The Ministry of Education and Science of the Kyrgyz Republic

The Ministry of Education and Science of the Russian Federation

State Educational Institution of Higher Professional Education

Kyrgyz-Russian Slavic University

Department of the anatomy, topographic anatomy and operative surgery

The systemic anatomy of the central nervous system

Textbook

Bishkek 2019
1
 The systemic anatomy of the central nervous system. Textbook.

Textbook is prepared by: senior lecturer Gaivoronskaya Y.B., senior lecturer Imanalieva A.S., senior
lecturer Lobzova V.V.

The nervous system controls the activity of various systems and individual organs, which make up the
entire body; it coordinates their work and establishes the relationships of the body with an external
environment. This textbook represents the description of the major divisions in the central nervous system,
their external and internal structure. The schematic illustration of the main paths is given here. This
textbook is elaborated for medical students.

2
 Introduction
The nervous system is organized into two parts: the central nervous system, which consists of
the brain and the spinal cord, and the peripheral nervous system, which connects the central nervous
system to the rest of the body.
In the central nervous system, the brain and spinal cord are the main centers where correlation
and integration of nervous information occur. Both the brain and spinal cord are covered with a system
of membranes, called meninges, and are suspended in the cerebrospinal fluid; they are further
protected by the bones of the skull and the vertebral column.
The central nervous system is composed of large numbers of excitable nerve cells and their
processes, called neurons, which are supported by specialized tissue called neuroglia. The long
processes of a nerve cell are called axons or nerve fibers. The interior of the central nervous system is
organized into gray and white matter. Gray matter consists of nerve cells embedded in neuroglia; it has
a gray color. White matter consists of nerve fibers embedded in neuroglia; it has a white color due to
the presence of lipid material in the myelin sheaths of many of the nerve fibers. The billions of neurons
in the brain are connected to neurons throughout the body by trillions of synapses.
The brain contains more than 90% of the body's neurons. The brain has been divided into three
different areas: the hindbrain, the midbrain, and the forebrain. The hindbrain is found in even the most
primitive vertebrates. It is made up of the cerebellum, the pons, and the medulla. The medulla is a
narrow structure nearest the spinal cord; it is the point at which many of the nerves from the left part of
the body cross to the right side of the brain and vice versa. The medulla controls such functions as
breathing, heart rate, and blood pressure. The pons, located just above the medulla, connects the top of
the brain to the cerebellum. The cerebellum is divided into two hemispheres and handles certain
reflexes, especially those that have to do with balance. It also coordinates the body's actions. The
midbrain lies between the hindbrain and forebrain and is crucial for hearing and sight. The forebrain is
supported by the brain stem and buds out above it, drooping somewhat to fit inside the skull. It consists
of the thalamus, the hypothalamus, and the cerebral cortex. The thalamus relays and translates
incoming messages from the sense receptors—except those for smell. The hypothalamus governs
motivation and emotion and appears to play a role in coordinating the responses of the nervous system
in times of stress. The cerebral hemispheres, located above the thalamus and hypothalamus, take up
most of the room inside the skull. The outer covering of the cerebral hemispheres is known as the
cerebral cortex. The cerebral hemispheres are what most people think of when they think of the brain.
They are the most recently evolved portion of the brain, and they regulate the most complex behavior.
Each cerebral hemisphere is divided into four lobes, delineated by deep fissures on the surface of the
brain. The occipital lobe of the cortex, located at the back of the head, receives and processes visual
information. The temporal lobe, located roughly behind the temples, is important to the sense of smell;
it also helps us perform complex visual tasks, such as recognizing faces. The parietal lobe, which sits
on top of the temporal and occipital lobes, receives sensory information, in the sensory projection
areas, from all over the body and figures in spatial abilities. The ability to comprehend language is
concentrated in two areas in the parietal and temporal lobes. The frontal lobe is the part of the cerebral
cortex responsible for voluntary movement and attention as well as goal-directed behavior. The brain
starts response messages in the motor projection areas, from which they proceed to the muscles and
glands. The frontal lobe may also be linked to emotional temperament. The brain lies in the cranial
cavity and is continuous with the spinal cord through the foramen magnum. It is surrounded by three
meninges: the dura mater, the arachnoid mater, and the pia mater; these are continuous with the
corresponding meninges of the spinal cord. The cerebrospinal fluid surrounds the brain in the
subarachnoid space.
The spinal cord is roughly cylindrical and begins superiorly at the foramen magnum in the
skull, where it is continuous with the medulla oblongata of the brain. It terminates inferiorly in the
lumbar region. Below, the spinal cord tapers off into the conus medullaris, from the apex of which a
prolongation of the pia mater, the filum terminale (internum), descends to attach to the back of the
coccyx. Thirty one pairs of spinal nerves are attached by the anterior or motor roots and the posterior
or sensory roots along the entire length of the spinal cord. The spinal cord is situated within the
3
vertebral canal of the vertebral column and is surrounded by three meninges: the dura mater, the
arachnoid mater, and the pia mater. Further protection is provided by the cerebrospinal fluid, which
surrounds the spinal cord in the subarachnoid space.

SPINAL CORD

The spinal cord is the lower elongated, cylindrical part of the CNS. It occupies the upper two thirds
of the vertebral canal. It extends from the level of the upper border of the atlas to the lower border of
vertebra LI, or the upper border of vertebra L2. It is about 45 cm long. The lower end is conical and is
called the conus medullaris. The apex of the conus is continued down as the filum terminale. The
filum terminale is a delicate, thread-like structure about 20 cm long. It extends from the apex of the
conus medullaris to the dorsum of the coccyx. It is composed chiefly of pia mater (fibrous tissue),
although a few nerve fibres. The filum terminale is subdivided into a part lying within the dural sheath
(called the filum terminale internum) which contains the nerve fibers; and a part lying outside the dural
sheath, below the level of the 2nd sacral vertebra (filum terminale externum). The filum terminate
internum is 15 cm long, and the externum is 5 cm long. Along its length, the cord presents two
thickenings, the cervical and lumbar enlargements, which give rise to large nerves for the limbs.
When seen in transverse section the grey matter of the spinal cord forms an H-shaped mass. In each
half of the cord the grey matter is divisible into (1) the anterior grey column (or horn), and (2) the
posterior grey column (or horn). In some parts of the spinal cord a small lateral grey column is also
present. The grey matter of the right and left halves of the spinal cord is connected across the midline
by the grey commissure which is traversed by the central canal.
The white matter of the spinal cord is divisible into right and left halves, in front by a deep anterior
median fissure; and behind by the posterior median septum. In each half the white matter is divided
into (1) the posterior white column or posterior funiculus; (2) the lateral white column or lateral
funiculus; and (3) the anterior white column or anterior funiculus. The white mater of the right and
left sides is continuous across the midline through the white commissure which lies anterior to the
grey commissure.
The spinal cord gives attachment, on either side, to a series of spinal nerves. Each spinal nerve
arises by two roots; (1) anterior (or ventral); and (2) posterior (or dorsal). Each root is made up of a
number of rootlets. The length of the spinal cord giving origin to the rootlets for one spinal nerve
constitutes one spinal segment.
As the spinal cord is much shorter than the length of the vertebral column the spinal segments do
not lie opposite the corresponding vertebrae. It is important to remember the position of a spinal
segment in relation to the surface of the body because vertebral column is always lower than the
corresponding spinal segment. The C8 (cervical) segment is related to the C7 (cervical) vertebrae.
The Th12 (thoracic) segment is related to the Th9 (thoracic) vertebrae. The lumbar segments are
related to the Th10-12 (thoracic) vertebras. The sacral segments are related to the L1-2 (lumbar)
vertebras.
The first, sensory neuron of reflex arc is situated in the dorsal root ganglia, the peripheral process
of neuron passes as a component of nerves to the organs and tissues and comes in contact there with
the receptors while the central process pierces the spinal cord as part of the posterior sensitive roots
through the dorsolateral sulcus and comes in contact in the cord with the cells of the posterior horns.
During development, the spinal cord grows in length more slowly than the vertebral column. To
accommodate for this disproportion the roots of the lumbar and sacral nerves below the level of the
termination of the cord form a vertical bundle of nerves that resembles a horse's tail and is called the
cauda equina.

4
 Internal Structure
The grey matter consists of nerve cells grouped to form nuclei whose position forms primary
three-member reflex arc. Also from posterior to anterior parts we distinguished ten layers (I –X).
Nuclei in posterior horn:
1. Postmarginal nucleus – receive dorsal root fibers (I layer)
2. Substantia gelatinosa – it acts as an relay station for pain and temperature fibers and give rise
to the lateral spinothalamic tract (II layer)
3. Nucleus proprius – it is concerned with sensory associative mechanism (III, IV layers)
4. V layer – visceral sensory information
5. VI layer – limb sensory information
Nuclei in anterior horn:
1. Medial group (anteromedialis and posteromedialis nuclei) – innervates the axial muscles of
the body (VIII layer)
2. Lateral group - present only in the cervical and lumbar enlargements and supplies
musculature of limbs (IX layer):
- anterolateralis nucleus – shoulder, arm, gluteal region, thigh
- posterolateral nucleus – forearm, leg
- post posterolateral nucleus – hand, foot
3. Central group – only in upper cervical segments as phrenic nerve nucleus and nucleus of
spinal root of accessory nerve (IX layer)
Central zone (X layer) – contains axons crossing to opposite side of the spinal cord.
The anterior and posterior horns in each half of the spinal cord are connected to each other by the
intermediate zone of the grey matter which is particularly pronounced in the thoracic and lumbar
segments of the spinal cord on the distance between the eight cervical and second lumbar spinal
segments and projects as the lateral horn.

Nuclei in lateral horn:

1. Dorsal (thoracic, Clark,s) nucleus – unconscious proprioceptive impulses to the
cerebellum (VII layer)
2. Intermediolateral nucleus - innervate the organs as a part of sympathetic nerve system (VII
layer).
The white matter
The posterior funiculi contain fibres of the posterior spinal roots which form two systems.
1. The m e d i a l l y s i t u a t e d fasciculus gracilis for lower limb.
2. The l a t e r a l l y situated fasciculus cuneatus o upper limb.
The fasciculi gracilis and cuneatus conduct from the corresponding parts of the body to the brain
cortex proprioceptive (muscle and j o i n t sense) sensitivity related to determining the position of the
body in space. Also fine touch and vibration.
The lateral funiculi contain the following tracts:
Ascending.
(1) The posterior spinocerebellar tract located on the periphery of the posterior part of the
lateral funiculus.
(2) The anterior spinocerebellar tract situated ventral to the posterior tract. Both
spinocerebellar tracts conduct involuntary (unconscious) proprioceptive impulses (involuntary
coordination of movements).
(3) The anterioalateral spinothalamic tract conducts temperature stimuli in the dorsal part and
pain stimuli in the ventral part, also crude touch.
Descending.
(1) The lateral pyramidal, or corticospinal tract. It is a voluntary efferent motor tract for limbs.
(2) The rubrospinal tract. This is an involuntary efferent motor pathway.
5
 The anterior funiculi contain the following tracts:
(1) The anterior pyramidal for axial musculature. Together with the lateral pyramidal tract it
constitutes the common pyramidal system.
(2) The tectospinal tract lies medial to the pyramidal tract and bounds the anterior median
fissure. It is concerned with protective reflex movements in visual and auditory stimulations and is
therefore the visual and auditory reflex tract.
Some fasciculi pass to the anterior horns of the spinal cord from different nuclei of the medulla
oblongata which are concerned with balance and coordination of movements. These are as follows:
(3) From the nuclei of the vestibular nerve, the anterior vestibulospinal tract lying at the
junction of the anterior and lateral funiculiand answer for balance and posture.
(4) From the reticular formation, the reticulospinal tract situated in the middle part of the
anterior funiculus. It answer for muscle tone and respiratory and circulatory systems.

The meninges of the spinal cord

The vertebral canal contains the following structures:

1. Epidural space.
2. Dura mater.
3. Subdural capillary space.
4. Arachnoid mater.
5. Subarachnoid space containing cerebrospinal fluid.
6. Pia mater. (The arachnoid and pia together form the leptomeninges.)
7. Spinal cord and the cauda equina.

Epidural Space
It lies between the spinal dura mater, and the periosteum and ligaments lining the vertebral canal. It
contains: (a) semi-liquid fat; (b) spinal arteries on their way to supply the deeper contents; and (c) the
internal vertebral venous plexus.

Spinal Dura Mater

It is a thick, fibrous membrane which forms a sheath around the spinal cord. It is continuous with
the meningeal layer of the cerebral dura mater. The spinal dura extends from the foramen magnum to
the lower border of the second sacral vertebra The dura gives tubular sheath to the dorsal and ventral
nerve roots and to the spinal nerves as they pass through the intervertebral foramina and fuses with the
periosteum.

Subdural Space
It is a capillary (potential) space between the dura and the arachnoid, containing a thin film of serous
fluid.

Arachnoid Mater
This is a thin, delicate and transparent membrane which inferiorly extends (like the dura) up to the
lower border of the second sacral vertebra.

Subarachnoid Space
It is a wide space between the pia and the arachnoid, filled with cerebrospinal fluid (CSF). It surrounds
the brain and spinal cord like a water cushion. The spinal subarachnoid space is wider than the space
around the brain. It is widest below the lower end of the spinal cord where it incloses the cauda equina.
Lumbar puncture is usually done in the lower widest part of the space, between vertebrae L3 and L4.
6
Spinal Pia Mater
The spinal pia is thicker, less vascular than the cerebral pia, but both are made up of two layers: (a) an
outer epi-pia containing larger vessels; and (b) an inner pia-glia or pia-intima which is in contact with
nervous tissue. Between the two layers there are many small blood vessels and also cleft like spaces
which communicate with the subarachnoid space. The pia mater closely invests the spinal cord, and is
continued below the spinal cord as the filum terminale.
On each side between the ventral and dorsal nerve roots, the pia forms a narrow vertical ridge, called
the ligamentum denticulatum. Each ligament has 21 processes; the first at the level of the foramen
magnum, and the last between spinal nerves T12 and LI. Each process passes through the arachnoid to
the dura between two adjacent spinal nerves. The processes suspend the spinal cord in the middle of the
subarachnoid space.

7
8
9
10
11
12
13
 THE BRAINSTEM

The brainstem is made up of the medulla obiongata, the pons, and the midbrain and occupies the
posterior cranial fossa of the skull. It is stalklike in shape and connects the narrow spinal cord with the
forebrain.

THE MEDULLA OBLONGATA

The medulla oblongata connects the pons superiorly with the spinal cord inferiorly. The junction
of the medulla and spinal cord is at the origin of the anterior and posterior roots of the first cervical
spinal nerve which corresponds approximately to the level of the foramen magnum. The central canal
of the spinal cord continues upward into the lower half of the medulla; in the upper half of the medulla
it expands as the cavity of the fourth ventricle.
On the anterior surface of the medulla is the anterior median fissure, which is continuous
inferiorly with the anterior median fissure of the spinal cord. On each side of the median fissure there
is a swelling called the pyramid. The pyramids are composed of bundles of nerve fibers, corticospinal
tracts. The pyramids pass inferiorly and it is here that the majority of the descending fibers cross over
to the opposite side, forming the decussation of the pyramids. Posterolateral to the pyramids are the
olives, which are oval elevations produced by the underlying inferior olivary nuclei. In the groove
between the pyramid and the olive emerge the rootlets of the hypoglossal nerve. Posterior to the olives
are the inferior cerebellar peduncles, which connect the medulla to the cerebellum. In the groove
between the olive and the inferior cerebellar peduncle emerge the roots of the glossopharyngeal and
vagus nerves and the cranial roots of the accessory nerve.
The posterior surface of the superior half of the medulla oblongata forms the lower part of the floor
of the fourth ventricle. The posterior surface of the inferior half of the medulla is continuous with the
posterior aspect of the spinal cord and possesses a posterior median sulcus. On each side of the
median sulcus there is an elongated swelling, the gracile tubercle, produced by the underlying gracile
nucleus. Lateral to the gracile tubercle is a similar swelling, the cuneate tubercle, produced by the
underlying cuneate nucleus.

Internal structure of the medulla oblongata

It contains the nuclei of cranial nerves from VIII to XII:

- Vestibulocochlear nerve (VIII) – medial and inferior vestibular nuclei, anterior and
posterior cochlear nuclei (all are sensory)
- Glossopharyngeal nerve (IX) – ambigus nucleus (motor), nucleus of tractus solitarius
(sensory), inferior salivatory nucleus (parasympathetic)
- Vagus nerve (X) - ambigus nucleus (motor), nucleus of tractus solitarius (sensory), dorsal
vagal nucleus (parasympathetic)
- Accessory nerve (XI) - accessory nucleus (motor)
- Hypoglossal nerve (XII) - hypoglossal nucleus (motor)

THE PONS
The pons in anterior to the cerebellum and connects the medulla oblongata to the midbrain. It is
about 1 inch (2.3 cm) long, the anterior surface, as a bridge connecting the right and left cerebellar
hemispheres.
The anterior surface is convex from side to side and shows many transverse fibers that converge on
each side to form the middle cerebellar peduncle.There is a shallow groove in the midline the basilar
groove, which lodges the basilar artery. On the anterolateral surface of the pons the trigeminal nerve
emerges on each side. Each nerve consists of a smaller, medial part—the motor root— and a larger
14
lateral part—the sensory root. In the groove between the pons and the medulla oblongata there
emerge, from medial to lateral, the abducent, facial, and vestibulocochlear nerves.
The posterior surface of the pons is hidden from view by the cerebellum and forms the upper part of
the rhomboid fossa.

Internal structure of the pons

It contains the nuclei of cranial nerves from V to VIII:

- Trigeminal nerve (V) – motor nucleus (supply muscles of mastication), main sensory
nucleus (touch and pressure sensation), mesencephalic nucleus (proprioceptions), spinal
nucleus (pain and temperature sensation)
- Abducent nerve (VI) – nucleus of abducent nerve (supply rectus lateralis muscle)
- Facial nerve (VII) – motor nucleus of facial nerve (supply facial muscles), nucleus of
tractus solitarius (sensory), inferior salivatory nucleus (supply glands of the head)
- Vestibulocochlear nerve (VIII) – lateral and superior vestibular nuclei (sensory)

ROMBOID FOSSA
The diamond-shaped floor is formed by the posterior surface of the pons and the superior half of
the medulla oblongata. The floor is divided into symmetrical halves by the median sulcus. On each
side of this sulcus there is an elevation, the medial eminence, which is bounded laterally by another
sulcus, the sulcus limitans. The superior end of sulcus limitans forms the cranial fossa and inferior
end the caudate fossa. In the cranial fossa is lied the motor nucleus of trigeminal nerve. In the
caudate fossa is lied the ambigus nucleus (common motor nucleus of the IX and X cranial nerves).
Beneath ambigus nucleus is located nucleus of accessory nerve. Lateral to the sulcus limitans there is
an area known as the vestibular area. The vestibular and cochlear nuclei lie beneath the vestibular
area.
Laterally from the sulcus limitans and medially from the vestibular area in the upper half are
located vegetative nuclei of the facial nerve – superior salivatory nucleus and glossopharyngeal nerve
– inferior salivatory nucleus; in the lower half is located solitary tract nucleus (common sensory
nucleus of the VII, IX and X cranial nerves).
The facial colliculus is a slight swelling at the superior end of the medial eminence that is produced
by the fibers from the motor nucleus of the facial nerve looping over the abducens nucleus. At the
superior end of the sulcus limitans there is a bluish-gray area produced by a cluster of nerve cells
containing melanin pigment; the cluster of cells is called the substantia ferruginea, beneath which lies
the pontine nucleus of the trigeminal nerve; above is located nucleus tractus mesencephali and
below – nucleus tractus spinalis of trigeminal nerve. The nerve fibers, the stria medullaris emerges
from the median sulcus and pass laterally over the medial eminence and the vestibular area and enter
the inferior cerebellar peduncle to reach the cerebellum. Inferior to the stria medullaris the following
features should be recognized in the floor of the ventricle. The most medial is the hypoglossal
triangle, which indicates the position of the underlying hypoglossal nucleus. Lateral to this is the
vagal triangle, beneath which lies the dorsal vegetative nucleus of the vagus nerve.

FOURTH VENTRICLE
The fourth ventricle is a tent-shaped cavity filled with cerebrospinal fluid. It is situated anterior to
the cerebellum and posterior to the pons and the superior half of the medulla oblongata. It is lined with
ependyma and is continuous above with the cerebral aqueduct of the midbrain and below with the
central canal of the medulla oblongata and the spinal cord. The fourth ventricle possesses lateral
boundaries, a roof, and a rhomboid-shaped floor, which forms by the rhomboid fossa.
The tent-shaped roof projects into the cerebellum. The superior part is formed by the medial borders of
the two superior cerebellar peduncles and a connecting sheet of white matter called the superior
15
medullary velum. The inferior part of the roof is formed by the flocculus of the cerebellum and
connecting sheet of the white matter called the inferior medullary velum. This part of the roof is pierced
in the midline by a large aperture, the median aperture or foramen of Magendie. Lateral recesses
extend laterally around the sides of the medulla and open anteriorly as the lateral openings of the
fourth ventricle, or the foramina of Luschka. Thus, the cavity of the fourth ventricle communicates
with the subarachnoid space through a single median opening and two lateral apertures. These
important openings permit the cerebrospinal fluid to flow from the ventricular system into the
subarachnoid space.
The choroid plexus is suspended from the inferior half of the roof of the ventricle and is formed
from by the vascular tela choroidea. The tela choroidea is a two-layered fold of pia mater that projects
through the roof of the ventricle and is covered by ependyma. The function of the choroid plexus is to
produce cerebrospinal fluid.

THE MIDBRAIN (MESENCEPHALON)

The midbrain measures about 0.8 inch (2 cm) in length and connects the pons and cerebellum with
the forebrain. The midbrain is traversed by a narrow channel, the cerebral aqueduct, which is filled
with cerebrospinal fluid.
On the posterior surface are four colliculi. These are rounded eminences that are divided into
superior and inferior pairs by a vertical and a transverse groove. The superior colliculi are centers for
visual reflexes, and the inferior colliculi are lower auditory centers. In the midline below the inferior
colliculi the trochlear nerves emerge.
On the lateral aspect of the midbrain, the superior and inferior brachia ascend in an anterolateral
direction. The superior brachium passes from the superior colliculus to the lateral geniculate body
and the optic tract. The inferior brachium connects the inferior colliculus to the medial geniculate
body.
On the anterior aspect of the midbrain there is a deep depression in the midline, the
interpeduncular fossa, which is bounded on either side by the crus cerebri. Many small blood vessels
perforate the floor of the interpeduncular fossa and this region is termed the posterior perforated
substance. The oculomotor nerve emerges from a groove on the medial side of the crus cerebri.

Internal structure of the midbrain

It contains the nuclei of cranial nerves III and IV:

- Oculomotor nerve (III) – nucleus of oculomotor nerve (supply muscles of eyeball),

Edinger-Westphal nucleus (supply cilliary and sphincter pupillae muscles)
- Trochlear nerve (IV) – nucleus of trochlear nerve (supply superior oblique muscle)

THE CEREBELLUM

The cerebellum is situated in the posterior cranial fossa and covered superiorly by the tentorium
cerebelli. It is the largest part of the hindbrain and lies posterior to the fourth ventricle, the pons and
the medulla oblongata. It consists of two cerebellar hemispheres joined by a narrow median vermis.
The sagittal section of vermis is called arbor vitae cerebelli or “tree of life”. The cerebellum is
connected to the posterior aspect of the brainstem by three symmetrical bundles of nerve fibers called
the superior, middle, and inferior cerebellar peduncles. The superior cerebellar peduncles are
connected with the midbrain, the middle cerebellar peduncles are connected with the pons and the
inferior cerebellar peduncles are connected with the medulla oblongata. A deep horizontal fissure
that is found along the margin of the cerebellum separates the superior from the inferior surfaces. On
the inferior surface is situates depression – vallecula cerebelli.
16
 The cerebellum is divided into three main lobes - the anterior lobe, the middle lobe, and the
flocculonodular lobe. The anterior lobe may be seen on the superior surface of the cerebellum and is
separated from the middle lobe by a wide V-shaped fissure called the primary fissure. The posterior
lobe which is the largest part of the cerebellum is situated between the primary and uvulonodular fis-
sures. The flocculonodular lobe is situated posterior to the uvulonodular fissure. Developmentally
cerebellum is divided into: archiocerebellum - flocculonodular lobe, which answer for balance,
paleocerebellum – anterior lobe, which answer for muscular tone and neocerebellum – posterior
lobe, which answer for coordination of movements.
STRUCTURE OF THE CEREBELLUM
The cerebellum is composed of an outer covering of gray matter called the cortex and inner
white matter. The white matter of the cerebellum has on section the appearance of small leaves of a
plant which correspond to each folium (gyri of cerebellum) covered on the periphery by a cortex of
grey matter. The gray matter of the cortex may be divided into three layers: (1) an external layer, the
molecular layer; (2) a middle layer, the Purkinje cell layer; and (3) an internal layer, the granular
layer. The cells of the molecular layer are: stellate cell, basket cell, which are interneuron in function.
Four masses of gray matter (nuclei) are embedded in the white matter of the cerebellum on
each side of the midline. From lateral to medial these nuclei are the dentate, the emboliform, the
globose, and the fastigial.
The dentate nucleus (part of neocerebellum) is the largest of the cerebellar nuclei. It has the shape
of a crumpled bag with the opening facing medially. The emboliform nucleus (part of
paleocerebellum) is ovoid and is situated medial to the dentate nucleus, partially covering its hilus.
The globose nucleus (part of paleocerebellum) consists of one or more rounded cell groups that lie
medial to the emboliform nucleus. The fastigial nucleus (part of archiocerebellum) lies near the
midline in the vermis and close to the roof of the fourth ventricle.

17
18
19
20
21
22
 THE DIENCEPHALON
The diencephalon is made up of three parts: the middle portion – thalamus, superior portion -
epithalamus and inferior portion – hypothalamus. The third ventricle is the diencephalic cavity.
The thalamus is a large paired mass of grey matter in the lateral walls of the diencephalon on
either side of the third ventricle. It is egg-shaped with the anterior end tapered to form the anterior
tubercle; the posterior end is thickened and forms the pulvinar. Its lateral surface faces the c a v i t y of
t h e lateral ventricle and is separated from the adjacent caudate nucleus by t h e terminal sulcus.
Above, the medial surface is demarcated from the dorsal surface by a band of white matter, the stria
medullaris thalami. The medial surfaces of both thalami are joined to each other by the interthalamic
adhesion of grey matter which is located almost in the middle. In sections of the thalamus the layers of
white matter, laminae medullaris thalami, divide the grey matter of the thalamus into nuclei. Behind
the thalamus are two small elevations, the lateral and medial geniculate bodies. The medial
geniculate body is smaller but more pronounced. It lies in front of the inferior brachium under the
thalamic pulvinar. The fibres of the l a t e r a l lemniscus t e r m i n a t e in it, as a consequence of which it
is a subcortical auditory centre together with t h e i n f e r i o r colliculi. The lateral geniculate body
is a large flat elevation on the inferolateral surface of the pulvinar. Most of the lateral part of the
optic tract ends in it (the other part of the tract terminates in the pulvinar). As a result, together with
the pulvinar and the superior colliculi, the lateral geniculate body is a subcortical visual centre.
The epithalamus. The striae medullares of both thalami pass to the back (caudally) and form on
either side a triangular area (trigonum habenulae). This trigonum gives rise to a rein-like structure, the
habenula, which, together with the habenula of the conlralateral side, joins with the pineal body. In
front of the pineal body both habenulae are united by means of the habenular commissure. The pineal
body itself, resembling a pine cone in shape, is related to the endocrine glands in structure and
function. Above the habenular commissure is a small pineal recess projecting into the base of the
pineal body.

The pineal body is a small oval, reddish body, whose narrower end is directed downward and to
the back. It measures 7 – 10 mm in length and 5 – 7 mm in width. Its cells are groups in the form of
strands and possess secretory properties. It composed of two types cells, pinealocytes and neuroglial
cells. Calcareous concretion are constantly present in the pineal body after 17 th year of life and may
form aggregation “brain sand”, or corpora arenacea. In 1958 Dr. Aoron Lerner reported that pineal
gland secrete melatonin. The pineal gland receives massages along nerve fibers from cells of the
suprachiasmatic nucleus of the hypothalamus, which themselves receive signal from the eyes via
optic nerve. The pineal body secretes the “darkness” hormone melatonin normally at night in sync with
circadian rhythmus. In children melatonin inhibits sexual development.
The hypothalamus is located ventrally under the floor of the third ventricle, in front of the
posterior perforated substance. According to the embryonic development, two parts are distin-
guished in the hypothalamus: the anterior, optic part, under the tuber cinereum with the
infundibulum and hypophysis cerebri (pituitary gland) as well as the optic chiasma with the
optic tract, and the posterior, olfactory part, consisting of the mammillary bodies. The mamillary
bodies are functionally related to the subcortical olfactory centres and are connected with the
columns of the fornix. The hypothalamus also is divided in to three portions: anterior, intermedial
and posterior, with underlying nuclei.

THE THIRD VENTRICLE

The third ventricle lies on the m i d l i n e ; on frontal section of the brain it, has the appeara nc e of
a slit-like cavity with six walls.

The lateral walls of the t h i r d v e n t r i c l e are formed by the medial surfaces of the thalami
which are bridged almost in the middle by the interthalamic adhesion.
23
 The anterior wall of the third ventricle is formed below by a fine terminal lamina and further upward
by the columns of the fornix (columnae fornicis) with the while anterior commissure lying across
them. On both sides, at the anterior ventricular wall, the columnar fornicis together with the anterior
ends of the thalami form the boundaries of the interventricular foramina, or foramina of Маnrо,
through which the t h i r d ventricle communicates with the lateral ventricles situated in the cerebral
hemispheres.

The superior wall (roof) of the t h i r d ventricle lies under the fornix and the corpus callosum. It is
actually formed of tela chorioidea of the third ventricle. The choroid plexus of the third ventricle
lies on either side of the m i d l i n e in the tela chorioidea.

In the posterior wall of the ventricle are the habenular commissure between which in caudally
directed blind projection of the ventricle, the pineal recess. The cerebral aqueduct communicates with
the third ventricle.

The narrow inferior wall (floor) of the t h i r d ventricle is separated on the inside from the lateral
walls by the hypothalamic sulcus corresponds to the posterior perforated substance, the mamillary
bodies, and the tuber cinereum with the optic chiasma on the base of the brain. The floor of the
ventricle forms two recesses: the infundibular recess projecting i n t o the tuber cinereum and the
infundibulum, and the optic recess situated in front of the chiasma. The i n n e r surface of the
t h i r d ve nt ri cle is lined with the ependyma.

HYPOPHYSIS CEREBRI
The hypophysis cerebri, or pituitary gland is a small spherical or oval gland, reddish in color,
which is connected with the brain, with the tuber cinereum and infundibulum. The gland is lodged in
the sella turcica and is attached there by the diaphragm sellae. The dimensions of the hypophysis are
small: 8 – 10 mm in length, 12 -15 mm width, and 5 -6 mm in height. It is with ranges between 0.35 –
0.65 g.
Two lobes differing in structure, function, and development a distinguished in the hypophysis:
anterior and posterior. The anterior lobe is called adenohypophysis posterior lobe is called
neurohypophysis.
Functions. The anterior lobe affects the growth and development of the whole body (the
somatotropic hormone), also stimulates the activity of other endocrine glands, namely the thyroid
(thyrotropic hormone), the adrenal cortex (the adrenocorticotropic hormone), and the sex glands (the
gonadotropic hormone).
The posterior lobe takes part in neurosecretion, i.e. the production of specific neurosecretory
substances by the hypothalamic neurons (supraoptic and paraventricular nucleus), neuromediators.
Chemomediators spread along the axons of these neurons, through the hypophysial stalk into the
neurohypophysis and pass there into the vessels through the vasoneural synapses. The posterior lobe
augments the smooth muscles of the vessels by raising blood pressure (vasopressin) and the muscles of
the uterus (oxytocin) and also exerts an influence on reabsorption of water in the kidneys (the
antidiuretic hormone).

24
25
26
27
 CEREBRAL HEMISPHERES (TELENCEPHALON)

The cerebral hemispheres are the largest part of the brain and are separated by a deep midline
sagittal fissure, the longitudinal cerebral fissure. In the depths of the fissure, the great commissure,
the corpus callosum, connects the hemispheres across the midline. A second horizontal fold of dura
mater separates the cerebral hemispheres from the cerebellum and is called the transverse cerebral
fissure.

To increase the surface area of the cerebral cortex maximally, the surface of each cerebral
hemisphere is thrown into gyri, which are separated from each other by sulci or fissures. The central,
parieto-occipital, lateral and calcarine sulci are boundaries used for the division of the cerebral
hemisphere into frontal, parietal, temporal, and occipital lobes. The lateral sulcus is a deep cleft
found mainly on the inferior and lateral surfaces of the cerebral hemisphere. It consists of a short stem
that divides into three rami: anterior ramus and the ascending ramus and the posterior ramus. An
area of cortex called the insuia lies at the bottom of the deep lateral sulcus and cannot be seen. The
parieto-occipital sulcus begins on the superior medial margin of the hemisphere about 2 inches (5
cm) anterior to the occipital pole. It passes downward and anteriorly on the medial surface to meet the calcarine
sulcus.

Superolateral surface of the cerebral hemisphere

The frontal lobe occupies the area anterior to the central sulcus and superior to the lateral sulcus. The
superolateral surface of the frontal lobe is divided by three sulci into four gyri. The precentral sulcus runs parallel
to the central sulcus and the precentral gyrus lies between them. Extending anteriorly from the precentral
sulcus are the superior and inferior frontal sulci. The superior frontal gyrus lies superior to the
superior frontal sulcus, the middle frontal gyrus lies between the superior and inferior frontal sulci, and
the inferior frontal gyrus lies inferior to the inferior frontal sulcus. The inferior frontal gyrus is invaded
by the anterior, ascending and posterior rami of the lateral sulcus and are separated in orbital,
triangular and opercular parts.
The parietal lobe occupies the area posterior to the central sulcus and superior to the lateral sulcus;
it extends posteriorly as far as the parieto-occipital sulcus. The lateral surface of the parietal lobe is di-
vided by two sulci into three gyri. The postcentral sulcus runs parallel to the central sulcus and the
postcentral gyrus lies between them. Running posteriorly from the middle of the postcentral sulcus is
the intraparietal sulcus. The intraparietal sulcus has superior to it the superior parietal lobule and
inferior to it the inferior parietal lobule.
The temporal lobe occupies the area inferior to the lateral sulcus. The lateral surface of the temporal
lobe is divided into three gyri by two sulci. The superior and middle temporal sulci run parallel to the
posterior ramus of the lateral sulcus, and divide the temporal lobe into the superior, middle, and
inferior temporal gyri; the inferior temporal gyrus is continued onto the inferior surface of the
hemisphere. The continuation of the superior temporal gyrus in parietal lobe is supramarginal gyrus and
the continuation of the middle temporal gyrus in parietal lobe is angular gyrus.
The occipital lobe occupies the small area behind the parieto-occipital sulcus. The continuation of
the intraparietal sulcus is transverse occipital sulcus, which is part of occipital lobe.
The insula is covered by the frontal, parietal and temporal operculums. The insula peripherally is
surrounded by the circular sulcus, the inferior part of this sulcus elevates as a limen. Middle part of
insula is separated by the central sulcus, in front of which lies the short gyri, behind – long gyrus.

Medial and inferior surfaces of the cerebral hemisphere

The lobes of the cerebral hemisphere are not clearly defined on the medial and inferior surfaces.
However, there are many important areas that should be recognized. The corpus callosnm, which is
the largest commissure of the brain, forms a striking feature on this surface. The cingulate gyrus
begins beneath the anterior end of the corpus callosum and continues above the corpus callosum until
it reaches its posterior end. The gyrus is separated from the corpus callosum by the callosal sulcus.
28
The cingulate gyrus is separated from the superior frontal gyrus by the cingulate sulcus.
The paracentral lobule is the area of the cerebral cortex that surrounds by the paracentral sulcus.
The precuneus is an area of cortex bounded anteriorly by the posterior end of the cingulate sulcus and
posteriorly by the parieto-occipital sulcus. The cuneus is a triangular area of cortex bounded above by
the parieto-occipital sulcus, interiorly by the calcarine sulcus, and posteriorly by the superior medial
margin.
The collateral sulcus is situated on the inferior surface of the hemisphere. This runs anteriorly
below the calcarine sulcus. Between the collateral sulcus and the calcarine sulcus is the lingual
gyrus. Anterior to the lingual gyrus is the parahippocampal gyrus; the latter terminates in front as
the hooklike uncus.
The medial occipitotemporal gyrus extends from the occipital pole to the temporal pole. It is
bounded medially by the collateral and rhinal sulci and laterally by the occipitotemporal sulcus.
The occipitotemporal gyrus lies lateral to the sulcus and is continuous with the inferior temporal
gyrus.
On the inferior surface of the frontal lobe, the olfactory bulb and tract overlie a sulcus called the
olfactory sulcus. Medial to the olfactory sulcus is the gyrus rectus and lateral to the sulcus are a
number of orbital sulci and gyri.

29
30
31
 INTERNAL STRUCTURE OF THE CEREBRAL HEMISPHERES
The cerebral hemispheres are covered with a layer of gray matter, the cerebral cortex. Located in the
interior of the cerebral hemispheres are the lateral ventricles, masses of gray matter, the basal nuclei,
and nerve fibers. The nerve fibers are embedded in neuroglia and constitute the white matter.

Basal Nuclei (Basal Ganglia)

The term basal nuclei is applied to a collection of masses of gray matter situated within each
cerebral hemisphere. They are the corpus striatum, the amygdaloid nucleus, and the claustrum.

CORPUS STRIATUM
The corpus striatum is situated lateral to the thalamus. It is almost completely divided by a band of
nerve fibers, the internal capsule, into the caudate nucleus and the lentiform nucleus. The caudate
nucleus, a large C-shaped mass of gray matter that is closely related to the lateral ventricle, lies lat eral
to the thalamus. The lateral surface of the nucleus is related to the internal capsule, which separates it
from the lentiform nucleus. The caudate nucleus consists in head, body and tail. The head is formed
the lateral wall of the anterior horn of the lateral ventricle. The body is lied on the floor of the central
part of the lateral ventricle. The tail passes downward and forms upper part of the inferior horn of the
lateral ventricle.
The lentiform nucleus is a triangular-shaped mass of gray matter whose broad convex base is
directed laterally and its apex medially. The medial of the lentiform nucleus is called globus pallidus
(medial and lateral) and the lateral part is forms the putamen.
AMYGDALOID NUCLEUS The amygdaloid nucleus is situated in the temporal lobe close to the
uncus.

CLAUSTRUM The claustrum is a thin sheet of gray matter that is separated from the lateral surface of
the lentiform nucleus by the external capsule. Lateral to the claustrum is the subcortical white matter
of the insula.

White Matter of the Cerebral Hemispheres

The corpus callosum, the largest commissure of the brain, connects the two cerebral hemispheres. It
lies at the bottom of the longitudinal fissure. For purposes of description, it is divided into the rostrum,
the genu, the body, and the splenium. The rostrum is the thin part of the anterior end of the соrpus
callosum, which is prolonged posteriorly to be continuous with the upper end of the lamina terminalis.
The genu is the curved anterior end of the corpus callosum that bends interiorly in front of the septum
pellucidum. The body of the corpus callosum arches posteriorly and ends as the thickened posterior
portion called the splenium.
The fibers of the body extend laterally as the radiation of the corpus callosum. They intersect with
bundles of association and projection fibers as they pass to the cerebral cortex.
The anterior commissure is a small bundle of nerve fibers that cross the midline in the lamina
terminalis. When traced laterally, a smaller or anterior bundle curves forward on each side toward the
anterior perforated substance and the olfactory tract.
The posterior commissure is a bundle of nerve fibers that cross the midline immediately above the
opening of the cerebral aqueduct into the third ventricle; it is related to the inferior part of the stalk of
the pineal gland.
The fornix is composed of myelinated nerve fibers and constitutes the efferent system of the
hippocampus that passes to the mammillary bodies of the hypothalamus. The nerve fibers first form
the alveus, which is a thin layer of white matter covering the ventricular surface of the hippocampus,
and then converge to form the fimbria. The fimbia of the two sides increase in thickness and, on

32
reaching the posterior end of the hippocampus as a crus of fornix then they arch forward above the
thalamus and below the corpus callosum form the columns of the fornix which ends in the mamillary
bodies. The two columns then come together in the midline to form the body of the fornix. The
commissure of the fornix consists of transverse fibers that cross the midline from one column to
another just before the formation of the body of the fornix.
Internal capsule is a compact band of neocortical projection fibers, which is continues above as
corona radiata, below as crus cerebri of mibrain. Because of the wedge shape of the lentiform nucleus,
as seen on horizontal section, the internal capsule is bent to form an anterior limb and a posterior
limb, which are continuous with each other at the genu.
Arrangement of fibers:
1. Anterior thalamic radiation – connects anterior nucleus of thalamus and cingulated gyrus
(Papez Circuit).
2. From globulus pallidus – to subthalamic nucleus and to thalamus.
3. Corticonuclear fibers – from areas 4, 6 and 8 to motor nuclei of cranial nerve.
4. Superior thalamic radiation – from thalamus to precentral and poscentral gyri of cerebral
cortex.

The septum pellucidum is a thin vertical sheet of nervous tissue consisting of white and gray matter
covered on either side by ependyma. It stretches between the fornix and the corpus callosum.
Anteriorly, it occupies the interval between the body of the corpus callosum and the rostrum. It is
essentially a double membrane with a closed, slitlike cavity between the membranes. The septum
pellucidum forms a partition between the anterior horns of the lateral ventricles.

LATERAL VENTRICLES

There are two lateral ventricles and one is present in each cerebral hemisphere. The ventricle is a
roughly C-shaped cavity and may be divided into a central part, which occupies the parietal lobe and
from which anterior, posterior, and inferior horns extend into the frontal, occipital, and temporal lobes,
respectively. The lateral ventricle communicates with the cavity of the third ventricle through the
interventricular foramen.
The central part of the lateral ventricle extends from the interventricular foramen posteriorly as far
as the posterior end of the thalamus. Here it becomes continuous with the posterior and the inferior
horns. The central part of the lateral ventricle has a roof, a floor, and a medial wall. The roof is formed
by the undersurface of the corpus callosum. The floor is formed by the body of the caudate nucleus and
the lateral margin of the thalamus. The choroid plexus of the ventricle projects into the body of the
ventricle through the slitlike gap between the body of the fornix and the superior surface of the
thalamus. This slitlike gap is known as the choroidal fissure; through it the blood vessels of the plexus
invaginate the pia mater of the tela choroidea and the ependyma of the lateral ventricle. The medial
wall is formed by the septum pellucidum anteriorly; posteriorly the roof and the floor come together on
the medial wall.
The anterior horn of the lateral ventricle extends forward into the frontal lobe. It is continuous
posteriorly with the body of the ventricle at the inter-ventricular foramen. The anterior horn has a
roof, a floor, and a medial wall. The roof is formed by the undersurface of the anterior part of the
corpus callosum. The floor is formed by the rounded head of the caudate nucleus. The medial wall is
formed by the septum pellucidum and the anterior column of the fornix.
The posterior horn of the lateral ventricle extends posteriorly into the occipital lobe. The roof and
lateral wall are formed by the fibers of the tapetum of the corpus callosum. Lateral to the tapetum are
the fibers of the optic radiation. The inferior swelling is produced by the calcarane sulus and is called
the calcar avis.
The inferior horn of the lateral ventricle extends anteriorly into the temporal lobe. The inferior
horn has a roof and a floor. The roof is formed by the tail of the caudate nucleus. The floor are
33
 formed by the hippocampus and collateral elevation.
The tela choroidea is a two-layered fold of pia mater. It is situated between the fornix superiorly and
the roof of the third ventricle and the upper surfaces of the two thalami inferiorly. When seen from
above, the anterior end is situated at the interventricular foramina. Its lateral edges are irregular and
project laterally into the central part of the lateral ventricles. Here they are covered by ependyma and
form the choroid plexuses of the lateral ventricle. Posteriorly, the lateral edges continue into the
inferior horn of the lateral ventricle and are covered with ependyma so that the choroid plexus projects
through the choroidal fissure.

34
35
36
37
 MENINGES OF THE BRAIN
The brain and spinal cord are surrounded by three membranes, or meninges: the dura mater, the
arachnoid mater, and the pia mater. The dura mater of the brain is conventionally described as two
layers, the endosteal layer and the meningeal layer. These are closely united except along certain lines,
where they separate to form venous sinuses.
The endosteal layer is nothing more than the periosteum covering the inner surface of the skull
bones. At the foramen magnum it does not become continuous with the dura mater of the spinal cord.
Around the margins of all the foramina in the skull it becomes continuous with the periosteum on the
outside of the skull bones. At the sutures, it is continuous with the sutural ligaments. It is most
strongly adherent to the bones over the base of the skull
The meningeal layer is the dura mater proper. It is a dense, strong fibrous membrane covering the
brain and is continuous through the foramen magnum with the dura mater of the spinal cord. It
provides tubular sheaths for the cranial nerves as the latter pass through the foramina in the skull.
Outside the skull, the sheaths fuse with the epineurium of the nerves.
The falx cerebri is a sickle-shaped fold of dura mater that lies in the midline between the two
cerebral hemispheres. Its narrow anterior end is attached to the internal frontal crest and the crista galli.
Its broad posterior part blends in the midline with the upper surface of the tentorium cerebelli. The
superior sagittal sinus runs in its upper fixed margin; the inferior sagittal sinus runs in its lower
concave free margin; and the straight sinus runs along its attachment to the tentorium cerebelli.
The tentorium cerebelli is a crescent-shaped fold of dura mater that roofs over the posterior cranial
fossa. It covers the upper surface of the cerebellum and supports the occipital lobes of the cerebral
hemispheres. In the anterior edge there is a gap the tentorial notch, for the passage of the midbrain.
The fixed border is attached to the posterior clinoid processes, the superior borders of the petrous part
of temporal bones, and the margins of the grooves for the transverse sinuses on the occipital bone.
The falx cerebri and the falx cerebelli are attached to the upper and lower surfaces of the tentorium,
respectively. The straight sinus runs along its attachment to the falx cerebri; the superior petrosal sinus,
along its attachment to the petrous bone; and the transverse sinus, along its attachment to the occipital
bone.
The falx cerebelli, a small, sickle-shaped fold of dura mater attached to the internal occipital crest,
projects forward between the two cerebellar hemispheres. Its posterior fixed margin contains the
occipital sinus.
The diaphragma sellae is a small, circular fold of dura mater that forms the roof for the sella turcica.
A small opening in its center allows passage of the stalk of the hypophysis cerebri.

Dural Venous Sinuses

The venous sinuses of the cranial cavity are situated between the layers of the dura mater. Their main
function is to receive blood from the brain through the cerebral veins and the cerebrospinal fluid from
the subarachnoid space through the arachnoid villi. The blood in the dural sinuses ultimately drains into
the internal jugular veins in the neck. The dural sinuses are lined by endothelium, and their walls are
thick. They have no valves. Emissary veins, which are also valveless connect the dural venous sinuses
with the diploic veins of the skull and with the veins of the scalp.

ARACHNOID MATER
The arachnoid mater is a delicate, thin membrane covering the brain and lying between the pia
mater internally and the dura mater externally. It is separated from the dura by a potential space, the
subdural space. It is separated from the pia by the subarachnoid space, which is filled with
cerebrospinal fluid. The arachnoid bridges over the sulci on the surface of the brain, and in certain
situations the arachnoid and pia are widely separated to form the subarachnoid cisternae. The
cisterna magna (cerebellomedullaris) lies between the inferior surface of the cerebellum and dorsal
surface of the medulla oblongata. The cisterna interpeduncularis lies between the two cerebral
peduncles. The cisterna chiasmatica (suprasellar) lies behind the optic chiasm. The cisterna of the
38
lateral fossa (Silvian) lies in the middle part of the lateral sulcus. Quadrigeminal cistern – is located
between the splenium of corpus callosum and upper surface of the cerebellum, dorsal to the midbrain.
Ambient cistern – extend around both sides of midbrain.
In certain areas, the arachnoid mater projects into the venous sinuses to form arachnoid villi. The
arachnoid villi are most numerous along the superior sagittal sinus. Aggregations of arachnoid villi are
referred to as arachnoid granulations. Arachnoid villi serve as sites where the cerebrospinal fluid
diffuses into the bloodstream. The arachnoid is connected to the pia mater across the fluid-filled
subarachnoid space by delicate strands of fibrous tissue.
The cerebrospinal fluid is produced by the choroid plexuses within the lateral, third, and fourth
ventricles of the brain. The two lateral ventricles communicate through the interventricular foramina
(of Monro) with the third ventricle. The third ventricle is connected to the fourth ventricle by the
cerebral aqueduct (aqueduct of Sylvius). The fourth ventricle in turn is continuous with the narrow
central canal of the spinal cord and, through the three foramina of the fourth ventricle: two lateral
apertures and one medial aperture in roof, with the subarachnoid space. The central canal has a small
dilatation at its inferior end, referred to as the terminal ventricle. The cerebrospinal fluid escapes from
the ventricular system of the brain through the three foramina in the roof of the fourth ventricle and so
enters the subarachnoid space. It now circulates both upward over the surfaces of the cerebral
hemispheres and downward around the spinal cord. The spinal subarachnoid space extends down as
far as the second sacral vertebra. Eventually the fluid enters the venous bloodstream (venous sinuses of
dura matter) by passing into the arachnoid villi and diffusing through their walls.

PIA MATER
The pia mater is a vascular membrane covered by flattened mesothelial cells. It closely invests the
brain, covering the gyri and descending into the deepest sulci. It extends out over the cranial nerves
and fuses with their epineurium. The cerebral arteries entering the substance of the brain carry a sheath
of pia with them. The pia mater forms the tela choroidea of the roof of the third and fourth ventricles
of the brain, and it fuses with the ependyma to form the choroid plexuses in (lie lateral, third, and
fourth ventricles of the brain.

39
40
41
42
 Conductive tract of the brain and the spinal cord

Conductive tract are the fascicles of nerve fibers, that are situated in a certain place in the grey and
white matters of the brain and the spinal cord and they connect different functional centers of the central
nervous system.

The conductive tract of temperature and pain sense i. e., lateral spino-thalamic tract conducts
impulses of pain and temperature sensivity from the skin to the cortex postcentral gyrus. Receptors of the
1st order neuron are situated in the skin and their bodies in dorsal root ganglions. Central process of these
neurons continue as a part of posterior spinal roots into the posterior horn, were they end with synapses
in the 2nd order neuron – substancia gelatinosa. The axons of the 2 nd order neuron continue through the
posterior grey commissure into the lateral funiculi of the opposite side, and then ascends through medulla
oblongata, pons and midbrain as a spinal lemniscus. Axons end in thalamus, forming synapses of body of
3rd order neuron in ventral posterior nucleus of thalamus and their axons continue through the posterior
limb of internal capsule. Axons are ended in fours layer of the cortex (internal granular cell layer) of the
postcentral gyrus.
Conductive tract of crude touch and pressure sensitivity – anterior spino-thalamic tract. Receptors 1st
order (sensitive) neuron are situated in the skin. Curse of tract same like lateral spino-thalamic tract, but
in the spinal cord it is situated in the anterior funiculi.
The conductive tract of proprioceptive sensitivity of cortical direction – dorsal column medial
lemniscus tract, conveys impulses of muscular joint sensitivity to the postcentral gyrus. Receptors of the
1st order neuron cells are situated in muscles, tendons, joint capsules, and ligaments. Bodies of the 1 st
order neuron are situated in the dorsal root ganglions. Axons of these neurons as a part of the posterior
root of spinal nerve continue to the posterior funiculi of the spinal cord, then axons of neurons ascend to
the medulla oblongata. The cuneate fasciculus is formed of the axons that convey information from upper
sections of the body, neck and upper limbs (T6 and above). The gracile fasciculus conveys impulses from
lower extremity and lower part of the body (below T6). Bodies of 2 nd order neurons are located in the
gracile nucleus and cuneate nucleus of medulla oblongata. Axons of the 2 nd order neurons come out of
these nuсlei forward and medially as internal arcuate fibres, then it go on the opposite side and make the
decussation of medial lemniscus. Then fibres of medial lemniscus ascend through the pons and midbrain
to the ventral posterior nucleus of the thalamus - 3 rd order neuron. Axons of the 3rd order neurons pass
through internal capsule and reach the postcentral gyrus.

The posterior spinocerebellar tract conveys impulses from muscles, tendons, and ligaments to the
cerebellum. Bodies of the 1st order neurons are situated in the dorsal root ganglions. Axons of these cells
go to the posterior horn as a part of the dorsal root of a spinal nerve. These axons end on the neurons of
the thoracic nucleus (Clarke`s column, C8 – L3), that is situated in the medial part of the posterior horn.
Axons of the 2nd order neurons ascend to the medulla oblongata as a part of the lateral funiculi of spinal
cord of ipsilateral side. These axons proceed to the cerebellum through the inferior cerebellar peduncle
and end with synapses on the neurons of the ipsilateral vermis cortex. The anterior spinocerebellar tract
is more complicated than posterior. Bodies of the 1st order neuron are situated in the dorsal root ganglions.
Axons of these cells go to the posterior horn as a part of the dorsal root of a spinal nerve. These axons end
on the 2nd order neuron of dorsal horn below L3. Then axons of the 2 nd order neuron intersect the anterior
grey commissure and go into the lateral funiculi of the opposite side. Then it passes through the medulla
oblongata and ponts. In the midbrain the axons of 2 nd order neuron crossing to opposite side and proceeds
the cerebellum through the superior cerebellar peduncle, here they end in the ipsilateral parts the vermis.
Both tracts receive proprioceptive input from the ipsilateral trunk and lower limb. Coordination of
movements of the lower limb, muscle posture maintence.
The cuneocerebellar tract receive proptioceptive input from the head and upper limb and coordinate
their movements. Bodies of the 1st order neuron are situated in the dorsal root ganglions. Axons of these
cells go to the posterior funiculi as a part of the cuneate fasciculus. Bodies of the 2 nd order neuron are
situated in accessory cuneate nucleus of the medulla oblongata. These axons proceed to the cerebellum
43
through the inferior cerebellar peduncle and end with synapses on the neurons of the ipsilateral anterior
lobe of the cerebellum.
The descending tracts – are motor or efferent. Conduct impulses from the cortex, subcorticos centers
and nucleus of the brainstem to subjacent pars of the spinal cord. They include the pyramidal tracts
(corticospinal and corticonuclear tracts) which conveys impulses of conscious movements, and
extrapyramidal tracts (rubrospinal, testospinal, vestibulospinal and reticulospinal tracts) which conveys
impulses of unconscious movements.
The corticonuclear tract starts from pyramidal cells that are situated in the fifth layer of cerebral
cortex of the precentral gyrus, on its lower third part. Axons of these neurons descend through the corona
radiata and genu of internal capsule, intersect the base of the cerebral сrus, then pons and medulla
oblongata. Fibers proceed to the nuclei of the III and IV cranial nerves in the midbrain. On a level
of the pons the fibres proceed to the motor nuclei of the V, VI, VII cranial nerves, in medulla oblongata
the motor nucleus of the X, XI, XII cranial nerves. Fibers mainly terminate on controlateral motor nuclei
of cranial nerves and also on ipsilateral nuclei. There are two motor nuclei of the cranial nerves, which
receive fibers from controlateral side – facial and hypoglossal.
The lateral and anterior corticospinal tracts arise from the pyramidal cells of higher two thirds of
the precentral gyrus. Axons of these cells descent through the corona radiate and posterior limb of the
internal capsule behind the corticonuclear tract. Then fibres of this tract intersect the cerebral crus
laterally, then pons and form the pyramids of the medulla oblongata, 85% of fibers crosses the opposite
side forming decussation of the pyramids. Then these fibers enter lateral funiculi of the spinal cord named
as a lateral corticospinal tract. Then those fibers enters the anterior column of the spinal cord and
terminates with synapses on motor neurons of anterior horn, controlling the limb muscle. The 15% of
fibers remain uncrossing and descend as a part of the anterior funiculi of the spinal cord named anterior
corticospinal tract. Its fibers cross to the opposite side of the spinal cord through the anterior white
commissure and terminate on motor nucleus of the anterior horn of the opposite side. The spinal cord of
their axons form anterior roots of the spinal nerves and innervate trunk muscles.
The rubrospinal tract is a part of a reflex arch and spinocerebellar proprioceptic conductive tract are
link of that arch. Rubrospinal tract arise from the red nucleus crosses to the opposite side forms ventral
tegmental decussation and processed through the pons and the lateral parts of the medulla oblongata and
then descend in the lateral funiculi of the spinal cord. Fibres of the rubrospinal tract terminate on the
motor neurons of the anterior horns of the spinal cord. Axons through the anterior roots of the spinal
nerve innervate the skeletal muscle maintaing of muscle tone, also control distal muscles of the upper
limb.

44
45
46
47
48
LITERATURE
49
 1. Textbook of human anatomy. M.R. Sapin., L.L. Kolesnikov., D.B. Nikitjuk. In two
volumes. New Wave Publishing Agency, Moscow, 2010.
2. Human Anatomy. B.D. Chaurasia's. Volume one, v. two, v. three. CBS Publishers &
Distributors, 2004.
3. Human anatomy. M. G. Prives. Volume I, II. English translation. Mir Publishers,
Moscow, 1985.
4. Clinical neuroanatomy for medical students. Richard S. Snell. Lippincott. Williams &
Wilkins, 2001.
5. Atlas of Human Anatomy. H. Netter ISBN 3-905298-05-8 Basel, 2003.
6. Human anatomy, Gosling, Harris, Humpherson, Whitmore. Mosby-Wolfe, 1995.

50