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Gross Brain and Spinal Cord BLOCK 3 – 2011-12 Robert R. Terreberry, PhD Room 142 Ph 864.327.9827 [email protected] Layers of Scalp Scalp B O N E Skin Connective Tissue Aponeurosis Loose CT Pericranium Frontalis Muscle Epicranial Aponeurosis Frontalis muscle Occipitalis Muscle Epicranial Aponeurosis Occipitalis muscle Innervation of Scalp and Face Blood Supply of Scalp & Face Skull Views • Superior – Norma verticalis • Inferior – Norma basalis • Posterior – Norma occipitalis • Anterior – Norma frontalis • Lateral – Norma lateralis Norma Verticalis • • • • • • • • Frontal bone Parietal bone Occipital bone Coronal suture Sagittal suture Bregma Lambda Parietal foramen = potential entry for infection Inner Calvaria • • • • • • Frontal bone Parietal bone Coronal suture Sagittal suture Frontal sinus Groove for superior sagittal sinus- important venously • Groove for middle meningeal artery • Granular foveolae- resorption of CSF into venous drainage Cranial Fossae Anterior Middle Posterior Anterior Cranial Fossa • Orbital plate of frontal bone • Cribriform plate of ethmoid bone • Lesser wing of sphenoid bone • Body of sphenoid (Not visible from this aspect) Anterior Cranial Fossa • Crista galli of ethmoid bone • Frontal sinus • Anterior clinoid process • Optic groove • Optic canal Middle Cranial Fossa • Lesser wing of sphenoid bone • Anterior clinoid process • Chiasmatic sulcus • Petrous temporal • Dorsum sellae of sphenoid bone Middle Cranial Fossa • Squamous temporal bone • Parietal bone • Greater wing of sphenoid bone Middle Cranial Fossa • • • • • The sella turcica (literally Turkey Chair - indirectly translating to Turkish Chair) is a saddle-shaped Sella turcica (outlined) Tuberculum sellae Hypophysial fossa Dorsum sellae Located anteriorly to the hypophyseal fossa is the tuberculum sellae dorsum sellae which is continuous with the clivus, inferoposteriorly. The dorsum Middle Cranial Fossa • Foramen ovale • Foramen spinosum • Foramen lacerum = filled with cartilage (little nerves but nothing of great magnitude… like the carotid artery) Middle Cranial Fossa • Carotid groove • Hiatus for greater petrosal nerve • Hiatus for lesser petrosal nerve Posterior Cranial Fossa • Basioccipital portion of occipital bone • Petrous temporal • Internal occipital crest • Internal occipital protruberance Posterior Cranial Fossa • Foramen magnum • Jugular foramen • Internal acoustic meatus • Hypoglossal canal Meninges • Dura mater Pachymeninx Tough Mother Outer • Arachnoid (Spider-webbed) Middle Leptomeninges • Pia Mater Intimate Mother Inner Meninges Cranial Dura Mater Spinal Dura Mater Spinal Dura Subdural Space Dura Mater Epidural Space • Loose CT • Fat • Epidural venous plexus Spinal Dura • Ends at S2 vertebral level • Spinal cord ends at L2 • Filum terminale externum S2 and attaches to the coccyx Terminal end Cranial Dura Cranial Dura Meningeal layer Endosteal layer Fused Cranial Dura Cranial Dura • Endosteal layer • Thick bundles of collagen • Cell rich • Numerous blood vessels • Meningeal layer • Thinner than endosteal layer • Inner layer smooth with squamous mesothelium • Inner layer forms sheet-like extensions Cranial Dura – Blood Supply • Anterior meningeal as. • Off ethmoidal as. • Middle meningeal a. • Off maxillary artery • Largest meningeal artery • Posterior meningeal brs. • Off vertebral /occipital as. Cranial Dura - Innervation Spinal Arachnoid Pia mater Arachnoid Dura mater Spinal Arachnoid • Ends at S2 vertebral level • Filum terminale externum S2 Terminal end Cranial Arachnoid • Similar to spinal arachnoid structurally • Does not extend into sulci or fissures • Enlargements of subarachnoid space are termed cisterns Spinal Pia Pia mater Arachnoid Dura mater Spinal Pia Conus Medullaris • Ends at L1/L2 vertebral level • Filum terminale internum conus medullaris Filum Terminale Internum Pia Mater • Tightly adherent to surfaces of CNS • Follows sulci and fissures • Highly avascular • Spinal pia mater is firmer and less vascular than cranial pia mater Cranial Pia Mater • Invaginates to form tela choroidea • 3rd ventricle • 4th ventricle • Forms choroid plexuses • 3rd ventricle • 4th ventricle • Lateral ventricles Cranial Dural Folds Falx Cerebri Falx Cerebelli Cranial Dural Folds Falx Cerebri Tentorium Cerebelli Cranial Dural Folds Falx Cerebri Tentorium Cerebelli Cranial Dural Folds Cranial Dural Folds Falx Cerebri Falx Cerebelli Cranial Dural Folds Hypophysis Diaphragma Sella Sphenoid Sinus Pons Spinal Cord 8 Cervical 12 Thoracic 5 Lumbar 5 Sacral 1 Coccygeal Spinal Cord Dorsolateral Sulcus Dorsointermediate Sulcus Dorsal Median Sulcus (Dorsal, in situ) Cervical Segment C8 Dorsal Median Sulcus Dorsointermediate Sulcus Dorsolateral Sulcus Ventrolateral Sulcus Ventral Median Fissure Thoracic Segment T10 Dorsal Median Sulcus Dorsolateral Sulcus Ventrolateral Sulcus Ventral Median Fissure Thoracic (T10) Dorsal Horn Lateral Horn Ventral Horn Thoracic Gray Matter (T10) Lissauer’s Tract Substantia Gelatinosa Nucleus Proprius IML VH Clarke’s Nucleus Cervical Enlargement (C8) DREZ FC LCST FG STT Thoracic (T10) DREZ FG LCST STT Medulla Ventral Medulla Olive Pyramid Ventral Median Fissure Pyramidal Decussation Ventral Medulla Post-olivary Sulcus Pre-olivary Sulcus Pyramid Lateral Olive Medulla CN IX CN X CN XI Ventral CN XII Medulla CN IX CN X CN XI CN XII Olive Ventrolateral Medulla Rhomboid Fossa of 4th Ventricle Obex Gracile Tubercle Dorsal Cuneate Tubercle Pons Ventral Pons Basilar Pons Basilar Sulcus Ventral Pons CN V CN VI CN VII CN VIII Ventral Pons CN VII CN V CN VIII Ventrolateral CN VI Pons CN V Lateral Middle Cerebellar Peduncle Pons Facial Colliculus Dorsal Rhomboid Fossa of 4th Ventricle Midbrain Ventral Midbrain Interpeduncular Fossa CN III Crus Cerebri Ventral Midbrain CN III Interpeduncular Fossa Ventral Crus Cerebri Midbrain Superior Colliculus Inferior Colliculus CN III Crus Cerebri Lateral Midbrain Superior Colliculus Inferior Colliculus CN IV Dorsal Midbrain Superior Brachium Sup. Coll. Inf. Coll. Dorsal Inferior Brachium CN IV Cerebellum Midbrain Pons 4th Vent Medulla Mid-sagittal Cerebellum Posterosuperior Cerebellar Peduncles Midbrain SCP Pons MCP Medulla ICP Cerebellar Peduncles SCP MCP Ventral ICP Cerebellum Anterior Lobe Posterior Lobe Posterosuperior PF Cerebellum Primary Fissure Anterior Lobe Flocculonodular Lobe Posterior Lobe Posterolateral Fissure Mid-Sagittal Cerebellum Anterior Lobe Posterior Lobe Anterior Lobe Flocculonodular Lobe Posterior Lobe Cerebellum Vermis Paravermis Lateral Hemisphere Cerebellar Cortex Granular layer Deep Cerebellar Nuclei Fastigial nucleus Globose nucleus Emboliform nucleus Dentate nucleus FGED Diencephalon Interventricular Foramen Lamina Terminalis Mid-sagittal Posterior Commissure 3rd Ventricle Diencephalon Thalamus MI Hypothalamus Mid-sagittal Pineal Gland Diencephalon Tuber Cinereum Mamillary Body Optic Chiasm Infundibulum Mid-sagittal Diencephalon Optic Nerve Optic Chiasm Median Eminence Optic Tract Ventral Mamillary Body Cerebral Hemispheres Interhemispheric Fissure Gyri Dorsal Sulci Brodmann’s Areas Select Cortical Areas Functional Designation Brodmann’s Anatomical Name Primary Motor Cortex Area 4 Precentral Gyrus Premotor Cortex Area 6 (lateral) Sup/Mid Frontal Gyri Frontal Eye Fields Area 8 Middle Frontal Gyrus Supplementary Motor Area Area 6 (medial) Sup. Frontal Gyrus Broca’s Area Areas 44 & 45 Inf. Frontal Gyrus Primary Somatosensory Cx Area 3,1,2 Postcentral Gyrus Unimodal SS Assoc. Cx Areas 5 & 7 Sup. Parietal Lobule Multimodal SS Assoc. Cx Areas 5 & 7 Sup. Parietal Lobule Primary Visual Cortex Area 17 Banks Calcarine Sul. Primary Auditory Cortex Areas 41 & 42 Transverse Temp. G. Wernicke’s Area Area 22 Surrounds 41 & 42 Cerebral Hemispheres Parietal Lobe Occipital Lobe Temporal Lobe Lateral – Right Hemisphere Frontal Lobe Frontal Lobe Central Sulcus Interhemispheric Fissure Frontal Pole Lateral Fissure Frontal Lobe Central Sulcus Precentral Sulcus Superior Frontal Sulcus Inferior Frontal Sulcus Lateral Fissure Frontal Lobe Precentral Gyrus Superior Frontal Gyrus Middle Frontal Gyrus Inferior Frontal Gyrus Frontal Lobe Pars Opercularis Pars Triangularis Inferior Frontal Gyrus Pars Orbitalis Frontal Lobe Superior Frontal Gyrus Cingulate Sulcus Medial Central Sulcus Frontal Lobe Orbital Gyri Olfactory Sulcus Olfactory Bulb Gyrus Rectus Olfactory Tract Ventral Parietal Lobe Central Sulcus Lateral Preoccipital Notch Lateral Fissure Parietal Lobe Postcentral Sulcus Intraparietal Sulcus Lateral Lateral Fissure Parietal Lobe Postcentral Gyrus Superior Parietal Lobule Inferior Parietal Lobule Lateral Lateral Fissure Parietal Lobe Supramarginal Gyrus Lateral Angular Gyrus Superior Temporal Sulcus Lateral Fissure Parietal Lobe Cingulate Sulcus Central Sulcus ParietoOccipital Sulcus Medial Occipital Lobe Lateral Central Sulcus Occipital Pole Preoccipital Notch Lateral Fissure Occipital Lobe Central Sulcus ParietoOccipital Sulcus Occipital Pole Calcarine Sulcus Medial Occipital Lobe ParietoOccipital Sulcus Upper bank Calcarine Sulcus Lower bank Medial Temporal Lobe Lateral Preoccipital Notch Central Sulcus Lateral Fissure Temporal Pole Temporal Lobe Lateral Inferior Temporal Sulcus Lateral Fissure Superior Temporal Sulcus Temporal Lobe Lateral Middle Temporal Gyrus Inferior Temporal Gyrus Lateral Fissure Superior Temporal Gyrus Temporal Lobe Superior Temporal Gyrus Transverse Temporal Gyri of Heschl Horizontal cut Temporal Lobe Occipitotemporal Sulcus Collateral Sulcus Inferior Temporal Lobe Inferior Temporal Gyrus Occipitotemporal Gyrus Parahippocampal Gyrus Inferior Temporal Lobe Medial Parahippocampal Gyrus Occipitotemporal Gyrus Collateral Sulcus Limbic Lobe Cingulate Gyrus Fornix Medial Septum Pellucidum Uncus Parahippocampal Gyrus Limbic Lobe Uncus Parahippocampal Gyrus Occipitotemporal Gyrus Inferior Limbic Lobe Fornix Hippocampal Formation Inferior Insular Cortex Opercular Cortex Lateral Insular Cortex Lateral Insular Cortex Frontal/Parietal Opercular Cortex Coronal Cut Insular Cortex Temporal Opercular Cortex Centrum Semiovale Horizontal cut Internal Capsule Internal Capsule Corona Radiata Putamen Internal Capsule Anterior Limb Genu Horizontal cut Posterior Limb Corpus Callosum B G R S Diencephalon Anterior Commissure Lamina Terminalis Mid-sagittal Posterior Commissure 3rd Ventricle Basal Ganglia Caudate Putamen Globus Pallidus Thalamus Horizontal cut Ventricular System Ependymal Cells • Ciliated, cuboidal epithelium • Lines ventricles of CNS • Discontinuous basal lamina allows for movement of material between CSF and brain rather easily Ventricular System Lateral Ventricle Third Ventricle Cerebral Aqueduct Fourth Ventricle Cerebral Blood Flow • Central nervous system • • • • 2% of body by weight 15% of all cardiac output 20% of all O2 consumed Total brain blood volume every 5-7/min • Loss of consciousness after 10 sec • Necrosis after 4-5 min of hypoxia Cerebral Blood Flow • Arterial supply to brain and much of spinal cord derived from 2 sets of arteries • Internal carotid arteries • Anterior circulation - 80% of blood supply • Vertebral arteries • Posterior circulation - 20% of blood supply • Linear extent of capillaries/Unit volume • Gray matter > White matter • Sensory, interneurons > Motor Questions??
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