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THE BRAIN AND CRANIAL NERVES A. BRAIN Information processing takes place at several levels within the central nervous system. Describe where and what types of processing occur at the lowest, intermediate, and highest levels. At the lowest level (spinal cord) are reflex responses to sensory input. There is not consciousness involved. Lower regions of the brain, such as the brainstem, basal ganglia, and cerebellum, control most unconscious activities, such as blood pressure, respiration, muscle tone, coordination, and posture. At the highest level, the cerebrum integrates conscious activities, processes and stores information, and provides the neuronal circuitry for abstract thought processes. 1. PRINCIPAL PARTS The adult brain consists of 4 main parts. Briefly describe the location of each of the following: Brainstem -- The brain stem consists of the medulla oblongata, pons, and midbrain. Its lower end is a continuation of the spinal cord. Diencephalon -- The diencephalon, sitting atop the midbrain of the brainstem, consists primarily of the hypothalamus and the thalamus. Cerebrum -- The cerebrum spreads over the diencephalon like the cap of a mushroom and occupies most of the space of the cranial vault. Cerebellum -- The cerebellum is inferior to the cerebrum and posterior to the brainstem. 2. PROTECTION AND COVERINGS Give a brief description of the cranial vault and the meninges. The brain is protected by the cranial bones that form the cranial vault, and the cranial meninges. The cranial meninges are continuous with the spinal meninges and surround the brain much as they do the spinal cord. There are, however, two major 115 differences: separations of the dura to form the dural (venous) sinuses) and folds of the dura to separate the cerebral and cerebellar hemispheres. Describe each of the following: Dural sinus -- The dura mater consists of an inner and an outer portion. In certain places these layers are separated to form large venous structures called the dural sinuses (superior sagittal, inferior sagittal, straight, and transverse (lateral) sinuses). are the routes of venous blood flow from the brain. Falx cerebri -- A second difference is the formation of three large sheet-like extensions of the dura that separate the larger parts of the brain. The falx cerebri is a large extension of the dura that extends between the two cerebral hemispheres. Falx cerebelli -- The falx cerebelli is a large extension of the dura mater that extends between the two cerebellar hemispheres. Tentorium cerebelli -- The tentorium cerebelli separates the cerebral hemispheres from the cerebellar hemispheres. 3. CEREBROSPINAL FLUID (CSF) Describe the flow of cerebrospinal fluid (CSF). The brain and spinal cord are nourished and protected against injury by cerebrospinal fluid (CSF). CSF continuously circulates through the subarachnoid space around the brain and through the cavities within the brain called the ventricles and the central canal of the spinal cord. There are four CSF-filled cavities within the brain called the ventricles. Ventricles 1 and 2 are the two lateral ventricles (right and left), one located within each hemisphere of the cerebrum. Each lateral ventricle empties via an interventricular foramen (of Monro) into the third ventricle, a vertical slit located in the midline between the right and left halves of the thalamus. The third ventricle drains via the cerebral aqueduct (of Sylvius) into the fourth ventricle, located between the brain stem and the cerebellum. 116 From the fourth ventricle CSF moves through the median aperture to enter the central canal of the spinal cord, and through the two lateral apertures to enter the subarachnoid space. Cerebrospinal fluid contributes to homeostasis in three ways. Name and describe them. Mechanical protection -- The fluid serves as a shock-absorbing medium to prevent the brain and spinal cord from crashing against their bony surroundings. In essence, CSF “floats” the CNS within the bony chambers of the cranial vault and the vertebral canal. Chemical protection -- CSF provides an optimal chemical environment for accurate neuronal activity; slight changes in ionic composition seriously disrupt neuronal homeostasis. Circulation -- CSF is a medium for exchange of nutrients and wastes between the blood and the nervous tissue. Describe the functions of the choroid plexuses, ependymal cells, and the arachnoid villi (granulations) as concerns cerebrospinal fluid. CSF is produced by the choroid plexuses, networks of blood capillaries covered by ependymal cells in the walls of the ventricles that bulge into the ventricular cavity. The capillaries become covered by the ependymal cells lining the ventricles, so that the CSF formed is an ultrafiltrate of the blood. This relationship of the blood capillaries with ependyma creates the blood-cerebrospinal fluid barrier, permitting certain substances to pass into the CSF, but excluding others that may be harmful to the CNS. From the subarachnoid space around the brain, the CSF is reabsorbed into the blood by finger-like projections of the arachnoid membrane called arachnoid villi or granulations that project into the superior sagittal sinus. Normally, CSF is reabsorbed into the blood at the same rate it is made by the choroid plexuses (about 20 mL/hour). What would occur if production exceeded reabsorption? 117 4. BRAIN STEM a. MEDULLA Describe the medulla oblongata: Location -- The medulla oblongata is continuous with the inferior spinal cord and the superior pons. It lies just inside the cranial vault, superior to the foramen magnum. Gray matter -- The gray matter of the medulla consists of nuclei that function in the regulation of processes necessary for immediate survival: blood pressure, heart rate, respiration, swallowing, coughing, vomiting, etc. White matter -- The medulla contains all ascending and descending tracts that communicate between the brain and spinal cord. These tracts form the white matter of the medulla. Cranial nerves -- Also found in the medulla gray matter are the motor nuclei for cranial nerves XII, XI, X, IX, and part of VIII. The sensory neuron cell bodies for these cranial nerves are located outside the medulla in various ganglia. b. PONS Describe the pons: Location -- The pons lies directly superior to the medulla, anterior to the cerebellum, and inferior to the midbrain. Gray matter -- The gray matter of the pons consists of two nuclei that are involved in the alteration of basic respiratory pattern. White matter -- The pons consists mostly of white matter, tracts passing between the lower and higher CNS structures, as well as communicating the cerebellum with the rest of the CNS. 118 Cranial nerves -- In addition to the centers, the motor nuclei of cranial nerves part of VIII, VII, VI, and V are also located in the pontine gray matter. The sensory neuronal cell bodies are located in ganglia outside the pons. c. MIDBRAIN Describe the midbrain: Location -- The midbrain extends from the superior portion of the pons to the inferior border of the diencephalon. Dorsal portion -- The dorsal portion of the midbrain, called the tectum (roof), is divided into four rounded eminences (a natural elevation) of gray matter called the corpus quadrigemina. There are two superior colliculi and two inferior colliculi The two upper elevations are the superior colliculi, gray matter nuclei associated with reflex movements of the eyes, head, and neck in response to visual and other stimuli. The two lower elevations, the inferior colliculi, consists of gray matter nuclei involved in reflex movements of the head and trunk in response to auditory stimuli). Ventral portion -- The ventral portion of the midbrain is all white matter, consisting of two groups of fiber tracts: the cerebral peduncles and the medial lemniscus. The cerebral peduncles pass motor fibers from the cerebrum through the brain stem. They also carry some sensory information passing to the cerebrum from the spinal cord. The medial lemniscus is a band of sensory fiber tracts passing from the lower CNS to the thalamus. In particular, the medial lemniscus carries impulses for discriminative touch, proprioception, pressure, and vibrations. Cranial nerves -- Also located in the tectum are the motor neurons for cranial nerves IV and III; the sensory neuron cell bodies associated with these cranial 119 nerves are located in the ganglia outside the midbrain. 5. DIENCEPHALON a. THALAMUS Describe the thalamus of the diencephalon. The thalamus (“inner chamber”) is an oval structure above the midbrain, forming 4/5 of the diencephalon. The thalamus consists of paired masses of gray matter organized into nuclei that form the lateral walls of the third ventricle. The two halves of the thalamus, right and left, are joined by the massa intermedia, a bridge of gray matter that crosses the midline through the third ventricle. The thalamus is the principal relay station for sensory impulses, except smell, that reach the cerebral cortex from the spinal cord, brain stem, and other parts of the cerebrum. The neurons of the thalamus provide some crude appreciation of some sensations (pain, temperature, pressure) and have some role in emotions and memory. Each pair of nuclei within the thalamus has a specific role in this relay function in that each is specific for a specific modality (sensation). b. HYPOTHALAMUS Describe the hypothalamus of the diencephalon. The hypothalamus is small portion of the diencephalon (about 1/5) lying below the thalamus. Like the thalamus, the hypothalamus is also primarily gray matter dividing into pairs of nuclei. Each nucleus pair is responsible for the control of a particular homeostatic function. The hypothalamus is, therefore, one of the major controllers of homeostasis. 120 Functions: 1) integration between the nervous and endocrine systems 2) control of the autonomic nervous system 3) regulation of rage and aggression 4) regulation of body temperature 5) regulation of food intake 6) regulation of thirst 7) regulation of sleep-wake patterns 8) regulation of sex drive. 6. CEREBRUM Describe the cerebrum: Location -- Supported on the diencephalon and brain stem and forming the bulk of the brain, thus filling most of the cranial vault, is the cerebrum. Cortex -- The surface of the cerebrum is composed of gray matter 2-4 mm thick called the cerebral cortex. It consists of approximately 6 billion neuronal cell bodies and their associated dendritic zones. White matter -- Beneath the cerebral cortex is the cerebral white matter consisting of axons traveling to and from the cortex. It is often referred to as the internal capsule. Function -- The neurons of the cerebral cortex are the seat of intelligence, consciousness, and where we “see,” “hear,” “smell,” “taste,” and “feel.” Gyrus/sulcus -- During development, as the gray matter outgrows the white matter, the gray matter is thrown into rolls and it folds upon itself. Each shallow fold is a gyrus and each groove between the gyri is a sulcus. Fissures -- The deep grooves of the cerebrum are called fissures. The three most prominent fissures are the longitudinal fissure, separating the two cerebral hemispheres, the lateral fissure, lying between the temporal and parietal lobes, and the transverse fissure, between the cerebrum and the cerebellum. Corpus callosum -- The two cerebral hemispheres are connected internally by a large bundle of whiter matter called the corpus callosum. 121 a. LOBES Name the lobes of the cerebrum named for the bones which cover them. Each cerebral hemisphere is further subdivided into lobes by sulci or fissures. The lobes are named for the cranial bones that cover them: frontal, parietal, temporal, and occipital. What is the insula? A fifth portion of the cerebrum, the insula, cannot be seen from the exterior of the cerebrum. It lies deep within the lateral fissure, under the parietal, temporal, and frontal lobes. b. WHITE MATTER Describe the following types of fibers found in the cerebral white matter: Association -- Association fibers transmit impulses between the gyri of one hemisphere, associating information between different inputs and outputs. Commissural -- Commissural fibers transmit impulses from the gyri one of the hemispheres to the gyri of the other hemisphere, passing through either the corpus callosum, the anterior commissure, or the posterior commissure. Projection -- Projection fibers form descending or ascending tracts that communicate the cerebral cortex with the spinal cord and other lower brain structures. c. GRAY MATTER What are the basal ganglia? The basal ganglia (cerebral nuclei) consist of several groups of paired nuclei found within the white matter of the cerebrum. The nuclei are interconnected by many nerve fibers with each other, and receive numerous inputs from the cerebral cortex, thalamus, and hypothalamus. What are their functions? The basal ganglia function in the control of large, learned, semi-voluntary skeletal muscle movements, such as 122 swinging the arms when walking, laughing, etc., and in the regulation of muscle tone. d. LIMBIC SYSTEM What is the limbic system? The limbic system is a ring of structures surrounding the inner border of the cerebrum and the floor of the diencephalon, encircling the midbrain. It is formed by gyri of the insular lobe, nuclei associated with the basal ganglia, hypothalamus, and the thalamus, the olfactory bulbs, and bundles of interconnecting white matter. What is its function? The limbic system, often called the emotional brain, functions in emotional aspects of behavior related to survival, memory, smell, pleasure and pain, rage and aggression, docility and tameness, affections, sexual desire, etc. e. FUNCTIONAL AREAS OF THE CEREBRAL CORTEX What are the functional areas of the cerebral cortex? Specific types of sensory, motor, and integrative signals are processed in specific regions of the cerebral cortex called functional areas. In general, the areas are divided into three types: primary sensory, primary motor, and association. Describe the following: Sensory areas -- Sensory areas receive sensory input, and integrate and interpret the sensations. There are at least 20 different specific areas for each of the individual modalities. Motor areas -- Motor areas contain the neuronal cell bodies of origin for practically all motor activities. They are divided into at least 5 different areas associated with muscular activity. Association areas -- Association areas make up several main areas that serve to connect the sensory and motor areas. They provide integrative and interpretive functions, such as memory, emotion, relationships between sensations, etc. 123 7. CEREBELLUM Describe the cerebellum. The cerebellum is located in the inferior and posterior aspect of the cranial cavity, inferior to the occipital lobes of the cerebrum and posterior to the brain stem. The cerebellum is separated from the cerebrum by a fold of dura known as the tentorium cerebelli. The cerebellum is designed like the cerebrum, with 2 cerebellar hemispheres divided into 3 lobes each, a cerebellar cortex, an inner white matter, and several cerebellar nuclei. The white matter of the cerebellum serves to connect the cerebellar cortex and the cerebellar nuclei with each other and with all of the other pertinent CNS structures. The cerebellar gray matter functions to compare intended bodily movement with what is actually happening, to help in regulating smooth, sequential skeletal muscle contractions, and to control muscle tone, balance, and posture. B. CRANIAL NERVES Describe the cranial nerves. How many are there? From where do they originate? How do they exit the skull? There are 12 pairs of cranial nerves, 10 of which originate in the brainstem. All pass through specific foramina of the skull to leave the cranial cavity. Where are the cell bodies of origin of the motor and sensory components of the cranial nerves? Motor neuron cells bodies are in the gray matter of the brainstem. The sensory neuron cell bodies are all found in ganglia located outside the brain. How are the cranial nerves designated? Roman numerals indicate the order in which they arise from the brain, anterior to posterior. The names indicate their distribution or function. Name the cranial nerves, describe there origin from the brainstem, give their sensory function(s) (if applicable), and the motor function(s) (if applicable). 124 I Olfactory origins -- arises from the olfactory epithelium within the nasal cavity sensory functions -- sense of smell motor function - none II Optic origins -- arises from retinal epithelium of the eye sensory functions -- sense of sight motor functions -- none III Oculomotor origins -- arises from the midbrain sensory functions -- proprioceptive to muscles served motor functions -- levator palpebrae superioris, superior rectus, medial rectus, inferior rectus, and inferior oblique muscles of eyeball; parasympathetic to ciliary muscle of eye for focusing lens and to sphincter and dilator pupillae muscle of iris for regulating pupillary diameter IV Trochlear origins -- arises from the midbrain sensory functions -- proprioceptive to muscle served motor functions -- superior oblique muscle of eyeball V Trigeminal origins -- arises from the midbrain sensory functions -- touch, pain, and temperature from skin of front half of the head, eyeball, nasal cavity, oral cavity (not taste), part of pharyngeal mucosa motor functions -- muscles of mastication (chewing) (masseter, temporalis, lateral and medial pterygoids) VI Abducens origins -- arises from the pons sensory functions -- proprioception to muscle served motor functions -- lateral rectus muscle of eyeball VII Facial origins -- arises from the pons sensory functions -- anterior 2/3 of tongue for taste, proprioceptive for muscles of facial expression motor functions -- muscles of facial expression, lacrimal and salivary glands secretion. 125 VIII Auditory (vestibulocochlear) origins -- arises from the cochlear and vestibular portions of the inner ear sensory functions -- senses of equilibrium and hearing motor functions -- none IX Glossopharyngeal origins -- arises from the medulla sensory functions -- posterior 1/3 of tongue for taste, carotid sinus and body related to blood pressure control, proprioceptive for muscles of swallowing motor function -- muscles of swallowing and salivary glands X Vagus origins -- arises from the medulla sensory functions -- aortic sinus and body related to blood pressure control, mucosa of respiratory and digestive systems motor functions -- muscles of the bronchial tree, digestive tract, pancreas, liver, and glands of the GI system XI Accessory origins -- arises from the medulla sensory functions-- proprioceptive for the muscles served motor functions -- muscles of the pharynx for swallowing, larynx, soft palate, sternocleidomastoid, and trapezius. XII Hypoglossal origins -- arises from the medulla sensory functions -- proprioceptive for the muscles served motor functions -- intrinsic and extrinsic muscles of the tongue 126