COMPILED BY D NCUBE

UNIVERSITY OF ZIMBABWE
COLLEGE OF HEALTH SCIENCES
2015

BRAIN AND SPINAL CORD

 Objectives
 To describe the anatomy of the CNS by considering:
 External features of the brain and spinal cord
 Cellular organization in the brain and spinal cord
 Meningeal coverings of the CNS
 To note relevant clinical correlates
The Spinal Cord
 Foramen magnum to L1 or L2
 Runs through the vertebral canal of the vertebral column

 Functions
1. Sensory and motor innervation of entire body inferior to
the head through the spinal nerves
2. Two-way conduction pathway between the body and the
brain
3. Major center for reflexes
 Spinal cord
 Fetal 3rd month: ends at
coccyx
 Birth: ends at L3
 Adult position at approx L1-2
during childhood
 End: conus medullaris
 This tapers into filum
terminale of connective tissue,
tethered to coccyx
 Spinal cord segments are
superior to where their
corresponding spinal nerves
emerge through intervetebral
foramina.
 Denticulate ligaments: lateral
shelves of pia mater anchoring
to dura.
Spinal
nerves
 Part of the
peripheral
nervous
system
 31 pairs
attach
through
dorsal and
ventral nerve
roots
 Lie in
intervertebral
foramina
 Spinal nerves continued
 Divided based on vertebral locations
 8 cervical
 12 thoracic
 5 lumbar
 5 sacral
 1 coccygeal
 Cauda equina (“horse’s tail”): collection of nerve
roots at inferior end of vertebral canal
 Spinal nerves continued
 Note: cervical spinal nerves exit
from above the respective vertebra
 Spinal nerve root 1 from above C1
 Spinal nerve root 2 from between C1
and C2, etc.
 Clinically, for example when
referring to disc impingement, both
levels of vertebra mentioned, e.g.
C6-7 disc impinging on root 7
 Symptoms usually indicate which
level
 Protection: Bone
Meninges
3 meninges:
CSF (cerebrospinal fluid)
dura mater (outer)
arachnoid mater (middle)
pia mater (inner)
3 potential spaces
epidural: outside dura
subdural: between dura &
arachnoid
subarachnoid: deep to arachnoid
 Spinal cord
coverings and
spaces
 Dura mater
 Arachnoid
mater
 Pia mater
LP (lumbar puncture) = spinal tap
(needle introduced into subdural space to collect CSF)
Lumbar spine
needs to be flexed
so that the needle
can go between
spinous processes
Originally thought to be a narrow fluid-filled interval between
the dural and arachnoid; now known to be an artificial space
created by the separation of the arachnoid from the dura as
the result of trauma or some ongoing pathologic process; in
the healthy state, the arachnoid is attached to the dura and a
naturally occurring subdural space is not present.
http://cancerweb.ncl.ac.uk/cgi-bin/omd?subdural+space

Epidural space is external to dura

Anesthestics are often injected into epidural space
Injection into correct space is vital; mistakes can be lethal
 Spinal cord anatomy
 Posterior median sulcus (“p”)
 Anterior median fissure (“a”)
 White matter (yellow here)
 Gray matter (brown here)
“p”

“a”
 Gray/White in spinal cord
 Hollow central cavity (“central
canal”)
 Gray matter surrounds cavity Dorsal (posterior)
 White matter surrounds gray
matter (white: ascending and white
descending tracts of axons)
gray
 “H” shaped on cross section Central canal______
 Dorsal half of “H”: cell bodies
of interneurons
 Ventral half of “H”: cell
bodies of motor neurons Ventral (anterior)

 No cortex (as in brain)

 Spinal cord anatomy
 Gray commissure with central canal
 Columns of gray running the length of the
spinal cord
 Posterior (dorsal) horns (cell bodies of interneurons)

 Anterior (ventral) horns (cell bodies of motor neurons)

 Lateral horns in thoracic and superior lumbar

cord *
*

*
*
 White matter of the spinal cord
(myelinated and unmyelinated axons)

 Ascending fibers: sensory information from sensory

neurons of body up to brain
 Descending fibers: motor instructions from brain to
spinal cord
 Stimulates contraction of body’s muscles
 Stimulates secretion from body’s glands
 Commissural fibers: white-matter fibers crossing from
one side of cord to the other
 Most pathways cross (or decussate) at some point
 Most synapse two or three times along the way, e.g. in
brain stem, thalamus or other
 Space restrictions force cerebral hemispheres to grow
posteriorly over rest of brain, enveloping it
 Cerebral hemispheres grow into horseshoe shape (b and c)
 Continued growth causes creases, folds and wrinkles
Brain development
Encephalos means brain
 Anatomical classification
 Cerebral
hemispheres
 Diencephalon
 Thalamus
 Hypothalamus
 Brain stem
 Midbrain
 Pons
 Medulla
 Cerebellum
 Spinal cord
Cerebrum
Diencephalon
Brainstem
Cerebellum
Usual pattern of gray/white
in CNS

 White exterior to gray

 Gray surrounds hollow
central cavity
 Two regions with
additional gray called
“cortex”
 Cerebrum: “cerebral cortex”
 Cerebellum: “cerebellar cortex”
Gray and White Matter

 Like spinal cord but with

another layer of gray outside
the white
 Called cortex
 Cerebrum and cerebellum have
 Inner gray: “brain nuclei”
(not cell nuclei)
 Clusters of cell bodies

Remember, in PNS clusters of cell

bodies were called “ganglia”
 Ventricles
 Central cavities expanded
 Filled with CSF (cerebrospinal fluid)
 Lined by ependymal cells (these cells lining
the choroid plexus make the CSF)
 Continuous with each other and central canal
of spinal cord
 Lateral ventricles
 Paired, horseshoe shape
 In cerebral hemispheres
 Anterior are close, separated only by thin
Septum pellucidum
 Third ventricle
 In diencephalon
 Connections
 Interventricular foramen
 Cerebral aqueduct
 Fourth ventricle
 In the brainstem
 Dorsal to pons and top of medulla
 Holes connect it with subarachnoid space
 Subarachnoid space
 Aqua blue in this pic
 Under thick
coverings of brain
 Filled with CSF also
 Red: choroid plexu
Surface anatomy

 Gyri (plural of gyrus)

 Elevated ridges
 Entire surface
 Grooves separate gyri
 A sulcus is a shallow
groove (plural, sulci)
 Deeper grooves are
fissures
 Gyri (plural of gyrus)
 Elevated ridges
 Entire surface
 Grooves separate gyri
 A sulcus is a shallow groove (plural, sulci)
 Deeper grooves are fissures
Parts of Brain
Cerebrum
Diencephalon
Brainstem
Cerebellum
simplified…

 Back of brain: perception

 Top of brain: movement
 Front of brain: thinking
Cerebral hemispheres
 Lobes: under bones of same name

 Frontal

 Parietal

 Temporal

 Occipital

 Plus: Insula (buried deep in lateral sulcus)

 Cerebral hemispheres: note lobes
 Divided by longitudinal fissure into right &
left sides
 Central sulcus divides frontal from parietal
lobes
 Lateral sulcus separates temporal lobe
from parietal lobe
 Parieto-occipital sulcus divides occipital
and parietal lobes (not seen from outside)
 Transverse cerebral fissure separates
cerebral hemispheres from cerebellum
 coronal section
 Note: longitudinal fissure, lateral sulcus,
insula
 Note: cerebral cortex (external sheet of
gray), cerebral white, deep gray (basal
ganglia)
Cerebral cortex
 Executive functioning capability
 Gray matter: of neuron cell bodies, dendrites,
short un-myelinated axons
 100+ billion neurons with average of 10,000
contacts each
 No fiber tracts (would be white)
 2-4 mm thick (about 1/8 inch)
 Brodmann areas (historical: 52 structurally
different areas given #s)
 Neuroimaging: functional organization
THE END
Anatomy of the Human
Cerebrum
Objectives
 To discuss the Neuron Doctrine
 To discuss the functional localization of
the human cerebrum
 To state any deficits of function as a
result of damage to functional areas
 Neuron Doctrine (4
principles)
 Formulated by Cajal in the 1890’s [popularized by Waldeyer in the early
1900’s] using a Golgi (silver) stain studying the brains of newborn animals
 1. Neuron is the fundamental structural[trophic and genetic] & functional element
in the brain
 2. Terminals of one neurons axon communicate with the dendrites of another neuron
only at specialized sites (later named synapses by Sherrington)
 Synapse between two neurons characterized by a gap
 Now called a synaptic cleft
 3. Connection specificity
 Neurons communicate with certain neurons & not with others
 4. Dynamic polarization
 Unidirectional signaling
 Both Cajal & Golgi shared the 1904 Nobel prize in physiology or medicine for
this work
 Cerebral Cortex
 Every cubic inch of cerebral cortex has about 10,000
miles of nerve fibers in it
 Thickness varies from region to region app. 4.5mm in
pre-central gyrus and 1.5 mm in the depths of the
calcarine sulcus.
 The number of neurons in the brain is about 30 X
greater than the number of humans on the planet. (180
billion)
 A typical neuron is wired to about 1000-2000 of its
neighbors
 It is the pattern of these connections that determines what
the brain does
 Glial-Neuron Debate

“My investigations showed that the functional superiority of the human brain
is intimately bound up with the prodigious abundance and unusual wealth of
forms of the so-called neurons with the short axons.”
 S. R. y Cajal: Recuerdos de mi vida. 1917.
“Interneurons are butterflies of the soul.”
 S.R. y Cajal 1923
 [Role of macroglia in the function of the brain: Glia: Neuron
debate…further complicated/supported by Einstein’s Brain; Marion C
Diamond]
 Recent studies show depletion of glia in chronic alcoholism partly
explaining decline in reasoning capacity in these individuals
Essence of gyri and sulci
 Increase the surface area of the brain
 Sulci are believed to be formed when
fibres connecting functionally associated
areas are developing and draw these
areas together
 Gyri are also implicated in a greater
integrative capacity though this is
debatable
 Cortical layers of the
cerebrum
 Differ from region to region
 The 6 layered cortex in humans is referred to as the neo-
cortex
 Phylogenetic classification of the cortex:
 Paleocortex (olfactory cortex) & Archicortex (hippocampal
formation & dentate gyrus)
 both have 3 layers and collectively constitute the
allocortex/heterogenetic/heterotypical
 Neocortex
 Homotypical
 Structural Organization
of the Cortex
Six Layers within a One Column
skull
Cerebral Cortex:
meninges

• neocortex: 6 layers
I

II processing
Glutamate released
III
IV
• paleocortex: 3 layers
V Output to column or

VI
other area
Glutamate released
• inside to outside
layering of cells during
Subcortex Input
development
 Type of fiber bundles within
the hemispheres
 Association: connect one cortical area to the next
e,g arcuate fasciculus, sup/inf longitudinal fasciculus
 Commissural: corpus callosum, ant, post comm
 Projection fibers: “ project” from the brain to and
from subcortical areas e.g. internal capsule: can be
afferent or efferent; most originate in the thalamus
 Association fibers are the most numerous of the 3
fiber types
Cytoarchitectonic Map
 Patterns of cellular organization determine regional
anatomical distribution of brain areas.
 This regional distribution of cellular organization is
related to behavior (i.e. functional organization).
 Korbinian Brodmann divided the cortex using
cytoarchitecture of cells in different brain regions
into areas
 These areas aren’t necessarily 100% accurate and
agreed by scientists but they are used as an
accepted scheme in studies of the human brain
from: Rosenzweig, et al., 2002
Defining the lobes

central (rolandic)
frontal lobe sulcus

parietal lobe

occipital
lobe

temporal lobe sylvyan (lateral) sulcus

Development of Sulci

Sulci appear at predictable points in fetal development with the most

prominent sulci (e.g., Sylvian fissure) appearing first.

Source: Ono, 1990

 Comparative Neuroanatomy

The complexity of sulci increased throughout

evolution
Source: Comparative Mammalian Brain Collection http://brainmuseum.org/
Major Sulci

Main sulci are formed early in development

Fissures are really deep sulci

Typically continuous sulci

•Interhemispheric fissure
•Sylvian fissure
•Parieto-occipital fissure
•Collateral sulcus
•Central sulcus
•Calcarine Sulcus

Typically discontinuous sulci

•Superior frontal sulcus
•Inferior frontal sulcus
•Postcentral sulcus
•Intraparietal sulcus
•Superior temporal sulcus
•Inferior temporal sulcus
•Cingulate sulcus
•Precentral sulcus

Other minor sulci are much less reliable

Source: Ono, 1990
Interhemispheric Fissure
- divides brain into 2
hemispheres
Sylvian Fissure (or lateral sulcus)
-deep, mostly horizontal
-insula (purple) is buried within it
-separates temporal lobe from parietal and frontal lobes

Sylvian Fissure
Parieto-occipital Fissure and Calcarine Sulcus
Parieto-occipital fissure (red) Cuneus (pink)
-very deep -visual areas on medial side above
-often Y-shaped from sagittal view, X-shaped calcarine (lower visual field)
in horizontal and coronal views Lingual gyrus (yellow)
-visual areas on medial side below
Calcarine sulcus (blue) calcarine and above collateral sulcus
-contains V1 (upper visual field)
 Collateral Sulcus
-divides lingual (yellow) and parahippocampal (green) gyri from fusiform gyrus (pink)
 Cingulate Sulcus
-divides cingulate gyrus (turquoise) from precuneus (purple) and paracentral lobule (gold)
 Central, Postcentral and Precentral Sulci
Central Sulcus (red) Precentral Sulcus (green)
-usually freestanding (no intersections) -often in two parts (superior and inferior)
-just anterior to ascending cingulate -intersects with superior frontal sulcus (T-
junction)
-marks anterior end of precentral gyrus (motor
Postcentral Sulcus (blue) strip, yellow)
-often in two parts (superior and inferior)
-often intersects with intraparietal sulcus
-marks posterior end of postcentral gyrus
(somatosensory strip, purple)

ascending band
of the cingulate
 Intraparietal Sulcus
-anterior end usually intersects with inferior postcentral (some texts call inferior postcentral the
ascending intraparietal sulcus)
-posterior end usually forms a T-junction with the transverse occipital sulcus (just posterior to the
parieto-occipital fissure - POF)
-IPS divides the superior parietal lobule from the inferior parietal lobule (angular gyrus, gold, and
supramarginal gyrus, lime)

POF
Slice Views

inverted omega
= hand area of motor cortex
Superior and Inferior Temporal Sulci
Superior Temporal Sulcus (red)
-divides superior temporal gyrus (peach) from middle temporal gyrus (lime)

Inferior Temporal Sulcus (blue)

-not usually very continuous
-divides middle temporal gyrus from inferior temporal gyrus (lavender)
 Superior and Inferior Frontal Sulci
Superior Frontal Sulcus (red)
-divides superior frontal gyrus (mocha) from middle frontal gyrus (pink)

Inferior Frontal Sulcus (blue)

-divides middle frontal gyrus from inferior frontal gyrus (gold) Frontal Eye fields lie at this junction

orbital gyrus (green) and frontal pole (gray) also shown

Medial Frontal
-superior frontal gyrus continues on medial side
-frontal pole (gray) and orbital gyrus (green) also shown
 Primary motor area M I

 Precentral gyrus, area 4

 Part of the cortex from which movements are easily produced by
electrical stimulation
 Motor homunculus (overrepresentation muscles of the thumb, hand,
face, tongue, somatotopic representation)
 Afferents : S I, thalamic VL
 Efferents : basal ganglia, thalamus, (VL) RF, superior colliculus, nc.
ruber, RF, pontine ncc., spinal cort
 Control of distal muscles
 Damage produces paralysis of contralateral muscles (namely upper
limb, tongue, facial muscles)
 Premotor area, PM

 Area 6
 Somatotopic representation of the body musculature, less precisely
organized
 Efferents – M I, basal ganglia, RF, Spinal cord (influences paravertebral
and proximal limb musculature)
 Afferents – thalamic VA (basal ganglia), S I,
 Preparation to move
 Supplementary motor area

 Area 6, medial surface of the hemisphere

 Somatotopic organization,less precisely organized
 Afferents – thalamic VA (basal ganglia), parietal cortex
 Efferents – MI, Basal ganglia, RF, Spinal cord
 Area involved in organizing and planning the sequence of
muscle activation
 Somatosensory area S I

 Postcentral gyrus
 Areas 3a, 3b, 1, 2
 Afferents : VPL, VPM
 Efferents : M I, thalamus (VPL, VPM), pontine ncc., nuclei of cranial
nerves (V.), spinal cord
 3a – signals from muscle spindles
 3b – cutaneous receptors
 2 – joint receptors
 1 – all modalities
Sensory
homunculus
LANGUAGE AREAS

Broca : patient losses the ability to speak, produces single words, or syllables. Understanding of language is
preserved. Often combined with agraphia.

Wernicke : sensory or receptive aphasia, spontaneous speech is fluent, but sounds

are often put together into meaningless words – „ word salad „. Often combined
with alexia – the inability to read.
 Auditory cortex

 Area 41
 Afferents – auditory pathway (thalamic medial geniculate
body)
 Efferents – thalamus (medial geniculate body), inferior
colliculus, associative cortical areas (what and where paths)
 Visual cortex

 Area 17, granular cortex

 Afferents – visual pathway, thalamic lateral geniculate body
 Efferents – thalamus (lateral geniculate body), area 18, 19, parietal
cortex, temporal cortex.
 Dorsal stream – parietal cortex (where : rods, periphery of
retina, area 7)
 Ventral stream – temporal cortex (what- colors, form : cones,
central area of retina, area 37, inferior. temporal cortex)
Sensory homunculus
Reading assignment :
sensorimotor dysfunctions

 Apraxia
 Aphasia
 Strereognosia
 Praxis
 Agnosia
 Locked in syndrome
The
End
Blood supply of the Brain and
Spinal Cord
Objectives
 Describe the four arteries supplying the CNS.

 Follow up each artery to its destination.

 Describe the circle of Willis and its branches.

 Discuss the principle of end artery type of

circulation.
 Describe venous drainage of the brain.

 Describe the blood supply and venous drainage

of the spinal cord.
 The brain is supplied by
two internal carotid &two
vertebral arteries.
 They lie within
subarachnoid space, and
their branches
anastomose on inferior
surface of brain to form
circle of Willis.
Internal Carotid Artery:
 It begins at the bifurcation of the
common carotid artery, where it has
the carotid sinus.
 It ascends by passing through the
carotid canal of the temporal
throubone.
 Then pass through cavernous sinus
and perforates the dura mater and
enters the subarachnoid space .
 At the medial end of the lateral
cerebral sulcus it divides into anterior
and middle cerebral arteries
Branches of internal carotid artery:
 Ophthalmic artery supplies the eye and its
terminal branches supply frontal area of scalp,
ethmoid and frontal sinuses, and dorsum of nose.
 Posterior communicating artery join the
posterior cerebral artery, forming part of circle of
Willis.
 Choroidal artery enters inferior horn of lateral
ventricle to form choroid plexus.
 It gives branches to crus cerebri,lateral geniculate
body, optic tract, and internal capsule.
 Anterior cerebral artery enters
longitudinal fissure of the cerebrum
where it joines artery of opposite side
by anterior communicating artery.
 Its cortical branches supply all the
medial surface of the cerebral till
parieto-occipital sulcus and 1 inch of
lateral surface (leg area).
 Central branches supply parts of
lentiform, caudate nuclei and internal
capsule.
 Middle cerebral artery, largest branch of
internal carotid, runs in lateral cerebral
sulcus.
 Its cortical branches supply entire
lateral & orbital surfaces of cortex
except 1 inch of lateral supplied by
anterior cerebral, occipital pole, and
inferolateral surface of hemisphere
supplied by posterior cerebral artery thus
supplies all body areas on the
homunculus except the leg area.
 Vertebral Artery:
 Branch of the first part of
subclavian artery, passes
through foramina
transverseria of the upper six
cervical vertebrae and enters
skull through foramen
magnum.
 At the lower border of the
pons, it joins the vessel of the
opposite side to form the
basilar artery.
Branches of vertebral artery:
 Meningeal branches supply bone and
dura in posterior cranial fossa.
 Posterior spinal artery.

 Anterior spinal artery.

 Posterior inferior cerebellar artery

largest branch of vertebral which supplies
cerebellum, medulla oblongata and
choroid plexus of fourth ventricle.
 Medullary arteries to medulla oblongata.
Basilar Artery:
 It is formed by union of the two
vertebral arteries at the pons.
 Its branches are:

 Pontine arteries to pons.

 Labyrinthine artery to internal ear.

 Anterior inferior cerebellar artery

for cerebellum, pons & upper
medulla.
 Superior cerebellar artery for
cerebellum,pons & pineal gland.
 Posterior cerebral artery is joined by
posterior communicating branch of
internal carotid.
 Its cortical branches supply
inferolateral & medial surfaces of
temporal lobe, lateral & medial
surfaces of occipital lobe (visual
cortex).
 Its central branches supply
thalamus, lentiform
nucleus,midbrain,pineal gland and
medial geniculate bodies.
 Choroidal branch for choroid plexus
of lateral & third ventricles.
Circle of Willis:
 It lies in the interpeduncular
fossa at the base of the brain.
 It is formed by the anastomosis
between the two internal
carotid arteries and the two
vertebral arteries.
 It allows blood that enters by
either internal carotid or vertebral
arteries to be distributed to any
part of both cerebral
hemispheres.
 Arteries to specific brain areas:
 Corpus striatum and internal capsule supplied
mainly by medial and lateral striate central branches
of middle cerebral artery pluss central branches of
anterior cerebral artery.
 Thalamus is supplied mainly by posterior
communicating, basilar, and posterior cerebral
arteries.
 Midbrain is supplied by posterior cerebral, superior
cerebellar, and basilar arteries.
 Pons is supplied by basilar and anterior, inferior,
and superior cerebellar arteries.
 Medulla oblongata is supplied by vertebral, anterior
and posterior spinal, posterior inferior cerebellar,
and basilar arteries.
 Cerebellum is supplied by superior cerebellar,
anterior inferior cerebellar, and posterior inferior
cerebellar arteries.
 End arteries (terminal):
 Anatomic (True) End Artery: No
anastomoses.
 Functional End Artery: Ineffectual
anastomoses.
 An example of a true terminal
arteries is that which supplies the
retina.
 Functional end arteries supply
segments of the brain.
 Veins of the Brain:
 They have no muscular tissue in their
walls, and they have no valves.
 They lie in subarachnoid space.
 They drain into the cranial (dural)
venous sinuses.
 Cerebral veins divided into:
 External Cerebral Veins:
 Superior cerebral veins drains superolateral & medial
surfaces and empty into the superior sagittal sinus.
 Superficial middle cerebral vein drains the lateral
surface of the cerebral hemisphere & empties into the
cavernous sinus.
 Superficial middle cerebral vein is connected to the
transverse sinus by the inferior anastomotic vein of
Labbe and to the sagittal sinus by superior
anastomotic vein of Trolard.
 Deep middle cerebral vein drains insula and is
joined by anterior cerebral vein to form the Basal
Vein(of Rosenthal).
 Basal vein joins the Great Cerebral Vein(of Galen),
which in turn drains into straight sinus.
 Internal Cerebral Veins
 There are two internal
cerebral veins.
 They are formed by union
of the thalamostriate vein
and choroid vein then
unite to form the great
cerebral vein, which joined
with basal veins & empties
into the straight sinus.
Veins of specific brain areas:
 Midbrain is drained by veins that
open into the basal or great
cerebral veins.
 Pons is drained by veins that
open into basal vein, cerebellar
veins.
 Medulla oblongata is drained by
veins that open into spinal veins.
 Cerebellum is drained by veins
that empty into great cerebral
vein or adjacent venous sinuses.
 Area deprived of oxygen deprived brain

Blockage

Thrombus

Plaque
 Microaneurysm

Lenticulostriate arteries

Subarachnoid hemorrhage
Intracerebral
hemorhage

Arteriovenous
malformation
 Branches of the Vertebral Artery

Anterior Spinal Artery, formed from a Y-

shaped union of a branch
from each vertebral artery.

Runs down the ventral median fissure the

length of the cord.

Distribution:
a. supplies the ventral 2/3 of the spinal cord.
 Branches of the Vertebral Artery

Posterior Spinal Arteries (2),

• originate from each vertebral artery
or Posterior Inferior Cerebellar on
each side of the Medulla.
• Descends along the dorsolateral sulcus.

Distribution:
supplies the dorsal 1/3 of the cord
of each side.
Spinal Cord Blood Supply

Ventral Dorsal
 Spinal Cord Blood Supply

Anterior Spinal Artery,

provides sulcal branches which
penetrate the ventral median
fissure and supply the ventral
2/3 of the spinal cord.

Posterior Spinal Arteries, each

descends along the
dorsolateral surface of the
spinal cord and supplies the
dorsal 1/3.
 Spinal Cord Blood Supply
Radicular arteries, originating
from segmental arteries at
various levels, which divide into
anterior and posterior radicular
arteries as they move along ventral
and dorsal roots to reach the
spinal cord.
Here they reinforce spinal arteries
and anastomose with their
branches.

From these varied sources of blood supply, a series of circumferential anastomotic

channels are formed around the spinal cord, called the arterial vasocorona, from
which short branches penetrate and supply the lateral parts of the cord
 Spinal Cord Blood Supply

The radicular arteries provide the main

blood supply to the cord at the thoracic,
lumbar and sacral segments. There are a
greater number on the posterior (10-23)
than anterior (6-10 only) side of the
cord.
One radicular artery, noticeably larger than
the others, is called the Artery of
Adamkiewicz (arteria radicularis
magna), or the artery of the lumbar
enlargement.
Usually located with the lower thoracic or
upper lumbar spinal segment on the left side
of the spinal cord
 Spinal Cord Blood Supply

The spinal cord lacks adequate collateral

supply in some areas, making these regions
prone to ischemia after vascular occlusions.

The upper Thoracic (T1-T4) and first

lumbar segments are the most vulnerable
regions of the cord.
 Spinal Cord Blood Supply

There are several arteries that reinforce the

spinal cord blood supply and are termed
segmental arteries

1. The Vertebral arteries, spinal branches

which are present in the upper cervical
(~C3-C5) levels

2. Ascending Cervical arteries, present in the

lower cervical areas

3. Posterior Intercostal, present in the

mid-thoracic region

4. First Lumbar arteries, present in the

mid-lumbar regions
 Spinal Cord Blood Supply
• The spinal veins arranged in
an irregular pattern.
• The anterior spinal veins run
along the midline and the
ventral roots.
• The posterior spinal veins run
along the midline and the
dorsal roots.
• These are drained by the
anterior and posterior
radicular veins.
• These in turn empty into an
epidural venous plexus which
connects into an external
vertebral venous plexus, the
vertebral, intercostal and
lumbar veins.
 Spinal Cord Blood Supply

Occlusion of the anterior spinal artery may lead to the anterior

cord syndrome, characterized by;

1. Loss of ipsilateral motor function, due to damage to ventral gray matter

and the ventral corticospinal tract.

2. Loss of contralateral pain and temperature sensation, due to damage to

the spinothalamic pathway
 Spinal Cord Blood Supply

Occlusion of the posterior spinal arteries may lead to the rare

posterior cord syndrome, characterized by;

1. Ipsilateral motor deficits, due to damage to corticospinal tract

2. Ipsilateral loss of tactile discrimination, position sense, vibratory sense,

due to damage to the dorsal columns
VENTRICLES AND
CEREBROSPINAL FLUID
 VENTRICLES AND CEREBROSPINAL FLUID

 Consider the location of the ventricles and the

communication between them
 List major functions of CSF in relation to the CNS.
 Describe concept of the cranial vault with a fixed total
volume in association with intracranial pressure.
 Discuss normal CSF values.
 Describe production, circulation, and absorption of CSF.
 Explain differences between the two types of hydrocephalus
and procedures available to correct hydrocephalus.
Brain Ventricles
Ventricles and Cerebrospinal
Fluid
 Internal chambers within the CNS
 lateral ventricles found inside cerebral
hemispheres
 third ventricle is single vertical space under corpus
callosum [in the diencephalon]
 cerebral aqueduct runs through midbrain
 fourth ventricle is small chamber between pons &
cerebellum
 central canal runs down through spinal cord
 Lined with ependymal cells and containing
choroid plexus of capillaries that produce CSF
 Basic facts of the brain & CSF
 Brain weighs 1200-1500 gm
 Females 1200-1300gm
 Males 1300-1500gm
 BUT the weight in the skull ==50gm
 This difference is caused by the
cushioning effect of CSF
 Vol: 80-150mL
 Pressure: 80-180cm H20
 CEREBROSPINAL FLUID

 CSF found in cerebral ventricles and cisterns and in

subarachnoid space surrounding brain and spinal cord
 Major functions of CSF:
 Provides support

 Regulates ionic composition

 Removes metabolites

 Cranial vault is a rigid structure with fixed total volume;

brain (80%), blood (12%), and CSF (8%). An increase in
one compartment must be offset by an equivalent
decrease in another
 Alterations in CSF composition present in various
disorders
 CEREBROSPINAL FLUID COMPOSITION
 Normal CSF; clear, colorless, and odorless
 Clear Specific gravity: 1.003-1.008 g/cm3
 Few cells present: 1-8 above 10: indicative of disease
Normal CSF values:
Area Appearance Pressure Cells Protein Miscellaneous

Lumbar Clear/colorless 70-180 0-5 <50 mg/dl Glucose

(lymphocytes) 50-75 mg/dl

Ventricular Clear/colorless 70-190 0-5 5-15 mg/dl

(lymphocytes)
 CEREBROSPINAL FLUID

CSF VOLUME
 CSF is present in a system that
comprises two parts:
 Internal portion

 External portion

 Communication between internal

and external portions occurs
through apertures:
 Foramens of Luschka

 Foramen of Magendie
 CEREBROSPINAL FLUID VOLUME

 In adults, total volume of CSF in all spaces combined is

normally about 150 mL
 Between 400–500 mL of CSF is produced and reabsorbed
daily
CSF PRESSURE
 Normal mean CSF pressure is 80-180 mm of water
 Pressure rises if there is an increase in intracranial volume,
blood volume, or CSF volume
 The pressure of CSF is increased in standing, coughing,
sneezing, crying, compression of internal Jugular vein
(Queckenstedt’s sign)
 CEREBROSPINAL FLUID PRODUCTION

 CSF formed primarily by the choroid plexuses of the

cerebral ventricles [ 95% -- lateral ventricles CP]
 Smaller amounts formed directly by ventricular
ependymal cell linings, and smaller quantities from
fluid leaking into perivascular spaces surrounding
cerebral vessels
 Secretion of CSF depends upon the active transport
of sodium ions through ependymal cells.
 Resulting fluid is isotonic with plasma despite lower
potassium, bicarbonate, and glucose concentrations
 CEREBROSPINAL FLUID

CSF PRODUCTION
 Factors that decrease CSF production:
 Carbonic anhydrase inhibitors

 Corticosteroids

 Spironolactone

 Furosemide

 Isoflurane

 Vasoconstrictors
CEREBROSPINAL FLUID
CSF CIRCULATION
 CSF flows from lateral ventricles
through interventricular foramina
(of Monro), into third ventricle,
through cerebral aqueduct (of
Sylvius), into fourth ventricle,
through median aperture (foramen
of Magendie) and lateral apertures
(foramina of Luschka) into cisterna
magna.
 CSF enters subarachnoid space,
circulating around brain and spinal
cord before being absorbed in
arachnoid granulations over
cerebral hemispheres
CSF Flow
 Lateral ventricles
 Foramina of Monroe
 3rd ventricle
 Aqueduct of Sylvius
 4th Ventricle
 Foramen of Magendie/foramina of Lushka
 Subarachnoid Space
 Arachnoid granulations (absorption)
 Superior sagittal sinus
CSF Flow
CEREBROSPINAL FLUID
CSF ABSORPTION
 CSF absorption involves
translocation of fluid from
arachnoid granulations
into cerebral venous sinuses.
 Endothelial cells of villi
contain openings that permit
free flow of CSF, protein, and
RBCs into venous circulation
 Absorption directly
proportionate to ICP and
inversely proportionate to
cerebral venous pressure
 CEREBROSPINAL FLUID

CSF ABSORPTION
 Factors affecting absorption:
 Blockage of villi by cell debris or fibrosis

 Tumors or hemorrhage which increase ICP

 Specific volatile anesthetic agents

 Restricting the circulatory pathway of CSF usually

leads to dilation of the ventricles upstream
(hydrocephalus), because production of CSF usually
continues despite obstruction
CLINICAL CONSIDERATIONS

 Non-communicating
(obstructive)
hydrocephalus occurs more
frequently
 CSF of ventricles unable to
reach subarachnoid space
 Production of CSF continues
 Gyri are flattened against
inside of skull
 If skull is still pliable head may
enlarge
CEREBROSPINAL FLUID

CLINICAL CONSIDERATIONS
 Communicating
hydrocephalus; obstruction is
in subarchnoid space due to
thickening of the arachnoid
with resultant block of return-
flow channels
 Can be the result of prior
bleeding or meningitis
 If ICP is increased due to
excess CSF, central canal of
spinal cord may dilate
CEREBROSPINAL FLUID

CLINICAL CONSIDERATIONS
 Various procedures have

been developed to bypass

the obstruction in
noncommunicating
hydrocephalus or to
improve overall absorption
in general
 *Harare Shunt
CHARACTERISTIC

CSF

PROFILES
Diencephalon:
Thalamus and Hypothalamus
 objectives
 To list the parts of the diencephalon;
 To describe location of the different parts
of the diencephalon and their functions;
 Discuss the anatomical basis of disorders
of the diencephalon.
 Diencephalon
 Relay between the brainstem & cerebral cortex
 Dorsal-posterior structures
 Epithalamus
 Habenular nuclei – integrate smell & emotions
 Pineal gland – monitors diurnal / nocturnal rhythm
 Thalamus
 Metathalamus
 Medial geniculate body – auditory relay
 Lateral geniculate body – visual relay

 Ventral-anterior structure
 Hypothalamus
 *Subthalamus
Function of the Thalamus

 Sensory relay
 ALL sensory information
(except smell)
 Motor integration
 Input from cortex, cerebellum and
basal ganglia
 Arousal
 Part of reticular activating system
 Pain modulation
 All nociceptive information
 Memory & behavior
 Lesions are disruptive---
emotionally, sensory and motor
Input to the Thalamus
Input to the Thalamus

Metathalamus
Vision and Hearing
Input to the Thalamus

Sensory relay - Ventral posterior group

all sensation from body and head, including pain
Input to the Thalamus

Motor control and integration

Input to the Thalamus

Behavior and emotion

connection with hypothalamus
Projections from the Thalamus

Metathalamus
Vision and Hearing
Projections from the Thalamus

Sensory relay
Ventral posterior group
all sensation from body and head,
including pain
Projections from the Thalamus

Motor control
and integration
Projections from the Thalamus
Behavior and emotion
connection with hypothalamus
Thalamus: axial view

Descending upper motor neurons

Cerebral peduncles Internal capsule
Thalamus: axial view
Thalamus: sagittal view

Pons
Thalamus: sagittal view
Thalamus: coronal view
Thalamus: coronal view

3rd ventricle
Thalamus: coronal view

Internal capsule
 Thalamus: coronal view

Cerebral
peduncles

Internal capsule
 Thalamus: coronal view

Dorsomedial nucleus has

reciprocal connections to
prefrontal cortex.

Concerned with judgment,

decision making, memory
and behavior.

Mediodorsal nucleus Internal capsule

 Thalamus
VL nucleus has reciprocal
connections with primary motor
cortex. It receives input from
Ventral cerebellar nuclei.
lateral
nucleus With VA nucleus (which receives
input from basal ganglia)
contributes to planning and
control of movement.

Mediodorsal nucleus Internal capsule

Thalamus: blood supply
Hypothalamus
Located ventral-anterior to
thalamus.

(Subthalamus, located
ventral to thalamus, will be
discussed with basal
ganglia.)
Hypothalamus

Coronal view
Hypothalamus

Sagittal view
Hypothalamus
Hypothalamus

Thalamus
Hypothalamus

Optic chiasm
Hypothalamus

Pituitary Gland
Hypothalamus

Mammillary body: termination of fornix

Hypothalamus

Fornix: part of the limbic system

Hypothalamus

Coronal view

Lateral view

Fornix to mammillary bodies

Hypothalamus: sagittal view
Hypothalamus: sagittal view
Hypothalamus: sagittal view
 Hypothalamus: sagittal view

Connects temporal lobes, sharing olfactory and audiovisual information

Hypothalamus: coronal view
(rostral to caudal)
MAMMILLARY

TUBERAL

SUPRACHIASMATIC

PRE-OPTIC
 Hypothalamus: coronal view
Pre-Optic Region

Gonadotropic releasing
hormone
Sexual arousal, appetite,
reproduction
Hypothalamus: coronal view
Hypothalamus: coronal view
 Hypothalamus: coronal view

Suprachiasmic Region

Secrete ADH, oxytocin

Transported via axons to
posterior pituitary
(hypophysis)
Hypothalamus: coronal view

Regulates thirst
Hypothalamus: coronal view

Body temperature
Circadian rhythms
Hypothalamus: coronal view
 Hypothalamus: coronal view

Tuberal Region

Satiety
Hypothalamus: coronal view

Regulates prolactin
and growth hormone
β endorphin for pain
Hypothalamus: coronal view
Hypothalamus: coronal view
Mammillary region

Limbic system
Hypothalamus: coronal view

Hypocretin
(orexin)
Narcolepsy,
reward
Hypothalamus
Relationship to Pituitary Gland
Hypothalamic Connections
Anterior pituitary

From Pre-optic nucleus

Tubero-infundibular tract to
Median eminence, then via
Portal veins
Gonadotropic releasing hormone
Hypothalamic Connections

Posterior pituitary

Supraoptic-hypophyseal tract
ADH / Vasopressin (supraoptic nuclei)
Oxytocin (paraventricular nuclei)
Function of the Pituitary
 SUBTHALAMUS
 Region of
diencephalon
located below
the thalamus &
dorsolateral to Th
hypothalamus
 Continues
caudally with the
midbrain Hypothalamus
Contents

 Rostral extension of:

 Red nucleus
 Substantia nigra
 Brainstem reticular formation as Zona incerta
 Long tracts passing through brain stem and heading
toward thalamus
 Spinothalamic & Trigeminothalamic tracts
 Medial lemniscus
 Dentatothalamic fibers
 Pallidothalamic fibers (fasciculus lenticularis, Ansa
lenticularis & thalamic fascicle)
 Subthalamic nucleus
 Subthalamic Nucleus

 Resembles a
biconvex lens in
shape
I
 Located in the C
ventrolateral part of
the subthalamus
 Lies against the
medial surface of
the internal capsule
 Connections

 Has reciprocal
connections with
ipsilateral:
 Globus pallidus via
subthalamic
fasciculus, which
passes through
the internal
capsule
 Substantia nigra
 Functions Lesions
 Plays an important  Rare
role in normal  Usually of
functioning of basal cerebrovascular origin
ganglia  Results in
Hemiballism
(sudden, forceful
involuntary, violent or
jerky, movements of
the limbs) on the
contralateral side
 Zona Incerta

 Rostral extension
of the brainstem
reticular formation
 Enveloped by
pallidothalamic
fibers (lies
between the
lenticular fascicle
and the thalamic
fascicle)
The pineal gland

Gross and Histology

 Pineal Gland: Physical Characteristics

•Small, pine-cone-shaped gland (hence its name)

•Reddish-gray in color
•It is larger in children, but shrinks with the onset of puberty

•In adults, it weighs a bit more than 0.1 grams and is about 0.8 cm long

•Situated between 2 cerebral hemispheres ;

•Attached to the posterior wall of the 3rd cerebral ventricle
•Suspended in a cavity of cerebrospinal fluid
•Lacks a blood-brain barrier, therefore, receives blood, oxygen, & nutrients through
a rich vascular network
•Contains a large supply of adrenergic nerve fibers
•Composed of pinealocytes (endocrine cells with extensions that interact with the
extensions of nearby cells) and supporting cells that resemble astrocytes
 Pineal Gland:
Chemical
Characteristics

•It contains a number of neuropeptides & neurotransmitters such as

somatostatin, norepinephrine, serotonin, and histamine.
•Somatostatin is a hormone that inhibits the secretion of several
hormones, including growth hormone, insulin, and gastrin.
•Norepinephrine is the main neurotransmitter that regulates its
melatonin secreting activity.
Structural Formula of
•Serotonin is a neurotransmitter that helps maintain a "happy feeling,"
melatonin
and seems to help keep our moods under control by helping with sleep,
calming anxiety, and relieving depression.
•Histamine is neurotransmitter that causes inflammation and several
allergic symptoms.
•However, melatonin, a derivative of tryptophan, is the only hormone
secreted by the gland.
•The chemical formula of melatonin is C13H16N2O2.
 Pineal Gland: Molecular
Characteristics

•It is developed from epithelial tissue

•The soft tissue of the adult pineal gland contains

more fluoride than any other soft tissue in the body -

a level of fluoride capable of inhibiting enzymes.
•The pineal gland also contains hard
tissue(hyroxyapatite crystals), which accumulates
more fluoride than any other hard tissue in the body
(ex. teeth and bone)
•Studies show that fluoride reduces the levels of
melatonin in the blood
 Histology of Pineal gland

• The pineal is consists of connective tissue , blood vessels , glial cells , and
pinealocytes (which secrete melatonin).
• Pinealocytes have larger, lighter staining nuclei
glial cells have small darker staining nuclei
• With age, calcified formations appear in the pineal gland (brain sand or corpora aranacea ).
Histology of the Pineal gland
Histology of Pineal gland
Histology of Pineal gland
Histology of Pineal gland
Functions of the Pineal Gland
 The major function of the pineal gland is producing melatonin, a hormone that has
several important effects on the body.
 Melatonin regulates daily body rhythms, most importantly circadian rhythm, the
wake/sleep cycle.
 We feel sleepy at night because darkness stimulates the pineal gland to produce
melatonin and we feel alert during the day because light inhibits the pineal gland from
producing melatonin.
 Since the activity of the pineal gland depends on the amount of available energy, it is a
photosensitive organ.
 The abundant levels of melatonin in children inhibit the secretion of gonadotropins,
hormones that regulate normal growth, sexual development, and reproductive
functions, before puberty.
 Therefore, they prevent the onset of puberty before the appropriate age.
 Functions of the Pineal Gland cont’d

 Melatonin levels are low in children with autism, and as a result, about 70% of them suffer from
sleeping problems.
 Studies show that low doses of melatonin can help children with autism sleep better without
giving them any noticeable side effects.
 Studies show that melatonin levels may be related to the risk of certain types of cancer.
 Melatonin levels tend to be lower in women with breast cancer than in those without the disease.
 Laboratory experiments show that low levels of melatonin stimulate the growth of certain types
of breast cancer cells. However, adding melatonin to these cells slows their growth.
 New research also suggests that melatonin may strengthen the effects of some chemotherapy
drugs used to treat breast cancer.
 In one study, several women with breast cancer were given melatonin 7 days before beginning
chemotherapy.
 The melatonin prevented the lowering of platelets in the blood, a common complication that can
cause bleeding.
 Functions of the Pineal Gland cont’d

 In another study, several women with breast cancer were taking tamoxifen, but were not improving.
However, once melatonin was added, the tumors in over 28% of the women modestly shrank.
 Studies also show that melatonin levels are lower in men with prostate cancer than in those without
the disease.
 In test tube studies, melatonin blocks the growth of prostate cancer cells.
 In one small-scale study, melatonin, along with improved regular medical treatment, improved
survival rates in 9 out of 14 men with metastatic prostate cancer.
 Melatonin has been found to be able to slow the aging process.
 It is a powerful antioxidant that can easily pass through cell membranes and the blood-brain barrier.
 It is a highly effective and direct scavenger of the very reactive and toxic free radicals.
 Unlike other antioxidants, melatonin does not undergo redox cycling. Once it is oxidized it can never
be reduced to its former state. Therefore, it never promotes free radical formation.
 By terminally disarming the free radicals, melatonin protects the cells’ DNA from oxidation damage.
 Pineal Gland: Interactions with Other Organs
 Secretion of melatonin by the pineal gland inhibits the secretion of the Gonadotropin-releasing
hormone (GnRH) by the hypothalamus.
 Secretion of melatonin also indirectly inhibits the pituitary from secreting gonadotropins, Leutenizing
Hormone (LH) and Follicle Stimulating Hormone (FSH), because the secretion of GnRH is necessary
for this to occur.
 Because its secretion reduces the levels of LH in the blood, melatonin may inhibit ovulation in
women and can decrease sperm mobility and sex drive in men.
 The pineal gland also interacts with the hypothalamus in regulating the circadian rhythm.
 Pineal Gland: Diseases & Disorders
 One sleep disorder is Delayed Circadian Rhythm Disorder. DCR constitutes a mismatch between you
external and internal clocks. Your internal clock runs slower than a normal circadian rhythm which is a 24-
hour period so your body doesn't 'wake up' until later in the morning or day.
 When this occurs in the body, the pineal gland releases the nighttime hormone, melatonin, too late,
often causing you to fall asleep later. When its time to wake up, your body clock believes it’s only midnight
and is still producing the nighttime hormones.
 As a result of this disorder a person may experience the following symptoms:
 Difficulty falling and staying asleep, and or late night insomnia.
 A general lack of energy in the morning.
 An increase of energy/mood in the evening or late at night.
 Difficulty concentrating, being alert, or accomplishing tasks
 Some DCR sufferers oversleep and have trouble getting up
 Treatment:
 Dawn Simulation helps people maintain a steady circadian rhythm by exposing their internal body
clocks to a properly timed signal of light through their retina. The light gradually becomes brighter,
simulating a sunrise, to reset the body clock while not to bright to cause premature awakening.
 Diseases & Disorders cont’d
 Advanced Circadian Rhythm Disorder (ACR) is the opposite of DCR.
 With ACR, your internal body clock is running faster than a normal circadian rhythm.
 You tend to run out of energy before their day is up. ACR compresses the sleep portion of your
daily cycle, causing you to lose valuable sleep.
 ACR sufferers often sleep less than 8 hours per night, and awaken early.
 Because your circadian rhythm is running fast, your pineal gland releases melatonin too soon,
causing lethargy earlier in the day. Then, because melatonin is released prematurely, you are unable
to maintain a complete sleep cycle, and you wake up too early.
 As a result of this disorder a person may experience the following symptoms:
 Early morning awakening and/or early morning Insomnia
 Inconsistent sleep with one or more awake periods during the night
 Lack of energy during the day, feeling tired in the early afternoon and/or evening
 Alertness and ability to function may also be diminished
 Some ACR sufferers may not notice a sleep problem but lose energy and feel tired or down in
the afternoon or evening time.
 Treatment:
 Specialized bright light is the only effective treatment for ACR. Bright light will inhibit the release
of melatonin for about 3 hours. Use bright light in the late afternoon and evening and
avoid bright morning light before 9:00 am. Wear sunglasses if you need to be exposed to
bright light early in the morning and make your night time as dark as possible.
 Diseases & Disorders cont’d

 Precocious Puberty: An unusually early onset of puberty beginning before age 8 for girls and before
age 9 for boys.
 If left untreated, children will become able to reproduce and will stop growing too soon.
 One of the causes for precocious puberty is having lower than normal levels of melatonin.
 This is a problem because melatonin is responsible for inhibiting the actions of the gonadotropins.
 Symptoms for girls are breast growth and a first menstruation
 Symptoms for boys enlarged testicles and penis, facial hair, and a deepening of the voice
 Symptoms for boys AND girls are pubic or underarm hair, rapid growth, acne, and adult body odor
 If the children’s precocious puberty is caused by abnormally low melatonin levels, melatonin
supplements can be a very successful form of treatment.
 Treatment is very important because precocious puberty will prevent children from reaching their full
height because they stop growing too early.
 Going through puberty before anyone their age can also have negative psychological effects on
children, including low self-esteem and depression.
 Caused when too much melatonin is
produced, especially during the long nights
of winter, causing profound depression,
oversleeping, weight gain, tiredness, or
sadness.
Treatment consists of exposure to bright
lights for several hours each day to inhibit
melatonin production.
SAD (Season Affective
Disorder)
BASAL GANGLIA
 Objectives
 Outline location and cellular characteristics
of the basal nuclei/ganglia;
 Describe functional roles of Basal nuclei and
associated structures in the planning,
execution and control of movement.
 Examine selected clinical cases
 Basal nuclei
 Subcortical masses of gray matter
 Involved in the planning, execution
and control of movement
 Composed of neurons that have unique
characteristics
Summary of basal ganglia
activity
 The striatum, subthalamic nucleus, and substantia nigra
receive excitatory afferents from the cerebral cortex.
 Dopaminergic neurons in the substantia nigra and ventral
tegmental area excite some striatal neurons and inhibit
others.
 The major output of the striatum is to the pallidum, and it
is inhibitory.
 Excitatory input to the pallidum comes from the
subthalamic nucleus.
 The output of the pallidum, which is also inhibitory, is to
various thalamic nuclei.
 The thalamic nuclei project to and excite the premotor
and supplementary motor areas of the cerebral cortex,
cortical areas concerned with eye movements, and parts
of the prefrontal and temporal cortex.
 Other pallidal efferents inhibit the subthalamic
nucleus, superior colliculus, and
pedunculopontine nucleus.
 The pedunculopontine nucleus, which is located in the
reticular formation, has extensive projections that
influence descending motor pathways, the waking
state, and (by way of the basal cholinergic
forebrain nuclei) neuronal activity throughout
the cerebral cortex.
 At rest, neurons in the striatum are quiescent, and
those in the pallidum are active, thereby
inhibiting the thalamic excitation of the motor
cortex.
 Before and during a movement, the striatum
becomes active and inhibits the pallidum, allowing
more excitation of the motor thalamic nuclei and
cortex.
 CORTEX

STN striatum SN

THALAMUS
PALLIDUM
 BASAL GANGLIA
 Derived from Telencephalon  w/ direct and indirect
 From thickening of the lateral pathways
telencephalon vesicle—  w/ excitatory and inhibitory
STRIATAL RIDGE except GP. fxns
 Include:
 Caudate nucleus
 Control:  Globus pallidus
 Background tone  Putamen
 Posture for movement  Amygdaloid
Claustrum
 Initiated in the cerebral cortex 

 Partly
 Participates in autonomic movements
 Substantia nigra
 Ex. Walking  Subthalamic nucleus
 Learning new motor
behavior
 Parts

 Corpus Striatum[caudate  Amygdaloid nuclear

+lentiform] complex
 Concerned with somatic motor  Component of the limbic
fxn system
 Neostriatum  Located beneath uncus
 Caudate nucleus (temporal lobe)
 Putamen  Has primarily olfactory input
 Paleostriatum  Has receiprocal connections
 Globus Pallidus w/:
 Forming the smaller and most  Hypothalamus
medial part of corpus striatum  Pre-pyriform cortex
 Lies medial to the putamen, lateral  Archistriatum
to internal capsule
 oldest part of basal ganglia
• Amygdaloid nuclear complex (cont’d)
– Divisions: (main nuclear masses)
– Corticomedial nuclear group
– Basolateral nuclear group
– Largest and most differentiated part of the
amygdaloid complex
 Striatum (Corpus Striatum)
 Dorsal Striatum • Glutamate
Caudate nucleus  Conveyed by corticostriate

fibers
 Putamen • Serotonin
 Receives afferent input  Transmitted by raph nuclei of
to the basal ganglia the midbrain
• Inhibits Globus Pallidus
 w/ high conc. of through axonal projections
Dopamine containing GABA
 Contained in small  Striatal efferent neurons
granular vesicles in • P. GABA
terminal buttons  Transported to
(terminals of  Globus pallidus
Nigrostriatal fibers)  Substantia nigra
 Lentiform/ lenticular  Basal Ganglia Circuits
 Fibers emanating and
nucleus going to basal ganglia
 Putamen  Efferent and Afferent
types
 Globus pallidus  StriatumGlobus
palldusThalamusCort
exStriatum
 StriatumSubstancia
nigraStriatum
 Globus Pallidus
SubthalamusGlobus
pallidus
1. Caudate nucleus
 C-shaped cellular  TAIL
mass  Evident caudal to the
thalamus
 related throughout
 Lies in the roof of the
its extent to the inferior horn of lat.
lateral ventricle vent.
 Suprathalamic  Terminal part
 HEAD  comes into a
relathionship with
 Rostral to thalamus
central nucleus of
 BODY ANC
 arches along the
dorsolateral border of
the thalamus
 Lateral to fibers of
stria terminalis
Putamen  Cytology:
 Largest and most lateral  Considered
portion of striatum identical w/
 Lies bet ext. capsule and caudate nucleus
lat. medullary lamina of the  Cells
Densely packed
globus pallidus 

 No laminations on
 Medial to the insular cortex special
arrangements
 Separated from insula by:  2 types:
 External capsule  Small

 Claustrum achromatic
neurons
 Extreme capsule
 Large
multipolar
neurons w/
rounded
contours and
irregularly
clumped Nissl
subs.
Globus Pallidus
 Forms smaller and inner  Pallidal neurons
part of lentiform nucleus  Large
 Medial to putamen  Ovoid or polygonal
 Dorsomedial margin cells with long, thick
 borders the posterior limb and smooth dendrites
of internal capsule
 Thin lateral medullary
lamina, lies on
 External surface of
pallidum
 Pallidum’s junction with
putamen
 Medial medullary lamina
 Divides GP into medial
and lateral segments
Claustrum  2 parts:
 Thin plate of gray mater  Insular part
 Lies in medullary subs. of  Large cells underlying
hemisphere between: the insular cortex
 Lentiform nucleus (LN)  Temporal part
 Loosely arranged
 Insular cortex (IC) cells located bet.
 2 white laminae Putamen and
temporal lobe
External capsule


Separated from LN and IC

 Contains discrete
visual and

medially
 Extreme capsule somatosensory
 separated from LN and IC subdivisions
laterally.  Have interconnections
 More closely related to the w/ corresponding
cerebral cortex than primary sensory areas
striatum of the neocortex
Internal Capsule
 Forms a broad  Mostly formed of
compact, fiber bands thalamic radiations
 Borders:
 M – thalamus
 the rest, by
- caudate corticofugal fibers or
 L – lentiform nucleus efferent cortical fibers
 Composed of all fibers  Corticospinal
(afferent and efferent)  Corticobulbar
which go to and from Corticoreticular
the cerebral cortex 

 Corticopontine tracts
 Genu of internal capsule
 Contains corticobulbar and corticoreticular tracts
 FUSION OF:
 Shorter anterior limb of internal capsule
 Ant. thalamic radiations
 Prefrontal corticopontine tracts
 Longer posterior limb of internal capsule
 Corticospinal tracts
 Frontopontine tracts
 Superior thalamic radiations
 Small numbers of coritcotectal, corticobulbar and
corticoreticular fibers
 Neurotransmitters involved  Afferent Fibers
 Glutamate  Corticostriate
 Corticostriate fibers  Thalamostriate
Subthalamic nucleus to
Nigrostriate

globus pallidus 

 Acetylcholine  Striatal Brainstem

 Utilized by neurons with Afferents
short axons within the  Efferent Fibers
nuclei
 Striopallidal
 Dopamine
 Manufactured in the
 Strionigral
substantia nigra  Pallidal connections
 Utilized by striatal neurons  Pallidal afferent fibers
 GABA  Pallidofugal fiber system
 StriatumGlobus Pallidus  Ansa lenticularis
 Globus  Lenticular fasciculus
PallidusSubstantia Nigra
 Pallidotegmental fibers
 Pallidosubthalamis fibers
Afferent Fibers
 Corticostriate • Nigrostriate
 From cortex to  From substantia
nigra to striatum
striatum
 Dopamine
 glutamate
• Striatal Brainstem
• Thalamostriate Afferents
Comes from
 From the


subthalamic nucleus
going to striatum brainstem
 GABA
Efferent Fibers
 Striopallidal  Strionigral
 From striatum to  Striatum to
globus pallidus substantia nigra
 Dopamine
 PREMOTOR AND PRIMARY
SUPPLEMENTARY MOTOR
MOTOR CORTEX CORTEX

VENTRAL STRIATUM
ANTERIOR
NUCLEUS OF
THALAMUS

SUBTHALAMIC GLOBUS SUBSTANTIA NIGRA

NUCLEUS PALLIDUS

BRAINSTEM
DIRECT ACTIVATION
INDIRECT
PATHWAYS
ACTIVATION
PATHWAYS
SPINAL CORD
KEY:
DOPAMINE
FINAL COMMON PATHWAY
GABA
GLUTAMATE
SCHEMA OF DIRECT AND INDIRECT ACTIVATION PATHWAYS
The Corticothalamic Loop Thalamus
Globus
As the cortex determines that a voluntary movement Pallidus
is needed, the basal ganglia become engaged in
selecting and presenting the motor cortex with the
right motor programs needed to perform the
movement.
The basal ganglia integrates all the necessary data
streams for the various cortex areas, processes
them, and the result is served back to the frontal
motor cortex as a buffet of carefully chosen motor
programs, ready to be performed in a synchronized
symphony of muscle contractions.

VA/VL complex Basal Ganglia

of Thalamus
Internal External Motivation
Striatum and
Globus Pallidus Globus Pallidus
Motor Cortex association
cortices
Subthalamic Substancia nigra
Spinal Cord
Nucleus
pars reticularis pars compacta
From Stimulus to Action Thalamus
Globus
Here are the basal nuclei laid out for clarity. Pallidus
Let’s suppose that the body is idle, so that no voluntary
movement occurs. Now assume a ball has been spotted,
and the motivation to grab the ball is born within the
motivation areas of the cortex. The motor has currently no
idea of how to actually get the ball, and cannot execute
any movement yet because the motor thalamus, that
acts as a motion “gatekeeper,” is inhibited. Without this
inhibition, wild and random movement would occur. So,
before a motion is started, the thalamus is prohibited to
allow any movements because one of the efferent parts of
the basal ganglia, the internal segment of the globous
pallidus, is inhibiting it.

VA/VL complex Basal Ganglia

of Thalamus
Internal External Motivation
Striatum and
Globus Pallidus Globus Pallidus
Motor Cortex association
cortices
Subthalamic Substancia nigra
Spinal Cord
Nucleus
pars reticularis pars compacta
A Decision is Born Thalamus
Globus
The cortical and subcortical motivation and Pallidus
association cortices decide that a certain action is to
be taken, e.g. to get the ball, but cannot execute the
“reach” and “grasp” motor programs on its own. Of
course, there are different reaching and grasping
programs for different types of objects at different
positions, and the programs need not only be chosen
and started—they must also be halted at the right
time. Thus, the motor cortex needs to have the correct
motor programs chosen and unlocked by the basal
ganglia.

VA/VL complex Basal Ganglia

of Thalamus
Internal External Motivation
Striatum and
Globus Pallidus Globus Pallidus
Motor Cortex association
cortices
Subthalamic Substancia nigra
Spinal Cord
Nucleus
pars reticularis pars compacta
The Duality of the Striatum Thalamus
Globus
The striatum consists mainly of medium spiny neurons, that Pallidus
are usually silent because they require strong input signals
to fire an action potential. The inputs are not only from the
cortex, but also from the dopaminergic neurons of the
substantia nigra pars compacta.
The striatum’s dopamine receptors are both of excitatory D1
and inhibitory D2 types, which selects for the balance
between the motion starting the direct and indirect
pathways. Keep in mind that the caudate and putamen are
parts of the striatum, and that both are reached by inhibitory
and excitatory nigral neurons. But for now, let’s just focus on
the motion starting the direct pathway.

VA/VL complex Basal Ganglia

of Thalamus
Internal External Motivation
Striatum and
Globus Pallidus Globus Pallidus
Motor Cortex association
cortices
Subthalamic Substancia nigra
Spinal Cord
Nucleus
pars reticularis pars compacta
The Direct Pathway Thalamus
Globus
When the striatum receives the input from the cortex, Pallidus
together with dopamine from the 5Nc to the D1
receptors. Its GABAergic neurons will inhibit the GPi.
The GPi has in itself a tonically inhibitory effect on the
motor thalamus, and this is the “gate” for preventing
unwanted movements. With the GPi inbihited, the
motor thalamus is now disinhibited, and it can now
present the frontal motor cortex with the
appropriate motor programs for the desired
movement, their temporal sequence and the
strength of the muscle contactions.

VA/VL complex Basal Ganglia

of Thalamus
Internal External Motivation
Striatum and
Globus Pallidus Globus Pallidus
Motor Cortex association
cortices
Subthalamic Substancia nigra
Spinal Cord
Nucleus
pars reticularis pars compacta
The Indirect Pathway Thalamus
Globus
Let’s say the brain changes its mind about the ball, Pallidus
and decides it’s best not to grasp it afterall. But the
movement to reach out and grasp the ball has already
begun. This is where the indirect pathway kicks in.
It serves as a way to nullify the disinhibitory
actions of the direct pathway. In short, it acts as a
brake, restoring the inhibition of the motor
thalamus. The key structure in accomplishing this
brake, is the subthalamic nucleus.

VA/VL complex Basal Ganglia

of Thalamus
Internal External Motivation
Striatum and
Globus Pallidus Globus Pallidus
Motor Cortex association
cortices
Subthalamic Substancia nigra
Spinal Cord
Nucleus
pars reticularis pars compacta
Inhibiting the Inhibitor Thalamus
Globus
The subthalamic nucleus (STN) is normally under Pallidus
tonic inhibition of the external segment of the globus
pallidus (GPe).

When this inhibition is lifted by the striatum, the STN,

excited the inhibitory GPi, which means that the GPi
will “brake” the motor thalamus to its original state.

VA/VL complex Basal Ganglia

of Thalamus
Internal External Motivation
Striatum and
Globus Pallidus Globus Pallidus
Motor Cortex association
cortices
Subthalamic Substancia nigra
Spinal Cord
Nucleus
pars reticularis pars compacta
A Black Brake Thalamus
Globus
The STN also excites the substantia nigra pars Pallidus
reticulata, causing it to also inhibit the motor thalamus.

This way, by influencing both the substantia nigra the

GPi, the STN performs as an effective 2-way brake
that stops the thalamus from permissing the cortex to
execute motor programs.

VA/VL complex Basal Ganglia

of Thalamus
Internal External Motivation
Striatum and
Globus Pallidus Globus Pallidus
Motor Cortex association
cortices
Subthalamic Substancia nigra
Spinal Cord
Nucleus
pars reticularis pars compacta
 Cortex
Direct pathway

Striatum Excitation (glutamate)

Inhibition (GABA)

VA/VL
* GPe

STN
* GPi/SNr * tonically active
~100 Hz
Modified from Wichmann and Delong,
Curr Opin Neurobiol. 6:751-758, 1996.
 Cortex
Direct pathway:
pathway
facilitates
movement
Striatum
Excitation (glutamate)

Inhibition (GABA)

VA/VL
* GPe
Disinhibition

STN
* GPi/SNr * tonically active
~100 Hz
Modified from Wichmann and Delong,
Brain stem/ Curr Opin Neurobiol. 6:751-758, 1996.
Spinal cord
Patterns of activity when glutamate is applied in striatum
Patterns of activity during motor behavior
 Cortex

Striatum
Indirect pathway
pathway:
inhibits
movement

VA/VL
* GPe
Excitation (glutamate)

Disinhibition Inhibition (GABA)

STN
* GPi/SNr * tonically active
~100 Hz
Modified from Wichmann and Delong,
Brain stem/ Curr Opin Neurobiol. 6:751-758, 1996.
Spinal cord
 Cortex
Direct pathway:
facilitates
movement
Striatum
D2 D1 Indirect pathway:
inhibits
movement
SNc
VA/VL
* GPe
Excitation (glutamate)

Inhibition (GABA)

STN
* GPi/SNr * tonically active
~100 Hz
Modified from Wichmann and Delong,
Brain stem/ Curr Opin Neurobiol. 6:751-758, 1996.
Spinal cord
CLINICAL CORRELATION
 Damping or  Disorders may be
modulating present with
system  Abnormal
 Excess discharge movements
Hypokinesia or
slowing


 hyperkinesia
 Lack of discharge  Changes in tone
 hyperactivity
  PARKINSON’S DISEASE
 1817 by James Parkinson
 Involuntary tremulous
motion, w/ lessened
muscular power, in parts not
in action and even when
 HYPOKINESIA supported; w/ propensity to a
 Increase in tone rigidity running pace, the senses and
 ATHETOSIS intellect being uninjured.
 Slow and writhing  Masked facies, poverty and
DYSTONIA
slowness of voluntary
movements “resting tremor”,


 Abnormal posturing of trunk stooped posture, rigidity and

and extremities festinating gait, infrequent
 HEMIBALLISMUS of blinking (5 to 10
 Rapid flinging movements in blinks/min, normal=20/min)
sub-thalamic lesions  Loss of pigmented cells in
 CHOREA substantia nigra
 Brief rapid jerks in disease of  Encephalitis, CO poisoning,
striatum Mn poisoning, toxicity from
 TREMOR psychoactive drugs (MPTP)
 3-4 Hz at rest
 Human midbrain

Parkinson’s Normal
disease
Parkinson’s disease
 HUNTINGTON’S  SYDENHAM’S
CHOREA CHOREA
 By George Huntington  Immunologic disorder
Associated w/
TRIAD of dominant

 Rheumatic fever
inheritance,  Protein structure of
choreoathetosis, and streptococcal antigen
dementia similar to that of
 Bilateral atrophy of the proteins in the
head of the caudate membrane of striatal
nucleus and putamen neurons
 Widespread loss of  Transient, full
cholinergic and recovery
GABAergic neurons
 Huntington’s disease
Pathophysiology
• Atrophy of striatum
• Loss of striatal GABAergic neurons
• Neuropathological sequence
1st: loss of striatal GABA/enkephalin/D2-R neurons
(indirect pathway)
2nd: loss of striatal GABA/dynorphin/D1-R neurons
(direct pathway) & cortical atrophy
Huntington’s disease pathology

Huntington’s

Normal
Huntington’s disease
The end!
 Objectives
 To describe the external and internal
anatomy of the cerebellum;
 Discuss functional and phylogenetic
subdivisions of the cerebellum;
 Review the functional connections of the
cerebellum;
 Discuss clinical correlates.
 Cerebellum External
Configurations

- located in posterior cranial fossa

- tentorium cerebelli (cerebrum), 4th ventricle (brain stem)
- communicate with other structure via
superior, middle, and inferior cerebellar peduncle

- longitudinal division
Vermis, Paravermal Region, Cerebellar Hemisphere

- transverse division
Anterior Lobe
------------ primary fissure
Posterior Lobe
------------ posterolateral fissure
Flocculonodular Lobe
 Cerebellum External
Configurations

Subdivision of Flocculonodular Lobe

Nodulus Flocculus

Subdivision of Anterior Lobe

Vermis Hemisphere

Lingula
Central Lobule Ala Central Lobule

postcentral fissure

Culmen Quadriangular Lobule

 Cerebellum External
Configurations

Subdivision of Posterior Lobe

Vermis Hemisphere
Declive Simple Lobule
postcentral fissure
Folium Superior Semilunar Lobule
horizontal fissure
Inferior Semilunar Lobule
Tuber
Gracile Lobule
prepyramidal fissure
Pyramis Biventer Lobule
secondary fissure
Uvula Tonsil
 Cerebellum Internal
Configurations

Cerebellar Cortex

• Molecular Layer
• Purkinje Cell Layer
•Granular Layer

Corpus Medullare (Medullary Center)

Deep Cerebellar Nuclei

Fastigial Nuclei
Nucleus Interpositus
i)Emboliform Nucleus
ii) Globose Nucleus
Dentate Nucleus [largest]
Deep Nuclei

1. fastigial
nucleus
2. globose
nucleus
3. emboliform
nucleus
4. dentate
nucleus
M-01
 Cerebellum Internal
Configurations

Cerebellar Cortex

I. Molecular Layer

Stellate Cell --- taurine (inhibitory)

afferent: parallel fiber
efferent: Purkinje cell dendrite

Basket Cell ---- GABA (inhibitory)

afferent: parallel fiber
efferent: Purkinje cell soma

Parallel Fiber
granule cell axon
Purkinje Cell Dendrite
 Cerebellum Internal
Configurations

Cerebellar Cortex

II. Purkinje Cell Layer

Purkinje Cell
-- 15,000,000 in number
-- GABA (inhibitory)
afferent: parallel fiber
climbing fiber
stellate cell
basket cell
efferent: deep cortical nuclei

Bergman’s glial cell

 Cerebellum Internal
Configurations

Cerebellar Cortex

III. Granular Layer

Granular Cell
-- 50,000,000,000 in number
-- glutamic acid (excitatory)
afferent: mossy fiber
efferent: Purkinje cell dendrite
basket cell, stellate cell
Golgi cell

Golgi Cell
-- GABA (inhibitory)
afferent: parallel fiber, mossy fiber rosette
efferent: granule cell dendrite
 1. Purkinje cell
2. granule cell
3. basket cell
4. Golgi cell
5. stellate cell
6. climbing fiber
7. mossy fiber
8. parallel fiber
9. inferior olivary
nucleus
10. deep cerebellar
nuclei
 Cerebellum Internal
Configurations

Synaptic Glomerulus

Afferent terminals on granular layer

 Mossy Fiber Rosette
-- afferent fibers except
inferior olivary input
-- 2/3 of medullary center
 Granular Cell Dendrite
-- main afferent input
 Golgi Cell Axon
-- synapse on granule cell dendrite
-- GABA (inhibitory)
- Surrounded by Astrocyte Foot Process
Synaptic Glomerulus
Vasculature of the
cerebellum
 Cerebellum
Classifications

*1. Classification by Phylogenetic and Ontogenic Development

a) Archicerebellum
b) Paleocerebllum
c) Neocerebellum
*2. Classification by Afferent Connection

a) Vestibulocerebellum
b) Spinocerebellum
c) Pontocerebellum
*Classification by Efferent Connection

Vermis
Paravermal Region
Cerebellar Hemisphere

Mostly 1 & 2 are frequently used

Phylogenetic classification

Archicerebellum
(nodulus)

Archicerebellum
(flocculus)

Paleocerebellum

Neocerebellum
Functional classification

Spinocerebellum

Pontocerebellum

Vestibulocerebellum
 Cerebellum
Connections

Afferent Connections (1):

1. Inferior Cerebellar Peduncle

Restiform Body
Posterior Spinocerebellar Tract
*Olivocerebellar tract
Cuneocerebellar Tract
Reticulocerebellar Tract

Juxtarestiform Body
Vestibulocerebellar Tract
Primary Vestibular Fiber
 Cerebellum
Connections

Afferent Connections (2):

2. Middle Cerebellar Peduncle

Pontocerebellar fiber
Corticopontocerebellar Fiber
Reticulocerebellar Fiber

3. Superior Cerebellar Peduncle

Ventral Spinocerebellar Tract

Cerulocerebellar fiber
Raphecerebellar fiber
Rubrocerebellar fiber
Hypothalamocerebellar fiber
 Cerebellum
Connections
Efferent Connections :

1. Superior Cerebellar Peduncle

Cerebellothalamic fiber
- from 3 deep nuclei to VPLo, VLc, CL

Cerebellorubral fiber[dentatorubrothalamic fibres

- from nucleus interpositus
and dentate nucleus
ascending portion of
uncinate fasciculus of Russell

2. Inferior Cerebellar Peduncle

Fastigiovestibular fiber
descending portion of
uncinate fasciculus of Russell
 Main Connections of the Vestibulocerebellum

Vestibular
Organ Floculonodular
Lobe
VESTIBULAR NUCLEUS Vermis

vestibulospinal tract

MLF FASTIGIAL
NUCLEUS

lower motor neuron ARCHICEREBELLUM

LMN
 Main Connections of the Paleocerebellum

RED NUCLEUS
INTERPOSITUS
NUCLEUS

Rubrospinal
tract Inferior ANTERIOR
Olivary LOBE
PARAVERMAL
Nucleus ZONE

lower motor neuron PALEOCEREBELLUM

SPINAL CORD spinocerebellar
tract
 Main Connections of the Neocerebellum

CEREBRAL DENTATE
THALAMUS
CORTEX NUCLEUS

pyramidal
tract Pontine POSTERIOR
LOBE
Nucleus CEREBELLAR
HEMISPHERE

lower motor neuron NEOCEREBELLUM

LMN
 Pyramidal Tract and Associated Circuits

upper motor neuron

UMN

BASAL
Cerebellum
GANGLIA
pyramidal tract

lower motor neuron

UMN
 Cerebellum and Automatic Motor Control

Motor Cortex

CEREBELLUM

Red Nucleus

Reticular Vestibular
Formation Nucleus

Lower Motor Neuron (LMN) Proprioceptors

 Cerebellum
Connections

Corticonuclear Connections

A zone ---------- fastigial nucleus

medial vestibular nucleus
B zone ---------- lateral vestibular nucleus

C1, C3 zone --- emboliform nucleus

C2 ---------------- globose nucleus

D1 ---------------- parvocellular portion of dentate nucleus

D2 ---------------- magnocellular portion of dentate nucleus
 1. vermis

2. paravermal region

3. cerebella hemisphere

4. nodulus

5. flocculus

6. fastigial nucleus

7. globose nucleus

8. emboliform nucleus

9. dentate nucleus

10. medial vestibular

nucleus

11. lateral vestibular

nucleus
 Cerebellum
Connections
Olivocerebellar Connections

Caudal portion of
medial and dorsal accessory olivary nucleus
----------------- vermis of cerebellar cortex (A and B)
fastigial nucleus
vestibular nucleus

Rostral portion of
medial and dorsal accessory olivary nucleus
----------------- paravermal region (C1, C2, C3)
nucleus interpositus

Principal Inferior Olivary Nucleus

----------------- cerebellar hemisphere (D1, D2)
dentate nucleus
 caudal portion rostral portion Principal
Inferior Olivary
medial and dorsal accessory olivary nucleus Nucleus
 Cerebellum

 Maintenance of Equilibrium*
- balance, posture, eye movement
 Coordination of half-automatic movement of
walking and posture maintenance*
- posture, gait
 Adjustment of Muscle Tone*

 Motor Leaning – Motor Skills*

Cognitive Function*

In summary it is a comparator: It compares the

with the intended and then helps to

synchronize the 2.
Balance
Motor Skill

Pablo Casals
Cerebellum Clinical Correlates

*Ataxia: incoordination of movement

- decomposition of movement
- dysmetria, past-pointing
- dysdiadochokinesia/adiadochokinesia
- [rebound phenomenon of Holmes]
- gait ataxia, truncal ataxia,
Titubation[
*Intention Tremor*
Hypotonia, Nystagmus
Archicerebellar Lesion: medulloblastoma
Paleocerebellar Lesion: gait disturbance
Neocerebellar Lesion: hypotonia, ataxia, tremor
 Clinical correlates
 Woman born
without a
cerebellum
 Discovered in
2014;24 yr old
Chinese woman
 September 2014
 Physicians in China discovered a 24-year-old woman who is only the ninth known case of a living
person with cerebellar agenesis. Her condition was described in the journal Brain.
 The woman’s condition was discovered after she sought medical attention due to nausea and
vertigo. CT scans and MRI images revealed the missing cerebellum, which readily explains why
those symptoms would be present. It also explains why she wasn’t able to speak until she was
six and wasn’t able to walk until age seven. She had never been able to play and jump like normal
kids due to this defect.
 Unsurprisingly, the woman had been unable to walk steadily without support throughout her life.
 While testing revealed that she had no trouble understanding vocabulary, the missing cerebellum
caused her to have difficulties with pronunciation. Her voice trembles, words are slurred, and the
doctors described her voice tone as “harsh.” Even still, the doctors were amazed that her
symptoms were more in line with a mild to moderate impairment, not a complete absence.
 In the space where the cerebellum should have been, cerebrospinal fluid has filled the gap. The
chemistry of the fluid appeared normal, though the pressure was a bit high. Initial measurements
read 210 mm H2O, exceeding normal limits of 70-180 mm H20. She was treated with a
dehydration treatment that removed some of the water pressure along with other techniques that
were less invasive, which provided immediate and lasting improvement of her symptoms. Even at
a follow-up appointment four years later, she was still doing quite well.
 Neurological defects do not appear to run in her family, and she was able to get married and have
a neurologically-typical daughter without pregnancy complications. The structures and tissues
surrounding the missing cerebellum appear to be mostly well-formed with no signs of extreme
defects. The pons appeared underdeveloped, but considering part of its job is to convey messages
from the frontal cortex to the cerebellum, that’s not completely surprising.
 Posture
Gait – Ataxia
Tremor
 a b c
Cerebellar
Ataxia

Ataxic gait and

position:
d Left cerebellar tumor

a. Sways to the right in

standing position
b. Steady on the
right leg
c. Unsteady on the
left leg
d. ataxic gait
 Cerebellar
Medulloblastoma

Cerebellar tumors on vermis

- Truncal Ataxia
- Frequent Falling

The child in this picture:

- would not try to stand
unsupported
- would not let go of the bed rail
if she was stood on the floor.
 Summary :Cerebellum
Post cranial fossa
 2 hemispheres and median vermis (folia and fissures) ;
 *Cerebellar surface area is 75% of cerebral surface area
 Internal structure resembles tree: abor vitae cerebelli;
 *Can be subdivided according to:
 Phylogeny (archi, paleo, neocerebellum)
 Function (vestibulo, ponto, spinocerebellum)

 Non functional lobulation (culmen, declive, pyramis etc)

P3 cell layers: 1.Cell poor molecular layer

2.Purkinje cell layer
3.Granule cell layer
*Principal inputs:
Vestibular nuclei, spinal cord and olive
Other: pons
Output: spinal cord,thalamus, red nucleus etc
*Mossy and climbing fibres
 Summary:
 Muscle tone
Function
 Function in vestibulo-ocular reflex
[optokinetic movements]/controls eye
movements
 Upright posture and balance
 Gait synchrony
 COMPARATOR: keeps a “blueprint” of the
perfect motion {muscle strength,
angulation of joints, range estimates etc}
 Lesions result in movement disorders
 Summary of connections
 SCP: cerebellar efferent fibres & ventral SCT;
 MCP: fibres from contralateral pontine nuclei;
 ICP: Olivocerebellar, dorsal SCT, vestibulocerebellar and
fastigiobulbar connections;
 Vestibular system connected to flocculonodular lobe and fastigial
nucleus---ipsilat vest nuclei and ret formation;
 Proprioceptive signals are carried ipisilat to vermis,paravermis,
and interposed nuclei and these project----contralat red nucleus
and post div of VLPn---cortex
 Cerebral ctx influences contralat cerebellar hemisphere and
dentate by way of relay in pontine nuclei...dentate---
dentatorubrothalamic tract to contralat VLPn
 Each side of the body is rep ipsilaterally in cerebellum,postural
fns located in midline region.
Brainstem

Part 1
Objectives

 Describe the anatomy of the brainstem

with particular attention to its constituent
parts;
 To note the conspicuous external and
internal features of the parts of the
brainstem;
 Consider clinical correlates relevant thereof.
Overview
 Major external features
 Transverse sections
 Pathways: The big Four
 Neurotransmitter nuclei
Major Brain Stem Activities
 Conduit
 Ascending and descending pathways
 Integrative functions
 Complex motor patterns
 Respiratory and cardiovascular activity
 Regulation of arousal and level of
consciousness
 Cranial Nerve functions
Brainstem facts
 7 cm long

 Contains nuclei for 10 cranial nerves

Major External Features
Brain Stem Midbrain
Pons
Medulla
Midbrain
 Cerebral Peduncles
 Middle 3/5 houses corticospinal fibres
 Interpeduncular cistern
 Origin of CN III -- Oculomotor Nerve
 Cerebral aqueduct
 Corpora Quadrigemina
 Superior Colliculi
 Inferior Colliculi
 Midbrain Corpora
quadrigemina

CN III

Cerebral
peduncles
Interpeduncular
cistern
Pons
 The name means “bridge”
 Forms a bridge between the cerebellar
hemispheres
 Cerebellar Peduncles
 Superior (Dives under the colliculi)
 Middle (Bridge of the pons)
 Inferior (inferior/medial to middle)
 Floor of the 4th Ventricle
Pons
 Pons
Middle cerebellar peduncle
Pons

Superior cerebellar peduncles

Middle cerebellar peduncle

Inferior cerebellar peduncles

Pons
 4th Ventricle
 Inflow from aqueduct of
Sylvius
 Sulcus limitans
Medulla
 3 cm long, begins at the level of the foramen
magnum
 Widens rostrally

 Ventral surface shows sharp junction with pons;

dorsal surface less conspicous
Some features of the medulla
 Pyramids

 Pyramidal decussation

 Tuberculum cinereum(spinal tract of V and DSCT)

 Inferior olive
 Obex (inferior-most point of the 4th ventricle)
 Medulla

Obex

Pyramids
Inferior olive
Medulla

Inferior Olive

Pyramids
Transverse Sections
Transverse Sections
 But first…a word about orientation…

Clinical Anatomical
Midbrain
 Cerebral peduncles
 Substantia nigra
 Red nucleus
Midbrain Myelin Stained

Cerebral peduncles
Midbrain

Substantia nigra
Midbrain

Red Nucleus
Midbrain

Colliculi
Midbrain

Substantia nigra
Midbrain

Red nucles

Substantia nigra
Pons
 4th ventricle
 Pontine nuclei
 Locus ceruleus
 Pontine nuclei
Pons

4th vent
Locus ceruleus
Pons

Locus ceruleus
Pons
 4th ventricle
 Pontine nuclei
 Locus ceruleus
Pons

4th ventricle

Sulcus Limitans

Middle cerebellar peduncle

Pons
Rostral Medulla
 Pyramids
 Inferior Olive
Rostral Medulla

Pyramids
Inferior olive
Caudal Medulla
 Sensory nuclei
 Nucleus Gracilis
 Nuclues Cuneatus
 Pyramidal decussation
Caudal Medulla

Nucleus cuneatus
Nucleus gracilis
Tectum and Tegmentum
 Tectum
 Area posterior to the ventricular space
(houses the sensory nuclei: copora
quadrigemina)
 Only prominent in the midbrain
 Superior and inferior colliculi (“tectal plate”)
Tectum and Tegmentum
Tectal Plate
 Tectum and Tegmentum
 Tegmentum
 Area anterior to the ventricular space (but not everything
anterior)
 This is the embryologically oldest areas of the brainstem
 Area anterior to the tegmentum “added on” during
development
Big Four Pathways
Remember the Big Four?
Corticospinal tract

Dorsal Columns

Spinothalamic tract

Spinocerebellar tracts
 Big Four Pathways
 Corticospinal tract
 Descending motor
 Spinothalamic tract
 From tract cells [lamina IV] cross over at spinal level; rostral end becomes continuous with
spinal tract of V
 Ascending pain/temperature
 Dorsal columns/Medial lemniscus
 Ascending somatosensory and conscious proprioception
 Spinocerebellar tracts
 Ascending unconscious proprioception
 Dorsal SC: from thoracolumbar region[ nucleus thoracis T1-L3/4] of spinal cord upwards
posterolateral funiculus through the tuberculum cinereum to the medulla giving of
collaterals to the nucleus Z of Brodal and Pompeiano [rostral to gracile nucleus & caudal
to inferior cerebellar peduncle] through the inferior cerebellar peduncle into cerebellum)
 Ventral SC: from base of dorsal horn and spinal border cells (lamina V-VI &VII)
The Big Four -- Caudal Medulla
Lateral Cuneate Nucleus

Corticospinal tract

Medial Lemniscus

Spinothalamic tract

Spinocerebellar tracts
The Big Four -- Rostral Medulla
Corticospinal tract

Medial Lemniscus

Spinothalamic tract

Spinocerebellar tracts
The Big Four…err…three -- Pons
Corticospinal tract

Medial Lemniscus

Spinothalamic tract
The Big Three -- Midbrain
Corticospinal tract

Medial Lemniscus

Spinothalamic tract
Brain Stem Nuclei
Brain Stem Nuclei
 Major neurotransmitter nuclei
 Reticular formation (not really a
“nucleus” but acts like a group of
nuclei)
 Nuclei associated with cranial nerves
Raphe Nuclei
 Ridge of cells along the midline in the
center of the brainstem
 Multiple nuclei
 Caudal
 projections to the spinal cord and other
parts of the brainstem
 Rostral
 projections to multiple cortical areas
Raphe Nuclei
 Major serotonin nuclei
 Technically part of the reticular formation
 Complex reciprocal relationships with multiple
areas
 Ascending pathways involved in many
neurobehavioral phenomena
 Mood
 Sleep
 Feeding/satiety
 Descending pathways modulate spinal cord
function
 Pain
Locus Ceruleus
 Major norepinephrine nucleus
 Dorsal wall of the rostral pons
 Projects to
 Spinal cord
 Brain Stem
 Cortex
Locus Ceruleus
 Function
 Arousal
 Modulation of stress responses
 Linked to
 Depression
 Anxiety
 Post-traumatic stress disorder
 Accounts for some of the psychiatric
symptoms in Parkinson’s Disease
Locus Ceruleus

Normal Parkinson’s Disease

Substantia Nigra
 One of a few major dopamine center
 Projects to the basal ganglia
 Function
 Modulation of movements
 Major role in Parkinson’s Disease
 NOT involved in psychiatric symptoms
Nucleus Basalis of Meynert
 NOT in the brainstem, but important
 Located in the basal forebrain as part of
the basal cholinergic nuclei of the S.
Innominata.
 Major acetylcholine nucleus in the brain
 Provides tonic stimulation to the
hippocampus
Nucleus Basalis of Meynert
 Major neurotransmitter associated with
Alzheimer’s Disease
 Major medications for Alzheimer’s are
cholinesterase inhibitors
Wallenberg Syndrome
 Caused by infarction of PICA
 Infarcted area may include spinal tract of V{ipsilateral loss
of pain and temp on V dermatome}
 below neck contrlateral loss of pain & temp;
 Due to involvement of medial lemniscus: diminished touch
 Nucleus Ambiguus: paralysis of ,muscles of
phonation/defective swallowing
 Horner’s syndrome (small pupil, ptosis, retraction of
eyeball, warm dry skin of the face on the side of lesion)
 infarct may include base of inferior cerebellar peduncle:
cerebellar ataxia, nystagmus;
 Medulla, lateral lesion
Infarction of P.I.C.A: Wallenberg Syndrome/Lateral
Medullary Syndrome
Medial Medullary Syndrome
 Caused by infarction of the anterior spinal
artery/medullary branch of vertebral which
supplies the medial medulla
 Structures affected involve:
 Pyramid[contralateral hemiparesis]--- why?
 Most of med lemniscus on the affected
side[impaired sense of position on the opp. side of
body]
 Hypoglossal nerve infra-nuclear lesion [ipsilateral
tongue paralysis]
 ..and maybe the inferior olive
 Medulla, medial lesion
Infarction of anterior spinal artery: Medial medullary
syndrome
Weber’s syndrome
 Infarction to posterior cerebral artery
 Medial aspect of midbrain affected:
 Contralateral hemiparesis
 CNIII affected: paralysis of all extraocular
muscles except LR and SO
 Lateral strabismus
 Inability to raise eyelid
 Dilation of pupil [why?]
Benedikt’s Syndrome
 Infarction of posterior cerebral artery
 Benedikt's syndrome, is similar to
Weber's syndrome, but the necrosis
involves the medial leminiscus and red
nucleus, producing contra lateral hemi
anesthesia and involuntary movements
of the limbs of the opposite side.
 AND: HEMIPARESIS IN BENEDIKTS
HEMIPLEGIA IN WEBER’S SYNDROME.
The
END
 To describe the location the nuclei of
origin for all the cranial nerves in the
brainstem
 To describe the anatomical basis of
clinical correlates
Brainstem

Overview
Medulla
Pons
Midbrain
Ventral – Lateral View
Corticospinal
tract descends
throughout 
Midbrain movement

Cerebral peduncles
Reticular
formation
Pons descends
throughout 
Basis pontis
movement
ascends
throughout 
Medulla arousal
Pyramid Olive
Ventral – Dorsal Organization
(anterior - posterior)

Basis
Large anterior fiber tracts:
cerebral peduncles, crossing
pontine fibers, pyramids
Ventral – Dorsal Organization

Tegmentum
Anterior cell body-rich
areas, floor of brainstem:
red nuclei,substantia nigra,
reticular formation
Ventral – Dorsal Organization

Tectum
Roof of the
brainstem: superior
colliculi, inferior
colliculi: corpus
quadrigemina

Cerebellum
Cuneatus, gracilis
(medulla)
Ventral – Dorsal Organization

Tectum

Tegmentum
Basis
Vertical Columns of
Cranial Nerves
Internal Columns of Nuclei

III, IV, VI, XII

V, VII, N. ambiguus, XII
EW, Salivatory, DMN X
V, VII, IX, X
N. Solitary tract
VIII
 Subdivisions of Vertical
Columns
 Motor nuclei
 Somatic motor  Sensory nuclei
 closest to midline  General sensory
 eyes, tongue  lateral to branchial motor
 CN III, IV, VI, XII  Face, sinuses, meninges
 Branchial motor  All modalities
 Lateral position  CN V mainly
 Branchial arches: chewing, Also CN VII, IX, X
expression, middle ear, pharynx, 

larynx, sternomastoic, trapezius  Visceral sensory

 CN V, VII, XI  lateral to visceral motor
 N. ambiguus (IX, X)  Taste; cardiorespiratory, GI info
 Visceral motor  N. of the solitary tract (CN VII,
 ventral / ventrolateral IX, X)
 Parasympathetic: glands, smooth  Special sensory
muscle, heart, lungs, GI above
splenic flexure  furthest lateral
 Edinger-Westfall (III)  Balance; hearing
 Sup. & Inf. salivatory (VII)  CN VIII (vestibular)
 Dorsal motor nucleus of X  CN VIII (cochlear)
Brainstem

Overview
Medulla
Pons
Midbrain

.
 Internal Structure of Medulla

Cross section at three levels

 Level of pyramidal decussation

 Level of lemniscal decussation

 Level of inferior olivary nuclei

Level of Pyramidal Decussation
Lateral corticospinal tract Gracile
75 – 90% nucleus

Spinal
nucleus
of V
From pons Contralateral movement
to C4
Pyramidal tract

Anterior corticospinal tract -- fibers to innervate muscles of trunk

 Internal Structure of Medulla
Cross section at three levels

 Level of pyramidal decussation

 Level of lemniscal decussation

 Level of inferior olivary nuclei

Level of Lemniscal Decussation
Gracile nucleus
Cuneate MLF
nucleus

Position & vibration sense

Pyramids Medial lemniscus

Internal arcuate Carries 2nd order sensory
fibers neurons to VPL thalamus
 Internal Structure of Medulla
Cross section at three levels

 Level of pyramidal decussation

 Level of lemniscal decussation

 Level of inferior olivary nuclei

Level of Inferior Olives
Vestibular nuclei
Hypoglossal nucleus
CN XII Medial Inferior

Inferior cerebellar
peduncle =
Restiform body MLF

Inferior olivary
nuclei
Relay between cortex,
vestibular nuclei,
cerebellum, basal ganglia,
and dorsal column nuclei
Arcuate nuclei  pontine nuclei
Cranial Nerves of the Medulla
Vestibular nuclei

CN XII
Cranial Nuclei of the Medulla
N. solitarious
Sensory nucleus
for
CN VII, IX, X
Cranial Nuclei of the Medulla
N. solitarious
Sensory nucleus
for
CN VII, IX, X

Spinal
trigeminal tract
CN V, VII, IX, X
Cranial Nuclei of the Medulla
N. solitarious
Sensory nucleus
for
CN VII, IX, X

Spinal
trigeminal tract N. ambiguus
CN V, VII, IX, X Motor nucleus for
CN IX, X & XI
Cranial Nuclei of the Medulla
N. solitarious
Dorsal motor Sensory nucleus
for
nucleus of X
CN VII, IX, X

Spinal
trigeminal tract N. ambiguus
CN V, VII, IX, X Motor nucleus for
CN IX, X & XI
CN IX: Glossopharyngeal Nerve
N. solitarious
Sensory nucleus
for
CN VII, IX, X

Spinal
trigeminal tract N. ambiguus
CN V, VII, IX, X Motor nucleus for
CN IX, X & XI
CN IX: Glossopharyngeal Nerve
N. solitarious
Sensory nucleus
for
CN VII, IX, X
Posterior 1/3 of
the tongue

Spinal
trigeminal tract N. ambiguus
CN V, VII, IX, X Motor nucleus for
CN IX, X & XI
CN IX: Glossopharyngeal Nerve
N. solitarious
Sensory nucleus
for
CN VII, IX, X
Posterior 1/3 of
the tongue

Spinal
trigeminal tract N. ambiguus
CN V, VII, IX, X Motor nucleus for
Sensation behind CN IX, X & XI
ear
CN IX: Glossopharyngeal Nerve
N. solitarious
Sensory nucleus
for
CN VII, IX, X
Posterior 1/3 of
the tongue

Spinal
trigeminal tract N. ambiguus
CN V, VII, IX, X Motor nucleus for
Sensation behind CN IX, X & XI
ear
Stylopharyngeus
(lifts pharynx)
CN IX: Glossopharyngeal Nerve
N. solitarious
Inf. salivatory Sensory nucleus
for
nucleus
CN VII, IX, X
Parotid gland,
parasympathetic Posterior 1/3 of
the tongue

Spinal
trigeminal tract N. ambiguus
CN V, VII, IX, X Motor nucleus for
Sensation behind CN IX, X & XI
ear
Stylopharyngeus
(lifts pharynx)
CN X: Vagus Nerve
“Wanderer”
N. solitarious
Sensory nucleus
for
CN VII, IX, X

Spinal
trigeminal tract N. ambiguus
CN V, VII, IX, X Motor nucleus for
CN IX, X & XI
CN X: Vagus Nerve
“Wanderer”
N. solitarious
Sensory nucleus
for
CN VII, IX, X
Taste, epiglottis
Cardiorespiratory

Spinal
trigeminal tract N. ambiguus
CN V, VII, IX, X Motor nucleus for
CN IX, X & XI
CN X: Vagus Nerve
“Wanderer”
N. solitarious
Sensory nucleus
for
CN VII, IX, X
Taste, epiglottis
Cardiorespiratory

Spinal
trigeminal tract N. ambiguus
CN V, VII, IX, X Motor nucleus for
Ear CN IX, X & XI
CN X: Vagus Nerve
“Wanderer”
N. solitarious
Sensory nucleus
for
CN VII, IX, X
Taste, epiglottis
Cardiorespiratory

Spinal
trigeminal tract N. ambiguus
CN V, VII, IX, X Motor nucleus for
Ear CN IX, X & XI
Pharynx
Larynx
CN X: Vagus Nerve
“Wanderer”
N. solitarious
Dorsal motor Sensory nucleus
for
nucleus of X
CN VII, IX, X
Taste, epiglottis
Cardiorespiratory

Spinal
trigeminal tract N. ambiguus
CN V, VII, IX, X Motor nucleus for
Ear CN IX, X & XI
Pharynx
Larynx
CN X: Vagus Nerve
“Wanderer”
N. solitarious
Dorsal motor Sensory nucleus
for
nucleus of X
CN VII, IX, X
Parasympathetic,
preganglionic Taste, epiglottis
Cardiorespiratory

Spinal
trigeminal tract N. ambiguus
CN V, VII, IX, X Motor nucleus for
Ear CN IX, X & XI
Pharynx
Larynx
Brainstem

Overview
Medulla
Pons
Midbrain
Pons
Landmarks
Basis pontis
4th ventricle
Cerebellum and Middle
cerebellar peduncle

Cranial Nerves
V, VI, VII, VIII
Pontine Nuclei
Input (ipsilateral)

Motor cortex
Sensory cortex
Association cortex
Cingulate cortex

Output (contralateral) Pontine nuclei

Transverse crossing via Project to cerebellum
middle cerebellar peduncle to
Continuation of arcuate
cerebellum
nuclei (over pyramids)
 Internal Structure of the
Pons
Cross section at three levels

• Level of facial nucleus (CN VII)

• Level of middle cerebellar peduncle

• Level of locus ceruleus

4th Ventricle
Pons
Connection of pons to
cerebellum
Restiform body (inf.
cerebellar peduncle)
Middle cerebellar peduncle

Medial lemniscus
Ascending 2nd order
sensory neurons

Descending upper motor neurons

Cranial Nerves of Lower
Pons Posterior view:
Cerebullum cut away

CN VIII – Vestibular Nuclei

Pure sensory  lateral location
Balance
 Cranial Nerves of Lower
Pons

CN VIII –
Vestibular Nuclei
(Cochlear Nuclei)
Cranial Nerves of Lower
Pons

At a slightly higher level

CN VI nucleus – Abducens
nerve
Abduction of eye
Longest, most vulnerable CN

CN VII nucleus – Facial nerve

Muscles of face
Cranial Nerves of Lower
Pons

CN VII nucleus - Facial nerve

Muscles of face
Cranial Nerves of Lower
Pons

CN VI nucleus – Abducens
nerve
Abduction of eye
 Internal Structure of the
Pons
Cross section at three levels

• Level of facial nucleus (CN VII)

• Level of middle cerebellar peduncle

• Level of locus ceruleus

Anterior view
 Mid Pons 4th Ventricle

Middle cerebellar
peduncle

Corticospinal tract,
corticobulbar tract,
corticopontine fibers
Descending fibers
 Mid Pons 4th Ventricle

Middle cerebellar
peduncle

Pontine nuclei in basis

 Mid Pons
Lateral lemniscus

from cochlear
nucleus
hearing

Pontine nuclei
Trapezoid body – transverse fibers in pontine tegmentum
Mid Pons
Medial lemniscus fibers
from dorsal column
Lateral lemniscus (position and vibration)

Trigeminal
tract pain,
temperature,
touch from
contralateral
face

Pontine nuclei
Lemniscal sensory system – in tegmentum of the pons
 Cranial Nerve of the Mid
Pons th
4 Ventricle
CN V
Motor trigeminal
nucleus
 Cranial Nerve of the Mid
Pons 4 Ventricle th

CN V
Motor trigeminal
nucleus

Principal trigeminal sensory nucleus

 Cranial Nerve of the Mid
Pons 4 Ventricle th

CN V
Motor trigeminal Trigeminal
nucleus fascicles

Trigeminal
nerve

Principal trigeminal sensory nucleus

 Internal Structure of the
Pons
Cross section at three levels

• Level of facial nucleus (CN VII)

• Level of middle cerebellar peduncle

• Level of locus ceruleus

 Upper Pons 4th ventricle  cerebral aqueduct

Superior cerebellar
peduncle decussation
 Upper Pons 4th ventricle  cerebral aqueduc

Superior cerebellar
peduncle

Transverse
ponto-cerebellar
fibers

Descending upper motor neurons

 Upper Pons
Periaqueductal gray matter 4th ventricle  cerebral aqueduc

MLF
 Upper Pons 4th ventricle  cerebral aqueduc

Locus ceruleus
MLF
Primary source of
noradrenergic
innervation to the
brain
Neurons contain
melanin
 Upper Pons 4th ventricle  cerebral aqueduc

Parabrachial Nucleus
MLF
Also release
catecholamines
Neurons also
contain melanin
 Upper Pons 4th ventricle  cerebral aqueduc

Pediculopontine Nucleus
MLF
Some neurons
release
acetylcholine
Other neurons
release glutamate
They assist in
learning and
voluntary motor
control,
e.g. locomotion,
saccadic eye
Brainstem

Overview
Medulla
Pons
Midbrain
Midbrain
Landmarks
Cerebral peduncles
Optic chiasm
Interpeduncular fossa
(Superior colliculi)
(Inferior colliculi)
(Superior cerebellar
peduncle)

Cranial Nerves
III, IV
 •Cranial nerves 3&4
(oculomotor and trochlear)
exit from the midbrain
•Midbrain also contains the
headquarters of the
reticular activating system
Midbrain
 On each side, the midbrain
contains a red nucleus and a
substantia nigra
 Red nucleus contains
numerous blood vessels and
receives info from the
cerebrum and cerebellum
and issues subconscious
motor commands concerned
w/ muscle tone & posture
 Lateral to the red nucleus is
the melanin-containing
substantia nigra which
secretes dopamine to inhibit
the excitatory neurons of
the basal nuclei.
 Damage to the substantia
nigra would cause what?
Patterning of the Midbrain
 External Structure of
Midbrain
1. Optic chiasm
2. Interpeduncular fossa
3. Oculomotor nerve (CN III)
4. Trochlear nerve (CN IV)
5. Pons
6. Cerebral peduncles (crus
cerebri)

Ventral surface
(anterior)
External Structure of
Midbrain
Quadrigeminal Plate
• Superior colliculus

• Inferior colliculus

CN IV Dorsal surface
Trochlear nerve
Cerebellum removed
 Cranial Nerves of the
Midbrain
Anterior exit Posterior exit
CN III (1) CN IV (2)
CN VI (5)

MLF - Medial longitudinal fasciculus (7)

Vestibular nuclei (6)
Pons (3)
 Internal Structure of
Midbrain
Cross section at two levels

• Level of inferior colliculus

• Level of superior colliculus

Lower Midbrain
Inferior colliculus
hearing
DORSAL

cerebral aqueduct

cerebral
peduncles
VENTRAL
 Lower Midbrain
Inferior colliculus

Substantia
nigra

Melanin-containing cells that produce dopamine

Project to the basal ganglia
 Lower Midbrain
Inferior colliculus

Substantia
nigra

Basis
Crus peduncularis
cerebri
(cerebral
peduncle)
Lower Midbrain
Inferior colliculus

CN IV
Trochlear nerve
Lower Midbrain
Inferior colliculus

CN IV
Trochlear nerve
MLF
Lower Midbrain
Inferior colliculus

CN IV
MLF

Dorsal raphe nucleus – projects serotonergic fibers to

basal ganglia and throughout cortex
 Lower Midbrain
Inferior colliculus
hearing
Mesencephalic
nucleus of V
analogous to
dorsal root
ganglion
but within
CNS
 Internal Structure of
Midbrain
Cross section at two levels

• Level of inferior colliculus

• Level of superior colliculus

 Upper Midbrain
Superior colliculus
vision

Substantia nigra Crus cerebri

(cerebral
 Upper Midbrain
Superior colliculus
vision

Medial geniculate body

hearing
Upper Midbrain

Vision
Superior colliculus 
Lateral geniculate body

Hearing
Inferior colliculus 
Medial geniculate body
Upper Midbrain
Superior colliculus
vision

Red nucleus – relay from cortex and cerebellum to

spinal cord, inferior olive, reticular formation, cerebellum
Controls arm movement
 Cranial Nerves of Upper Midbrain
Superior colliculus
vision
Edinger Westphal
nucleus
Parasympathetic
to ciliary ganglion
Pupillary sphincter
ciliary muscles

Red nucleus
CN III Oculomotor
nucleus
Cranial Nerves of Upper Midbrain
Superior colliculus
vision
Edinger Westfal
nucleus

MLF

Red nucleus
CN III Oculomotor
nucleus
Innervation of Eye Muscles

Dorsal view
Cerebellum removed
Innervation of Eyes &
Muscles
Lacrimal gland (CN
VII)

Superior rectus
Inferior rectus Medial
rectus Inferior Oblique
(CN III)

Superior oblique (CN

IV)

Lateral rectus (CN Parasympathetic: Edinger-Westfal (CN III)

VI)
Sympathetic: Superior Cervical Ganglion
 Reading assignment
 Clinical correlates
 Hemianopia
 Quadarantopsia
 Argyll-Robertson pupil
 Paralysis of downward
gaze
 Trigeminal neuralgia
 Bell’s palsy
 Nystagmus
 Lmnl/upmnl of XI
The Spinal Cord
Sensory & Motor Pathways
Objectives
 To describe the anatomy of the internal
anatomy spinal cord
 To describe the course of tracts that pass
through the spinal cord
 Discuss relevant clinical correlates
 spinal cord sections
 Regional differences of the spinal cord which
are related to the function of spinal cord in
those regions
 Sub-division of gray mater into sections
called laminae according to the
cytoarchitecture [Rexed 1952,54 & 58]
 Thoracic region: intermedio-lateral gray
column
 Sacral region: sacral autonomic nucleus
 There is a continuous flow of information between the
brain, spinal cord, and peripheral nerves. This
information is relayed by sensory (ascending) and
motor (descending) ‘pathways’.
 Generally the pathways:
 Consists of a chain of tracts, associated nuclei and

varying number of relays (synapses)

 Consist of two or three neurons

 Exhibit somatotopy (precise spatial relationships)

 Decussate

 Involve both the brain and spinal cord

 Are paired (bilaterally and symmetrically)

Somatic Sensory Pathways
 Sensory Pathways

 Monitor conditions both inside the body and in the

external environment
 Sensation-stimulated receptor passes information
to the CNS via afferent (sensory) fibers
 Most sensory information is processed in the spinal
cord , thalamus, or brain stem. Only 1% reaches
the cerebral cortex and our conscious awareness
 Processing in the spinal cord can produce a rapid
motor response (stretch reflex)
 Processing within the brain stem may result in
complex motor activities (positional changes in the
eye, head, trunk)
 Sensory Pathways

 Contain a sequence of THREE

neurons from the receptor to the 3
cerebral cortex
 First order neuron: Sensory
neuron that delivers information
from the receptor to the CNS.
 Cell body located in the dorsal
root ganglion. The Axon (central 2
process) passes to the spinal
cord through the dorsal root of
spinal nerve gives many
collaterals which take part in 1
spinal cord reflexes runs
ipsilaterally and synapses with
second-order neurons in the
cord and medulla oblongata
 Second order neuron:
 Has cell body in the
spinal cord or medulla
oblongata
 Axon decussate &
 Terminate on 3rd order
neuron
 Third order neuron:
 Has cell body in
thalamus
 Axon terminates on
cerebral cortex
ipsilaterally
 White Matter: Pathway Generalizations
 Ascending and descending fibers are organized in
distinct bundles which occupy particular areas and
regions in the white matter
 Generally long tracts are located peripherally in the white
matter, while shorter tracts are found near the gray
matter

• The TRACT is a bundle of nerve fibers (within CNS)

having the same origin, course, destination &
function
• The name of the tract indicates the origin and
destination of its fibers
• The axons within each tract are grouped according
to the body region innervated
 Tracts of the Spinal Cord

 Tracts that serve to join brain to the spinal

cord
 Ascending

 Descending

 Fibers that interconnect adjacent or distant

segments of the spinal cord
 Intersegmental (propriospinal)
 Intersegmental Tracts
 Extensive fiber connections
between spinal segments
 Fasciculus proprius
 Short ascending &
descending fibers
 Both crossed &
uncrossed
 Begin and end within the
spinal cord
 Participate in
intersegmental spinal
reflexes
 Present in all funinculi
adjacent to gray matter
 Intersegmental Tracts

 Dorsolateral tract of
Lissauer: Primary sensory
fibers carrying pain,
temperature and touch
information bifurcate upon
entering the spinal cord.
 Their branches ascend and
descend for several spinal
segments in the dorsolateral
tract, before synapsing in
the dorsal horn

Intersegmental fibers, establishing connections with

neurons in the opposite half of the spinal cord, cross
the midline in the anterior white commissure
 Ascending Spinal Tracts

Transmit impulses:
 Concerned with specific sensory modalities:
pain, temperature, touch, proprioception, that
reach a conscious level (cerebral cortex)
 Dorsal column funiculi

 Spinothalmic tracts

 From tactile and stretch receptors to

subconscious centers (cerebellum)
 Spinocerebellar tracts
 Three major pathways carry sensory information
 Posterior column pathway (gracile & cuneate

fasciculi)
 Anterolateral pathway (spinothalamic)

 Spinocerebellar pathway
 Ascending Spinal Tracts
 Dorsal white column
 Lateral spinothalamic
 Anterior spinothalamic
 Anterior spinocerebellar
 Posterior spinocerebellar
 Cuneocerebellar
 Spinotectal
 Spinoreticular
 Spino-olivary
 Visceral sensory tracts
 Dorsal Column

 Contains two tracts,

Fasciculus gracilis (FG) &
fasciculus cuneatus (FC)
 Carry impulses concerned
with proprioception and
discriminative touch from
ipsilateral side of body
 Contain the axons of primary
afferent neurons that have
entered cord through dorsal
roots of spinal nerves
• FG contains fibers received at sacral, lumbar and
lower thoracic levels
• FC contains fibers received at upper thoracic and
cervical levels
 Fibers ascend without
interruption where they
terminate upon 2nd order
neurons in nucleus gracilis and
nucleus cuneatus
 The axons of the 2nd order
neurons decussate in the
medulla as internal arcuate
fibers and ascend through the
brain stem as medial lemniscus.
 The medial lemniscus
terminates in the ventral
posterior nucleus of the
thalamus upon 3rd order
neurons, which project to the
somatosensory cortex
(thalamocortical fibers)
 Spinothalamic Tracts

 Located lateral and ventral to

the ventral horn
 Carry impulses concerned
with pain and thermal
sensations (lateral tract) and
also non- discriminative touch
and pressure (medial tract)
 Fibers of the two tracts are
intermingled to some extent
 In brain stem, constitute the
spinal lemniscus
 Fibers are highly somato- Information is sent to the
topically arranged, with those
for the lower limb lying most primary sensory cortex on
superficially and those for
the upper limb lying deeply the opposite side of the
body
 Lateral Spinothalamic Tract
 Carries impulses
concerned with pain and
thermal sensations.
 Axons of 1st order neurons
terminate in the dorsal horn
 Axons of 2nd order neuron
(mostly in the nucleus
proprius), decussate within
one segment of their origin,
by passing through the
ventral white commissure &
terminate on 3rd order
neurons in ventral posterior
nucleus of the thalamus
 Thalamic neurons project
to the somatosensory
cortex
 Anterior Spinothalamic Tract
 Carries impulses concerned
with non- discriminative
touch and pressure
 Axons of 1st order neurons
enter cord terminate in the
dorsal horn
 Axons of 2nd order neuron
(mostly in the nucleus
proprius) may ascend several
segments before crossing to
opposite side by passing
through the ventral white
commissure & terminate on 3rd
order neurons in ventral
posterior nucleus of the
thalamus
 Thalamic neurons project to
the somatosensory cortex
 Spino-reticulo-thalamic System

 The system represents an additional route

by which dull, aching pain is transmitted to
a conscious level
 Some 2nd order neurons terminate in the
reticular formation of the brain stem, mainly
within the medulla
 Reticulothalamic fibers ascend to
intralaminar nuclei of thalamus, which in turn
activate the cerebral cortex
 Spinocerebellar Tracts
 The spinocerebellar system
consists of a sequence of
only two neurons
 Two tracts: Posterior &
Anterior
 Located near the
dorsolateral and
ventrolateral surfaces of the
cord
 Contain axons of Carry
information derived from
muscle spindles, Golgi
tendon organs and tactile
receptors to the
cerebellum for the control
of posture and
coordination of
movements
 Posterior Spinocerebellar Tracts
 Present only above
level L3
 The cell bodies of 2nd
order neuron lie in
Clark’s column
 Axons of 2nd order
neuron terminate
ipsilaterally (uncrossed)
in the cerebellar cortex
by entering through the
inferior cerebellar
peduncle
 Ventral Spinocerebellar Tracts
 The cell bodies of 2nd order
neuron lie in base of the dorsal
horn of the lumbosacral segments
 Axons of 2nd order neuron cross to
opposite side, ascend as far as
the midbrain, and then make a
sharp turn caudally and enter the
superior cerebellar peduncle
 The fibers cross the midline for a
second time within the cerebellum
before terminating in the
cerebellar cortex
 Both spinocerebellar tracts convey
sensory information to the same
side of the cerebellum
 Spinotectal
Tract
 Ascends in the
anterolateral part in close
association with
spinothalamic system
 Primary afferents reach
dorsal horn through dorsal
roots and terminate on 2nd
order neurons
 The cell bodies of 2nd order
neuron lie in base of the
dorsal horn
 Axons of 2nd order neuron
cross to opposite side, and
project to the
periaqueductal gray
matter and superior
colliculus in the midbrain
 Spino - olivary Tract
 Indirect spinocerebellar pathway (spino-
olivo-cerebellar)
 Impulses from the spinal cord are
relayed to the cerebellum via inferior
olivary nucleus
 Conveys sensory information to the
cerebellum
 Fibers arise at all levels of the spinal
cord
 Spinoreticular Tract
 Originates in laminae IV-
VIII
 Contains uncrossed
fibers that end in
medullary reticular
formation & crossed &
uncrossed fibers that
terminate in pontine
reticular formation
 Form part of the
ascending reticular
activating system
Somatic Motor Pathways
 Motor Pathways

 CNS issues motor commands in response to

information provided by sensory systems, sent by
the somatic nervous system (SNS) and the
autonomic nervous system (ANS)
 Conscious and subconscious motor commands
control skeletal muscles by traveling over 3
integrated motor pathways
 The corticospinal pathway – voluntary control of
motor activity
 Corticobulbar tracts
 Corticospinal tracts

 The medial and lateral pathways – modify or direct

skeletal muscle contractions by stimulating,
facilitating, or inhibiting lower motor neurons
 Motor Pathways
UMN

• Contain a sequence of TWO

neurons from the cerebral
cortex or brain stem to the
muscles
• Upper motor neuron : has cell
body in the cerebral cortex or
brain stem, axon decussates
before terminating on the lower
motor neuron
• Lower motor neuron: has cell
body in the ventral horn of the
spinal cord, axon runs in the
ipsilateral ventral root of the
spinal nerve and supply the
muscle.
LMN
 Descending Spinal Tracts

 Originate from the cerebral cortex & brain stem

 Concerned with:
 Control of movements
 Muscle tone
 Spinal reflexes & equilibrium
 Modulation of sensory transmission to higher
centers
 Spinal autonomic functions
 The motor pathways are
divided into two groups
 Direct pathways

(voluntary motion
pathways) - the
pyramidal tracts
 Indirect pathways

(postural pathways),
essentially all others -
the extrapyramidal
pathways
 Direct (Pyramidal) System

 Regulates fast and fine (skilled) movements

 Originate in the pyramidal neurons in the
precentral gyri,
 Impulses are sent through the corticospinal
tracts and synapse in the anterior horn
 Stimulation of anterior horn neurons activates
skeletal muscles
 Part of the direct pathway, called corticobulbar
tracts, innervates cranial nerve nuclei
 Indirect (Extrapyramidal) System

 Complex and multisynaptic pathways

 The system includes:
• Rubrospinal tracts: control flexor muscles

• Vestibulospinal tracts: maintain balance and

posture
• Tectospinal tracts: mediate head neck, and eye
movement
• Reticulospinal tracts
 Descending Spinal Tracts

 Pyramidal
 Corticospinal
 Extrapyramidal
 Rubrospinal
 Tectospinal
 Vestibulospinal
 Olivospinal
 Reticulospinal
 Descending
Autonomic Fibers
 Corticospinal Tracts

 Concerned with
voluntary, discrete,
skilled movements,
especially those of
distal parts of the limbs
(fractionated
movements)
 Innervate the
contralateral side of the
spinal cord
 Provide rapid direct
method for controlling
skeletal muscle
 Origin: motor and sensory
cortices
 Axons pass through corona
radiata, internal capsule, crus
cerebri and pyramid of
medulla oblongata
 In the caudal medulla about
75-90% of the fibers
decussate and form the
lateral corticospinal tract
 Rest of the fibers remain
ipsilateral and form anterior
corticospinal tract.
 They also decussate before
termination
 Distribution:
 55% terminate at
cervical region
 20% at thoracic
 25% at lumbosacral
level
 Termination: Ventral horn
neurons (mostly through
interneurons, a few fibers
terminate directly)
 Corticobulbar tracts end
at the motor nuclei of CNs
of the contralateral side
 Rubrospinal Tract
 Controls the tone of limb
flexor muscles, being
excitatory to motor
neurons of these muscles
 Origin: Red nucleus [caudal
magnocellular region]
 Axons course ventro-
medially, cross in ventral
tegmental decussation,
descend in spinal cord
ventral to the lateral
corticospinal tract
 Cortico-rubro-spinal pathway
(Extrapyramidal)
 Tectospinal Tract
 Mediates reflex movements of
the head and neck in response
to visual stimuli
 Origin: Superior colliculus
 Axons course ventro-medially
around the periaqueductal gray
matter, cross in dorsal
tegmental decussation,
descend in spinal cord near the
ventral median fissure,
terminate mainly in cervical
segments
 Cortico-tecto-spinal pathway
(Extrapyramidal)
 Vestibulospinal Tracts
 Lateral Vestibulospinal
Tracts
 Origin: lateral vestibular
(Deiter’s) nucleus
 Axons descend ipsilaterally
in the ventral funiculus
 Terminate on ventral horn
cells throughout the length
of spinal cord
 Has excitatory influences
upon extensor motor
neurons, control extensor
muscle tone in the
antigravity maintenance of
posture
 Vestibulospinal Tracts
 Medial vestibulospinal
tract
 Origin: medial vestibular
nucleus
 Axons descend bilaterally in
the ventral funiculus, with the
medial longitudinal
fasciculus
 Most of the fibers end in the
cervical region, some
reaching upper thoracic
segments
 Involved in movements of
the head required for
maintaining equilibrium
 Reticulospinal Tracts
 Influence voluntary movement,
reflex activity and muscle tone
by controlling the activity of both
alpha and gamma motor
neurons
 Mediate pressor and depressor
effect on the circulatory system
 Are involved in control of
breathing
 Mediate motor actions that do
not require constant
conscious effort.
 Origin: pontine & medullary
reticular formation
 Medial (pontine) reticulospinal
tract descends ipsilaterally
 Lateral (medullary) reticulospinal
tract descends bilaterally
 Both tracts located in the ventral
funiculus
 Descending Autonomic Fibers
 The higher centers associated with
the control of autonomic activity
are situated mainly in the
hypothalmus
 Stimulation of the ventral regions elicits
“parasympathetic-like effects”;
stimulation of the posterior and lateral
regions = “sympathetic-like effects”
 Fibres run in the Dorsal Longitudinal
Fasciculus then to
 the reticulospinal tracts
 Terminate on the autonomic
neurons in the lateral horn of
thoracic & upper lumbar
(sympathetic) and sacral segments
(parasympathetic) levels of the
spinal cord
 Clinical correlates
LMNLesion
 Severe damage to ventral root results in flaccid paralysis (limp and unresponsive
 Skeletal muscles cannot move either voluntarily or involuntarily
 Without stimulation, muscles atrophy.
 Areflexia

When only UMN of primary motor cortex is damaged

 spastic paralysis occurs - muscles affected by persistent spasms and exaggerated tendon
reflexes
 Muscles remain healthy longer but their movements are no longer subject to voluntary
control.
 Hyper-reflexia
 Muscles commonly become permanently shortened(spastic).

 Transection (cross sectioning) at any level results in total motor and sensory loss in body
regions inferior to site of damage.
 If injury in cervical region, all four limbs affected (quadriplegia)
 If injury between T1 and L1, only lower limbs affected (paraplegia)
 Clinical correlates
 Spinal shock – transient period of functional loss
that follows the injury
 Results in immediate depression of all reflex
activity caudal to lesion.
 Bowel and bladder reflexes stop, blood pressure
falls, and all muscles (somatic and visceral) below
the injury are paralyzed and insensitive.
 Neural function usually returns within a few hours
following injury
 If function does not resume within 48 hrs,
paralysis is permanent.
 Clinical correlates
Amyotrophic Lateral Sclerosis (aka, Lou Gehrig’s disease)
 Progressive destruction of anterior horn motor neurons and
fibers of the pyramidal tracts
 Lose ability to speak, swallow, breathe.
 Death within 5 yrs.
 Cause unknown (90%); others have high glutamate levels

Poliomyelitis
 Virus destroys anterior horn motor neurons
 Victims die from paralysis of respiratory muscles
 Virus enters body in faeces-contaminated water (public
swimming pools)
To read!
 Brown-Sequard Syndrome
 Syringomyelia
 Sub-acute combined degeneration
Visual
system
Objectives
 To describe the anatomy of the visual system
 Describe the different responses to visual stimuli by
the eye and brain
 Describe the pathway of visual and non-image forming
impulses from the retina to respective points of
termination
 Discuss relevant clinical correlates
Visual system
 The retina is the principal neural structure of the
visual system
 It receives impulses which are sent to the cerebral
cortex after having passed through several relay
stations
Introduction

 Neurons in the visual system

 Neural processing results in perception
 Parallel pathway serving conscious visual perception
originate in the retina
 Progress to lateral geniculate nucleus, primary visual cortex
& higher order visual areas in temporal and parietal lobes
 Overlapping neuronal receptive fields
 Sensitive to different facets of the visual input
The Retinofugal Projection
 The Optic Nerve, Optic Chiasm, and Optic Tract
 The Eye

Lens – focuses
light on the retina

Ciliary muscles
alter the shape of
the lens as needed

Accommodation
– the process of
adjusting the lens
to bring images
into focus
Figure 6.4
Eye Position and Binocular Disparity
 Convergence
 eyes must turn slightly inward when objects are close

 Binocular disparity
 difference between images on the two retinas

 Both are greater when objects are close

 provides brain with 3-D image and distance information
The Retina
 The retina is in a sense “inside-out”
 Light passes through several cell layers before reaching its
receptors

 LIGHT-> retinal ganglion cells -> bipolar cells ->

receptors cells
 Lateral communication
 Horizontal cells
 Amacrine cells
Figure 6.5
 Cone and Rod Vision

 Duplexity theory of vision

 cones and rod mediate different kinds of vision

 Cones – photopic (daytime) vision

 High-acuity
 Color information in good lighting

 Rods – scotopic (nighttime) vision

 High-sensitivity, low-acuity vision in dim light
 Lacks detail and color information
Rods and Cones
Synaptic endings
Cell nucleus
Inner segments

Outer segments

Rod Cone
 Highly sensitive to low light  Sensitive to high light level
level or scotopic conditions. or photopic conditions.
 Black and white.  Three types of cones
responsible for color vision.
 Dispersed in the periphery of
the retina.  Concentrated in the fovea.
Adaptation
 Why can’t you see
Photopic (cones) immediately after you enter
Threshold of detection

a movie theater from

daylight?
(log scale)

Scotopic (rods)
 The threshold of detection
changes with overall light
level.
 The switch is quite gradual,
0 5 10 15 20 25 30 until the sensitivities of
Time in dark (minutes) cones and rods cross over
at about 7 minutes in the
dark.
Figure 6.8
 Cone and Rod Vision
Distribution of rods and cones

 More
convergence in
rod system,
increasing
sensitivity while
decreasing
acuity
 Only cones are
found at the
fovea

Figure 6.9
Spectral Sensitivity
 Lights of the same intensity but different
wavelengths may not all look as bright

 A spectral sensitivity curve shows the

relationship between wavelength and
brightness

 There are different spectral sensitivity curves

for photopic (cone) vision and scotopic (rod)
vision
 Human
photopic
and
scotopic
spectral
sensitivity
curves

Figure 6.10
Human Vision
 Human Cone Response to Color
 three cone types (S,I,L) correspond to B,G,R

S I L

Relative response

400 460 490 500 530 600 650 700

Wavelength (nm)

Blue Cyan Green Red

Visible Light
 Properties of Light
 Wavelength – perception of color
 Intensity(amplitude) – perception of brightness
 The electromagnetic spectrum: colors and wavelengths visible to humans

Figure 6.2
 The Retinofugal Projection
 Right and Left Visual Hemi-fields
 Left hemi-field projects to right side of brain

 Ganglion cell axons from nasal retina cross, temporal retinal axons
stay ipsilateral
The Retinofugal Projection

 Visual deficits from

lesions in the
retinofugal
projection
 The Retinofugal Projection

 Non-thalamic & Non-image forming targets

of the Optic Tract:
 Hypothalamus: Biological rhythms, including
sleep and wakefulness

 Pretectum : Size of the pupil; certain types

of eye movement

 Superior colliculus: Orients the eyes in

response to new stimuli[tectospinal tracts]
The
Lateral
Geniculate
Nucleus
(LGN)
The Lateral Geniculate Nucleus
(LGN)

 Inputs Segregated by Eye and Ganglion

Cell Type
The Lateral Geniculate Nucleus
(LGN)
 Receptive Fields
 Receptive fields of LGN neurons: Identical to the
ganglion cells that feed them

 Magnocellular LGN neurons: Large, monocular

receptive fields with transient response

 Parvocellular LGN cells: Small, monocular receptive

fields with sustained response
 The Lateral Geniculate Nucleus
(LGN)

 Non-retinal Inputs to the LGN: important!!

 Primary visual cortex provides 80% of the synaptic

input to the LGN

 Brain stem neurons provide modulatory influence on

neuronal activity
The Visual System
 Does the visual system create an exact copy of the
external world?
 No!

 The visual system creates a perception of reality.

 Chaplin Movie
Visual Illusions
Visual Illusions
Visual Illusions
Visual Illusions
Visual Illusions
 Retina
Light Cones

Rods

To optic nerve Bipolar

cells
Amicrine
cells
Ganglion
cells
Horizontal
 The retina is made of network of nerve cells. cells
 The network works together to reduce the amount of
information in a process called lateral inhibition.
Hermann Grid

 Illustrates lateral inhibition.

Hermann Grid

A B

 Point A looks darker because there are 4 inhibitory inputs

 Point B looks lighter because there are only 2 inhibitory inputs
Mach Bands

Actual
brightness

Perceived
by you
 Anatomy of the Striate Cortex

 Retinotopy
 Map of the visual field onto a target structure (retina, LGN, superior colliculus,
striate cortex)

 Central visual field overrepresented

 Discrete point of light: Activates many cells in the target structure due to
overlapping receptive fields

 Perception: Based on the brain’s interpretation of distributed patterns of activity

Anatomy
of the
Striate
Cortex
Anatomy of the Striate Cortex

 Retinotopy
Anatomy of the Striate Cortex
 Lamination of the Striate
Cortex
 Layers I - VI
 Spiny stellate cells: Spine-
covered dendrites; layer IVC
 Pyramidal cells: Spines; thick
apical dendrite;
layers III, IV, V, VI
 Inhibitory neurons: Lack spines;
All cortical layers;
 Form local connections
 Anatomy of the Striate Cortex

 Inputs to the Striate Cortex

 Magnocellular LGN neurons: Project to layer IVC

 Parvocellular LGN neurons: Project to layer IVC

 Koniocellular LGN axons: Bypasses layer IV to make

synapses in layers II and III
 Anatomy of the Striate Cortex
 Ocular Dominance Columns
 Studied with transneuronal autoradiography from retina, to LGN, to

striate cortex.
Anatomy of the Striate Cortex
 Ocular Dominance Columns
 Present in humans- alternating inputs from two eyes
 Anatomy of the Striate Cortex
 Inputs to the Striate Cortex
 First binocular neurons found in striate cortex - most layer III neurons are binocular
(but not layer IV)
Anatomy of the Striate Cortex

 Outputs of the Striate

Cortex:
 Layers II, III, and IVB:
Projects to other cortical
areas
 Layer V: Projects to the
superior colliculus and pons
 Layer VI: Projects back to
the LGN
 Visual Attention:
Color, Form, and Movement

Activation remaining after

divided condition subtracted
from each of 3 focal attention
conditions.
Red boxes = color activation.
Yellow boxes = motion activation.
(Courtesy of Posner and Raichle).
Physiology of the Striate Cortex
• Cortical Module
– Each module capable of analyzing every
aspect of a portion of the visual field
PET Identification in Humans of Cortical Region MT for
Motion Perception

A single slice shows

the location of MT
found by Frackowiak
and Zeki in London
(red squares) and
Miezen, Petersen,
and Fox in St. Louis
(green circles). The
areas of activation in
the extrastriate cortex
almost superimpose.
 Beyond Striate Cortex

 Dorsal stream
 Analysis of visual motion and the visual

control of action
 Ventral stream
 Perception of the visual world and the

recognition of objects
 Dorsal (“Where”) and Ventral (“What”) Visual
Streams in Human (PET)

Dorsal (where) pathway shown

in green and blue and Ventral
(what) pathway shown in yellow
and red serve different functions.
(Courtesy of Leslie Ungerleider).
Beyond Striate Cortex

 The Dorsal Stream (V1, V2, V3, MT, MST, Other dorsal
areas)
 Area MT (temporal lobe)
 Most cells: Direction-selective; Respond more to the motion of
objects than their shape
 Beyond area MT - Three roles of cells in area MST (parietal
lobe)
 Navigation
 Directing eye movements
 Motion perception
Beyond Striate Cortex

 The Ventral Stream (V1, V2, V3, V4, IT, Other

ventral areas)
 Area V4
 Achromatopsia: Clinical syndrome in humans-caused by
damage to area V4; Partial or complete loss of color
vision
 Area IT
 Major output of V4
 Receptive fields respond to a wide variety of colors and
abstract shapes
From Single Neurons to
Perception

 Visual perception
 Identifying & assigning meaning to objects
 Hierarchy of complex receptive fields
 Retinal ganglion cells: Center-surround
structure, Sensitive to contrast, and wavelength
of light
 Striate cortex: Orientation selectivity,
direction selectivity, and binocularity
 Extra-striate cortical areas: Selective
responsive to complex shapes; e.g., Faces
From Single Neurons to
Perception

 From Photoreceptors to Grandmother Cells

 Grandmother cells: Face-selective neurons in
area IT?
 Probably not: Perception is not based on the
activity of individual, higher order cells
 Parallel Processing and Perception
 Groups of cortical areas contribute to the
perception of color,motion, and identifying
object meaning
Visual reflexes
Pupillary or consensual light reflex
Smooth pursuit movements: eyes are normally directed toward an object in the center of the
visual field; if the object moves both eyes will execute smooth movements to maintain visual
fixation[involuntary]
 Visual cortex-----parietal
 Connections involve the cerebellum and vestibular nuclei
Saccadic movements of the eyes
 Occur when the point of visual fixation is constantly shifting
 E.g. looking out the window in a moving car.
Ocular Convergence movements
 Both eyes move medially to focus at a near object or laterally to look into distance[ FEF]
Conjugate lateral gaze
 Following an object passing through visual field eliciting the contraction of LR of one eye and MR
of the other eye
 Invovles PPRF,(center for lateral gaze) n prepositus Hypoglossi, VIn and IIIn(via MLF).
 Vestibular-Ocular Reflex (VOR)
► Causes eyes to move in the opposite
direction to head movement
► Speed of the eye movement equals that of

the head movement

► Allows objects to remain in focus during

head movements
Clinical correlates
Argyll-Robertson Pupil
 Complication of syphilitic infection of the CNS
 Loss of pupillary light reflex
 Accommodation intact
 Lesion in pre-tectal area
Blindsight

 The human condition known as blindsight is seen

occasionally in patients with destructive lesions of the
geniculostriate pathways.
 Despite the complete lack of conscious vision,
behavioral tests can detect the perception of
movements or of changes in illumination
 Concluding Remarks

 Vision
 Perception combines individually identified properties of
visual objects
 Achieved by simultaneous, parallel processing of several
visual pathways
 Parallel processing
 Like the sound produced by an orchestra of visual areas
rather than the end product of an assembly line
Auditory System
Introduction
Sensory Systems
 Sense of hearing, audition
 Detect sound
 Perceive and interpret nuances
 Sense of balance, vestibular system
 Head and body location
 Head and body movements

2
The Nature of Sound
Sound
 Audible variations in air pressure
 Sound frequency: Number of cycles per second
expressed in units called Hertz (Hz)
 Cycle: Distance between successive compressed
patches
 Range: 20 Hz to 20,000 Hz
 Pitch: High and Low
 Intensity: Difference in pressure between
compressed and rarefied patches of air

3
The Nature of Sound

Psychology 355 4
The Nature of Sound

5
The Structure
of the Auditory System

Psychology 355 6
The Structure
of the Auditory System
 Auditory pathway stages
 Sound waves
 Tympanic membrane
 Ossicles
 Oval window
 Cochlea fluid
 Sensory neuron response
 Brain stem nuclei output
 Thalamus to MGN to A1 7
The Middle Ear

Components of the Middle Ear

Psychology 355 8
The Middle Ear

 Sound Force Amplification by the Ossicles

 Pressure: Force by surface area
 Greater pressure at oval window than tympanic membrane,
moves fluids
 The Attenuation Reflex
 Response where onset of loud sound causes tensor tympani
and stapedius muscle contraction
 Function: Adapt ear to loud sounds, understand speech better

9
The Inner Ear
Anatomy of the Cochlea

10
The Inner Ear
Anatomy of the Cochlea

11
The Inner Ear

Physiology of the Cochlea

Pressure at oval window, pushes perilymph
into scala vestibuli, round window
membrane bulges out

12
The Inner Ear
The Organ of Corti

Psychology 355 13
The Inner Ear
Cilia

Psychology 355 14
The Inner Ear
Cilia

Psychology 355 15
The Inner Ear

16
 The Inner Ear

Transduction by Hair
Cells
Sound:
Basilar membrane
upward
reticular lamina up
stereocilia bends
outward
The
Inner Ear

18
The Inner Ear

 The Innervation of Hair Cells

 One spiral ganglion fiber: One inner hair cell, numerous
outer hair cells
 Amplification by Outer Hair Cells
 Function: Sound transduction
 Motor proteins: Change length of outer hair cells
 Prestin: Required for outer hair cell movements

19
 The Inner Ear

The Basilar Membrane

Structural properties:
Wider at apex, stiffness
decreases from base to
apex

Psychology 355 20
The Inner
Ear

Psychology 355 21
Central Auditory Processes
Auditory Pathway
 More synapses at nuclei than visual pathway,
more alternative pathways
 Anatomy
 Dorsal cochlear nucleus, ventral cochlear

nucleus, superior olive, inferior colliculus,

MGN, lateral lemniscus, auditory nerve fiber
 Primary pathway: Ventral cochlear nucleus

to superior olive to inferior colliculus to

MGN to auditory cortex
Auditory
Pathway

Psychology 355 23
Auditory
Pathway

24
Central Auditory Processes
Response Properties of Neurons in
Auditory Pathway
 Characteristic frequency
Frequency at which neuron is most
responsive
 Response
More complex and diverse on ascending
auditory pathway in brain stem

26
 Encoding Sound
Intensity and Frequency
 Encoding Information About Sound
Intensity
 Firing rates of neurons
 Number of active neurons
 Stimulus Frequency, Tonotopy, Phase
Locking
 Frequency sensitivity: Basilar
membrane
 Frequency: Highest at base,
lowest at cochlea apex
 Tonotopy: Systematic
organization of characteristic
frequency within auditory
structure

27
 Encoding Sound
Intensity and Frequency

Phase Locking
Consistent firing
of cell at same
sound wave
phase

Psychology 355 28
Mechanisms of Sound Localization

 Techniques for Sound Localization

 Horizontal: Left-right, Vertical: Up-down
 Localization of Sound in Horizontal Plane
 Interaural time delay: Time taken for sound to
reach from ear to ear
 Interaural intensity difference: Sound at high
frequency from one side of ear
 Duplex theory of sound localization:
 Interaural time delay: 20-2000 Hz
 Interaural intensity difference: 2000-20000 Hz

29
Mechanisms of Sound Localization

The Sensitivity of Binaural Neurons to Sound

Location
Monaural: Sound in one ear
Binaural: Sound at both ears
Superior olive: Cochlear nuclei input to superior
olive, greatest response to specific interaural
delay

30
Mechanisms of Sound Localization

 Delay Lines and Neuronal Sensitivity to Interaural Delay

 Sound from left side, activity in left cochlear nucleus, sent
to superior olive
 Sound reaches right ear, activity in right cochlear nucleus,
first impulse far
 Impulses reach olivary neuron at the same time
summation action potential
 Localization of Sound in Vertical Plane
 Sweeping curves of outer ear
31
Mechanisms of
Sound Localization

A given binaural neuron

indicates the amount of
phase disparity between
inputs from the left and
right ear.

32
Auditory Cortex

 Acoustic Radiation
 Axons leaving MGN project to auditory cortex via
internal capsule in an array
 Structure of A1 and secondary auditory areas:
Similar to corresponding visual cortex areas
 Neuronal Response Properties
 Frequency tuning: Similar characteristic frequency
 Iso-frequency bands: Similar characteristic
frequency, diversity among cells
33
 Principles in Study of Auditory Cortex
Auditory Cortex Tonotopy, columnar organization of cells
with similar binaural interaction

34
Vestibular system
objectives
 To state the structure and function of the vestibular
system
 Consider clinical correlates of the system
The vestibular organ lies in the temporal
bone

Foramen
Magnum
 The Vestibular System

 Importance of Vestibular System

 Balance, equilibrium, posture, head, body, eye
movement
 The Vestibular Labyrinth

Lateral line Organs

Small pits or tubes

Function
Sense vibration or pressure changes

4
 The Vestibular System

Head Rotation

Head Angle
Linear
Acceleration

5
 Deformation of the stereocilia
towards the kinocilium causes
hyperpolarization

 depolarization
 hyperpolarization
 Hair cells respond to deformation
Hair Cell

Vestibular Neuron
The Vestibular System
The Otolith Organs

Psychology 355 8
The Vestibular System
The Otolith Organs

Psychology 355 9
The Vestibular System

 The Semicircular Canals

 Function: Detect head movements
 Structure
 Crista: Sheet of cells where hair cells of semicircular
canals clustered
 Ampulla: Bulge along canal, contains crista
 Cilia: Project into gelatinous cupula
 Kinocili oriented in same direction so all excited or
inhibited together
 Semicircular canals: Filled with endolymph

10
The Vestibular
System

Psychology 355 11
 The Vestibular System

 Push-Pull Activation of Semicircular Canals

 Three semicircular canals on one side
 Helps sense all possible head-rotation angles

 Canal: Each paired with another on opposite side of head

 Push-pull arrangement of vestibular axons: Rotation
causes excitation on one side, inhibition on the other

12
There are 3 major vestibular reflexes
 Vestibulo-ocular reflex – keep the eyes still in space
when the head moves.
 Vestibulo-colic reflex – keeps the head still in space –
or on a level plane when you walk.
 Vestibular-spinal reflex – adjusts posture for rapid
changes in position.
Connections to the vestibular nucleus
from the canals
Nuclear Connections of the Otolith
Organs
The lateral vestobulospinal tract
● Originates in the lateral vestibular nucleus,
predominantly an otolith signal.
● Projects to cervical, thoracic, and lumbar segments
via the ventral funiculus.
● Entirely ipsilateral.
● Allows the legs to adjust for head movements.
● Provides excitatory tone to extensor muscles.
● Decerebrate rigidity is the loss of inhibition from
cerebral cortex and cerebellum on the LVST,
and exagerates the effect of the tonic signal in
the LVST.
The Medial Vestibulospinal Tract
(MVST)

● Originates in the medial vestibular

nucleus, predominantly a canal signal.
● Predominantly projects to cervical
segments via the medial longitudinal
fasciculus.
● Predominantly ipsilateral.
● Keeps the head still in space – mediating
the vestibulo-colic reflex.
The Horizontal Rotational
Vestibulo-ocular Reflex

Head position

Eye position

Gaze position
The Horizontal Translational VOR
 Keeps the eyes still when the head moves laterally (for
example when you are looking out of the window of a
train and trying to read the name of the station past
which you are traveling).
 Gain is dependent on viewing distance: during
translation a far object moves less on the retina than
a near object.
 The rotational VOR is not dependent upon viewing
distance.
 Most head movement evokes a combination of the
rotational (canal) and translation (otolith) VOR’s.
The VOR is plastic
 It can be suppressed when you don’t want it.
 Its gain can change.
 How do you know if the VOR is doing a good job?
 There is no motion on the retina when the head moves.
 If a muscle is weakened, a given central signal will be
inadequate, and the world will move on the retina.
 This can be mimicked by spectacles that increase retinal
slip.
 In either case, the brain adjusts the VOR signal so the
retinal slip is eliminated.
 The cerebellum is necessary for both suppression of the VOR and for
slip-induced gain change.
 The horizontal vestibulo-ocular reflex
(VOR)
Left Medial Rectus Right Lateral Rectus

Oculomotor
Abducens
Nerve (III)
Nerve (VI)
Oculomotor
Nucleus

Abducens
Vestibular Nuclei Nucleus
Lateral
Medial
Nucleus
Prepositus
Hypoglossi
Vestibular Nystagmus
The optokinetic signal
 The vestibular system is imperfect
 The cupula habituates in 5 seconds.
 The brainstem and cerebellum extend this time to roughly 25 seconds, after
which there is no further response to head acceleration.
 The vestibular system is a poor transducer of very slow (<0.1Hz) rotation.
 The visual system compensates for the inadequacies of the vestibular
signal by providing a description of the retinal motion evoked by the
head movement.
 The optokinetic response is mediated by neurons in the accessory optic
system in the pretectum, and the motion-sensitive areas in the cortex
(MT and MST).
The vestibular nucleus combines
visual and vestibular signals
Rotate in Dark

Rotate in Light

Visual Motion
Visual-vestibular conflict
 Full-field stimulation is an effective stimulus for the
vestibular nucleus. The neurons can’t tell the
difference, nor can you!
 Ordinarily the head movement implied by the visual
and visual signals are equal.
 Motion sickness – nausea and vomiting – occurs when
the visual and vestibular signals are unequal.
 The Vestibular System

 The Vestibulo-Ocular Reflex (VOR)

 Function: Line of sight fixed on visual target
 Mechanism: Senses rotations of head, commands
compensatory movement of eyes in opposite direction
 Connections from semicircular canals, to vestibular nucleus, to
cranial nerve nuclei  excite extraocular muscles

26
The Vestibular System
Vestibular Pathology
 Drugs (e.g., antibiotics) can damage vestibular system
 Effects:
 Trouble fixating on visual targets

 Walking and standing difficult

27
Vertigo and nystagmus
 The vestibular system has a tonic signal, changes of
which are interpreted as head motion.
 Anything that deranges that signal causes vertigo, a
perception of head motion when the head is still.
 This may be associated with visuovestibular conflict,
nausea, and vomiting.
Other sequelae of peripheral vestibular
dysfunction
 Head tilt.
 Difficulty compensating for perturbations of head
positon – functional imbalance.
 Difficulty with path integration.
Peripheral causes of vestibular
dysfunction
 Benign positional vertigo: debris from the otoconia in the utricle float
into the posterior canal, causing interference with cupula function,
brought out by motion in the plane of the affected posterior canal. This
can be treated by the Epley maneuver, that rotates the head to float the
debris away.
 Acute viral labyrinthitis.
 Alcohol – alcohol is lighter than blood, so the hair cells float in the
endolymph.
 Meniere’s disease – increased endolymphatic pressure.
 Toxins – especially guanidino-sugar antibiotics like streptomycin and
gentamycin.
 Alcohol and Dizziness
Normally, the cupula has neutral
buoyancy in endolymph that
surrounds it.

Alcohol is less dense than water (see

demo to right). When you drink,
alcohol enters the blood, and then into
the cupula. The cupula becomes less
dense. It floats in the endolymph
more. The cupula bends a little more
than usual away from the ground.
This bends hair cells, as if you are
rotating, even when you are still. This
Blue H2O cubes float in water (left) but sink in
gives you the sensation of rotating alcohol (right)

when you are still, i.e., you get the

dreaded spins.
Central causes of vertigo and nystagmus.
 Vestibular nuclei.
 Cerebellum.
 Peripherally caused nystagmus is worse with the eyes
closed, because the normal cerebellum can use vision
to suppress the nystagmus.
Cortical vestibular areas
Monkey Human
Perceptual aspects of vestibular function
 Self-motion.
 Vertical orientation.
 The vestibular nuclei project to the ventral thalamus
(VP/VL) and thence to area 2v. A number of cortical
areas have vestibular responses, but cortical vestibular
processing is poorly understood.
 Patients with lesions of parietoinsular cortex have
difficulty perceiving the vertical: they think vertical
lines tilt away from the side of the lesion.
 Concluding Remarks

Balance
 sensory receptors (hair cells)
 Movement detectors: rotational, and linear force
 Vestibular system: Senses movements of itself

35
THE LIMBIC SYSTEM
Objectives
 Discuss the components of the limbic system
 State the functions of the components concerned
 State clinical correlates of the limbic system
History
 Paul Broca (1824-1880):
1878: “le grand lobe limbique”
Refers to a ring of gray matter on the medial aspect of
the cerebral hemispheres.
 James Papez (1883-1958):
1930’s: defined a limbic system that might underlie
the relationship between emotion and memory (Papez’
circuit).
Components
 Amygdaloid body
 Hippocampus (“seahorse”)
 Cingulate gyus
 Parahippocampal gyrus
 Hypothalamus
 Mamillary bodies
 Anterior nucleus of thalamus
Current Conceptualization of the Limbic System

 Forebrain: Cortex, and subcortical forebrain structures that

include the amygdala, the hippocampus, the hypothalamus,
the nucleus accumbens, and the cingulate cortex.
 In some conceptualizations, the limbic system also includes
the midbrain nuclei that project to these regions: the locus
coeruleus, the ventral tegmental area, and the raphe nuclei.
 In modern conceptualization of the limbic system, 2
important regions not originally recognized are the
prefrontal cortex and the amygdala

The limbic lobe: “Cortex on the

medial aspect of the cerebral hemisphere.
Includes the cingulate gyrus and the
parahippocampal gyrus
The Functions of the Limbic System

 Plasticity
 Responding to stress
 Vigilance/attention
 Learning about emotional stimuli
 Pavlovian learning, or classical conditioning
 Affective state
 The Limbic System
“The hypothalamus, the anterior thalamic nucleus, the cingulate gyrus, the
hippocampus and their interconnections, constitute a harmonious mechanism which
may elaborate the functions of central emotion as well as participate in the emotional
expression.” -James Papez, 1939

•Broca, Papez, Kluver and Bucy

•Parts of the brain underlying emotional
behavior
•Associated with the olfactory system;
rhinencephalon = “smell brain”

http://www.hallym.ac.kr/~de1610/nana/chp-12n.htm#II
 Limbic Structures
 Hippocampus
 Amygdala
 Olfactory system
 Amygdala most closely associated
with emotional behavior
 “Angst and the Amygdala
 “Fear, faces, and the human amygdala.”
 “The neurobiology of psychopathy”
 “Emotion, decision making, and the amygdala”
 “Neuroanatomy of autism”
 “The functional neuroanatomy of PTSD: a critical
review”
 “Neurobiology of escalated aggression and violence.”
 Pub Med search for “Amygdala”
Functions of the Amygdala
 Relate environmental stimuli to coordinated behavioral
autonomic and endocrine responses seen in species-
preservation.
 Responses include:
Feeding and drinking
Agnostic (fighting) behavior
Mating and maternal care
Responses to physical or emotional stresses.
From the Digital Anatomist website
From the Digital Anatomist website
Olfactory System

thalamus.wustl.edu/ course/lim5.gif

From the Digital Anatomist website

 Olfactory Cortex
•Also cortical
amygdaloid nucleus
and periamygdaloid
area
•Projects to ventral
striatum, MD
thalamus, insula and
orbitofrontal cortex

•Pyriform cortex = 1˚ olfactory cortex

•Allocortex, paleocortex
•3 layered
From the Digital Anatomist website
Olfactory Cortex

http://www.hallym.ac.kr/~de1610/nana/chp-12n.htm#II
The Amygdala: Structure and
Composition
 Burdach 1819: the amygdaloid complex (“almond”)
 Johnston 1923: central, medial, cortical, basal nuclei
 Price 1980’s: basolateral, cortical, central medial
nucleus
 De Olmos and Heimer 1991: extended amygdala
 Swanson 1998: there is no amygdala
 The amygdaloid complex

 Over 20 divisions/nuclei, depending on whom you talk to

 500-1000 different connections identified (Swanson)
 Swanson: “The amygdala is neither a structural nor a
functional unit of the cerebral hemispheres; instead, its cell
groups participate in at least four distinct, though
interconnected, functional systems or differentiations of the
corticostriatopallidal system…. Terms such as 'amygdala' and
'lenticular nucleus' combine cell groups arbitrarily rather
than according to the structural and functional units to
which they now seem to belong. ” .
 L. W. Swanson: The amygdala and its place in the cerebral hemisphere, PNAS
985: 174, 2003.
 One view
(based on Heimer, 1996)

 Basolateral
 Similar to cortex
 Projects to ventral striatum
 Has pyramidal like cells
 Receives input from primary sensory cortex, polysensory cortex and thalamus
 Connections are reciprocal
 Cortical
 Olfactory amygdala
 Receives direct input form olfactory system, both the olfactory bulb and olfactory cortex
 Central Medial group
 Main output of amygdaloid complex
 Input from hippocampus, orbitofrontal, insula, anterior cingulate cortex as well as
basolateral group
 Projects to hypothalamus, brainstem via stria terminalis and amygdaloventral fugal
pathway
 Part of “central autonomic network”
http://www.driesen.com/amygdala_connections.htm

Price, Ann. NY Acad Sci., 985:50-58 (2003)

Model of associative learning in the amygdala
 The amygdala
 The amygdala appears to be a critically important gate through which
internal and external stimuli are integrated.
 Information from the primary senses is interwoven with internal
drives, such as hunger and thirst, to assign emotional
significance to sensory experiences.
 The amygdala may mediate learned fear responses, such as
anxiety and panic, and may direct the expression of certain
emotions by producing a particular affect.
 Neuroanatomical data suggest that the amygdala exerts a more
powerful influence on the cortex, to stimulate or suppress cortical
activity, than the cortex exerts on the amygdala.
 The amygdala
 Pathways from the sensory thalamic relay stations separately send
sensory data to the amygdala and the cortex, but the subsequent
effect of the amygdala on the cortex is the more potent of the
two reciprocal connections.
 In contrast, damage to the amygdala has been reported to
ablate the ability to distinguish fear and anger in other
persons' voices and facial expressions.
 Persons with such injuries may have a preserved ability to recognize
happiness, sadness, or disgust.
 The limbic system appears to house the emotional association
areas, which direct the hypothalamus to express the motor
and endocrine components of the emotional state.
 The Hippocampus
 Greek: “Sea Monster”
 Another terminology mess
 Allocortex/ archicortex
 Hippocampal formation (after Amaral and
Witter)
 Dentate gyrus
 Hippocampus proper “Cornu ammonis”
 Subicular complex
 Subiculum
 Presubiculum
 parasubiculum
 Entorhinal cortex
“C” shaped structure in medial
temporal lobe
Development
 Gross Anatomy
•Septal-temporal
poles
•Fornix
•Fimbria, body,
columns

Supracommissural
hippocampus=supracallosal
gyrus, indusium griseum
 Connections

•Afferents:
•Much of cortex is reciprocally connected to
entorhinal cortex
•Cholinergic and GABA input via septal nuclei
•Amygdala
•VTA, LC, Raphe n
•Efferents
•Via the fornix
•Pre-commissural: septal nuclei
•Post-commisural: mammillary bodies (to
anterior thalamic nucleus via
mammillothalamic tract)
 Cytoarchitectu
re
•Two interlocking cell fields
•Dentate gyrus
•Hippocampus
 2 Schemes of studying
the hippocampus are
employed
 Hippocampal fields of
Rose [H1-H6]
 Cornu Ammonis fields of
Lorente dề No [CA1-
CA4]
 so sp
•Stratum oriens sl
•Stratum pyramidale sr
•Stratum lucidum sl-m
•Stratum radiatum
•Stratum lacunosum- ml
moleculare

•ml=molecular layer

Hilus
www.deltagen.com/.../nervous/ cerebrum_hippo_10x.htm

CA1-CA3: pyramidal neurons

Dentate Gyrus: granule cells
Cajal, 1901
Intrinsic connections
Limbic System and Basal Nuclei
Anterior Cingulate Gyrus
Orbitofrontal Areas (10, 11)

Medial and lateral temporal lobe Ventral Striatum

Hippocampus
(nucleus accumbens)
Amygdala Caudate Nucleus
Entorhinal cortex (24) (head)

Ventral Pallidum
Medial Globus Pallidus Ventral Anterior Nucleus
Pars Reticularis Dorsomedial Nucleus
(Substantia nigra)
Papez Circuit (Emotions)
Mammillothalamic
Fornix
Mammillary bodies tract
Other hypothalamic nuclei
Septal nuclei
Substantia innominata
(Basal nucleus of Meynert)

Hippocampal Formation
(hippocampus Anterior Thalamic
Neocortex nuclear group
and dentate gyrus)

Parahippocampal Gyrus Cortex of Cingulate Gyrus

Pathologies (lesions)
 Voracious appetite
 Increased (perverse) sexual activity
 Docility:
Loss of normal fear/anger
response
 Memory loss:
Damage to hippocampus portion:
Cells undergoing calcium-induced changes associated with memory
 Kluver-Bucy
Syndrome
 Results from bilateral destruction of amygdala.
 Characteristics:
-Increase in sexual activity.
Compulsive tendency to place
-
objects in mouth.
Decreased emotionality.
Changes in eating behavior.
Visual agnosia.
Alzheimers’
 Depletion of basal cholinergic nuclei of the S
Inomminata
 Memory loss
 Inability to form new memories
 Wernicke’s encephalopathy- result of chronic
alcoholism
 Kosakoffs pyschosis –result of chronic alcoholism; glial
depletion leading to psychotic behavior
 Uncal fits
 Olfactory hallucinations
Anxiety Disorders I
• Phobias: Specific fears, often learned.
•Treated by psychotherapy “progressive
desensitization”.
• Panic attacks: Severe sympathetic overreactions
to uncomfortable situations. Usually treated with
tranquillizers and psychotherapy. Amygdala?
• Post-traumatic stress: Fear brought on by specific
trauma, e.g., violence or accident. Nightmares.
• Generalized anxiety: Persistent excessive worries,
associated with depression. Treated with SSRIs or
tranquillizers.
Posttraumatic Stress Disorder
Anxiety Disorders II
 Obsessive-compulsive disorders: Uncontrollable
and irrational desire to perform repetitive tasks, e.g.
washing, or checking for safety. Overactivity in
striatum. Treated with neuroleptics.
 Tourette’s Syndrome: Uncontrollable tics, either
motor or verbal. Treated with neuroleptics.
 Amygdala
Involved in
Fear
3. Perception,
ANS Response
& Memory
2.
1.
5. 4.
Memory of
object/event
6.
NE/LC Enhances Negative Memories
Affect & Motivation in Cingulate Gyrus (Flat map)
1. Location
3. MCC: Resolves conflict
MCC Regulates skeletomotor output
ACC

2. ACC
Stores Valenced
Memories
Regulates ANS
 ACC Stores Memories of Sad Events
Positron Emission Tomography (PET) study
of healthy women remembering sad events

Summary of
functional
imaging studies of
simple emotions
Fear, Sadness &
Happiness are
segregated
CinguloSpinal/Layer Vb Projection Neurons
I
II

IIIab

IIIc

Va
Vb
VI

MCC Directly Regulates Skeletomotor

Behavioral & Emotion Relevant Activity
Facial Region of the Cingulate Motor Area:
Expressing & Interpreting Emotional States

All emotions can impact

the facial region in ACC

The Facial Region Projects

to the Facial Motor Nuc;
Muscles of facial expression
Interpreting Internal Emotional States:
Empathy

Facial ambiguity is
not resolved in
amygdala

What is this bride’s face saying

about her emotional state ?
ACC uses context information
 Internal State and Expression of
Complex Emotions Requires ACC

Context resolves complex

and ambiguous emotional
states

Can you now understand

what this woman is saying
with her face?
The Autonomic Nervous
System
Objectives
 Describe the divisions of the ANS;
 Describe subdivisions of the ANS;
 Discuss central control of the ANS;
 Consider clinical correlates.

2
The Autonomic
Nervous System
Visceral sensory
&
Visceral motor
 Autonomic nervous system
 The autonomic nervous system is the
subdivision of the peripheral nervous
system that regulates body activities that
are generally not under conscious control
 Visceral motor innervates non-skeletal
(non-somatic) muscles
 Visceral sensory will be covered later

4
To repeat…

 ANS is the subdivision of the peripheral nervous

system that regulates body activities that are
generally not under conscious control
 Visceral motor innervates non-skeletal (non-
somatic) muscles
 Composed of a special group of neurons serving:
 Cardiac muscle (the heart)
 Smooth muscle (walls of viscera and blood vessels)
 Internal organs
 Skin 5
 Basic anatomical difference between the motor
pathways of the voluntary somatic nervous
system (to skeletal muscles) and those of the
autonomic nervous system

 Somatic division:
 Cell bodies of motor neurons reside in CNS (brain or
spinal cord)
 Their axons (sheathed in spinal nerves) extend all the
way to their skeletal muscles
 Autonomic system: chains of two motor neurons
 1st = preganglionic neuron (in brain or cord)
 2nd = gangionic neuron (cell body in ganglion outside
CNS)
 Slower because lightly or unmyelinated

(see next diagram)

6
 Axon of 1st (preganglionic) neuron leaves
CNS to synapse with the 2nd (ganglionic)
neuron
 Axon of 2nd (ganglionic) neuron extends to
the organ it serves
Diagram contrasts somatic (lower) and autonomic:

autonomic
this dorsal
root ganglion
is sensory

somatic

Note: the autonomic ganglion is motor 7

Divisions of the autonomic nervous system
(visceral motor part of it)
 Parasympathetic division
 Sympathetic division

8
Divisions of the autonomic nervous system

 Parasympathetic division
 Sympathetic division

Serve most of the same organs but

cause opposing or antagonistic
effects
Parasysmpathetic: routine maintenance
“rest &digest”
Sympathetic: mobilization & increased metabolism
“fight, flight or fright” or “fight, flight or freeze”
9
 Where they come from

Parasympathetic: Sympathetic:
craniosacral thoracolumbar

10
 Parasympathetic nervous system
“rest & digest”

 Also called the craniosacral system because

all its preganglionic neurons are in the brain
stem or sacral levels of the spinal cord
 Cranial nerves III,VII, IX and X
 In lateral horn of gray matter from S2-S4
 Only innervate internal organs (not skin)
 Acetylcholine is neurotransmitter at end
organ as well as at preganglionic synapse:
“cholinergic”
11
Parasympathetic continued

 Cranial outflow
 III - pupils constrict (sphincter pupillae)
 VII - tears, nasal mucus, saliva (corneal reflex)
 IX – parotid salivary gland
 X (Vagus n) – visceral organs of thorax & abdomen:
 Stimulates digestive glands

 Increases motility of smooth muscle of digestive tract

 Decreases heart rate

 Causes bronchial constriction

 Sacral outflow (S2-4): form pelvic splanchnic

nerves
 Supply 2nd half of large intestine
 Supply all the pelvic (genitourinary) organs
12
Parasympathetic

(only look at
this if it helps
you)

13
 Sympathetic nervous system
“fight, flight or fright”

 Also called thoracolumbar system: all its neurons

are in lateral horn of gray matter from T1-L2
 Lead to every part of the body (unlike parasymp.)
 Easy to remember that when nervous, you sweat; when
afraid, hair stands on end; when excited blood pressure
rises (vasoconstriction): these sympathetic only
 Also causes: dry mouth, pupils to dilate, increased heart
& respiratory rates to increase O2 to skeletal muscles,
and liver to release glucose
 Norepinephrine (aka noradrenaline) is
neurotransmitter released by most postganglionic
fibers (acetylcholine in preganglionic): “adrenergic”
14
Sympathetic nervous system continued
 Regardless of target, all
begin same
 Preganglionic axons exit
spinal cord through ventral
root and enter spinal nerve
 Exit spinal nerve via
communicating ramus
 Enter sympathetic
trunk/chain where
postganglionic neurons are
 Has three options…
15
Options of preganglionic axons in sympathetic
trunk
(see next slides for drawing examples)

1. Synapse on postganglionic neuron in chain

ganglion then return to spinal nerve and follow
its branch to the skin
2. Ascend or descend within sympathetic trunk,
synapse with a posganglionic neuron within a
chain ganglion, and return to spinal nerve at that
level and follow branches to skin
3. Enter sympathetic chain, pass through without
synapsing, form a splanchnic nerve that passes
toward thoracic or abdominal organs
 These synapse in prevertebral ganglion in
front of aorta
 Postganglionic axons follow arteries to organs
16
Synapse in chain ganglia
at same level or different level

17
Pass through ganglia and synapse in
prevertebral ganglion

18
Sympathetic

19
 Adrenal gland is exception
On top of kidneys

Adrenal medulla
(inside part) is a
major organ of
the sympathetic
nervous system

20
 Adrenal gland is exception

 Synapse in gland
 Can cause body-wide
release of epinephrine
aka adrenaline and
norepinephrine in an
extreme emergency
(adrenaline “rush” or
surge)
21
Summary

22
 Visceral sensory system
Gives sensory input to
autonomic nervous
system

23
 Visceral sensory neurons
 Monitor temperature, pain, irritation, chemical changes and
stretch in the visceral organs
 Brain interprets as hunger, fullness, pain, nausea, well-being
 Receptors widely scattered – localization poor (e.g. which part
is giving you the gas pain?)
 Visceral sensory fibers run within autonomic nerves, especially
vagus and sympathetic nerves
 Sympathetic nerves carry most pain fibers from visceral organs of
body trunk
 Simplified pathway: sensory neurons to spinothalamic tract to
thalamus to cerebral cortex
 Visceral pain is induced by stretching, infection and cramping
of internal organs but seldom by cutting (e.g. cutting off a
colon polyp) or scraping them

24
Referred pain: important to know
Plus left shoulder,
from spleen

Pain in visceral
organs is often
perceived to be
somatic in origin:
referred to somatic
regions of body that
receive innervation
from the same
spinal cord
segments
Anterior skin areas to which pain is
referred from certain visceral organs
25
 Visceral sensory and autonomic
neurons participate in visceral
reflex arcs
 Many are spinal reflexes such as defecation and
micturition
reflexes

 Some only
involve peripheral
neurons: spinal
cord not involved
(not shown)*
*e.g. “enteric” nervous system: 3 neuron reflex arcs entirely within the wall of the26gut
Central control of the Amygdala: main limbic
region for emotions
Autonomic NS -Stimulates sympathetic
activity, especially previously
learned fear-related behavior
-Can be voluntary when
decide to recall frightful
experience - cerebral cortex
acts through amygdala
-Some people can regulate
some autonomic activities by
gaining extraordinary control
over their emotions

Hypothalamus: main
integration center(
electrical stimulation of the
posterior and lateral
regions: sympathetic;
elctrical stimulation of
anterior region:
parasympathetic
effects)
Reticular formation: most
direct influence over
autonomic function

27
The end!