Gross Anatomy of the Brain
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Section of Neurosurgery, Department of Surgery, University of Michigan Hospital, Ann Arbor, Michigan
ANATOMIC PATHWAYS RELATED TO PAIN IN FACE AND NECK* JAMES A. TAREN, M.D., AND EDGAR A. KAHN, M.D. Section of Neurosurgery, Department of Surgery, University of Michigan Hospital, Ann Arbor, Michigan (Received for publication May 19, 1961) HE remarkable ability of the higher V is most dorsal in the tract. Fig. 4 is a dia- portions of the central nervous system gram of the medulla 6 mm. below the obex T to readjust to surgical lesions presup- which we believe to be the optimal level for poses the existence of alternate pathways. tractotomy. The operation is done with the This hypothesis has been tested with regard patient in the sitting position to facilitate to a specific localized sensory input, pain exposure. The medullary incision, 4-5 mm. from the face. in depth, extends from the bulbar accessory Our method has been to study the degen- rootlet to a line extrapolated from the pos- eration of nerve fibers by Weil and Marchi terior rootlets of the ~ud cervical nerve root. techniques following various surgical lesions An adequate incision results in complete in man and monkey. The lesions have con- analgesia of all 8 divisions as well as analgesia sisted of total and selective retrogasserian in the distribution of VII, IX, and X except rhizotomy in 3 humans and 3 monkeys, for sparing of the vermilion border of the lips medullary tractotomy in ~ humans and (Fig. 5). A degree of ataxia of the ipsilateral monkeys, and extirpation of the cervical upper extremity usually accompanies effec- portion of the nucleus of the descending tract tive tractotomy and is caused by compromise of V in ~ monkeys. -
Pharnygeal Arch Set - Motor USMLE, Limited Edition > Neuroscience > Neuroscience
CNs 5, 7, 9, 10 - Pharnygeal Arch Set - Motor USMLE, Limited Edition > Neuroscience > Neuroscience PHARYNGEAL ARCH SET, CNS 5, 7, 9, 10 • They are derived from the pharyngeal (aka branchial) arches • They have special motor and autonomic motor functions CRANIAL NERVES EXIT FROM THE BRAINSTEM CN 5, the trigeminal nerve exits the mid/lower pons.* CN 7, the facial nerve exits the pontomedullary junction.* CN 9, the glossopharyngeal nerve exits the lateral medulla.* CN 10, the vagus nerve exits the lateral medulla.* CRANIAL NERVE NUCLEI AT BRAINSTEM LEVELS Midbrain • The motor trigeminal nucleus of CN 5. Nerve Path: • The motor division of the trigeminal nerve passes laterally to enter cerebellopontine angle cistern. Pons • The facial nucleus of CN 7. • The superior salivatory nucleus of CN 7. Nerve Path: • CN 7 sweeps over the abducens nucleus as it exits the brainstem laterally in an internal genu, which generates a small bump in the floor of the fourth ventricle: the facial colliculus • Fibers emanate from the superior salivatory nucleus, as well. Medulla • The dorsal motor nucleus of the vagus, CN 10 • The inferior salivatory nucleus, CN 9 1 / 3 • The nucleus ambiguus, CNs 9 and 10. Nerve Paths: • CNs 9 and 10 exit the medulla laterally through the post-olivary sulcus to enter the cerebellomedullary cistern. THE TRIGEMINAL NERVE, CN 5  • The motor division of the trigeminal nerve innervates the muscles of mastication • It passes ventrolaterally through the cerebellopontine angle cistern and exits through foramen ovale as part of the mandibular division (CN 5[3]). Clinical Correlation - Trigeminal Neuropathy THE FACIAL NERVE, CN 7  • The facial nucleus innervates the muscles of facial expression • It spans from the lower pons to the pontomedullary junction. -
Projections from the Trigeminal Nuclear Complex to the Cochlear Nuclei: a Retrograde and Anterograde Tracing Study in the Guinea Pig
Journal of Neuroscience Research 78:901–907 (2004) Projections From the Trigeminal Nuclear Complex to the Cochlear Nuclei: a Retrograde and Anterograde Tracing Study in the Guinea Pig Jianxun Zhou and Susan Shore* Department of Otolaryngology and Kresge Hearing Research Institute, University of Michigan, Ann Arbor, Michigan In addition to input from auditory centers, the cochlear cuneate nucleus innervation of cochlear nucleus has been nucleus (CN) receives inputs from nonauditory centers, hypothesized to convey information about head and pinna including the trigeminal sensory complex. The detailed position for the purpose of localizing a sound source in anatomy, however, and the functional implications of the space (Young et al., 1995). In addition, interactions be- nonauditory innervation of the auditory system are not tween somatosensory and auditory systems have been fully understood. We demonstrated previously that the linked increasingly to phantom sound perception, also trigeminal ganglion projects to CN, with terminal labeling known as tinnitus. This is demonstrated in the observa- most dense in the marginal cell area and secondarily in tions that injuries of the head and neck region can lead to the magnocellular area of the ventral cochlear nucleus the onset of tinnitus in patients with no hearing loss (VCN). We continue this line of study by investigating the (Lockwood et al., 1998). projection from the spinal trigeminal nucleus to CN in We demonstrated previously projections from the guinea pig. After injections of the retrograde tracers Flu- trigeminal ganglion to CN in guinea pigs (Shore et al., oroGold or biotinylated dextran amine (BDA) in VCN, 2000). Terminal labeling of trigeminal ganglion projec- labeled cells were found in the spinal trigeminal nuclei, tions to the CN was found to be most dense in the most densely in the pars interpolaris and pars caudalis marginal cell area and secondarily in the magnocellular with ipsilateral dominance. -
Quantitative Analysis of Axon Collaterals of Single Pyramidal Cells
Yang et al. BMC Neurosci (2017) 18:25 DOI 10.1186/s12868-017-0342-7 BMC Neuroscience RESEARCH ARTICLE Open Access Quantitative analysis of axon collaterals of single pyramidal cells of the anterior piriform cortex of the guinea pig Junli Yang1,2*, Gerhard Litscher1,3* , Zhongren Sun1*, Qiang Tang1, Kiyoshi Kishi2, Satoko Oda2, Masaaki Takayanagi2, Zemin Sheng1,4, Yang Liu1, Wenhai Guo1, Ting Zhang1, Lu Wang1,3, Ingrid Gaischek3, Daniela Litscher3, Irmgard Th. Lippe5 and Masaru Kuroda2 Abstract Background: The role of the piriform cortex (PC) in olfactory information processing remains largely unknown. The anterior part of the piriform cortex (APC) has been the focus of cortical-level studies of olfactory coding, and asso- ciative processes have attracted considerable attention as an important part in odor discrimination and olfactory information processing. Associational connections of pyramidal cells in the guinea pig APC were studied by direct visualization of axons stained and quantitatively analyzed by intracellular biocytin injection in vivo. Results: The observations illustrated that axon collaterals of the individual cells were widely and spatially distrib- uted within the PC, and sometimes also showed a long associational projection to the olfactory bulb (OB). The data showed that long associational axons were both rostrally and caudally directed throughout the PC, and the intrinsic associational fibers of pyramidal cells in the APC are omnidirectional connections in the PC. Within the PC, associa- tional axons typically followed rather linear trajectories and irregular bouton distributions. Quantitative data of the axon collaterals of two pyramidal cells in the APC showed that the average length of axonal collaterals was 101 mm, out of which 79 mm (78% of total length) were distributed in the PC. -
Direct Projections from Cochlear Nuclear Complex to Auditory Thalamus in the Rat
The Journal of Neuroscience, December 15, 2002, 22(24):10891–10897 Direct Projections from Cochlear Nuclear Complex to Auditory Thalamus in the Rat Manuel S. Malmierca,1 Miguel A. Mercha´n,1 Craig K. Henkel,2 and Douglas L. Oliver3 1Laboratory for the Neurobiology of Hearing, Institute for Neuroscience of Castilla y Leo´ n and Faculty of Medicine, University of Salamanca, 37007 Salamanca, Spain, 2Wake Forest University School of Medicine, Department of Neurobiology and Anatomy, Winston-Salem, North Carolina 27157-1010, and 3University of Connecticut Health Center, Department of Neuroscience, Farmington, Connecticut 06030-3401 It is known that the dorsal cochlear nucleus and medial genic- inferior colliculus and are widely distributed within the medial ulate body in the auditory system receive significant inputs from division of the medial geniculate, suggesting that the projection somatosensory and visual–motor sources, but the purpose of is not topographic. As a nonlemniscal auditory pathway that such inputs is not totally understood. Moreover, a direct con- parallels the conventional auditory lemniscal pathway, its func- nection of these structures has not been demonstrated, be- tions may be distinct from the perception of sound. Because cause it is generally accepted that the inferior colliculus is an this pathway links the parts of the auditory system with prom- obligatory relay for all ascending input. In the present study, we inent nonauditory, multimodal inputs, it may form a neural have used auditory neurophysiology, double labeling with an- network through which nonauditory sensory and visual–motor terograde tracers, and retrograde tracers to investigate the systems may modulate auditory information processing. -
Isolated Relative Afferent Pupillary Defect Secondary to Contralateral Midbrain Compression
OBSERVATION Isolated Relative Afferent Pupillary Defect Secondary to Contralateral Midbrain Compression Cheun Ju Chen, MD; Mia Scheufele, MD; Maushmi Sheth, MD; Amir Torabi, MD; Nick Hogan, MD, PhD; Elliot M. Frohman, MD, PhD Background: Relative afferent pupillary defects are typi- accounts for the relative afferent pupillary defect con- cally related to ipsilateral lesions within the anterior vi- tralateral to the described lesion. sual pathways. Result: Magnetic resonance imaging of the brain revealed a pineal tumor compressing the right rostral midbrain. Objective: To describe a patient who had a workup for headache and was found to have an isolated left relative Conclusion: While rare, a relative afferent pupillary de- afferent pupillary defect without any other neurological fect can occasionally occur secondary to lesions in the findings. postchiasmal pathways. In these circumstances, the pu- pillary defect will be observed to be contralateral to the Design: We review the neuroanatomy of the pupil- side of the lesion. lary light reflex pathway and emphasize the nasotem- poral bias of decussating fiber projections, which Arch Neurol. 2004;61:1451-1453 RELATIVE AFFERENT PUPIL- though retinal fibers concerned with this lary defect (RAPD) is char- reflex transmit information to both the ip- acterized by pupillary dila- silateral and contralateral midbrain, there tion upon illuminating the is a slight crossing bias, with about 53% of eye during the swinging the fibers crossing in the optic chiasm Aflashlight test. The presence of this sign sig- (chiefly derived from the nasal retina) and nifies an abnormality in the transmission 47% remaining ipsilateral. This anatomi- of light information within the pupillary cal organization of the pupillary constric- light constrictor pathway from the retina tor pathway results in the possibility of pro- to the rostral midbrain circuitry involved ducing an RAPD during illumination of the in this reflex. -
Measurement of the Normal Optic Chiasm on Coronal MR Images
Measurement of the Normal Optic Chiasm on Coronal MR Images Andrew L. Wagner, F. Reed Murtagh, Ken S. Hazlett, and John A. Arrington PURPOSE: To develop an objective method for measuring the optic chiasm and to document its normal range in size. METHODS: Measurements of the height and area of the optic chiasm, made on coronal T1-weighted MR images with the use of commercially available region-of-interest software, were obtained in 114 healthy subjects who had a total of 123 MR studies. A normal range and standard deviation were calculated, and the information was broken down by age and sex. RESULTS: The mean area of the optic chiasm was 43.7 mm2, with a standard deviation of 5.21. The mean width was 14.0 mm, with a standard deviation of 1.68. CONCLUSION: The area and width of the optic chiasm can be measured with the use of commercially available software, which allows an objective estimate of the chiasm’s size. Knowledge of the normal size range of the optic chiasm can be helpful in the early detection of some disorders. Index terms: Optic chiasm; Brain, anatomy; Brain, measurement AJNR Am J Neuroradiol 18:723–726, April 1997 The optic chiasm is an important land- months and that had been interpreted as normal. No pa- mark when interpreting magnetic resonance (MR) tient had suspected visual or endocrine abnormalities. All examinations of the brain. A small chiasm can be the examinations had been performed with a 1.5-T Gen- an indication of several disorders, the most com- eral Electric (Milwaukee, Wis) Signa or 1.5-T Siemens mon of which is septooptic dysplasia (1), and a (Cary, NC) Somatom MR system using routine imaging large chiasm can be the result of glioma, menin- protocols, with additional 3-mm T1-weighted contiguous coronal sections used for measurements. -
Telovelar Approach to the Fourth Ventricle: Microsurgical Anatomy
J Neurosurg 92:812–823, 2000 Telovelar approach to the fourth ventricle: microsurgical anatomy ANTONIO C. M. MUSSI, M.D., AND ALBERT L. RHOTON, JR., M.D. Department of Neurological Surgery, University of Florida, Gainesville, Florida Object. In the past, access to the fourth ventricle was obtained by splitting the vermis or removing part of the cere- bellum. The purpose of this study was to examine the access to the fourth ventricle achieved by opening the tela cho- roidea and inferior medullary velum, the two thin sheets of tissue that form the lower half of the roof of the fourth ven- tricle, without incising or removing part of the cerebellum. Methods. Fifty formalin-fixed specimens, in which the arteries were perfused with red silicone and the veins with blue silicone, provided the material for this study. The dissections were performed in a stepwise manner to simulate the exposure that can be obtained by retracting the cerebellar tonsils and opening the tela choroidea and inferior medullary velum. Conclusions. Gently displacing the tonsils laterally exposes both the tela choroidea and the inferior medullary velum. Opening the tela provides access to the floor and body of the ventricle from the aqueduct to the obex. The additional opening of the velum provides access to the superior half of the roof of the ventricle, the fastigium, and the superolater- al recess. Elevating the tonsillar surface away from the posterolateral medulla exposes the tela, which covers the later- al recess, and opening this tela exposes the structure forming -
DR. Sanaa Alshaarawy
By DR. Sanaa Alshaarawy 1 By the end of the lecture, students will be able to : Distinguish the internal structure of the components of the brain stem in different levels and the specific criteria of each level. 1. Medulla oblongata (closed, mid and open medulla) 2. Pons (caudal, mid “Trigeminal level” and rostral). 3. Mid brain ( superior and inferior colliculi). Describe the Reticular formation (structure, function and pathway) being an important content of the brain stem. 2 1. Traversed by the Central Canal. Motor Decussation*. Spinal Nucleus of Trigeminal (Trigeminal sensory nucleus)* : ➢ It is a larger sensory T.S of Caudal part of M.O. nucleus. ➢ It is the brain stem continuation of the Substantia Gelatinosa of spinal cord 3 The Nucleus Extends : Through the whole length of the brain stem and upper segments of spinal cord. It lies in all levels of M.O, medial to the spinal tract of the trigeminal. It receives pain and temperature from face, forehead. Its tract present in all levels of M.O. is formed of descending fibers that terminate in the trigeminal nucleus. 4 It is Motor Decussation. Formed by pyramidal fibers, (75-90%) cross to the opposite side They descend in the Decuss- = crossing lateral white column of the spinal cord as the lateral corticospinal tract. The uncrossed fibers form the ventral corticospinal tract. 5 Traversed by Central Canal. Larger size Gracile & Cuneate nuclei, concerned with proprioceptive deep sensations of the body. Axons of Gracile & Cuneate nuclei form the internal arcuate fibers; decussating forming Sensory Decussation. Pyramids are prominent ventrally. 6 Formed by the crossed internal arcuate fibers Medial Leminiscus: Composed of the ascending internal arcuate fibers after their crossing. -
Auditory and Vestibular Systems Objective • to Learn the Functional
Auditory and Vestibular Systems Objective • To learn the functional organization of the auditory and vestibular systems • To understand how one can use changes in auditory function following injury to localize the site of a lesion • To begin to learn the vestibular pathways, as a prelude to studying motor pathways controlling balance in a later lab. Ch 7 Key Figs: 7-1; 7-2; 7-4; 7-5 Clinical Case #2 Hearing loss and dizziness; CC4-1 Self evaluation • Be able to identify all structures listed in key terms and describe briefly their principal functions • Use neuroanatomy on the web to test your understanding ************************************************************************************** List of media F-5 Vestibular efferent connections The first order neurons of the vestibular system are bipolar cells whose cell bodies are located in the vestibular ganglion in the internal ear (NTA Fig. 7-3). The distal processes of these cells contact the receptor hair cells located within the ampulae of the semicircular canals and the utricle and saccule. The central processes of the bipolar cells constitute the vestibular portion of the vestibulocochlear (VIIIth cranial) nerve. Most of these primary vestibular afferents enter the ipsilateral brain stem inferior to the inferior cerebellar peduncle to terminate in the vestibular nuclear complex, which is located in the medulla and caudal pons. The vestibular nuclear complex (NTA Figs, 7-2, 7-3), which lies in the floor of the fourth ventricle, contains four nuclei: 1) the superior vestibular nucleus; 2) the inferior vestibular nucleus; 3) the lateral vestibular nucleus; and 4) the medial vestibular nucleus. Vestibular nuclei give rise to secondary fibers that project to the cerebellum, certain motor cranial nerve nuclei, the reticular formation, all spinal levels, and the thalamus. -
Morphometric Assesment of the External Anatomy of Fourth Ventricle and Dorsal Brainstem in Fresh Cadavers
DOI: 10.5137/1019-5149.JTN.24942-18.1 Turk Neurosurg 29(3):445-450, 2019 Received: 26.09.2018 / Accepted: 20.11.2018 Published Online: 19.12.2018 Original Investigation Morphometric Assesment of the External Anatomy of Fourth Ventricle and Dorsal Brainstem in Fresh Cadavers Veysel ANTAR1, Okan TURK1, Salim KATAR2, Mahmut OZDEN3, Balkan SAHIN4, Sahin YUCELI5, Erdogan KARA6, Ayse YURTSEVEN6 1Istanbul Training and Research Hospital, Department of Neurosurgery, Istanbul, Turkey 2Selahattin Eyyubi City Hospital, Department of Neurosurgery, Diyarbakir, Turkey 3Bahcesehir University, Department of Neurosurgery, Istanbul, Turkey 4Sultan Abdulhamit Han Training and Research Hospital, Department of Neurosurgery, Istanbul, Turkey 5Erzincan Neon Hospital, Department of Neurosurgery, Erzincan, Turkey 6Ministry of Justice, Council of Forensic Medicine, Istanbul, Turkey Corresponding author: Veysel ANTAR [email protected] ABSTRACT AIM: To investigate the external anatomy of the fourth ventricle and dorsal brainstem using morphometric data, which could be useful for preoperative surgical planning. MATERIAL and METHODS: Between January 2017 and December 2017, 42 fresh adult cadavers were investigated for the measurements of the cadaver brainstems and fourth ventricle, and they were recorded by photography. Measurements were evaluated according to body mass indexes (BMIs) of the patients. We also investigate the visualization of facial colliculus and stria medullaris on brainstem. RESULTS: A total of 42 fresh cadavers with a mean age of 45.38 ± 16.41 years old were included in this research. We found no statistically significant difference between measurements and BMIs. Facial colliculus was visualized in 92.9% (n=39), but it could not visualized in 7.1% (n=3) of the subjects. -
Lecture (6) Internal Structures of the Brainstem.Pdf
Internal structures of the Brainstem Neuroanatomy block-Anatomy-Lecture 6 Editing file Objectives At the end of the lecture, students should be able to: ● Distinguish the internal structure of the components of the brain stem in different levels and the specific criteria of each level. 1. Medulla oblongata (closed, mid and open medulla) 2. Pons (caudal and rostral). 3. Midbrain ( superior and inferior colliculi). Color guide ● Only in boys slides in Green ● Only in girls slides in Purple ● important in Red ● Notes in Grey Medulla oblongata Caudal (Closed) Medulla Traversed by the central canal Motor decussation (decussation of the pyramids) ● Formed by pyramidal fibers, (75-90%) cross to the opposite side ● They descend in the lateral white column of the spinal cord as the lateral corticospinal tract. ● The uncrossed fibers form the ventral corticospinal tract Trigeminal sensory nucleus. ● it is the larger sensory nucleus. ● The Nucleus Extends Through the whole length of the brainstem and its note :All CN V afferent sensory information enters continuation of the substantia gelatinosa of the spinal cord. the brainstem through the nerve itself located in the pons. Thus, to reach the spinal nucleus (which ● It lies in all levels of M.O, medial to the spinal tract of the trigeminal. spans the entire brain stem length) in the Caudal ● It receives pain and temperature from face, forehead. Medulla those fibers have to "descend" in what's known as the Spinal Tract of the Trigeminal ● Its tract present in all levels of M.O. is formed of descending (how its sensory and descend?see the note) fibers that terminate in the trigeminal nucleus.