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dr. Isabella Kurnia Liem, MBiomed, PhD, PA
Department of Anatomy
Faculty of Medicine, Universitas Indonesia
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Gross Anatomy of
Human Nervous System
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Topics
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Central nervous system
Peripheral nervous system
Basic neuroanatomical pathways
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Division of Nervous System
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Functions of Nervous System
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Sensory receptors --tomonitor changes inside and
outside the body
Integration -- processes and
interprets the sensoryinput, and make decision
Motor outputdictates a
response by activating the
effector organs
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Central Nervous System
Protection of the brain
Cerebrum
Brain stem: mid brain, pons and medulla oblongata
Cerebellum
Spinal cordVascularisation
Ventricle system and Cerebrospinal fluid
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PROTECTION OF THE BRAIN
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Skull (cranium)
Covered by SCALP: Skin, Connective tissue,Aponeurotic
Galea, Loose connective tissue and Pericranium
Meninges
Cerebro-Spinal Fluid
Blood-brain barrier
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Loose connective tissue (areolar tissue)
=Dangerous area
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Meninges
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Three membranous connective tissue layers: Dura mater: though, thick external fibrous layer
Arachnoid mater: thin intermediate layer
Pia mater: delicate internal vasculated layer
Dura mater = pachymeninx
Arachnoid + pia mater; continuous = leptomeninx
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Dura mater
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two layered membrane
adherent to the internal surface of canium
external --periosteallayer
internal -- meningeallayer
Reflection or reduplication of the meningeal layer:
Falx cerebri
Tentorium cerebelli
Falx cerebelli Diaphragma sellae
Blood suply: middle meningeal arteries.
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Dural sinuses
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Superior sagittal sinus
Inferior sagittal sinus
Straight sinus
Transverse sinusOccipital sinus
Confluence of sinuses
Cavernous sinus
Intercavernous sinus
Superior petrosal sinus
Inferior petrosal sinusBasilar plexus sinus
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Meningeal spaces
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The dura-cranium interface (Extradural space or Epidural space )
not natural/pathologic
between cranium and external periosteal layer
The dura-arachnoid junction or interface (Subdural space) not natural/pathologic
between the dura and the arachnoid.
Subarachnoid space:
real space between arachnoid mater and pia mater.
contains CSF, trabecular cells, cerebral arteries and superior cerebral
veins.
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Intracranial hemorrhage
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Meningeal spaces
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Cisterns : areas of subaracnoid space where the brain countour isgreatly changed such that the pia and arachnoid diverge from
each other.
Major subarachnoid cistern include the:
Posterior cerebellomedullary cistern (Cisterna Magna)
Lateral cerebellomedullary cistern
Pontocerebellar cistern (cisterna pontis)
Quadrigeminal cistern Chiasmatic cistern
Interpeduncular cistern (cisterna basalis)
Lumbal cistern
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Lumbal cistern
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CEREBRUM (TELENCEPHALON)
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2 hemispheres, separated by longitudinal fissure.
Macrostructure: gyry, sulci and fissures on the surface of
cerebral hemisphere.
5 lobes: Frontal lobe
Parietal lobe
Occipital lobe
Temporal lobe
Insula
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CEREBRUM
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Special features on the lateral view of the cerebrum: Precentral gyrus the primary motor cortex
Postcentral gyrus the rimary sensory cortex
Superior temporal gyrus the primary auditory cotex
Occipital pole the primary visual cortex
Triangular part and opercular part of inferior frontal gyryBrocas speech area
Angular gyrus and suramarginal gyrusWernickes speech
area
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Functional areas of cerebral cortex
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Outstanding landmarks on the medial view of cerebrum: Corpus callosum
The fornix
The septum pellucidum
Anterior commisure
Principal fissures and sulci on the medial view of cerebrum:
Calcarine fissure
Cingulate sulcus
Parieto-occipital fissure
Inferior temporal sulcus
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Lobes on the medial view of cerebrum: Frontal lobe cingulate gyrus and paracentral lobule
Parietal lobe rostrally: frontal lobe, posteriorly: parieto-
occipital fissure
Occipital lobe is divided into cuneus and lingual gyrus bycalcarine sulcus.
Temporal lobe
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Functional areas of cerebral cortex
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Body maps in the primary motor cortex and somatosensory
cortex of the cerebrum.
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White fiber tracts of cerebral hemispheres
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Deep gray matter of cerebrum
(Basal Ganglia)
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Caudate nucleus Lentiforme nucleus:
Putamen
Globus palidus
Claustrum
Amigdala
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DIENCHEPALON
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3 structures Epithalamus
Thalamus
hypothalamus
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Epithalamus contains the pineal gland, which secretes a hormone called
melatonin that is involved in the nighttime stage of the sleep-
wake cycle
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Thalamus a paired egg-shaped group of brain nuclei
Gateway to the cerebral cortex
Major relay station for sensory impulses (ascending pathway)
and impulses from all brain regions that communicate withcerebral cortex
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Hypothalamus a series of brain nuclei, is the brains most important visceral
control center
regulates sleep cycles, hunger, thirst, body temperature,
secretion by the pituitary gland, the autonomic nervous system,and some emotions and behaviors.
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Thalamus
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BRAIN STEM
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The three basic subdivision of brain stem are: Mid brain (Mesencephalon )
Pontine (Pons)
Medulla oblongata
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Ventral of the brain showing the three parts of the brain stem:
medulla olblongata, pons and midbrain
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Mesenchepalon
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Mesenchepalon is divided into a tectum and paired cerebralpeduncles, crus cerebri (containing the pyramidal motortracts).
In the tectum, the superior and inferior colliculi mediatevisual and auditory reflexes.
The red nucleus and substantia nigra participate in motorfunctions.
The periaqueductal gray matter elicits the fear response. contains motor nuclei of cranial nerves III and IV; control
eye muscles
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Pons
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In the pons, nuclei of cranial nerves VVII lie near the fourthventricle.
The ventral region of the pons contains the pyramidal tracts
plus the pontine nuclei that project to the cerebellum.
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Pons
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Medula oblongata
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Contains the pyramids and their decussation, all formed bythe pyramidal tracts. The olives contain relay nuclei to the
cerebellum.
Nuclei of cranial nerves VIIIXII lie near the fourth ventricle.
Centers in the medullary reticular formation regulate
respiration, heart rate, blood pressure, and other visceral
functions.
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Medula oblongata
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CEREBELLUM
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The cerebellum smooths and coordinates body movements
and helps maintain posture and equilibrium.
Its main divisionsthe paired cerebellar hemispheres and the
vermisare divided transversely into three lobes: anterior,
posterior, and flocculonodular.
The cerebellar surface is covered with folia (ridges) and
fissures.
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CEREBELLUM
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From superficial to deep, the main regions of the cerebellumare the cortex, the arbor vitae, and the deep cerebellar
nuclei.
The cerebellum connects to the brain stem by the superior,
middle, and inferior cerebellar peduncles, thick fiber tractsthat carry information to and from the cerebellum. All these
fibers are ipsilateral.
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CEREBELLUM
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THE SPINAL CORD
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THE SPINAL CORD
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THE SPINAL CORD
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Function Sensory and motor innervation
Conduction pathwaysto and from the brain
Major center for reflexes
extends from the foramen magnum to VL 1 or 2.
terminal end = conus medullaris; filum terminale
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THE SPINAL CORD
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Thirty-one pairs of spinal nerve roots issue from the spinalcord.
The most inferior bundle of roots resembles a horses tail
(cauda equina).
The spinal cord is enlarged in its cervical and lumbar regions,
reflecting the innervation of the limbs.
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THE SPINAL CORD
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Spinal cord has 31
segment 31 pairs
of spinal nerve
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THE SPINAL CORD
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The white matter of the cord is divided into dorsal, lateral, andventral funiculi containing ascending and descending fibers.
The H-shaped gray matter of the spinal cord has two ventral horns
containing motor neurons and two dorsal horns containing
interneurons. The dorsal horns are subdivided into somatic and visceral sensory
regions; the ventral horns, into visceral and somatic motor
regions.
The roots of the spinal nervesdorsal sensory roots and ventralmotor rootsare PNS structures that attach to the spinal cord.
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THE SPINAL CORD
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THE SPINAL CORD (Protection of the
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THE SPINAL CORD (Protection of the
spinal cord)
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Three connective-tissue membranes, the meninges, encloseand protect both the brain and the spinal cord: the tough
outer duramater, the arachnoid, and the inner vascularized
pia mater.
Cerebrospinal fluid both floats and cushions the structures ofthe CNS.
It fills the subarachnoid space and the central cavities of the
brain and spinal cord.
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THE SPINAL CORD
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THE SPINAL CORD
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THE SPINAL CORD
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VASCULARIZATION
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The blood supply to the brain is from the internal carotid andvertebral arteries.
The internal carotid arteries arise in the neck from the
common carotid arteries and enter the cranial cavity with the
carotid plexus of sympathetic nerves through the carotidcanals.
The terminal branches of the internal carotids are the
anterior and middle cerebral arteries.
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Circle of Willis
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Circle of Willis
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A circular anastomosis formed by: posterior communicating arteries
posterior cerebral arteries
internal carotid artery
anterior cerebral arteries anterior communicating arteries
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VENTRICULAR SYSTEM ANDCEREBROSPINAL FLUID
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4 ventricles:
lateral ventricles (1 and 2) in the cerebral hemispheres
third ventricle in the diencephalon; cerebral aqueduct in midbrain fourth ventricle in the pons and medulla regions of the brain stem.
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Ventricles of the brain
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