A LAB GUIDE TO MODULE 13

NEUROANATOMY: The General Topography of the Brain

OBJECTIVES
At the end of the season, the student is expected to be able to recognize the
general topography of the brain, its segments and major structures.

Laboratory Instructions:
In this section, work in small groups. You will need a whole brain specimen in a
basin and a mid-sagittally sectioned one in another. The leader will please sign them
out for the study period and be responsible, that the specimens will be handled with
care and not be mutilated. Use a disposable glove in handling the specimen and a
probe to point and structures.

Examine a whole brain. The adult brain is divided 3 gross parts: cerebrum,
cerebellum; and brain stem. The cerebrum includes the cerebral hemispheres and
the diencephalon. The cerebral hemisphere is the largest segment of the brain. The
right and left hemispheres are incompletely separated by the medial longitudinal
fissure, which contains the falx cerebri (a double fold of dura mater). The surface of
each hemisphere contains elevations or eminences – known as gyri; and furrows,
which are called sulci or fissures. It is important to know the relations in positions
between the cerebral hemispheres, the cerebellum and components of the brain stem.
There are grooves seen on the lateral surface of the cerebral hemisphere: 1.) lateral
Sylvian fissure – which begins as a deep cleft on the basal surface of the brain and
extends laterally, upward and posteriorly, 2.) central sulcus of Rolando – which runs
from the dorsal border of the hemisphere near its midpoint going downward to meet
nearly the lateral fissure. The anterior portion of each hemisphere is formed by the
frontal lobe; the posterior portion, by the occipital lobe; and the inferior portion, by
the temporal lobe. The parietal lobe lies at the superior portion, just between the
frontal and occipital lobes and above the temporal lobe.

Examine the ventral surface of the brain. Review the appearance of the
cerebral hemisphere in this view. The cerebral hemisphere covers most of the
diencephalon, except for a small portion, represented by the following structures:
optic chiasma – transversely oriented fiber bundle at the midline, its two diverging
arms directed anteriorly form the optic nerve, while its diverging arms directed
posteriorly constitute the optic tract. The mammillary bodies – are the two small
rounded elevations near the midline just posterior to the optic chiasma. The tuber
cinereum – is the area between the optic chiasma and the mammillary bodies, where
the stalk of the pituitary gland arises.

On the same ventral surface, locate the brain stem and its components: the
midbrain, pons, and medulla. The midbrain is represented by the cerebral peduncles
(two large diverging fiber bundles at the midline); and the interpeduncular fossa (the
depression between the peduncles). The pons lies caudal to the midbrain,
represented by two elevations – the eminentia pyramidalis; and the groove between
them, the sulcus basilaris. The medulla is the most posterior segment demonstrates
two medial elevations – the pyramids; and two lateral ovoid elevations beside them –
the olivary bodies.

The cerebellum lies dorsal to the brain stem, especially the pons and medulla.
It is separated from the occipital lobe of the cerebral hemispheres by the transverse
cerebral fissure – where a double fold of dura mater, the tentorium cerebelli is
lodged.

The medial (midsagittal) surface of the cerebral hemisphere is exposed when

the brain is cut in half on a plane through the medial longitudinal fissure. This surface
view shows continuations of the components of the cerebral hemisphere previously
seen in the lateral surface, (i.e. parts of the frontal, parietal, temporal and occipital
lobes).

The corpus callosum – a large fiber bundle connecting to the two cerebral
hemispheres is evident. Parts of the diencephalon are also seen in this surface view,
represented by the thalamus and septum pellucidum.

Consolidate your work by reading your textbook and giving attention to

theoretical and practical studies.
NEUROANATOMY: The Cerebrum

OBJECTIVES
At the end of the session, the student is expected to be able to identify the parts
and structures of the cerebral hemisphere and diencephalon and recognize their roles.

Laboratory instructions: Work in small groups. Use a cerebrum specimen in a basin to

study the parts of the cerebral hemisphere and diencephalon. You may also use
models.

EXTERNAL CONFIGURATION
The cerebral hemisphere and diencephalon at its core is taken together as the
cerebrum. The cerebral hemisphere is folded externally. The folding of the surface
increases the surface area, and therefore the volume of the cerebral cortex. These
folds or convolutions are called gyri and they separated by grooves, which maybe
sulci or fissure. Some gyri are constant features; others vary from one brain to
another and even between the two hemispheres of the same brain. Fissures which
tend to be deeper than sulci, are visible earlier during development and separate large
functional areas.

In studying and locating the parts of the cerebral hemisphere. It is useful to

consider its surfaces (dorsolateral/lateral, medial, or basal) and also certain landmarks
as points of reference in the study of this part central nervous system.

Dorsolateral surface:
The Sylvian fissure (lateral cerebral fissure) runs obliquely extending from the
anterior tip to the parietal lobe. It divides into 3 branches: the anterior horizontal, and
the anterior ascending, which incise the inferior frontal gyrus; and the posterior
branch which continues backwards to end in the parietal lobe.

Another landmark that can be seen laterally is the central sulcus of Rolando,
which arises about the middle of the hemisphere and courses supero-inferiorly to a
point just above the Sylvian fissure. This groove lies between 2 parallel gyri: the
precental gyrus, anteriorly, and the postcentral gyrus, posterior. It also separates
the frontal from the parietal lobe.

An imaginary line drawn from the tip of the parieto-occipital fissure (at the
superior margin) to the pre-occipital notch (at the inferior margin) separates the
occipital lobe from the rest of the hemisphere.
 After locating these 4 landmarks, it is now easier to locate the frontal lobe (lies
anterior to the central sulcus of Rolando and above the Sylvian fissure); the parietal
lobe (lies posterior to the central sulcus, of Rolando; the temporal lobe (lies below the
Sylvian fissure); the occipital lobe (lies posterior to the imaginary line between tip of
parieto-occipital fissure and pre-occipital notch).

Locate the following structures in the frontal lobe, laterally

1. Precentral gyrus – the elevation anterior to the central sulcus, and contains
the primary motor cortex, which gives rise to fibers of the corticospinal tarct;
2. Precentral sulcus – a groove anterior to the precentral gyrus;
3. Superior frontal and inferior frontal sulci - these sulci divide the anterior
frontal portion into the: Superior frontal, middle frontal, and inferior frontal
gyri

The inferior frontal gyrus is further subdivided into these portions:

1. Pars opercularis – the part nearest the precentral gyrus:
2. Pars triangularis – part that lies between the anterior horizontal and anterior
ascending branches of the Sylvian fissure; (middle part)
3. Pars orbitalis – the most rostral part of the inferior gyri.

In the left hemisphere, the opercular and triangular portions contain the cortex of the
Broca’s expressive or motor speech area.

Locate the following structures in the parietal lobe, laterally – the part of the hemisphere
from the central sulcus of Rolando caudally to the point where an imaginary line could be
drawn from the tip of the parieto-occipital fissure to the pre-occipital notch:

1. Postcentral gyrus – the elevation posterior to the central sulcus of Rolando; it

is the landmark for the primary sensory area of the cortex;
2. Postcentral sulcus – a groove that runs from the postcentral gyrus;
3. Intraparietal sulcus – the groove divides the remainder of the parietal lobe
into:
3.1 Superior parietal lobule – portion superior to intraparietal sulcus;
3.2 Inferior parietal lobule – portion inferior to the intraparietal sulcus; this
part is divided into:
3.2.1 Supramarginal gyrus – the anterior part which surrounds the
end of the posterior branch of the Slyvian fissure;
3.2.2 Angular gyrus – the posterior part which caps the end of the
superior temporal sulcus.

In the left hemisphere, these gyri contain the cortex included in the receptive language
area, which is important for the perception and interpretation of spoken and written
language.
Locate the following structures in the temporal lobe, laterally – the part of the
hemisphere inferior to the Sylvian fissure:
1. Superior temporal gyrus 3 parallel gyri inferior to the Sylvian fissure,
2. Middle temporal gyrus which are separated by the superior &
middle
3. Inferior temporal gyrus temporal sulci

The inferior temporal sulcus extends from the temporal pole to the occipital lobe, and
this is seen most inferior. A small part of the superior temporal gyrus that dips into the
Sylvian fissure is named the transverse gyrus of Heschl – which marks the location of
the auditory cortical area. The posterior part of the left temporal gyrus also forms part
of the receptive language area.

By spreading the frontal, parietal, and temporal opercula, the insula is exposed. The
insula is a shrunken portion of the cerebral cortex, which lies deep within the lateral
cerebral fissure.

The occipital lobe, laterally lays posterior to an imaginary line drawn from the tip of
the parieto-occipital fissure to the pre-occipital.

Medial surface:
At about the center of the specimen is a curved structure, the corpus
callosum, which connects the 2 cerebral hemispheres. Its anterior and is called the
genu; the intermediate portion, is the body of the corpus callosum; and its posterior
end is the splenium. Around the corpus callosum are parts of the cerebral
hemisphere; but immediately ventral to it are parts of the diencephalon. The sulcus
of the corpus (callosal sulcus) separates the corpus callosum from the rest of the
hemisphere.

The gyrus cinguli begins beneath the genu of the corpus callosum and continues
above the corpus callosum as far back as the splenium. The cingulated sulcus
(sulcus cinguli) runs dorsally around the gyrus cinguli. It gives off 3 branches:

1. Paracentral sulcus – a dorsal branch anterior to the end of the central sulcus ;
2. Marginal sulcus – a dorsal branch behind the central sulcus;
3. Subparietal sulcus – the part of sulcus cinguli that runs most posteriorly.

The superior frontal gyrus (seen in the lateral surface) is continued medially
above the sulcus cinguli. It is limited by the paracentral sulcus. The paracentral
lobule is seen between the paracentral and marginal sulci. The anterior and posterior
parts of the paracentral and marginal sulci. The anterior and posterior parts of the
paracentral lobule are extensions of the precentral and postcentral gyri respectively.
Just behind the paracentral lobule and above the subparietal sulcus is the precuneus.

The calcarine fissure divides the medial surface of the occipital lobe into the
cuneus and lingual gyri. The cuneus lies between the calcarine fissure and Parieto-
occipital Fissures; while the lingual gyrus is seen the calcarine fissure and posterior
part of the collateral fissure. Both cuneus and the lingual gyri contain the cortex for
visual perception (primary center for vision).

Basal Surface:
Locate the following structures:
1. Parahippocampal gyrus – which is separated from the parts of the
diencephalon by the
2. Hippocampal fissure
3. Collateral fissure – this fissure limits the parahippocampal gyrus laterally;
4. Uncus – forms the anterior part of the parahippocampal gyrus, which curves in
the form of a hook; where fibers of the olfactory tract end.
5. Fusiform gyrus – the elevation between the collateral fissure and inferior
temporal sulcus and is seen lateral to the parahippocampal gyrus;
6. Rhinnal fissure – the rostal part of the collateral fissure;
7. Inferior temporal gyrus – the elevation at the inferior margin of the
hemisphere.

The olfactory bulb and olfactory tract on the orbital surface of the frontal lobe
conceal most of the olfactory sulcus. The bulb receives the first cranial nerve from
the nasal mucosa. The olfactory tract ends as the olfactory trigone at the region
where the orbital and temporal portions meet. The anterior perforated substance or
area is a small zone next to the olfactory trigone. The gyrus rectus lies medial to the
olfactory sulcus; and the larger area lateral to the olfactory sulcus consists of the
orbital gyri.

Other parts that can be identified on the medial and basal surfaces, some of which
form part of the diencephalon:
1. Anterior commissure – bundle of fibers crossing the midline connecting the
olfactory bulbs and temporal lobe structures;
2. Subcallosal gyrus – seen underneath the rostrum of the corpus callosum, also
known as the para-olfactory area – part of the septal area, a component of the
limbic system;
3. Fornix – fiber bundle that sweeps upwards and backwards to the body of the
corpus callosum; it brings fibers from the hippocampus to the mammillary
bodies;
4. Septum pellucidum – double layered white lamina stretching from the fornix to
the genu of the corpus callosum. When this is destroyed, the anterior horn of
the lateral ventricle is exposed and the elevation seen in the cavity is the
head of the caudate nucleus;
5. Foramen of Monro – lies just behind the fornix;
6. Thalamic area – part of the diencephalon dorsal to the shallow hypothalamic
sulcus; in some specimens a gray mass – the massa intermedia connects the
thalami of both hemispheres; the hypothalamus lies ventral to the hypothalamic
sulcus.
7. Pulvinar thalami – seen as the posterior projection of the thalamus;
 8. Pineal body, optic nerve, optic chiasma, optic tract

INTERNAL CONFIGURATION
The internal parts of the cerebrum can now be studied using horizontal sections
of the specimen. Recall what composes the surface cortex, and white matter. Basal
ganglia components and the lateral ventricle parts are also displayed in these
sections.

Each of the given sectioned hemispheres is wrapped; please do not interchange

individual brain sections with other groups. In the course of your studies of the
specimens, take care that they will not dry up.
1. On the section made at about 1 cm. above the campus callosum – locate the
cerebral cortex and centrum semiovale. Recall the fiber type that run through in
this part of the hemisphere and some examples of them.
2. On the section made at the level of the genu and splenium of the corpus
callosum, locate the following:
2.1 Forceps minor – fibers of the genu that go to frontal lobe
2.2 Forceps major – fibers in the splenium that go the occipital lobe.
2.3 Anterior limb, genu, and posterior limb of the internal capsule
(Recall fibers passing through these structures);
3. Caudate nucleus, putamen, globus pallidus, claustrum (parts of the basal
ganglia)
4. Thalamus;
5. Insula of Reil, extreme capsule, external capsule;
6. Lateral ventricle and its parts;
7. Hippocampus, fornix
8. On the section made at the level of the anterior commissure – locate the ff:
9. Anterior commissure;
10. Some of structures above which you can still appreciate in this section.

Support laboratory study with reading and be able to connect structure/part to

respective roles.
NEUROANATOMY: The Brain Stem
OBJECTIVES
At the end of the session, the student is expected to be able to identify the
external and internal structures of the brain stem and recognize their roles.

EXTERNAL FEATURES

Laboratory instructions: Use a brain stem specimen in a basin to study its segments
and corresponding external structures. You may also use a brain stem model for this
purpose.

The brain stem is the part of the brain, composed of the: the midbrain, pons and
medulla. The boundaries of its segments constitute imaginary lines or planes passing
through certain points indicated on the dorsal and ventral surfaces of the brain stem.

1. Medulla: this is the most caudal part of the brain stem that is continuous with
the spinal cord
Rostrally, - the boundaries include:
Ventrally: the plane passing through the inferior pontine sulcus
Dorsally > imaginary line drawn through lateral recesses of the IV ventricle
The inferior pontine sulcus is formed by the caudal most bundles of
the transverse fibers of the pons (pontocerebellar tract). The imaginary
boundary on the dorsal surface roughly coincides with the transversely-
running bundles of the stria medullares acusticae.

Caudally, the rostral limit of the spinal cord, which is –

1. The plane of the foreman magnum, when the brain and spinal cord
are in situ or;
2. The plane passing through the caudal portion of pyramidal
decussation;
3. The plane passing through a point just above the attachments of
the roots of the 1st cervical nerve.

2. Pons: this part of the brain stem is rostral to the medulla

Rostrally, the boundaries are
Ventrally: the plane passing through the superior pontine sulcus
Dorsally > a point just caudal to the inferior colliculi.
The superior pontine sulcus is formed by the most rostral bundle
of the transverse fibers of the pons. The boundary on the surface
roughly coincides with the point of emergence and decussation of the IV
 cranial nerve (trochlear). Laterally, indicated by a plane passing
through points just lateral to the attachment of Cranial nerve V –
Trigeminal nerve. The part lateral to the plane is the brachium pontis
(middle cerebellar peduncle), which is considered part of the cerebellum.

Caudally, the rostral limit of the medulla

3. Midbrain:
Rostrally, the boundaries are:
Ventrally, the plane passing through a point just caudal to the mamillary
bodies
Dorsally, a point just rostral to the superior colliculi.
The boundary on the dorsal surface coincides with the posterior
commissure. Rostral to this plane is the Diencephalon. The mammillary
bodies belong to that segment.
Caudally, the rostral limit of the pons.

The brain stem has been dissected from the brain in one piece. Identify the
visible gross structures without dissection. As you locate the structures, study the
relations of the structure, correlate this to the nuclei, fibers etc. underneath. Use your
textbook as reference.

The best guide in determining which is dorsal and which is ventral surface is
the large transverse fiber bundle of the pons on ventral view, and the diamond
shaped depression of the fossa rhomboidea on the dorsal view.

VENTRAL ASPECT OF THE BRAINSTEM: note the appearance of the medulla,

pons, and midbrain in this view, and identify/locate the structures characteristic of each
segment.

MEDULLA
The anterior median fissure divides the medulla into 2 symmetrical halves. It is
continuous with the anterior median fissure of the spinal cord, and ends as a
depression, the foramen caecum, when it meets the inferior pontine sulcus. On
both sides of this fissure are the pyramids which are produced by the corticospinal
tract. The pyramids are morphologically continuous with the anterior funiculi of the
cord, but not actually since the bulk of the corticospinal tract that produced the pyramid
on one side, crosses the midline at the pyramidal decussation and continues in the
lateral funiculus of the spinal cord as the lateral corticospinal tract. Only a few fibers in
the pyramids continue uncrossed into the anterior funiculus of the spinal cord.

Lateral to the pyramids are round or oval prominent bodies – the olives
(olivary body) produced by the underlying inferior olivary nucleus. The grooves
ventral and dorsal to the olive are the preolivary sulcus and post-olivary sulcus is
thought to be the rostral continuation of the posterolateral sulcus of the spinal cord
which has diverged laterally as it enters the medulla.

The hypoglossal nerve emerges from the medulla at the preolivary sulcus.
The rootlets of the glossopharyngeal, vagus, and bulbar division of spinal
accessory nerves emerge from the medulla at the posterolateral sulcus, in a rostro-
caudal manner. The spinal division of the accessory nerve emerges for the lateral
surface of the upper cervical segments of the spinal cord, ascend and pass through
the foramen magnum to join the bulbar division.

PONS
The shallow midline groove is the sulcus basilaris and the elevations on both
sides of the sulcus are the eminentia pyramidalis. These eminences are produces by
the underlying corticospinal tract.

The trigeminal nerve emerges at the lateral portion of the pons, about midway
between the superior and inferior pontine sulci. The abducens, facial and auditory
nerves emerge at the inferior pontine sulcus; the VI in line with the postolivary sulcus,
the VII, in the line with the postolivary and the VIII, just lateral to the VII.

MIDBRAIN
The ventral surface of the midbrain is represented by the cerebral peduncles –
the diverging large fiber bundles. They are produced by the corticospinal tract and the
companion corticobulbar and corticopontine tracts. The interpeduncular fossa is the
depression between the 2 cerebral peduncles. Since numerous blood vessels
perforate the area, it is also called the posterior perforated substance or area.

The oculomotor nerve emerges at the medial mesencephalic sulcus (an

inconspicuous sulcus between cerebral peduncles and posterior perforated area.)

DORSAL ASPECT OF THE BRAINSTEM: Identify/locate the structures of the brain

stem in each segment as seen in this view.

MEDULLA
The central canal of the spinal cord continues into the caudal portion of the
medulla, where it opens rostrally into the IV ventricle. The caudal portion of the
medulla is designated as closed portion, while; the rostral portion… is the open
portion the floor of the fourth ventricle serves as the dorsal surface.

The CLOSED portion of the MEDULLA

The posterior median sulcus of the spinal cord continues into this part of the
medulla ends at the obex. Lateral to this are elevations called the fasciculus gracilis
– one on each side. Still lateral to the fasciculus gracilis is another elevation, the
fasciculus cuneatus. The groove between the 2 elevations is the sulcus intermedius.
At the rostral end of fasciculus gracilis, the elevation is the clava; at the same end of
fasciculus cuneatus, it is the tuberculum cinereum. Lateral and rostral to the
tuberculum cuneatum is the tuberculum cinereum produced by the underlying
nucleus and tract of the nerve.

The OPEN portion of the MEDULLA & PONS

The dorsal surface of medulla’s open portion is coextensive with that of the
pons; both are formed by the floor of the IV ventricle (fossa rhomboidea). The IV
ventricle is the cavity overlying the pons and medulla. The lateral angles are the
lateral recesses of the IV ventricle. The rostral angle is represented by the anterior
medullary velum; with the arms formed by the converging brachium conjunctivum
(superior cerebellar peduncles). The caudal angle and its arms are the obex and the
rostral borders of the clava, tuberculum cuneatum respectively.

Its floor, the diamond-shaped fossa rhomboidea, is divided into symmetrical

halves by a furrow the sulcus medianus. Each half is further subdivided into 2 areas by
a sulcus that runs parallel to the sulcus medianus – the sulcus limitations; the medial
area is the eminentia mediana; while the lateral area, is the area acusticae (where
the vestibular nuclei lie underneath).

The sulcus limitans ends in a bifurcation. The point of bifurcation being at a

small depression is the fovea. The superior fovea is at the upper end and the
bifurcation encloses the locus caeruleus – a small strip of pigmented neurons which
is considered to be the pneumotaxic center. The caudal end of the sulcus limitans is at
the inferior fovea; and the bifurcation encloses the trigonum vagi (ala cinerea) >
produced by the dorsal motor nucleus of the vagus.

The elevation on the ementia mediana, medial to the superior fovea is the
colliculus facialis (where the nucleus abducentis and genu of facial nerve lies
underneath); while the elevation on the eminentia, medial to the inferior fovea is the
trigonum hypoglossi (the external indication of the nucleus hypoglossi).

At the region of the lateral recess of the 4th ventricle, is a small elevation, the
tuberculum acusticum, produced by the dorsal cochlear nucleus. Transverse running
fibers that are seen at the intermediate zone of the fossa from sulcus medianus to the
lateral recesses constitute the stria medullaris cerebellaris (which enter the
cerebellum).

MIDBRAIN
The dorsal part of the midbrain is occupied by the 2 pairs of rounded elevations
– the superior and interior colliculi, which are collectively called corpora
quadrigemina. The superior and inferior colliculi are connected to the lateral and
medial geniculate bodies, respectively; by the superior and inferior quadrigeminal
brachium.

A ridge is formed at the lateral surface of the midbrain by the lateral lemniscus
(part of auditory pathway) and is thus called trigonum lemnisci.
 The trochlear nerve emerges at a point just caudal to the inferior colliculi after
undergoing complete decussation.

INTERNAL FEATURES

The internal surface of the brain stem varies from that of the spinal cord due to the
following:
1. The opening of the central canal of the spinal cord and the closed portion of the
medulla to the IV ventricle
2. The H-shaped configuration of the spinal gray matter is lost because of the
decussating fibers in the brain stem.
3. The appearance of the motor nuclei of the cranial nerves
4. The appearance of relay nuclei for sensory inputs through cranial and spinal
nerves
5. The presence of cerebellar peduncles… either origin or termination.
6. Greatly expanded reticular formation. The reticular formation of the brainstem
consists of a network of fibers and cells extending through the medulla, pons,
and midbrain. It contributes to the autonomic nervous system through
groups of neurons that function as cardiovascular and respiratory centers. It
provides influence on levels of consciousness and degrees of alertness
(ascending reticular activating system). It has also a role in the control of
movement via efferents to motor nuclei of cranial nerves and to the spinal cord.

Nerve cell aggregates in the brainstem

Cells in the sensory nuclei can be:
1.) interneurons, homologous to propriospinal neurons of the spinal cord, and
primarily for reflex, and
2.) relay neurons – 2nd order neurons for the sensory pathway from the head
region.
Somatic and branchial motor nuclei are groups of motor neurons that give
axons which innervate skeletal muscles in the head and neck region. Visceral motor
nuclei are aggregate of motor neurons whose axons are the pre-ganglionic
parasympathetic fibers incorporated in some cranial nerves. They convey impulses
to smooth, cardiac muscles, and glands in the head and neck, thoracic and abdominal
regions of the body.

There are other neuron groups which can’t be definitely categorized. They may
be distinct or diffusely arranged and form part of the reticular formation.

Nerve fiber aggregates in the brain stem

Nerve fibers may be myelinated. These fibers may be:
1. Sensory or motor roots of cranial nerves which course in the brain stem before
reaching their nuclei of termination, or points of exit respectively.
2. Longitudinal oriented fibers tract, which may be:
 2.1 Fibers of passage – these are fiber bundles whose cell bodies are in the
cerebrum, diencephalon, or spinal cord; and whose fibers course through
the brain stem to transmit impulses from the higher centers to the spinal
cord or vice versa; or to or form certain structures within the brain stem, i.e.
corticospinal tract.
2.2 Fibers arising from outside the brain stem that ends in the brain stem, I.e.
corticobulbar tract.
2.3 Fibers arising from nuclei in the brain stem project to the diencephalon, or
cerebrum (i.e medial lemniscus).
2.4 Fibers arising from and terminating with the different segments of the brain
stem, (i.e. lateral lemniscus).
3. Transversely oriented fibers tracts. These are cerebellar fibers, (afferent and
efferent tracts).

LABORATORY INSTRUCTIONS:
Use the transparencies for the study of the internal structures of the brain
stem. Before closer study, it is important that you can identify the segment of the
brain stem, i.e. are you looking at an open medulla? Or pons?

The brain stem segments are sectioned at this level:

1. Medulla – closed portion, level of pyramidal decussation (caudal third of
medulla).
2. Medulla – closed portion, level of posterior column nuclei, (middle third of
medulla)
3. Medulla – open portion, (upper third of medulla)
4. Pons
5. Midbrain – level of superior colliculus
6. Midbrain – level of inferior colliculus

The sections of the brain stem were cut perpendicular to its long axis. In
Weigert stained sections, the chemical in the stain bind components of myelin: thus,
myelinated fibers, (white matter) appears as dark areas in slides and illustrates; and
parts free of such fibers, (gray matter and unmyelinated fibers) appear
pale/colorless.

MEDULLA, CLOSED portion, level of pyramidal decussation

The corticospinal tract is seen at the ventral part of the medulla adjacent to
the midline and rostral to it is the pyramidal decussation – the point of crossing of
fibers of the corticospinal tract. The groove seen anteriorly at the midline is the
anterior median fissure. At about the center of the section is the central canal, with
its surrounding central gray. The reticular formation lies adjacent to the central gray.
At the dorsal part of the section, midline is a groove – the posterior median sulcus.
From this structure, going laterally, these can be seen: nucleus & fasciculus
gracilis; nucleus and fasciculus cuneatus; nucleus and spinal tract of the V
(trigeminal nerve).
MEDULLA, CLOSED portion, level of posterior column nuclei
The central gray, fasciculus & nucleus cuneatus and nucleus & spinal
tract of the V are located in the same position as above. However, the nucleus gracilis
& cuneatus (posterior column nuclei) are quite prominent. Fine fibers arise from the
ventral part of the posterior column nuclei, curve around the central gray and get lost at
the midline – these constitute the internal arcuate fibers. Their decussation is the
decussation of medial lemniscus (or internal arcuate decussation, or sensory
decussation of the medulla).

The pale area lateral to the central gray is the reticular formation. The
corticospinal tract lies on each side of the anterior median fissure. There is no
crossing of its fibers here.

MEDULLA, OPEN
The main features of this section are the: IV ventricle and the inferior olivary
nucleus. On the ventral part at the midline is the anterior median fissure, then the
corticospinal tract, on each side which produces the elevation, pyramid, externally.
The arcuate nucleus may be seen as a small mass of gray matter ventral to the
pyramid, just beneath the surface. A large folded nucleus, the inferior olivary nucleus
lies dorsal to the corticospinal tract. A dorsal accessory olivary nucleus may be
appreciated at the dorsal aspect of the main inferior olivary nucleus. A medial
accessory olivary nucleus also, is at the medial aspect of the main inferior olivary
nucleus.

A band of fibers extending anteroposteriorly (vertically) lateral to the midline

consist of the medial lemniscus. This is the rostal continuation of the internal
arcuate fibers after their decussation in the caudal part of the medulla. Above the
medial lemniscus is a small fiber bundle of multiple origins, the medial longitudinal
fasciculus, which provides interconnection between certain cranial nerve nuclei. The
fibers running transversely across the hilus of the inferior olivary nucleus, passing to
the opposite side through the medial lemnisci and the opposite inferior olivary nucleus
forms the olivocerebellar fibers.

At the dorsal surface of the section is the central gray. Within this is the
hypoglossal nucleus (medially), which supplies the skeletal muscles of the tongue.
Lateral to it, is the dorsal motor nucleus of the vagus, (a pre-ganglionic
parasympathetic nucleus). The nucleus and tractus solitarius, appears as a dot
(tractus) lateral to the DMV. The cavity seen outside the central gray is the IV
ventricle.

At the dorsolateral periphery of the section, is a prominent fiber bundle, the

restiform body (inferior cerebellar peduncle). The spinal vestibular nucleus may be
seen medial to the restiform body and in the central gray. The nucleus & spinal tract
of the V is also seen medial to the restiform body but outside the central gray. This is
the 2nd order neurons mediating pain and temperature sensation from the face area.
 Between the central gray and the inferior olivary nucleus is a pale area, the
reticular formation. In its lateral part is the nucleus ambiguous, which innervates
muscles of the larynx, pharynx, & soft palate. Its axons are incorporated in cranial
nerves IX, X, XI.

PONS
The distinguishing characteristic of this section are its outline and division into 2
parts by the trapezoid body into:
1. Pars tegmentalis – dorsally
2. Pars basalis (basilaris) – ventrally

The pons is extensive. The section described below is taken at the level of facial
colliculus. Dark rounded structures on each side of the midline at the pars basalis are
the corticospinal & corticobulbar tracts, which produce the eminentia pyramidalis
externally. The gray matter (pale area) around them constitutes the nuclei pontis,
which give off axons that comprise the pontocerebellar tract. This crosses the midline
transversely collected in the lateral part of the section into the brachium pontis,
(midline cerebellar peduncle) and proceed to the cerebellar hemisphere.

The trapezoid body is made up of transversely oriented and decussating

fibers mainly coming from the ventral cochlear nucleus. (Small nuclear masses, the
nucleus of the trapezoid body lie among the fibers). The rostral continuation of the
medial lemniscus is located passing through the fiber bundles of the trapezoid body.
In this section then, the fiber mass in this area is actually composed of fibers of the
trapezoid body and medial lemniscus. In the lateral part of the pons, at the region of
the superior olivary nucleus, fibers of the trapezoid body bend rostrally as the lateral
lemniscus (not seen in the section).

The medial lemniscus is the 2nd relay for proprioception & tactile discrimination
from the body and limbs. The lateral lemniscus is part of the central auditory pathway.
Both bands of nerve fibers are concerned with sensory perception.

The term extralemniscal ascending system is used for reticular pathways

conducting sensory information related principally to arousal, attention and
wakefulness, rather than to sensory perception.

The tegmental part of the pons is continuous anatomically with the medulla and
contains the fossa rhomboidea. Above the fossa is the cavity of the IV ventricle.

In the central gray bordering the fossa, are the cranial nerve nuclei – abduscens
nucleus near the midline; and the vestibular nuclei, in the lateral part. The VI cranial
nerve arises from its nucleus and course ventrally to supply the lateral rectus muscle
of the eye. A fiber bundle is seen arching over the abducens nucleus, the genu of the
facial nerve. The facial nucleus lies in the ventrolateral part of the tegmentum,
adjoining the superior nucleus. Its fibers – the facial nerve, run dorsomedially towards
the fossa and hook around (genu) the abducens nucleus then course ventrolaterally
towards the exterior of the pons.

MIDBRAIN
The midbrain is divided into 2 areas by an imaginary line passing through the Sylvian
aqueduct:
1. Tectum – dorsally
2. Cerebral peduncle – ventrally
The cerebral peduncles are further subdivided into:
2.1 tegmentum – dorsally
2.2 basis pedunculi (crus cerebri) – ventrally
By a band of gray matter – the substantia nigra.

To determine whether the section of the midbrain is taken at the level of the
superior colliculus or that of the inferior colliculus, examine ventral part of the
tegmentum near the midline. If you find a pair of rounded (pale) masses of gray matter
– the red nucleus, in thios area, the section is at the level of the superior colliculus; and
the tectum is occupied by the superior colliculus nucleus. If in the same part, a large
dark mass of decussating fibers is seen, the decussation of the branchium
conjunctivum, the section os at the inferior colliculus level; and the tectum contains the
inferior colliculus nucleus.

These Structures are seen at both levels of the midbrains:

1. Basis pedunculi – formed by the following fibers coming from the cortex:
corticospinal and corticobulbar tracts at the center, and corticopontine tracts on
either side
1.1 corticospinal tract – end at the ventral horn cells of the spinal cord, opposite
side;
1.2 corticobulbar tract – ends at motor cranial nerve in the pons and medulla,
on the same or opposite side
1.3 corticopontine tract – ends at the nuclei pontis

2. Substantia nigra – a band of pigmented neurons; the red nucleus single

nuclear mass in the midbrain

3. Medial lemniscus – lies lateral to the red nucleus and decussation of brachium
conjunctivum. (Recall the origin and course of this fiber bundle and itd location
in the brain stem segments). In the course through the brain stem, the medial
lemniscus is joined by several fiber tracts. The lateral lemniscus and lateral
spinothalamic tract at the lateral edge of the medial lemniscus.
 4. Sylvian aqueduct – the remnant of the neural canal in the midbrain, which is
continuation with gray around it is the periaqueduct gray. It contains nuclear
masses and fiber bundles. The medial longitudinal fasciculus lies ventral to
it.

5. Nucleus interpeduncularis – gray matter between the cerebral peduncles

forming the floor of the interpeduncular fossa (posterior perforated substance).

Structures seen at the level of superior colliculus:

1. Red nucleus – rounded mass of gray matter that receives most of the fibers
coursing in the brachium conjunctivum (dentatorubral tract) after decussation.
This nucleus project to the thalamus and to the caudal levels of the brain stem
and spinal cord.

2. Oculomotor nuclei complex – nuclear groups that lie in the ventral part of the
periaqueductal gray which supply the intrinsic and most of the extrinsic muscles
of the eye. Its fibers run ventrally through and around the red nucleus, emerging
at the medial mesencephalic sulcus.

3. Superior colliculus – lies at the tectum; considered as the somatic reflex

center for vision and contains the superior colliculus nucleus.

Structures at the level of the inferior colliculus:

1. Decussation of the branchium conjunctivum (superior cerebellar
peduncle) – its fibers end at the red nuclei and the thalamus.
2. Trochlear nucleus – lies in a similar position as the oculomotor nucleus; its
fibers course around the central gray dorsally and decussate completely before
emerging
3. Inferior colliculus – the somatic reflex center for audition; also lies at the
tectum; contain the inferior colliculus nucleus

As an exercise, review on various nuclei in the brain stem related to cranial nerves.
Consider areas of innervations, points of exits/entry at the brain stem and exit from the
skull. Tabulate various tracts showing origin, termination, and function is so far as it is
known. Make a diagram linking together functionally related tracts. Trace the course
of the corticospinal tract and corticobulbar tracts. Recognize areas of involvement
following lesions that may occur at various points along their courses.
NEUROANATOMY: The Cerebellum
OBJECTIVES
At the end of the session, the student is expected to be able to identify the parts
and structures of the cerebellum and recognize their roles.

Laboratory instructions: Work in small groups. Use a cerebellum specimen in a basin

to study its part and structures. You may also use models.

EXTERNAL FEATURES
The surface of the cerebellum (cortex) is thrown into folds called folia. They are
parallel to the transverse axis of the cerebellum.

Grossly, the cerebellum consists of: a single central portion, the vermis and
two lateral cerebellar hemispheres. Dorsally, the vermis forms a median elevation,
superior vermis. Ventrally, the vermis lies at the bottom of a deep fissure, the
cerebellar notch, and is referred to as the inferior vermis.

A deep groove, the primary fissure divides the cerebellar hemisphere (corpus
cerebellar) into anterior and posterior cerebellar lobes. These lobes are further
subdivided into lobules based mainly on shape.

Another groove, the posterolateral fissure separates the flocculus and nodulus
(flocculonodular lobe) from the posterior lobe. The nodules are the vermal portion and
the flocculus, the hemispheric portion.

The cerebellum is connected to the brain stem by 3 peduncles:

1. The inferior cerebellar peduncle (restiform body) = connects the medulla
and lower parts of the CNS to the cerebellum;
2. The middle cerebellar peduncle (brachium pontis) = connects to the pons;
3. The superior cerebellar peduncle (brachium conjunctivum) = connects the
cerebellum to the midbrain.

The fiber connections are afferent or efferent. The afferent cerebellar fibers
terminate in the cerebellar cortex, with a few, ending directly in some of the deep
cerebellar nuclei.

The efferent fibers are given off by the deep cerebellar nuclei, not from the
cerebellar cortex. Efferents from the cerebellar cortex are axons of Purkinje cells that
go to the deep cerebellar nuclei.

Fibers from the flocculonodular lobe (with predominantly vestibular

connections) project to the nucleus fastigii; those from the anterior lobe and part of
the inferior vermis next to the nodulus (which receives primarily proprioceptive &
exteroceptive information from the head & body) go to the globose nuclei and or
emboliformis; and those from the posterior lobe, except inferior vermis next to the
nodulus (with extensive connections with cerebral cortex) project to the dentate
nucleus.

Review the relations of the cerebellum with other parts of the brain: brain stem,
occipital lobe of the cerebrum. What is the contribution of the cerebrellum to the
formation of the IV ventricle?
Identify/locate the following: vermis (superior and inferior); anterior and
posterior lobes of the cerebellar hemisphere; primary fissure; posterolateral fissure;
flocculus and nodulus; and the 3 cerebellar peduncles.

INTERNAL FEATURES

On the basis of its internal/histological structure, the cerebellum is made up of

the cortex (gray matter) and white matter (medullary portion).

The cerebellar cortex is the outer gray matter which is composed of 3 layers:
1. Molecular layer = the outermost part, has 2 neurons, the outer stellate cells
and the inner basket cells; with dendrites and axons; and neuroglial cells;
2. Purkinje cell layer = a single layer of cells, characteristic of the cerebellum,
between the molecular and granular layer; they are large Golgi type 1 neurons,
flask-shaped.
3. Granular layer = has small cells with densely staining nuclei and scanty
cytoplasm the granule cells; and neuroglia.

The white matter (corpus medullaris) of the cerebellum contains many fiber
bundles. The branching tree-like distribution of the white has led to the use of “arbor
vitae” in its reference.

Deep in the white matter, the deep cerebellar nuclei are embedded. They are the
following, from the medial to the lateral aspect:
1. Fastigial nucleus > in the roof of the IV ventricle
2. Nucleus globosus
3. Nucleus emboliformis > close to the hilus of dentate nuclei
4. Nucleus dentatus > biggest; the most laterally placed; gives to fibers of
brachium conjunctivum

The cytoarchitecture of the cerebellum is the same in all parts.

Identify/locate the layers of the cortex; and white matter. Recall their contents.

Cerebellar Function
The cerebellum is a center in which various types of sensory impulses, not
only proprioceptive but also exteroceptive modalities are coordinated, and then
impulses are fired to the motor areas for effective motor responses. Neurologic
deficits are reflected in hypotonicity, incoordination and lack of stabilization of
cerebellar influences from normal reflexes and voluntary acts.

Exercise:
Plot some of the connections of the cerebellum with the:
1. Spinal cord – dorsal and ventral spinocerebellar tracts
2. Brain stem – olivocerebbellar, pontocerebellar, etc.
3. Cerebral cortex – cortico-pontocerebellar, dentate-rubrothalamic then
thalamocortical

What are the fiber tracts (sensory and motor) passing through the cerebellar
peduncles?

NEUROANATOMY: The Spinal Cord

OBJECTIVES
At the end of the session, the student is expected to be able to identify the
external and internal structures of the spinal cord.

Laboratory instructions:
Use a spinal cord specimen in a basin to study its external configuration. Use a set
of transparencies to study its internal configuration.

External configuration of the spinal cord

Membranes invest the spinal cord and brain, collectively called meninges. This
covering is composed of: dura mater – outer tough membrane consisting of
collagenous connective tissue; arachnoid – delicate avascular membrane next to the
dura mater; and the pia mater - delicate membrane closely applied to the spinal
arachnoid is fused - dura-arachnoid mater, and what you see around the cord itself is
the pia mater.

There are specializations of the pia mater; 1.) linea splendens – which
appears as a glistening ribbon lodged at the region of the anterior median fissure; 2.)
denticulate ligaments – which are lateral extensions of the pia, midway between the
anterolateral and posterolateral sulci which become attached to the dura mater; and 3.)
filum terminale – the caudal extension of the pia mater beyond the termination of the
spinal cord.

On the ventral surface of the cord, 3 grooves run longitudinally: the anterior
median fissure – at the midline; and the 2 anterolateral sulci, on each side of the
anterior median fissure. The anterior (motor) roots of the spinal nerves emerge at the
anterolateral sulci. The anterior median fissure is deeper and more prominent than the
posterior median sulcus.
 On the posterior or dorsal surface of the cord, 3 shallow grooves are seen:
the posterior median sulcus, at the midline; and the two posterolateral sulci, one on
each side of the posterior median sulcus. The posterior (sensory) roots of the spinal
nerves enter the cord at the posterolateral sulcus.

The spinal cord ends at the level of the lower border of the first lumbar
vertebra. Its tapered ends are called the conus medullaris. The caudal most spinal
nerve roots (from the lumbar and sacral spinal nerves) are long and descend in a
bundle from the conus forming the cauda equina.

Internal configuration of the spinal cord

Use a set of transparencies of the cross sections of the different spinal cord
segments. Note the variations in appearances between the different cord segments.
Identify the cervical, thoracic, lumbar and sacral cord segments.

Locate the anterior, posterior, lateral horns and substancia gelatinosa of

Rolando; as well as the anterior, posterior, lateral funiculi, reticular formation and
zone of Lissauer. Locate also the sites for the different sulci.
PHYSIOLOGY: Peripheral Nervous System – Reflexes in Man

OBJECTIVES
At the end of the session, the student is expected to be able to:
1. Identify the various deep reflexes as regards afferent fiber, efferent fiber, center
and response.
2. Identify the various superficial reflexes as regards afferent fiber, efferent fiber,
center, and response.

The nervous system serves as one of the two systems for communication and
control in the body. It collects information about the external and internal
environments and initiates appropriate responses in muscles and gland cells. It is
also responsible for sensation, thought, memory, learning speech, etc.

Receptors are specialized non-neuronal cells that respond to specific stimuli by

generating impulses in sensory neurons which conduct the signals to the central
nervous system. The central nervous system, in turn, integrates sensory
information and transmits impulses to motor neurons to bring about specific
responses. Impulses from the central nervous system are carried by somatic motor
neurons to skeletal muscles, and by autonomic motor neurons to cardiac and
smooth muscles and gland cells. If impulses from receptors reach the thalamus
and cerebral cortex, a sensation may be felt.

Much of the activity of the nervous system takes place over reflex pathways.
Reflexes of the somatic nervous system may be modified at will, but not for
autonomic reflexes.

As a rule, reflexes in man may be classified into the following categories

according to their use in the clinics:

1. Superficial reflexes
These are elicited from mucous membranes or from the skin
2. Deep reflexes
These are elicited by striking the tendon of a given muscle
3. Visceral reflexes
These are elicited from deep lying structures
4. Pathological reflexes
These are present only in the presence of an abnormality
 NAME ______________________________ Date ___________

Peripheral Nervous System Reflexes in Man

Results:

Reflex Afferent Nerve Center Efferent Nerve Response

Patellar reflex Femoral L 2-4 Femoral
Ankle jerk Tibial S 1-2 Tibial
Biceps reflex Musculocutaneous C 5-6 Musculocutaneous
Triceps reflex Radial C 6-7 Radial
Wrist reflex Median C 6-8 Median
Corneal reflex Trigeminal Pons Facial
Pharyngeal Glossopharyngeal Medulla Vagus
reflex
Epigastric reflex T 7-10 T 7-10 T 7-10
Abdominal T 10-12 T 10-12 T 10-12
reflex
Plantar reflex Tibial S 1-2 Tibial
Accommodation Optic Occipital Oculomotor
reflex cortex
Cilio-spinal A sensory nerve T 1-2 Cervical
reflex sympathetics
Convergence Optic Areas 19 Oculomotor
and 22

Conclusion:

Study Question:
1. Stimulation of a receptor may lead to sensation or to reflex action. Can it
produce (a) both, (b) sensation without reflex action, (c) reflex action without
sensation? Can you give examples?
HISTOLOGY: The Sense Organs – Eye and Ear

OBJECTIVES:
At the end of the session, the student is expected to be able to:
1. Recognize/identify the parts and structures of the eye and the cochlea (a part of
the inner ear)
2. Correlate organ, structural features and cells to functional significance.

The sense organs receive information from the environment and form within the
body for processing at the central nervous system. In the distal portions of these
organs are the receptors – which are structures of any size or complexity (examples:
nerve ending of a peripheral neurite of sensory neuron; muscle spindle) that collect
and usually also edit information about conditions inside or outside the body. In this
topic, we shall consider the eye and cochlea. The latter is a part of the inner ear.

The eye permits an analysis of form, light intensity, and color reflected from objects. It
is located in the bony structures of the skull- the orbits. It has a lens to focus the
image; a system of cells and nerves to collect process and transmit visual
information’s to the brain.

The Eye
The eye is formed by three layers, or tunics. Each of these three layers contributes
with parts that have structural/nutritive functions and parts that form the optic and
photoreceptive apparatus of the eye. From the outside to the inside of the eyeball the
three tunics are the:

1. Fibrous tunic - forms a capsule enclosing and protecting the other

components of the eye. It is subdivided into the sclera, with primarily structural
functions, and the cornea, which is part of the refractive apparatus.
2. Vascular tunic – composed of the choroid, ciliary body and iris. This tunic is
also called the uvea. The choroid has primarily nutritive functions. The ciliary
body generates the aqueous humor of the eye; the ciliary muscle’s function is
in visual accommodation. The iris is part of the optic apparatus where it
functions as a contractile diaphragm, i.e. the aperture of the eye.
3. Neural tunic consists of the retina. The retina proper forms the photoreceptive
layer of the eye. As a double-layered epithelium, the retina also covers the
ciliary process and the posterior surface of the iris, where it is has both
nutritive and structural functions.

The Fibrous Tunic: Cornea and Sclera

Cornea
The cornea forms the anterior surface of the eye in an area largely corresponding to
the pigmented iris, which is visible behind the cornea. The diameter of the cornea is
~11 mm; the thickness ranges from ~0.5 mm centrally to ~0.1 mm along the margins
of the cornea. The cornea is formed by five layers. Blood vessels are not normally
found in the cornea, and the cells are not pigmented.
 The layers of the cornea:
1. anterior surface lined by a stratified squamous epithelium.
2. basement membrane – the anterior limiting lamina or Bowman’s
membrane, consists of densely packed collagen fibrils embedded in ground
substance.
3. The corneal stroma consists of 200 – 250 layers of regularly organized
collagen fibrils (mainly tropocollagen type I, but also types III, V and VI).
Flattened fibrocytes, referred to as keratocytes, are located between the
layers of collagen fibers. The regular arrangement of the collagen fibers
and their small diameter (20 – 60 mm) account for the transparency of the
cornea.
4. posterior limiting lamina or Descemet’s membrane,
5. The posterior surface of the cornea is lined by an endothelium, the
posterior endothelium.

The lateral margins of the cornea are continuous with the conjunctiva (anterior corneal
epithelium) and (corneal stroma).

Sclera
The sclera is a tough layer of dense connective tissue consisting of collagenous
fibers and networks of elastic fibers. Melanocytes are present in deep parts of the
sclera in addition to the usual complement of connective tissue cells. Distended by the
intraocular pressure, the sclera maintains the shape of the eyeball. It is also the site
of attachment of the ocular muscles.

Anteriorly, the sclera forms a slight protrusion into the eyeball before it merges with
the cornea – the sclera spur, which provides a point of insertion for part of the cilliary
muscle. The sclerocornealjunctions house the canal of Schlemm, through which
the aqueous humor is drained into ciliary veins.

The Vascular Tunic: Choroid, Ciliary Body and Iris

Choroid
The choroid consists of loose connective tissue, which houses a dense network
of blood vessels. Connective tissue cells and melanocytes are numerous. The latter
give the choroid its dark color. Small blood vessels are especially frequent in the
innermost part of the choroid, which is called the choriocapillary layer. This layer
supplies the retina with nutrients. Bruch’s membrane is located between the choroid
and the retina. It consists of two layers of collagen fibers and network of elastic fibers
between them.

Ciliary Body
The ciliary body is an inward extension of the choroidea at the level of the lens.
Ciliary processes are short extensions of the ciliarybody towards the lens. Asmall
amount of loose connective tissue similar to that of the choroid is located between
smooth muscle cells which form the bulk of the ciliary body – the ciliary muscle.
 The inner surface of the ciliary body and its processes are lined by two layers of
columnar cells which belong to the retina – the ciliary epithelium formed by the pars
ciliaris of the retina. The outer cell layer is pigmented, whereas the inner cells layer,
i.e. the layer that faces the posterior chamber of the eye, is non-pigmented.

The ciliary processes contain a dense network of capillaries. The cells of the
inner layer of the ciliary epithelium generate the aqueous humor of the eye. , i.e.
they transport the plasma filtrate generated by the capillaries in the ciliary processes
into the posterior chamber of the eye. Tight junctions between the cells form the
blood – aqueous humor barrier.
Fibers, which consist of fibrillin, extend from the ciliary processes towards the lens
and form the suspensory ligament of the lens. These fibers are also called zonule
fibers. Two of the bundles of the ciliary muscles attach to the sclera and stretch the
ciliary body when they contract, thereby regulating the tension of the zonule fibers. The
reduced tension will result in a thickening of the lens which focuses the lens on close
objects – a process called accommodation.

Iris
The posterior surface of the iris is covered by the retina. The inner layer of the
retina, i.e. the layer facing the posterior chamber, is called the posterior epithelium of
the iris. Both layers of the retina are pigmented, but pigmentation is heavier in the
inner layer. In the region of the central opening of the iris, the pupil, the retina extends
for a very short distance unto the anterior surface of the iris. The iridial stroma
consists of a vascularized loose connective tissue rich in melanocytes in addition to
macrophages and fibrocytes, which are all surrounded by a loose meshwork of fine
collagen fibers. The anterior surface of the iris is not covered by an epithelium –
instead we find a condensation of fibrocytes and melanocytes, the anterior border
layer of the iris.

The iris forms the aperture of the eye. Myoepithelial cells in the outer (or
anterior) layer of the retina, i.e. the layer adjacent to the stroma of the iris, have radially
oriented muscular extensions. These extensions form a flat sheet immediately beneath
the anterior layer of the retina, the dilator papillae muscle. Embedded in the central
portion of the iridial stroma are smooth muscle cells which form the annular Sphincter
papillae muscle. In humans, this muscle regulates the size of the pupil. Papillary
constriction, which is mediated by the sphincter pupillae muscle, is clinically referred
to as meiosis. Dilation mediated by the dilator papillae muscle, as mydriasis.

The pigmentation of cells in the stroma and anterior border layer of the iris
determines color of the eyes. If cells are heavily pigmented the eyes appear brown. If
pigmentation is low the eyes appear blue. Intermediate levels create shades of green
and grey.

Lens
The lens consists of a lens capsule, the subcapsular epithelium and lens
fibers. It does not contain blood vessel or nerves. The lens capsule is generated by
the cells of the subcapsular epithelium and corresponds to a thick, elastic basal
lamina. The zonule fibers insert into the lens capsule. Cells of the subcapsular
epithelium (or anterior lens cells) are mitotically active.

The mature lens fibers, i.e. very long (up to 12 mm), hexagonal cells, form the
body of the lens. They are located immediately deep to the cells of the subcapsular
epithelium, lens fibers are nucleated in the soft, outer cortex of the lens. As new lens
fibers are added to the periphery of the cortex, lens fibers located deeper in the cortex
lose their nuclei and become part of somewhat harder nucleus of the lens. In the intact
lens, lens fibers are tightly connected to each other. Few organelles are scattered in a
cytoplasm filled with crystallin proteins. These proteins are responsible for the
transparency and refractive properties of the lens and account for up to 60% of the
mass of lens fibers.

The optical properties of the lens change from periphery to central parts because
differences in the amounts of crystalline contained in lens fibers. These differences
correct for distortions of colors and shapes (called spherical and chromatic
aberrations) which commonly occur at the margins of glass lenses.

The Neural tunic: Retina

Similar to the retinal lining of the iris and ciliary body, the outer layer of the light
sensitive retina forms a single layer of cuboidal cells – the pigment epithelium. The
inner layers of the retina contain the photoreceptors, the first neurons which
process the sensory information, and the neurons which convey the pre-processed
sensory information to the central nervous system. Receptors, neurons, supporting
cells and their processes are segregated into these layers: (which can be appreciated
next to the pigment epithelium, at the posterior wall of the eyeball).

1. The layer of rods and cones contains the outer, rod – or cone-shaped light
sensitive segments of the photoreceptive cells. The light sensitive part and the
perikaryon of the rods and cones are connected by a narrowed bridge of
cytoplasm, at the level of this connection the rods and cones are surrounded by
the processes of a specialized type of glial cells, Muller cells, which form the
2. Outer limiting membrane.
3. The outer nuclear layer contains the nuclei and perikarya of the rods and
cones. Their processes form part of the
4. Outer plexiform layer, where they form synapses with the processes of
neurons whose cell bodies are located in the
5. Inner nuclear layer. The cells of the inner nuclear layer are concerned with the
initial processing of the sensory input. The three major neuron types are
horizontal, bipolar and amacrine cells. The inner nuclear layer also houses
the perikarya of the Mϋller cells.
6. The inner plexiform layer contains the processes of the inner nuclear layer
neurons which convey the sensory input to the
7. Ganglion cell layer. Ganglion cells are not evenly distributed. There are few of
them towards the periphery of the retina. Close to the fovea, ganglion cells
 form a densely packed layer. Both ganglion cells and the cell bodies located in
the inner nuclear layer which contact the rods and cones of the fovea are
displaced towards the margins of the fovea.
8. Layer of optic nerve fibers. The axons of the ganglion cells travel in this layer
towards the optic disc. Towards the optic disc, the thickness of the layer
increases as more and more axons are added to it.
9. The inner limiting membrane corresponds to a basal lamina formed by the
Mϋller cells.

Eyelid
The posterior (facing the eyeball) and anterior (facing the world) surfaces of the
eyelid are also called conjunctival and cutaneous parts. The cutaneous part is covered
by skin and contains sweat glands, sebaceous glands and, along the margins of the
lid, 3-4 rows of hairs – the eyelashes. Modified apocrine sweat glands, the glands of
Moll, empty into the follicles of the eyelashes. The eyelashes lack arrector pili
muscles.

The inner, conjunctival part of the lids is lined by conjunctiva. Beneath the
conjunctiva, large sebaceous glands are embedded in a plate of dense connective
tissue containing many elastic fibers. The plate and the sebaceous glands within it are
called the tarsal plate with the tarsal glands (also Meibomian glands). Extensive
skeletal muscle bundles between the tarsal plate and the skin belong to the orbicularis
oculi muscle.

Conjunctiva
The margins of the cornea merge with the conjunctiva. The conjunctiva extends over the
“white of the eye”, which corresponds to the anterior part of the sclera, folds back and
continues over the posterior part of the eyelid. At the opening formed by the eyelids,
the conjunctiva merges with the skin covers the anterior surface of the eyelids. The
epithelium of the conjunctiva varies from stratified squamous (most of it) to stratified
columnar (at the reflection from the sclera to the eyelid). Goblet cells occur where the
epithelium is stratified columnar. The conjunctival epithelium rests on the loose
connective tissue of its lamina propria.

Slide 48: Eyeball

Examine the eyeball. Locate the layers of the eye with their component structures:
1. Outermost wall: cornea (anteriorly) and sclera (posteriorly)
Look at the 5 layers of the cornea: stratified squamous epithelium;
Bowman’s membrane; corneal stroma; Descemet’s membrane; and
endothelium. Note the absence of capillaries. Locate the sclera and
appreciate the tissues here. At the region where cornea and sclera meet:
corneoscleral junction or limbus, the structures for aqueous humor drainage are
seen, i.e. canal of Schlemm and trabecular mesh works.
2. Middle layer: Iris, ciliary body and choroid
 Locate the iris – and its respective tissues, structures
Ciliary body – ciliary processes with ciliary epithelium and loose connective
tissue; ciliary muscle and the choroid – and its components tissues.
3. Innermost layer: retina
Only at the photosensitive region of the retina posteriorly with all its layers seen
and anteriorly, at iris and ciliary body only the pigmented epithelium is seen.

Identify the layers of the retina from the pigmented epithelium inwards.
Locate the other parts of the eye: vitreous body, lens, anterior and
posterior chambers, eyelids and its contents.

Slide 45: Cochlea

The specimen is taken from part of the inner ear – the cochlea, which is bony
structure, and is a component of the osseous labyrinth. The cochlea houses the
cochlear duct (part of the membranous labyrinth) containing endolymph. At the base
of the cochlear duct (also called scala media, lie the organ of Corti– the epithelial
structure containing the auditory receptors (inner & outer hair cells) with their
supporting cells.

Locate/identify the following:

Cochlear duct, organ of Corti, basilar membrane, stria vascularis; spiral ganglion;
modiolus; and helicotrema.

Read your textbook for details regarding the eye and ear.

REFERENCES
1. Allain C.C. and al., Clin. Chem., 20, (1974), 470.
2. Boron and Boulpaep. Medical Physiology 2nd Updated Edition, Elsevier 2011
3. Davies and Moores. The Respiratory System 2nd Edition, Churchill Livingstone
Elsevier 2010
4. Di Fiore, Mariano S. Atlas of Human Histology 5th Edition
5. Dugdale, D.C. Creatinine Blood Test. Medline Plus. A.D.A.M Inc. Last update on
August 4,
2014. http://www.nlm.nih.gov/medlineplus/ency/article/003475.htm
6. Field, Pollock and Harris. The Renal System 2nd Edition, Churchill Livingstone
Elsevier 2010
7. Ganong’s Review of Medical Physiology 23rd Edition, Lange-McGraw Hill, 2010
8. Henry’s Clinical Diagnosis and Management by Laboratory Methods 22nd Edition,
Elsevier 2011
9. Mescher, Anthony. Junquiera’s Basic Histology: Text & Atlas 13th Edition. McGraw-
Hill 2013
10. Murray and Bender. Harper’s Illustrated Biochemistry 29th Edition McGraw-Hill 2012

Updated 04/04/2022
MMVP