RETICULAR SUBSTANCE(of the brain stem)

• Its a large network of neurons; with different shapes and forms and FIBERS—>mainly the the
special disposal of the fibers is transversal to the longitudinal axis of the brainstem
-In the transversal plane we have dendrites, and ascending and descending fibers
-Where is it located the RETICULAR SUBSTANCE—>around the LONGITUDINAL AXIS OF
THE BRAINSTEM
-It continues caudally with the RETICULAR SUBSTANCE OF THE spine
-Continues Cranially with the SUBTHALAMUS and the Lateral region of the hypothalamus.
• so its a system along the Nervous system
• Whats the role of it?
-It receives collaterals from almost all the ascending pathways, so retic substance receives
afferences (collaterals) from all the ascending pathways EXCEPT FOR THE MEDIAL
LEMNISCUS
-What happens with this large amount of nervous input that comes to the Reticular system—
>the input loses its specificity when it reaches the reticular system

-again; the reticular system is a large network of neurons and fibers disposed transversal to the
brainstem by the dendrites and the axons; parallel to the longitudinal axis of the brainstem
-Where is it situated? —> In the central part of the Tegmentum; around the Cerebral aqueduct
(Of Sylvius), and continues the reticular substance of the spinal cord and superiorly reaches the
subthalamic substance
-How it works? —>it receives specific impulses from the ascending pathway and those impulses
lose the specificity in the RETICULAR SUSTANCE.
-Ret substance fills the spaces between the ascending and desc pathways and the nuclei of the
brainstem; we have 3 types of systems in the brainstem 1)ascending and descending pathways
2)all nuclei of the brainstem 3)Reticular substance
-How to describe the Reticular substance> we will talk only about the most important nuclei
• Generally speaking, we have median, medial and lateral columns of NUCLEI
• Medial column has paramedian and central nuclei; we all talk about the CENTRAL nuclei
CENTRAL NUCLEI:
-The central tegmentum tract passes through these central nuclei and separate them into 2
parts; medial part and lateral part
-The Lateral part: receives afferences; all types of afferences of the ascending pathways
EXCEPT FROM THE MEDIAL LAMNISCUS
-The medial part; is the Efferent part, made by the axons, the axons go to the superior part of
the nervous system(to the brain) and go also to the SPINE —>Reticulo-Cortical tract that
reaches the cortex(Ascending fibers) and Reticulo-Spinal tract(Descending fibers)
-The ascending fibers; We call these fibers the ASCENDING ACTIVATING RETICULAR
SYSTEM(AARS); these fibers are the MOST IMPORTANT PART OF THE RETICULAR
SYSTEM;
-What is the function of the AARS? —> It sends a small amount of impulses but Permanent to
the Cerebral Cortex and realizes the functional CORTICAL TONUS of the brain; Due to the
functional tonus of the brain we have the conscious state
-SO, AARS maintains the CORTICAL TONUS of the brain; so its responsible for the
CONSCIOUS STATE. ; if a lesion damages the AARS—>the patient loses consciousness and
cant be aroused to interact(COMA state)
-so when we are awake, the cortical tonus is present, when tonus disappears we fall asleep
THUS, AARS is involved in the mechanism of sleep

• 2 types of sleep
-During sleep, the AARS system is inhibited, so the CORTICAL TONUS DISAPPEARS; using
eeg whe observe 2 periods of sleep
1)Recuperative/superficial sleep
2)Paradoxical/deep sleep
-The sleep is a cyclical phenomena, by EEG we find 2 types of sleep periods; the recuperative
and paradoxial
1)Recuperative: SLOW WAVES; when the patient has slow waves, patient is agitated, the
person has BIG TONUS OF THE NECK, REFLEXES ARE PRESENT, MOVEMENTS AND
MYOSIS…so its like a quite brain but a Restless body
2)Paradoxical sleep; fast waves in EEG, so a restless brain with a quite body; how does the
person look?—->Person has MYDRIASIS, and then all the phenomena which are connected
with the PARASYMPATHETIC TONUS like: Hypotension, Bradypnea(slower respiratory rate),
Bradycardia, RAPID EYE MOVEMENT, and AN ERECTION
Frequency of the 2 types of sleep:
• we have usually 4-5 cycles per night
-1 hour/ 1 hour and a half—>Recuperative type of sleep; which is interrupted by 15 minute
periods of Paradoxical sleep(RAPID EYE MOVEMET REM)
-The cycle when patient is fallen asleep or awake is called NICTEMIRAL cycle (cycle of light
and darkness)
-To feel the feeling of good rest what is necessary? —>The arousal reaction after the
PARADOXICAL sleep; if the awakeness is before the paradoxial sleep, the patient is restless
and feels discomfort so its important that the arousal reaction appears after the
paradoxical(REM) type of sleep
-Nictemiral rythm; the ryhtm of darkness and light, people must sleep when its darkness and
must be awake when its dark; so the cycle of the nature of the human MUST BE PARALLEL;
cuz also into the THALAMUS we have an osilatory cycle depending on the LIGHT; so we
depend on the light!!;
-during darkness when light disapperas the epiphysis is stimulated by the sympathetic pathway
and produces Melatonin; For Melatonin there is a nucleus called SUPRACHIASMATIC
NUCLEUS which is like a device that puts the sleep on on and off; when suprachiasmatic
nucleus is activated by the melatonin, that nucleus is on for the sleep so like Melatonin”turns it
on”….During light when its not activated by MELATONIN, IT’S OFF for the sleep(no sleep)
—->That suprachiasmatic nucleus activates the nuclei of the reticular substance named THE
RAPHE NUCLEI; Those Raphe nuclei produce SEROTONIN which is an inhibiting substance
and SEROTONIN inhibits the AARS and the Cortical tonus(tonus of the cortex) disappears and
the patient falls asleep
-But what happens? —> The amount of the SEROTONIN grows, and when the amount of
serotonin reaches a specific level, this specific amount of serotonin stimulates another nuclei of
the reticular substance in the brainstem called LOCUS COERULEUS; and locus coeruleus
produces NOREPINEPHRINE and the NOR produces on the brain the FAST WAVES and the
patient gets the PARADOXICAL SLEEP
; not only the LOCUS COERULEUS is involved in the PARADOXICAL(REM) sleep, there are
involved another Reticular nuclei which produce mainly Ach; BECUASE we saw that into the
REM/paradoxical of the sleep, we have parasympathetic function (Bradycardia, hypotension
bradypnea)
Question: what types of mediators produce the PARADOXICAL/REM type of sleep?
—>NOR and ACH(mainly for the parasym)
• How appears the awakeness/arrousal reaction; these phenomena are cyclical; serotonin
decreases serotonin increases ach decreases ach increases until the capacity of these cycles
disappears, so, the brain is exhausted from these mediators, those cycles of serot and ach
are repeated until the mechanism is exhausted and the THALAMUS recovers the information
from the ascending pathways and practically the thalamus recovers the ascending pathways
and sends impulses to the cortex of the brain
-So in which phenomena consists the arrousal reaction—>mainly the thalamus recovers the info
from the ascending pathways and then send these info to the brain cortex and the patient is
awake
-rapid eye movement; that period of the sleep is when we dream and the dream is connected to
the mediation of the dopamine; we have a circuit of the dreams; the first impulses start in the
brainstem but the brainstem has no capacity of the will, its simple electrical impulses; those
impulses reach normally the frontal lobe but the frontal lobe is inhibited(its activity is decreased
cuz of the sleep) and unusually these impulses reach the temporal and the occipital lobe; the
occipital lobe sends the impulses by the optic pathway back to the retina and stimulates the
cones and rodes; the stimulated rodes and cones send the info back to the occipital lobe (retro
projection) and the occipital lobe sends the info to the boss of the brain(frontal lobe) but frontal
lobe is in hypoactivity, due to that hypoactivity, we have the unusual aspect of the dream ; when
the occipital lobe send abnormally the info to the eyes, the eyes try to put the image on the
center of the retina, but cuz its impossible, cuz we don’t have an image (we have an image
when it starts from outside the body) and the eyes move in all directions (rapid eye movement)
trying to put the image on the retina
ANATOMY; CORTICAL ASCENDING PATHWAYS
sensory, motor and associative
• the sensory area, a region in the brain where ends the ascending pathways
- We have 3 types of sensory areal
1)principle 2)secondary 3supplementary
that classifcation cuz if appears a lesion into the sensory area(principle), the patient loses the
sensation.
; but if appears a lesion in the secondary area—>its possible that the patient doesnt lose the
sense
-a well known sensory area its the main somatosensory area in the postcentral gyrus in the
partieal lobe; areas numbers 1,2,3 in those areas, all the body, considering the main organs that
havae receptors for the kinesthetic pathways, tactile pathywas, algesic pathways,
temperature..all those receptors project into this POSTCENTRAL GYRUS;
and we can obtain here a projection named SENSORY HOMONCULUS; its a charectaristic
drwaing of human being, its reversed, and different segments have different representations;
—>the tongue is very well represented in comparison with the abdomen
-its interesting how this area works; when information reach this area, these neurons send the
info into the parietal areas which are involved in the memory, and the brain compares the new
info with other info which are already in the brain; THIS MECHANISM IS CALLED “GNOSIA”
-GNOSIA is a greek word means the power of someone that knows things;
-its a general mechanism of the brain
-What does Gnosia mean?—>It means comparing the recent information that reaches the brain
with the previous information ; when that area is broken —>APPEARS ASTEREOGNOSIA;
(without Gnosia) which means we dont recognize a part of the body so like we see the hand but
we dont recognize that its a hand; In the same time, its about the stereoscopic image (we lose
that capacity) —>So again, disease is called ASTEREOGNOSIA
• We have also secondary and supplementary (we dont have to know more about them)
• THE VISUAL/OPTIC AREA; 17,18,19
-The main/primary visual area is 17, located on the margins of the CALCARINE sulcus in the
OCCIPITAL LOBE; 50CM (LARGE AREA)
-In the layer number 4, that area has STRIA GENARRI; cuz of that genarri fascicle, it called
STRIATE AREA; here ALL THE RETINA is projected, and the MACULA is projected
POSTERIORLY.
-What happens with the info from the primary area (17)? —->these info are sent to AREA 18
which sends the info by 2 fasicles named LONGITUDINAL FASCICLES OF THE
BRAIN(superior and inferior)—>INTO THE FRONTAL LOBE
again, optic pathway sends info into primary visual area (17)—>and primary area sends info to
area 18—>which is connected with the Motor area of the frontal lobe; and cuz of that
connection, we can move to a specific direction when we see someting
-If the person becomes blind, the motor area of the frontal appears INVOLUTED.
• Visual area 19; which is involved in the process when we see something in the same time with
both eyes(CONVERGENCE VISION)
• Auditory area;
Are very easy to recognize cuz they are located in the SUPERIOR TEMPORAL GYRUS
—>in AREAS 41, 42 , 22 ; here we find transversal gyri of HESCHL
-When the 22 area is damaged, appears the SENSORY APHASIA(person hears the speech but
doesnt understand what it means)
• EFFERENT AREA;
-Located in the PRECENTRAL GYRUS, where we find the type of projections of the body
named MOTOR HOMONCULUS (same idea as the sensory but motor); the Hands and the
digits are very well represented
-Here we see the BIG Pyramidal NEURON OF BETZ; to control the muscles, we have a big nr
of huge PYRAMIDAL NEURONS which controls INFERIOR LIMB MUSCLES.
- The most efficient neurons(BIG PYRAMIDAL NEURONS) control the muscles of the
INFERIOR LIMB (not superior!!!) why?—>cuz its more important to escape during a
threatening situatuon lol like escaping from dinosaurs haha.
IMPORTANT FOR FINAL EXAM:
-On the motor pathways:
the motor pathways have 2 neurons
1)One in the brain and called the CENTRAL/FIRST NEURON and
2) The second neuron is situated in the anterior horn of the grey matter and called the
PERIPHERIC NEURON/SECOND NEURON/FINAL MOTOR PATHWAY
—>how many neurons we find in descending pathway? —>2
one is central in the precentral gyrus
second one in the anterior horn of grey matter of the spine its named is mentioned above
-THIS TOPIC IS THE MOST IMPORTANT IN ALL THE SEMESTER;
-Cuz in the case of a lesion of the central MOTOR neuron —>APPEARS PARALYSIS aka
PLEGIA
-Monoplegia — when one limb is involved
-Hemiplegia — when superior and inferior limbs from one side are involved
-Paraplegia — when 2 superior limbs or 2 inferior limbs are involved (paralysed)
-Tetraplegia — when ALL THE LIMBS ARE PARALYSED.
; initially that paralysis for the FIRST month its HYPOTONIC and WITHOUT REFLEXES
; AFTER 1 MONTH, the paralysis becomes hypertonic, SPASTIC(long spasm), exaggerated
reflexes
—>The recovery of the movements is not fast, it starts from the center to the periphary, and its
IMPOSSIBLE to recover the small (FINE) movements
-in the case of Peripheric motor neuron LESION; —> the patient has PARALYSIS with hypotony,
ATROPHY of the muscles and without reflexes;
-Not to forget that the MAIN DESCENDING PATHWAYS DECUSSATE; so when a lesion of the
brain appears on one side of the brain, the paralysis is present on the other side of the
body(CONTRALATERAL); the main descending pathway deccusate in the pyramidal
decussation of the medulla and small part in the spine
Association areas;
connected with the sensory and motor areas, and the axons of neurons from that area REMAIN
IN THE BRAIN;
-some of those areas are involved in the GNOSTIC PROCESSES(capacity to know the things
about the world?)
-Other association areas are involved in the PRAXIS (Praxis is the ability to perform voluntary
skilled movements)
-In the lesion of the association area involved in PRAXIS—>APPEARS APRAXIA;
The patient knows what he is asked to do, but he couldn’t perform/execute it
; this pathology is very frequent in patients with VASCULAR NECROSIS of the brain

After birth, the both hemispheres are equal, we have to know that if do an action, both
hemispheres work simultanously, cuz the brain(the cortical part of the brain) is like a large
electrical network with wire;
so if we do something both hemispheres work in the same time
- But, one of the hemispheres is PREFERED to command the processes;—>the situation is
called DOMINANCE of one of the hemispheres;
-The dominance appears cuz the the child starts using mainly one hand; so like if the child starts
using the right hand, the dominance is in the left hemisphere of the brain
-So, in that way appears a difference between hemispheres;
lots of people underline the differences but actually the differences are not that important cuz
both hemispheres are more or less equal and are involved in all the actions BUT when we
aquire a hand/ or foot preference,”we develop a dominant hemisphere”; its better to say a
PREFERENCE hemishpere and NOT DOMINANCE cuz there is no really a dominant one
good to know; 45 years old CEO had a brain tomography and results showed that he almost
had no brain (literally) ; the cortex was only a very thin layer near the bone and that patient lived
normally until 45 years of age? sound insane but yes its possible! cuz the brain has
PLASTICITY;
plasticity means that the brain evolves, so like if the doctor removes a brain hemisphere of a
child, after 10 years we find that the hemisphere has evolved again and filled all the space again
; traditionally we learned that neurons don’t regenerate; ITS NOT TRURE—>some neurons
have the capacity to regenerate
• MEMORY PROCESSING ; its like a highway of the impulses in the brain, when an impulse
with a particular intensity takes the highway path (goes from a specific synapse to another
synapse and another..until reaching the particular neuron), and repeats that pathway—>that
pathway that was used by an impulse remains in the same situation and this is how we make
memories; memories are like highways of impulses in the brain; if we dont send time by time
impulses on those highways, the synapses disappear and the neurons move the dendrites
into another connections and “Establishes another highway”
CEREBELLUM LECTURE 4
-Cerebellum is a nervous organ involved in the control of movement; in the fine control of the
movement; so if main nervous pathway is in that direction, the cerebellum is parallel to the main
nervous pathway;
-Cerebellum doesnt “decide” the movement, it rather accommodates the movement..I’ts
connected with hemispheres of brain with some extrapyramidal nuclei like red nucleus, striatum,
the olives and vestibular nuclei.
-Has more AFFERENTS than Efferents.
-Not connected directly with the spine; it influences movements controled by the spine through
the nuclei; stiatum, red olives, vestibular nuclei. so it works in some circuits which involve the
extrapyramidal nuclei.

-Involved in the control of fine movement, muscular tonus and equilibrium—>Doesn’t directily
conrtol the movement; between the cerebellum and the 2nd neuron of the anterior horn of grey
matter, there are the extra pyramidal nuclei; striatum, red nuclei, olives, and vestibular nuclei.

-It looks like the brain; 2 hemispheres same way like the brain, connected by a central part
called vermis.
-On the surface we find grooves which separate cerebellar folia, cerebellar lobules and
cerebelar lobes. (depending how deep is the groove)
Postion: lies in the posterior fossa of endobase(posterior cranial fossa)
-between cerebellum and occipital lobes we have part of the dura mater named cerebellar tent/
tentorium; seprates cerebellum from occipital lobe of the cerebrum, and in the same time closes
the posterior cranial fossa giving rise to the condition of the compartment syndrome.
When there is a hemorrhage or something that causes the pressure to grow in posterior fossa;
the organs there will be compressed!! what happens if they are compressed? some of the
lobules of the Cerebellum will protrude through the occipital foramen, these lobules are called
the tonsila or amygdala of cerebellum—> they press the medulla and cause cardiac and
respiratory arrests.
- so normally the posterior fossa is closed, contains the cerebellum and the brainstem, when
the pressure grows in post fossa the events we mentioned above will occur (cardiac and
respiratory arrests) cuz of medulla compression.

• Cerebellum is posterior to 4th ventricle; 4th ventricle is situated between the cerebellum,
medulla and the pons.
• The ependymal canal which comes from the spine and medulla—>will open at dorsal aspect
of pons giving rise to the 4th VENTRICLE.
• on the post wall of the 4th ventricle, we have the choroid plexus
- THE CHOROID PLEXUS:
The posterior wall of the 4th ventricle is made by the TELA CHOROIDEA of the 4th ventricle;
this is formed by pia mater and the ependym of the 4th ventricle.
between the epyndmal pia we have vessels and c.t with glomerular aspect which gives rise to
the choroidal plexus.
(choroidal arteries, veins, capillaries —>take a fold of pia mater; this structure/tuft and the fold of
pia matter is called TELA CHOROIDEA. when tela choroidea is covered by lining ependymal
cells its called choroid plexus)
-the plexus secretes the csf INSIDE THE VENTRICULAR SYSTEM.
Practically the plexus hangs on the Tela choroidea and produces csf inside the ventricle
—>Then the fluid fills the ventricular system and then by the Magendie(lateral) and
Luschka(median) foramina reach the subarachnod space, the fluid fills the subarachnoid space
and finally its reabsorbed by the Arachnoid villi(bunch of Arachnoid villi make Arachnoid
granulations) into the blood of the Sagittal sinus of the dura mater. (Superior sagittal sinus is
between the 2 layers of Dura mater).
-Choroidal plexus is T shaped, so like the long part of T is expelled by Magendie foramen and
branches of the T are expelled by the Luschka(2) foramena into the Subarachnoid space.
Wall of 4th ventricle is between inferior peduncles of cerebellum; these peduncles are
connected by Tela Choroidea which has 3 foremana;Luscka (2) and Magendie.
• Inside the ventricle if foramena/orifices are blocked during meningitis; when meninges
become inflammed, the membrane starts to exudate proteins and the proteins close the
orifices/foramena and interrupt the csf circuits, so amount of csf grows in Ventricular system,
so the pressure grows and presses the floor of the 4th ventricle (The Rhomboid fossa).
• In the floor of rhomboid fossa we have the nucleus of the CN 6 Abducens and the nucleus of
CN 7 Facial; The region that surround the nuclei is called the Facial Colliculus which is
formed by fibers from the facial motor nucleus of the facial nerve as they loop over the
Abducens nucleus; this is clinically important cuz when foramena are blocked, csf pressure
grows and acts first on the most superficial strucutres which is the Facial nerve; that region is
called the internal knee of the Facial nerve(GENU OF FACIAL NERVE)and when this region
is compressed, appears paralaysis of the face; its important cuz pressure continues to grow
and the 2nd event is CARDIAC ARREST(deeper to nucleus of facial nerve in Rhomboid fossa
we have RESPIRATORY CENTER that control respiration and cardiac rythm) so when
pressure grows first attacks the facial nerve and appears paralysis of facial nerve and the 2nd
syndrome is cardiac arrest!!! —>So the doctor must know that facial praralysis could be a
sign of an upcoming event of CARDIAC ARREST.

• What is the name of lobules involved in protruison of compartment syndrome—>amygdala/

tonsila of cerebellum.
*we don’t have to remember names of cerebellar lobules but we have to remember the lobules
involved in the compartment syndrome; which is the the tonsila or amygdala of the cerebellum
• We have sulcus called primary fissure, posterolateral fissure, and horizontal fissure
-Primary fissure separates the Paleocerebellm(which is anterior) from the rest
-So the Paleocerebellum is anterior to the primary fissure, the Archicerebellum(made from
Nodulus and Floculus) is anterior to the posterolateral fissue.
-The main fissures are Primary and Posterolateral fissure; between them is Neocerebellum
-Another important sulcus/groove is Horizontal fissure which separates the superior part from
the inferior part of the Cerebellum;
-Remember: Anterior to primary fissure is Paleocerebellum and anterior to posterolateral fissure
is Archicerebellum
• Phylogenetically speaking, first appears (in fish) the Archicerebellum which is involved in the
equilibrium and is connected to the vestibular nuclei;
• The second which appears is the Paleocerebellum which is involved in the Muscular tonus;
connected with the spine and recevies lots of afferents from the spine; it appears first in
Amphibians.
• The newest/most modern part is the Neocerebellum(also biggest part), which is involved in
the control of the movement; especially the fine movement.
Archi cerebellum—> Equilibrium
Paleocerebelum—>Muscular tonus, connected to the spine
Neocerebellum—>Control of fine movement; connected mainly to Hemispheres of the
brain(Telencephalon).
STRUCTURE OF CEREBELLUM:
• Has grey and white matter, Grey matter is into the cerebellar cortex at the surface of the
Cerebellum, and also we have grey matter in the Cerebellar nuclei which is deep into the
white mater.
CEREBELAR CORTEX; made of 3 layers; Granular, Intermediate and Molecular.
-The most known strucute of intermediate layer and of the cerebellum in general is the
PURKINJE cells; are pear shaped and are aligned in a single row.
-The Cerebellar nuclei are deep in the white matter:
A)The Fastigial nucleus is connected to the Archicerebellum and situated in the vermis.
B) Globose and Emboliform nuclei are situated at the limit between the vermis and the
hemispheres.
C)The biggest nucleus(also most lateral) which looks like the medullar olive; is called the
Dentate nucleus; it has a hilum and a capsule of nervous fibers around it
-The nuclei are important because all the efferents of the Cerebellum leave the organ by the
axons of neurons from these nuclei; so the nuclei represent all the efferents.
-Inside cerebellum we have circuit of the impulse.
-The cortex and the nuclei are connected; inside the cerebellum we have a circuit of the
impulse; so, the first impulse comes to the Cerebellum by the afferents, and the afferents send
collaterals to the nuclei, the type of collaterals is excitatory(they stimulate the nuclei), then the
afferents go to the cortex and all the cells send the impulse to the PURKINJE cells, and the
purkinje cells send INHIBITORY Efferents from the cortex to the nuclei; The axons of the nuclei
represent all the efferents of the Cerebellum

Afferents is dominant; arrive from many structures: from the spine by the inferior and superior
peduncles, from the brain by the pons by the intermediate peduncles, from the midbrain and
another extrapyramidal strucutres, from all the peduncles.
-So, the efferences reach the Extrapyramidal structures and then enumerate efferents to the:
Striatum nucleus, red nucleus, olivary nuceli, and vestibular nuclei—>WE DON’T HAVE
DIRECT EFFERENCES TO THE SPINE(importnat for exam) .

CEREBELAR SYNDROME: appears when one of the 3 parts of the Cerebellum is destroyed.
The Archicerebelar syndrome—>when Archicerebelum is destroyed; The person has jerky
speech, he speaks stammeringly(To speak with involuntary pauses or repetitions.). Also the
patient can’t walk on a straight line like a drunk(loses balance).
-Patient has a Nystagmus syndrome; the eye moves to the nose slowly and then moves quickly
to the other side( a vision condition in which the eyes make repetitive, uncontrolled movements)
The Paleocerebelar syndrome; the patient has convulsions and a very specific posture named
Opisthothonos (spasm of the muscles causing backward arching of the head, neck, and spine,
as in severe tetanus, some kinds of meningitis, and strychnine poisoning).
Neocerebelar syndome; when the patient presents coordination disorders of the fine
movements; such as Hypermetria( aka Dysmetria)example: asking the patient to put his finger
in his nose but the patient doesn’t manage to do so(misses target). Another condition is
Adiadochokinesia; its impossible to do rapid alternative movements, also incordination of the
tongue with the lips and palate; so that the patient presents a syndrome named Cerebellar
ataxia, which means the absence of fluence in movement and speech and also TREMOR
during intentional movement.
HYPOTHALAMUS LECTURE
-The hypothalamus is a part of the diencephalon(grey matter) together with the thalamus, they
realize the limits of the 3rd ventricle inside the the DIENCEPHALON
-so thalamus and hypothalamis in the left and right side; between them we find a cavity called
the 3rd ventricle
• Drawing #1; Lateral wall of 3rd ventricle
—>we observe superioly the thalamus and inferiorly the hypothalamus; btwn them is a sulcus
called HYPOTHALAMIC SULCUS which continutes the traject of the column of the fornix(fornix
is a fascicle that connects the hippocampus to the mammilary body)
-Hypothalamus; the inferior angle which is FUNNEL shape is called INFINDUBILUM and
continues with the stem/peduncle/stalk of Hypophysis; so infundibulum of 3rd ventricle
contintues with the stem of hypophysis;
Relations:
Anteriolry: Optic chiasm with the supra-chiasmiatic/supra-optic recess
So, hypoth is grey matter, a nucleus together of thalamus that are part of Diencephalon, they
limitate inside the diencephalon the 3rd ventricle; so the lateral wall of the 3rd ventricle in the
inferior part—>when we say inferior part we mean inferior to the hypothalamic sulcus which
separates the thalmus from hypothalamus)
-lateral wall of 3rd ventricle consists of INFUNDIBULUM(funnel shape in inferior angle) and
contunies with hypophysis STALK
-Another relation of hypothalamus is with the OPTIC CHIASMA; if we take the brain in the hand,
reverse the bain and between the interpeduncular fossa we observe an outgrowth with 4 parts
Drwaing #2; 2 peduncles with interpeduncular fossa; which is related to the optic chiasma and
optic tracts
—>we find inside the interpduncular fossa:
• Outgrowth called TUBER CINEREUM with 4 4 emininces; -Anterior is median
eminence(external aspect), -Laterla emininces, -Posterior eminence
• Posterior to the Tuber Cinereum—->2 Mammilary bodies, and Posterior Perforated
Substance(perforated by branches of arteries)

-Agian, Hypothalamus is grey matter, normally it continues the Reticular substance, together
with the Thalamus realize the Diencephalon which represents the lateral wall of the 3rd
ventricle; hypothalamis is situated inferior to hypothalamic sulcus and ends in the funnel shape
structure called infindibulum; In that region, the EXTERNAL ASPECT—>Tuber Cinereum is
situated in the Interpeduncular fossa, and consists of median, lateral(2) and posterior
emininces; posterior to the tuber cinereum are the mammilary bodies and posterior to mamillary
bodies is posterior perforated substance
—>Tuber Cinereum continues inferiorly with the STEM OF HYPOPHYSIS.
-Sagittal axis: hypothalamus is anterosuperior to the reticular substance of Mesencephalon
-Vertical axis: Hypothalamus is inferior to Thalamus.
Drwaing #3; in center is 3rd ventricle near the infindibulum; so its a transversal section of the
hypothalamus and infindinulum of 3rd ventricle; we observe on that section that the cells are
organized in 3 layers—>1)Periventricular, 2)Medial 3)Lateral
-In every layer we have lots of nuclei, some are well known;
1)Periventricular layer; that layer is anterior to the infundibulum; Anatomically speaking, its NOT
part of the Hypothalamus; only the function is connected to the Hypothalamis; so anatomically
its ANTERIOR BRAIN; that part of nervous structure connects the HYPOTHALAMUS WITH
THE FRONTAL LOBE; its called PRE-OPTIC AREA/PERIVENTRICULAR LAYER.
-In this layer we find 3 nuclei on each side of the inuindibulum; 1)Periventricular 2)Medial
3)Lateral
So, how we systemize the internal structure of hypothalamus—>IN LAYERS; What type of
layers?—> We make a transversal section and observe the section on the microscope and we
observe 1)PERIVINTRICULAR LAYER(situated anterior) 2)Medial(more anterior than lateral
layer) 3)Lateral layer(More posterior);
-Periventricular—>Not a real part of hypothalamus; its an area that connects the hypothalamus
to the frontal lobe/anterior brain; and it has 3 nuclei mentioned above
• The biggest layer is the LATERAL layer; (drawing #3)
• Medial layer; in that layer we have 3 regions; 1)Supra-optic region 2)Tuberal region
3)Mamillary region
-Each region has a few nuclei;
-See drwaing nr #4 (position of nuclei in hypothalamus of supraoptic region, tubelar region and
mammilary region)
• Supra-optic region nuclei:
1)Supra-optic—>situated superior to the optic chiasm
2)Supra-chiasmatic—>Superoposterior to optic chiasm
3)Anterior nucleus
4)Periventricular nucleus
-Why are these nuclei so important—>because:
- The supra-optic produce the vasopressin/ADH a hormone that regulates the diuresis and BP
- The perivintricular produces Oxytocin which controls uterus contraction during childbirth
- Suprachiasmatic nucleus; involved in the nectimeral rytthm (mechanism that starts the sleep)
when this nucleus is “on” starts the serotonin production
-So supraoptic and perevintricular are the most imporant nuclei of the hypothalamus;
• Tubelar region nuclei (Green nuclei in drawing) :
1)Ventro-medial
2)Dorso-medial
3)Posterior
4)Arcuate(Infundibular)
-From the tubular region—>The most important nucleus is the ARCUATE(INFUNDIBULAR)
situated near the infundibulum; —->ITS THE SOURCE OF THE RELEASING AND INHIBITING
HORMONES of the hypothalamus

• Mammilary body region nuclei:

1)Intermediate
2)Medial
3)Lateral

CONNECTION OF HYPOTHALAMUS
• Afferences:
1)Medial fascicle of the anterior brain; which starts in the Rhinencephalon —>goes through
hypothalamus—>ends into the TEGMENT of the midbrain
2)Stria-terminalic thalamica(between thalamus and caudate nucleus); it connects the
amygdalian nucleus/body to the hypothalamus and the Pre-optic area
3)Stria-medullaris thalamica; which gets information from the Habenular nucleus;
4)The fornix; its a fascicle of white matter which starts in the hippocampus and ends in the
mamillary bodies, and from the mammilary bodies start Mammilo-thalamic and Mammilo-
tegmental fascicles/
5)From the Retina; WITH THE RETINA, THE HYPOTHALAMUS HAS IN THE SAME TIME
AFFERENCES AND EFFERENCES; —>The efferent fibers are called TANGENTO-RETINIAL
FIBERS, and if those fibers are broken appears a disease called RETINITIS PIGMENTOSA and
the patient becomes blind.
• EFFERENCES; 2 types of efferences:
• 1 to the same structures that send Afferences, and also to the CEREBELLUM AND TO THE
THALAMUS
-The endocrine efferences; which are complicated
*See drwaing #5 schema of hypophysis; Infundibulum, arcuate nucleus, optic chiasma,
mamillary bodies, hypophysis(adenohypophysis, intermediate lobe and posterior/
neurohypophysis), hypophyseal stalk.
-Tuberal region drawing #5, where we find tuber cinereum—>Medial eminence is anterior to it
-Superior Hypophyseal artery ends in the network of capillaries, we name that network the
superior network of capillaries; from the capillaries start veins named PORTAL VEINS cuz they
also end in a network of capillaries IN THE ANTERIOR LOBE
-In anterior aspect of hypothalamus—>supraoptic and paraventricular nuclei that produce adh
and oxytocin; the axons of these nuclei realize the Hypothalamo-Hypophyseal tract and
transport the hormones to the Nuerohypophysis/Posterior pituitary, where the inferior
hypophyseal artery realizes the capillary network and from the capillary network goes veins to
the bloodstream.
-From the arcuate nucleus—>their axons go to the Superior network of capillaries, giving rise to
a tract called Tubero-infundibular tract(tubelar region and infundibulum); the
Arcuate(infundibular nucleus) produce Releasing and inhibiting hormones for the
ADENOHYPOPHYSIS HORMONES that are called TROP hormones; so, arcuate nucleus
produces releasing and inhbiting hormones, those hormones pass in the tubero infundibular
tract, reach the superior network of capillaries, go to the portal veins, reach the second capillary
network, and here cuz the capillary is fenestrated, the releasing and inhibiting hormones go
outisde into the ADENOHYPOPHYSIS and stimulate the cells of adenohypophysis to produce
TROP HOMRONES; like somatotropm, corticotrop hormones etc..then the trop hormones go
back into the capillaries and then expelled by the hypophyseal veins into the bloodstream

FUNCTIONS OF HYPOTHALAMUS;
-we should think of a hypothalams like a visceral control brain and like a nucleus which generate
the control of the endocrine system; neurosecretion (ADH AND OXYTOCIN) are also important
-The hypothalamis regulates temperature, intake of water and food, sexual activity, biological
clock(by efferences to the habenular nucleus and epiphysis), emotion, fear, aversion, pleasure
connected to the VISCERAL ACTIVITY, And also cuz the hypothalamus is connected to the big
circuit of the Papez, its thus involved in the RECENT MEMORY.
question example: which are the afferences of the hypothalamus? which are the endocrine
connections of the hypothalamus? where we find in the brain the hypothalamus?—>in the
interpeduncular fossa…..how is the portal system built…
THE LIMBIC SYSTEM
-In latin it means “at border” cuz they find some parts of the limbic system at the margins of the
hemispheres.
-The concept of the limbic system is different among neuroanatomits cuz it has 9-11 structures;
so its a system; its basically lots of strucutres put together by an anatomist that believes that
they are connected to some functions
; functions such as the emotions— that system is the base of the emotion, the olfaction, and
memory.
1) First structure is the olfactory system; in the primitive human, the olfactory sense was more
important cuz it helped them smell dangerous animals coming towards them..(just an
example) cuz they could smell animals without the need of them being in sight; so the most
imporant for survival of the human being was the olfaction sense
- when humans evolved, the olfaction sense became less powerfull cuz other structure has to
evolve; so during the human evolution, the olfaction becames less powerful and the CORTEX
EVOLVED and appeared the SUPRAGRANULAR CORTEX, which is absent in other
mammals
- Which part of olfaction became less evolved within evolution?—->The periphary part of the
olfactory pathway(nasal mucosa and olfactory nerve..) decreased BUT the central
part(Cortical projetion and nuclei involved in olfaction of the pathway) remained the SAME
with the same importance
; so we understand that olfaction remained very important cuz its involved in the connection
between people; mother and son, husband and wife…
-Modern life took advantage of olfaction by making fragnances…
Why does someone smell bad? —>the substances on the skin; we find the sweat secretion and
sebacous secretions ; if we leave these substances on the skin without showering —>those
secretions are chemically modified by the saprophyte germs that live on the skin, that transform
the proteins and lipids of the secretions; the proteins are transformed into ammonia which
smells bad and the lipids OXIDATION which also smells bad.
-Why do newborn smell differently? —>cuz the amount of time needed to develop the
saprophyte germs on the skin is longer; thus newborns dont have enough germs to transform
the proteins into the smelly ammonia; while older people have “well trained” germs to transform
the proteins into smelly ammonia
-These type of germs live on the hair; so to reduce the smell we can cut the hair..axillary hair,
pubic hair..
OLFACTORY PATHWAY
-The nasal mucosa is located in the DEEP TRANSVERSAL PART; we have here the first order
neuron which is in the same the RECEPTOR; its dendrites are CILLIA which are into the small
layer of fluid (that fluid comes from the secretion of the mucosal glands which are stimulated by
the facial nerve; lacrimo-muco-nasal nucleus in PONS)
; so, when the mucus secretion stops, the sensation of smell also ceases; cuz the
substance(odor) must be dissolved in the mucosal fluid; so in absence of mucosal secretions,
the odor substance is not dissolved and thus wont be smelled
-The axons of the first neuron give rise to the olfactory nerve which passes through the
CRIBRIFORM PLATE until the 2ND NEURON which is the OLFACTORY BULB—>From the
olfactory bulb we have 2 OLFACTORY TRACTS which end near the rostrum of the corpus
callosum by a flattened area called OLFACTORY TRIGONE; in front of the oflactory trigone we
find a small outgrowth named olfactory TUBERCLE, from the TRIGONE we have 3 fascicles
named 1)Stria lateralis 2)stria intermedialis 3)Stria medullaris ; those ones end into the cortical
projection;
we have a primary olfactory area and a secondary olfactory area
-The primary is situated around the AMYGDALIAN BODY AND PIRIFORM LOBULE
-So, the cortical projection is connected with 3 important structures with the
1)amygdalian body
2)hippocampus
3)hypothalamus
(connections could be exam question)

• The Amygdalian body;

-Is a small nucleus located DEEP in the anterior pole of the TEMPORAL LOBE
; the most imporant efferences of this nucleus are made by 1)STRIA TERMINALIS 2)CAUDATE
NUCLEUS ; and send the info to the HYPOTHALAMSU AND FRONTAL LOBE
; What we have to know about the amygdalian body?
1)Where is it situated? —> In the anterior pole of the TEMPORAL LOBE
2)Posterior to the nucleus(Amygdalian) —>WE FIND THE HIPPOCAMPUS
an we have an aspect of the raltion;
-What is the function of the amygdalian body—>It gives AFFECTIVE part of all the info which
come from the periphary
so all the pathways go to the brain, but gives collaterals to the amygdalian body, and the a.b
decides if that info is good pleasant or unpleasant —->and that modification contributes to us as
being humans —-> a child with autism for example what would be his reaction when he sees
that his mother cut her hand and sees the blood ; He observes but doesnt react to the situation
cuz his AMYGDALIAN BODY DOESNT WORK!!
so the amygdalian body is the main structure which puts AFFECTIVITY ON THE PERIPHERIC
INFORMATION;
-If the amygdalian body doesnt work, the human becomes like a computer
; with autism, the amygdalian body is UNDERSTIMULATED and its DIAMETER IS DIMINISHED
- thalamus and amygdalian body are invovled in the mood; they are connected together to
regulate the MOOD
- but, the THALAMUS is involved in the Primary/Not evolved part of the mood
; while the Amygdalian body regulates the complex/evolved part of the MOOD
• HIPPOCAMPUS (most imporant pt of limbic system)
What is the hippocampus? its a CORTEX ; so grey matter but NOT A NUCLEUS
; its a layer of cortex situated on the FLOOR of the INFERIOR HORN of the LATERAL
VENTRICLE
-Posterior to the amygdalian body, we have the INFERIOR HORN OF THE LATERAL
VENTRICLE, and on its FLOOR, an outgrowth called hippocampus(deep in the hemisphere)
-Its a primitive cortex made by 3 layers; IT THE ONLY POSITION IN THE BRAIN WHERE THE
GREY MATTER OF THE CORTEX IS COVERED BY A LAMINA OF WHITE MATTER CALLED
ALVEUS (normally the cortex is over the white matter but here the cortex is covered with white
matter called AVLEUS)
-The alveus connects all the efferences of the hippocampus; and sends into fasciles called
FIMBRIA; (represent all the efferences of the hippocampus; we have two fimbria on both sides
of hippocampus)
; The FIMBRIA contintues with the FORNIX;
-The FORNIX represents ALL THE EFFERENCES OF THE HIPPOCAMPUS
-Whats the function of the HIPPOCAMPUS? —>Its the BASE of the emotion ; its the main
structure involved in EMOTIONS
; it gives the the EMOTIONS all the information; so the Amygdalian body classifies the info
pleasant or unpleasant ; BUT the HIPPOCAMPUS gives HUMAN EMOTIONS to all the info
and in the same its involved in MEMORIES; the recent memories but most importantly the
conenction between the recent and the old memories
; We have 2 types of memories; recent and old
the recent becomes old—>in that process the hippocampus is involved (to transform the recent
memories into “old” long term memories
-an experiment where they cut the hippocampus of the patient, and the patient lost the
“ANTEROGRADE MEMORIES”—>so like if he is having a convo with a person and a minute
ago the person tells him something, later during the convo the patient forgets what the patient
told him so the patient has ONLY THE OLD LONG TERM MEMORIES
-so again, the hippocampus is the anatomical base of the emotion; how? —> it gives emotions
to ALL the information
-also INVOLVED IN the memory; MAINLY THE RECENT memory but also the connection
between the recent and the old long term memories
-Pathology of hippo: its neurons have a small level of excitation; so its involved in initiating the
EPILEPSY process;
Also its involved in Schizophrenia, Depression and MAINLY its involved in the ALZHEIMER
; In Alzheimer dementia patients—> the HIPPOCAMPUS is ATROPHIC
-REMEMBER that its involved into the process by which the INFO IS GIVEN EMOTIONS
-when hippo is damaged; patient has memory problems, personality problems, Alzheimer
dementia, schizofrenia, epilepsy, depression
• FORNIX
-all the efferences of the hippocampus continue with the FORNIX;
; its a complex arch of white matter—>it starts by two CRURA of fornix —>then the Crura are
connected to form the BODY —>and the body ends by forming 2 COLUMNS of fornix—>which
ends into the 2 MAMILLARY BODIES

WE HAVE STRUCUTRES THAT ARE VERY EASY TO IDENTIFY IN TOMOGRAPHY;

-Corpus callosum, Lentricular body, THALAMUS, the FORNIX

• Another strucutre invovled in the limbic system is the SEPTAL AREA

-Its a thin septum of WHITE MATTER, between the internal aspect of the CORPUS CALLOSUM
and the FORNIX ;
; between the 2 layers of the Septuc Pelucidum is a cavity called CAVUM OF THE SEPTUM
(SEPTAL CAVUM)
; Between the inferior part of the corpus callosum and the FORNIX —> we find SEPTUM
PELLUCIDUM which has inside SEPTAL CAVUM; it has some nuclei inside that are involved in
the CENTRAL AREA OF THE OLFACTORY SYSTEM
DIENCEPHALON:
Complex of structures made by the hypothalamus(kind of vegetative brain), thalamus(sensitive
brain; sensory nucleus), metathalamus (involved in the optic and auditory pathway),
subthalamus (which connects the midbrain with thalamus), Epithalamus(posterior and superior)
• Parts of the Epithalamus: Habenular trigones/triangles that contain the habenular nucleus, 2
habenulae which are fascicles of white matter, and the Epiphysis(pineal gland)
(could be a question in the exam(parts of EPITHALAMUS)
-The diencephalon is situated at the base of the brain; at the base of the brain we have a cavity
between the right and left diencephalons; called the 3rd ventricle; the THALAMUS is there in the
SUPERIOR WALL of the 3rd ventricle; its an oval nucleus with the following features:

-Anterior extremity/pole is narrow, posterior extremity is developed, expanded and called

PULVINAR.
-The two thalamic nuclei are connected anteriorly into a region called”adhesio
interthalamica” (Interthalamic adhesion); its not a commisure cuz its not white matter its Grey
matter)
-The thalamus presents 4 surfaces; the superior surface/aspect is the most comlicated part;
here we find from the Medial to the Lateral some structures named: stria medullaris, stria
terminalis(white matter fibers), thalamus striat vein, caudate nucleus.
stria terminalis is also a fascicle of white matter, between the caudate and the thalamus is the
thalamustriate vein; Exam question: which part of thalamus is most complicated? what we find
on superior aspect of the thalamus?
-Stria medullaris of thalamus are 2 fascicles of white matter, continue with the Habenula, the 2
Habenulae fuse at the epiphysis.

-Because the thalamus is the biggest nucleus of the brain, its very easy to recognize it on the
tomography; its important in practical work and hospitals to recognize the thalamus.
-Between the thalamus and caudate nucleus and lentiform/lentricular nucleus: we find 2 white
matter fascicles named anterior arm of the internal white capsule, and posterior arm of the
internal white capsule.
-Why those fascicles of white matter are so important? cuz when they are destroyed, appears a
a hemiparalysis(paraylysis of half of the body); so we have to recognize the arms of the white
capsule;
-Between the thalamus and the lentricular nucleus: we have the Posterior arm of the white
capsule
-Between the caudate nucleus and the Lenticular nucleus we have the Anterior arm of the white
capsule
-From medial to lateral: Thalamus and caudate nucleus, Lenticular nucleus, Claustrum(between
the extreme white capsule and external white capsule), Island lobe,
• Important: Lateral relations of thalami nucleus:
1)Posterior arm/limb of the internal white capsule 2)Lentiform nucleus 3)External white capsule
4)Claustrum nucleus(Grey matter), 5)Extreme white capsule, 6)Cortex of the Island lobe of the
brain.
• Internal aspect of thalamus:
-Inside the thalamus we find 2 laminae of white matter;
The principle one is internal white medullaris lamina of thalamus (Y Shaped), lateral to the
thalamus is the external medullaris lamina of the THALAMUS;—>These laminae separate the
nuclei of the thalamus
-Between the arms of the Y(of internal medullaris lamina) we find the ANTERIOR NUCLEI OF
THE THALAMUS,
-Also we have Medial an Lateral nuclei of the thalamus.(see drawing)
- Between the ependyma of the 3rd ventricle and the thalamus; we find the MEDIAN NUCLEI of
the thalamus.
-Inside the internal white lamina, we find the INTRALAMINAR NUCLEI(IL), on the other side
there is the VENTRAL nuclei.
-Laterlaly we find the RETICULAR NUCLEI(R);Has the aspect of grey matter nuclei, cuz
between them we have the EFFERENTS of the thalamus
-could be subject for the exam; nuclei of the thalamus
• Function of the Nuclei:
• Anterior nuclei; these nuclei are part of the Papez circuit, the presence of the circuit explains
how the emotions reach the brain MEDIATED by the thalamus
-The circuit is as follows: The Hippocampus—>The fornix(white matter fascicles)—>Mammilary
nuclei—>MAMMILO-THALAMIC FASCICLES.—>The Gyrus Cinguli—>The Frontal lobe of the
brain
-When the mammilo-thalamic fascicle is damaged, the patient develops Korsakoff Dementia/
Syndrome; when the patient forgets their recent memories.
-So the group of anterior nuclei is very importnat cuz that group connects the limbic system to
the brain, by the Thalamus, and represents the anatomical pathway by which the emotions
reach the brain.
Other nuclei;
• VENTRAL NUCLEI DIVISIONS:
1)VPL-Ventral posterolateral nucleus—>Here ends the Lemnsical meniscus(ymkn Medial
Lemniscus)
2)VPM-Ventra posteromedial nucleis—>Here ends the Trigeminal Lemniscus and the Gustatory
pathways.
3)VPI-Ventral posteroinferior nucleus—>where ends the Vestibular pathway and represents the
3rd neuron on the vestibular pathway
• PEDUNCLES OF THE THALAMUS; the thalamic nuclei is connected with other nuclei arount
it by Groups of white matter fibers called peduncles of the thalamus.
-Anterior Peduncle—>Connects the thalamus with the frontal lobe
-Superior Peduncle—>connects thalamus with parietal lobe
-Posterior Peduncle—> connects thalamus with occipital lobe, and passes through the
Retrolentiform/Retrolenticular part of the Internal capsule
-Inferior peduncle—>Connects the thalamus with the Temproal lobe; and passes through the
Sublenticular/Sublentiform fascicle of the internal capsule
FUNCTIONS OF THALAMUS
• Biggest grey matter nuclei in the brain, sensory nucleus
• It’s a sensory nculeus; it realizes the connection between the periphery and the brain, its a
station for the lemniscus and for the vestibular pattern; Also its connected with the
Hypothalamus
• How it works?Why do these information have a station at the thalamus—>its because the
Thalamus adds to the information some EMOTIONS; the thalamus decides if the information
is pleasent or unpleasent; So the infromation doesn’t reach the brain “Nude”—>If the
thalamus receives info that “its cold”, the thalamus doesn’t just “nudely send info to the
cerebral cortex that its “cold”, it rather sends that its cold and pleasent; so it adds
“EMOTIONS” by saying that its “pleasent” …(to get the point)
-Conisdering all these facts, we can say that the thalamus is involved in the PRIMITIVE
AFFICTIVITY OF THE PERSON, and this affictivity is involved in the mood of the person
• Also the Thalamus is inolved in the AWAKE REACTION, cuz its connected with the Reticular
Substance/formation
• What happens when the Thalamus is damaged; when the left thalamus is damaged—-
>appears problems in the left hemispheres of the brain; here we have the Center of the
Speech, and the patient starts STUTTERING(Speech disruption) the condition is called
THALAMIC APHASIA
• When the right Thalamus is damaged, the patient has problems with special
orientations(patient is disoriented)
• Thalamic pain syndrome/Head-Thalamic syndrome—>The patient develops Hyperalgesia to
touch; so if the doctor lightly touches the patient’s hand, the patient doesn’t instantly feel any
pain, but after a period of time the pain starts and the pain is VERY INTENSE
(HYPERALGESIA)
-This syndrome can be a question in the exam; so basically its the hyperalgesia to the light
touch, and its not very well connected in time, the pain can appear after long time after the
touch has stopped
Visual anato
-The cornea is transparent
-The iris has the color of the eye; in the center of the iris we have an orifice called PUPIL
-between the cornea and the iris we have the anterior chamber
-Posterior to the Iris we have the CRYSTALINE LENS; the crystaline is situated and circled by a
crystaloid membrane which is pulled by the suspensory ligament of lens (zonular fibers)
-between the iris and the crystaline is the posterior chamber; into the post chamber we habe
those outgrowths which are ciliary processes; the ciliary body has muscles and processes
-the orifice is the pupil, by the pupil, the anterior chamber communicates with the anterior
chamber, both chambers are filled with aqueous humor;
-behind the crystaline, we have the viterous body
-the light goes through the cornea, the fluid, the pupil, the crystaline and the viterou
- the center of the crystaline is the optic center; the light which goes to the optic center remains
in the same direction, the other light which goes to the periphary change the direction and
itnersect into the focar(see drawing nr 1)
- -Macroscopically speaking about the visual retina, we have The Ovea centralis and macula
lutea;
in the center of the retina is a small fossa named MACULA LUTEA(from yellowish color) and its
3mm in diameter
in center of macula lutea we have a small fossa 0.5 mm in diameter where we have CONES
ONY
-So, the most important parts of the retina : in center is macula lutea which has in its center the
fovea centralis, Inferior and medial to the macula lutea is the PAPILLA OF OPTIC NERVE/
OPTIC DISC
-The optic papilla is a region where we can see white matter of the brain which is externalized;
its importnat cuz when the brain has an edema, the same edema appears on the papilla of the
optic nerve; and the reverse of the situation is when exists the ATROPHY of the optic nerve
-so optic papilla/disc is important cuz its the region where the arteries go inside the eye and the
veins go outside the eye;
The papilla is involved in CEREBRAL EDEMA AND into the ATROPHY of the optic nerve
-What else is imporant to see on the retina??—>by an external exam using the ophthalmoscope
and observe the retina; what we can see—> the aspect of the VESSELS mainly the
ARTERIES!! its the only place in the body where we can see the aspects of the arteries directly;
its important cuz we can establish the grade of HYPERTENSION; we have classification of 4
grades conserning the aspect of the vessels into the retina
-so the opthalmologist can observe using the opthalmoscope info about the: Macula, Fovea,
papilla of optic nerve, and about the VESSELS Which change the aspect parallel to the
hypertension
-STRUCTURE OF THE RETINA; its very complicated, mainly we have 10 layers of cells (we
dont have to memorize them) but we have to know few things about the retina; if we compare
the retina of humans to retina of dragon flies we observe that in the retina of the dragon flies the
receptors are in the external aspect and the light reaches first the receptors
In human beings the retina is reversed, so light has to go through all the retina until it reaches
the receptors which is deep into the wall of the eye
—>so whats the main feature of the retina in human beings? —>ITS REVERSED, the light must
go through all the retina until it reaches the RECEPTORS
-What we find mainly in the retina?—>receptors, first 2 order neurons of the optic pathway,
some special cells; one of them is pigment cells which makes “dark rooms” for the optic system;
without these cells we cant see; they also absorb the excess of the light(the photos which didnt
excite the receptors) and also creates a good temperature/astmosph for the optic system
other types of cells are INTERNEURONS which modify the reception and the main neurons are:
• BIPOLAR neurons which are the FIRST ORDER NEURON of the optic pathway
• Ganglion/multipolar neurons—> second order neurons of the optic pathway
RODES AND CONES:
-They are modified neurons that lose the axons and the dendrites;
-every receptor has 3 parts,
1)biggest part, which has rode shape or cone shape
2)part that is similar to a nick(restrained)
3)basal part where comes the dendrites of the first neuron, and it has the CELL BODY
mainly in the biggest part which has rode or cone shaped, we have transversal discs filled with
pigment(around 2000 discs) when the light reaches the disc, the pigment changes in structure;;
the receptors of the visual pathways which realize 2 transformations;
1)Electromagnetic energy to Chemical energy
2)Chemical energy to Electrical impulses
cuz of that aspect, the optic pathway is different compared to other pathways;
-the 2 kind of receptors have DIFFERENT pigments ; RODOPSIN for RODES and IODOPSIN
for CONES
these pigments have protetic and prostetic parts;
-what happens when light reaches the rodopsin? it transforms by lots of reactions until it
produces the ELECTRICAL IMPULSE
-The RETINAL which is part of these reactions transforms into VITAMIN A, which is Utilized to
be Resynthesize the Rodopsin and Iodopsin
-So vitamin A is invovled in the ACCOMODATION PROCESS to the light
-So, when light reaches the pigment which is in the TRANSVERSAL DISC, and when the
pigment changes the compostion, the membrane is Hyperpolarized; in optic system is not about
to depolarize the cells its about the HYPERPOLARIZATION OF THE CELLS;
-so Light reaches the pigment in the transversal disc, starts a cascade of the CHEMICAL
REACTION, and that reaction changes the permability of the rodes and cones and that cause
them to HYPERPOLARIZE
-Cuz we have a few types of receptors, we have different parts of the optic pathway; normally,
we have a very big number of receptors, then we have a small nr of first neuron and then a
smaller number of the 2nd neuron—> we say that on the optic pathway we have a
CONVERGENCE OF THE IMPULSES; this is a part of the optic pathway; but for the few
neurons we have a private optic pathways..what it means private—>it means that one receptor
for first neuron and one 2nd neuron
Recap of what said above:
-Features of the optic pathway:
We have 2 types of fibers ; some fibers realize a convergence and some fibers realize a private
optic pathway which means for one receptor there is 1 first neuron and 1 second neuron
-The anterior margin of the retina is called ORA SERRATA; the anterior part of the RETINA IS
NOT A VISUAL RETINA;
we can split the retina by a vertical axis into 2 HEMIRETINA
1)Nasal hemiretina 2)Temporal hemiretina ; each half of retina sees half of the visual field
-The Nasal hemiretina sees perpindiculary; so it sees the TEMPORAL VISUAL FIELD
-The Temporal hemiretina sees the NASAL VISUAL FIELD
-The nasal fields of the optic fields intersect; giving rise to the BINUCLEAR VISUAL FIELD
which explains why we see with 2 eyes only 1 object
after that, from the eye gets out the optic nerves; those go through the orbits until the optic
orifice on the endobase and then the optic nerves intersect but the intersection is special called
the OPTIC CHIASMA AND ONLY the nasal fibers of the optic nerve DECUSSATE;
the temporal fibets continue on the same optic tract(dont decussate)
-The OPTIC CHIASM is a quadrilateral lamina of whiter matter in which the fibers of the optic
nerve decussate; that decussation is very unique; only the fibers from the nasal retina
decussate.
the temporal fibers continue their way in the same tract
-posterior to the optic chiasm is the hypophysis; when inside the hypophysis appears a tumor, it
grows and presses on the optic chiasma—->good exam question; if the tumor presses on the
optic chiasm, the pressed fibers are from the NASAL RETINA AND THE NASAL RETINA SEES
THE TEMPORAL FIELD!! ; so the patient with a hypophysis tumor will have a BILATERAL
TEMPORAL HEMIANOPSIA (hemianopsia means that we don’t see half of the optic field and its
the temporal field in this case)
—>Its a frequent situation
-So, until the optic tract, in the optic nerve, optic chiasma, optic tract—> we have the axons only
of the 2nd neuron; so a long path of the optic pathway is made by axons of the 2nd neuron
-coming out from the chiasm is the optic tract; one side of the optic tract transforms fibers from
the temporal retina of the same way, and from the nasal retinal of the other eye
-from the optic tract we have COLLATERALS to the
1)Superior colliculus; those collateral are involved in the reflexes connected with the optic
pathway
-The Optic tract ends in the LATERAL GENICULATE BODY OF THE METATHALAMUS—>
LGB contains the THIRD ORDER NEURON and its connected with the superior colliculus
through the brachium of this colliculus
-What happens of the axons of the 3rd neuron—>they FORM a fascile of fibers called OPTIC
RADIATION; —>this OPTIC RADIATION passes through the SUBLENTICULAR part of the
INTERNAL CAPSULE—>and they project on the VISUAL CORTEX of the occipital lobe; into
areas of 17,18,19
; THE PRIMARY VISUAL AREA IS AREA 17; situated on the margin of the CALCARINE
SULCUS which is a longitudinal sulcus on the OCCIPITAL LOBE.
-The info dont remain in the OCCIPITAL LOBE; —>it goes by the longitudinal fascicle of the
brain to the FRONTAL LOBE; its so evident that connection cuz when the patient becomes
blind, the cells in the fronal lobe die; so the impact of the optic pathways on the brain is very big
*When the patient is completely blind its called AMAUROSIS
*When only one spot in the optic field is absent when call it SCOTOMA (restricted areas of
blindness depending on the affected optic fibers)
*when the patient doesnt see with half of the optic field its called HEMIANOPSIAE
*When the crystaline lens is opaque(loss of transparency); ITS CATARACT
*Increased intraocular pressure(cuz of restricted re entry of the aqeous humor into the
bloodstream) causes destruction of the optic nerve fibers; GLAUCOMA;
the fluid is produced by the ciliary processes; fills the ant and post chambers and its absorbed
into the veins by a venous canal called SCHLEMM canal which is situated at the limit of the
CORNEA; here the cornea realizes an angle with the remaining part of the eye; when that angle
becomes straight, the pressure of the fluid increases so its called GLAUCOMA WITH
STRAIGHT ANGLE; in the straight angle the schlemm canal is compressed and the pressure of
the fluid grows
*Discromatopsia;deficiency of the visual acuity for colors; (ex; Daltonism; patient cant make a
difference between RED AND GREEN)