INTRODUCTION TO NEUROANATOMY

Objectives:

By the end of the topic, you should be able to:

- discuss the nervous system and its function

- differentiate the main division of the nervous system

- discuss the basic function of each parts of the nervous system

- discuss other structures found in the nervous system

NEUROANATOMY

 is the study of the structure and organization of the nervous system

 is the study of the relationship between structure and function in the nervous system

Nervous system

• One of the smallest but the most complex systems of the body

• has a mass of 2kg (4.5lbs) and about 3% of the total body weight

• made up of organized networks of billions of neurons and more neuroglia

General function of Nervous system

• Sensory function – detecting sensation or stimuli

• Integrative function – process information by analysing and interpreting for appropriate

responses

• Motor function – elicit appropriate responses such as muscle contraction and glandular
secretion

Two Principal of Cell in the Nervous system

A. Neuron or Nerve cell

- it is the functional and anatomical unit of the nervous system

- are excitable cells that are specialized for reception of stimuli and conduction of impulses

- these are cells that respond to electrical impulses called “Action potential” and may travel at a
speed of 0.5 – 130 m/sec

- main parts are cell body and nerve fibers or neurites (which includes axon and dendrites)

B. Neuroglia or Glial cells

- these are supporting cells of the nervous tissue

- can either be astrocytes, oligodendrocytes, Schwann cells, microglia, ependymal and satellite
cells

Organization of the Nervous System

Two Main Divisions

1. Central Nervous System – responsible for processing different kinds of sensory information;
source of thought, emotions and memories

2. Peripheral Nervous System – all nervous tissues outside the CNS

Division of the Peripheral nervous System

 Somatic Nervous System – responsible for conscious control of only the skeletal muscle, thus
voluntary in control

 Enteric nervous System – brain of the gut; responsible for monitoring chemical changes,
contraction and stretching of the walls of the gastrointestinal tract (GIT)

 Autonomic Nervous System – responsible for unconscious control of smooth and cardiac
muscles and glands; thus involuntary in control

Divided into:

 Sympathetic – for fight and flight response

 Parasympathetic – for rest and digest response

 Central Nervous System

Central Nervous System

- includes the brain and the spinal cord protected by the skull and vertebral column

- main center for correlation and integration of nervous information

- suspended in a fluid called cerebrospinal fluid (CSF)

- composed of neurons and neuroglia

- its interior is made up of gray matter and white matter

Brain

- enclosed and protected by the skull

- surrounded by meninges

- contains spaces or cavities called ventricles that contains cerebrospinal fluid (CSF), where brain
is suspended

- accounts for about 2% of the body's weight, contains many billions of neurons and glial cells

STRUCTURES found in the CNS

- Meninges

- Blood brain barrier

- Blood- CSF barrier

- Cerebrospinal fluid (CSF)

- Ventricles of the brain

Meninges

- these are coverings of the brain which wraps around the CNS

- there are three meninges, namely Dura mater, Arachnoid mater and Pia mater

Dura Mater

- a.k.a. Pachymeninx

- A tough fibrous outermost membrane of the brain that bends inward into septum that divide
cranial cavity into freely communicating space lodging subdivision of brain

- has 2 layers separated by venous sinus:

 Periosteal or endosteal layer

 Meningeal layer

Extensions of the Dura Mater

- Falx cerebri – sickle shaped folds of dura between the cerebral hemisphere

- Falx cerebelli – small sickle shaped folds of dura between the cerebellar hemisphere

- Tentorium cerebelli - crescent shape; found between occipital lobe and cerebellum

- Diaphragma sellae – small circular fold; forms at the sella turcica; has an opening for the
passageway of the hypophysis cerebri

Arachnoid Mater

- A thin delicate, avascular impermeable middle membrane

- Separated from the dura by “Subdural space” – contains venous sinuses

 - Separated from the pia by “Subarachnoid space” – filled with CSF and major cerebral arteries
and veins and extend up to S2 vert.

- Arachnoid and Pia mater is also called as leptomeninges

Pia Mater

- A thin delicate, vascular innermost membrane that is closely attached to the brain & spinal cord;
wraps around the blood vessel and extends deep to the sulci & fissures of the brain

- Forms the tela choroidea, choroid plexus of the third & fourth ventricle, filum terminale and
dentate ligament of spinal cord

Blood Brain barrier (BBB) and Blood Cerebrospinal fluid (CSF) barrier

- Provide stability by isolating the nervous system from the blood

- Are semipermeable membrane or barrier that protect the brain and spinal cord from potentially
harmful substances while permitting gases and nutrients to enter the nervous system

Blood Brain Barrier (BBB)

- Isolates the nervous system from the blood

- Its permeability is inversely related to the size of the molecules and directly proportional to their
lipid solubility

- Ex: gas & water readily passes the BBB

glucose and electrolytes pass more slowly

plasma protein – impermeable

- structures separating the blood capillary to the extracellular space of neurons and neuroglia
contain:

 Tight junctions (endothelial cells) in the capillary wall – largely responsible for BBB

 Continuous basement membrane

 Foot processes of astrocytes that adhere to the capillary wall

- Some areas of the brain has no BBB because their capillary endothelium contains fenestrations
that allows protein and organic material to pass

- Examples of areas of the brain has no BBB: the basal hypothalamus; pineal gland; the area
postrema of the fourth ventricle; several small areas near the third ventricle

Blood Cerebrospinal fluid (CSF) barrier

- Allows free passage of gases, water and lipid soluble substances from the blood to the CSF;

- but macromolecules such as proteins an most hexoses other than glucose are unable to enter

- Structures forming the barrier:

 - Endothelium – has fenestrations

- Continuous basement membrane

- Scattered pale cells with flattened processes

- Continuous basement membrane with choroid epithelial cells containing tight junctions

Cerebrospinal fluid (CSF)

- A clear colorless fluid containing inorganic salts similar with blood plasma

- Glucose content is half of the blood and a trace of protein, lactic acid, urea, cations (Na, K, Ca,
Mg), anions (Cl, HCO3) and some WBC

- Total volume/amount: 130 mL (Snell); 80 – 150mL or 3 – 5 oz. (Tortora)

- Normal pressure: 60 – 150 mm of water

- Contains 0 -3 cells/mm3 of lymphocytes

- Formed mainly by the choroid plexus

- Function:

 Bathes the external and internal surface of the brain and spinal cord that serves as a
cushion from mechanical trauma

 provides mechanical support of the brain and acts like a protective water jacket

 Serve as a reservoir and assists in regulation of the contents of the skull

 Plays an active role in the nourishment of the nervous tissue

 It controls brain excitability by regulating the ionic composition

 carries away metabolites (because the brain has no lymphatic vessels)

 provides protection from pressure changes (venous volume versus CSF volume).

- 3 ways by which CSF contributes to homeostasis

 Mechanical protection

 Chemical protection

 Circulation

- CSF examination – via spinal (lumbar) tap at the level of L3 – L4 or L4 – L5 interspace while pt. at
lateral decubitus position

Absorption of Cerebrospinal fluid (CSF)

 Arachnoid villi – fingerlike extensions - main sites of absorption of CSF that projects into the
dural venous sinuses especially at the superior sagittal sinus
 - Arachnoid granulations – an elevation formed by groups of arachnoid villi; increase in number &
size with age and tends to calcified with advanced age

- Normal rate of absorption: 20 mL/hr (480 mL/day)

- Queckenstedt sign - detect blockage of subarachnoid space

Ventricular System of the Brain

Ventricular System of the Brain

- Derived from the cavity of the neural tube

- Lined by the ependyma and filled with CSF

- The ventricles acts as a cavity of the different parts of the brain

- Continuous from the brain to the spinal cord

- Contains: the lateral ventricle, third ventricle, fourth ventricle in the brain, and terminal
ventricle at the inferior end of the spinal cord

Lateral ventricle

- (+) 2 lateral ventricle; one in each hemisphere of the cerebrum; roughly C – shaped cavity
divided into:

- Body – occupies the parietal lobe

- Horns (ant, post & inf.) – extends in the frontal, occipital & temporal lobes respectively

- has choroid plexus and tela choroidea

- Interventricular foramen/Foramen of Monro

Third ventricle

- A slitlike cleft between the two thalamus

- Communicates anteriorly with lat. vent. via interventricular foramen

- Communicates posteriorly with fourth vent. via cerebral aqueduct

- has choroid plexus and tela choroidea above the roof of the ventricle

 Cerebral aqueduct/Aqueduct of Sylvius

Fourth ventricle

- A cavity situated anterior to cerebellum and post to the pons and medulla

- Continues above with cerebral Aqueduct and below with the central canal of the spinal cord

- has a T shaped choroid plexus and has 3 openings:

 Foramen of Magendie – located at the median aperture at the roof of fourth vent.

 Foramen of Luschka – two lateral opening

Cavity At the Spinal cord

- Central canal of the spinal cord - opens superiorly at the medulla

- Extends the whole length of the cord at the subarachnoid space - filled with CSF

- Inferiorly at the conus medullaris, it expands to form the terminal ventricle

- Closes inferiorly

Summary of the Cavities of the Brain/SC and their corresponding Cavities/Ventricle

- Cerebrum – Lateral ventricle

 Interventricular foramen/Foramen of Monro connect lateral to third ventricle

- Diencephalon – Third ventricle

- Midbrain – Aqueduct of Sylvius

- Hindbrain – fourth ventricle

 Foramen of Magendie and Luschka – connects fourth ventricle to the central canal of
spinal cord

- Spinal Cord – Central canal & terminal ventricle

Mnemonics on CSF Flow

- Come (Choroid plexus)

- Let (Lateral ventricle)

 - Me (foramen of Monro )

- Treat (Third ventricle)

- Sylvia (Aqueduct of Sylvius)

- For – Fourth ventricle

- Lunch – Foramen of Luschka

- Mamaya - foramen of Magendie

- Sa – subarachnoid space of spinal cord

- Aristocrat – Arachnoid villi

Division of the Brain

Three Division of the Brain

1. Prosencephalon (forebrain) – divides into telencephalon and diencephalon

2. Mesencephalon (Midbrain)

3. Rhombencephalon (hindbrain) - divides into myelencephalon (medulla oblongata),

metencephalon (pons) and cerebellum

 Brainstem – part of the brain that remains when cerebrum and cerebellum are removed

Prosencephalon

 Cerebrum (Telencephalon)

- largest part of the brain

- divided into two cerebral hemisphere separated by the longitudinal fissure, and connected by a
white matter called corpus callosum

Features:
 - cortex – the surface layer of each hemisphere composed of gray matter. which is turned
into folds called “Gyri/gyrus” that are separated by fissures or sulci

- Lobes – formed by large fissures/sulci

Main Lobes of the brain

- Frontal lobe – found anterior to the central sulcus and superior to the lateral sulcus

- Parietal lobe – situated posterior to the central sulcus and superior to the lateral sulcus

- Temporal lobe – found inferior to the lateral sulcus

- Occipital lobe – inferior to the parieto-occipital sulcus

 Basal ganglia - a collection of masses of gray matter situated within each of the
cerebral matter

- divided into corpus striatum, amygdaloid complex (amygdala) and claustrum

 Corpus striatum – situated lateral to the thalamus; divided by the internal

capsule into caudate nucleus and lentiform nucleus

Diencephalon

- hidden from the surface of the brain, consist of the ff:

 Thalamus – egg shape mass of gray matter that lies on each side of the third ventricle; its
posterior swelling is called pulvinar

 Hypothalamus – controls ANS and endocrine system

 Epithalamus – contains pineal gland and habenular nucleus

Subthalamus – helps control bodily movement

 Lateral view of the brain showing the major parts of the brain

Mesencephalon or Midbrain

- narrow part of the brain connecting the forebrain and hindbrain

- its narrow cavity is the cerebral aqueduct

- connected to the cerebellum via superior cerebellar peduncle

Features:

 Tectum – lies post. to the cerebral aqueduct that contains four swelling (2 superior and 2
inferior colliculi)

 Cerebral peduncle - lies anterior to the cerebral aqueduct; divided by a pigment of gray matter
called substantia nigra into crus cerebri (ant. part) and tegmentum (post. part)

 Interpeduncular fossa

Pons or Metencephalon

- derived from a word meaning “bridge”

- located anterior to the cerebellum, inferior to the midbrain and superior to the medulla
oblongata

- Ant. lies the basilar groove containing the basilar artery

- attach to the cerebellum via the middle cerebellar peduncle

- pons is separated by the fibers of trapezoid body into basal part (ant.) and tegmentum (post
part)
 Medulla oblongata or Myelencephalon

- conical shape in structure situated anterior to the cerebellum and connected superiorly to the
pons and continues inferiorly to the spinal cord

Features:

 anteriorly is dived by a median fissure and on each side lies a swelling called pyramids

 Olive - posterior to the pyramids

 inferior cerebellar peduncles – lies post. to the olives and attach the medulla to the cerebellum

 Gracile tubercle – contains nucleus gracilis

 Cuneate tubercle – contains the nucleus cuneatus

Image showing the brainstem with the cerebellum

Cerebellum

- located at the posterior cranial fossa; post. to the pons and medulla oblongata

- divided into two cerebellar hemisphere connected by a white matter called vermis

- the surface is thrown into folds called folia

- divided into three main lobes and has three functional division
Main lobes of the Cerebellum

- Anterior lobe – separated from middle lobe by a V-shaped fissure called primary fissure

- Middle/Posterior lobe – largest part of the cerebellum; found between primary fissure and
uvulonodular fissure

- Flocculonodular lobe – post to the uvulonodular fissure

Functional Division of the Cerebellum

- Paleocerebellum – maintains posture and performance of gross voluntary movt of head and
body

- Neocerebellum – smooth, coordinated fine voluntary movt

- Archicerebellum – maintaining balance and equilibrium

Spinal Cord

- conical shape and tapering at its end, consists of gray and white matter situated within the
vertebral column

- responsible for propagation and integration of information to and fro with the brain and
peripheral nervous system

Peripheral Nervous System

- contains nervous tissue outside the CNS, which includes Cranial nerves, associated ganglia,
spinal and peripheral nerves

 Cranial nerves

- are pair of nerves that arises directly from the brain and connect the brain to different parts of
the head, neck and trunk

- there are twelve cranial nerves that functions either sensory, motor or both and others have
autonomic function
 Spinal nerve

- are nerves that emerges out of the spinal cord, consists of:

 Afferent fibers / sensory fibers

 Efferent fibers / motor fibers

 Associated ganglia

 these are cell body found outside the CNS, such as autonomic ganglia and cranial nerve ganglia