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Tvorí Miecha (Medulla Spinalis) a Mozog (Encephalon)

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Tvorí Miecha (Medulla Spinalis) a Mozog (Encephalon) doc. MUDr. Adriana Boleková, PhD. MVDr. Natália Hvizdošová, PhD. CENTRÁLNY NERVOVÝ SYSTÉM – tvorí miecha (medulla spinalis) a mozog (encephalon) MEDULLA SPINALIS kraniálne hranice: foramen magnum, decussatio pyramidum, výstup 1. páru miechových nervov kaudálne hranice: úroveň stavcov L1 – L2 conus medullaris – filum terminale (S2) – cauda equina zhrubnutia: intumescencia cervicalis (C5 – Th1): vystupujú z nej nervy pre plexus brachialis intumescencia lumbosacralis (L1 – S2): vystupujú z nej nervy pre plexus lumbosacralis vonkajšia štruktúra: fissura mediana anterior sulcus anterolateralis – radices anteriores nn. spinalium sulcus posterolateralis – radices posteriores nn. spinalium sulcus medianus posterior sulcus intermedius posterior vnútorná štruktúra: Substantia alba funiculus anterior (medzi fissura mediana anterior a sulcus anterolateralis) funiculus lateralis (medzi sulcus anterolateralis a sulcus posterolateralis) funiculus posterior (medzi sulcus posterolateralis a sulcus medianus posterior) fasciculus gracilis fasciculus cuneatus Substantia grissea cornu anterius (ventralis) – motorická funkcia: Rexedova lamina I – VI cornu laterale – viscerálne funkcie: Rexedova lamina VII cornu posterius (dorsalis) – prijíma senzitívne informácie: Rexedova lamina VIII – IX substantia grissea centralis – interneuróny: okolo canalis centralis Rexedova lamina X Canalis centralis kraniálne prechod do IV. mozgovej komory kaudálne rozšírenie do ventriculus terminalis cievy miechy: Artérie: rr. spinales okolitých tepien – aa. radiculares anteriores et posteriores: aa. spinales posteriores (v sulci posterolaterales) – pre zadnú 1/3 miechy, najmä bielu hmotu a. spinalis anterior (vo fissura mediana anterior) – pre predné 2/3 miechy, najmä sivú hmotu Vény: plexus venosi vertebrales interni sa vlievajú do plexus venosi vertebrales externi obaly a priestory miechy: endorhachis – periost canalis vertebralis spatium epidurale: tukové tkanivo, plexus venosi vertebrales interni dura mater arachnoidea mater spatium subarachnoidale: liquor cerebrospinalis pia mater ENCEPHALON Rhombencephalon (kosohranový mozog) Myelencephalon (Medulla oblongata, predĺžená miecha) Metencephalon (zadný mozog) – Pons (most) + Cerebellum (mozoček) Mesencephalon (stredný mozog) Prosencephalon (predný mozog) Diencephalon (medzimozog) Telencephalon (koncový mozog) Truncus encephali (mozgový kmeň) Medulla oblongata (Bulbus medullae spinalis) Pons Mesencephalon TRUNCUS ENCEPHALI Medulla oblongata od decussatio pyramidum (miesto kríženia tractus corticospinales anteriores) po sulcus bulbopontinus (priečna ryha medzi medulla oblongata a pons) pozdĺžne členenie: – ventrálne: fissura mediana anterior foramen caecum pyramis: val podmienený priebehom tractus corticospinalis sulcus anterolateralis: miesto výstupu n. hypoglossus (HN XII) oliva sulcus posterolateralis: miesto výstupu n. glossopharyngeus (HN IX), n. vagus (HN X), n. accessorius (HN XI) pedunculi cerebellares inferiores: spájajú predĺženú miechu s mozočkom – dorzálne: sulcus medianus posterior fasciculus gracilis – tuberculum gracile sulcus intermedius fasciculus cuneatus – tuberculum cuneatum dolná časť fossae rhomboideae Pons kraniálne nadväzuje na predĺženú miechu štruktúry: – ventrálne: sulcus bulbopontinus: miesto výstupu n. abducens (HN VI) sulcus basilaris: brázda na ventrálnej ploche, prebieha v nej a. basilaris pedunculi cerebellares medii: spájajú most s mozočkom angulus pontocerebellaris (trigonum pontocerebellare): miesto výstupu n. facialis (HN VII), n. vestibulocochlearis ( HN VIII) linea trigeminofacialis: tvorí laterálnu hranicu mosta, medzi výstupmi n. trigeminus (HN V) a n. facialis (HN VII), oddeľuje most a mozoček – dorzálne: horná časť fossae rhomboideae Fossa rhomboidea zadná plocha predĺženej miechy a mosta, tvorí spodinu IV. mozgovej komory popis štruktúr: sulcus medianus fossae rhomboideae: spája canalis centralis s aqueductus cerebri eminentia medialis: laterálne od sulcus medianus sulcus limitans: laterálne od eminentia medialis, hranica medzi alárnou a bazálnou platničkou z vývojového obdobia pars superior – fovea superior, locus coeruleus, colliculus facialis (vyvýšenie podmienené ohybom vlákien n. facialis okolo jadra n. abducens) pars intermedia – striae medullares fossae rhomboideae, area vestibularis a tuberculum acusticum (laterálne od sulcus limitans) pars inferior – trigonum n. hypoglossi: po stranách sulcus medianus (jadro n. hypoglossus) trigonum n. vagi: laterálne od trigonum n. hypoglossi (uložené jadro n. vagus) area postrema: kaudálne od trigonum n. vagi fovea inferior: vo vrchole trigonum n. vagi Mesencephalon pozdĺž stredného mozgu prebieha aqueductus cerebri (spája III. a IV. mozgovú komoru) pedunculi cerebellares superiores: spájajú mesencephalon s mozočkom časti: pedunculus cerebri: – crus cerebri (basis pedunculi): fossa interpeduncularis, substantia perforata posterior výstup n. oculomotorius (HN III) – tegmentum: substantia nigra, nucleus ruber tectum mesencephali: posteriórne k aqueductus cerebri – colliculus superior – brachium colliculi superioris (súčasť zrakovej dráhy) – colliculus inferior – brachium colliculi inferioris (súčasť sluchovej dráhy) – výstup n. trochlearis (HN IV) CEREBELLUM vermis cerebelli: stredová nepárová časť mozočka hemispheriae cerebelli: mozočkové pologule lobus anterior lobus posterior lobus flocculonodularis vonkajšie členenie: folia cerebelli fissurae cerebelli: fissura prima: medzi lobus anterior a lobus posterior fissura posterolateralis: medzi lobus posterior a lobus flocculonodularis vnútorná štruktúra: cortex cerebelli: kôra, sivá hmota arbor vitae: biela hmota nuclei cerebelli: sivá hmota nuclei fastigii nucleus emboliformis nuclei globosi nucleus dentatus pedunculi cerebellares superiores: spojenie so stredným mozgom pedunculi cerebellares medii: spojenie s mostom pedunculi cerebellares inferiores: spojenie s predĺženou miechou anatomické delenie mozočka: vermis cerebelli hemispheriae cerebelli lingula vinculum lingulae lobulus centralis ala lobuli centralis culmen lobulus quadrangularis fissura prima declive lobulus simplex folium lobulus semilunaris superior fissura horizontalis tuber lobulus semilunaris inferior pyramis lobulus biventer uvula tonsilla cerebelli fissura posterolateralis nodulus flocculus DIENCEPHALON uložený nad a pred stredným mozgom sulcus hypothalamicus: hranica medzi senzitívnymi a motorickými časťami medzimozgu Hypothalamus uložený pod sulcus hypothalamicus, primárne centrum ANS štruktúry: corpus mammillare tuber cinereum infundibulum – hypophysis chiasma opticum – tractus opticus Thalamus (thalamus dorsalis) – senzitívny nad sulcus hypothalamicus, najväčšia časť medzimozgu 'brána vedomia', prijíma všetky senzitívne informácie (okrem čuchových) štruktúry: Facies medialis thalami – adhaesio interthalamica stria medullaris thalami – tenia thalami Facies posterior (dorsalis) sulcus terminalis – v. thalamostriata superior, stria terminalis tenia choroidea – plexus choroideus ventriculi lateralis lamina affixa tuberculum anterius thalami pulvinar thalami Metathalamus: corpus geniculatum mediale – podkôrové centrum sluchu corpus geniculatum laterale – podkôrové centrum zraku Epithalamus dorzomediálne od thalamus, spojený s limbickým systémom štruktúry: habenula – trigonum habenulae commissura habenularum – epiphysis (corpus pineale) commissura posterior TELENCEPHALON hemispheriae cerebri: cortex cerebri – sivá hmota corpus medullare – biela hmota bazálne gangliá – sivá hmota čuchový a limbický systém Facies: superolateralis, medialis et inferior Margo: superior, medialis, inferior Lobus: frontalis, parietalis, occipitalis, temporalis a lobus insulae Polus: frontalis, occipitalis et temporalis Cortex cerebri – gyrifikácia Facies superolateralis cerebri sulcus lateralis – ramus anterior, ascendens et posterior sulcus centralis Lobus frontalis gyrus praecentralis sulcus praecentralis gyrus frontalis superior sulcus frontalis superior gyrus frontalis medius sulcus frontalis inferior gyrus frontalis inferior – pars orbitalis ramus anterior sulci lateralis – pars triangularis ramus ascendens sulci lateralis – pars opercularis ramus posterior sulci lateralis Lobus parietalis gyrus postcentralis sulcus postcentralis lobulus parietalis superior sulcus intraparietalis lobulus parietalis inferior – gyrus supramarginalis: obtáča koniec sulcus lateralis – gyrus angularis: obtáča koniec sulcus temporalis superior Lobus occipitalis gyri occipitales sulcus occipitalis transversus sulcus lunatus incisura praeoccipitalis Lobus temporalis gyrus temporalis superior – gyri temporales transversi sulcus temporalis superior gyrus temporalis medius sulcus temporalis inferior gyrus temporalis inferior Insula limen insulae sulcus circularis insulae gyrus longus insulae – sulcus centralis insulae gyri breves insulae Facies medialis cerebri gyrus frontalis medialis lobulus paracentralis praecuneus sulcus parietooccipitalis cuneus – sulcus calcarinus sulcus cinguli gyrus cinguli – isthmus gyri cinguli sulcus corporis callosi corpus callosum – rostrum, genu, truncus, splenium septum pellucidum – laminae et cavum septi pellucidi fornix – columna, corpus et crus fornicis gyrus paraterminalis area subcallosa Facies inferior cerebri gyrus rectus sulcus olfactorius bulbus olfactorius – tractus olfactorius – stria olfactoria medialis et lateralis trigonum olfactorium – substantia perforata anterior
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