GROSS BRAIN FEATURES, CORTEX, AND GROSS

ANATOMY
NEUROHISTOLOGY BLOCK 6
Dan Neftalie Juangco, MD, FPNA, FINS | March 29, 2021

TABLE OF CONTENTS
I. GROSS NERVOUS SYSTEM FEATURES……………………………….....….1
A. ORIENTATION OF THE BRAIN…………………………………….…...1
B. SECTIONS AND PLANES…………………………………………….…..1
C. OVERVIEW OF BRAINSTEM……………………………………….…...1
D. SKULL……………………………………………………………………. 2
E. MENINGES………………………………………………………………...2
II. CEREBRAL CORTEX…………………………………………………....…......3
A. CEREBRAL HEMISPHERE……………………………………………....3 Figure 2. Infratentorial orientation of the brain [2024 Trans] (rostral = superior;
B. LOBES……………………………………………………………………...3 often in 2-legged species [humans])
C. ORGANIZATION OF THE CORTEX…………………………………….6 B. SECTIONS AND PLANES
D. SOMATOTOPIC ORGANIZATION……………………………………...6
E. BRODMANN/FUNCTIONAL AREA…………………………………….7
● Some structures/connections are better seen in some planes
F. LAYERS OF THE CORTEX………………………………………….…...8 ● Horizontal plane: most commonly used
G. DOMINANCE………………………………………………………...…...9
III. CLINICAL CONDITIONS………………………………………………….….9
A. CORTICAL FUNCTIONS: APHASIA…………………………….….......9
B. GERTSMANN’S SYNDROME………………………………………….10
IV. REVIEW QUESTIONS……………………………………………………….10
V. REFERENCES…………………………………………………………………11
VI. MNEMONICS………………………………………………………………...11
VII. APPENDIX…………………………………………………………………..11
VIII. SUMMARY…………………………………………………………………15

✓All information is directly lifted from Doc’s lecture, unless stated otherwise
I. GROSS NERVOUS SYSTEM FEATURES
The nervous system is divided into:
1. Central Nervous System (CNS)
a. Brain (also encephalon)
b. Spine (also myelon)
2. Peripheral Nervous System (PNS)
Table 1. Major divisions of the brain (phylogenetic and embryologic)

Major divisions of Phylogenetic Parts of the

the brain structures Phylogenetic
structures Figure 3. Section and planes and its corresponding images
(From L→ R: Horizontal plane, Coronal plane, Sagittal plane)
Cerebral hemisphere
C. OVERVIEW OF BRAINSTEM
Subcortical white ● Has two main divisions
matter ○ Tectum “roof” dorsal, upper part
Telencephalon
○ Tegmentum “floor” lower part
Basal ganglia Table 2. Ventral and Dorsal Side; Parts of the Brainstem (Numbered
Prosencephalon accordingly in Figure 4)
Basal forebrain
Ventral Side Dorsal Side
Thalamus
● Cerebral peduncles (1) ● Quadrigeminal plate (1,2)
Diencephalon Hypothalamus ○ AKA crus cerebri made up of:
○ Located at the base of ○ 2 Superior colliculi (1)
Epithalamus the midbrain ○ 2 Inferior colliculi (2)

Mesencephalon Midbrain ● Interpeduncular fossa (2) ● 4th ventricle (3)

○ Between the peduncles ○ Ventricles are spaces
Pons ○ Important because which contain the
Metencephalon some structures go out cerebrospinal fluid
Rhombencephalon Cerebellum from there (e.g. CN III)

Myelencephalon Medulla ● Pons (3) ● Cerebellar peduncles

○ Bulb-shaped structure ○ Attaches the midbrain to
○ Middle part of the the cerebellum
organ = basilar groove ○ Composed of ★
(where basilar artery is ■ Superior: Brachium
found) conjunctivum (4)
■ Middle: Brachium
pontis (6)
■ Inferior: Restiform
body (5)
✓Doc emphasized to be familiar
Figure 1. Subparts of the phylogenetic structures
with alternative names of
★ Brain Stem = Midbrain (Mesencephalon) + Pons structures
(Metencephalon, left green arrow) + Medulla (Myelencephalon)
● Tentorium cerebelli (Black line, Figure 1) ● Medulla (4) ● Medulla
○ Separates the supratentorial from the infratentorial ○ Comprised of pyramids ○ Gracile tubercles (medial)
regions of the brain (5) (7)
○ Decussation (6) of the ○ Cuneate tubercles
A. ORIENTATION OF THE BRAIN fibers of the pyramids (lateral) (8)

● Olives (7)
○ Bumps lateral to the
pyramids

Figure 2. Supratentorial orientation of the brain [2024 Trans] (dorsal =

superior; often in 4-legged species)

1 of 18
Trans 6.02 | TH Placino & Medenilla | TG #1&2: Abrencia, Baoas, Chua, Perez, Sagayo, &
★ IMPORTANT!! ✓ TG/TH Note
Villamayor
 GROSS ANATOMY GROSS FEATURES, CORTEX AND NEUROHISTOLOGY

Figure 7. Sutures in posterior and superior view

E. MENINGES
● Protective, membranous coverings of the brain
● Lie immediately internal to the cranium
● Supporting framework for arteries, veins, and venous sinuses
● Enclose a fluid-filled cavity (subarachnoid space), which is
vital to the normal function of the brain
● Organized from external to internal: pachymeninx (dura
Figure 4. Ventral (L) and Dorsal Side (R) of the Brainstems [Juangco, 2021]
mater) and leptomeninges (arachnoid and pia mater)
D. SKULL ✓Figure 8 in the appendix shows the gross anatomy of the meninges
● Composed of 8 cranial bones connected by sutures covering
the brain, named after respective lobes
● Major Cranial Bones:
○ Frontal bone
○ 2 Parietal bones
○ Occipital bone
○ 2 Temporal bones
● Additional Cranial Bones (better viewed sagittally)
○ Sphenoid→ Has greater and lesser wings
○ Ethmoid
● Other bones of the skull:
○ Facial bones
■ Maxillae, palatine, nasal, inferior nasal conchae,
zygomatic, lacrimal, vomer, and mandible
○ Associated bones Figure 9. Meninges[Moore,1965]
■ Auditory ossicles enclosed in temporal bones, and PACHYMENINX
hyoid bone ● AKA Dura mater
● Tough, thick dense external fibrous layer
● “pachy” “menix” = thick membrane
● A bilaminar membrane
○ External periosteal layer
○ Internal meningeal layer
● Dural Infoldings
○ Divide the cranial cavity into compartments
○ Forms partitions (dural septa) between certain parts of the
brain and providing support for other parts [Moore, 1966]
Figure 5. Sagittal view of facial bones. Emphasis on Sphenoid
and Ethmoid bones. [PPT, Juangco, 2021]

[PPT, Juangco, 2021]

Figure 10. Overview of the dural infoldings [PPT ,Juangco, 2021]
Figure 6. Lateral view of the skull bones and their sutures
Table 3. Dural Infoldings [Moore, 1970] ★
Sutures
● Subdural hemorrhages do not cross these suture lines Falx ● Largest dural infolding
● Connects the cranial bones to each other ★ cerebri ● Lies in the longitudinal cerebral fissure
○ Lambdoid suture: occipital - parietal ● Separates the right and left cerebral
○ Sagittal suture: parietal - parietal hemispheres[Juangco, 2021]
○ Squamous suture: parietal - temporal ● Continuous with tentorium cerebelli
○ Coronal suture: parietal - frontal ● Partially incomplete (in the center) because there is
● Weak points of the skull the corpus callosum which connects the R and L
○ Areas easily cut during neurosurgery halves of the brain [Juangco, 2021]

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 GROSS ANATOMY
Tentorium ● 2nd largest dural infolding
cerebelli ● Division of supratentorial and infratentorial areas
● Separates cerebral hemispheres (occipital lobe)
from the cerebellum [Juangco, 2021]
● Tentorial notch -- gap formed because the
concave anteromedial border is free
○ Brain stem extends from posterior into medial
cranial fossa
GROSS FEATURES, CORTEX AND NEUROHISTOLOGY
Insula
● Aka Island of Reil
● Considered as the “5th lobe”
● Lies deep within the lateral/sylvian fissure
● Only seen when banks of fissure are separated
● Involved in autonomic functions

Falx ● Vertical dural infolding

cerebelli ● Separates the R and L cerebellar hemispheres
● Lies inferior to the tentorium cerebelli in posterior
part of the posterior cranial fossa
● Attached to internal occipital crest

✓ NTK: Diaphragma sellae = smallest dural infolding

● Forms pituitary fossa and has an aperture for passage of
infundibulum and hypophyseal veins
✓Doc did not discuss the ff. in detail, these simply serve as an overview.
LEPTOMENINGES
● Composed of the Arachnoid mater and the Pia mater
○ The two are separated by the subarachnoid
(leptomeningeal) space Figure 19. Lateral view of right Cerebral hemisphere dissected to show
■ Contains cerebrospinal fluid (CSF) Insula
■ Where most of the brain’s arterial trunks and CN are
A. CEREBRAL HEMISPHERE
found[2024 Trans]
● Separated in the midline by the Interhemispheric fissure
Arachnoid Mater (AKA sagittal or longitudinal fissure)
● The intermediate layer ○ Falx cerebri -- occupies the Interhemispheric fissure
● Delicate, avascular membrane closely applied but separate ○ Corpus callosum -- floor of the cerebral fissure that
to the inner surface of the dura mater [2024 Trans] forms a connection between the R and L hemispheres
○ Pressure of CSF in subarachnoid space holds this layer B. LOBES
against the dura
● The cerebral cortex is then divided into lobes that are
Pia Mater delineated by certain sulci
● The most internal layer ● These lobes are named according to the cranial bones under
● Delicate, highly vasculated layer which they lie [Snell’s, 258]
● Consists of thin layers of mesodermal cells resembling Frontal Lobe
endothelium ● Anterior to the central sulcus and superior to the lateral
● Covers the entire brain and spinal cord sulcus (Snell, 260)
● Fixed to the CNS by an ectodermal membrane consisting of ● Superolateral surface of the frontal lobe is divided by 3 sulci
marginal astrocytes (pial-glial membrane) and 4 gyri (Snell, 260)
II. CEREBRAL CORTEX
✓Figure 11-17 in the appendix shows the different POVs of the cortex
● Highly folded collection of gray matter (folding increases
surface area)
● Consists of:
○ Gyri
■ Bumps or ridges, made up of the brain cells
■ Brain parenchyma, likened to “hills” on the brain’s
surface [Trans, 2024]
○ Sulci
■ Infoldings or crevices
■ Fissures found between the folds, likened to “valleys”
on the brain’s surface [Trans, 2024]
MAIN SULCI
★Central Sulcus of Rolando/Rolandic Sulcus
○ Downward sulcus separating the frontal and parietal lobes
○ More evident on the lateral than the medial side of the Figure 20. Frontal Lobe and its Gyri and sulci
brain
Table 4. Parts of the Frontal Lobe
★Lateral/Sylvian Fissure
○ Horizontal sulcus separating the temporal lobe from the Precentral ● Anterior to the Central Sulcus of Rolando
frontal and parietal lobes gyrus ● Primary motor area
○ Not continuous from ventral to dorsal ● AKA Brodmann Area 4 (BA4)
Lesions in this gyrus will produce contralateral
○ Laterally, divided into 3 rami → Anterior horizontal ●
hemiparesis (weakness) Snell’s, 271]
ramus, anterior ascending ramus, and posterior ● Precentral sulcus
ramus[2024 Trans]
Premotor ● For movement: initiating new programs for
area movement and introducing changes in programs
that are in progress [Trans, 2024]
● Functions to store programs of motor activity
assembled as a result of past experience
○ Also identified as (BA 6)[2024 Trans]
● Secondary/Supplementary Motor Area [Snell, 291]
○ Found in the medial frontal gyrus on medial
surface
○ Stimulation of this region yields similar effects
as the primary motor complex but needs
stronger stimulation

Superior ● Superior frontal sulcus separates it from middle

frontal frontal gyrus
gyrus
Figure 18. Lateral view of the R cerebral hemisphere showing the main
sulci

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 GROSS ANATOMY GROSS FEATURES, CORTEX AND NEUROHISTOLOGY

Middle ● Inferior frontal sulcus separates it from inferior fissure in the medial cut
frontal frontal gyrus
gyrus Temporal Lobe
● Occupies the area inferior to the lateral sulcus [Snell, 260]
Brodmann
● Divided into 3 gyri
● Located in the middle frontal gyrus
Area 8 (BA- AKA Frontal eye fields: controls eye movement ● Parts of the Temporal Lobe: [Juangco, 2021]
8) ● A component of the “gaze pathway” [Juangco, 2021] ● Sylvian fissure
● Superior temporal gyrus,
○ AKA transverse temporal gyri of Heschel
Inferior Composed of the:
■ Located on the banks of, or deep to the lateral fissure
frontal ● Pars Orbitalis
gyrus ● Pars Triangularis ■ Can only be viewed when the gyri surrounding the
● Pars Opercularis sylvian fissure is inflicted [2024 Trans]
✓Broca’s Area (P. Triangularis + P. Opercularis) ■ Primary auditory area (BA 41,42)
motor area for speech (speech production) ■ Superior to the superior temporal sulcus
*Lesion in this area → Broca’s aphasia/ motor ○ Wernicke’s Area
aphasia/ expressive aphasia ■ Located posterior to the primary auditory area, in the
**Broca’s Aphasia → manifests when there is a dominant side of the individual’s brain
lesion in this area in which output of spontaneous
speech is diminished [Snell’s, 296] ■ For the comprehension of spoken language
■ Lesion → Wernicke's aphasia/ Sensory aphasia/
Frontal Pole ● Just the pole or end of the frontal lobe Receptive Aphasia
● 1 of 3 poles of the brain (along w/ the occipital ● Middle temporal gyrus
and temporal poles) ○ Between the superior and middle temporal sulci
● Inferior temporal gyrus
Orbital ● Lateral to the olfactory sulcus ○ Inferior to the middle temporal sulcus
Gyrus ● Found underneath inferior frontal gyrus ○ Continues to the inferior face of the hemisphere
● Part of the prefrontal cortex [Snell, 291] ● Superior temporal sulcus
● Connected to emotion, judgement, and behavior
● Middle temporal sulcus
[Trans, 2024]
● Temporal pole

Figure 21. Parts of the inferior frontal gyrus. [PPT, Juangco, 2021]
Parietal Lobe [Snell, 260]
● Posterior to the central sulcus and superior to the lateral Figure 22. Lateral view of the left cerebral hemisphere [Snell, 290]

sulcus; extends posteriorly as far as the parieto-occipital lobe Occipital Lobe

● Its lateral surface is divided by 2 sulci into 3 gyri ● Occipital pole
Table 5. Parts of the Parietal Lobe ○ Only part of the occipital lobe that can be seen in the
lateral view
Postcentral ● Primary sensory area ○ Contains the primary visual area (BA 17)
gyrus ● BA 3-1-2
■ Located in the walls of the posterior part of the
✓ NTK: conventionally arranged (and read) this way in
calcarine sulcus [Trans 2024]
journals
● Postcentral sulcus: located posterior to the ✓ See figure 11 in appendix for the simplified drawing
postcentral gyrus PARTS OF THE MEDIAL CUT OF THE BRAIN
✓Refer to Appendix Figure 12 for Medial View of the Brain
Intraparietal ● Perpendicular, runs posteriorly from the middle of ★ Major Parts of the Medial Cut
sulcus the post central sulcus [Snell, 260]
● Divides the parietal lobe into inferior and superior ● Corpus callosum (CC)
lobules ○ “Bundle of nerve fibers which seeks to connect the right
and left hemispheres of the brain” [Juangco 2021]
Superior ● Involved in the interaction of the individual with ○ Large, C-shaped band of white matter [Trans 2024]
parietal the surrounding environment ○ Has 4 parts (Juangco 2021; 2024 Trans)
lobule ● Lesions (especially in the nondominant ■ Rostrum- “head” or the thin anterior end of the corpus
hemisphere) will result in neglect callosum that is continuous with the upper end of the
○ Neglect: “Hindi na nakikita or na-iinterpret ng lamina terminalis
brain mo yung area na yun.” ■ Genu- “bend/ U” or the curved anterior end of the
○ “Hemineglect” or neglect on one side (R or L) corpus callosum that bends inferiorly in front of the
○ Patients neglect to shave their face or dress
body parts contralateral to it [Trans 2024] septum pellucidum
○ Patients write on one side of the paper only, ■ Body- Arches posteriorly to the splenium
or can see and describe one side of a picture ■ Splenium- “tail” or the thick posterior portion
only ○ Lesions: Disconnection Syndromes
■ Causes the disconnection of the R and L sides of the
Inferior ● Integrates sensory information to help the brain that function differently, leading to uncoordinated
parietal individual make sense of what they feel or see or opposing tasks
lobule ○ For integration of diverse sensory information ● Pericallosal sulcus
for speech and perception [Trans 2024]
● Divided into 2 parts: ○ Located above the corpus callosum, and separates it from
○ Supramarginal gyrus (BA 40)- surrounds the the cingulate gyrus [2024 Trans]
posterior end of the Sylvian/Lateral Fissure ● Cingulate gyrus
○ Angular gyrus (BA 39)- surrounds the
superior temporal sulcus ○ Above the pericallosal sulcus; extends from the frontal to
parietal lobe
Parieto- ● Separates the parietal lobe from the occipital lobe ○ Part of the limbic association cortex[2024 Trans]
occipital ○ Not as obvious from a lateral view, seen more ■ Helps with emotions, behavior and visceral functions
● Central sulcus

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 GROSS ANATOMY
○ Not obvious in this view (compared to lateral), but is
related to the paracentral sulcus
○ Located above the cingulate gyrus, and separates it from
the superior frontal gyrus
○ Marginal sulcus (AKA marginal branch of the cingulate
sulcus)
■ Extension of the cingulate sulcus to the superior part
■ Not always present
● Paracentral lobule
○ Mixture of the frontal lobe (anterior) and parietal lobe
(posterior) surrounding the medial extension of the central
sulcus
○ “Paracentral”- around the central sulcus
○ Contains representation for the:
■ Motor and sensory function of the lower extremities
■ Autonomic function, especially in controlling urination
Table 6. Parts of Lobes (seen in a medial cut).
GROSS FEATURES, CORTEX AND NEUROHISTOLOGY
○ Divides the orbital gyrus (lateral) and gyrus rectus
(medial)
○ Has olfactory bulb and tract
○ Contains the olfactory nerve (CN 1)
✓ Olfactory nerves with a role in smell end in the olfactory bulb
through the olfactory tract.
● Orbital gyrus
○ Lateral to the olfactory sulcus
○ part of the orbitofrontal cortex
● Frontal Pole/Orbitofrontal gyrus/area
○ Located near the orbits, in the frontal lobe
○ Special functions: emotion, executive functions, intention

Occipital Lobe

Lingula/ ● Inferior to the calcarine sulcus

Lingual gyrus ● Posterior to the parahippocampal gyrus
● visual function(2024 Trans) Figure 24. Inferior View of the Frontal Lobe

Calcarine ● Separates the lingula from the cuneus

Temporal Lobe
fissure ● Primary visual cortex (BA 17)
○ Found at the banks of the calcarine sulcus
○ For vision on the contralateral visual field
○ Lesion: contralateral hemianopia

Cuneus ● Posterior to the parieto-occipital sulcus

● Aids in vision(2024 Trans)

Parieto- ● Separates parietal lobe from occipital lobe

occipital ● More prominent in the medial side compared
sulcus/fissure to lateral side
● Posterior to the precuneus

Parietal Lobe

Precuneus ● Caudal to the paracentral lobule

● Between the marginal branch or marginal
sulcus and the parieto-occipital sulcus
● Anterior to the parieto-occipital sulcus Figure 25. Inferior View of the Temporal Lobe (PPT, Juangco, 2021)
● Posterior to the marginal sulcus Table 7. Parts of the Temporal Lobe seen Inferiorly; From most lateral to
most medial.
Other Structures
Inferior temporal ● Lateral to inferior temporal sulcus
gyrus ● Aids in vision and memory
Septum ● Film-like partition that separates the R&L
pellucidum lateral ventricles
● Lateral ventricles: space underneath the Inferior temporal ● Separates the inferior temporal gyrus from
corpus callosum which contains CSF sulcus the occipito-temporal/fusiform gyrus

Fornix ● Connects the temporal lobe (hippocampal Occipito- ● In between the ff:
formation) of either side temporal gyrus/ ○ laterally is inferior temporal sulcus
Fusiform gyrus ○ medially is the collateral sulcus
● Has a role in object and face processing
Anterior ✓commissure is a white matter connection from
commissure one site to the other Collateral/ ● Separates the occipito-temporal/fusiform
● For interhemispheric transfer of visual Rhinal sulcus gyrus from the parahippocampal gyrus
information
Parahippocampal ● Most medial gyrus seen at the underside of
Lamina ● Most anterior boundary of the embryologic gyrus the brain
Terminalis neural tube ● Has a role in memory, smell, and
emotion
● Uncus
○ Has a function with memory and
emotions
○ Contains the 3rd cranial nerve
○ Prone to uncal herniation: the uncus
can press on CN III (oculomotor) → can
be lethal because it may compress the
brainstem and cranial nerves attached
to it

Other structures
● Optic nerve
○ Crosses over via the optic chiasm and extends through
the optic tract
○ Has a role in vision
Figure 23. Occipital lobe ● Optic chiasm
● Optic tract
INFERIOR PARTS OF THE BRAIN
● Hypothalamus
Frontal Lobe ○ Controls emotional state
● Gyrus rectus/straight gyrus ○ As well as metabolic processes and other body functions
○ Seen most medially ● Mammillary bodies
● Olfactory sulcus
○ Lateral to the gyrus rectus
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 GROSS ANATOMY GROSS FEATURES, CORTEX AND NEUROHISTOLOGY
○ Damage to these areas is associated with Wernicke-
Korsakoff syndrome
✓ Wernicke-Korsakoff syndrome is a neurodegenerative
disorder due to deficiency in Vitamin B1 (Thiamine).
Associated with confusion, ataxia & nystagmus .(2024 Trans)
● Midbrain
○ Contains CN III and IV
○ Lies at the junction of the middle and posterior cranial
fossae(2024 Trans)
✓ Importance of knowing the different areas of the brain:
localization → certain areas of the brain will have certain
functions and lesions on certain areas of the brain will produce
certain deficits
✓ In the olden times, it is called phrenology → there is a specific
location in the skull that produces certain diseases. (Kind of got
it correct but it is more of a loss of function in these areas.) Figure 27. Transverse temporal gyri of Heschl
C. ORGANIZATION OF THE CORTEX D. SOMATOTOPIC ORGANIZATION
● A particular arrangement of certain areas in the cortex
● These somatotopic maps on the cortex are sometimes called
the motor or sensory homunculus (“little man”)
● The primary somatosensory cortex and primary motor cortex
represent sensation and movement, respectively, for the
opposite side of the body in the postcentral gyrus
★ Lateral to medial: Head → Arm → Leg (Remember HAL)
○ 1 vascular supply only for H and A; separate supply for L

Figure 26. Organization of the Cortex(PPT, Juangco, 2021)

★ Table 8. Organization of the Cortex
Primary motor ● Near the central sulcus
cortex ● Lies in the precentral gyrus
● Controls movement of the opposite side of
the body

Figure 28. The Cortical Homunculus

Primary ● Lies in the postcentral gyrus
somatosensory ● Involved in sensation for the opposite side of Motor Homunculus
cortex the body

Primary visual ● Lies in the occipital lobe along the banks of

cortex the calcarine fissure

Primary auditory ● Located in the temporal lobe

cortex ● Composed of the transverse gyri of heschl
● Not totally separated from other areas

Transverse ● Primary auditory area (BA 41 and 42)

temporal gyri of ● Found in the inferior wall of the lateral fissure;
Heschl can only be viewed when the gyri
surrounding the sylvian fissure is inflicted (2023
Trans)

✓ Additional Info from 2024 Trans:

● Anterior portion: reception of low frequency
sounds
● Posterior portion: reception of high frequency
sounds Figure 29. Localization of functions in the primary motor cortex
● Unilateral lesion → produces partial deafness ● A representation of the body parts in the motor area
in both ears; greater loss in contralateral ear ● Each part of the body is represented differently
○ Related to complexity of movement especially fine motor
Superior temporal gyrus movement
○ Face & hands → finer motor control so more areas in the
Insula brain are needed to execute certain movements, so they
have a bigger representation in the motor homunculus as
opposed to arms and legs.
■ Face fine motor movements → eye motor, eyebrows,
facial expression, chewing, swallowing [2024 Trans]
○ Legs → “malaking muscle nga siya, pero...its
movements does not require fine motor control as much
as the face and hands do ”(Juangco, 2021)
■ Legs and toes cannot be moved as much compared
to your fingers due to less representation [2024 Trans]
✓Importance: the locations will determine the manifestation or
deficit in the patient in cases of stroke (e.g., leg, facial weakness)
Sensory Homunculus

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 GROSS ANATOMY GROSS FEATURES, CORTEX AND NEUROHISTOLOGY

9-12 Superior, middle Thought, cognition, Prefrontal

frontal gyri, movement planning; association cortex;
medial frontal “Personality, attention, frontal eye fields
lobe executive functions,
planning” (Juangco, 2021)

44 Inferior frontal Speech, movement Prefrontal

gyrus (frontal planning association cortex;
operculum) frontal eye fields

★Broca’s Area
(Mostly BA 44, but
also partially BA 45)

In the Parietal lobe

3-1-2 Postcentral Touch Primary sensory

gyrus cortex

Figure 30. Sensory Homunculus Primary

somatosensory
● A representation of the sensation of specific parts of the body cortex
in the postcentral gyrus.
● Facial area and fingers need finer sensation as opposed to 5 Superior parietal Stereognosis Tertiary
lobule somatosensory
arms and legs so they are represented more. cortex; posterior
○ Its parts are more sensitive to touch than back, arms, or parietal association
area- supplemental
legs sensory area
✓Stimulation of this area in humans elicits sensations of
tingling/numbness in the part of the body that corresponds to 7 Superior parietal Visuomotor; Posterior parietal
lobule perception association area;
(and is contralateral to) the area stimulated [2024 Trans] supplemental
● A lesion in this area results in the loss of sensation sensory area
contralateral to the site of the lesion (2024 Trans)
● Genitals are represented 39 Inferior parietal Perception, vision, Parietal-temporal-
lobule (angular reading, speech occipital association
● Tongue and pharynx more sensitive to being pricked by a gyrus) cortex
fishbone than the feet (2024 Trans]
Visual Cortex 40 Inferior parietal Perception, vision, Parietal-temporal-
lobule reading, speech occipital association
● Extension of the somatotopic organization (supramarginal cortex
● Responsible for control of color and certain visual fields gyrus)
✓Auditory cortex also uses the same principle in differentiating
In the Temporal lobe
different volumes, pitches, and frequencies
E. BRODMANN/FUNCTIONAL AREA 22 Superior Hearing and speech Higher-order auditory
● Can be microscopically seen and differentiated temporal gyrus cortex
○ Based on cell type and arrangement ★Wernicke’s Area
■ Difference is due to different cell functions
● Published by Korbian Brodmann in 1909 [2024 Trans] 41 Heschl’s gyri and Hearing Primary auditory
superior cortex
temporal gyrus

42 Heschl’s gyrus Hearing Secondary auditory

and superior cortex
temporal gyrus

In the Occipital lobe

17 Banks of Vision Primary visual cortex

calcarine fissure

18 Medial and Vision; depth Secondary visual

lateral occipital cortex
gyri

19 Medial and Vision, color, motion, Tertiary visual

lateral occipital depth cortex, middle
Figure 31. Brodmann/Functional area in the brain gyri temporal visual area
(medial view)
● 52 cytoarchitectonic areas, each assigned a number Others
corresponding to the order in which Brodmann prepared the
slides [Trans 2024] 38 Temporal pole Smell, emotions Primary olfactory
cortex; limbic
★Table 9. Brodmann Area (BA) location and function. association cortex

BA Location★ Function★ Functional area 43 Insular cortex, Taste Gustatory cortex

frontoparietal
In the Frontal lobe operculum

4 Precentral gyrus Voluntary movement Primary motor ✓ See Fig 36 in the appendix for the location in the brain of these BAs
control complex
★ Remember the difference of BA 17, 18, 19 in lateral vs medial
6 Precentral gyrus Limp and eye Supplementary cuts → BA 17 can be completely seen to be along the banks of
and rostral movement planning motor cortex; calcarine fissure in a medial cut!
adjacent cortex supplementary eye
field; premotor CELLS OF THE NERVOUS SYSTEM
cortex; frontal eye
fields ✓Figures 32-35 in the appendix shows their physical characteristics
Neurons
8 Superior, middle Saccadic eye Frontal eye fields ● Primary functional and anatomical unit of the nervous system
frontal gyri, movements
medial frontal [2024 Trans]
lobe ● Specialized for the reception of stimuli and the conduction of
nerve impulses
Table 10. Classification of neurons [Snell, 37]
Morphologic Classification Arrangement Locations

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of Neurite(s)
○ Located internal in the CNS, external in the PNS
● A collection of cell bodies in the CNS is called nucleus
Number, Length and Mode of Branching of Neurites ○ In the PNS it is called ganglion
● A collection of nerve fibers in the CNS is called tract
Unipolar Single neurite Posterior root ○ In the PNS, it is called a nerve
divides a short ganglion
distance from F. LAYERS OF THE CORTEX
cell body ● Due to Brodmann areas having different cell types and
arrangements

Bipolar Single neurite Retina,

emerges from sensory
either end of cell cochlea,
body vestibular
ganglia

Figure 37. Layers of the cortex under a microscope (PPT, Juangco, 2021)
Multipolar Many dendrites Fiber tracts of ★Neocortex (aka isocortex)
and one long brain and
axon spinal cord, ○ Most advanced cortex
peripheral ○ Divided into 6 layers, arranged from superior to inferior
nerves and
motor cells of Table 12. Cell Layers of the Neocortex
spinal cord
Layer Layer Name AKA Main Connections

I Molecular - Dendrites and axons from

other layers
Anaxonic No axon or Brain and
cannot be Retina (as the II Small External Cortical-cortical
differentiated amacrine cell
from dendrites and retina pyramidal granular connections
horizontal
cells)
III Medium External Cortical-cortical
pyramidal pyramidal connections

IV Granular Internal Receives inputs from

granular thalamus
✓See Appendix Figure 32. for clearer image of neuron classification
V Large Internal Sends outputs to
Neuroglia pyramidal pyramidal subcortical structures
● Supporting structure of the neurons (other than thalamus)
● Consists of all other nervous system cells aside from the
neurons VI Polymorphic Multiform Sends outputs to thalamus
Table 11. Glial cell types

Oligodendro ● Myelinates and insulates CNS axons

cytes (CNS) ● Aids in faster action potential propagation
● Can myelinate several neurons

Astrocytes ● Most numerous type of glial cells

(CNS) ● Provides structural and metabolic support for
neurons, especially at synapses
● Aids in the formation of the blood-brain barrier
● Regulates interstitial fluid composition
● Has repair processes
● Assists with neuronal development
● Replicates to occupy space of dying neurons
● “looks like a star under the microscope because
they have a lot of processes”

Ependymal ● Aids in the production & movement of

cells (CNS) cerebrospinal fluid
● Lines the ventricles and central canals of the
CNS

Microglia ● Phagocytic cell

(CNS) ● Protects the CNS by engulfing potentially Figure 38. The six layers of the neocortex
harmful substances
● Allocortex: older type of cortex which has 3 layers and 2
Satellite cells ● Electrically insulates PNS cell bodies
types:
(PNS) ● Regulates nutrient and waste exchange for cell ○ Paleocortex is located in the olfactory area
bodies ○ Archicortex is located in the hippocampus and
● Located in the peripheral ganglia parahippocampal gyrus
● Can myelinate several neurons ● The layers cannot be seen by the naked eye, except
sometimes for the line of Gennari
Schwann ● Forms the myelin sheath of axons in the PNS
cells (PNS) ● Aids in electrical insulation
● Can only myelinate a single neuron
● Located in the peripheral nerves
● Has points in between called, Nodes of Ranvier

★Organization of the cells

● Gray matter is composed of soma or cell bodies
○ Located external in the CNS, internal in the PNS
● White matter is composed of axons Figure 39. Line of Gennari in the occipital lobe [Juangco, 2021]

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G. DOMINANCE ○ Agnosia = Ignorance
● Suggests that a part of your brain (left vs right) is more active ○ Inability to recognize sensory stimuli
than the other; i.e., “left-brainer” or the “right brainer” ○ Will manifest different problems depending on the side
● The majority of the R-handed and L-handed population is L- damaged
brain dominant ○ Different types of agnosia [Ex. color agnosia, finger
○ But a significant amount of L-handed people is still R- agnosia, tactile agnosia (astereognosis), visual agnosia]
brain dominant A. CORTICAL FUNCTIONS: APHASIA
Table 13. Language Dominance and Dominant Hand ● Inability to understand or express words as symbols for
Language Right Handed Left Handed communication, even though the primary sensorimotor
Dominance pathways to receive and express language and the mental
status are relatively intact
Left Brain 95% 60-70% ● Generally means problem with language [Trans, 2024]
○ One can hear or read but can’t express or understand
Right Brain 5% 30-40% [Trans, 2024]
● “Just know Broca’s and Wernicke’s aphasia for now”
● L-brain dominant = language areas, Broca’s and Wernicke’s ● Broca’s Aphasia (Broca’s Area: Area 44) [Trans, 2024]
Area, are on the left side of your brain ○ AKA: Motor/Expressive/Anterior/Non-fluent aphasia
● Importance: CT scan and MRI were previously uncommon ○ Site of lesion: Inferior frontal gyrus
○ Surgeons would assume that in aphasic patients who are ○ Not fluent
right-handed, that the patient’s language dominance is at ○ Can understand
the left and open the brain there ○ Cannot repeat and name
Table 14. Responsibilities of the dominant and non-dominant sides ● Wernicke’s Aphasia (Wernicke’s area: Area 22)
Dominant Non Dominant ○ AKA: Fluent/Posterior/Sensory/Receptive aphasia
○ Wernicke’s area location: Posterior parasylvian, temporal
Language: Prosody (emotion conveyed by operculum
-Fluency is affected tone of voice) ○ Very fluent but “Word salad”
-Speech impairment
■ “Kung anu-ano sinasabi. Salita nang salita, but
Skilled motor formulation (praxis) Visual-spatial analysis and makes no sense”
spatial attention ○ Understanding, repetition and naming is poor
○ Each type is located differently in the brain
Arithmetic: Sequential and Arithmetic: Ability to correctly Table 15. Characteristics of Broca’s and Wernicke’s Aphasia
analytical calculating skills line up columns of numbers on
the page Type Fluency Understands Repetition Naming

Musical Ability: Sequential and Musical Ability: In untrained Broca’s Poor; Effortful Good Poor Poor
analytical skills in trained musicians and for complex
musicians musical pieces in trained
musicians Wernicke’s Good; Poor Poor Poor
Fluent sounds
but “word
Sense of direction: Following a set Sense of direction: Finding one’s salad”
of written directions in sequence way by overall sense of spatial
orientation
✓ Flowchart of types of aphasia is in the Appendix
● Interplay of the two sides results to a great outcome of ★LOCALIZING LESIONS CASES
function such as in arithmetic and in music wherein both This previously healthy 48-year-old bank employee was dancing
sides play a role and chatting when his dance partner suddenly noticed that he
III. CLINICAL CONDITIONS could no longer lead properly and had become unusually taciturn.
● Lesions on different sides of the brain will give different From that moment onward, his speech seemed increasingly
clinical effects, as seen in figure labored. He could barely produce even fragmentary sentences.
● Lesions on areas below will give the corresponding effects His wife took him to the hospital. Examining him, the neurologist
found the patient’s right limbs felt heavy to him, his right arm sank
when he extended both arms in front of his chest. He barely spoke
at all except in response to questions, to which he gave
telegraphic, monosyllabic answers. He had difficulty finding words
and naming objects, and his sentence construction was faulty.
WHERE IS THE LESION?
1st Case
● Seemingly with a motor problem
○ No longer lead properly
○ Heavy arms
○ Right arms sank when extended both arms in front of the
chest
○ Problems with the right extremities
● Appears to have Broca’s aphasia due to
○ Telegraphic speeches
○ Monosyllabic answers
○ Cannot name objects
○ Fragmented speech
● Motor and Broca’s area both found in the frontal lobe
● Broca’s area and control of the right side of the body is at the
left side of the brain

Figure 40. Locations in the cerebral cortex in relation to functional deficits

due to lesions
● Hemiplegia [Trans, 2024]
○ Lesion on the primary motor cortex
○ Hemi (half) + plegia (weakness) = One-sided weakness
● Hemihypesthesia [Trans, 2024]
○ Lesion on the somatosensory cortex
○ Hemi (half) + hypesthesia (low sensation)
● Head and eyes turned to the left [Trans, 2024]
○ Damage to area 8 (gaze area)
● Sensory agnosia [Trans, 2024]

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Figure 41. MRI showing Broca’s aphasia. (L) Axial cut, (R) Coronal cut.
(Orange = Anterior; Yellow = Right; Green = Posterior; Blue = Left)
● Axial cut at the left
○ Lesion at the left side of the brain-> Broca’s aphasia and
right sided weakness
● Coronal cut at the right
○ Lesion seen in the inferior portion of the frontal lobe
(location of Broca’s area)
● Broca’s Aphasia [Trans, 2024]
○ Lesion in area 44, inferior frontal gyrus
● Right Hemiplegia [Trans, 2024]
○ Lesion in area 4, precentral gyrus (primary motor cortex)
2nd Case
Figure 42. MRI showing Wernicke’s aphasia
● Patient with a lesion at the parietal lobe (near the temporal
lobe)
○ So possibly patient has Wernicke’s aphasia (near
temporal lobe)
○ Possible sensory deficits in the face
B. GERSTMANN’S SYNDROME
● Lesion at the left parietal lobe in the region of the angular
gyrus
● Lesion of the dominant parietal lobe
● Agraphia (Inability to write)
● Acalculia (Loss of ability to do mathematics)
● Finger agnosia (Inability to name one’s own or another
person’s fingers)
● Right-left disorientation (Inability to make the distinction
between the right and left side of the body)
Case
★ This 69-year-old retiree had had poorly controlled arterial
hypertension for a number of years and two brief episodes of left
arm weakness in recent months. Getting up from bed one night,
he suddenly fell to the ground and could not stand up again. He
shouted for help, waking a neighbor who had a spare key to his
apartment. She notified the emergency physician on call, who took
him to the hospital. The admitting house officer noted sinking of
the left arm and leg and impaired fine motor control of the left
hand. The patient failed to notice a light tap on the left side of his
body when simultaneously tapped at a mirror-image location on
the right side. He did not react when spoken to from his left side.
When the doctor asked him to draw a house and a tree, he drew
only the right sides of these objects. He generally tended to look to
the right and appeared to be conscious only of the right side of
space. WHERE IS THE LESION?
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GROSS FEATURES, CORTEX AND NEUROHISTOLOGY
Figure 43. Result after asking patient to divide the lines in half; Both show
there is a tendency to divide more to the right side
Figure 44. Result when the patient was asked to draw a clock
Figure 45. MRI showing lesion of patient at the right parietal lobe causing
left sided weakness and neglect of the left side
FRONTAL LOBE SIGN [TRANS, 2024] [JUANGCO, 2021]
● Abulia (no energy to exert effort, lazy)
● Disinhibition (risky behavior, profanities)
● Witzelsucht or inappropriate jocularity (Nagpapatawa)
● Limited insight
● Perseveration (Repetition of answer or statement)
○ Okay lang po, okay lang po, okay lang po
● Frontal release signs (Reemergence of primitive reflexes that
are normally present in infants)
✓A summary of lesions is provided in the appendix. However, to
better locate a lesion, it is more important to know the function
first of each part of the brain
IV. REVIEW QUESTIONS
1. What bone is anterior to the temporal bone?
A. parietal
B. sphenoid
C. occipital
D. frontal
2. The location of the primary auditory area (BA 41 & 42):
A. Temporal lobe
B. Parietal lobe
C. Occipital lobe
D. Frontal lobe
3. The following statements concern the longitudinal cerebral
fissure:
A. The fissure contains the fold of dura mater, the falx
cerebelli
B. The fissure contains the middle cerebral arteries.
C. The superior sagittal sinus lies below it.
D. In the depths of the fissure, the corpus callosum crosses
the midline.
E. The inferior sagittal sinus lies above it.
4. The following statements concern the central sulcus:
A. The central sulcus extends onto the medial surface of
the cerebral hemisphere.
B. The frontal lobe lies posterior to it.
C. The parietal lobe lies anterior to it.
D. The central sulcus is continuous inferiorly with the lateral
sulcus.
★ IMPORTANT!! ✓ TG/TH Note
 GROSS ANATOMY GROSS FEATURES, CORTEX AND NEUROHISTOLOGY
E. The arachnoid mater extends into the central sulcus. sinus lies superior to the longitudinal fissure; The 5th statement is
5. It is the largest dural infolding that separates the R from the false because the inferior sagittal sinus runs along the inferior
L cerebral hemisphere edge of the falx cerebri), 4A (The 2nd statement is false because
A. Tentorium cerebelli the frontal lobe lies anterior to the central sulcus; The 3 rd
B. Falx cerebri statement is false because the parietal lobe lies posterior to it;
C. Falx cerebelli The 4th statement is not true because the central sulcus actually
D. Diaphragma sellae terminates near the lateral sulcus and is not continuous with it;
6. The postcentral gyrus is the primary motor area. Lesions in The 5th statement is incorrect because the arachnoid is not
this gyrus will produce contralateral hemiparesis (weakness) supposed to come in contact with the cerebral cortex as it is only
A. Only 1st statement is TRUE the intermediate meningeal layer.), 5B, 6D (The primary motor
B. Only 2nd statement is TRUE area is the precentral gyrus, not the postcentral gyrus; Lesions in
C. Both statements are TRUE the precentral gyrus produces contralateral hemiparesis), 7A,
D. Both statements are FALSE 8D, 9B, 10C (Remember, in Broca’s Aphasia, the damage is
7. What BA is the Wernicke’s area motor in nature and the gist of the sentence makes sense given
A. BA 22 the context but might not be properly formed or grammatically
B. BA 45 correct in its delivery. In Wernicke’s Aphasia, the damage is in
C. BA 44 the part that enables interpretation and often results in “word
D. BA 17 salad” or nonsense words put together.)
8. Which of the following is true about the parietal lobe V. REFERENCES
A. Its lateral surface is divided into 4 gyri by 3 sulci Brain Lesions. (2018, May 07). Retrieved from Cleveland Clinic:
B. The intraparietal sulcus runs parallel to the post central https://my.clevelandclinic.org/health/diseases/17839-brain-lesions
Douglas, G., Nicol, F., & Robertson, C. (2013). Macleod's Cllinical
sulcus Examination. London: Elsevier Health Sciences UK.
C. The superior parietal lobule is divided into 2 parts Dubin, M. (n.d.) Retrieved from Professor Mark Dubin- University of
Colorado: https://spot.colorado.edu/~dubin/index.html
D. Lesions in the superior parietal lobule lead to Krebs, C., & Fejtek, M. (n.d.). Retrieved from Functional Neuroanatomy:
hemineglect http://neuroanatomy.ca/about.html
9. Gertsmann’s syndrome involves the following except: Lingford-Hughes, A., Kalk, N.. (2012). Parietal lobe. Clinical
neuroanatomy. Retrieved from
A. Agraphia https://www.sciencedirect.com/topics/neuroscience/parietal-lobe
B. Hemiplegia Moore, K. L., R., A. A., & Dalley, A. F. (2018). Clinically oriented
anatomy (8th ed.). Wolters Kluwer Health.
C. Right-left disorientation Patestas, M. A., & Gartner, L. P. (2006). A textbook of neuroanatomy.
D. Finger agnosia Hoboken, NJ: Wiley Blackwell.
Snell, R. S. (2010). Clinical Neuroanatomy (7th ed.). Philadelphia
10. A person who said “A book book two table” when the person Pennyslvania: Wolters Kluwer Health.
actually means “There are two books on the table” has: Tidy, C., & Willacy, H. (2016, Sept 29). Temporal Lobe Lesion. Retrieved
A. Wernicke’s aphasia from Patient: https://patient.info/doctor/temporal-lobe-lesions-pro
B. Dyslexia VI. MNEMONICS
C. Broca’s aphasia ● BA 22 is Wernicke’s area, double it, 44, you get the Broca’s
D. Hemiplegia area
Answers: 1B, 2A, 3D (The 1st statement must be changed to falx ● In remembering parts of the corpus callosum, “Remember
cerebri, not falx cerebelli; The 2nd statement is not true for the Genu Before Splenium”
middle cerebral artery because it actually traverses the Sylvian ○ Rostrum -> Genu -> Body -> Splenium
fissure, The 3rd statement is false because the superior sagittal
VII. APPENDIX

Figure 8. Gross Anatomy of the meningeal layers of the brain

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Figure 11. Diagram for lateral view of brain

Figure 12. Medial View of the Brain [PPT, Juangco, 2021

Figure 13. Superior view of the brain

Figure 14. Inferior View of the Brain

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Figure 15 &16. Lateral view of the left cerebral hemisphere and the 2 Major Sulci Figure 45. Lateral view of the Right cerebral hemisphere and the 2 Major
Sulci

Figure 17. Lateral view of the left cerebral hemisphere (Image from PPT, Juangco 2021)

Figure 32. Types of neurons

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Figure 33. Neuron and Glial Cell Types

Figure 34. Cells of the nervous system

Figure 35. Brodmann Areas [Dubin, n.d.]

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Figure 46. Aphasia Flowchart

Figure 47. Features of localized cerebral lesions

VIII. SUMMARY

Major Division Phylogenetic structures

Cerebral hemisphere

Subcortical white matter

Telencephalon
Basal ganglia

Prosencephalon Basal forebrain

Thalamus

Diencephalon Hypothalamus

Epithalamus

Mesencephalon Midbrain

Pons
Metencephalon
Rhombencephalon Cerebellum

Myelencephalon Medulla

Cranial bones
● Occipital (1), parietal (2), frontal (1), temporal (2), sphenoid, ethmoid
● Sphenoid and ethmoid bones are seen better in the sagittal view
Sutures
● Lambdoid: occipital - parietal
● Sagittal: parietal - parietal
● Squamous: parietal - temporal
● Coronal: parietal - frontal
Meninges
● Membranous coverings of the brain
● Functions of the Meninges:

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○ protect the brain,

○ form supporting framework for arteries, veins, and vesour sinuses
○ enclose the subarachnoid space
● 3 membranous connective tissue layers:
○ Dura Mater: tough, thick external fibrous layer ; aka pachymeninx
○ Arachnoid Mater: thin intermediate layer
○ Pia Mater: delicate internal vasculated layer
● Leptomeninx: continuous membranes collectively made up of arachnoid + pia maters
● Subarachnoid space: separates arachnoid from the pia mater; contains CSF
Projections/Infoldings of the Dura
● Divides the cranial cavity into compartments
Falx Cerebri Tentorium Cerebelli Falx Cerebelli Diaphragma Sellae

● largest infolding ● 2nd largest infolding ● lies inferior to the tentorium ● smallest infolding
● lies in the interhemispheric ● separates occipital lobes of cerebelli in posterior part of ● covers pituitary gland in the
fissure cerebral hemispheres from the posterior cranial fossa fossa and has an aperture
● separates R/L cerebral the cerebellum ● separates the cerebellar for passage of infundibulum
hemispheres ● divides the cranial cavity hemisphere and hypophyseal veins
into supratentorial and
infratentorial
compartments

Functional Anatomy of the Cerebral Hemispheres

● Largest part of the brain
● Cerebral cortex: highly folded collection of gray matter which increases surface area
○ Gyrus/Gyri -- elevations/folds
○ Sulcus/Sulci -- depressions/fissures
● Main Sulci of the brain
○ Central Sulcus of Rolando: downward sulcus that separates the frontal and parietal lobes
○ Lateral/Sylvian Fissure: horizontal sulcus that separates the temporal lobe from the frontal and parietal lobes
● Insula/Island of Reil
○ considered the “5th lobe”
○ lies deep within the lateral fissure
○ involved in autonomic functions
● Cerebral Hemispheres
○ (2) hemispheres separated in the midline by the Interhemispheric fissure
● Each hemisphere subdivided into 5 lobes: Frontal, Parietal, Temporal, Occipital, Insula, and Limbic
Parts seen in the Lateral Surface
[Frontal Lobe]
● Extends from the frontal pole to the central sulcus
● The frontal lobe’s superolateral surface is subdivided into four gyri and three sulci
Sulcus Gyrus Relationship of gyrus to sulcus

Precentral sulcus Precentral gyrus lie between precentral sulcus (A) and central
sulcus (P)

Superior frontal sulcus Superior frontal gyrus lie superior to the superior frontal sulcus

Superior and Inferior frontal sulcus Middle frontal gyrus lie between the superior and inferior frontal
sulcus

Inferior frontal sulcus Inferior frontal gyrus lie inferior the inferior frontal sulcus

● Precentral Gyrus
○ Primary Motor Area
○ Brodmann Area 4 (BA 4)
○ Lesions in this gyrus will produce contralateral hemiparesis (weakness)
● Premotor Area
○ Anterior to the precentral sulcus
○ Brodmann Area 6 (BA 6)
○ For movement: initiating new programs for movement and introducing changes in programs that are in progress [Trans, 2024]
○ Secondary/Supplementary Motor Area: stimulation of this region yields similar effects as the primary motor complex but
needs stronger stimulation
● Frontal Gyrus
○ Divisions: Superior, Middle, Inferior Frontal Gyrus
○ Inferior Frontal Gyrus: (anterior to posterior)
■ Pars orbitalis
■ Pars triangularis
■ Pars opercularis
○ Broca’s Area = pars opercularis + pars triangularis
■ Functions in speech production
○ Middle Frontal Gyrus:
■ Frontal Eye Fields (controls eye movement)
■ Brodmann Area 8 (BA 8)
○ Frontal Pole
■ End of the frontal lobes
○ Orbital Gyrus
■ Part of the prefrontal cortex
[Parietal Lobe]
● Extends posteriorly from central sulcus to the parieto-occipital lobe
● divided by 2 sulci and 3 gyri (see table 2)
○ from the central sulcus → postcentral gyrus → postcentral sulcus
○ perpendicular to the middle of the postcentral sulcus: intraparietal sulcus separates the superior parietal lobule (gyrus) and
inferior parietal lobule (gyrus)

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Gyrus Relationship of gyrus to sulcus Details

Postcentral gyrus lie between postcentral sulcus (P) and central ● Primary sensory area
sulcus (A) ● BA 3,1,2

Superior parietal lobule lie superior to the intraparietal sulcus ● Involved in the interaction of the individual with the
(gyrus) surrounding environment
● Lesions cause hemineglect

Inferior parietal lobule (gyrus)
lie inferior to the intraparietal sulcus
● Integrates sensory information to helps the individual
make sense of what they feel or see
● Divided into
● Supramarginal gyrus (BA 40)
● Angular gyrus (BA 39)

[Temporal Lobe]
● Occupies the area inferior to the lateral sulcus
● Its lateral surface is divided into 3 gyri by 2 sulci
○ from lateral sulcus: sup temporal gyrus → sup temporal s. → middle temporal g. → middle temporal s. → inf temporal g.
Gyrus Relationship of gyrus to sulcus Details

Superior temporal gyrus
lie superior to the superior temporal sulcus
● Transverse temporal gyri of Heschel
○ in the inferior wall of the lateral fissure
○ Primary auditory area (BA 41,42)
● Wernicke’s area
○ posterior to the primary auditory area, in the dominant side
○ for the comprehension of spoken language
○ Lesions: Wernicke's aphasia/ Sensory aphasia/
Receptive Aphasia

Middle temporal gyrus lie between the superior and middle temporal n/a
sulci

[Occipital Lobe]
● Occipital pole- contains the primary visual area (BA 17)
Parts seen in the Medial Cut of the Brain
[Major Medial Sulci of the Brain]
Sulci Description

Pericallosal sulcus Located above the corpus callosum, and separates it from the cingulate gyrus

Cingulate sulcus Located above the cingulate gyrus, and separates it from the superior frontal gyrus
Marginal Sulcus
○ extension of the cingulate sulcus to the superior part

Central sulcus Surrounded by the paracentral lobule

[Major Parts of Medial Cut]
Part Description

Corpus Callosum - Bundle of nerve fibers which connects the right and left hemispheres of the brain
- Lesions: Disconnection Syndromes
- 4 parts: rostrum, genu, body, splenium

Cingulate Gyrus - Above the pericallosal sulcus; extends from the frontal to parietal lobe
- Part of the limbic association cortex

Paracentral Lobule
- Mixture of the frontal lobe (anterior) and parietal lobe (posterior) surrounding the medial extension of the
central sulcus
- Contains representation for the:
○ Motor and sensory function of the lower extremities
○ Autonomic function, especially in controlling urination

[Occipital Lobe]
● Lingula/Lingual gyrus → has visual function
● Calcarine fissure → has primary visual cortex (BA 17) for vision of contralateral visual field
● Cuneus → aids in vision
● Parieto-occipital sulcus/fissure → prominent in medial side
[Parietal Lobe]
● Precuneus → between marginal branch/cingulate sulcus and parieto-occipital sulcus
[Other Structures]
● Septum pellucidum → separates lateral ventricles
● Fornix → connects the temporal lobe and diencephalon
● Anterior commissure → for interhemispheric transfer of visual information
● Lamina terminalis → most anterior boundary of the embryologic neural tube
Inferior Parts of the Brain
[Frontal Lobe]
● Frontal pole/Orbitofrontal gyrus/area → near the orbits, for emotion, executive functions, intention
● Gyrus rectus/straight gyrus → most medially
● Olfactory sulcus → has bulb and tract; contains olfactory nerve
● Orbital gyrus → lateral to olfactory sulcus
[Temporal Lobe]
● Inferior temporal gyrus → aids in vision and memory
● Inferior temporal sulcus → separates infer. temporal gyrus and occipito-temporal gyrus
● Occipito-temporal gyrus/Fusiform gyrus → role in object and face processing
● Collateral/Rhinal sulcus → separates occipito temporal gyrus and parahippocampal gyrus

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 GROSS ANATOMY GROSS FEATURES, CORTEX AND NEUROHISTOLOGY

● Parahippocampal gyrus → most medial; role in memory smell, emotion

● Uncus → part of hippocampal gyrus, contains Cranial Nerve III
[Other Structures]
● Optic nerve → role in vision
● Optic chiasm
● Optic tract
● Hypothalamus → controls emotional state and metabolic process
● Mammillary bodies → involved in Wernicke-Korsakoff Syndrome
● Midbrain → contains CN III and IV
Organization of the Cortex
● Primary motor cortex → at precentral gyrus; controls movement of opposite side of body
● Primary somatosensory cortex → at postcentral gyrus; sensation for opposite side of body
● Primary visual cortex → in occipital lobe, along banks of calcarine fissure
● Primary auditory cortex → has transverse gyri of heschl; not totally separated
○ Transverse temporal gyri of heschl → primary auditory area (BA 41 and 42)
Cortical Homunculus
● somatotopic organization
● disproportionate representation of body parts
○ related to fine motor movements (motor homunculus)
○ related to finer sensation (sensory homunculus)
[Area with large representation in the homunculus]
Motor Homunculus Sensory Homunculus

● face ● face
● hands ● tongue
● fingers
Brodmann Areas
● are different regions of the cerebral cortex that are classified based on microscopic appearance and function
The nervous system is composed of two groups of cells: the neurons and the neuroglia.
The neuroglia:
● In the CNS: Oligodendroglia, Astrocytes, Ependymal cells, and Microglia
● In the PNS: Satellite cells and Schwann cells
There are two type of cortex: The 1) Neocortex (6 layers) and 2) Allocortex (3 layers)
● The brain and spinal cord composes the central nervous system
● The cerebral cortex has gyri (ridges) and sulci (furrows), and has five key lobes which are the frontal, parietal, temporal, occipital,
and limbic lobes
● The brainstem can be divided into the midbrain, pons, and medulla
● The gray matter is the accumulation of neuronal cell bodies and is located located to the external of the white matter in the CNS
● The white matter is the accumulation of myelinated axons and can be seen internal to the gray matter
● The ventricular system is a fluid-filled space consisting of:
○ Two lateral ventricles with each having an inferior, posterior, and anterior horn
○ A third ventricle
○ A fourth ventricle which is connected to the third via a cerebral aqueduct
● Broca’s Aphasia (Broca’s Area: Area 44)
○ AKA: Motor/Expressive/Anterior/Non-fluent aphasia
○ Broca’s area location: (inferior frontal gyrus)
○ Not fluent
○ Can understand
○ Cannot repeat and name
● Wernicke’s Aphasia (Wernicke’s area: Area 22)
○ AKA: Fluent/Posterior/Sensory/Receptive aphasia
○ Wernicke’s area location:Superior temporal gyrus
○ Understanding, repetition and naming is poor
○ Each type is located differently in the brain
Type Location Fluency Understands Repetition Naming

Broca’s Inferior frontal gyrus Poor; Good Poor Poor

Effortful

Wernicke’s Superior temporal gyrus Good; Poor Poor Poor

Fluent sounds but “word salad”

Gertsmann’s Syndrome
● Lesion at the left (dominant) parietal lobe in the region of the angular gyrus
● Agraphia (Inability to write)
● Acalculia (Loss of ability to do mathematics)
● Finger agnosia (Inability to identify one’s own or another’s fingers)
○ Inability to name the fingers
● Right-left disorientation (Inability to make the distinction between the right and left side of the body)

18 of 18 SLMCCM-WHQM 2025 #BenteSingko ★ IMPORTANT!! ✓ TG/TH Note