Neuroanatomy. Dr. Maha ELBeltagy. Assistant Professor of Anatomy Faculty of Medicine The University of Jordan

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Neuroanatomy Dr. Maha ELBeltagy Assistant Professor of Anatomy Faculty of Medicine The University of Jordan 2018 Prof Yousry 10/15/17

Types of brain fibers

THE WHITE MATTER OF THE BRAIN The white matter of the brain consists of: 1) Association fibers: Connect different areas in the same hemisphere. 2) Commissural fibers: Connect similarareas areas in the 2 hemispheres. 3) Projection fibers: Fibers from & to the cerebral cortex.

Association fibers There are short & long association fibers. A) Short association fibers: Connect adjacent gyri, forming U shaped arcuate fibers in all parts of the hemisphere. B) Long associationfibers: 1) Superior longitudinal bundle: Connects frontal, occipital & temporal regions. 2) Inferior longitudinal bundle: Runs from temporal to occipital poles. 3) Cingulum: Forms incomplete circle around corpus callosum. It begins near rostrum of corpus callosum & ends in the uncus connects it with hippocampus and cingulate gyrus. 4) Uncinate Fasiculus: Runs from frontal to temporal poles.

Commissural fibers 1) Anterior commissure crosses cossesthe middle line within lamina a terminalis (connect both piriform fossae) temporal lobes. acute pain and smell. 2) Posterior commissure lower pineal stalk (pupillary light reflex)(connect superior colliculi and pretectal nuclei) 3) Habenular commissure: superior to pineal stalk connectsright and left habenular nuclei (connected to Amygdaloid nucleus) center of integration of olfactory, visceral pathways. 4) Fornix commissure (efferent of hippocampus) connectes crura and body of the fornix across both hippocampi. 5) Corpus Callosum. Anterior commissure Mammillary body Habenular commissure Posterior commissure Pineal body

5 Corpus Callosum: It is the great (10 cm) transverse commissure that connects the cerebral hemispheres & roofs the lateral ventricle (except ant part of temporal lobes which are connected by the anterior commissure). It is divided into 4 parts ; rostrum, genu, body & splenium. Fibers of the genu curve forwards to connect frontal lobes forming Forceps minor. Fibers of splenium curve backwards to connect occipital lobes forming Forceps Major. Tapetum: fibres of body and splenium intersecting with corona radiata of the internal capsule. Blood Supply: It is supplied by anterior cerebral artery except the splenium by the posterior cerebral artery Lesion : 1 callosal Syndrome (split brain) 2 Apraxia Genu Rostrum Body

Projection fibers A) Projection fibers TO the cortex: Include all thalamo cortical fibers (thalamic radiation). Sensory radiation: From PLVNT to area 3,1,2 in the postcentral gyrus. Anteior thamic radiation at : from anterior thalamus aa usto cingulate guate Visual radiation: from lateral geniculate body to the visual area 17 in the occipital lobe. Auditory radiation: from the medial geniculate body to the auditory aea area in the etemporal lobe.

B) Projection fibers FROM the cortex: Includethefollowing fibers: Pyramidal tract. Extrapyramidal tracts. Cortico pontine fibers. Cortico thalamic fibers. Corona radiata

Internal Capsule It is a V shaped bundle of projectionfibers between thalamus, caudate & lentiform nuclei. Lies on medialsurface of lentiform nucleus separating it from caudate above and thalamus below. Continous above as corona radiata and below with crus cerebri of midbrain. It is divided into anterior limb, genu, posterior limb, retrolentiform & sublentiform parts. Caudate nucleus Anterior limb Genu Posterior limb Retrolentiform part Internal capsule External capsule Lentiform nucleus thalamus Lentiform

Types of fibers in the internal capsule The anterior limb of the internal capsule contains: 1) Descending Frontopontine (fronto ponto cerebellar) fibers project from frontal cortex to pons 2) Ascending Thalamocortical (Anterior thalamic radiation) fibers connect the thalamus to the frontal lobes and cingulate gyrus The genu contains corticobulbar fibers which run between the cortex and the cranial nuclei in the brainstem. The posterior limb of the internal capsule contains: Descending anterior half Corticospinal fibers: From motor area 4 to AHC s in the spinal cord. Ascending posterior half Sensory fibers (superior thalamic radiation) from VP of thalamus to post centeral gyrus. The retrolenticular part contains fibers the optic radiation (posterior thalamic radiation). The sublenticular part contains the auditory radiation (Inferior thalamic radiation). Lesion :arterial /cerebral hemorrhage in high blood pressure patient (contralateral side)

Blood supply of the internal capsule

Voluntary movement FUNCTION OF BG Initiation of movement Change from one pattern to other Programming and correcting movement while in progress Learning skills (football,drawing,singing, ) Postural P t l control Automatic associated movement (walking, dancing) Control axial and girdle movements No direct connection with spinal cord or brain stem

SUBDIVISION OF BG A. Neostriatum or Striatum Putamen Caudate nucleus B. Pallio striatum or Pallidum Globus pallidus C. Lentiform nucleus Putamen lateral Globus Pallidus medial D. Archistiatum Amygdela E. Substantia nigra F. Subthalamic nucleus G.Claustrum

1. head of caudate nucelus 2. body ofcaudate nucelus 3. caudatolenticular gray bid bridge 4. putamen 5. tail of caudate nucleus 6. external segment of globus pallidus 7. internal segment of globus pallidus 8. amygdaloid body 9. nucleus accumbens septi

Prof Yousry 10/15/17 Relation of the basal ganglia and the lateral ventricle Anterior horn posterior horn Amygdala Inferior horn

Horizontal section, Basal ganglia and lateral ventricle

Coronal section, Basal ganglia and lateral ventricle

Caudate nucleus C-shaped Head, body, tail Large head, tapering curved tail Head-frontal lobe Tail-occipital lobe End of tail-temporal lobe -terminates in amygdaloid nucleus (roof of inf horn of lateral ventricle) Head Lies in the floor and lateral wall of anterior horn of the lateral ventricle Body forms the floor of central part of lateral ventricle Tail lies in the roof of the inferior horn of lateral ventricle

Lentiform nucleus Lens like nucleus which consists of 2 parts: large lateral dark part called putamen & small medial pale part called globus pallidus which is subdivided into external and internal segments. It is surrounded by external capsule (laterally)separating it from claustrum & internal capsule (medially) separating it from thalamus and caudate nucleus.

Amygdaloid Nucleus In the temporal lobe (uncus) connected to caudate tail. Part of limbic system functionally. Gives axons of stria terminalis that curves on superior surface of thalamus and ends in hypothalamus. Sense of fear& smell function Subtantia Nigra Midbrain anterior to aqueduct Substantia Nigra (pars compacta) (Dopamine/inhibitory) Pars reticulata (output to brain) Subthalamic Nuclei Diencephalon(Glutamine/excitatoy) Claustrum Lateral to lentiform& unknown function. Lies between external and extreme capsules. Blood supply of BG Anterior part of corpus striatum: ACA Posterior part of corpus striatum: MCA Tail of caudate and amygdaloid: anterior choroidal of ICA

Connections Receive input: Caudate nucleus Putamen (Corpus striatum) Output leaves: Globus Pallidus

Afferent Corticostriate Mostly from same side Sensory/Motor Glutaminergic++ Thalamostriate Nigrostriate Dopaminergic Brainstem striatal fibres Serotonin Subthalamic nucleus Mostly end in neostriatum except subthalamic N end in paleostriatum Efferent Striatopallidal i t l GABA Striatonigral GABA, Acetylcholine,Substance P Pallidofugal fibres (from GB) Ansa lenticularis (thalamus) Fasciculus lenticularis (thalamus) Subthalamic fasiculus (subthalmus) Pallidotegmental Tegmentum of midbrain

INTERNAL CONNECTIONS OF THE BASAL GANGLIA: DIRECT PATHWAY

INTERNAL CONNECTIONS OF THE BASAL GANGLIA: INDIRECT PATHWAY

Disease of basal ganglia g (on the opposite side) 1- Hypokinetic +hypertonia Parkinsonism Lesion of direct pathway Degeneration of dopamine-producing cells in substantia nigra-depletion of dopamine in striatum Resting tremor (N.B: intention tremor in cerebellar disease) Rigidity simultaneous contraction of flexors and extensors Bradykinesia = Slowness of movement (slurred speech) and mask face Postural disturbance No loss of motor or sensory function Treated by L-Dopa not dopamine

Disease of basal ganglia g 2- Hyperkinetic (lesion of indirect pathway) Huntington s disease (hypotonia+hyperkinesia) hereditary disease of unwanted movements. It results from degeneration of the caudate and putamen, and produces continuous dance-like movements of the face and limbs choreoathetosis Sydenham Chorea Rheumatic fever- transient- full recovery Hemiballism flailing movements of one arm and leg (onesided), which is caused by damage (i.e., stroke) of the subthalamic nucleus.

Huntington schorea Sydenham s chorea hemiballismus

Normal Basal Ganglia circuit

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