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Neuroanatomy Objectives

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1 ` 2019 Neuroanatomy Objectives Cerebral Cortex Cortical Lobes Frontal Lobe Parietal Lobe Occipital Lobe Temporal Lobe Limbic Lobe (Insula) Major Cortical Fissures and Lobe Division Landmarks Central Sulcus (CS) Lateral Fissure (LF) Preoccipital Notch Parieto-occipital Fissure (POF) Frontal Lobe Central Sulcus Precentral Gyrus (Primary Motor Cortex – M1) Precentral Sulcus Brocca’s Area (Expressive Speech) Prefrontal Cortex (Cognition) Parietal Lobe Postcentral Sulcus Postcentral Gyrus (Primary Sensory Cortex – S1) Central Sulcus Occipital Lobe Calcarine Fissure Primary Visual Cortex (V1) Temporal Lobe Superior Temporal Sulcus Heschl’s Gyrus (Primary Auditory Area –A1) Wernicke’s Area (Comprehensive Speech Area) Limbic Lobe Structures Cingulate Gyrus (Cognition). Cingulate Sulcus Parahippocampal Gyrus (Memory) Uncus – Near Primary Olfactory Cortex (Smell). Summary of Major Functional Centers of the Cerebral Cortex Head and Neck Motor Control – Precentral Gyrus (M1), cranial nerves V, VII, IX, X, XII. 2 Head and Neck Sensory Perception – Post Central Gyrus (S1), head area receives sensory information largely from cranial nerve V. Speech – Broca’s Area (speech production) and Wernicke’s Area (speech comprehension). Hearing – Primary Auditory Cortex (A1) Vision – Primary Visual Cortex (V1) (within the depths of the calcarine fissure) Smell –Limbic Cortex (Near Uncus) Interhemispheric Commissures Corpus Callosum Anterior and Posterior Commissures Brainstem Diencephalon Thalamus (sensory relay to cortex and motor relay to cortex) Hypothalamus (basic physiologic drives and homeostasis) 3rd Ventricle Midbrain Superior Colliculus (visual system relay) Inferior Colliculus (auditory system relay) Cerebral Aqueduct (Aqueduct of Sylvius) Pons and Cerebellum Superior Cerebellar Peduncle - white matter pathway (i.e., nerve fibers) connecting midbrain and cerebellum. Middle Cerebellar Peduncle -white matter pathway connecting pons and cerebellum. Inferior Cerebellar Peduncle -white matter pathway connecting medulla and cerebellum. 4th Ventricle Medulla Pyramids Olives 4th Ventricle Blood Supply of Central Nervous System Circle of Willis Anterior Communicating Artery Anterior Cerebral Artery Internal Carotid Artery Posterior Communicating Artery Posterior Cerebral Artery Anterior Circulation (Internal Carotid Artery) Internal Carotid Artery Anterior Cerebral Artery Anterior Communicating Artery Middle Cerebral Artery Posterior Communicating Artery 3 Posterior Circulation (Vertebral and Basilar Arteries) Vertebral Arteries Posterior Spinal Arteries Posterior Inferior Cerebellar Artery (PICA) Anterior Spinal Artery Basilar Artery Anterior Inferior Cerebellar Artery (AICA) Superior Cerebellar Artery Posterior Cerebral Artery CSF Cavities and Passageways Lateral Ventricle Foramen of Monro 3rd Ventricle Cerebral Aqueduct 4th Ventricle Cisterna Magna Superior Sagittal Sinus CSF Circulation Interventricular Lateral Ventricles 3rd Ventricle Foramen of Monro Cisterna Magna Aqueduct of Sylvius Superior Sagittal (Cerebral Aqueduct) Sinus (Arachnoid Granulations) 4th Ventricle Confluence of Sinuses Transverse Sinus Sigmoid Sinus Internal Jugular Vein 4 Meninges Dura matter - The external covering that forms the outermost layer of the meninges. Is dense connective tissue. Contains the sinuses and forms folds of septa (i.e. falx cerebri). Arachnoid matter - Middle layer of meninges. Web-like connective tissue matrix that does not enter sulci of cerebral cortex. The arachnoid is partly separated from the pia matter by the subarachnoid space which contains cerebrospinal fluid (CSF). Pia matter - Inner layer of meninges. Thin connective tissue membrane that adheres to the nervous tissue (faithfully follows the underlying nervous tissue of the central nervous system). Folds of Dura Matter Falx cerebri – Sickle shaped sheet of dura that forms a partition between the two cerebral (cortical) hemispheres. Tentorium cerebelli- Fold of dura that separates the cerebral hemisphere from the cerebellum. (Forms roof over posterior cranial fossa). Falx cerebelli-Small sickle shaped fold of dura that extends slightly between the cerebellar hemispheres. Venous Sinuses of the Dura Matter Superior sagittal sinus-Located within superior part of falx cerebri. Contains many arachnoid villa that constitute the main site of passage of CSF into the venous blood. Drains into the confluens of sinuses. Inferior sagittal sinus- Located on the free margin (inferior border) of the falx cerebri. Drains into the straight sinus. Straight sinus- Located in the tentorium cerebelli. Drains into the confluens of sinuses. Transverse sinus- Drains into the sigmoid sinus. Sigmoid sinus – Drains into the internal jugular vein. Superior and inferior petrosal sinuses- Both drain posteriorly. The inferior petrosal sinus drains into internal jugular vein and the superior petrosal sinus into sigmoid sinus. Cavernous sinus- Drains posteriorly into the superior and inferior petrosal sinuses. Cranial Nerves (CN’s) CN I – Olfactory CN VII - Facial CN II – Optic CN VIII -Vestibulocochlear CN III – Oculomotor CN IX - Glossopharyngeal CN IV – Trochlear CN X - Vagus CN V – Trigeminal CN XI - Accessory CN VI - Abducens CN XII-Hypoglossal 5 CRANIAL FOSSA I. Cranial Fossae: Anterior, Middle and Posterior Cranial Fossae A. Anterior cranial fossa- Formed by frontal bone (orbital plate), ethmoid bone (crista galli, cribriform plate) and the sphenoid bone (lesser wings). 1. Foramen: a. Cribriform plate - (for CN I) B. Middle cranial fossa – Formed by the sphenoid bone (greater wings, sella turcica), and temporal bone (petrous part, inner surface of squamous part). 1. Foramen: a. Optic canal - CN II and ophthalmic artery. b. Superior orbital fissure - Ophthalmic vein, CN V1, CN III, CN IV, CN VI, sympathetic fibers. c. Foramen rotundum - CN V2. d. Foramen ovale - CN V3. e. Foramen spinosum - Middle meningeal artery. f. Foramen lacerum - Internal carotid artery and greater petrosal nerve. g. Carotid Canal – below middle cranial fossa, contains internal carotid artery. g. Hiatus of greater petrosal nerve - Greater petrosal nerve (of CN VII). i. Hiatus for the lesser petrosal nerve - Lesser petrosal nerve (of CN IX). C. Posterior cranial fossa - Formed by occipital bone, temporal bone (petrous part, mastoid part), and sphenoid bone (body). a. Foramen magnum - Spinal cord, meninges, CN XI, and spinal arteries. b. Jugular foramen - CN’s IX, X and XI, internal jugular vein, sigmoid sinus, inferior petrosal sinus. c. Hypoglossal canal - CN XII. d. Internal acoustic meatus - CN VII, CN VIII, labyrinthine (auditory) artery. 6 Foramina of the Skull Anterior Ethmoidal Forman Located in the anterior frontoethmoidal suture. Contains the anterior ethmoidal branch of the nasociliary nerve (V1), anterior ethmoidal artery, and anterior ethmoidal vein. Carotid Canal Located in the petrous portion of the temporal bone. Contains the internal carotid artery, internal carotid plexus (sympathetic), and deep petrosal nerve (sympathetic) arising from the internal carotid plexus. Condylar Canal Located posterior to occipital condyle. Contains emissary vein linking the vertebral vein with the sigmoid sinus. Also called the posterior condylar canal (see hypoglossal canal for anterior condylar canal). Also may contain an arterial branch from the occipital artery that supplies the dura of the posterior cranial fossa. Foramen Lacerum Located at the medial end or apex of the petrous portion of the temporal bone, basal portion of the occipital bone, and sphenoid bone. It is spatially continuous with the carotid canal. During life the lower part floor of the foramen lacerum is closed with dense fibrous connective tissue and only a few small vessels pass through this foramen from the cavity of the skull to the exterior base of the skull. The main portion contains the internal carotid artery (and internal carotid plexus, deep petrosal nerve) and greater (superficial) petrosal nerve of CN VII. Inferior and anterior the foramen lacerum is continuous with the pterygoid canal. Foramen Magnum Located in the occipital bone. Contains the spinal cord and meninges, spinal portion of the accessory nerve (CN XI), right and left vertebral arteries, anterior and posterior spinal arteries, tectorial membrane and apical ligament of the odontoid process of the axis. Foramen Ovale Located in the greater wing of the sphenoid bone. Contains the mandibular nerve (V3) lesser (superficial) petrosal nerve and accessory meningeal vessels. Foramen Rotundum Located in the greater wing of the sphenoid bone. Contains V2. Foramen Spinosum Located in the greater wing of the sphenoid bone. Contains the middle meningeal artery and vein, and a meningeal branch of the mandibular nerve (a recurrent sensory branch from V3 passing upward from the infratemporal fossa to innervate the cranial dura). 7 Greater Palatine Foramen Located between the maxilla and the palatine bone at the posterior lateral border of the hard palate. Contains the greater (anterior) palatine nerve, greater palatine artery (know up to this point as the descending palatine artery) and corresponding veins. Hiatus for the Greater Petrosal Nerve Located in the tegmen tympani (roof of middle ear) of the petrous temporal bone, in front of the arcuate eminence. Contains the greater (superficial) petrosal nerve of CN VII. Hiatus for the Lesser Petrosal Nerve Located in the tegmen tympani of the petrous temporal bone, about 3 mm anterolateral to the hiatus for the greater petrosal nerve. Contains the lesser (superficial)
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