Neuroscience module

Nervous system
Central nervous system
1-Brain (cerebrum &cerebellum).
2-Brain stem (midbrain, pons
& medulla oblongata).
3-Spinal cord.
Peripheral nervous
system
1-Cranial neves:
12 pairs, attached to
cerebrum & brainstem.
2-spinal neves:
31 pairs, attached to spinal
cord (8 cervical, 12 thoracic,
5 lumbar, 5 sacral & 1
coccygeal).
Autonomic nervous system
1-Parasympathetic (cranio-
sacral) part:
*Cranial part: Related to 3rd, 7th, 9th
& 10th cranial nerves.
*Sacral part: Related to 2nd, 3rd & 4th
sacral spinal neves.
2-Sympathetic (thoracolumbar)
part: Related to spinal nerves from
1st thoracic to 3rd lumbar).

Spinal cord
1-External features:

*Site & length: It occupies upper 2/3 of vertebral canal, 45cm long in males &
42 cm long in females.

*Beginning: At lower border of foramen magnum at level of 1st cervical n., as

continuation of medulla oblongata.

*End: Lower end tapers forming conus medullaris which ends at following levels;
a.By 3rd month intrauterine life, it occupies whole vertebral canal.

b.At birth, it ends at L3 vertebra level c.In adults, it ends at level of disc
between L1/L2 vertebrae. These changes are due to differential growth
between spinal cord (slower) & vertebral column (faster).

*Shape: Cylindrical, showing 2 enlargements;

a.Cervical enlargement: from C5-T1 spinal segments, where spinal cord
gives origin to brachial plexus of upper limb.
b.Lumbar enlargement: from L1-S3, where spinal cord gives origin to
lumbar & sacral plexuses of lower limb.

*Sulci (grooves): It shows 6 external longitudinal sulci (grooves);

Ant. median fissure Post. median sulcus Two antero-lateral sulci Two postero-lateral sulci

Deepest For exit of ventral (motor) roots For entry of dorsal (sensory)
of spinal nerves. roots of spinal nerves.
 *Spinal Segments & nerves: It is divided into 31 segments, each segment
gives attachment to a pair of spinal nerves (8 cervical, 12 thoracic, 5 lumbar, 5
sacral & 1 coccygeal nerves). Each nerve is attached to its corresponding spinal
segment by 2 roots;

Ventral (motor) root Dorsal (sensory) root Trunk

Emerges from antero-lat. Enters through postero-lat. sulcus. Both roots unite at corrosponding
sulcus. intervertebral foramen forming
spinal nerve trunk which is mixed
(motor & sensory).

Contains somatic efferent
motor fibers, in addition to
sympathetic & para-
sympathetic fibers in
certain spinal segments.
Contains general somatic afferent Trunk is very short, once it emerges
sensory fibers from body below head. from the foramen it divides into ant.
N.B. Each root carries oval swelling & post. rami which are mixed,
called dorsal root (spinal) ganglion, supply ant. & post. aspects of body.
representing 1st order neuron in
pathways of general somatic
sensations from body below head.

Vertebral levels of spinal cord segments: Spinal cord segments are

present higher than their corresponding vertebrae.
a)Cervical region: Add one to spine. C5 spine opposite to C6 segment.
b)Upper thoracic region: Add 2 to spine. T3 spine opposite to T5 segment.
c)Lower thoracic region: Add 3 to spine. T10 spine opposite to L1 segment.
d)T11 spine: Opposite to L2 to L5 segments.
e)T12 & L1 spines: Opposite to all sacral segments.

N.B.: 1-Each cervical n. from C1 to C7 emerges above its corresponding

vertebra (C1 nerve emerges above atlas & C8 emerges above T1). Each of
remaining spinal nerves from T1 emerges below corresponding vertebra.
2-The gap in length between spinal cord & vertebral canal results in, gradual
lengthening of lumbar & sacral n. roots which have to descend downward to
reach their exit foramina as a leash of fibers called cauda equine.
 2-Coverings (spinal meninges): Spinal cord is surrounded by 3
membranes (meninges) ; pia, arachnoid & dura maters (from inside outwards).

Pia mater Arachnoid mater Dura mater

Delicate membrane adherent to spinal Delicate membrane between pia Thick fibrous tough
cord. & dura maters. outermost membrane.

Above, it is continuous through Above, it is continuous through Above, it is attached to

foramen magnum with pia mater of
brain, below it ends at tip of conus
medullaris. Outwards it sends sheaths
around spinal n. roots, inwards it sends
sheaths around spinal blood vessels.
foramen magnum with arachnoid
mater of brain, below it ends at
S2 vertebra.
margins of foramen
magnum, below it ends at
S2 vertebra, outwards it
sends sheaths around
spinal n. roots & trunk (in
inter-vertebral foramina),
around filum terminale.

It is thickened forming 4 bands: It is related to 2 spaces: It is related to 2 spaces:

-Linea splendens: Median - Subarachnoid space: - Subdural space:

glistening pia mater band, extending Between arachnoid & pia maters, Between dura &
along ant. median fissure. contains:*CSF *Spinal n. roots arachnoid & maters,
*Spinal blood vessels. contains thin film of
-Subarachnoid septum: Backward serous fluid.
pia mater extension at post. median N.B. 1-Lumbar cistern:
sulcus, to attach to dura mater. Lower part of spinal sub-arachnoid
space (devoid of spinal cord)
-Filum terminale: extending from L2-S2. It contains
* Slivery glistening pia mater fibrous CSF, cauda equine & filum
band, extending downwards from tip of terminale. Important site
conus medullaris among cauda equine. for lumbar puncture.
*At level of S2 vertebra it pierces
arachnoid & dura, acquires a dural 2-Lumbar puncture: A needle is - Epidural (extra-
investment to attach to coccyx back. introduced in subarachnoid space dural) space:
to obtain CSF sample or to inject Between dura mater &
-Denticulate ligaments: drug. Done below L2 to avoid vertebral canal periosteum,
*2 pia mater lat. bands, piercing spinal cord injury, cauda nerves contains:
arachoid to attach to dura mater. Its are not liable to be injured by *Loose areolar tissue & fat.
lat. edge is serrated & has 21 processes. needle being floating in CSF. *Internal vertebral v. plexus.
*It extends from foramen magnum to *Spinal nerve roots.
L1 vertebra, lying midway between - Subdural space: Between
ventral & dorsal spinal nerve roots. arachnoid & dura maters, contains
thin film of serous fluid.
 Spinal cord fixation: *Subarachnoid septum; attach it post. to dura mater.

*Filum terminale; attach it below to coccyx back.

*Denticulate ligament; attach it on both sides to dura mater.

*Dura mater; attached above to margins of foramen magnum & on each

side to margins of intervertebral foramina.

3-Blood supply : A- Arterial supply;

Ant. spinal a. Post. spinal aa. Radicular spinal aa.

One median trunk formed by
union of 2 ant. spinal aa.,
each arises inside skull from
4th part of verterbral a.
Leaves skull through foramen
magnum & continues down
along ant. median fissure of
spinal cord.
Supplies ant. 2/3 of spinal
cord (ventral & lat. horns, ant.
& most of lat. white funiculi)
by central branches).
2 arteries, each arises Many transverse arteries, arising from
inside skull from 4th part verterbral aa. (in neck), post. intercostal
of vertebral a. or its post. aa. (in thorax), lumbar aa. (in abdomen)
inf. cerebellar branch. & lat. sacral aa. (in pelvis) on both sides .
Leaves skull through Enter vertebral canal through inter-
foramen magnum & vertebral foramina, dividing into ant. &
continues down along post. branches running along ventral &
dorsal spinal n.roots. dorsal spinal nerve roots.
Supply post. 1/3 of They are main blood supply source to
spinal cord (dorsal horns spinal cord lower 1/3.
& post. white funiculi).

Anastomose together around conus medullaris Anastomose with ant. & post. spinal aa.
The one supplying lumbar enlargement is
very large (arteria radicularis magna).
B-Venous drainage: 6 longitudinal venous channels (anteromedian &
posteromedian, Rt. & Lt. anterolat., Rt. & Lt. posterolat.) which are drained
by radicular vv. into internal vertebral venous plexus in epidural space.

Brain stem
Formed of medulla oblongata, pons & midbrain (from below upwards). Above
it is directly continuous with diencephalon, while below it is directly continuous
with spinal cord.

1-Medulla oblongata

*Definition: lower most part of brain stem.

*Size & extent: 3 cm long, continuous above with pons lower border & below
with spinal cord.
 *Parts: -Lower 1/2 (closed medulla): Traversed by central canal.

-Upper 1/2 (open medulla): Forms lower 1/2 of floor 4th ventricle.

*External features (surfaces):

Ventro-lateral surface Dorsal surface

From med. to lat. presents; a)Dorsal surface of lower 1/2 (closed medulla): From
med. to lat. presents;
*Ant. median fissure: *Post. median sulcus; Continuous with that of spinal cord.
Continuous with that of spinal cord. *Gracile tract & tubercle (overlies gracile nucleus): On
each side of sulcus.
*Pyramid: Elongated elevation, *Cuneate tract & tubercle (overlies cuneate nucleus).
produced by corticospinal fibers of *Tuberculum cinereum (overlies spinal nucleus of trigeminal).
pyramidal tract.
*Inf. cerebellar peduncle: On either side as 2 bundles
th
*Olive: Oval elevation produced extending upwards & lat. along 4 ventricle sides till they reach
by inf. olivary nucleus. It is separated lower border of pons back, where they bend sharply entering
from pyramid by antero-lateral cerebellum.
th
sulcus for exit of hypoglossal (12
cranial ) n.
b)Dorsal surface of upper 1/2 (open medulla):
*Inf. cerebellar -Forms lower 1/2 of 4th ventricle floor. Separated from pons back
peduncle (I.C.P): Bundle of by bundle of fibers (medullary stria) & bounded lat. by I.C.P.
nerve fibers connecting medulla -Traversed by vertical median sulcus, lat. to it inverted v shaped
with cerebellum. It is separated
from olive by postero-lateral sulcus depression called inf. fovea. On each side, inf. fovea divides the
for exit of glossopharyngeal (9th medullary part into 3 triangular areas, from med. to lat.:
th
cranial), vagus (10 cranial ) & *Hypoglossal trigone; overlies hypoglossal n. nucleus.
th
cranial root of accessory (11 *Vagal trigone; overlies vagus n. dorsal nucleus.
cranial) nerves. *Lower vestibular area; overlies inf. & med. vestibular nuclei.
N.B.: Area postrema (vomiting center); protuberance at 4th
ventricle inferoposterior limit.
*Arterial supply: Branches of vertebral a.

-Antero-lateral surface: Ant. spinal a. & 4th part of vertebral a.

-Postero-lateral surface: Post. inf. cerebellar a.

-Gracile & cuneate tracts: Post. spinal a.

 2-pons

*Definition & size: Middle part of brain stem, 1 inch long, lying between
medulla & midbrain.
*Parts: Divided into 2 parts; ventral (basis pontis) & dorsal (tegmentum).
*External features (surfaces):

Ventral (basilar) surface Dorsal (tegmental) surface

Shows following features;: -Forms upper 1/2 of 4th ventricle floor.
*Basilar groove: Median shallow groove, lodging Separated from back of open medulla by
basilar a. medullary stria & bounded lat. by S.C.P.
*Transverse pontine fibers: Thick ridges which -Shows following features;
collect on on each side forming middle cerebellar peduncle
(M.C.P), which connects pons to cerebellum. *Med. eminence & facial
*Exit of middle 4 cranial nerves: colliculus (at medial eminence lower
-Trigeminal (5th cranial)n.: Emerges by a large lat. end, produced by abducent nucleus &
sensory & small med. motor roots, from lat. part of front encircling facial n. fibers).
pons close to it's upper border. *Sulcus limitans: Lat. to med.
-Abducent (6th cranial)n.: Emerges from sulcus eminence, its lower part lies lat. to facial
between pyramid & pons. colliculus & called superior fovea.
-Facial (7th cranial) & vestibulo-cochlear (8th *upper vestibular area: Overlies
cranial) nn.: Emerge from cerebello-pontine angle. sup. & lat. vestibular nuclei.
*Arterial supply: -Ant. part (basis pontis): Pontine branches of basilar a.
-Post. part (tegmentum): * In lower pons: Post. inf. cerebellar a. (vertebral a.).

*In upper pons: Sup. cerebellar a . (basilar a.).

3-Midbrain

*Definition & size: Uppermost & shortest part of brain stem, 2 cm long, lying
between pons & diencephalon.

*Parts: It is divided by a narrow canal (cerebral aqueduct of sylvius) into ant.

part (cerebral peduncle) & post. part (tectum).

*External features (surfaces): It has 4 surfaces;

Ventral surface Dorsal surface 2 lateral surfaces

*2 cerebral *4 Colliculi (corpora They are lat. surfaces of cerebral
peduncles: quadrigemina):4 rounded elevations; peduncles & related to tentorial
-2 large bundles of n. -2 sup. colliculi: Centers visual reflexes. notch of tentorium cerebelli, showing;
fibers emerging from pons -2 inf. colliculi: Centers auditory reflexes.
upper surface & ascend *Sup. & inf. brachia
*Sup. cerebellar peduncleS:
to disappear in cerebral (brachia quadrigemina):
hemispheres substance.
Bundles of n. fibers running downards,
backwards & laterally along 4th
ventricle sides, entering cerebellum.
*Interpeduncular *Trochlear (4th cranial )n.:
fossa: In median Emerges from midbrain below inf.
plane between the 2 colliculus. It is the only cranial n.
cerebral peduncles. emerging from back of brainstem.
Connect sup. & inf. colliculi with lat. &
med. geniculate bodies respectively.
*Stuctures crossing lat.
surfaces;
-3 arteries: Post. cerebral a., sup.
cerebellar a. & ant. choroidal a.
-2 nerves: Optic tract & trochlear n.
-One vein: Basal v. (in great cerebral v.)

*Arterial supply: -Post. cerebral & sup. cerebellar aa. (basilar a.).
-Post. communicating a. (I.C.A.).

Superficial attachment of cranial nerves

1st (Olfactory) n.: Consists of 20 filaments, arising from olfactory bipolar

cells of olfactory mucosa to reach olfactory bulb.

2nd (Optic) n: Arises from ganglion cells of retina & joins antero-lat. angle
of optic chiasma (its fibers are 2nd order neuron of vision).

3rd (Oculomotor) n.: Emerges on med. aspect of cerebral peduncle.

4th (Trochlear) n. (smallest): Emerges from midbrain below tectum & it is

the only cranial n. attached to brainstem dorsal surface.
th
5 Trigeminal n.: Attached to pons lat. side (at junction of pons with M.C.P).

6TH Abducent n.: Emerges ant. from ponto-medullary junction.

7TH (Facial) & 8th (Vestibulocochlear) nn.: Emerge at
pontomedullary junction near M.C.P.

9th (Glossopharyngeal), 10th (Vagus) & 11th (Cranial root of

accessory) nn.: Arise from postero-lat. sulcus of medulla.
N.B.: Spinal part of accessory n.: Arises from spinal cord upper 5 segments.

12th Hypoglossal n.: Arises from antero-lat. sulcus of medulla.

N.B.: 3RD & 4TH are nerves of midbrain; 5th, 6th, 7th, & 8th are nerves of pons;
while 9th, 10th, 11th & 12th are nerves of medulla.
 Cerebellum

*Site: Largest part of hindbrain, lying in post.cranial fossa.

*Relations:-Above: Tentorium cerebelli separating it from cerebral hemispheres.
-Infront: Back of pons & medulla separated by 4th ventricle.
-Lat.: Sigmoid dural sinus, mastoid antrum & mastoid air cells.
*Parts: -Two large lat. cerebellar hemispheres; formed of many gyri called
folia separated by deep fissures.
-Vermis: Narrow median part joining the two cerebellar hemispheres.
It is divided into sup. & inf. vermis.
*Shape:
Two Two surfaces
notches
*Ant. notch: *Superior surface: shows;
Wide notch -Superior vemis: Median longitudinal ridge merging with cerebellar hemispheres.
related to Formed of 5 lobules; lingula, central lobule, culmen, declive & folium (from before
brain stem backward).
back. -Fissura prima (1ry fissure): Wide V-shaped fissure separating ant. lobe from
middle (post. lobe).
*Post. notch: Inferior surface: shows;
Narrow notch -Vallecula: Deep median longitudinal groove between inf. surfaces of both hemisphes.
receiving falx -Inferior vermis: Longitudinal ridge lying in vallecula. It is divided into 4 lobules;
cerebelli. nodule, uvula, pyramid & tuber vermis (from before backward).
-Flocculus: Lies on each side along ant. border of inf. surface of hemisphere. It is
almost isolated from hemisphere by postero-lat. fissure. The 2 flocculi are connected
to nodule forming flocculo-nodular lobe.
-Tonsil: Small part of hemisphere, on either side of inf. vermis uvula. It is partly
separated from hemisphere inf. surface by retrotonsillar fissure.
*Fissures:
1-Primary fissure : On sup. surface separating ant. from post. lobes.
2-Posterolat. fissure: Separates flocculonodular lobe from rest of hemisphere.

4-Horizontal fissure: Separates sup. & inf. surfaces of cerebellum.

 *Subdivisions:
Anatomical division Functional division
It is divided into 3 It is divided into 3 functional zones;
anatomical lobes by 1ry
& posterolat. Fissures; 1-Vestibulo-cerebellum (Archi-cerebellum):
-Formed of flocculo-nodular lobe. Phylogenetically, it is the oldest part of
1-Ant. lobe: Area on sup. cerebellum.
surface cranial to 1ry -Connected with internal ear vestibular system. It is concerned with
fissure. equilibrium.

2-Post. lobe: Large area 2-Spino-cerebellum (Paleo-cerebellum):

between 1ry & -Formed of vermal (midline vermis) & paravermal (part of hemisphere
postrolat. fissures, lying adjacent & parallel to vermis) zones.
in sup. & inf. surfaces. -Connected with spinal cord & brain stem. It is concerned with regulation of
muscle tone & muscle coordination.

3-Flocculo-nodular lobe:
3-Cerebro-cerebellum (Neo-cerebellum):
Consists of Rt. & Lt.
-Remaining largest part of cerebellum. Phylogenetically, it is the last & recent
flocculi & median
part of cerebellum.
nodule, lying caudal to
-Connected with cerebral cortex. It is concerned with planning & control of
postrolat. fissure. movements.

*Arterial supply: a)Sup. cerebellar a.: From basilar a. , supplies sup. surface.
b)Ant. inf. cerebellar a. : From basilar a., supplies small ant. part of inf. surface.
c)Post. inf. cerebellar a. : From vertebral a., supplies large post. part of inf. surface.

Fourth ventricle

*Definition & site:: Cavity of hindbrain, lying between pons & upper part
medulla (infront) & cerebellum (behind).

*Shape & angles: Diamond shaped with 4 angles; -Upper angle: Continuous
with Sylvius aqueduct -Lower angle: Continuous with central canal closed
medulla -2 Lat. angles: Each at meeting of S.C.P & I.C.P of it's own side.
 *Boundaries: It has roof, floor & 2 lat. borders;

a) Lat. borders: -Above: S.C.P -In middle: Lat. angle forming lat. recess.

-Below: Gracile & cuneate tubercles, I.C.P.

B)Floor: It is divided by median longitudinal sulcus into 2 similar halves, it

is also divided by transverse n. bundles (medullary stria) into upper pontine
part & lower medullary part .

Upper pontine part lower medullary part

Dorsal (tegmental) surface Dorsal surface of medulla upper 1/2
pons: (open medulla):
-Forms upper 1/2 of 4th ventricle floor, -Forms lower 1/2 of 4th ventricle floor, separated from
separated from back of open medulla by pons back by medullary stria & bounded lat. by I.C.P.
medullary stria & bounded lat. by S.C.P.
-Traversed by vertical median sulcus, lat. to it inverted v
-Shows following features;
*Med. eminence & facial shaped depression (inf. fovea). On each side, inf. fovea
colliculus (at medial eminence lower divides medullary part in 3 triangular areas, from med. to lat.:
end, produced by abducent nucleus & *Hypoglossal trigone; overlies hypoglossal n. nucleus.
encircling facial n. fibers).
*Vagal trigone; overlies vagus n. dorsal nucleus.
*Sulcus limitans: Lat. to med.
eminence, its lower part lies lat. to facial *Lower vestibular area; overlies inf. & med.
colliculus & called superior fovea. vestibular nuclei.
*upper vestibular area: Overlies N.B.: Area postrema (vomiting center); protuberance at
sup. & lat. vestibular nuclei 4th ventricle inferoposterior limit.
C)Roof:
-Sup.: Sup. medullary velum (thin sheet of white matter connecting 2 S.C.P).
-Inf.: *Upper area; cerebellum nodule & inf. medullary velum (connecting 2 I.C.P).
*Lower area; tela choroidea of 4th ventricle (where choroid plexus invaginates
4th ventricle & where pia mater comes in contact with ependyma).
*Recesses (3): a)Median recess: 4th ventricle roof is drawn backwards
towards cerebellum forming median recess with upper wall formed by sup.
medullary velum & lower wall formed by cerebellum.
b)2 lateral recesses: At 4th ventricle lat. angles. Each runs
forward around medulla to open ant. into subarachnoid space by lat. aperture
(foramen of Luschka).
*Communications:
-At upper angle : Communicates with 3rd ventricle through Sylvius aqueduct.
 -At lower angle: Communicates with central canal of medulla.
-With subarachnoid space: by median (foramen of Magendie which opens in
cisterna magna) & 2 lateral apertures (foramina of Luschka which open into
ponto-medullary cistern).
*Choroid plexus: Invaginates lowermost area of 4th ventricle roof above
median aperture of Magendie. T shaped with median stem & 2 arms extending
to lateral recesses. Blood supply is post. inf. cerebellar arteries.
Cerebrum
It consists of; a)2 cerebral hemispheres: Separated by median longitudinal
fissure which contains falx cerebri. b)Diencephalon.

Cerebral hemisphere

*Position: Cerebral hemispheres occupy ant., middle & upper part of post.
cranial fossae. The 2 hemispheres are separated from cerebellum by a
horizontal dural fold (tentorium cerebelli).
*Surfaces (3): -Lat. (supero-lat.) surface: Convex, related to skull vault.
-Med. surface: Flattened & related to its fellow of opposite hemisphere with
falx cerebri in between
-Inf. surface: Irregular & divided by lat. sulcus into orbital part which lies
on orbit roof & tentorial which lies on tentorium cerebelli.
*Borders (3): -Sup. (supero-med.): Separates lat. from med. surfaces.

-Superciliary: Separates lat. from orbital part of inf. surfaces.

-Inf. (infero-lat.): Separates lat. from tentorial part of inf. surfaces. It

presents slight depression 2 inches infront of occipital pole (preoccipital notch).

*Division into lobes: Each hemisphere is divided into 4 lobes by 3 major sulci;

Sulci

Central Lateral Parieto-occipital

(Rolando (Sylvius fissure)
sulcus)
Runs obliquely It's stem begins on inf. surface & extends lat. Present on med. surface
across lat. surface between temporal pole & orbital surface of frontal near to occipital pole. It's
& it's upper end lobe, reaching lat. surface where it divides into 3 rami: upper end cuts sup. border
usually cuts in sup. -Post. ramus: Longest & deepest, runs backwards & 2 inches infront of occipital
border of hemi-sphere its post. end turns upwards into parietal lobe. pole & extends a little on
& extends a little -Ant. horizontal ramus: Runs forwards in frontal lobe. lat. surface of hemisphere.
on it's med. surface. -Ant. ascending ramus: Runs upwards in frontal lobe.
It separates motor
from sensory areas.

Lobes

Frontal Parietal Temporal Occipital

-Infront: Frontal pole. -Infront: Central sulcus.
-Behind: Central sulcus. -Behind: Upper 1/2 of line
-Above: Sup. border. between parieto-occipital
-Below: Superciliary sulcus & preoccipital notch.
border & lat. sulcus. -Above: Sup. border.
-Below: Post. ramus of lat.
sulcus & line joining post.
ramus with middle of line
between parieto-occipital
sulcus & preoccipital notch.
-Infront: Temporal pole. -Infront: line
-Behind: Lower 1/2 of line between parieto-
between parieto-occipital occipital sulcus &
sulcus & preoccipital notch. preoccipital notch.
-Above: Post. ramus lat. sulcus. -Behind:
-Below: Inf. border. Occipital pole.

*Internal structure: 1-Grey matter (Cerebral cortex); formed of millions of

cell bodies of neurons lying on hemisphere surface. It shows elevated areas
(gyri) separated by grooves (sulci) to increase cortex surface area within
cranial cavity limited space.
2-White matter; formed of myelinated n. fibers which are axons of neurons.
It lies inside to gray matter in contrast to spinal cord.
3-Basal nuclei (Basal ganglia); masses of gray matter situated within white
matter near hemisphere base.
4-Lateral ventricle; Cavity lying inside cerebral hemisphere.
 *Sulci & gyri of cerebral cortex

Sulci & gyri on lat. surface Sulci & gyri on inf. surface Sulci & gyri on tentorial & med. surfaces
Frontal lobe Orbital part: Sulci Gyri
Ant. 1/3 (inf. surface of *Callosal & *Lingual gyrus:
Sulci Gyri frontal lobe). Rests on orbit, hippocampal sulci: Between calcarine & post-
*Precentral sulcus: *Precentral gyrus: faces down & lat. Callosal begins below calarine sulci (sup.) & collateral
Parallel & ant. to Between central & precentral sulci. corpus callosum rostrum. sulcus post. part (inf.).
central sulcus. *Sup., middle & inf. frontal gyri: Sulci & gyri of orbital part Arches around genu, body Ant. it is continuous with
*Sup. frontal sulcus: The remaining part of frontal lobe is & finally bends around parahippocampal gyrus.
Begins in upper part divided into these 3 gyri by sup. & *Olfactory sulcus: splenium to become continuous

precentral sulcus & inf. frontal sulci. Near & parallel to med. with hippocampal sulcus *Cuneus:
runs forwards parallel N.B. Inf. frontal gyrus is divided by border, lodging olfactory which extends forwards Triangular area between
to upper border. ant. ascending & ant. horizontal bulb & tract. from splenium to the bend postcalcarine & parieto-
*Inf. frontal sulcus: rami of lat. sulcus into 3 parts; between parahippocampal occipital sulci.
-Orbital : Below ant. horizontal ramus. *Gyrus rectus (straight):
Begins in lower part gyrus & uncus.
precentral sulcus & -Angular (triangular): Between 2 rami. Med. to olfactory sulcus. *Precuneus:
*Cingulate sulcus: Quadrilateral area between
runs forwards then -Opercular: Between ant. Begins below corpus callosum
downwards. ascending ramus & precentral *Orbital sulcus (H-shaped): marginal sulcus (infront),
Divides remaining part into rostrum, passes above & parieto-oocipital sulcus
sulcus. It covers part of insula. parallel to callosal sulcus. (behind), upper border
Parietal lobe Ends post. by dividing into
*4 orbital gyri (ant., post., (above) & subparietal
med. & lat.) marginal & subparietal sulcus (below).
Sulci Gyri (supra-splenial) sulci.
*Postcentral sulcus: *Postcentral gyrus:
Tentorial part: Post. *Paracentral lobule:
Parallel & post. Between central & postcentral sulci. *Calcarine sulcus:
*Sup. & inf. parietal lobules: 2/3 (inf. surface of temporal Quadrilateral area
to central sulcus. Begins below corpus
*Intraparietal sulcus: The remaining part of parietal lobe & occipital lobes). Rests on surrounding upper end of
tentorium cerebelli, faces splenium, passing back- central sulcus on med. surface.
Begins from post- is divided into these 2 lobules by
 *Sulci & gyri of cerebral cortex

central sulcus & runs intraparietal sulcus. down & med., so described wards & upwards to meet *Med. frontal gyrus:
backwards parallel to N.B. Inf. parietal lobule contains 2 gyri; with hemisphere med. surface. postcalcarine sulcus. Infront of paracentral lobule.
upper border towards -Supramarginal :
occipital lobe. Surrounds up-turned post. end of N.B.: Orbital & tentorial *Postcalcarine sulcus:
post. ramus lat.sulcus. parts are separated by lat. Begins at occipital pole, *Cingulate gyrus:
-Angular: Surrounds upturned post. fissure stem. passing forwards & up-wards Between cingulate & callosal
end of sup. temporal sulcus. to meet calcarine sulcus. sulci. Post. it is continuous
with parahippocampal
Temporal lobe *Parieto-occipital sulcus: gyrus & uncus through
Begins at junction of calcarine isthmus of limbic lobe.
& postcalcarine sulci,
Sulci Gyri
passing upwards. With
*Sup. temporal sulcus: *Sup. temporal gyrus:
calcarine & post-calcarine *Parahippocampal gyrus
Begins near temporal Between post. ramus lat. sulcus & sulci it forms y-shaped sulcus. & uncus: Between hippo-
pole & runs backwards sup. temporal sulcus.
below & parallel to *Middle temporal gyrus: campal & collateral sulci,
*Collateral sulcus:
post. ramus lat. sulcus. Between sup. & inf. temporal sulci. it's ant. end forms uncus.
Extends from occipital
*Inf. temporal sulcus: *Inf. temporal gyrus:
pole to temporal pole. *Med. occipito-temporal
Below & parallel to Below inf. temporal sulcus. *Rhinal sulcus: Extends
sup. temporal sulcus. gyrus (fusiform):
forwards from a point near
Between collateral &
collateral sulcus ant. end to
occipito-temporal sulci.
complete uncus outline.
*Lat. occipito-temporal gyrus:
*Occipito-temporal
Lat. to occipito-temporal
sulcus: Interrupted sulcus sulcus, represents inf.
lat. & parallel to collateral sulcus.
temporal gyrus from below
 *Sulci & gyri of cerebral cortex

Occipital lobe Insula

Sulci Gyri -Large part of cerebral cortex, buried in lat. fissure bottom. It is conical mass having
*Lat. occipital sulcus: *Arcus parieto-occipitalis: apex & base which is surrounded by circular sulcus. Subdivided into 2 long gyri
Horizontal sulcus, runs Surrounds parieto-occipital sulcus (behind) & small short gyri (in front). Its surface is crossed by middle cerebral a.
backwards. termination.
*Lunate sulcus: *Sup. occipital gyrus: -Parts of cortex which overlap insula are termed opercula, they are lips of post. ramus
Vertical sulcus. Above lat. occipital sulcus. lat. sulcus. They include parts from frontal, parietal & temporal lobes.
*Inf. occipital gyrus:
Below lat. occipital sulcus.
*Functional areas of cerebral hemisphere

Frontal lobe Parietal lobe Temporal lobe Occipital lobe

*Motor area (4):
-Lies in precentral gyrus & extends in ant. part
of paracentral lobule.
-It's function is giving 40% of pyramidal tract
(cortic-ospinal & corticonuclear fibers) being motor
area for highly skilled movements of opposite 1/2.
N.B.: 1-It is motor area for all body except eye.
2-Body is represented upside down (motor area
of lower part lower limb & perineum lies in ant.
part of paracentral lobule).
-Lesion leads to contralat. hemiplegia.
*Main sensory area (3, 1 &2):
-Lies in postcentral gyrus & extends
in post. part of para-central lobule.
-It's functions are; giving 20%
pyramidal tract & receiving general
somatic sensations from opposite 1/2.
N.B.: Body is represented upside
down. Its lower 1/3 receives
general sensations from head,
while upper 2/3 receives general
sensations from body below head.
*Auditory sensory area (Heschl's
gyrus) (41 & 42):
-Lies in middle of sup. temporal
gyrus.
-It's function is receiving auditory
radiation from med. geniculate
body (perception).
-Lesion leads to bilateral hearing
diminution mainly on opposite side.
*Visual sensory area (17):
-Lies in lips of postcalcarine
sulcus (cuneus & lingual
gyri) on med. surface of
occipital lobe.
-It's function is receiving
visual radiation from lat.
geniculate body (perception).
-Lesion leads to contralat.
homonymous hemianopia
with macular sparing.
 *Sulci & gyri of cerebral cortex

-Lesion leads to contralat.

*Premotor area (6):
-Lies infront of & parallel to motor area (4).
-It's functions are; give origin to 40% of
pyramidal tract, storage of programs of skilled
movements learned by experience,
extrapyramidal function by controlling
postural adjustment of proximal girdle muscles
& inhibition of muscle tone.
-Lesion leads to; Motor apraxia (impaired
performance voluntary movements in spite of
absence of paralysis, loss of postural stability
of proximal girdle muscles & muscle spasticity.
hemianaesthesia.
*Parietal (sensory) association area:
-Lies in remaining part of parietal
lobe & adjoining parts of occipital
& temporal lobes.
-It's function is associating visual,
auditory & tactile sensations so
that one can know meaning of
sensations he feels (recognition of
stuctures).
-Lesion leads to tactile agnosia
(asterognosis) where patient
cannot identify objects he feels.
*Auditory association area (22): *Visual association area
-Lies around heschls gyrus & (18 & 19)):
occupies rest of sup. temporal gyrus.
-Lies around visual sensory
-It's function is is giving meaning
area in cuneus & lingual
of received sounds. gyri, on med. surface of
-Lesion leads to auditory agnosiaoccipital lobe.
(patient can still hear sounds but
-It's function are; giving
cannot understand their meaning).meaning of pictures seen &
color vision.
*Rest & main part temporal lobe: -Lesion leads to visual
Seems to be concerned with agnosia (patient can see
memory. objects but cannot identify
them, in addition to color
blindness.

*Frontal eye field (8):
-Lies in post. part of middle frontal gyrus.
-It's function is lat. conjucate movements of
both eyes to opposite side & being responsible
for accomadation reflex.
-Lesion leads to Loss of conjugate movements
of both eyes to opposite side (lat. deviation of
both eyes to same side) & loss of
accommodation reflex.
*Supramarginal gyrus (40):
-Lies in inf. parietal lobule,
surrounding upturned post. end of
lat. fissure post. ramus.
-It's functions contains 2nd
(sensory) speech Wernicke area in
dominant hemisphere, responsible
for; understanding spoken &
written words & thoughts
*Piriform area of rhinencephalon:
-Lies in uncus & adjoining part of
parahippocampal gyrus on
tentorial surface.
-Its function is 1ry smell center,
receiving fibers from lat. root
olfactory tract.
*Occipital eye field area:
-Lies in 2ry visual area in humans.
-It's function is conjugate
eyes deviation, especially to
opposite side which is
believed to be reflex &
associated with eye
movements when following
an object.
 *Sulci & gyri of cerebral cortex

*Brocas (1ry or motor speech) area (44): formation then sending it to

-Lies in post. part of inf. frontal gyrus in Broca's area for execution.
dominant hemisphere. -Lesion leads to sensory aphasia
-It's function is words formation & coordinates (inability to understand spoken &
movements of tongue, lips & larynx. written words).
-Lesion leads to motor aphasia (patient is
unable to express his idea in form of speech in
absence of paralysis).

*Prefrontal (frontal association )area: *Angular gyrus (39):

-Lies Remaining part of frontal lobe lat. surface. -Lies in inf. parietal lobule,
-It's function is to receive association fibers surrounding upturned post. end of
from other sensory areas & determines sup. temporal sulcus .
personal reactions of individual, so responsible -Its functions are; contains rest of
for control of conduct, behavior & emotions. 2nd speech Wernicke area, also
-Lesion leads to personality changes. contains reading & writing centers.
-Lesion leads to alexia & agrahia
*Frontal lobe med. surface: Related to (inability to read & write).
emotional behavior.
*Frontal lobe orbital surface: Related to
control of autonomic (visceral) activities.
Paracentral lobule:
-Lies on med. surface of hemisphere.
-Its functions are; motor & sensory areas of leg, foot & perineum, also concerned
with voluntary control of defecation & micturation reflexes.
 Base of Brain
1-Interpeduncular fossa

*Site: Occupies base central region & midbrain ant. aspect.

*Boundaries: Diamond-shaped space bounded by;
-Optic chiasma (Ant.) -Pons upper border (Post.).
-Optic tracts (Antero-lat.) -Cerebral peduncles (Postero-lat.).
*Contents:
Tuber cinereum Mammillary bodies Post. perforated Oculomotor nn.
substance
Slightly elevated grey 2 small rounded elevations on Behind mammillary Emerge from
matter area behind optic each side of median plane, in bodies, in angle fossa post.
chiasma. Gives attachment fossa middle part. between cerebral part, just med.
to post. lobe infundibulum *Afferents: From fornix column. peduncles. Pierced by to cerebral
of pituitary gland. *Efferents: To thalamus central branches of peduncles.
(mammillo-thalamic tract) & to post. cerebral aa.
brain stem tegmentum
(mammillo-tegmental tract).
Most of interpeduncular fossa contents belong to hypothalamus.
2-Ant. part of brain base (infront of interpeduncular fossa)

1-Rt. & Lt. optic nerves: Join optic chiasma antero-lat. aspect.

2-Ant. perforated substance: -Rhomboid-shaped area bounded by:

*Ant.: Olfactory trigon & striae *Post.: Optic tract & uncus.
*Med.: Optic chiasma *Lat.: Lateral sulcus.
*Above: Corpus striatum *Below: ICA termination.
-Pierced by central branches of ant. & middle cerebral arteries.
3-Olfactory bulb & tract:
a)Olfactory bulb; -Lies in contact with frontal lobe orbital surface.
-Rests on ethmoid bone cribriform plate, through which olfactory n. filaments
from nasal mucosa upper third pass to enter olfactory bulb.
b)Olfactory tract; -Runs backwards from bulb & ends by dividing into:

*Med. root (stria); passes med. & ends in indusium griseum of corpus callosum.
*Lat. root (stria); passes lat. over ant. perforated substance & terminates in
 temporal lobe uncus.
-Area between the 2 roots sometimes forms a small elevation; olfactory
trigone (pyramid).
Cerebral hemisphere White matter
Consists of myelinated nerve fibres which are devoid of neurolemmal sheaths.
3 types of fibres; Association, commissural & projection fibres.

1-Association fibers
Fibres which connect different cortical areas in same hemisphere. 2 types;
1-Short association fibers: U-shaped bands (arcuate fibres) which
connect adjacent gyri of same brain lobe.

2-Long association fibers: Tend to collect themselves in fasciculi

which connect different distant lobes of same hemisphere.
Cingulum Inf. Uncinate Sup. Fronto- Arcuate
longitudinal bundle longitudinal occipital fasciculus
fasciculus fasciculus bundle
C-shaped bundle Lies in cerebral Makes an arch Connects frontal Begins in frontal Connects frontal
lobe with temporal
within cingulate hemisphere inf. over lat. fissure to occipital pole pole, passes
gyrus, connecting surface, extending stem, connects med. to sup. lobe cortex (werrnick
& adjoining part to Broca speech areas).
it to para- from temporal frontal lobe longitudinal
of temporal lobe.
hippocampal pole. (orbital gyri) & bundle & ends
gyrus & uncus temporal pole. in occipital pole.
forming incomplete
circle around
corpus callosum.

2-Commissural fibers
*Commissure: Band of white matter connecting part of CNS on one side
with same part of opposite side crossing middle line, helping to co-ordinate
activities of both hemispheres.

*5 major commissures: a)Corpus callosum b)Ant. commissure.

c)Post. commissure d)Hippocampal commissure e)Habenular commissure.
A-Corpus callosum

-Arched mass of fibers 10 cm long, connecting nearly all areas of both

cerebral hemispheres except ant. parts of temporal lobes, which are
connected by ant. commissure. Lies at median longitudinal fissure bottom,
nearer to frontal lobe than occipital lobe.
-Consists of; rostrum, genu, body & splenium
 Genu Rostrum Body (trunk) Splenium
*Most ant. part of corpus *Connected to optic *Extends from genu to splenium, lying *Most post. part of corpus callosum.
callosum chiasma by grey matter at median longitudinal fissure bottom. *Fibres passing through curve backwards &
*It's post. aspect gives sheet; lamina terminalis. *In median plane, it's lower surface med. into occipital lobe forming forceps
attachment to septum *It's upper surface is
gives attachment to septum pellucidum posterior (major), causing bulging into
pellucidum in median plane & attached to septum
in front & is closely related to fornix post. horn med. wall of lat. ventricle; bulb
forms ant. limit of lat. ventricle pellucidum in median
ant. horn on each side. plane & forms ant. horn body behind. On each side, it's lower of posterior horn.
*Fibres passing through curve floor of lat. ventricle on surface forms roof of ant. horn & *Some of fibres of splenium & body post.
forwards & med. into frontal each side. central part of lat. ventricle. part form roof & lat. wall of lat. ventricle
lobe forming forceps ant. *Fibres passing through *Fibers passing through connect both post. horn as they pass lat. then
(minor), connecting prefrontal connect orbital surfaces of downwards into occipital & temporal
parietal lobes & post. parts of both
region on either side. both frontal lobes. lobes, constituting tapetum
frontal lobes.

Blood supply of corpus callosum: All supplied by ant. cerebral a. except splenium which is supplied by post. cerebral a.

B-Ant. commissure
*Small rounded bundle of fibres crossing middle line within lamina terminalis, forming part of 3rd ventricle ant. wall.
* Some of its fibers join olfactory tract lat. root, but the remainder pass to temporal lobe cortex of. It connects temporal lobes,
olfactory bulbs & nuclei of both sides.
 C-Hippocampal commissure
Crosses midline between bodies & 2 crura of fornix, connecting hippocampi of both sides.
D-Post. commissure

Slender bundle of fibres lying in pineal stalk lower aspect, connecting Rt. & Lt.
superior colliculi, pretectal nuclei & med. longitudinal bundles.
E-Habenular commissure

Bundle of fibres lying in pineal stalk upper aspect above pineal recess & post.
commissure, connecting Rt. & Lt. habenular nuclei.
3-Projection fibers
Fibres passing through internal capsule either; to cortex from thalamus
(afferents sensory) or from cortex to lower centers (efferents motor).
a)Projection fibres to cerebral cortex (from thalamus):
*All impulses to cerebral cortex must stop first in thalamus; so the only fibers which
reach cortex come from thalamus; thalamo-cortical fibres or thalamic radiation.
1-Sensory radiation (sup. thalamic radiation): From PVNT to
sensory area (3, 1,2) in parietal lobe postcentral gyrus.
2-Visual (optic) radiation (post. thalamic radiation): From lat.
geniculate body to visual area (17) in occipital cortex.
3-Auditory radiation (inf. thalamic radiation): From med.
geniculate body to auditory area (41 &42) in temporal lobe.
4-Ant. thalamic radiation.

b)Projection fibres from cerebral cortex to lower centers:

1-Pyramidal tract (cortico-spinal & corticobulbar fibers).
2-Cortico-pontinefibres: Fronto-pontine fibers, Temporo-parieto-
occipito-pontine fibers.
3-Many extrapyramidal fibers to many extra-pyramidal centers.
4-Cortico-thalamic fibers to different nuclei of thalamus.

Internal capsule
*Def. & site: Broad projection fibers bundle, lying between lentiform nucleus
(lat.) & caudate head & thalamus (med.). Almost completely divides corpus
striatum into 2 parts. Continuous above with corona radiata & below with
basis pedunculi of midbrain cerebral peduncles.
 *Shape, parts, relations & contents: In horizontal section, it has a V-shaped
appearance, having;
Short ant. Apex (genu) Longer post. limb Retro-lenticular Sub-
limb part lenticular
part
Lies between Angle at Lies between lentiform Lies behind Lies below
lentiform nucleus junction of ant. nucleus (lat.) & lentiform nucleus. It lentiform. It
(lat.) & caudate & post. limbs. thalamus (med.). It contains optic contains auditory
nucleus head Fits into interval contains frontopontine,
radiation, parieto- radiation &
(med.). It between caudate corticospinal, corticorubral
pontine & occipito- temporo-pontine
contains fronto- head (in front) & & corticostriate fibers,
pontine fibers & thalamus (behind). sup. thalamic radiation, pontine fibers. fibers.

ant. thalamic It contains cortico-

radiation. nuclear fibers.
*Blood supply: -Ant. part of ant. limb is supplied by central branches of ant.
cerebral a.
-Post. part of ant. limb, genu & ant. part of post. limb are supplied by central
branches of middle cerebral a.
-Post. part of post. limb, retrolentiform & sublentiform parts are supplied by
ant. choroidal a. (branch of I.C.A).
Corona radiata
Mass consisting of nerve fibers passing between cerebral cortex & CNS other
parts (projection fibers diverging towards cerebral cortex different areas,
passing through internal capsule, from which they radiate into cerebral cortex
both antero-posteriorly & transversely reaching all hemisphere lobes).

Basal ganglia (nuclei)

*Def.: Gray matter collections which are deeply placed inside cerebral
hemisphere white matter.

*Components: a)Corpus striatum; formed of caudate & lentiform nuclei.

b)Amygdaloid nucleus (smell center) C)Claustrum (unknown function).
 Caudate nucleus Lentiform nucleus Amygdaloid nucleus Claustrum
*C-shaped mass of grey matter which is *Completely embedded in hemisphere. *Small round mass which *Thin gray matter
partly exposed in ventricular wall & partly *Consists of 2 parts: lies mostly in uncus, at layer between
buried in hemisphere. 1-Larger darker lat. part; putamen. ant. end of caudate lentiform nucleus
*It has; head, body & tail. 2-Smaller pale med. part; globus pallidus which is more nucleus tail, in inf. horn lat. surface &
1-Head: -Large ant. end. Forms lat. wall subdivided into internal & external segments by internal roof of lat. ventricle. insula.
& floor of lat. ventricle ant. horn. medullary lamina. Both parts are separated by whitish Fuses with cerebral cortex *Separated from
Laterally it is separated from lentiform streak. lat. to ant. perforated lentiform nucleus
substance. by external capsule
nucleus by internal capsule. *It looks like a biconvex lens having two convex surfaces;
& from insula by
-Inferiorly it becomes continuous with a)Lat. surface: Slightly convex & related to external
extreme capsule
putamen ant. end of lentiform nucleus & capsule which separates it from claustrum.
*It is smell center. It's *Its function is
ant. perforated substance grey matter.
b)Med. surface: Markedly convex & related to internal axons form stria unknown.
2-Body: Forms lat. part of body floor of capsule which separates it from thalamus & caudate nucleus. terminalis which ends in N.B.: External
lat. ventricle. Its lat. aspect is related to hypothalamus. capsule; thin layer
internal capsule. N.B.: Lentiform nucleus is related to two capsules; of white matter,
internal & external capsules. covering lentiform
3-Tail: Presents in inf. horn roof of lat.
ventricle. Terminates in amygdaloid nucleus lat. surface
nucleus in most ant. part of inf. horn roof. & separating it
from claustrum.

Blood supply of corpus striatum:

1-Ant. part of corpus striatum & ant. part of internal capsule ant. limb are supplied by central branches of ant. cerebral a.
2-Rest of corpus striatum, post. part of ant. limb, genu & ant. part of internal capsule post. limb are supplied by central (striate) branches of middle cerebral a.

N.B.: Caudate tail & amygdaloid nucleus are supplied by ant. choroidal a. (branch of I.C.A).
 Fornix
*It is an arched structure formed by axons of hippocampus cells (axons are projection fibers which will finally end in mammillary
body of hypothalamus). Each fornix has; crus (post. column), body (forming an arch) & column (ant. column). In inf. horn floor of lat.
ventricle, axons of hippocampus cells spread to form alveus which collect med. forming hippocampus fimbria.
*Purely olfactory in function, but recent evidence suggests that it plays role in visceral sensory function.

Septum pellucidum
*Sheet of gray & white matter, occupying interval between corpus callosum & fornix. 2 layers with slit like cavity inbetween. It forms
partition between ant, horns & central parts of both lat. ventricles
Lateral ventricle
*Site: Cavity of cerebral hemisphere (2 lat. ventricles; one in each cerebral hemisphere), lined by cubical epithelium (ependyma).
*Communictions: It communicates with 3rd ventricle through inter-ventricular foramen of Monro.
*Shape & parts: elongated crescentic cavity, consisting of body (central part) & 3 horns (ant., post. & inf.);
a)Ant. horn: Part in front of interventricular foramen, passes forwards & lat. into frontal lobe.
b)Central part (body): Extends from interventricular foramen to corpus callosum splenium, lies in parietal lobe.
c)Post. horn: Begins at corpus callosum splenium & runs backwards & med. into occipital lobe.
d)Inf. horn: Direct continuation of body; passes downwards & lat. round thalamus post. end, then forwards & med. into
temporal lobe as far as uncus.

N.B.: Meeting of body post. end, post. & inf. horns is called collateral trigone.
 *Boundaries & relations:

Ant. horn Central part (body) Post. horn Inf. horn

Triangular in coronal *Roof: Post. part of corpus callosum body. *Roof & lat. wall: * Roof: a)Caudate tail; passing forwards to end
section *Med. wall: Posterior part of septum pellucidum. Corpus callosum in amygdaloid nucleus.
*Ant. wall (limit): *Floor (from lat. to med.) by: tapetum, lateral to b)Stria terminalis; amygdaloid nucleus efferent,
Corpus callosum genu. a)Caudate body which arches above & lat. to which run optic runs backwards along caudate tail med. edge.
*Roof: Ant. part of corpus thalamus, with stria terminalis & thalamo-striate radiation fibers. *Floor (from med. to lat.) it shows:
callosum body. vein in between. *Med. wall: Sloping a)Fimbria(axons of hippocampus cells)
*Med. wall: Ant. part of b)Lat. part of thalamus dorsal (upper) surface. & shows 2 parallel b)Hippocampus; its ant. end (below
septum pellucidum c) Lateral ventricle choroid plexus. elevations: amygdaloid nucleus) is expanded to form pes
(above) & fornix body d) Fornix body which arches above med. part of a) Posterior horn hippocampi.
(below & behind). thalamus dorsal (upper) surface separating it bulb (above). c)Collateral eminence; slight elevation formed
*Lat. wall & floor: from lat. ventricle floor. b)Calcar avis by collateral sulcus.
Caudate head & upper (below). *Lat. wall: Formed by tapetum.
surface of corpus *Med. wall: Occupied by choroid fissure lower
callosum rostrum. part, through which choroid plexus (branch
from ant. choroidal a.) enters inf. horn.
Choroid plexus of lateral ventricle: In body (derived from post. choroidal a.) & inf. horn (derived from ant. choroidal a.).
 Diencephalon
*Site: Lies between lower parts of both cerebral hemispheres, above midbrain & surrounds 3rd ventricle.
*Subdivisions: 5 parts;
a)Thalamus: Cerebral cortex secretory; all impulses (except smell) have to stop & synapse in thalamus before reaching cortex.
b)Metathalamus: Formed of lat. & med. geniculate bodies which are attached to lower surface of thalamus post. part.
c)Subthalamus: Lies directly over midbrain & contains motor nuclei in extrapyramidal tracts pathway from cerebral cortex to
lower centers.
d)Hypothalamus: Lies in front of subthalamus & contains certain autonomic nuclei.
e)Epithalamus: Formed of 2 habenular nuclei (trigones), habenular commissure & pineal body. It is relay station on descending
pathways from cerebral hemisphere smell centers to midbrain tegmentum.

A)Thalamus
*Site: Above midbrain & projects beyond it, both in front & behind.
*Shape & relations: Oval in shape having 2 ends & 4 surfaces;
Ant. end Post. end Upper surface Lower surface Lat. surface Med. surface
Narrow & Expanded to form *Extra-ventricular med. *Its ant. part lies on Related to internal *Forms 3rd ventricle lat.
rounded, forms prominent swelling; part: Covered by 3rd hypothalamus. capsule post. limb, wall & connected to its
inter-ventricular pulvinar which ventricle tela choroidea & *Its middle part lies separating it from fellow by gray matter
foramen post. overhangs med. & lat. fornix body. over subthalamus lentiform nucleus. mass; interthalamic
boundary. geniculate bodies. *Intra-ventricular lat. which connects it with connection.
part: In floor of lat. midbrain cerebral *Separated from
ventricle body with peduncles. hypothalamus &
caudate body, separated *Its post. part subthalamus by
from it by stria terminalis overhangs med. & lat. hypothalamic sulcus.
& thalamo-striate v. geniculate bodies
 *Blood supply:
1-Posterior cerebral a. (basilar a. terminal branch); main supply through post. choroidal branch, med. & lat. central branches.
2-Post. communicating a. (I.C.A branch).

*Nuclei: Divided anatomically into subgroups of nuclei by white matter Y-shaped sheet; internal medullary lamina

Ant. Med. Lat. nucleus 2 post. nuclei 3 scattered

nucleus nucleus nuclei
Lies Lies med. *Lies lat. to lamina. Constitutes Intralaminar,
between to lamina. *Subdivided into dorsal & ventral parts which are in turn subdivided into several smaller
thalamus post. midline &
both nuclei; the most important of ventral nuclei is post. ventral nucleus of thalamus (PVNT).
expanded end, reticular
limbs *PVNT can be divided into: a)Lat. part (PLVNT) receiving : which over-
nuclei
of -Conscious proprioceptive & fine touch from body below head via med. lemniscus. hangs med. &
lamina. -Pain, temperature, crude touch & pressure from body below head via spinal lemniscus. lat. geniculate
b)Med. part (PMVNT) receiving: Pain, touch, temperature, proprioceptive & taste bodies.
sensations from head via trigeminal lemniscus.
N.B.:PVNT sends its efferent fibres to main sensory area (3, 1 & 2) in parietal lobe post
central gyrus.
B)Metathalamus (geniculate bodies)
Geniculate bodies constitute metathalamus & are placed on under-surface of posterior end thalamus (pulvinar). Considered as
thalamic centers of hearing & vision.
1-Med. geniculate body (MGB): Receive afferent fibres from lat. lemniscus & from inf. colliculus via inf. brachium. Sends efferent fibres
via internal capsule sub-lentiform part (auditory radiation) to area 41 & 42 (Heschl'sgyrus). Functions as relay on auditory pathway.

2-Lat. geniculate body (LGB): Receives afferent fibres from optic tract. Sends efferent fibres via internal capsule retro-lentiform
part (visual radiation) to area 17 (occipital cortex). It constitutes 3rd order neuron in vision pathway.

C)Subthalamus
Diencephalon part lying immediately below thalamus & connecting it to midbrain tegmental region.
D)Hypothalamus
*Horizontal part; structures forming 3rd ventricle floor (interpeduncular fossa contents): infundibulum, tuber cinereum,
mammillary bodies & post. perforated substance.
*Vertical part; structures lying in 3rd ventricle lat. wall, below & in front of hypothalamic sulcus.

E)Epithalamus (Pineal body)

*Connected to 3rd ventricle post. wall by pineal body stalk. Pineal body stalk is penetrated by 3rd ventricle pineal recess, which
subdivides stalk into upper & lower parts (roots). The lower root curves downwards covering post. commissure, while upper root
connects both habenular trigones (habenular commissure).
* Has been considered to be ductless gland secreting melatonin & playing role in biological clock rhythm. Also secretes indolamines
& polypeptide hormones which regulate hormones secreted by adenohypophysis (ant. pituitary). Becomes fibrosed & usually
contains calcareous deposits in adult life.
 Third Ventricle (Diencephalon Cavity)
*Def. & site: Diencephalon cavity, lying between both thalami.

*Communications: 1-In front; with lat. ventricles through interventricular foramina. 2-Behind; with midbrain aqueduct.

*Boundaries, relations & recesses:

Roof Floor Ant. wall Post. wall Lat. wall
*Consists of ependyma, which is *Hypothalamus (optic *Lamina terminalis. *Upper opening of midbrain aqueduct. *Thalamus.
invaginated by 3rd ventricle choroid chiasma, infundibulum, *Ant. commissure. *Post. commissure in pineal body *Hypothalamus.
plexus. tuber cinereum, *Fornix column. stalk lower limb. *Hypothalamic sulcus.
mammillary bodies & *Pineal body stalk invaginated by
*Sup., it is related to transverse
post. perforated pineal recess.
cerebral fissure containing tela
substance) (in front). *Habenular commissure in pineal
choroidea (contains post. choroidal
*Subthalamus (behind). body stalk upper limb.
a. & internal cerebral v.).
*More sup.; fornix body, lat.
ventricle body, septum pellucidum
& corpus callosum body.
Recesses (4): *Below & in front; 1-Optic recess: Above & in front of optic chiasma.
2-Infundibular recess: Below & behind optic chiasma.
*Above & behind; 3-Suprapineal recess: Above pineal body stalk.
4-Pineal recess: Projects into pineal body stalk, above post. commissure & below habenular commissure.
 Meninges
Brain & spinal cord are surrounded by 3 membranes called meninges;; pia, arachnoid & dura mater (from inside outwards).
Pia mater Arachnoid mater Dura mater

*Innermost covering & closely applied *Thin & delicate membrane between pia & dura maters, *Brain outermost covering, firmly
to brain surface, carried into all sulci by bridges over sulci on brain surface. adherent to periosteum lining skull
cerebral arteries branches. *subarachnoid space: Space between pia & arachnoid bones inner surface. Both layers cannot
*Pia mater double fold intervenes maters. Contains CSF & crossed by fine fibers reticulum which be separated from each other except at
between fornix body (above) & both connect pia & arachnoid, keeping subarachnoid space narrow. dural venous sinuses sites.
thalami upper surfaces (below), In certain situations reticulum is much reduced & both
*At certain sites it becomes folded
coming in contact with ependymal membranes are widely separated leading to subarachnoid
forming double-layered septa between
floor of lat. ventricle central part space widening; subarachnoid cisterns. Brain blood vessels lie
(above) & with ependymal roof of 3rd in subarachnoid space. brain different parts (falx cerebri,
ventricle (below). It is called 3rd *Subarachnoid cisterns: tentorium cerebelli & falx cerebelli).
ventricle tela choroidea & contains a)Cerebello-medullary cistern: (cisterna *Subdural space: Lies between dura &
post. choroidal a. magna): Lies between cerebellum & lower half of 4TH
arachnoid mater, contains subdural
*Over lower part of 4th ventricle roof, ventricle roof which opens into cistern by Magendie median
serous fluid.
pia mater comes in direct contact with aperture for CSF drainage.
ependyma forming 4th ventricle tela b)Pontine (ponto-medullary) cistern: Lies in front of *Extradural (epidural) space:
choroidae which contains choroidal pons & medulla, contains vertebral & basilar aa. Traversed by Restricted only to vertebral canal. Spinal
branch of PICA forming choroid plexus, lower eight cranial nerves roots. 4th ventricle opens into it by dura is not adherent to vertebral canal
below which ventricle roof is pierced by Luschka lat. apertures for CSF drainage. periosteum, being separated from it by
median aperture. c)Interpeduncular cistern: Lies in interpeduncular narrow epidural space. Local anesthetics
*Pia double fold intervenes between fossa, contains arteries forming circulus arteriosus. Traversed injected into this space is called spinal
RD TH
temporal lobe med. surface & by the 3 & 4 cranial nerves roots. epidural anesthesia.
d)Lat. fissure cistern: interpeduncular cistern extension
midbrain lat. surface forming tela
*At foramen magnum margin, cranial
choroidea of lat. ventricle inf. horn, into lat. fissure main stem, contains middle cerebral a.
dura becomes continuous with spinal
where pia comes in contact with e)Corpus callosum cistern: Extends along callosal sulcus
ependyma of inf. horn med. wall. It on corpus callosum upper surface, contains ant. cerebral a. dura. As cranial & spinal nerves leave
f)Chiasmatic cistern: Lies around optic chiasma.
contains ant. choroidal a. brain & spinal cord surface, they carry
N.B.: All cisterns communicate freely with each other.
fine coverings of pia & arachnoid mater
*Arachnoid villi & granulations: Arachnoid mater projections
which push themselves inside dural venous sinuses. Found in with them & finally acquire a dura mater
large numbers especially along SSS, increasing in size & number investment.
in old age. Serve as channels for CSF drainage to blood stream.

Cerebrospinal fluid (csf)

*Def.: Fluid which circulates in ventricles & central canals of CNS, also fills subarachnoid space & cisterns.

*Production: Secreted by choroid plexuses in brain ventricles. Each ventricle has a choroid plexus; 1-One in central part floor of each lat.
ventricle 2-One in inf. horn med. wall of each lat. ventricle 3-Pair in roof of each of 3RD & 4TH ventricles.
 *Circulation: It circulates in CNS ventricles & central canals. After circulation it drain out from 4th ventricle through 3 apertures (1
median and 2 lateral) found in roof reaching subarachnoid space, where it flows over brain & spinal cord surfaces.

*Absorption (Drainage) into blood stream: CSF finally leaves subarachnoid space by means of arachnoid villi & granulations to drain
into dural venous sinuses.

*Functions: 1-It takes lymph place in CNS which is devoid of lymph vessels.
2-In subarachnoid space, it acts as protective water cushion which protects brain & spinal cord & minimize shock effects.
3- Intracranial pressure regulation 4-Reduces brain weight 30 folds.
*Amount & pressure: It's average amount in adult is about 135 cc. It is constantly absorbed & produced in rate of 400 to 500 cc
daily (renewed three times daily). It's pressure is normally about 100 mm water. Any obstruction to it's normal passage especially
at narrow foramina & canals causes increased intracranial pressure & ventricles dilatation; hydrocephalus.
ARTERIAL SUPPLY OF BRAIN
Brain receives its blood supply from 2 sources; vertebrobasilar & internal carotid systems.

Vertebrobasilar system
Vertebral a. Basilar a.
*Origin: At neck root, from subclavian a. 1st part. *Origin: At pons lower border, by union of 2 vertebral aa.

*Course of 4th part: Vertebral arteries enter skull through foramen *Course: Passes along pons basilar groove, lying on occipital bone
magnum, where they run upward forwards & med. on medulla ant. surface. basilar part.
*End: At pons lower border where both aa. unite together forming basilar a. *End : At pons upper border by dividing into 2 post. cerebral aa.

*Branches: *Branches:
1-Post. inf. cerebellar a. (largest branch): Runs backwards around 1-Ant. inf. cerebellar a.: Passes lat. & backwards around pons
medulla just below olive, then it turns round ICP reaching cerebellum inf. lower border. Ends by supplying ant. part of cerebellum inf. surface
surface. It supplies post. part of cerebellum inf. surface & hemisphere inf. & MCP. Sometimes give labyrinthine a.
vermis, medulla dorsolateral zone including ICP, 4th ventricle choroid plexus
2-Pontine branches: Paramedian; supplies basis pontis median
& usually gives post. spinal a. Its Occlusion results in lat. medullary syndrome.
zone, short circumferential; supplies basis pontis lat. zone & long
2-Post. spinal a.: From vertebral a. or its PICA branch. Descends to spinal circumferential; supplies pons tegmentum.
cord along spinal nerves post. roots. Supplies spinal cord post. 1/3, gracile & 3-Labyrinthine a.: Accompany 7th & 8th cranial nerves into internal
cuneate nuclei. auditory meatus to supply internal ear.
3-Ant. spinal a.: 2 ant. spinal aa. run obliquely downwards & med. in 4-Sup. cerebellar a.: Passes around midbrain lower part
front of medulla & unite forming single ant. spinal a. which descend along reaching cerebellum sup. surface & ends by supplying it & SCP.
spinal cord ant. median sulcus down to filum terminale. Supplies spinal cord
5-Posterior cerebral aa: 2 terminal branches (see later).
ant. 2/3 & medulla med. zone. Occlusion results in med. medullary syndrome.

4-Medullary branches: Supplies medulla middle zone.

Internal carotid system

*Origin: In neck as one of 2 terminal branches of common carotid artery (CCA), opposite disc between C3 & C4.
*Course: Enters skull through carotid canal reaching cavernous sinus. Leaves cavernous sinus by piercing dura & arachnoid
 maters reaching subarachnoid space in interpeduncular cistern, where it gives; a)Ophthalmic a. to orbit.
b)Post. communicating a. to join post. cerebral a. sharing in circulus arteriosus formation. c)Ant. choroidal a.
*End: Terminates below ant. perforated substance by dividing into 2 terminal branches; ant. cerebral a. (small) & middle cerebral
a. (larger & nearly in direct line with ICA main trunk).
*Branches: 1-Ant. choroidal a.: Passes backwards along optic tract around cerebral peduncle lat. surface as far as lat.
geniculate body. Ends by entering lat. ventricle inf. horn (in its med. wall) through choroid fissure lower part supplying it's choroid
plexus. Also supplies optic tract, lat. geniculate body & internal capsule (post. part of post. limb, retrolentiform & sublentiform parts).
2-Post. communicating a. 3-Ophthalmic a. 4-Ant. cerebral a. 5-Middle cerebral a.

Cerebral arteries
Ant. cerebral a. Middle cerebral a. Post. cerebral a.
*Origin At ant. perforated substance as smaller At ant. perforated substance as larger of 2 Rt. & Lt. post. cerebral aa. begin at pons
of 2 terminal branches of ICA. terminal branches of ICA. It is in more direct upper border as the 2 terminal branches
continuation with ICA (therefore, small emboli of basilar a.
which pass through ICA go more frequently to
MCA than to ACA).

*Course -Passes forwards & med. reaching ant. Runs laterally in lat. fissure stem till it reaches -Curves lat. & backwards around midbrain
part of median longitudinal cerebral hemisphere lat. surface. It continues backwards cerebral peduncle, above & parallel to sup.
fissure, where it becomes in close in lat. fissure post. ramus crossing over insula. cerebellar a. with trochlear nerve in between.
relation with its fellow of opposite site &
 become connected to each other by -Then it continues to reach below corpus
short ant. communicating a. splenium on hemisphere med. surface.

-It turns sharply upwards reaching

cerebral hemisphere med. surface, where
it runs in callosal sulcus lying 1ST below
corpus rostrum, then curving upwards in
front of genu & finally backwards along
upper surface of corpus body reaching
splenium where it ends.

*End By breaking up into many terminal cortical By dividing into terminal cortical branches
By turning upwards ant. to parieto-
occipital sulcus, becoming cortical a. branches which emerge from in between lips of run in parieto-occipital & calcarine sulci.
lat. fissure post. ramus to appear on hemisphere N.B.: Each a. is connected to I.C.A of it's
lat. surface. side by post. communicating a.
*Branches a)Cortical branches: Supply; a)Cortical branches: Supply; a)Cortical branches: Supply;

*Med. 1/2 of hemisphere orbital surface. *Lat. 1/2 of hemisphere orbital surface. *Hemisphere tentorial surface behind
*Hemisphere med. surface from frontal *Temporal pole & insula. temporal pole (which is supplied by MCA).

pole back to parieto-occipital sulcus. *Whole hemisphere lat. surface, except: *Narrow strip on temporal lobe lat.
*Upper 1 inch of hemisphere lat. surface. 1-Narrow strip (1 inch breadth) along surface along hemisphere inf. border.
 hemisphere sup. border back to parieto-occipital * Whole occipital lobe (med., lat. & inf.
sulcus, which is supplied by ACA.
surfaces).
2-Occipital lobe lat. surface & narrow strip of
temporal lobe along hemisphere inf. border,
which are supplied by PCA.

b)Central branches: Penetrate ant. b)Central (striate) branches: Penetrate ant. b)Central branches: -Short med. group;
perforated substance to supply; perforated substance to supply; pierce post. perforated substance &

-Corpus striatum ant. part. -Corpus striatum. supply: Midbrain cerebral peduncles,
-Internal capsule (post. part of ant. limb, genu mammillary bodies, thalamus ant. part &
-Ant. part of internal capsule ant. limb. & ant. part of post. limb). subthalamic region.
c)Branches to septal region: Including -Long lat. group; curve round midbrain
septum pellucidum. lat. side & supply: Thalamus post. part,
N.B.: One large branch of these arteries is called lat. & med. geniculate bodies, pineal
cerebral haemorrhage a. which frequently body & midbrain tectum.
ruptures causing haemorrhage inside cerebral
d)Callosal branches: Supply all corpus
hemisphere & causes pressure on internal c)post. choroidal a.: Arises from PCA
callosum parts, except splenium while lying below corpus splenium.
capsule motor fibres producing hemiplegia
(supplied by post. cerebral a.). Passes forwards inside 3rd ventricle tela
(paralysis of body muscles of opposite 1/2). choroidea to supply choroid plexuses of
3rd & lat. ventricle central part. Also
supplies thalamus upper surface.
 *Clinical ACA supplies 3 importance regions: MCA supplies following importance areas: PCA supplies 5 important regions:
importance *Motor & sensory areas for lower limb &
*Motor & sensory areas for whole body, except *Smell centre in uncus.
perineum. *Septal region
lower limbs.
(lesion result in prolonged unconsciousness).
*Whole visual cortex in occipital lobe.
*Auditory area in sup. temporal gyrus.
*Corpus callosum: It's lesion may result
*Most thalamus. *Most midbrain.
in apraxia (inability to do purposeful *Motor & sensory speech areas.
movements, while muscles concerned * Insula & internal capsule. *Most of lat. & 3rd ventricles choroid
are not paralysed). plexuses.

CIRCULUS ARTERIOSUS (CIRCLE OF WILLIS)

*Site: Lies in interpeduncular cistern at brain base, in interpeduncular fossa neighborhood & around hypothalamus region.

*Formation: a)6 large aa.; Rt. & Lt. ant. cerebral aa., Rt. & Lt. internal carotid aa., Rt. & Lt. post. cerebral aa.
b)3 communicating aa.; 1 ant. (connects the 2 ant. cerebral aa.) & 2 post. (each connects ICA with PCA of its same side.).

N.B.: -It is common that one of arteries forming circle of Willis may be very small or even completely absent without any clinical
disturbances under normal conditions.
-Under normal conditions little mingling of blood of both sides occurs, but if one big a. becomes closed before it enters in circle
formation, the connections may open up.
–Cortical branches anastomose with one another before entering brain, while central branches are end arteries.
 Veins of brain
Superficial veins draining cortex Deep veins draining hemisphere deeper parts
a)Veins on hemisphere lat. surface; 1-Deep middle cerebral v.: Lies in bottom of lat. fissure post. ramus on
1-Sup. cerebral vv.: Drain upper part of hemisphere lat. surface & insula surface. Runs med. to end near ant. perforated substance by joining
end in SSS. ant. cerebral v. to form basal v.

2-Superficial middle cerebral v.: Lies on lat. fissure post. ramus &
receives veins of lat. surface middle part to end in cavernous sinus.

3-Inf. cerebral vv.: Drain lowest part of hemisphere lat. surface &
end in transverse sinus.

b)Veins on hemisphere med. surface; 2-Basal v.: (Rt. & Lt.): Formed below ant. perforated substance by union of
deep middle cerebral & ant. cerebral vv. Curves backwards around midbrain
1-Veins from upper part: Drain into both SSS & ISS.
lat. surface reaching below corpus splenium.
2-Veins from lower part: Drain into ant. cerebral v. which begins
near splenium, runs forwards over corpus upper surface, then
downwards around genu to end into basal v. near ant. perforated 3-Internal cerebral vv.: Emerge from tela choroidea below corpus splenium,
substance. draining lat. & 3rd ventricles choroids plexuses.

4-Great cerebral v.: Begins below corpus splenium by union of Rt. & Lt.
internal cerebral vv. & Rt. & Lt. basal vv. It turns upwards behind splenium to
join ISS forming straight sinus.