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The Cerebrum

Prof. Yama O.E.


• Cerebrum is the largest part of the
brain made up of 2-hemispheres
(right & left) partially joined by the
corpus callosum.
• Each hemisphere is divided into 4
lobes.
• Cerebrum controls emotions, sensory
perception, memory, thoughts,
judgment & all voluntary action.
• The 2 hemispheres are separated by
the longitudinal cerebral fissure
which contains the falx cerebri.
• Cerebral hemispheres are separated
from the cerebellum by the
tentorium cerebelli, a horizontally
lying dural reflection.
• Cerebral hemisphere has 3
surfaces:
oLateral (superolateral)
surface: is convex being
moulded to the cranial vault.
oMedial surface: is flattened.
oInferior surface: is irregular
being moulded to the
irregular floor of the anterior
& middle cranial fossae & to
the upper surface of the
tentorium cerebelli.
Surfaces characteristics of the Cerebrum

• The surfaces of the cerebral


hemisphere are not smooth.
• They are interrupted by a large
number of depressions (sulci)
which separate various
elevations (gyri).
• Each sulcus is produced by an in
folding of the cerebral cortex.
• Accordingly the sulci result in
marked increase in the surface
area of the cortex without
increasing the size of the
cerebral hemisphere.
• Cerebral hemisphere has 3
boarders:
o An arched superior border:
separates the lateral from the
medial surfaces. It is related to the
superior sagittal venous sinus of the
dura.
o A curved superciliary border:
separates the lateral from the
inferior surfaces in the anterior
cranial fossa.
o The inferior border: separates the
lateral from the inferior surfaces
in the middle & posterior cranial
fossae. A slight depression called
the preoccipital notch is seen on
this border about 2-inches in front
of the occipital pole.
Division of the Cerebral hemisphere into Lobes
• 3 major sulci (fissures) divide the
hemisphere into lobes. They are:
• (i.) Central sulcus (fissure of
Rolando):
oIt runs obliquely downwards &
forwards across the lateral
surface of the hemisphere,
extending from a point a little
behind the middle of the
superior border down to a point
immediately above the middle of
the posterior ramus of lateral
fissure.
oIt separates the motor area
(anterior to it in the frontal lobe)
from the sensory area (posterior
to it in the parietal lobe).
• (ii.) Lateral fissure (Fissure of Sylvius):
begins on the inferior surface extends
laterally between the temporal & frontal
lobes, to reach the lateral surface of the
hemisphere where it divides into 3 rami:
oAscending ramus: runs upwards
cutting into the frontal lobe.
oAnterior (horizontal) ramus: runs
forwards cutting into the frontal lobe.
oPosterior ramus: runs backwards on
the lateral surface, almost parallel to the
inferior border. Its posterior end turns
upwards cutting into the parietal lobe.
• (iii.) Parieto-Occipital Sulcus: is a deep
sulcus found on the medial surface close to
occipital pole. Its upper end cuts the
superior border of the hemisphere about 2
inches in front of the occipita1 pole &
turns down a little on the lateral surface of
the hemisphere.
• Lobes of the Cerebral Hemisphere
• Each hemisphere is divided into 4
lobes & the Insula:
• Frontal lobe: is bounded by the
central sulcus behind, the superior
border above, the superciliary border
below & the frontal pole in front.
• Parietal lobe: is bounded by the
central sulcus in front, the superior
border above, the upper half of the
line joining the parieto-occipital
sulcus & pre-occipital notch behind &
the posterior ramus of lateral fissure &
an imaginary line joining the posterior
ramus with the middle of the line
between the parieto-occipital sulcus &
preoccipital notch below.
• Temporal lobe is bounded by the inferior border below, the posterior ramus of
the lateral fissure above, the lower half of the line joining the parieto-occipital
sulcus & preoccipital notch behind & temporal pole in front.
• Occipital lobe forms the posterior extremity of the lateral surface of the
hemisphere. It lies behind an imaginary line drawn from the upper end of the
parieto-occipital sulcus down to the preoccipital notch. It is bounded posteriorly
by the occipital pole.
• The insula is a submerged part of the cortex which lies in the bottom of the
posterior ramus of the lateral fissure.
Sulci & Gyri on the Lateral Surface
• Frontal Lobe
• Sulci: sulci on the lateral aspect:
o Precentral sulcus: is about a finger’s breath anterior to
the central sulcus. It is nearly parallel to the central
sulcus and is usually divided into upper and lower parts.
o Superior frontal sulcus: begins in the upper part of
precentral sulcus & runs forwards nearly parallel to the
upper border.
o Inferior frontal sulcus: begins in the lower part of
precentral sulcus & runs forwards & then downwards.
• Gyri: gyri on the lateral aspect:
o Precentral gyrus lies between central & precentral
sulci.
o Superior, Middle & Inferior frontal gyri by the
superior & inferior frontal sulci.
o The inferior frontal gyrus is subdivided by the anterior
& ascending rami of lateral fissure into 3 parts:
 Orbital part, below the anterior ramus.
 Angular or triangular part, between the two rami.
 Opercular part, between the ascending ramus &
precentral sulcus. It covers part of the insula.
• Parietal Lobe
• Sulci: sulci include:
o Post central sulcus, runs nearly parallel to the
central sulcus & about one finger's breadth
behind it
o Intraparietal sulcus, begins from the post-
central sulcus & runs backwards towards the
occipital lobe parallel to superior border.
• Gyri: gyri include:
o Postcentral gyrus between central &
postcentral sulci.
o Superior parietal lobule
o Inferior parietal lobule cut into from
below by the upturned posterior ends of the
posterior ramus of lateral sulcus & superior
temporal sulcus. The ends of these sulci are
capped by 2 arcuate gyri in inferior parietal
lobule: (a) Supramarginal gyrus:
surrounds upturned back end of posterior
ramus of lateral sulcus (b) Angular gyrus:
surrounds the upturned back end of the
superior temporal sulcus.
• Temporal Lobe
• Sulci: sulci include:
o Superior temporal sulcus, which begins
near the temporal pole & runs backwards
nearly parallel to the posterior ramus of
lateral fissure about one finger breadth below
it. Its posterior end turns up cutting into the
parietal lobe where it is surrounded by the
angular gyrus.
o Inferior temporal sulcus, is an interrupted
sulcus which runs parallel to the superior
temporal sulcus about one finger breadth
below it.
• Gyri: gyri include:
o Superior temporal gyrus, lies between the
posterior ramus of lateral fissure & superior
temporal sulcus.
o Middle temporal gyrus, lies between the
superior & inferior temporal sulci.
o Inferior temporal gyrus (Lateral occipito-
temporal gyrus), lies below the inferior
temporal sulcus.
• Occipital Lobe
• The main parts of
the occipital lobe
are found on the
medial surface.
• On the lateral
surface the
posterior end of
the intra-parietal
sulcus may extend
into the occipital
lobe.
• The Insula
• It is a large submerged part of the cerebral
cortex which is buried in the bottom of the
lateral fissure on the lateral surface of the
hemisphere.
• It is a conical mass having a base & an
apex, base is surrounded by a circular
sulcus.
• It has 2 long gyri on its posterior aspect & a
number of small short gyri in front. Its
surface is crossed by the middle cerebral
artery.
• The parts of the cortex which overlap the
insula are termed the opercula. They are the
lips of the posterior ramus of the lateral
sulcus. The opercula includes parts from
frontal, parietal & temporal lobes.
Sulci & Gyri on the Inferior Surface
• Sulci & Gyri on Inferior Surface
• Anterior 1/3rd of the inferior
surface rests on the orbit & is
called the Orbital surface.
oIt represents the inferior surface of
the Frontal lobe.
oThe orbital surface faces down &
laterally.
• Posterior 2/3rd is called the
Tentorial surface as it partly rests
on the upper surface of the
tentorium cerebelli.
oIt represents the inferior surface of
the Temporal & Occipital lobes.
oThe tentorial surface faces down
& medially, that is why it is
described with the medial surface
of the hemisphere.
Orbital Surface (Sulci & Gyri):
• Olfactory sulcus is a straight deep
sulcus near the medial border &
nearly parallel to it.
• The olfactory tract (with the
olfactory bulb at its anterior end)
lies in this sulcus.
• The Straight gyrus (gyrus rectus)
lies medial to the olfactory sulcus.
• The remaining part of the orbital
surface is divided into Anterior,
Posterior, Medial & Lateral
Orbital Gyri by an H-Shaped
Orbital Sulci.
Tentorial Surface (Sulci & Gyri):
• In a median sagittal section of the
brain, the medial surface of the
cerebral hemisphere is marked by
the presence of the sectioned great
white commissure termed the
corpus callosum.
• The corpus callosum comprise 4
parts, from in front backward:
o Rostrum (pointed anterior end)
o Genu (anterior bend)
o Body (elongated trunk)
o Splenium (rounded posterior)
Sulci on Tentorial surface include:
1) Callosal sulcus
2) Cingulate sulcus divides
into 2 branches:
• (a) Marginal sulcus
• (b) Sub-Parietal Sulcus
3) Parieto-Occipital sulcus
4) Post calcarine sulcus
5) Calcarine sulcus
6) Collateral sulcus
7) Temporo-Occipital
sulcus
8) Hippocampal sulcus
9) Rhinal sulcus
Gyri on the medial & tentorial surfaces include:
oMedial frontal gyrus
oParacentral lobule
oPrecuneus
oCuneus
oLingual gyrus
oCingulate gyrus
oParahippocampal gyrus
oMedial & Lateral
Occipitotemporal gyrus
There are 3 types of fibers in the white matter:
• Association Fibers: connect different
areas within the same hemisphere
allowing communication between
adjacent cortical regions. Association
fibers can be either short or long,
depending on the distance between the
areas they connect. e.g.: superior
longitudinal fasciculus, arcuate
fasciculus, & uncinate fasciculus.
• Commissural Fibers: connect the 2
hemispheres, allowing for
communication & integration of
information between them. The largest
commissural fiber bundle in the brain
is corpus callosum, other e.g. are
anterior & posterior commissures.
• Projection Fibers: connect the
cerebral cortex to other areas of
the brain & spinal cord. They
transmit information between
the cortex & subcortical
structures such as the thalamus,
basal ganglia & brainstem.
Projection fibers can be divided
into two categories: ascending
& descending fibers. Ascending
fibers transmit information from
lower regions of the brain to the
cortex, while descending fibers
transmit information from the
cortex to lower regions of the
brain e.g. of projection fibers
include the corticospinal tract,
thalamocortical fibers &
internal capsule
Important Functional Areas of the Different
Lobes of Cerebral Hemisphere
• Main Sensory Area (Areas 3, 1 & 2):
It lies in the postcentral gyrus &
contains the higher centers for general
somatic sensations for the opposite
half of the body.
• Motor Area (Area 4): Found in the
precentral gyrus & extends to occupy
the large anterior part of paracentral
lobule on the medial surface. It is the
motor area for the movements of the
opposite half of the body.
• Premotor Area; (Area 6): in front of • Frontal Eye Field (Area 8): It lies in front of
the premotor area in the posterior end of the
the motor area & parallel to it. It is middle frontal gyrus. It is the pyramidal motor
related to the motor area. control of area for the eyes. Responsible for voluntary,
skilled & coordinated movements, e.g. intentional movements of the eyes, including
reaching, grasping, & manipulating saccades
objects • Broca's Area (Motor Area for Speech; Area
44): It lies in the inferior frontal gyrus controls
speech.
• Prefrontal Area (frontal association
area): On lateral surface of the frontal
lobe. It is responsible for the control of
conduct, behavior & social interaction.
• Parietal Association Area: occupies
parts of the parietal lobe behind the
postcentral sulcus & adjoining parts of the
occipital & temporal lobes. In this region
the visual, auditory & tactile sensations
are integrated to form a coherent
perception of our body & environment
• Supramarginal gyrus: It contains 2nd
speech area of Wernicke (Area 40).
Damage of this area in the dominant
hemisphere leads to inability to
understand spoken on written words a
condition called sensory aphasia.
• Angular gyrus: It also contains the rest of
the 2nd speech area of Wernicke (Area 39).
• Paracentral lobule:
• It contains the motor & sensory areas for
the leg, foot & perineum, i.e. it contains
the upper ends of the Motor area (4) &
the Sensory area (3, 1 & 2). It is also
concerned with voluntary control of
defecation & micturition reflexes.
• Auditory Sensory Area; (Areas 41&
42) found in the middle of the superior
temporal gyrus. It receives the auditory
radiation from the medial geniculate
body.
• Auditory Association Area; (Area 22) is
responsible for knowing the meaning of
the received sounds. If this area is
damaged, the patient will hear sounds but
will not be able to know their meaning.
• Piriform Area of the Rhinencephalon:
is formed by the uncus & adjoining part
of the hippocampal gyrus on the inferior
(tentorial) surface of the temporal lobe.
It receives fibers from the lateral root of
the olfactory tract & is therefore
concerned with the olfactory sensation
(primary smell center).
• Visual Sensory Area (Area 17):
receives the visual radiation from the
lateral geniculate body.
• Visual Association Area (Areas 18 &
19): is responsible for knowing the
meaning of the pictures seen. Damage
of this area does not cause blindness.
Objects can be seen but they cannot be
known & identified.
Blood Supply to Cerebrum
END OF
LECTURE-1
The Pons

Prof. Yama O.E.


• Introduction
• In plain term pons means bridge, i.e. it is the
link that connects the midbrain & medulla
oblongata the other parts of the brainstem
• External features
• It has 2 surfaces: ventral (anterior) & dorsal
(posterior) surfaces
• Anterior surface
oIt is convex in both directions.
oHas a midline groove called basilar sulcus
oOn the lateral side of the pons’ anterior
surface, it is continuous with the middle
cerebellar peduncle & at the junction
between it & the peduncle, the 5th CN
attaches.
oAt its lower border the 6th, 7th & 8th CNs
attach.
Pons Atlas
Posterior surface (rhomboid fossa or floor of 4th ventricle)
oThis surface is concealed by the cerebellum
oIt forms the upper half of floor of 4th
ventricle. Presents:
oStriae medullares: Split the rhomboid
fossa into the superior pontine & the
inferior medullary parts.
oSulcus limitans: Separates the alar plate
from the basal plate.
oLocus ceruleus: contains the largest
collection of norepinephrinergic neurons
in the CNS.
oFacial colliculus: contains the abducent
nucleus & internal genu of the facial
nerve.
Pons Atlas
Internal Features
• The interior of Pons is divided into 2 parts:
• (a) Basilar (Anterior) part: (Gray matter & White Matter)
• (b) Tegmental (Posterior) part:
o (i) Tegmental part (lower aspect): Gray matter & White Matter.
o (ii) Tegmental part (upper aspect): Gray matter & White Matter

Posterior or Tegmental parts.

Anterior or Basilar parts


• Basilar part: Has a uniform structure throughout its length.
o Gray matter of basilar part:
 Pontine nuclei: are scattered among the longitudinal & transverse fibres, they are part of the cortico-
ponto-cerebellar pathway. Fibres from these nuclei cross the midline to the contralateral posterior lobe of
the cerebellum.
 Cerebellar relay nuclei: in the base of pons, from it originates pontocerebellar fibers that makes up the
middle cerebellar peduncle.
o White matter of basilar part:
 Longitudinal fibres: Include corticospinal fibres which synapses in the anterior horn of spinal cord
corticonuclear & corticopontine fibres which synapses in the pontine nuclei
 Transverse fibres: Made up of pontocerebellar fibres connecting pons to cerebellum.
Pons Atlas
• Tegmental part
(A) Tegmental part (lower aspect of pons)
oGray matter
o(i) Abducent nerve (CN6)
nucleus (ANN)
oANN lies below & behind
the medial tegmental part at
the facial colliculus of the
rhomboid fossa.
oIt gives rise to projecting
fibers (general somatic
efferent) that pass through
the trapezoid body &
through the corticospinal
tract of the base of pons, it
innervate the lateral rectus
muscle.
oANN also gives rise to fibers that project via the
medial longitudinal fasciculus (MLF) to
innervate the contralateral medial rectus muscle
via the subnuclei of oculomotor nerve.
oANN is the pontine center for executing lateral
conjugate gaze, which receives commands from
the contralateral frontal eye field (Area 8).
• (ii)Facial nerve nucleus (CN7)
(motor)
• Gives rise to special visceral
efferent (SVE) fibers that innervate
the muscles of facial expression.
• Receives bilateral input for upper
facial muscles & contralateral
input for lower facial muscles.
• Contains neurons that project to
encircle the abducent nucleus as a
genu (forming the facial colliculus)
& pass laterally to the front between
the facial nucleus & spinal trigeminal
nucleus to exit the brainstem in the
cerebellopontine angle
• Superior salivatory nucleus (of
facial nerve): Includes the lacrimal
nucleus. Gives rise to general
visceral efferent (GVE)
(iii) Vestibulocochlear nucleus (CN 8)
(a) Cochlear nuclei (ventral & dorsal) of CN 8
oAre found at the
medullopontine junction.
oVentral cochlear nucleus:
Receives input from the
cochlear nerve. Projects
bilaterally to the superior
olivary nuclei & contralaterally
to the lateral lemniscus. Gives
rise to the trapezoid body
(ventral acoustic striae).
oDorsal cochlear nucleus: Lie
behind the acoustic tubercle of
floor of 4th ventricle. Receives
input from the cochlear nerve.
Projects contralaterally to the
lateral lemniscus.
(b) Vestibular nuclei (medial, lateral & superior) of CN 8

oReceive
proprioceptive
(special somatic
afferent) input from
the semicircular
ducts, utricle,
saccule &
cerebellum.
oProject to the
cerebellum & medial
longitudinal fasciculus
(MLF).
oThe lateral vestibular
nucleus gives rise to
the lateral
vestibulospinal tract.
• White Matter
• Medial longitudinal fasciculus (MLF): From the lateral
wall of the 3rd ventricle to become continuous with the
intersegmental tract in the spinal cord. Has connections with
3rd to 8th, 11th & 12th CNs. Functions: It enables responses of
head & neck muscles to stimulus from the 8th nerve. It
coordinates movement of lips & tongue during speech. It
coordinates medial & lateral recti in eye movement
• Trapezoid body: Decussating fibres from the cochlear nuclei
of both sides to the opposite sides. Is located in the caudal
pontine tegmentum at the level of the abducent nucleus. Is
transversed by intra-axial abducent fibers of CN 6. Contains
decussating fibers from the ventral cochlear nucleus.
• Medial lemniscus: From the posterior column medial
lemniscus pathway (fine touch, proprioception). It regulates
contralateral posterior column modalities to the ventral
posterolateral nucleus of the thalamus.
• Spinal lemniscus: comprise spinotectal & spinothalamic
(anterior & lateral) tracts. The nucleus proprius makes up the
first synapse of the spinothalamic tract carrying pain &
temperature sensations from peripheral nerves
• Spinal tract of trigeminal nerve: Descending fibres from
the trigeminal ganglion to the nucleus of the spinal tract for
pain & temperature
• Abducent & facial nerve fibres: Facial colliculus is formed
when facial nerve fibres wind round abducent nerve nucleus
(B) Tegmental part (upper aspect of pons)
• Gray matter
• (1) Trigeminal nerve motor nucleus
is medial to its main sensory nucleus
& is situated in the lateral
midpontine tegmentum at the level of
entry of the trigeminal nerve. Motor
nucleus receives corticobulbar
inputs from 2-lateral sides. Its fibers
that innervate muscles of
mastication.
• (2) Trigeminal nerve main sensory
nucleus, lies lateral to the motor
nucleus & collects discriminative
tactile & pressure stimulus input
from face.
• White matter
MLF: runs vertically along the midline from the
• The Medial longitudinal bundle/fasciculus (MLF) pons to the midbrain. It is primarily involved in
• The 4 lemnisci from medial to lateral are (a) medial, (b) trigeminal, (c) the control of eye movements & coordination of
spinal &(d) lateral lemnisci: head & eye movements
• (1) Medial lemniscus
o Receives discriminative tactile & pressure sensation input from the face.
o Gives rise to trigeminothalamic fibers that join the contralateral ventral
trigeminothalamic tract
o Gives rise to the uncrossed dorsal trigeminothalamic tract, which terminates
in the ventral posteromedial nucleus (VPL) of the thalamus.
• (2) Trigeminal lemniscus
o It comprise crossing fibres from the nucleus of spinal tract of trigeminal
nerve in the lower medulla
o It joins the spinal lemniscus
o It receives pain & temperature sensations from the head
o It relays at the VPL nucleus of the spinal cord
• (3) Spinal lemniscus (lateral spinothalamic tract)
o It comprise crossing fibres from substantia gelatinosa of the posterior
gray horn of the spinal cord
o It receives pain & temperature sensations from the rest of the body
o It relays at the VPL nucleus of the spinal cord
• (4) Lateral lemniscus
o It receives input from the contralateral cochlear nuclei.
o It receives input from the superior olivary nuclei.
o It is connected to the contralateral lateral lemniscus via commissural fibers.
o It projects to the nucleus of the inferior colliculus.
The different levels of the pons & the major features at each level
Level Cavity Nuclei Motor tracts Sensory tracts
Trigeminal (a) Main sensory & motor (a) Lateral,
nuclei (upper) nucleus of 5th CN, Both: spinal lemniscus
Present in (b) Pontine nuclei, (a) Corticospinal tract (b) Medial
both: (c) Trapezoid nuclei (b) Corticonuclear lemniscus
Fourth tract
Facial ventricle (a) Facial nucleus, (c) Pontine fibers (a) Spinal tract of
colliculus (b) Abducent nucleus, (transverse), 5th CN
(lower) (c) Vestibular nucleus (Medial), (d) Medial longitudinal (b) Lateral,
(d) Spinal nucleus of 5th CN fasciculus spinal lemniscus
(e) Pontine nuclei, (c) Medial
(f) Trapezoid nuclei lemniscus
Blood Supply of the Pons
• Pons is supplied by the Basilar
artery through some of its
branches namely:
• Pontine arteries
• Anterior inferior cerebellar
arteries (AICA)
• Superior cerebellar arteries
Clinical Anatomy of Pons
• Medial Inferior Pontine Syndrome (Foville's syndrome): Cause: Results from occlusion of
the branches of basilar artery that supply the medial part of the inferior pons.
• Lateral Midpontine Syndrome (Millard-Gubler syndrome): Cause: Results from occlusion of
branches of the basilar artery that supply the lateral part of the pons.
• Lateral Superior Pontine Syndrome: Cause: Results from occlusion of the basilar artery,
specifically the superior cerebellar artery.
• Lateral Inferior Pontine Syndrome (AICA Syndrome): Cause: Results from occlusion of
AICA (anterior inferior cerebellar artery) branch of the basilar artery.
• Medial Longitudinal Fasciculus (MLF) Syndrome: Results from interruption of fibers that
extend through the MLF to the ipsilateral medial rectus subnucleus of 3rd CN from the
contralateral abducent nucleus.
• Locked-In Syndrome (Pseudocoma): Cause: occlusion of the basilar artery that results in
infarction of structures at base of superior pons e.g. corticobulbar & corticospinal tracts,
resulting in quadriplegia & paralysis of the lower CNs.
• Facial Colliculus Syndrome: Cause: Usually results from a pontine glioma or a vascular
accident which lead to damage to the facial colliculus.
Assignment: What are the structures affected
with ensuing deficits?
END OF
LECTURE-2

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