BRAIN

R.Yuvaraj
2018 Batch
Madha College Of Physiotherapy
Introduction
• The brain is a complex organ that
controls thought, memory, emotion,
touch, motor skills, vision, breathing,
temperature, hunger and every process
that regulates our body.
• Weight
Male – 1380g
Female – 1250g
Protection of Brain

Skull (Cranium) Meninges

• 8 Cranial Bones • 3 Membranes
• Parietal (2)
• Temporal (2)
• Frontal (1)
• Occipital (1)
• Ethmoid (1)
• Sphenoid (1)
Protection of Brain
• Skull (Cranium)
Meninges
• Three layers of membranes
known as meninges protect the
brain and spinal cord.
• Duramater
• Arachnoid mater
• Piamater
Features of dura mater?
• In Latin, dura mater means “hard
mother.”
• Dura mater is the outer, thick, strong
membrane layer.
• Blood supply - middle meningeal artery
and vein, and trigeminal nerve
(V1,V2,V3).
• The dura mater is composed of two
layers: the periosteal/endosteal layer
and the meningeal layer.
• The dural venous sinuses are between
these two layers.
• The dura folds to form septa that create
the falx cerebri, tentorium cerebelli, falx
cerebelli, and diaphragma sellae.
• In the brain, the periosteal layer
provides a tubular sheath-like covering
for the cranial nerves as they pass
through the different foramina of the
skull.
• As soon as the cranial nerves exit the
foramen, the periosteal layer fuses with
the epineurium of nerves.
Features of arachnoid mater?
• Arachnoid” means Spider
• The middle layer of your meninges, lies
directly below your dura mater.
• Between your dura mater and pia mater.
• It has a spiderweb-like appearance because it
has connective tissue projections that attach to
your pia mater. Between your arachnoid mater
and pia mater is the subarachnoid space, which
contains cerebrospinal fluid that helps cushion
your brain
Features of the pia mater?
• innermost layer, is a thin layer that’s held
tightly — like shrink wrap — to the surface
of your brain and spinal cord.
• Many blood vessels pass through this layer
to supply your brain tissue with blood.
• It also helps contain cerebrospinal fluid. In
your spinal cord, pia mater helps maintain
the stiffness of the cord.
Scanning electron micrograph of the cranial meninges of a young dog. The apparent space
between the dura mater and the arachnoid is an artifact of processing and would not
normally be present. (Courtesy Dr. Delmas J. Allen, Medical College of Ohio.)
Spaces in Meninges
• Epidural space is a space between your
skull and dura mater.
• Subdural space is a space between your
dura mater and your arachnoid mater.
• Subarachnoid space is a space between
your arachnoid mater and pia mater.
The Ventricles of the Brain
• The ventricular system is a set of
communicating cavities within the
brain.
• These structures are responsible for
the production, transport and removal
of cerebrospinal fluid, which bathes
the central nervous system.
Functions of Cerebrospinal Fluid
• Protection – acts as a cushion for the brain,
limiting neural damage in cranial injuries.
• Buoyancy – by being immersed in CSF, the net
weight of the brain is reduced to approximately 25
grams. This prevents excessive pressure on the
base of the brain.
• Chemical stability – the CSF creates an
environment to allow for proper functioning of the
brain, e.g. maintaining low extracellular K+ for
synaptic transmission.
CSF
Ventricles of the Brain
• The ventricles are structures that
produce cerebrospinal fluid, and
transport it around the cranial cavity.
• They are lined by ependymal cells,
which form a structure called the
choroid plexus.
• It is within the choroid plexus that CSF
is produced.
Four ventricles
• Right lateral ventricle
• Left lateral ventricle
• Third ventricle
• Fourth ventricle
Lateral Ventricles
• The left and right lateral ventricles are
located within their respective
hemispheres of the cerebrum.
• They have ‘horns’ which project into
the frontal, occipital and temporal
lobes.
• The volume of the lateral ventricles
increases with age.
Ventricles
Third Ventricle
• The lateral ventricles are connected to
the third ventricle by the foramen of Monro.
• The third ventricle is situated in between the
right and the left thalamus.
Fourth Ventricle
• The fourth ventricle is the last in the system – it
receives CSF from the third ventricle via
the cerebral aqueduct.
• It lies within the brainstem, at the junction between
the pons and medulla oblongata.
• From the 4th ventricle, the fluid drains into two
places:
• Central spinal canal – bathes the spinal cord
• Subarachnoid cisterns – bathes the brain, between
arachnoid mater and pia mater. Here the CSF is
reabsorbed back into the circulation.
• Drainage of the CSF occurs in
the subarachnoid cisterns (or space).
• Small projections of arachnoid mater
(arachnoid granulations) protrude into
the dura mater.
• They allow the fluid to drain into
the dural venous sinuses
Dural venous sinuses
Definition:
A collection of sinuses or blood
channels that drains all venous blood from
the cranial cavity and returns it towards the
heart.
Location:
Situated between periosteal and
meningeal layers of dura mater
Paired venous sinuses
• Transverse sinus
• cavernous sinus
• superior petrosal sinus
• inferior petrosal sinus
• sphenoparietal sinus
• sigmoid sinus
• basilar sinus
Unpaired venous sinuses
• Superior sagittal sinus
• inferior sagittal sinus
• straight sinus
• occipital sinus
• intercavernous sinus
Dural venous sinuses
Parts of Brain
• Forebrain (Prosencephalon)
• Midbrain (Mesencephalon)
• Hindbrain(Rhombencephalon)
Forebrain (Prosencephalon)
• Greek prosō - Forward
enkephalos - Brain
• Telencephalon
• Diencephalon
Telencephalon
• The cerebrum, or telencephalon, is the
large upper part of the brain.
• It is divided into two hemispheres.
• the cerebrum sits atop the brainstem,
with the cerebellum underneath the rear
portion.
• The primary Three parts of the
cerebrum.
• basal ganglia
• cerebral cortex
• Limbic System
Basal ganglia
• The “basal ganglia” refers to a group of
subcortical nuclei within the brain
responsible primarily for motor control,
as well as other roles such as motor
learning, executive functions, emotional
behaviours, and play an important role
in reward and reinforcement, addictive
behaviours and habit formation.
Cerebral cortex
• The cerebral cortex is the outermost
layer of the cerebrum, or its gray matter.
• gray matter has an uneven surface with
many folds.
• Ridges called gyri.
• grooves called sulci help increase the
surface area of the cerebral cortex.
limbic system
• The limbic system was originally
called the rhinencephalon (meaning
‘smell brain’) because it was thought
to be primarily involved with the sense
of smell.
• Emotions, survival instincts, and memory
formation and connects senses, such as
odors, to our memories and emotions.
limbic system structures
• The amygdala (involved in forming
emotional responses, particularly fear
responses, and memories)
• The hippocampus (indexes and stores
memories)
• The hypothalamus (regulates emotional
responses).
limbic system
Right & Left Brain
• The cerebrum is divided into
two halves: the right and left
hemispheres.
• They are joined by a bundle of
fibers called the corpus
callosum that transmits
messages from one side to the
other.
corpus callosum
• Each hemisphere controls the
opposite side of the body.
• If a stroke occurs on the right
side of the brain, your left arm
or leg may be weak or
paralyzed.
• Not all functions of the
hemispheres are shared.
left hemisphere
• Controls speech
• Comprehension
• Arithmetic
• writing
Right hemisphere

• controls creativity
• spatial ability
• Artistic
• Musical skills.
Lobes
• Frontal
• Parietal
• Occipital
• Temporal.
Frontal
• Personality, behavior, emotions
• Judgment, planning, problem
solving
• Speech: speaking and writing
(Broca’s area)
• Body movement (motor strip)
• Intelligence, concentration, self
awareness
Parietal
• Interprets language, words
• Sense of touch, pain,
temperature (sensory strip)
• Interprets signals from vision,
hearing, motor, sensory and
memory
• Spatial and visual perception
Occipital
• Interprets vision (color, light,
movement)
Temporal
• Understanding language
(Wernicke’s area)
• Memory
• Hearing
• Sequencing and organization
Broca’s area
• Broca’s area lies in the left frontal lobe.
• If this area is damaged, one may have
difficulty moving the tongue or facial
muscles to produce the sounds of speech.
• The person can still read and understand
spoken language but has difficulty in
speaking and writing (i.e. forming letters
and words, doesn't write within lines) –
called Broca's aphasia.
Wernicke's area
• Wernicke's area lies in the left temporal
lobe.
• Damage to this area causes Wernicke's
aphasia. The individual may speak in long
sentences that have no meaning, add
unnecessary words, and even create new
words.
• They can make speech sounds, however
they have difficulty understanding speech
and are therefore unaware of their
mistakes.
Diencephalon
• The diencephalon has a central location
within the human brain sitting just
above the brain stem.
• Thalamus
• Hypothalamus
• Epithalamus
• Subthalamus
Thalamus
• The thalamus looks like two paired
"bulbs" consisting of mostly grey matter
that sit on each side of the third ventricle
of the brain.
• These bulbs sit atop the subthalamus and
are also connected to the epithalamus. The
two parts of the thalamus are connected
via the interthalamic adhesion.
Function
• crucial role in regulating consciousness
and alertness.
• auditory information
• Pain
• Touch
• Temperature
Epithalamus
• The epithalamus makes up the posterior
portion of the diencephalon and consists
of multiple structures including the
habenula, the stria medullaris, and the
pineal gland.
Function
• Pineal gland secretes melatonin.
Melatonin is responsible for the sleep-
wake cycle (circadian rhythm) in
humans.
Subthalamus
• Ventral to the thalamus is the
subthalamus.
• The main structure within the
subthalamus is the subthalamic nucleus.
• zona incerta, the reticular nucleus, and
the perigeniculate nucleus.
subthalamic nucleus
Divided into three subsections
• dorsolateral motor territory
• ventromedial associative territory
• medial limbic territory.
Function
• control center for the
peripheral nervous system and connects
the endocrine system with the nervous
system and limbic system.
• The zona incerta which stimulates the
thalamus (responsible for the function
of smooth muscle, cardiac muscles, and
glands, focus, reflexes, and more)
• The reticular nucleus which is
responsible for the regulation of the
thalamocortical pathway and
consciousness
• The perigeniculate nucleus which plays
an important role in vision
• The subthalamic nucleus which is
responsible for somatic motor function
Hypothalamus
• The hypothalamus is a very small cone-
shaped structure that lies beneath the
thalamus.
• small size, it is one of the most
important structures in the human brain.
The hypothalamus ends in the pituitary
stalk (also called the infundibular stalk)
which connects it to the pituitary gland.
Function
• Body temperature
• Appetite
• Metabolism
• Emotions, behavior, memory
• Circadian rhythms
• Growth
• The regulation of fluid and electrolyte
levels in the body, which in turn
maintains functions such as blood
pressure
• Sex drive
• Oxytocin plays an important role in
childbirth and breastfeeding
• The hypothalamus communicates with the
pituitary gland which is often called the
master gland.
• Signals coming from the hypothalamus
cause other endocrine glands in the body to
release vital hormones.
• For example, it signals the adrenal glands to
release cortisone or the thyroid gland to
release thyroid hormones.
Midbrain
• The midbrain (also known as the
mesencephalon) is the most superior of
the three regions of the brainstem. It
acts as a conduit between the forebrain
above and the pons and cerebellum
below.
• 2cm in length.
Important Structure
cerebral peduncles
• crus cerebri
• substania nigra
• tegmentum
Tectum
• superior colliculus
• inferior colliculus
RED Nucleus
Cerebral Aqueduct
rd th
crus cerebri
• Frontopontine fibres(1/6)
• Corticospinal fibres(4/6)
• Temporopontine,parietopontine,occip
itopontine fibers(1/6)
substania nigra
• Latin - black substance
• Considered as a part of basal ganglia
• Neuromelanin secretion
Divied into
• pars reticulata (anterior)
• pars compacta (posterior)
• Pars lateralis (part of pars reticulata)
Functions
Pars compacta (Dopaminergic Neuron)
• Secrets L-Dopa precursor of dopamine.
• Pars compacta (GABAergic neuron).
• Secrets Gamma Amino Butyric Acid.
RED Nucleus
• Also called nucleus ruber
• 0.5cm diameter
• Due to presence of hemoglobin and
ferritin (iron) its look red/pale pink
color.
• Function: Control muscle tone.
Lemniscus
• Latin –Ribbon

• Medial Lemniscus
• Trigeminal Lemniscus
• Spinal Lemniscus
• Lateral Lemniscus
Medial Lemniscus
• Reil’s band or reil’s ribbon.
• From spinal cord to thalamus.
• Function:touch,vibratory,proprioceptive
sensation
Trigeminal Lemniscus
• Trigeminal Lemniscus/trigemino
thalamic tract
• Principal nucleus of trigeminal system
to ventral posterior nucleusof
thalamus.
Function:
• Tactile
• Pain
• Temperature
• Impulse from the skin of the face
• The mucous membranes of the nasal and
oral cavities
• Proprioceptive information from the
facial and masticatory muscles
Spinal lemniscus
• A parts of spinothalamic tract
• Posterior horn of spinal cord to superior
colliculus-spinotectal fiber
• Posterior horn of spinal cord to central
grey matter – spino periaqueduct fibers
• Posterior horn of spinal cord to
thalamus – spinothalamic fibers
• Posterior horn of spinal cord to reticular
formation – spinoreticular fiber
• Posterior horn of spinal cord to olivary
nucleus – spino olivary fiber
Rhombencephalon
• The hindbrain’s chief role is in
coordinating the vital functions of
our bodies such as breathing and
heart rate.
• The pons (Latin for "bridge") serves
to connect the brain and spinal cord,
and the medulla, pons, and midbrain
together are known as the brainstem.
Rhombencephalon
Metencephalon
• Pons
• Cerebellum
Myelencephalon
• medulla oblongata
Pons
• The pons is a portion of the brain stem,
located above the medulla oblongata
and below the midbrain. Although it is
small, at approximately 2.5 centimeters
long
• breathing, taste, sleeping
Pons
• The trigeminal nerve is responsible for
feeling in the face. I also controls the muscles
that are responsible for biting, chewing, and
swallowing.
• The abducens nerve allows the eyes to look
from side to side.
• The facial nerve controls facial expressions.
• The vestibulocochlear nerve allows sound to
move from the ear to the brain.
Cerebellum
• The cerebellum (which is Latin for
“little brain”) is a major structure of the
hindbrain that is located near the
brainstem.
Function
• Maintaining balance: The cerebellum has
special sensors that detect shifts in balance
and movement. It sends signals for the
body to adjust and move.
• Coordinating movement: Most body
movements require the coordination of
multiple muscle groups. The cerebellum
times muscle actions so that the body can
move smoothly.
• Vision: The cerebellum coordinates eye
movements.
• Motor learning: The cerebellum helps
the body to learn movements that
require practice and fine-tuning. For
example, the cerebellum plays a role in
learning to ride a bicycle or play a
musical instrument.
medulla oblongata
• The medulla oblongata is a tail-like
structure at the base of the brain that
connects the brain to the spinal cord.
• It carries signals from the brain to the
rest of the body for essential life
functions
Function
• controls your heart rate, breathing,
blood pressure
• Manages other automatic
processes:coughing, sneezing,
swallowing, vomiting and maintaining
your balance.
• Glossopharyngeal nerve – these
nerves coordinate some taste
sensations as well as movements of
the mouth.
• Vagus nerve – these also control
mouth movements, as well as our
voice and gag reflexes.
• Accessory nerve – these
coordinate movements of the head
and the neck.
• Hypoglossal nerve – these nerves
control movements of the tongue
and muscles that are involved in
speech.
Types of Brain Disorders
• Alzheimer's Disease.
• Dementias.
• Brain Cancer.
• Epilepsy and Other Seizure Disorders.
• Mental Disorders.
• Parkinson's and Other Movement
Disorders.
• Stroke and Transient Ischemic Attack (TIA)
Alzheimer’s disease
• Alzheimer’s disease is the most
common form of dementia, which is
a term to describe the loss of
cognitive functioning. Over time,
Alzheimer’s can lead to an inability
to carry out daily activities, such as
getting dressed, having
conversations.
Stages
• Stage 1: Before Symptoms
Appear
• Stage 2: Basic Forgetfulness
• Stage 3: Noticeable Memory
Difficulties
• Stage 4: More Than Memory Loss
• Stage 5: Decreased Independence
• Stage 6: Severe Symptoms
• Stage 7: Lack of Physical Control
Stage 1: Before Symptoms Appear
• cognitive abilities beginning to slip

Stage 2: Basic Forgetfulness

• Forgetting people’s names or where
they left their keys, but they can still
drive, work and be social.
Stage 3: Noticeable Memory Difficulties
• Have trouble remembering recently read
material, such as books or magazines
• Find remember plans and organizing
increasingly difficult
• Have more difficulty retrieving a name or
word
• Experience challenges in social settings
or at work
Stage 4: More Than Memory Loss
• Confusion about what day it is and
where they are
• Changes in sleep patterns, such as
restlessness at night and sleeping
during the day
• Difficulty choosing appropriate
clothing for the weather or the
occasion
• feeling suspicious of others
• having less interest in things
• feeling depressed
Stage 5: Decreased Independence
• trouble remembering people that are
important to them, such as close family and
friends.
• They may struggle with learning new things
• Hallucinations: Seeing things that aren’t
there
• Delusions: False beliefs that you believe to
be true
• Paranoia: The feeling that others are
against you
Stage 6: Severe Symptoms
• use words and phrases, but
communicating about specific
thoughts, such as where they’re
experiencing pain, can be
challenging.
• increased anxiety, hallucinations,
delusions and paranoia
Stage 7: Lack of Physical Control
• They may need round-the-clock
care for help with walking, sitting
and eventually swallowing.
Brain Tumor
• A brain tumor is a mass or
growth of abnormal cells in
your brain.
• Noncancerous (benign)
• Cancerous (malignant)
Types
1.Acoustic neuroma
2.Astrocytoma
3.Brain metastases
4.Choroid plexus carcinoma
5.Craniopharyngioma
6.Embryonal tumors
7. Ependymoma
08.Glioblastoma
09.Glioma
10.Medulloblastoma
11.Meningioma
12.Oligodendroglioma
13.Pediatric brain tumors
14.Pineoblastoma
15.Pituitary tumors
Acoustic neuroma
• Acoustic neuroma, also known
as vestibular schwannoma, is
a noncancerous and usually
slow-growing tumor that
develops on the main
(vestibular) nerve leading from
your inner ear to your brain.
• Branches of this nerve
directly influence your
balance and hearing, and
pressure from an acoustic
neuroma can cause hearing
loss, ringing in your ear and
unsteadiness.
Astrocytoma
• Astrocytoma begins in cells
called astrocytes that
support nerve cells.
• Astrocytomas that occur in
the brain can cause seizures,
headaches and nausea.