Basic Neuroanatomy Ppt Slides 5rn6n

Basic anatomy

Basic Anatomy  Hair  “SCALP” o Skin o Connective tissue o Aponeurotis (galea aponeurotica) o Loose areolar connective tissue

o Pericranium

Basic Anatomy  Skull o Frontal bone o Parietal bone o Temporal bone • Petrous part • Squamous part • Mastoid part

o Occipital bone

Basic Anatomy  Dura mater (not attach to arachnoid)  Subdural space -bridging veins  Arrachnoid membrane

 Subarrachnoid space : CSF, Vessels o CSF : Shock absorber, immunological function

 Pia membrane  Brain parenchyma

Basic Anatomy Tentorium cerebelli Supratentorial compartment Infratentorial compartment

Uncal herniation Kernohan’s notch syndrome :hemiplegia and dilated pupil on the same side

6/7/12

Basic Anatomy  Forebrain o Frontal lobe o Parietal lobe o Temporal lobe o Occipital lobe o Diencephalon

Basic Anatomy  Surface anatomy

Basic Anatomy  Midbrain (mesencephalon)

 Hindbrain (Rhombencephalon)

Basic Anatomy  Cranial nerve = Brainstem except CN I and II

 Reticular activating system :midbrain and upper Pons

Basic Anatomy  Cranial nerve CN III,IV :midbrain CN V: mid pon

CN VI :pontomedullary CN VII,VIII :A CN IX-XII :Medulla

Basic Anatomy  Brainstem o Reticular nuclei influence direct by cortex • Pontine reticular formation : + extensor , - flexor • Medullary reticular formation : - extensor, + flexor • Receives input from cerebral hemisphere • Role of voluntary response

o Rubral nuclei (red nucleus) • Tegmentum of midbrain @ sup. Colliculus • + flexor movement in contralat. UE

Inhibit by higher center

Basic Anatomy Lesion at Red nuclei Midbrain Decerebrate (M2)

Lesion at above level of red nuclei Decorticate (M3)

Size of pupils depending on site of pathology

Depend on Pupillary light reflex Parasym /Sym Pupillary light reflex

- Sym -parasym - Both sym and parasym

Basic Anatomy  Impairment of level of consciousness o Focal destruction in the reticular formation o Diffuse lesion in both cerebral hemisphere o Bilateral diencephalon dysfunction

 Rule out metabolic cause

Basic Anatomy  Cerebellum

Basic Anatomy  Motor system : Pyramidal tract  Cortico-spinal tract  Cortex : precentral gyrus

 Corona radiata  Posterior limb of internal capsule  Cerebral peduncle

Basic Anatomy o Pyramidal decussation at caudal third of medulla o Lateral cortico-spinal tract o LE : lateral o UE : Medial o Uncrossed : ventral cortico-spinal tract

Basic Anatomy

Sensory level assessment 

Pain-temp o Lateral Spinothalamic tract



Light ( Crude ) touch o anterior cord o Ventral spinothalamic tract



Proprioception/t position sense,

discriminative touch o posterior column –medial lemniscus o Crossed at Lower medulla

6/7/12

Basic Anatomy

Basic Anatomy Reflex

Peripheral reflex o Barbinski o Clonus

Brainstem reflex Pupillary light reflex Corneal reflex Oculocephalic reflex (doll’s eye) Oculovestibular reflex (cold water calorics test) Oropharyngeal reflex (gag) Cough response