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CNS Basic Anatomy 1 SLP and Neuroscience • Speech-Language Pathology – Study of developmental and acquired disorders of human cognition, language and speech – Complete neurolinguistic assessments and management 2 Neuroscience • Neurology • Neurosurgery • Neuroanatomy • Neuroradiology • Neuroembryology • Neurophysiology • Neuropathology 3 The Nervous System • Central Nervous System (CNS) – Brain + Spinal Cord • Peripheral Nervous System(PNS) – Spinal Nerves – Cranial Nerves – All nerves to muscles and sensory reception sites 4 Terms for Fiber Tracts • Fiber tracts like the internet – sending information across distances – – – – Bundle - a group of fibers Column - a pillar of fibers Fasciculus - a small bundle Funiculus - a cord; a cord of nerve fibers in a nerve trunk – Lemniscus - a ribbon of fibers – Tract - a large group of fibers, a pathway 5 Organization • CNS – Relays incoming and outgoing messages – Integrates Information – Higher mental functions (language, cognition) – Regulates 6 The two hemispheres • • • • • Bilateral Anatomical Symmetry Connected by Corpus Callosum Unilateral Functional Differences Little lateralization of function at birth Gradual development of specialization • Left hemisphere is dominant for language and handedness • Right hemisphere is dominant for music, emotion, and spatial processing 7 Laterality and Function • Sensory information projects to opposite hemisphere – Object felt in right hand, Information processed by left hemisphere – Pain felt in left foot, Information processed by right hemisphere • Motor functions are also contralateral Sensory Functions Motor Functions 8 Types of Brain Tissue • Gray Matter: The neurons or cells which have specialized neurologic functions (motor or sensory) • White Matter: Axons which form pathways for conducting different types of information. 9 Distinct Pathways • Connections are not random – specific. organization of connections. • Carry information from peripheral body parts to specific areas of the brain project to particular cortex (outside bark) of the brain • Each peripheral body part has a receptive area of the brain responsible for processing or receiving input • Example: visual cortex 10 Plasticity of the Brain • Brain injury is permanent, but individuals can show recovery. • Plasticity refers to the brain’s ability to reorganize and modify functions and adapt to internal and external changes – Important for learning – Important for rehabilitation – Younger brains tend to be more plastic 11 How do we learn about brain function? • Classically, examine deficits following brain injury, infer that damaged brain area is required for task. • Today, most studies of brain function utilize neuroimaging techniques such as fMRI (functional Magnetic Resonance Imaging) or PET(Positron Emission Tomography) – These studies usually focus on normal brains 12 MRI scan L This image is in radiological orientation (left is shown on right). Images can also be in neurological orientation (left on left) These structural scans can show abnormalities and injury. 13 CT Scans CT scans use X-Rays to see inside body. Excellent for bone Often first scan in acute care (e.g. unconscious patient can not tell us if they have pacemaker, cochlear implant, or other contraindications to MRI). 14 PET/SPECT Images Measures of blood flow can help determine brain metabolism. PET: Inject radioactively labeled glucose. Note: reduced uptake in posterior region. 15 Combining anatomy and metabolism Anatomical scans (T2 MRI) have excellent spatial resolution. Metabolic scans can identify abnormalities (e.g. tumor). Combining takes advantage of complementary strengths 16 Relative Coordinates • On the globe we talk about North, South, East and West. • Lets explore the coordinates for the brain. 17 Orientation • Human anatomy described as if person is standing • If person is lying down, we would still say the head is superior to feet. 18 Orientation - animals Dorsal back Dorsal Rostral Caudal Ventral • Cranial head • Rostral beak Caudal tail Ventral belly 19 Coordinates – Dorsal Ventral • Human dorsal/ventral and rostral/caudal differ for brain and spine. – Head/Foot, Superior/Inferior, Anterior/Posterior not ambiguous. Dorsal Ventral Dorsal Ventral 20 Coordinates – Human • Human dorsal/ventral and rostral/caudal differ for brain and spine. – Head/Foot, Superior/Inferior, Anterior/Posterior not ambiguous. R R C Anterior C C R Posterior 21 Anatomy – Relative Directions Anterior/Posterior aka Rostral/Caudal Posterior <> Anterior Ventral/Dorsal aka Inferior/Superior aka Foot/Head Posterior <> Anterior Ventral <> Dorsal lateral < medial > lateral 22 Coordinates - Anatomy coronal sagittal • 3 Common Views of Brain: – Coronal (head on) – Sagittal (profile) – Axial (bird’s eye), aka Transverse. The book calls this ‘Horizontal’ but it is not horizontal when we are lying in a scanner. axial 23 Coronal • Corona: ‘crown’ a coronal plane is parallel to crown that passes from ear to ear – Coronal cut creates anterior, posterior portions 24 Transverse • Transverse: perpendicular to the long axis – These cuts are also referred to as Axial. Example: cucumber slices are transverse to long axis. 25 Sagittal • Sagittal – ‘arrow like’ – Sagittal cut divides object into left and right – sagittal suture looks like an arrow. top view 26 Sagittal and Midsagittal • A Sagittal slice down the midline is called the ‘midsagittal’ view. midsagittal sagittal 27 Oblique Slices • Slices that are not cut parallel to an orthogonal plane are called ‘oblique’. • The oblique blue slice is neither Coronal nor Axial. Cor Oblique Ax 28 Distance from midline – Medial – near sagittal midline Optic chiasm C medial of eyes – Lateral – far from sag. Midline Eyes are lateral of optic chiasm – Ipsilateral – same side Damage to A will cause blindness in ipsilateral eye – Contralateral –different side Damage to D will lead to a contralateral field cut. – Note: after brain injury (lesions) we talk about contralesional and ipsilesional Damage to visual cortex G leads to problems with contralesional vision. 29 Relative positions • Distance From Body – Proximal, Central: near center of body • Think ‘proximity’ • Shoulders are proximal parts of arms – Distal,peripheral: away from body • Think distant • Fingers are distal parts of the arms • Distance from Surface – Superficial, external: near surface • The bump bruised superficial tissue. – Profound, deep: far from surface • The car crash injured deep organs. 30 Movements Flexion Extension Supination Pronation Adduction Abduction 31 Types of cells in the brain • Neuron: Cell which is responsible for receiving, transmitting and synthesizing information – cell body: contains organelles for metabolism and a nucleus • Glial Cells: Support cells for Neurons (CNS: oligodendrocytes, astrocytes, ependymal cells, radial glial; PNS : Satellite and Schwann cells) 32 Neuron Types • Neurons come in different types – some only communicate locally, while others have very long axons that communicate with distant regions. 33 Glial Cells • Glial cells have crucial functions www.mult- sclerosis.org/glialcells.html – Repair, maintenance and cleaning. They produce new myelin when it become damaged, lay down scar tissue, and remove dead cells and other debris. – Physical support. They have hairlike filaments which hold the neurons in place and allow the central nervous system to retain its structural integrity. – CNS development. Help migration of neurons. – Chemical regulation. Supply chemicals such as potassium and calcium and regulate neurotransmitter levels. • Ten times as many glial cells as neurons • Glial cells involved with many tumours (gliomas) 34 The Central Nervous System • Telencephalon (Cerebrum) – Cortex – Basal Ganglia • Diencephalon – Thalamus – Hypothalamus) • Mesencephalon (Midbrain) • Rhombencephalon – Cerebellum – Pons – Medulla 35 Deep Structures • Basal Ganglia – Initiates movements – Caudate nucleus, Putamen,Globus pallidus • Diencephalon – Thalamus: Relay from body to cortex – Hypothalamus and pituitary gland: Regulation (e.g. hormone secretion) 36 Deep Structures • Basal Ganglia – Initiates movements – Caudate nucleus(red) – Putamen (green) – Globus pallidus (blue) • Diencephalon – Thalamus: (yellow) – Hypothalamus: (not shown) 37 Brain Stem • Midbrain – Early auditory/visual processing – Dopamine for movement control – CN III and IV emerge • Pons – CN V, VI, VII VIII • Medulla Oblongata – Pyramidal decussation: nerves from left cross to right side and vise versa – CN IX, X, XI, XII 38 The cortex • Cortex – ‘Bark’ shell of brain – mostly gray matter ~80% of human brain ~20% of squirrel brain 39 Cortical folding • Cortical folding increases surface area. • Ridges are called Gyri (singular = Gyrus) – Greek gyros = circle, hence a coil of brain cortex • Valleys are called Sulci (singular = Sulcus). – Latin = a groove. Gyri Sulci 40 Gray and White Matter • The outer surface of the cortex is gray matter: lots of interconnected neurons (like cities) • Underneath is the white matter – the highways connecting regions. 41 Functional Classifications • Some neurons transmit general information – Pain and Temperature – Originate in surface structures • Other neurons transmit specialized information – Specialized receptors – Hearing and vision • Somatic: Skeletal muscles • Visceral: Refer to internal vital body organs • Can be either – Afferent: Sensory – Efferent: Motor 42 Cortical layers • Neurons are in six layers I. Molecular layer II. External granular layer III. External pyramidal layer IV. Internal granular layer V.Internal pyramidal layer VI. Fusiform layer • Functions – Superficial layers (I-III): intercortical connections – IV: input from thalamus – V,VI: outputs to leave cortex 43 The big folds • The folds of your brain are like a fingerprint – there are a few general patterns, with individual variability. • Two main folds – Central Sulcus Fissure of Rolando Rolandic sulcus – Lateral sulcus Sylvian fissure 44 Describing cortex location • Brodmann Areas (BAs, 1909) • Appearance of cortex under microscope • Not necessarily function • Arbitrary numbers are hard to remember • Some are crucial for a speech pathologist: – 44 Broca’s Area – 22 Wernicke’s Area 45 Brodmann Areas (medial slice) • Note that gray matter is located in the longitudinal fissure (between the two hemispheres) 46 Cortical Names • Much of cortex referred to by combination of coordinate+lobe+gyr us • E.G. Superior Temporal Gyrus (STG) • Middle Temporal Gyrus(MTG) • Lateral Occipital 47 Cortical names • Tip of an object called a ‘pole’ • Frontal Pole • Temporal Pole 48 Sulci names • Many of sulci referred to by combination of coordinate+lobe+sulcus – Superior temporal sulcus (STS) – Inferior frontal sulcus (IFS) – Precentral and postcentral sulci are just anterior and posterior to the central sulcus. 49 Brain function • Anatomy is interested with the structure of an organism. • Physiology is interested in the function of the structure. • We are still learning about brain function • Modern maps of brain function are primitive… 50 Brain function • Much of the primate cortex devoted to vision. • In some monkeys, up to 50% of neocortex is devoted to vision. 51 Brain function • Two striking features of human brain 1. Lots of cortex ‘left over’ (yellow) not devoted to specific task – we are flexible 2. Not much of the cortex is solely devoted to language. 52