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The starting point of all achievement is desire

Blumenfeld
Basic Macroscopic OrgAnization of the Nervous System
Main parts of the nervous system
Central NS- brain & spinal nerve
Peripheral NS- cranial nerves & ganglia; spinal nerve &
ganglia; parasympha & sympha nerves & ganglia; and
enteric nervous system
Ectoderm- neural tube
Neural tube
Swelling & outpouching brain
Running down at the back spinal cord
Fluid filled cavity - ventricles
Fluid CSF
3 main division dev brain
Forebrain prosencephalon
Midbrain mesencephalon
Hindbrain rhombencehalon
Forebrain- largest
Telencephalon- cerebral hemisphere

Cerebral cortex

Subcortical white matter

Basal ganglia

Basal forebrain nuceli

Diencehalon thalamus, hypothalamus, &
epithalamus
on top of Brain stem midbrain , pons & medulla
Midbrain short narrow region, connecting forebrain &
hindbrain
Cerebral peduncles
Midbraiun tectum
Midbrain tegmentum
Hindbrain
Pons
Cerebellum - metencephalon
Medulla myelencephalon
Midbrain, pons, & medulla form connection btwn forebrain
& spinal cord
Ventricles interconnected fluid fld spaces lying core of
forebrain & brainstem
Choroid plexus vascular tuffs w/ in ventricles where CSF
is formed.
Meninges three membranous layers that protects the CNS
(P.A.D.)
Pia
Arachnoid
Dura
Orientation
Above the brain
Anterior rostral
Posterior caudal
Superior dorsal
Inferior ventral
Below the midbrain

Anterior ventral
Posterior dorsal
Superior rostral
Inferior caudal

Basic Cellular & Neurochemical Organization

Neurons- basic units of signalling
Cell body contain nucleus
Dendrites short processes that receive most inputs
Axons- long processes that carry outputs
Multipolar several dendrites & several axons
1 axon travel for a distance then 1 or several axon
collateral branch off to reach target
Bipolar single dendrite and single axon arising from the
cell body
Sensory neurons vision & smell
Pseudo-unipolar their processes are initially
fused then split to produce two long axons
Unipolar both axon & dendrites arise from single process
coming off the cell body
Synapse specialized regions where communication btwn
neurons
Axon dendrite
Axo-axonic
Dendro-dendritic
* Some reverse
Chemical synapses neurotransmitters
Electrical synapses direct electrical coupling
Action potentials trigger release of neurotransmitters
Neurotransmitter Blumenfeld 20
Neurotransmitters have diff actions at diff synase of even
at same synapse
Glial cells supporting cells
Oligodendrocytes wrap processes around portion of
axons in the CNS forming myelin sheaths
Schwann cells- forms myelin around 1 axon in the PNS
Astrocytes provide regulated microenvironment for
neurons, for dev of neurons, structural support, contribute
to the BBB, reg inflammatory processes, for synaptic
growth & plasticity.
Ependymal cells- movt of CSF
Microglia- immune cells of the CNS
CNS Gray & White Matter; PNS Ganglia & Nerves
White matter myelinated areas in the CNS
Axons transmit over distances
Gray matter unmyelinated areas, mainly cell bodies
Where local synaptic communication btwn
neurons in CNS occurs
Found in large clusters of cells nuclei deep in
the cerebral hemisphere & brainstem

Basal ganglia

Thalamus

Cranial nerve nuclei

Cerebral hemisphere
Gray matter - cerebral cortex, mantle

White matter- convey signal to from the cortex

Spinal cord
Gray matter inside
White matter outside
Brain stem
Gray & white matter found inside & outside
surface
Outside- mostly white matter
White matter pathways tract, fascicle, lemniscus &
bundle
Commisure white matter pathway that connect structures
on the R & L side of CNS
Peripheral nerves bundles of axons in the PNS
Ganglia cluster of cell bodies in the PNS
Afferent pathways carrying signal towards a structure
Efferent carry signals away from a structure

Spinal Cord and Peripheral Nervous System

Cranial nerves exit the segment of embryonic segments of
the forming cerebral hemisphere
Spinal nerves arise from the segments of the spinal cord
w/c give rise to both sensory & motor nerve roots on each
side of the body.
Motor systems- anterior/ ventral
Sensory systems- posterior/ dorsal
Dorsal nerve roots of SC afferent sensory info into the
dorsal SC
Ventral nerve roots of SC carry efferent motors from the
ventral SC to the periphery
Spinal nerves
Cervical 8
Thoracic 12
Lumbar 5
Sacral 5
Coccyx 1
During devt bony vertebral canal length faster than SC
SC ends at L1to L2
Cauda equina collection of nerve roots below the spinal
cord w/c continue down to their exit points
Spinal nerve formed by dorsal-sensory nerve root and
motor-ventral nerve roots joined together in ahort distance
outside SC
Plexus elaborate meshwork of nerves
Brachial plexus arms
Lumbosacral plexus legs
Cervical enlargement segment in the SC where there is
amt of gray matter in region of Brachial plexus
Lumbosacral enlargement segment in the SC where
there is amt of gray matter in region of Lumbosacral
plexus
PNS also include some specialized neurons involved in
ctrling automatic fxns Autonomic NS
Major division: Sympa & Parasympa
Sympa NS
Arises from T1 to L3/ thoracolumbar division
Releases norepinephrine
Parasympa NS
Arises from Cranial nerves & S2 to S4/ craniosacral
division
Releases ACh

Sympa & Parasympa pathways are ctrled by higher centers in

the hypothalamus & limbic system and by afferent sensory info
from the periphery
Cerebral Cortex: Basic Organization & Primary Sensory
Motor Areas
Sulci numerous infoldings or crevices of the cerebral
cortex
Fissure deep sulci
Gyri bumps or ridges rising in btwn sulci
Lobes of the Cerebral Hemispheres
Frontal
In front & extends back to the central sulcus of
Rolando
Sylvian/ lateral fissure separates frontal lobe
inferiorly & laterally to the Temporal lobe
Temporal lobe
Lateral
Sylvian fissure separates frontal lobe
No demarcation from parietal lobe
Parietal lobe
Bound anteriorly by central sulcus
No sharp demarcation from temporal or occipital
when viewed laterally
Parieto-occipital sulcus separates parietal &
occipital lobe when viewed medially.
Occipital lobe
Posterior, inferior
Parieto-occipital sulcus
Other regions of the brain:
Insular cortex buried w/ in Sylvian fissure

Anterior: covered by a lip of frontal cortex

(frontal operculum)

Posterior: lip of parietal cortex (parietal

operculum)
Limbic cortex formerly limbic cortex
Surface Anatomy of the Cerebral Hemisphere
There is variability but sulci & gyri form certain fairly
consistent patterns

Lateral surface
Central sulcus bound frontal lobe posteriorly
Precentral gyrus gyrus infront
Lateral-frontal surface divided to Superior, Middle &
Inferior Frontal gyri by Superior & Middle Temporal
suclus
Post central gyrus most anterior portion of the parietal
lobe lying just behind the Central sulcus
Intraparietal sulcus divides the superior parietal
lobule from the inferior parietal lobule
Inferior parietal lobule consist of supramarginal gyrus
and angular gyrus
Supramarginal gyrus surrounds end of
Sylvian fissure
Angular gyrus surrounds end of the Superior
Temporal sulcus
Medial Surface
Corpus callosum largest white matter, connects 2
hemisphere of the brain consist of :
Rostrum
Genu

Body
Sphlenium
Cignalate gyrus (belt) surrounds Corpus callosum; runs
anteriorly from Paraterminal gyrus to posteriorly from
Isthmus
Marginal branch running up to the surface forms
central sulcus
Central sulcus dont run onto medial surface but the
region surrounding it is the Paracentral lobule
Calcarine fissure - deep sulcus of the medial surface of
the occipital lobe
Superior: Lingua gyrus little tongue
Inferior: Cuneus gyrus wedge

Anterior: Precuneus gyrus of medial

Parietal lobe

Inferior Surface
Orbital frontal gyri lies on top of orbital ridges of the
eyes
Olfactory sulcus separates Orbital frontal gyri from
gyrus Rectus
Inferior temporal sulcus located inferior surface of
Temporal lobe that separates Temporal gyrus from
Occipitotemoral/ Fusiform gyri
Collateral sulcus located medially which continues
anteriorly as Rhinal sulcus; separates Fusiform gyri from
Parahhiocampal gyrus
Superior Surface
Same lateral land marks can be seen
Figures: pp 26-25 Blumenfeld
Primary Sensory & Motor Areas
Primary motor cortex Precentral gyrus in the Frontal
lobe w/c ctrls movement of opposite side of the body
Primary somatosensory cortex Postcentral gyrus in
the Parietal lobe
Both separated by central sulcus
Like in SC motor is anterior while somatosensory
is posterior
Primary visual cortex Occipital lobe along the banks of
Calcarine fiure
Primary auditory cortex transverse gyri of Heschl
two fingerlike gyri lying inide the Slvian fissure.
Association cortex higher order sensory & motor
processing
Topographical organization of sensory & motor pathways
Adjacent areas on the receptive (or motor)
surface are maped to adjacent fibers in the white
matter pathways and to the adjacent regions of
cortex
Somatotopic maps on the cortex motor or sensory
homunculus (little man)
Retinal areas are maped in a retinotopic fashion onto the
primary visual cortex
Regions of cochlea have tonotopic representation on the
primary auditory cortex
Primary somatosensory cortex & motor cortex represent
sensation & movement of opposite side of the body
Primary visual cortex represent visual inputs from opposite
visual field
Left half of visual field for each eye is mapped to
the right primary visual cortex

Cell Layers & Regional Classification of the Cerebral Cortex

Neocortex composed of 6 cell layer from surface inward
Layer I Molecular layer main connection: dendrites &
axon from other layers
Contain mainly dendrites from deeper neurons &
axons
Layer II Small pyramidal/ External granular main
connection: cortical-cortical connections
Contains neuron projecting mainly to other areas
of the cortex
Layer III Medium pyramidal/ External pyramidal
main connection: cortical-cortical connections
Contains neurons projecting to other areas of the
cortex
Layer IV Granular/ Internal pyramidal main
connection: receive input from thalamus
Receive inputs from thalamus
Layer V Large pyramidal/ Internal pyramidal main
connection: sends outputs to subcortical structures other
than thalamus
Projects mostly to subcortical structure other than
thalamus, eg brain stem, SC & basal ganglia
Layer VI Polymorphic/ Multiform layer main
connection: sends output to thalamus
Projects primarily to thalamus

Info reaching primary auditory cortex us less lateralized &

represent more mixture of inputs from both ears

Thicknes of cell laers varies according to the main fxn of

the particular area of cortex
PMC many large efferent projections to ctrl
movt thicker Layer V containing more cell
bodies than IV
PVC receive sensory input thicker Layer IV
containing more cell bodies than V
Classification scheme for diff region of the cerebral cortex
Korbinian Brodmann parcelled the cortex into 52
cytoarchitectonic areas w/ assigned # based on how he
prepared the slide.
Many areas correlate fairly well w/ various fxnal areas of
the cortex
Table 2.4 p31 Blumenfeld

Motor Systems
Motor ctrl involves delicate balance btwn multiple parallel
pathways & recurrent feedback loop
Main Motor Pathways
Corticospinal tract begins in the PMC down thru
cerebral white matter & brain stem to reach SC
Most imt pathway
Pyramidal tract - shape in the medulla
PMC where neuron cell bodies project via
axons
Majority of fibers cross over to ctrl movt of
opposite side of the body known as Pyramidal
decussation
Pyramidal decussation occurs at the junction
btwn medulla & SC
Lesion above decussation contralateral
weakness
Lesion below decusation ipsilateral weakness

Upper Motor Neurons motor neurons that roject from

cortex down the SC or brain stem
Lower Motor Neurons located in the anterior horns of
central gray matter of SC or brain stem motor nuclei
Axons project out of CNS via anterior spinal
roots or cranial nerves to reach muscle cells in
the periphery

Cerebellum and Basal Ganglia

Motor system perform delicate & complicated task
Cerebellum & basal ganglia used for multiple feedback
system to refine output of motor system
Both act by modulating output of pyramidal tract & other
descending motor system
Both receive major input from motor cortex
Cerebellum also receive significant inuts from brainstem
& SC
Project back to motor cortex via thalamus
Lesions in cerebellum dso corrdination & balance eg
Ataxia
Lesion in basal ganglia
Hypokinetic movt dso Parkinsonism
Hyperkinetic movt dso Huntingtons

Somatosensory System
Sensation conveyed by parallel pathways mediating diff
senor modalities that travel to the CNS
Main Somatosensory Pathway
Somatic sensation conscious perceptions of touch, pain,
tem, vibration & proriocetion
2 main pathways
Posterior column pathways convey
proprioception, vibration sense & fine,
discriminative touch
Anterolateral pathways convey pain, temp, &
crude touch

Primary sensory neuron cell bodies are located outside

CNS in the dorsal root ganglia w/ bifurcating axons 1
long process extensing to the periphery & 1 into the SC

Posterior Column Pathway

Stimulus
(proprioception, vibration & fine touch)

Primary sensory neuron axons

Dordal roots

SC

Ipsilateral white matter dorsal column

Dorsal column nuclei of medulla

Make synapses

2ndary sensory neuron

Axons cross over to other side

(contralateral)

Thalamus

Primary Somatosensory Cortex of Postcentral gyrus

Anterolateral Pathway
Stimulus
(pain, temp & crude touch)

Primary sensory neurons

Dorsal roots

SC

1st synapses in the gray matter of SC

Secondary sensory neurons

Cross over other side of SC

Ascend anterolateral white matter

Forms spinothamic tract

Thalamus

Primary somatosensory cortex

Thalamus
Relay center
Gray matter structures deep w/ in cerebral white matter
Superior to brainstem, posterior to basal ganglia
Egg shaped w. Posterior ends angled outward forming
inverted in horizontal sections
Consist of multiple nuclei
Each sense has own nuclear area where synpases
occur b4 info is relayed to the brain
Nonsensory also relay to thalamus
Process info from basal ganglia, cerebellum,
limbic pathways & reticular formation on their
way to the cortex
Reciprocal nature of cortical thalamic connections
All cortical regions project strongly vi Alayer I back to
thalamic areas
Diencephalon formed by thalamus, hypothalamus &
eithalamus
Hypothalamus- autonomic, neuroendocrine, limic system
etc.
Epithalamus encompas several small nuclei e.g. pineal
body, habenula, & small part of pretectum
Stretch Reflex
Monosynaptic stretch reflex provides rapid local
feedback from motor ctrl
Begin w/ specialized receptors muscle spindles
Muscle spindles detect amt & rate of stretch in
muscles
Info detected distal process of sensory neuron
dorsal roots SC gray matter where are
multiple synapses including LMNs in the anterior
horn.
LMNS project via ventral roots muscles
contraction.
Afferent sensory neurons also forms synapses onto i
inhibitory excitatory interneurons the SC gray matter w/c
then synapses w/ LMNs

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Local circuits in the SC can use sensory info to regulate
activity of LMNs w/o conscious input from higher center
Nevertheless there are descending pathways hat modulate
activity of the stretch reflex
Lesions/ damage: hypoactive or hyperactive reflex
Deep tendon reflex

Brainstem and cranial nerves

Composed of midbrain, pons, and medulla
Superior: diencephalon
Inferior: SC
Posterior: cerebellum
Most of the CNrvs arise from the brainstem
CNrvs analogous in some ways to SNrvs having both
sensory & motor fxns
But CNrvs also carry out more specialized fxn r/t organ of
the head
Tightly packed w. Numerous other impt nuclei & white
matter tracts
All info passing btwn cerebral hemispheres & SC must
pass through the brainstem
Contain nuclei that play impt role in motor system,
Nuclei that produce N/V in resp to certain
chemicals
Nuclei containing neurotransmitters e.g.
norepinephrine, serotonin, dopa, & Ach
Nuclei involved in pain modulation
Nuclei ctrling HR, BP RR etc
Lesions: devastating effect on sensory & motor fxn
Reticular formation
Impt region of the brainstem
Contains many nuclei
Network like appearance of its fibers in
histologicl sec
Extends throughout the central portions of the
brainstem from medulla to the midbrain
More inferior portion (medulla & lower pons)
involved mainly in motor & autonomic fxns
Superior (midbrain & upper pons) regulate lvl
of consciousness, influcen higher areas through
modulation of thalamic & cortical activity
Lesions: affect LOC

Limbic system
Medial edge of cerebral cortex
Regulate emotion, memory, appetie drive, autonomic &
nueroendocrine ctrl
Includes cortical areas located in the medial anterior
temporal lobes, anterior insula, inferior medial frontal lobes
& circulate gyri
Include deeper structures hippocampal formation and
amygdale located w/in medial temporal lobes.
Several nuclei in the medial thalamus, hypothalamus, basal
ganglia, septal area and brainstem
Fornix connect pathways to diff area in the limbic
system.Paired, arch shaped white matter connecting
hippocampal formation to the hypothalamus & septal
nuclei
Lesions: long term memory loss,
Dysfxn: pysch dsos, & epileptic siezures
Association system
Carriers higher order of processing

Unimodal assoc cortex higher order of processing takes

place mostly in for a single sensory or motor modality.
Usually located adjacent to a primary motor or
sensory area
E.g. unimodal motor association cortex (premotor
cortex & supplemental motor area) is located
adjacent to primary mortor cortex
Heteromodal assoc cortex involved in integrating fxns
from multiple sensory and/or motor modalities.

Language
Usually perceived 1st by the PAC in the superior temporal
lobe when listening or in PVC when reading.
Convey info to Wernickes area in the dominant (usually
left) hemisphere
Lesion: Wernickes / Receptive/ Sensory aphasia
Brocas area frontal love, left hemisphere near PMC
involed in moving lips, tongue, face & larynx
Lesion: Brocas / Expressive/ Motor aphasia
Parietal lobe
Intraparietal sulcus divides superior & inferior parietal
lobule
Lesion inferior parietal lobule: Gerstmanns
syndrome dyscalculia, dyslexia, R-L confussion
& Finger agnosia
Spatial awareness
Lesions nondominant hemisphere:
hemineglect, anosognosia, extinction

Complex task- needs higher order planning before PMC

can be activated
Motor lanning distributed in many areas of the cortex
Diffuse lesion or sometimes more focal leion can produce
apraxia
Apraxia abnormalities in motor conceptualization,
planning & excecution

Frontal lobes
Largest hemispheres containing vast areas of association
cortex
Lesions: cognitive dsos & cognitive fxning,
primitive reflexes/ Frontal release signs,
perseveration of action, abulic (stare passively &
delay response to command), magnetic gait (feet
shuffle close to the floor) and urinary
incontinence
Visual assoc cortex parieto-occipital & inferior temporal
lobes
Lesions:prosopagnosia (faces), achromatopsia
(color) and palinopsia (persistace or reappearance
of an object viewed earlier)
Seizure in Visual assoc cortex- can cause
elaborate visual hallucination
Blood Supply to the Brain and SC
2 pairs of Arteries that carry all blood supply
1 pair of draining Veins
Internal Carotid As form anterior blood supply
Vertebral As join together in a single Basilar A form the
posterior blood supply
Circle of Willis joining of Internal Carotid & Vertebral
As in an anastomosing ring at the base of the brain
Give rise to main arteries supplying the cerebral
hemisphere

Anterior & Middle Cerebral As derive main blood

supply from the Internal Carotid As (anterior circulation)
Posterior Cerebral As derive main blood supply from
vertebrobasilar system (posterior circulation)
Superior, Anteroinferior, & Posteroinferior Cerebellar
As supply brainstem and cerebellum
Internal Jugular Vs venous drainage of the brain

Anterior Spinal A supply SC, runs along medial ventral

surface
Posterior Spinal As suppy SC, run along R & L dorsal
surface of SC
A & P Spinal As supplied by Vertebral As in the cervical
region and by Radicular As arising from the Aorta in the
thoracic & lumbar region