- Gray’s 40/e p 354-56
C. Lateral sulcus
Explanation:- D. Parieto – occipital sulcus

White matter of cerebrum


Ans: B. Calcarine sulcus
Arcuate Projection Commissural
Ref: Essentials of Human Anatomy, 3/e, A.K Datta vol
fibres fibres fibres
Connec Connect Connect 4, p.47
t cerebral correspondin
differen cortex to g parts of two
t other hemisphere
BRAIN: DIENCEPHALON
cortical parts of eg
areas of CNS eg -Corpus 1. True regarding cavity of diencephalons is
same -Spinal callosum A. Septum pellucidum forms partition
hemisp cord connecting B. Septum pellucidum cavity opens superiorly
here to (Corticosp cerebral C. Lateral wall is lamina terminals
one- inal) cortex of two D. Inter thalamic adhesions join lateral walls
another -Brain sides
E. Lamina terminalis contain anterior communicating
and are stem -Anterior
artery
of 2 (crticopon commisure,co
types tine tract) nnect
archipallilal
Ans: D & E. Inter thalamic adhesions join lateral Walls
bulbs,
& Lamina terminalis contain anterior communicating
piriform area
and anterior artery
temporal of Ref:- Gray's 40/e p 227,239
two sides
Explanation:-
-Hipocampal
commissue,

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- Lamina terminalis is a thin sheet of gay matter, which B. Posterior commissures


extend between two hemisphere from rostrum of corpus C. Trigonum Habenulae
callosum to top of optim chiasma forming the anterior D. Geniculate bodies
wall of 3rd ventricle. It represents the rostral(cranial)
boundary of embryonic neural tube. Anterior
Ans: D. Geniculate body
commisure crosses midline in lamina terminalis. Lamina
terminalis forms roof of cistern of lamina terminalis (a 4. Which of the following are the ventral posterior
small virtual cavity lying immediately below 3rd neucleus of thalamus
ventricle) which contains anterior communicating A. Medial lemniscus
artery. So aneurysm formation at this site may cause B. Corticospinal
intraventricular haemorrhage through thin membrane C. Spinothalamic
of lamina terminalis. D. Trigeminal lemniscus
- Septum pellucidum is a thin vertical sheet of (gray & E. A,C&D
white) nervous tissue, which connects corpus callosum
(rostrum, genu & front of body) to anterior column of Ans: E .A,C&D. Medial lemniscus ,Spinothalmic tract
fornix and forms partition between anterior horns of and Trigeminal lemniscus
lateral venticles (not 3rd ventricle or cavity of
5. Lateral lemniscus is formed by the decussation of
diencephalon). The septum consists of double
A. Cochlear fibres
membrane (covered on either side by ependyma) that
B. Vestibular fibres
may be adherent; but when lie apart the cavity of
C. Proprioceptive fibres
septum pellucidum is a closed space which is lined with
D. Spinothalamic tract
piameter and has no connection with ventricular system
- Lateral wall of cavity of diancephalon (3rd ventricle) is
formed by thalmus, hypothalmus, hypothalmic sulcus & Ans: A. Cochlear fibres
subthalmus. Laterals walls of 3rd ventricle are joined Ref: Essentials of Human Anatomy, 3/e, A.K Datta vol
(gummed) by interthalmic adhesion or massa 4, p.130
intermedia (in 60% of brain). It is a band of gray matter
that extend from one thalamus to another (Gray). It is
not a commissure & there is no interchange of fibres 6. Which of the following thalamic nuclei do not project
between the two sides (last). It gives a fenestrated to neocortex-AIIMS 2003
shadow in images. A. Intralaminar nuclei
B. Reticular nuclei
2. All are seen in the floor of 3rd ventricle except C. Pulvinar nuclei
A. Infundibulun D. Anterior thalamic nuclei
B. Oculomotor nerve
C. Mammillary body
D. Optic chiasma Ans: B. Reticular nuclei
Ref: Gray's .38/e P-1082-86, 11)92
Explanation:
Ans: B. Occulomotor Nerve - Epithalmus consists of habenular commisure,
Ref: Snell's Neuroanatomy 7/e p. 257 posterior commisure, and pineal body (but not
Explanation:- geniculate body)
- 'Non limbic portion of cerebral hemisphere is
Floor of 3rd ventricle is formed by optic chiasma, tuber
k/a Neocortex. Every thalamic nuclei except
cinerium, infundibulum, mamillary body, posterior
reticular nuclei sends axon to different part of
perforated substance and tegmentum of midbrain.
cortex. The output of reticular nuclei is mainly
Occulomotor nerve forms no wall of 3rd ventricle
to other thalatnic nucleic. The dorsal group of
thalamic nuclei project to neocortex. These are
3. Which of the following in not a part of Epithalamus
A. Pineal body

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Pulvinar nuclei, Intralaminar nuclei, Anterior D. Fibres leaving the stria terminalis and reaching
(Rostral) nuclei. habenular nuclei are called as stria medullaris
- Ventral posterior nucleus of thalamus include thalami
medial (not lateral) lemniscus,
spino/solitario/& trigemino - thalamic tracts. Ans: C. Throughout the course, it is related lateral to the
caudate nucleus
Ref: Essentials of Human Anatomy, 3/e, A.K Datta vol
7. Hippocampal formation includes all except 4, p.88-89
A. Dentate gyrus
B. Subicular complex
C. Amygdaloid nucleus 10. Cavity of diencephalon is
D. Entorhinal cortex A. Lateral ventricle
B. Fourth ventricle
C. Cerebral aqueduct
Ans: C. Amygdaloid nucleus
D. Third ventricle
Ref: Gray’s 40/e p 349-51
Ans: D. Third ventricle
Explanation:
Ref: Essentials of Human Anatomy, 3/e, A.K Datta vol
- Hippocampal formation includes 4, 3/e, p.98
parahippocampal gyrus, hippocampus, dentate
gyrus, subicular complex and entorhinal cortex
mn- Phd in subject ENT
11. Thalamus is the largest relay centre for all sensory
- Alveus, fimbria & fornix, mammilo thalamic
inputs EXCEPT
tract body and anterior nuclear group of
A. Touch
thalamus and stria terminalis form the
B. Olfaction
connecting pathays of limbic system.
C. Hearing
D. Pressure
8. Following is true about Amygdaloid body except
A. It belongs to archistriatum
B. It is situated near the temporal pole of cerebrum Ans: B. Olfaction
C. It is anterior to hippocampus and in close proximity Ref: Snell’s Clinical Neuroanatomy, 5/e, p. 375
with the tail of caudate nucleus
D. Inferiorly it is related to anterior part of lentiform
nucleus 12. Followings is true about medial geniculate body
EXCEPT
A. It is situated posteriorly on the ventrolateral surface
Ans: D. Inferiorly it is related to anterior part of of thalamus
lentiform nucleus B. It receives fibres from medial lemniscus
Ref: Essentials of Human Anatomy, 3/e, A.K Datta vol C. It has a relay station on the auditory pathway
4, p.88,79 D. Fibres arising in it form acoustic radiations, which
pass through sublentiform part of internal capsule
of brain.

9. Following is true about stria terminalis except


A. These are the efferent fibres of Amygdaloid body Ans: B. It receives fibres from medial lemniscus
B. They run in the root of inferior horn and floor of the Ref: Essentials of Human Anatomy, 3/e, A.K Datta vol
body of lateral ventricle of brain 4, p.102-03
C. Throughout the course, it is related lateral to the
caudate nucleus

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13. Following is true about lateral geniculate body A. Para ventricular


EXCEPT B. Preoptic
A. It is a part of metathalamus C. Lateral
B. It is a relay station is the visual pathway D. Supra chiasmatic
C. It is connected with superior colliculus of midbrain
and Pulvinar of thalamus Ans: A. Para ventricular
D. Efferent from its form the optic radiations, which Ref: Essentials of Human Anatomy, 3/e, A.K Datta vol
pass through posterior limb of internal capsule of 4, p.109
brain to reach the parietal cortex

Ans: D. Efferent from its form the optic radiations, 17. Following nucleus of hypothalamus is mainly
which pass through posterior limb of internal capsule of responsible for secretion of antidiuretic hormone
brain to reach the parietal cortex A. Preoptic
Ref: Essentials of Human Anatomy, 3/e, A.K Datta vol B. Supraoptic
4, p.68 C. Posterior
D. Lateral

14. Following is true about the fornix of brain except


A. These are the fibres arising predominantly from Ans: B. Supraoptic

hippocampus Ref: Essentials of Human Anatomy, 3/e, A.K Datta vol


B. Body of fornix is separated from corpus callosum 4, p.109
by septum pellucidum
C. Crus of fornix are connected to each other by
BRAIN: CEREBELLUM
hippocampal commissure
D. Pre commissural fibres of fornix reach the
mammillary bodies
CEREBELLUM

1. Purkinje cells from that the cerebellum end in


Ans: D. Pre commissural fibres of fornix reach the
A. Extrapyramidal system
mammillary bodies
B. Cranial nerve nuclei
Ref: Essentials of Human Anatomy, 3/e, A.K Datta vol
C. Cerebellar nuclei
4, p.93-94
D. Cerebral cortex

Ans: C. Cerebellar nuclei


HYPOTHALAMUS
15. Following nucleus of hypothalamus is mainly 2. Efferent tracts from cerebellum arisen from
responsible for controlling circardian rhythm A. Purkinje cells
A. Supraoptic nucleus B. Deep cerebellar nuclei
B. Para ventricular nucleus C. Cerebellar cortex
C. Preoptic nucleus D. Vermis of cerebellum
D. Supra chiasmatic nucleus
Ans: B. Deep cerebellar nuclei
Ans: D. Supra chiasmatic nucleus Ref: IBS Neuro6/e P-158
Ref: Essentials of Human Anatomy, 3/e, A.K Datta vol
Explanation:
4, p.109
- The deep nuclei provide the only output for the
spinocerebellum, & neocerebellum.
16. Following hypothalamic nucleus is mainly
responsible for the secretion of oxytocin
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- Purkinje cells axon are the only output from the A. Vestibule cerebellar
cerebellar cortex, generally pass to deep nuclei. B. Oliver cerebellar
C. Spino cerebellar
D. Ponto cerebellar
3. Following part of vermis of cerebellum belongs to
neocerebellum
A. Lingual Ans: D. Pontocerebellar
B. Central lobule 8. Middle cerebellar penducle transmits…fibres
C. Culmen A. Ponto cerebellar pathway
D. Declive B. Tectospinal pathway
C. Spino cerebellar pathway
Ans: D. Declive D. Middle cerebellar pathway
Ref: Essentials of Human Anatomy, 3/e, A.K Datta vol
4, p. 161 fig 8.3
Ans: A. Pontocerebellar

9. Middle cerebellar peduncle transmits fibres of


4. The term archicerebellum is applied to the following
A. Ponto cerebellar pathway
EXCEPT
B. Tectospinal pathway
A. Lingual
C. Spinocerebellary pathway
B. Uvula
D. Olivo cerebellar pathway
C. Nodule
D. Flocculus
Ans: A. Pontocerebellar pathway
Ans: B. Uvula Ref: Gray's 40/e p. 298
Ref: Essentials of Human Anatomy, 3/e, A.K Datta vol
Explanation:-
4, p. 161 fig 8.3
- Middle Cerebellar Peduncle transmits ponto cerebellar
5. By three cerebellar peduncies, the cerebellum is (afferent) tract; it has no efferent tract. Anterior
attached to spinocerebellar tract is in superior crebellar peduncle,
A. Spinal cord whereas, posterior spinocerebellar tract is in inferior
B. Medulla peduncle. (Mn- Anterior in Superior and Posterior in
C. Midbrain Inferior").
D. Pons - Vestibulo cerebellar (mossy) fibers arise from vestibular
E. B,C & D nerve/ganglion (1°) and nucleus (2° fibers). These fibers
terminate in granular layer of nodule, uvula, vermis
(ipsilaterally = 1°) and flocculus (all bilaterally = 2°)
Ans: B, C &D. Medulla, Mid brain , Pons

6. Structures not passing through inferior cerebellar 10. Vestibulocerebellar tract terminates in the… of
peduncle cerebellum
A. Pontocerebellar A. Flocculus
B. Cuneocerebellar B. Lingual
C. Anterior spinocerebellar C. Nodulus
D. Posterior spinocerebellar D. Uvula
E. A& C E. A, C & D

Ans: A & C . Pontocerebellar & Anterior


Ans: A, C &D. Flocculus , Nodules & Uvula
spinocerebellar
11. Following part of vermis of cerebellum belongs to
7. The inferior cerebellar peduncle has all the following
paleocerebellum
tracts except

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A. Culmen 15. Following afferent fibres of cerebellum are called as


B. Declive climbing fibres
C. Folium vermis A. Olivocerebellar
D. Tuber vermis B. Vestibuocerebellar
C. Tectocerebellar
D. Reticulo cerebellar

Ans: A. Culmen
Ref: Essentials of Human Anatomy, 3/e, A.K Datta vol Ans: A. Olivocerebellar
4, p. 162 Ref: Essentials of Human Anatomy, 3/e, A.K Datta vol
4, p. 164

12. Mossy fibres of cerebellum include following afferent


tracts EXCEPT 16. Following efferent fibres of cerebellum pass through
A. Olivocerebellar the superior cerebellar peduncle EXCEPT
B. Tectocerebellar A. Cerebello – rubral
C. Ventral spinocerebellar B. Cerebello – vestibular
D. Dorsal spinocerebellar C. Cerebello – thalamic
D. Cerebello – hypothalamic

Ans: A. Olivocerebellar
Ref: Essentials of Human Anatomy, 3/e, A.K Datta vol Ans: B. Cerebello – vestibular
4, p. 164 Ref: Essentials of Human Anatomy, 3/e, A.K Datta vol
4, p. 169
13. Following tracts pass through the superior cerebellar
peduncle EXCEPT
A. Hypothalamocerebellar 17. Following is true about substantia nigra except
B. Dorsal spinocerebellar A. It is a neuromelanin containing pigmented
C. Ventral spinocerebellar substance present in midbrain
D. Tectocerebellar B. It is connected with cerebral cortex spinal cord and
hypothalamus
C. It has connections with ventral posterior nucleus of
Ans: B. Dorsal spinocerebellar
thalamus
Ref: Essentials of Human Anatomy, 3/e, A.K Datta vol
D. Lesions of dopaminergic nigro-striated fibres cause
4, p. 167-69
Parkinson’s disease.

14. Following tracts pass through the inferior cerebellar


peduncle EXCEPT Ans: C. It has connections with ventral posterior
A. Posterior spinocerebellar tracts nucleus of thalamus
B. Anterior spinocerebellar tracts Ref: Essentials of Human Anatomy, 3/e, A.K Datta vol
C. Posterior external arcuate fibres 4, p. 138-39
D. Vestibulo cerebellar tracts

Ans: B. Anterior spinocerebellar tracts


Ref: Essentials of Human Anatomy, 3/e, A.K Datta vol BRAIN: MID BRAIN (MESENCEPHALON)
4, p. 167-69
1. Cavity of mesencephalon is
A. Lateral ventricle
B. Third ventricle

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C. Cerebral aqueduct A. 3 cms in length


D. Fourth ventricle B. Connects III. Ventricle to IV ventricle
C. Connects two lateral ventricles
Ans: A. Lateral ventricle D. None of the above
Ref: Essentials of Human Anatomy, 3/e, A.K Datta vol
4, p. 38
Ans:-B. Connects III ventricle to IV ventricle

2. Facial colliculus is seen in


5. Red nucleus is situated in the
A. Midbrain
A. Midbrain at the level of superior colliculus
B. Pons
B. Midbrain at the level of inferior colliculus
C. Medulla
C. Pons at the level of facial colliculus
D. Interpeduncular foosa
D. Medulla oblongata at the level of inferior salivary
nucleus
Ans: B. Pons
Ref: Gray's 39/e p. 291 Ans: A. Midbrain at the level of superior colliculus
Explanation: Ref: Essentials of Human Anatomy, 3/e, A.K Datta vol
4, p. 141
Facial colliculus is a slight elevation in the rhomboid
fossa (or floor of 4th ventricle) produced by the fibers
from motor nucleus of facial nerve looping over
abducent (motor) nucleus. It lies at the inferior end of
medial eminence in pons. BRAIN: PONS

2. True about 4th ventricle is


1. Superior salivary nucleus is situated in the
A. Rhomboid fossa forms floor
A. Midbrain
B. Choroid plexus lies at its floor
B. Pons
C. Connection between two cerebral hemispheres
C. Medulla oblongata
D. Lies inferior to inferior cerebellar peduncle
D. Cerebellum

Ans: B. Pons
Ans: A. Rhomboid fossa forms the floor
Ref: Essentials of Human Anatomy, 3/e, A.K Datta vol
Ref: Gray's Anatomy 39/e p. 291
4, p. 131
Explanation:

- Rhomboid fossa or floor of 4th ventricle has abducent


motor nucleus, dorsal motor nucleus of vagus, 2. Following are the contents of pontine cistern EXCEPT
hypoglossal nucleus, and facial nucleus. A. Basilar artery
- 4th ventricle communicates through cerebral aqueduct B. Labyrinthine branches of basilar artery
of sylvius with 3rd ventricle. C. Posterior cerebellar artery
D. Fifth to twelfth cranial nerves
3. Which nucleus is not found in the floor of the fourth
ventricle
A. Abducens N Ans: D. Fifth to twelfth cranial nerves
B. Dorsal vagal nuclei Ref: Gray’s Anatomy 39/e, p. 278
C. Facial N
D. Hypoglossal N
E. None
Ans: E. None

4. Cerebral aqueduct (Duct of Sylvius)- which is true

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BRAIN: MEDULLA C. Posterior external arcuate fibres


D. All of the above
1. Nuclei of following cranial nerves are present in the
medulla oblongata EXCEPT
A. Hypoglossal
Ans: B. Anterior external arcuate fibres
B. Vagus nerve
Ref: Essentials of Human Anatomy, 3/e, A.K Datta vol
C. Vestibulo – cochlear nerve
4, p. 127
D. Abducens nerve

Ans: D. Abducens nerve


5. Following is true about ‘medial medullary syndrome’
Ref: Essentials of Human Anatomy, 3/e, A.K Datta vol
EXCEPT
4, p. 122-127
A. It is caused because of thrombosis of medullary
branches of AICA
B. There is infarction of ventral medulla

2. Following is true about cerebello medullary cistern C. There is contralateral limb paralysis
D. There is ipsilateral paralysis of tongue muscles
EXCEPT
because of involvement of hypoglossal nerve
A. It lies between clivus and anterior surface of
medulla oblongata
B. It contains posterior inferior cerebellar artery
Ans: A. It is caused because of thrombosis of
C. It can be tapped by a needle passing through the
medullary branches of AICA
posterior atlanto – occipital membrane
Ref: Essentials of Human Anatomy, 3/e, A.K Datta vol
D. Foramen of Magendie communicates with it
4, p. 156

Ans: A. It lies between clivus and anterior surface of 6. Following is true about ‘lateral medullary syndrome’
medulla oblongata EXCEPT
Ref: Essentials of Human Anatomy, 3/e, A.K Datta vol A. It is caused by thrombosis of medullary branches of
4, p. 193 posterior inferior cerebellar artery
B. Lateral and dorsal parts of medulla oblongata are
involved
3. Following white matter fibres are present in the C. Loss of function of nucleus ambiguous causes
paramedian area in medulla oblongata at the level of ipsilateral paralysis of vocal folds as well as palatal
inferior olivary nucleus EXCEPT and pharyngeal muscles
A. Medial lemniscus D. Lesion of spinal lemniscus causes ipsilateral loss of
B. Tectospinal tracts pain and temperature sensations
C. Olivocerebellar tracts
D. Medial longitudinal fasciculus
Ans: D. Lesion of spinal lemniscus causes ipsilateral
loss of pain and temperature sensations
Ans: C. Olivocerebellar tracts Ref: Essentials of Human Anatomy, 3/e, A.K Datta vol
Ref: Essentials of Human Anatomy, 3/e, A.K Datta vol 4, p. 155
4, p. 127

BRAIN: RETICULAR FORMATION


4. Following fibres start from the arcuate nuclei of
medulla oblongata
A. Internal arcuate fibres VERTEBRAL CANAL
B. Anterior external arcuate fibres 1. All are TRUE about intervertebral disc, except

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A. Nucleus pulposus is a remnant of notochord Ref: Essentials of Human Anatomy, 3/e, A.K Datta vol
B. Rich vascular supply 4, p. 203
C. Prolapsed is most common in lumbosacral region
D. None of the above 4. Spinal cord is composed off
A. Grey matter in the centre
B. White matter in the centre
Ans: B. Rich vascular supply
C. Grey matter in the periphery
Ref: Gray's 38th/e P-512-513
D. B and C
Explanation:
Ans: A. Grey matter in the centre
Except for the periphery, the intervertebral disc is
Ref: Gray’s Anatomy 38/e, p. 977
avascular structure.

5. Posterior column of spinal cord is


SPINAL CORD A. Sensory
B. Motor
1. Normally, in adults, spinal cord ends at the level of C. Mixed
A. T12 D. none of the above
B. L1
C. L4 Ans: A. Sensory
D. S1 Ref: Gray’s Anatomy 39/e, p. 314-15

Ans: B. L1 6. Which component of spinal cord is analogous to


Ref: Essentials of Human Anatomy, 3/e, A.K Datta vol mesencephalic nuclei of trigeminal
4, p. 203
A. Spinothalamic tract
B. Spinocerebellar tract
C. Fasciculus gracilis
Essentials of Human Anatomy, 3/e, D. B and C
B
A.K Datta vol 4, p. 203

Ans: D,B and C. Spinocerebellar tract and Fasciculus


2. Following nuclear groups are present in the dorsal
gracilis
horn of spinal cord EXCEPT
Ref: Gray’s Anatomy 39/e, p. 314-15
A. Substantia gelatinosa
B. Nucleus proprius
C. Clarke’s column
7. The length of the spinal cord is
D. Phrenic nucleus
A. 12 inches
B. 15 inches
Ans: D. Phrenic nucleus C. 18 inches
Ref: Essentials of Human Anatomy, 3/e, A.K Datta vol D. 21 inches
4, p. 211-12
Ans: C. 18 inches
3. At birth spinal cord extends up to Ref: Gray’s Anatomy 39/e, p.775
A. L2
B. L3
C. L4
D. L1

Ans: B. L3 SPINAL CORD: TRACTS


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A. Motor tracts
B. Sensory tracts
1. Following tract carries pain sensation C. Mixed tracts
A. Posterior spinocerebellar D. Sympathetic
B. Anterior spinocerebellar
C. Lateral spinothalamic
D. Vestibulospinal Ans: A. Motor tracts
Ref: Gray’s Anatomy 39/e, p. 320

Ans: C. Lateral spinothalamic


Ref: Essentials of Human Anatomy, 3/e, A.K Datta vol
4, p.217

2. Which of the following tracts is seen in the posterior


column of spinal cord
A. Lateral spinothalamic tract
B. Fasciculus gracilis
C. Fasciculus cuneatus
D. Rubrospinal tract
E. Posterior spinocerebellar

Ans: B & C. Fasciculus gracilis & Fasciculus cuneatus

Ref: BDC 4/e Vol III P-314

Explanation:

Fasciculus gracilis & cuneatus tracts are seen in


posterior column of spinal cord.

3. Following tracts are included in the posterior


funiculus of spinal cord EXCEPT
A. Fasciculus gracilis
B. Fasciculus cuneatus
C. Posterior spinocerebellar tracts
D. Posterior intersegmental tracts

Ans: C. Posterior spinocerebellar tracts


Ref: Essentials of Human Anatomy, 3/e, A.K Datta vol
4, p.215

CLASSIFICATION OF TRACTS

4. Pyramidal tracts are an example of

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