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27/02/2016 1 Neuroanatomia Major functional areas of the cerebral cortex: (A) Lateral aspect of left cerebral hemisphere; 27/02/2016 2 Major functional areas of the cerebral cortex: (B) Medial aspect of right cerebral hemisphere in sagittal section. Lateral aspect of the cerebral hemisphere showing major gyri and sulci. Median sagittal section of the cerebral hemisphere showing major gyri and sulci. The brain stem and cerebellum have been removed to show the inferomedial aspect of the temporal lobe. 27/02/2016 3 Coronal section of the cerebral hemisphere. Coronal section of the cerebral hemisphere Coronal section of the cerebral hemisphere. Coronal section of the cerebral hemisphere. Coronal section of the cerebral hemisphere. Coronal section of the cerebral hemisphere. 27/02/2016 4 Coronal section of the cerebral hemisphere. Coronal section of the cerebral hemisphere. Coronal section of the cerebral hemisphere. Coronal section of the cerebral hemisphere Horizontal (axial) magnetic resonance image of the living brain. Horizontal section of the brain. 27/02/2016 5 Coronal magnetic resonance image of the living brain. Superolateral aspect of the left cerebral hemisphere. The frontal and parietal operculae have been removed to show the location of the transverse temporal gyri (Heschl’s convolutions) and the insula. Coronal section of the cerebral hemisphere. The diagram shows the location of the principal association, commissural and projection fibres. Principal association and commissural fibres of the cerebral hemisphere projected onto a median sagittal section. Dissection of the brain from the superior aspect revealing the corpus callosum. Diffusion MRI tractography reconstruction of the projection fibres passing through the internal capsule. Tractography measures the diffusion of water along axonal fibres and allows reconstruction of their trajectories in the living human brain. 27/02/2016 6 Horizontal section of the cerebral hemisphere showing the parts of the internal capsule. Horizontal section of the brain showing the relationships of the corpus striatum. Mulligan’s stain has been used to increase the contrast between cell-rich areas (blue) and white matter. Coronal section of the brain showing the relationships of the corpus striatum. Mulligan’s stain Lateral aspect of the left caudate nucleus, putamen, amygdala and thalamus. The globus pallidus is obscured by the putamen. The course of the internal capsule is shown in red. The putamen and the head of the caudate nucleus are separated by the anterior limb of the internal capsule, except at their most rostral extent where the two are in continuity. The posterior limb of the internal capsule separates the globus pallidus and putamen from the thalamus. Schematic diagram illustrating the principal connections of the corpus striatum and related nuclei. Afferents to the striatum from the intralaminar thalamic nuclei and raphe nuclei have been omitted. For the sake of clarity, all efferents from the basal ganglia system are shown to originate from the medial segment of the globus pallidus, those from the pars reticulata of the substantia nigra being omitted. Similarly, efferents from the striatum are shown to originate only from the putamen and not from the caudate nucleus. Transverse section through the midbrain showing the substantia nigra. 27/02/2016 7 Coronal sections through the corpus striatum and diencephalon. Loyez method for myelin. Coronal sections through the corpus striatum and diencephalon. Loyez method for myelin. Coronal section through the corpus striatum and diencephalon illustrating the efferent projections of the globus pallidus. A sagittal section of the diencephalon. The diagram shows the medial aspect of the hypothalamus. The approximate location of some of the principal hypothalamic nuclei is shown. Supraoptic and paraventricular nuclei projecting to the posterior pituitary via the hypothalamohypophyseal tract. Pituitary portal system linking anterior and posterior parts of the pituitary gland. 27/02/2016 8 Coronal section of the brain showing the location of the amygdala and anterior commissure and their relationships with the basal ganglia. Mulligan’s stain Transverse section through the hippocampus and inferior horn of the lateral ventricle. The interconnection of limbic structures that constitute the Papez circuit. Dissection of the medial aspect of the diencephalon to show the relationships of the fornix, mammillary body and mammillothalamic tract. The Papez circuit projected onto the medial aspect of the cerebral hemisphere. The hippocampus–fimbria–fornix system. The brain is viewed from above. The cerebral cortex and white matter, including the corpus callosum, have been removed to reveal the lateral ventricle and its contents. (A) Choroid plexus of lateral ventricle intact; (B) Choroid plexus removed. 27/02/2016 9 Ventral surface of the brain. The illustration shows the olfactory bulb and tract, the lateral olfactory stria and the primary olfactory area of the cerebral cortex (uncus). Areas 3, 1 & 2 – Primary Somatosensory Cortex (frequently referred to as Areas 3, 1, 2 by convention) Area 4 – Primary Motor Cortex Area 5 – Somatosensory Association Cortex Area 6 – Premotor cortex and Supplementary Motor Cortex (Secondary Motor Cortex)(Supplementary motor area) Area 7 – Somatosensory Association Cortex Area 8 – Includes Frontal eye fields Area 9 – Dorsolateral prefrontal cortex Area 10 – Anterior prefrontal cortex (most rostral part of superior and middle frontal gyri) Area 11 – Orbitofrontal area (orbital and rectus gyri, plus part of the rostral part of the superior frontal gyrus) Area 12 – Orbitofrontal area (used to be part of BA11, refers to the area between the superior frontal gyrus and the inferior rostral sulcus) Area 13 and Area 14* – Insular cortex Area 15* – Anterior Temporal Lobe Area 16 – Insular cortex Area 17 – Primary visual cortex (V1) Area 18 – Secondary visual cortex (V2) Area 19 – Associative visual cortex (V3,V4,V5) Area 20 – Inferior temporal gyrus Area 21 – Middle temporal gyrus Area 22 – Superior temporal gyrus, of which the caudal part is usually considered to contain the Wernicke's area Area 23 – Ventral posterior cingulate cortex Area 24 – Ventral anterior cingulate cortex. Area 25 – Subgenual area (part of the Ventromedial prefrontal cortex)[4] Area 26 – Ectosplenial portion of the retrosplenial region of the cerebral cortex Area 27 – Piriform cortex Area 28 – Ventral entorhinal cortex Area 29 – Retrosplenial cingulate cortex Area 30 – Part of cingulate cortex Area 31 – Dorsal Posterior cingulate cortex Area 32 – Dorsal anterior cingulate cortex Area 33 – Part of anterior cingulate cortex Area 34 – Dorsal entorhinal cortex (on the Parahippocampal gyrus) Area 35 – Perirhinal cortex (in the rhinal sulcus) Area 36 – Ectorhinal area, now part of the perirhinal cortex (in the rhinal sulcus) Area 37 – Fusiform gyrus Area 38 – Temporopolar area (most rostral part of the superior and middle temporal gyri) Area 39 – Angular gyrus, considered by some to be part of Wernicke's area Area 40 – Supramarginal gyrus considered by some to be part of Wernicke's area Areas 41 and 42 – Auditory cortex Area 43 – Primary gustatory cortex Area 44 – Pars opercularis, part of the inferior frontal gyrus and part of Broca's area Area 45 – Pars triangularis, part of the inferior frontal gyrus and part ofBroca's area Area 46 – Dorsolateral prefrontal cortex Area 47 – Pars orbitalis, part of the inferior frontal gyrus Area 48 – Retrosubicular area (a small part of the medial surface of the temporal lobe) Area 49 – Parasubicular area in a rodent Area 52 – Parainsular area (at the junction of the temporal lobe and the insula) Dorsal aspect of the brain stem. Lateral aspect of the brain stem. 27/02/2016 10 Ventral aspect of the brain stem. Ventral aspect of the brain stem showing the decussation of the pyramids. Transverse section through the caudal medulla at the level of the decussation of the pyramids. The sections shown in Figs 9.5-9.13 have been stained by the Weigert–Pal method. Areas rich in nerve fibres stain darkly, while areas rich in cell bodies are relatively pale. Transverse section through the mid-medulla at the level of the great sensory decussation. Transverse section through the rostral medulla at the level of the inferior olivary nucleus. Transverse section through the caudal pons. 27/02/2016 11 Transverse section through the mid-pons at the level of the trigeminal nerve. Transverse section through the rostral pons. Transverse section through the brain stem at the level of the pontine– mesencephalic junction. Transverse section through the caudal midbrain at the level of the inferior colliculus. Transverse section through the rostral midbrain at the level of the superior colliculus. The base of the brain illustrating the locations of the cranial nerves. The points of attachment are shown, except for the trochlear nerve, which arises from the dorsal aspect of the brain stem. 27/02/2016 12 The brain stem viewed from the dorsal aspect. The diagram illustrates the locations of the afferent cranial nerve nuclei (left) and the efferent cranial nerve nuclei (right). On the right, nuclei shaded in the same colour share a common embryological origin. Ventral aspect of the brain showing the points of attachment of cranial nerves I, II and III. Dorsal aspect of the brain stem, after removal of the cerebellum, showing the origin of the cranial nerve IV. Ventral aspect of the brain showing cranial nerves III, IV and V. Ventral aspect of the brain showing the points of attachment of cranial nerves VI to IX. Ventral aspect of the brain stem showing the points of attachment of cranial nerves VIII–XII. 27/02/2016 13 27/02/2016 14 Lateral aspect of the brain stem and cerebellum, showing the cerebellar peduncles. Parts of the anterior, posterior and flocculonodular lobes have been removed to display the peduncles more clearly. Superior surface of the cerebellum. Posterior aspect of the cerebellum Anteroinferior aspect of the cerebellum Schematic representation of the cerebellum in which the peduncles have been cut and the surface flattened out. The relationships between the anatomical and functional divisions of the cerebellum are shown. 27/02/2016 15 Parasagittal section through the cerebellum. Mulligan’s stain. 27/02/2016 16 Coronal section of the brain at the level of the dentate nucleus; myelin stain Horizontal section through the cerebellum and brain stem at the level of the fourth ventricle, showing the cerebellar nuclei. The cerebellar cortex. Diagram shows afferent and efferent connections and their relationships to the principal cells of the cerebellar cortex. Ventral aspect of the diencephalon. Median sagittal section of the brain showing the relationships of the diencephalon. 27/02/2016 17 Coronal sections through the diencephalon. Luxol fast blue stain for myelin. Dorsal aspect of the diencephalon. The choroid plexus has been removed on the right side. The left thalamus viewed from the anterolateral aspect (A,C) and in coronal section (B,D) showing the principal nuclear groups (A,B) and the divisions of the lateral nuclear group (C,D). Organisation of thalamic nuclei and their principal relationships with the cerebral cortex. The thalamus is viewed from its anterolateral aspect (A) and in coronal section (B). Colours indicate the relationships between thalamic nuclei and corresponding cerebral cortical regions on the lateral (C) and medial (D) aspects of the cerebral hemisphere. 8 segmentos cervicais, 12 segmentos torácicos, 5 segmentos lombares, 5 segmentos sacrais e 1 coccígeo. Intumescência cervical Plexo braquial Intumescência lombossacral Plexo lombossacral Cone medular filamento terminal (cauda equina) Termina em L1-L2 Nervos espinais: 31 pares 27/02/2016 18 Nervos • Radículas Raízes nervosas anterior e posterior (forame intervertebral) gânglios ramo posterior e ramo anterior Possui as três meninges; a pia-máter forma uma continuação membranácea plana entre as raízes anteriores e posteriores – ligamento denticulado Transverse section through the thoracic region. The diagram shows the relationship between the spinal cord, spinal nerves and vertebral column. MR image of the vertebral column and spinal cord in the living subject. The relationships between spinal cord segments, spinal nerves and vertebral column. Dorsal aspect of the spinal cord caudal to T9– T10. The dura/arachnoid mater have been cut longitudinally and reflected to reveal the spinal cord and nerve roots within the subarachnoid space. Ventral aspect of the spinal cord, showing relationships of the spinal nerve roots and the meninges. 27/02/2016 19 Lateral aspect of the spinal column in the lumbar region, illustrating the intervertebral foramina and the emerging spinal nerves. Sulco mediano anterior; fissura anterior Sulco lateral anterior; sulco lateral posterior Sulco intermédio posterior (cervical) Canal central (contínuo com o sistema ventricular) Transverse section through the spinal cord showing the general disposition of grey and white matter. Substância cinzenta formando o “H medular” Colunas anterior, posterior e lateral (apenas em origem de plexos) Funículo anterior (entre a fissura mediana e o sulco lateral anterior), lateral (entre os sulcos laterais) e posterior (entre os sulcos lateral posterior e mediano posterior – é dividido pelo sulco intermédio posterior em fascículos grácil e cuneiforme) Transverse sections through the spinal cord at (A) cervical, (B) thoracic, (C) lumbar and (D) sacral levels. The histological method employed (Weigert–Pal) stains white matter (myelinated nerve fibres), leaving grey matter (nerve cell bodies) relatively unstained. 27/02/2016 20 Lamination of spinal grey matter (Rexed’s laminae). Posterior/dorsal horn: I-VI Lamina I: marginal nucleus of spinal cord or posteromarginal nucleus Lamina II: substantia gelatinosa of Rolando Laminae III/IV: nucleus proprius Lamina V: Neck of the dorsal horn Lamina VI: Base of the dorsal horn, Intermediate zone: VII and X Lamina VII: intermediomedial nucleus, intermediolateral nucleus, nucleus dorsalis of Clarke in the thoracic and upper lumbar region[3] Lamina X: central gray matter i.e. neurons bordering Central canal; Grisea Centralis[3] Anterior/ventral horn: VIII-IX Lamina VIII: motor interneurons; Commissural nucleus[3] Lamina IX: lateral (in limb regions) and medial motor neurons, also phrenic and spinal accessory nuclei at cervical levels, and Onuf's nucleusin the sacral region Centrally Lamina X: Central Zone, grey matter surrounding the central canal A section through the skull, illustrating the relationships between the meninges and the CNS. 27/02/2016 21 Floor of the skull showing the three cranial fossae and principal foramina. Cranial cavity showing the arrangement of the dura mater. Paramedian sagittal section of the head, showing the disposition of the brain and meninges. Cisterna magna. 27/02/2016 22 Resin cast of the ventricular system. (A) Lateral view; (B) posterior view. Median sagittal section of the brain showing the ventricular system. Dorsal aspect of brain stem illustrating the floor of the fourth ventricle. Cerebellopontine angle. The point of continuity between the lateral recess of the fourth ventricle and the subarachnoid space is indicated by a small tuft of choroid plexus, which protrudes through the lateral aperture. Posterior view of the brain. The cerebellum and brain stem have been slightly separated to show the median aperture of the fourth ventricle. Superior aspect of a dissection of the cerebral hemispheres in which much of the corpus callosum has been removed to reveal the lumen of the lateral ventricles. 27/02/2016 23 Sagittal T2-weighted MR image of the brain demonstrating CSF within the ventricular system and subarachnoid space. The cerebral ventricular system and its relationship with the subarachnoid space. The circulation of cerebrospinal fluid is indicated by arrows. Transverse section through the superior sagittal sinus showing arachnoid villi. Superior aspect of the cerebral hemispheres showing arachnoid granulations on the right side. On the left side, the arachnoid mater has been removed. The arterial supply and venous drainage of the spinal cord. The arrangement of arterial vessels on the base of the brain. The diagram shows the circulus arteriosus (circle of Willis). 27/02/2016 24 Arteries on the base of the brain. The arterial system has been injected with a red resin. Carotid angiograms. Radio-opaque material has been introduced into the internal carotid artery in order to display its intracranial course and the distribution of its branches. (A) Left carotid, lateral view; (B) Right carotid, frontal view. The cerebral cortical distribution of the anterior, middle and posterior cerebral arteries. (A) Lateral aspect; (B) Medial aspect. 27/02/2016 25 Vertebral angiograms. Radio-opaque material has been introduced into the vertebral artery in order to display its intracranial course and the distribution of its branches. (A) Lateral view; (B) Frontal view. ‘Time-of-flight’ MR arteriograms. The scans were performed on a 3.0T MR scanner. This method does not require the injection of contrast media into the patient; rather it relies on complex MR sequences to produce signal from structures with flow, while suppressing signal from stationary tissues. (A) Lateral view; (B) Frontal view. The deep cerebral veins. The brain is viewed from above and the corpus callosum has been removed to reveal the third and lateral ventricles. Venous drainage of the brain. (A) Lateral view; (B) Sagittal view. 27/02/2016 26 Phase contrast MR venograms. The scans were performed on a 3.0T MR scanner. (A) Lateral view; (B) Frontal view. Transverse section through the cavernous sinus. Ascending and descending tracts of the spinal cord. All ascending and descending tracts are present bilaterally. In this figure, ascending tracts are emphasised on the left side and descending tracts are emphasised on the right side. In addition, the location of Lissauer’s tract and the fasciculus proprius (which contain both ascending and descending fibres) are shown. The dorsal columns. The central pathways carrying conscious proprioception and discriminative touch are illustrated. The spinothalamic tract. The central pathways for pain, temperature, touch and pressure are illustrated. 27/02/2016 27 Corticospinal tracts. Rubrospinal tract. Tectospinal tract. Vestibulospinal tracts. The stretch reflex and reciprocal innervation. (A) The quadriceps stretch reflex is illustrated, whereby striking the patellar tendon elicits extension of the knee; (B) Reciprocal innervation. While stretching of the quadriceps muscle causes its reflex contraction, the motor neurones of antagonistic muscles (knee flexors) are inhibited by interneuronal connection within the spinal cord. Gamma reflex loop. 27/02/2016 28 Flexor reflex and crossed extensor reflex. Connections of the archicerebellum. Contralateral projections of the fastigial nucleus are not shown. Connections of the paleocerebellum. Connections of the neocerebellum. Transverse section through the midbrain at the level of the superior colliculus. The diagram shows the origin and course of oculomotor nerve fibres within the brain stem. Superficial distribution of sensory fibres in the three divisions of the trigeminal nerve. 27/02/2016 29 The brain stem indicating the location of the trigeminal sensory nucleus and its major connections. Transverse section through the pons. The diagram shows the origin and course of the motor fibres of the facial nerve. Principal ascending connections of the auditory component of the vestibulocochlear nerve. The caudal medulla and rostral spinal cord. The diagram illustrates the origin and course of the motor fibres of the vagus and accessory nerves. Transverse section through the medulla. The diagram shows the origin and course of the fibres of the hypoglossal nerve. Transverse section through the caudal pons. The diagram shows the location of the abducens nucleus and the course of abducens nerve fibres. 27/02/2016 30 Component fibres of the facial nerve and their peripheral distribution. (Red, motor; blue, sensory; purple/orange, parasympathetic.) Schematic representation of a transverse section through the most rostral part of the midbrain. The diagram shows the pathways involved in the pupillary light reflex. Transverse section through the midbrain at the level of the inferior colliculus. The diagram shows the location of the trochlear nucleus and the course of trochlear nerve fibres.
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