BRAIN: It’s Structure and

Functions
https://www.youtube.com/watch?v=DtkRGbTp1s8
The brain structure is composed of three main parts: the forebrain, midbrain and hindbrain, each with multiple parts.
Forebrain

The Cerebrum: 

Also known as the cerebral cortex, the cerebrum is the largest part of the human brain, and it is associated with higher brain function

such as thought and action.

Nerve cells make up the gray surface, which is a little thicker than our thumb. White nerve fibers beneath the surface carry signals

between nerve cells in other parts of the brain and body. Its wrinkled surface increases the surface area, and is a six-layered structure

found in mammals, called the neocortex.

It is divided into four sections, called “lobes”. They are;

 the frontal lobe,

 the parietal lobe,

 the occipital lobe and

 the temporal lobe.

Functions Of The Lobes:

Frontal Lobe – The frontal lobe lies just beneath our forehead and is associated with our brain’s ability to reason,

organize, plan, speak, move, make facial expressions, serial task, problem solve, control inhibition, spontaneity, initiate

and self-regulate behaviors, pay attention, remember and control emotions.

Parietal Lobe – The parietal lobe is located at the upper rear of our brain, and controls our complex behaviors,

including senses such as vision, touch, body awareness and spatial orientation. It plays important roles in integrating

sensory information from various parts of our body, knowledge of numbers and their relations, and in the

manipulation of objects. Portions are involved with our visuospatial processing, language comprehension, the ability to

construct, body positioning and movement, neglect/inattention, left-right differentiation and self-awareness/insight.
Functions Of The Lobes:

Occipital Lobe – The occipital lobe is located at the back of our brain, and is associated with our visual processing, such

as visual recognition, visual attention, spatial analysis (moving in a 3-D world) and visual perception of body language;

such as postures, expressions and gestures.

Temporal Lobe – The temporal lobe is located near our ears, and is associated with processing our perception and

recognition of auditory stimuli (including our ability to focus on one sound among many, like listening to one voice

among many at a party), comprehending spoken language, verbal memory, visual memory and language production

(including fluency and word-finding), general knowledge and autobiographical memories.

Midbrain

The midbrain is located below the cerebral cortex, and above the hindbrain placing it near the center of the brain. It is comprised of
the tectum, tegmentum, cerebral aqueduct, cerebral peduncles and several nuclei and fasciculi.

The primary role of the midbrain is to act as a sort of relay station for our visual and auditory systems. Portions of the midbrain called
the red nucleus and the substantia nigra are involved in the control of body movement, and contain a large number of dopamine-
producing neurons.

The degeneration of neurons in the substantia nigra is associated with Parkinson’s disease. The midbrain is the smallest region of the
brain, and is located most centrally within the cranial cavity.
Midbrain

Anatomy
The midbrain is the most superior region of the brainstem.
Structure
Your brainstem connects your brain to your cervical spinal cord (neck) and consists of three main parts:
•Midbrain
•Pons
•Medulla oblongata
(Sometimes, the diencephalon is also considered part of the brainstem.)
Together, these three parts work to regulate various involuntary functions, such as breathing, heart rate, and blood pressure. Your
brainstem also plays a critical role in sleep and consciousness.
Your midbrain can then be broken down into two main parts: 1
•Tegmentum: This anterior surface of the midbrain contains numerous structures including the reticular formation, the
periaqueductal gray (PAG) matter, certain cranial nerve nuclei, sensory and motor nerve pathways (the corticospinal and
spinothalamic tract), the red nucleus, the substantia nigra, and the ventral tegmental area (VTA).
•Tectum: The posterior surface of the midbrain contains the corpora quadrigemina, which contains clusters of nerve cells called the
superior and inferior colliculus.
Midbrain

Location
The midbrain measures around 1.5 centimeters in length and is sandwiched between the diencephalon (which includes the thalamus
and hypothalamus) and the pons.2

The midbrain receives blood supply from the basilar artery and its branches, including the posterior cerebral artery and the superior
cerebellar artery.
There are also two cranial nerves present in the midbrain:
• The oculomotor nerve (cranial nerve III)
• The trochlear nerve (cranial nerve IV).
Midbrain: Function

The midbrain is a complex region of your brainstem that serves many functions.
Tegmentum
The structures within the tegmentum serve these specific functions: 1
•Reticular formation: This highly diverse and integrative area contains a network of nuclei responsible for many vital functions
including arousal, consciousness, sleep-wake cycles, coordination of certain movements, and cardiovascular control.

•Periaqueductal gray (PAG) matter: This area plays a primary role in processing pain signals, autonomic function, and
behavioral responses to fear and anxiety. Recently, this structure has been linked to controlling the defensive reactions associated
with post-traumatic stress disorder (PTSD).

•Cranial nerve nuclei: Oculomotor nerve nuclei are responsible for controlling the pupil and most eye movements. The trochlear
nerve nuclei innervate the superior oblique muscle of the eye, which abducts, depresses, and internally rotates the eye. 

•Spinothalamic tract: This major nerve pathway carries information about pain and temperature sensation from the body to the
thalamus of the brain.
Midbrain: Function

•Corticospinal tract: This major nerve pathway carries movement-related information from the brain to the spinal cord.

•Red nucleus: This region is involved in motor coordination. It is called the "red" nucleus because of its pinkish color, resulting from
the presence of iron.

•Substantia nigra: This area contains nerve cells that make the neurotransmitter (brain chemical) dopamine. It serves as a relay
station for nerve signals responsible for controlling movement.

•Ventral tegmental area (VTA): This structure contains dopamine-producing cell bodies and plays a key role in the reward
system.
Midbrain: Function

Tectum
Nerve cells within the superior colliculi process vision signals from the retina of the eye before channeling them on to the occipital
lobe located at the back of the head. The superior colliculi of the midbrain is also responsible for generating eye movements and neck
muscle activity.

The inferior colliculi is responsible for processing auditory (hearing) signals before they are channeled through the thalamus and
eventually to the primary auditory cortex in the temporal lobe. In addition to sound localization, the inferior colliculus is responsible
for the following:

• Creating the startle response

• Orienting the body towards certain stimuli
• Discriminating pitch and rhythm
Midbrain: Function

Associated Conditions
The midbrain may be affected by a number of different pathological processes including stroke, tumor, a demyelinating process,
infection, or a neurodegenerative disease. 5

Examples of specific conditions include the following:

Oculomotor (Third) Nerve Palsy
Any lesion within the midbrain (stroke, tumor, inflammation, infection) may damage the oculomotor nerve, resulting in an eye that is
positioned in a downward and outward direction.
Other symptoms of an oculomotor nerve palsy include: 1
•A dilated pupil
•Droopy eyelid
•Diplopia (double vision)
•Inability to accommodate
Midbrain: Function

Associated Conditions…
Trochlear (Fourth) Nerve Palsy
As with an oculomotor nerve palsy, a lesion within the midbrain may cause a trochlear nerve palsy. Symptoms of a trochlear nerve
palsy include:1
•Upward deviation of the eye
•Blurry vision
•Diplopia
•Tilting of the head towards the unaffected side to compensate for visual changes
Midbrain Syndromes

There are five classic midbrain syndromes:

•Parinaud’s syndrome: Also known as the dorsal midbrain syndrome, this condition usually results from the mass effect of an
adjacent pineal gland tumor. Symptoms may include a downward gaze at rest, pupils that are poorly reactive to light, eyelid retraction,
and convergence-retraction nystagmus (when you have uncontrollable, jerky eye movements)

•Weber's syndrome: Also known as midbrain stroke syndrome and superior alternating hemiplegia, this condition is caused by a
stroke in a branch of either the basilar artery or the posterior cerebral artery. It results in ipsilateral (same-sided) third nerve palsy and
contralateral (opposite side) weakness.

•Claude's syndrome: This condition results from a stroke within the dorsal (upper side) tegmentum of the midbrain. It results
in ipsilateral oculomotor nerve palsy with contralateral cerebellar ataxia (uncoordinated movements).
 third nerve palsy is characterised by ipsilateral ptosis with
a ‘down and out’ eye appearance. A third nerve palsy
usually presents with sudden onset diplopia (double vision)
and noticing ptosis (drooping eyelid). Other neurological
features are dependent on the underlying aetiology.
•Benedikt's syndrome: Like Claude's syndrome, this condition results from a stroke within the tegmentum of the midbrain. In
addition to oculomotor nerve palsy and ataxia, there is damage to the corticospinal tract, resulting in contralateral weakness.

•Nothnagel's syndrome: This condition usually results from a tumor of the midbrain, such as a glioma. Symptoms include
unilateral or bilateral oculomotor nerve paralysis and ipsilateral cerebellar ataxia.
Multiple Sclerosis
Multiple sclerosis (MS) occurs when a person's own immune system attacks the insulating covering (myelin) of nerve fibers in their
brain, spinal cord, and/or eyes.
If the brainstem is affected, a patient may experience symptoms like:
•Vision changes, including diplopia
•Problems swallowing (dysphagia)
•Problems speaking (dysarthria)7
•Altered sensation or weakness of the face
•Hearing difficulties
•Ataxia
•Headache that resembles a migraine8
•Rarely, problems that affect vital functions (e.g., breathing or heart rate)
Parkinson's Disease
Parkinson’s disease is a progressive neurological disease (meaning symptoms are subtle at first and slowly get worse). It is caused by
the death of dopamine-producing nerve cells in the substantia nigra.
As a result of this dopamine depletion, various symptoms may develop, including:9
• Resting tremor
• Slowness of movement
• Stiffness and shuffling gait
• Small handwriting
• Sleep troubles

Congenital Malformations
Rarely, a person's midbrain may not form correctly during fetal development. Midbrain dysplasia is one such genetic malformation
that results in microcephaly, spasticity, intellectual disability, and seizures.
Treatment
Treatment depends on the specific pathology that is affecting the midbrain.

For example, patients with a brain tumor that affects the midbrain may require surgery, radiation, and/or chemotherapy.

Likewise, an ischemic stroke (caused by a blood clot) within the midbrain may warrant treatment with a "clot-busting" medication

called tissue-type plasminogen activator. In addition, a patient will need an extensive workup to sort out the cause behind the stroke

(e.g., heart disease, atrial fibrillation, etc.).

From there, various therapies may be advised including medications, like an anticoagulant, and rehabilitation therapy (e.g. physical

and occupational therapy).

MS-related inflammation of the midbrain often requires short-term treatment with corticosteroids and long-term treatment with

a disease-modifying therapy. Rehabilitation therapies to manage symptoms is also often warranted.

The treatment of Parkinson's disease requires engaging in physical and occupational therapy and taking medications aimed at

replacing dopamine or optimizing dopamine's action in the brain (e.g., levodopa).

 Limbic System – the limbic system is often referred to as our “emotional brain”, or ‘childish brain’. It is found buried within the
cerebrum and contains the thalamus, hypothalamus, amygdala and hippocampus.

 Thalamus – the primary role of the thalamus is to relay sensory information from other parts of the brain to the cerebral cortex

 Hypothalamus – the primary role of the hypothalamus is to regulate various functions of the pituitary gland and endocrine activity, as
well as somatic functions e.g.body temperature, sleep, appetite.

 Amygdala – the primary role of the amygdala is to be a critical processor for the senses. Connected to the hippocampus, it plays a role
in emotionally laden memories and contains a huge number of opiate receptor sites that are implicated in rage, fear and sexual
feelings.

 Hippocampus – the primary role of the hippocampus is memory forming, organizing and storing information. It is particularly
important in forming new memories, and connecting emotions and senses, such as smell and sound, to memories.

 Pituitary Gland – the primary role of the pituitary gland is an important link between the nervous system and the endocrine system. It
releases many hormones which affect growth, metabolism, sexual development and the reproduction system. It is connected to the
hypothalamus and is about the size of a pea. It is located in the center of the skull, just behind the bridge of the nose.
Hindbrain
 The Cerebellum – The cerebellum, or “little brain”, is similar to the cerebrum with its two hemispheres and highly
folded surface. It is associated with regulation and coordination of movement, posture, balance and cardiac,
respiratory and vasomotor centers.

 Brain Stem – The brain stem is located beneath the limbic system. It is responsible for vital life functions such as
breathing, heartbeat, and blood pressure. The brain stem is made of the midbrain, pons, and medulla.
 Pons – The primary role of the pons is to serve as a bridge between various parts of the nervous system, including
the cerebellum and cerebrum. Many important nerves that originate in the pons, such as the trigeminal nerve,
responsible for feeling in the face, as well as controlling the muscles that are responsible for biting, chewing, and
swallowing.

It also contains the abducens nerve, which allows us to look from side to side and the vestibularcochlear nerve,
which allows to hear. As part of the brainstem, a section of the lower pons stimulates and controls the intensity of
breathing, while a section of the upper pons decreases the depth and frequency of breaths. The pons is also associated
with the control of sleep cycles, and controls respiration and reflexes. It is located above the medulla, below the
midbrain, and just in front of the cerebellum.

 Medulla – The primary role of the medulla is regulating our involuntary life sustaining functions such as breathing,
swallowing and heart rate. As part of the brain stem, it also helps transfer neural messages to and from the brain
and spinal cord. It is located at the junction of the spinal cord and brain.
Spinal Cord

The spinal cord is a part of the central nervous system. It is a long pipe-like structure arising from the medulla

oblongata, part of the brain consisting of a collection of nerve fibres, running through the vertebral column of the

backbone. It is segmented with a pair of roots (dorsal and ventral roots) consisting of nerve fibres joining to form the

spinal nerves.

Contents

•Anatomy

•Structure

•Injuries

•Nerves

•Functions
Spinal Cord Anatomy

In adults, the spinal cord is usually 40cm long and 2cm wide. It forms a vital link between the brain and the body.
The spinal cord is divided into five different parts.
 Sacral cord
 Lumbar cord
 Thoracic cord
 Cervical cord
 Coccygeal
Spinal Cord Anatomy

 Several spinal nerves emerge out of each segment of the spinal cord. There are 8 pairs of cervical, 5 lumbar, 12 thoracics, 5 sacral
and 1 coccygeal pair of spinal nerves.

 It performs the primary processing of information as it carries sensory signals from all parts of the body to the Central Nervous
System through afferent fibres.

 Nerve tissue consists of the grey and white matter spread across uniformly.

 The smooth muscles and the skeletal system carrying nerve fibres liaise different reflexes when ventral horn projects axons which
carry motor neurons.

 It also helps intercede autonomic control for visceral functions which consist of neurons with descending axons. It is a sensitive
site, which is severely affected in case of a traumatic injury.

 Understanding the physiology of the spinal cord helps in detecting and determining the various methods to deal with diseases and
damage related to the spinal cord.
Structure Of Spinal Cord

 The Spinal cord runs through a hollow case from the skull enclosed within the vertebral column. Spinal nerves arise
from different regions of the vertebral column and are named accordingly, the regions are – Neck, chest, pelvic and
abdominal.

 Cross-section of spinal cord displays grey matter shaped like a butterfly surrounded by a white matter.

 Grey matter consists of the central canal at the centre and is filled with a fluid called CSF (Cerebrospinal fluid). It
consists of horns (four projections) and forms the core mainly containing neurons and cells of the CNS. There are
two dorsal and two ventral horns.

 The white matter consists of a collection of axons permitting communication between different layers of CNS. A
tract is a collection of axons and carries specialized information. Ascending tracts and descending tracts send and
transmit signals from the brain respectively to various nerve cells across the body.
• Spinal nerves act as mediators, communicating information to and from the rest of the body and the spinal cord. We

have 31 pairs of spinal nerves.

• Three layers of meninges surround the spinal cord and spinal nerve roots.

 Dura mater

 Arachnoid mater

 Pia mater

• Dura mater consists of two layers- periosteal and meningeal. Epidural space is present between the two layers.

• Subarachnoid space lies between the arachnoid mater and pia mater. It is filled with cerebrospinal fluid.
Spinal Cord Injuries

 Damage to any part of the spinal cord or spinal nerves results in permanent and life-long damage to the spinal cord
affecting the normal functioning of the spinal cord without any replacements.

 It often causes long-term changes in the strength, body posture and reflexing of the body. Voluntary control of limbs
post an injury depends on the severity and location of the injury.

 One has a complete injury when he loses the ability to move or sense below the injury. The incomplete injury allows
the injured to perform some sensory and motor functions.

 Spinal cord injury not only has an impact on the spinal nerves and the vertebral column but affects other muscles
and vital organs as well.
Paralysis from an injury can be of two types:

 Tetraplegic

 Paraplegic

 Tetraplegia is a paralysis that results in total or partial loss of use of all four limbs and torso.

 Paraplegia, on the other hand, is similar to tetraplegia, except it doesn’t affect the arms.

These injuries result in the inability to voluntarily move limbs, lose sensation, delayed or exaggerated reflexes, changes

in sexual functions, intense shooting pain due to damaged nerve fibres. It also causes shortness of breath, cough and

muscle spasms.
Spinal Cord Nerves

 The spinal nerves consist of a group of 31 nerves. These nerves are attached to the spinal cord by two roots- dorsal

sensory root and ventral motor root.

 The sensory root fibres carry sensory impulses to the spinal cord. The motor roots, on the contrary, carry impulses

from the spinal cord.

 The spinal nerves carry messages to and from the skin of specific regions of the body called dermatomes.

The spinal cord nerves can be grouped as:

• Cervical

• Thoracic

• Sacral

• Lumbar

• Coccygeal
 Cervical Nerves
Cervical means of the neck. There are 8 cervical nerves that emerge from the cervical spine (C1-C8).

 Thoracic Nerves
Thoracic means of the chest. There are 12 thoracic nerves that emerge from the thoracic spine (T1-T12).

 Lumbar Nerves
Lumbar means from the lower back region. There are 5 lumbar nerves that emerge from the lumbar spine (L1-L5).

 Sacral Nerves
Sacral means of the sacrum. The sacrum is a bony plate at the base of the vertebral column.
There are 5 sacral nerves that emerge from the sacral bone (S1-S5).

 Coccygeal Nerves
Coccygeal means of the tailbone. There is 1 nerve that emerges from the coccygeal bone.
Function Of Spinal Cord

Important functions of Spinal Cord are mentioned below:

 Forms a connecting link between the brain and the PNS

 Provides structural support and builds a body posture

 Facilitates flexible movements

 Myelin present in the white matter acts as an electrical insulation

 Communicates messages from the brain to different parts of the body

 Coordinates reflexes

 Receives sensory information from receptors and approaches towards the brain for processing.
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