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. EDC
EDO .


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: EDO : -

General Considerations

.
:
-1 (CNS) Central Nervous System

Spinal cord (Encephalon) Brain
Vertebral Canal
Cranium .
Meninges .
-2 (PNS) Peripheral Nervous System

Spinal Nerves
Cranial Nerves .
.
:
-1 (SNS) Somatic Nervous System )
( .
-2 (ANS) Autonomic (Visceral) Nervous System
) (Viscera .

.
.
Sympathetic Parasympathetic
) (Oculomotor Nerve
) (Facial Nerve ) (Glossopharyngeal Nerve ) (Vagus Nerve
) (S 2 , S3 , S 4 - (Cranio, Sacral, Nervous,
) System ) (T1 T12 ) (L1 , L 2

) (Thoraco- Lumbar Nervous System

) (Sympathetic, Chain
) (Pre and post ganglionic fibers
) (Cardiac plexus (Pulmonary
) plexus ) (gastric,plexus ) (Coeliac plexus

) (Hypogastric plexus ) (Vesical plexus Peripheral

.

Embryology of Nervous System

Differentiation
:
-1 Ectoderm .
-2 Mesoderm
-3 Endoderm .

Neural Ectoderm General
Ectoderm .
Neural plate
Neuroectodermal Junction ) (1-1

Neural Groove Neuroectodermal Junction
Neural Fold ) .(1-2

) (1-1

Neutoectrodermal Junction

) (1-2
Neural Tube
) .(1-3

) (1-3

.
Cranial Neuropore
. Caudal Neuropore ) . (1-4 Cranial Neuropore
Caudal Neuropore .
Neural Crest
Dorsal ) .(1-3

) (1-4
Anterior Neuropore Posterior Neuropore

Lumen
Central Canal
Neural epithelial cells
Inner Limiting membrane Outer Limiting membrane
. )
( Pseudostratified
. Mitotic
Intermediate
: Ventricular Zone
Germinal Layer Ependymal Layer Matrix ) .(1-5
Intermediate Zone Mantle
) .(1-5

) (1-5

Marginal Zone
Neuroblast
Glioblastes
.

Central canal
. mantle Grey matter Marginal
White matter .
Development of Spinal cord

. Primitive
germinal cells Spongioblast Neuroblast
Neuroglia
Limiting sulcus
dorsal Ventral
(Dorsolateral Lamina) Alar Lamina Roof plate
(Ventrolateral Lamina) Basal Lamina
Floor plate ) (1-6

) (1-6

Functional
Neuroblast interneuron
Neuroblast interneuron
) . (1-6
Neuroblast Marginal Ventral
Nerve Root ) Neuroblast .(1-6
Lateral Column
Preganglionic fibers
.
Marginal Neuroblast
Mantle . Neuroblast
Dorsal Nerve Root ) . (1-8
Oval
Posterior Funiculus .
Descending Fibers
Anterolateral funiculus ) (1-6

S1
L 3
) .(1-7

) (1-7 ) (A (B) 8
(C) 28 ) (D . .

Congenital Abnormality of the cord

.
.
Spina bifida
Anencephalus .
:Spina Bifida
.

Lumbosacral
.
Spina bifida occulta .

Sac Meningocele .

Meningomyelocele
.
Spina bifida
) (exposed Rachischisis
Myelocele .
Development of the brain

Cranial
Cranial Neuropore
Primary cerebral vesicles
Caudorostrally ) Hind brain (Rhombencephalon )(Mesencephalon
Midbrain ) Prosencephalon (Forebrain ) .(1-8

) :(1-8

Ventral Midbrain flexure
Cephalic filexure .
ventral Cervical flexure .
Pontine flexure
ventral ) . (1-9
Telencephalon Diencephalon
Myelencephalon Metencephalon
) .(1-8
The Rhombencephalon
Isthmus
Rhombencephali
Caudal
Cranial ) . (1-9
Roof plate
.

) (1-9
:Myelencephalon
. Basal Alar
.
) .(1-10
:Metencephalon Rostral

) (A) :(1-10 (B) 5

C) . (D

Basal Alar . Alar

Alar Basal .

Mesencephalon .
Basal Alar .
Crus cerebri .

.
.
Prosencephalon

.
Hypothalamic sulcus .
Interventricular
Rostral .
Choroid plexus .
Subthalamus .

) . .(1-11

) (A) :(1-11 (B) 5 (C) 7 7

(D) 8 (E)

.

Rostral Neuropore
Optic vesicle Optic stalk .
Ventral
Optic stalk

Cerebral Hemispher .
) .(1-11
Lamina Terminalis
optic stalk .
(End-Brain) Telencephalon
. )(Inter-Brain
Diencephalon .
.

Lateral ventricle .
Congenital Malformation of Encephalon


.
Squamous Occipital

Foramen Magnum .
Meningocele
Meningoencephalocele

Meningohydroencephalocele .
Anencephalus Rostral Neuropore
Vault .

.
Hydrocephalus ) Cerebrospinal Fluid (C.S.F
.
Aqueduct cerebri (C.S.F) Cerebro spinal Fluid
.
Suture .
) (Corpus callosum
. Coordination
.

:
-1 T.w.sadler
1385
-2 1372
-3 K.L.Moore
1371

)(Histology of the Nervous system

- :
-1 Exitable Neurons
-2 Non- exitable Neuroglia and Ependym
100 .

.
: The Neuron .
) (Anatomical unit Functional unit .
) (Soma, Perikarion or cell body
Neurites
dendrites Axon .
Dendritic tree
.
) (Soma :
Nucleus . Neucleul
) .(2-1
Cytoplasm : Nissl bodies
Ribosome .
Golgi complex .
.
Lysosome . Neurofilaments
Microtubules
Neurofibril .
Centriole

. Lipofuscin

) .(2-1
:Dendrites
.
.
Free Ribosomes
(rER)Rough Endoplasmic Reticulum
.

Dendritic Transport .

) :(2-1
.

Dendritic spines ) ..(2-1
:Axon .
Axon hillock .
Initial segment .
.
) (Initial segment .
) (Internode
Internodal segment . ) (Nodes of Ranviere .
Axolema
.
Axonic Flow .
.
Synapse .

Terminal boutons ) .(2-1
:
5 ) (5m
120 ) ( 120m
.
.
-1 Unipolar Neurons

Pseudounipolar
) .(2-2
-2 Bipolar Neurons
) .(2-2

-3 Multipolar Neurons

) .(2-2
2-2 .

) :(2-2 (1) (2) (3) Stellate

) (5) (4 ) (11 (6) (7) (8)
) (9 ) (10 ) (12 .
Golgi Cajal
:
- Golgi type I
.
- Golgi type II
. Microneuron Interneuron 90
.

Synapses
.

.

Presynapic bouton ) (Synaptic bag
Postsynaptic process Synaptic cleft
. .

Mictotubules .

) (2-3

) (Synaptopores .

) :(2-3 ) (
.

. ) (Gap junction
.
.
:Neuroglia
.
.

Neuroglia cell types

.
-1 Macroglia
.
-2 Microglia
.
Macroglia Astrocytes Oligodendrocytes .

:Astrocytes .
Protoplasmic Astrocytes
Fibrous Astrocytes
) . ( 2-4
Gap junction.
:Oligodendrocytes .
Intrafascicular
Perineuronal .
.
) .(2-4
:Glioblasts .
.
. subependymal .

) : (2-4 ) (

:Microglia
) . ( 2-4

.
.
) :(Ependymal cell
. ) Neuroblasts
( ) Gilioblasts ( .
Microvilli Cilia Ventricular .
Gap junction .
.
:Choroid plexus
Tela choroid
. .
Choroid plexuls .

.
: Peripheral Nervous system

) (Lower motor Neurons
.
:Schwann cells Neurolemal cells
. .
.
. Neuroectodermal .
:
Internodal segment .
40 50 Internodal segment .

.

:Structure of Peripheral Nerves

Perineurium , Epineurium :
.Endoneurim
Epineruium
.
Perineurilem
.

Endoneurium ) (
) (Axon .
:Peripheral Ganglia
Capsular perineuronal Satellite
.
Perineurium , Endoneurium Epineurium
.
Satellite
.
: Nervous Stem Cells


.
. .
.

.
.
.

Clinical points
)(Tumors of Neurons

.
.
.
)(Tumors of Neuroglia
40 50 Gilioma .
Astrocytoma Glioblastomas .
) (Ependymomas ) (Invasive.
):(Gliosis

Gliosis .
)(Microglial cells and desease
.
.

Spinal Medulla or Spinal Cord

) (C.N.S
) (Vertebral canal . 43-45 70
2
.
3
) (Meninges .

:
Axis .
.
:
12 )
( .
.
) (Filum Terminal
) (Coccyx ) .(3-1

) :(3-1 - .

) (3-2

18 24
) (Denticulat Ligament

) .(3-2

31 .
) (Ventral Root ) (Dorsal Root .
) (efferent
) (afferent )(Spinal granglion
.
intervertebral foramen
) (Dorsal Ramus
.
) (Ventral Ramus
) . .(3-2

. 8 C1 12 C8 D1 T1 ) D12 5 (T12
L1 5 L5 S1 S5 31 .
) (Spinal Segment 31
.

): (3-3
) ( 3-6
- )(Anterior Median Fissure
- )(Posterior Median Sulcus
- )(Anterolateral sulcus
- (Posterolateral Sulcus
:
) :(Posterior intermediate Sulcus
.

. ) : ( 3-3
) (Cervical Enlargement
C 3 T2 C 3 T2 .
) (Lumbar Enlargement
L 2 - S3 T9 - T12 .
12
.
) (Conus Terminale ) .(3-1

) :(3-3 .

C1 C7 . 7 8
) (C8 ) (C7 .
T1-T12
)(L1-L5 ) (S1-S4 ) (S5
.
.


) (L2
(Horse Tail)Cauda equina
) (3-4 ) .(3-5

. ) (Central canal
) .(3-6
H .
) (Grey commissure .
-
) (Anterior horn ) (Posterior horn .

) (Anterior column ) (Posterior column .

) (Lateral column
) (Lateral horn ) .(3-6

) :(3-4 : .

 :
) :(3-5 ) (A
- (B) .

) (Anterior Funiculus
) (Posterior Funiculus
) (Lateral funiculus
) (Fasciculus Gracilis
) (Fasciculus cuneatus ) . ( 3-6

) :(3-6 .

) (Posterior median septum

.

) (Posterior intermediate septum .

.

) (Commissure .
)
(
) (Anterior white commissure ) .(3-6

.


.
I
) (efferent . ) (
) (
) (Neuromuscular spindles .

. interneuron.

) :(3-7

) : ( 3-7
- :

-1 )(Phrenic Nucleus
C3 C7 ) (Phrenic nucleus
.
-2 )(Spinal Nucleus of Accessory Nerve
5 6 ) (Accesory group
.

- :
-1 II
.
-2 ) (Nucleus proprius
.
-3 ) (Clark Nucleus ) (Dorsal Nucleus
) (C 8
) (L 3 .

interneuron .

- :
.
-2 .
-1

) (intermedio medial )(intermedio Lateral

.
C 8 ) (L 2
.

) (S 2 , S3 , S 4 Sacral parasympathetic grey column
) . .(3-7

:
-1 ) (Afferent fibers
.
-2 ) (Long ascending fibers
.
-3 ) (Long descending fibers

.

-4 ) (interegmental fibers
) (intrasegmengal fibers ) (properia fibers .

) ( )
( .
-5 ) (Efferent fibers

.


)(Lissauer ) (Dorsolateral fasciculus ) .(3-8

.

) :(3-8

.
. ) (Proprioceptive
.
) :(Fasciculus gracilis
) . ( 3-8 ) ( 3-9
):(Fasciculus cuneatus
). ( 3-8)( 3-9

) : ( 3-9
) (Dorsal Column Medial Lemniscus

:
) : (Spinothalamic tract
) (
. ) (Anterolateral tract ) . ( 3-10

) : ( 3-10

. .
) :(Anterior spinocerebellar tract

).(3-11
) :(Posterior spinocerebellar tract

) .(3-11

) : ( 3-11

) :(Spinotectal tract
.
) :(Spinoreticular fibers
.
) .(3-12

) :(3-12

) :(Spinovestibular fibers
.

):(Corticospinal tract
.
70 90
) (Lateral corticospinal tract

. 10 30
) (Anterior corticospinal tract .
.
) . (3-13 ) .(3-14
):(Rubrospinal tract
) (Red Nucleus
Ventral tegmental deccussation
) . (3-15
) :(Tectospinal tract
) (
) . (3-15
) :(Vestibulospinal
) (
.

) : (3-13

) :(3-14

):(Reticulospinal tract

) . ( 3-12 ) ( 3-16

) :(3-15 - .
) :(Descending Autonomic Fibers

.

7 : ) - C
) 5 (L - L ) (S - S )
7

12 (C ) ( )

- T12

5 (T

. Co1 - Co 4

. :
-1 C1 . C1

-2 C 8 C 6
-3 T6 T4
-4 T12 . T10
-5 L 5 . T12

) : ( 3-16

) : ( 3-17

:
:
) (Posterior spinal arteries
) . ( 3-18
) (Anterior spinal arteries
.
.
) (Radicular arteries )
( .
.
) (Arteria Radicularis Magna Adamkiewtiz
. Intersegmental
.
) . ( 3-18

) . ( 3-19
.

. .

) : ( 3-18 Radicular

) : ( 3-19 Radicolar

):(Clinical points
-1 ) :(Spinal cord injuries
.

.
L1 L 2
.

-2 ):(Spinal Nerve injuries

) (Disease and Intervertebral foramina
.
Herniation .
:Disc Herniation C6 C5 C7 - C6
. C 5 C 6
C 6 . .
Herniation L4-L5 L5-S1
. L 5 L 5
S1 Herniaition . Herniation
.

:Ischemia of the spinal cord -3

.
:Complete cord Transsection syndrom -4 :
-1 .
-2 .
:Anterior cord syndrom -5 :
-1 .
-2 .
-3 .
) (Two point discrimination
.
:Central cord syndrom -6
-1
-2
-3

:Poliomylitis -

.
.
.
.
:Syringomylia -8

. - .
.
.
.

.

Brain Stem
.
.
:
-1 .
-2
.
-3 III XII .
: :
: :

:
.
) (Anterior Median Sulcus
)(Foramen caecum
.
) (pyramid
) (Cortico-Spinal fibers . 70-90
.

.
) .(4-1

:
.
Basilar Basilar . .
-
- ) .(4-1
:

.
) (Crus Cerebri . ) (Medial Sulcus
) (Oculomotor Nerve
) (Lateral sulcus
) (Lateral Lemniscus .
) (Interpedunclar space

) (Posterior perforated substance
) (Optic tract ) . .(4-1

) : ( 4-1 ) (

:
:
:
) (caudal ) (cranial .
) (closed part
.
.

) .(4-2

) :(4-2 .
) (

) (open part .

.
.
) (inferior cerebellar peduncle .

:
) .(4-2
:
) (Corpora quadrigemina
Colliculi .
) (Pineal body
.
)(Frenulum veli
.
) ( ) ( .
) (Superior colliculi
) (Inferior colliculi .

) (Brachium of Superior colliculi ) (Ventrolateral
) (Lateral geniculate body .

) (Brachium of inferior colliculi
) (Medial geniculate body .

) (Trochlear Nerve .
:
.

:
.
.
) (olive
.

- ).(4-3
:

) (Middle cerebellar peduncle .
) . .(4-3
:

.
) . .(4-3

) : ( 4-3 ) (

III XII ) : 4-1 4-2 ( 4-3

(Hypoglossal Nerve) XII
) (Antero lateral sulcus of bulb .
X XI (Accessory Nerve, Vagus, Glossopharyngeal Nerve) IX
- ) (Posterolateral sulcus of boulb .
VII VIII VI - .
(Trigeminal Nerve) V
.
(Trochlear Nerve) IV Frenulum veli

.
(Ocmlonotor Nerve) III Medial )(Crus cerebri
.
Internal structure of the medulla oblongata

.

-1 ) (4-4
) (Decussation of the pyramids
.
:
) (Spinal Nucleus of accessory nerve
.
ambiguus Branchial ) cranial
( ) (10 ) (9 .
Cortico- Nuclear .
) (gracilis Nucleus
.
) (Cuneatus Nucleus
.
.
) (Spinal Nucleus of trigeminal Nerve
. .
) (Dorsolateral tract
) (Spinal tract of trigeminal Nerve .

) : (4-4 .

.
.
.

-2 ) (4-5
.
) (Internal arcuate fibers .
) (Decussation of Lemnisci

) (Medial Lemniscus
.

.
) (Posterior external arcuate fibers
-
) (Cuneocerebellar fibers.

) :(4-5 .

.
- ) (Ventral
.
:
. .
- .
ambiguus Branchial ) (cranial
- .
) (Dorsal vagal Nucleus .
.
) (Solitary Nucleus and Tract
.
. Baroreceptor
Chemoreceptor .

) (Medial Iemniscus .
- ventral
. .

-3 ) (4-6
.
) (inferior olivary Nucleus
) (hilum ) (Afferent
.
) (Efferent
.
ventral
) (olive .

) :(4-6 .

) (arcuate Nucleus -
Anteromedial .
)( Anterior external arcuate fibers

. .
.
) (Olivocerebellar .

.

) (4-7

-4 ) ( 4-7
.
.

"
. .
Internal Structure of pons :
: Ventral Basilar
Dorsal .Tegmental
Vental Dorsal .
:Ventral
) ( .
Ventral :
-a - ) (cortico- spinal fibers
.
-b - ) (Cortico Nuclear fibers
.

. .
-c - ) (Cortico- pontine fibers
) (Pontine Nuclei .

. -
- )(Cortico- ponto- cerebellar pathway
) .(4-8

):(Pontine- Nuclei

Ventral
.
Dorsal:
:
-1 ) : 4-8 ( 4-9
dorsal :
) : ( Vestibular Nuclei

. -
) (MLF .
Fastigial
MLF .
MLF .
) : ( Cochlear Nuclei
.
- . ) (Ventral cochlear nucleus
) (Dorsal Cochlear Nucleus
) ( Cochlear Tubercle .

) :(4-8 ) (Basilar .

) (Trapezoid body
. .
) (Lateral Lemniscus .
.

):(Nucleus of the abducent nerve

.
Corticonuclear .
Ventral Basilar
- . .
): (Facial Nucleus
Abducent Ventrolateral .

) (Cortico- Nuclear
.
) (Facial Nerve .
Abduceut
) (Genu of the facail Nerve . Ventrolateral
Abducent - .

.
) : ( Superior Olivary Nucleus

.
. .

):(Salivatory Nucleus
.
)( -
.
.

.

) . (4-8 ) .(4-9

) :( 4-9
.

-2 ) : ( 4-10
.
.
) : (Motor Nucleus Of Trigeminal Nerve
Ventral .
.
Mandibular
). ( 4-10

) : ( 4-10

) : ( Main Sensory Nucleus Of Trigeminal Nerve

.
.
Trigeminal Lemniscus
) . ( 4-11

) : ( 4-11

Internal Structure of Midbrain:

)(Cerebral peduncle
. :
-1 ) -2 (Crus cerebri ) -3 (Substantia nigra
) (Tegmentum -4 )(Tectum

) (Aqueduct cerebri .

.
)(Crus cerebri
- - .
2
- ) (Pyramidal pathway
3
. -
. -

. . -
:
: )(Fronto- pontine fibers
: )(Tempro- pontine fibers
1
.
6
1

.
6

) . .(4-12
)(Substantia nigra

) (Cranial ) (Subthalamic .
) (Neuromelanin
.

) :(4-12

.
Nigrostriatal .

)(Tegmentum of the midbrain

:
) (4-13
:
-1 (P.A.G) Periaqueductal gray matter
) (Reticular Nuclei.
-2 ) (Nucleus of trochlear Nerve
) (P.A.G .

. Trochlear
.
-3 ) (Mesencephalic Nucleus of Trigeminal Nerve

.
) (Trigeminal ganglion Properioceptive .

) :(4-13

:
-1

.

) (Nucleus Venteralis Lateralis .
-2 Lateral Lemniscus, Trigeminal Lemniscus , Medial Lemniscus
Spinothalamic .
-3

.
) (4-14
:
-1 ) (Nucleus of oculomotor Nerve
) (Ventromedial .
:

( .
.
(
) (Edinger westphal) (Accessory oculomotor Nucleus .
)( .
Oculomotor
.
-2 ) (Red Nucleus
) (Dorsomedial
.

) :(4-14

) : ( 4-15

) : ( 4-15
(a Corticorubral
.
(b Dentatus
.
) : ( 4-15
(a - ) (Rubro spinal
) (Ventral Tegmental Decussation
.
(b - ) (Rubro bulbar

.
:
-1 .
-2 ).(Trigeminal Lemniscus

-3
.
-4 (MLF) Medial Longitudinal Fasciculus
) ( 4-16

. MLF ) (Interstitial Nucleus
MLF .
.

) (ventral .



. MLF
.
.

)(Tectum of the midbrain

.
)(Inferior colliculus

. .
.
.
.
.

.

) (Auditory Radiation .

.

) : ( 4-16 )(MLF

)(Superior Colliculus
.
.
:
.
- ) (Spinotectal .
.
:
.

- ) (Tectospinal Tract
.
) (Dorsal Tegmental decussation .
)(Pretectal Nucleus

.
.
) (Accessory oculomotor nuclei
) (Iris .

The Reticular Formation :

) (Dorso Lateral

. .
.
:
-1 .
-2
.
-3 .
-4
.
-5 ) (Somatic ) (Visceral.

) (Longitudinal columns ) .(4-17

):(Median column of reticular nuclei

.
) (Rapheal Nuclei .
):(Medial column of reticular Nuclei
. Magnocellular .

) :(4-17

):(Lateral column of reticular nuclei

.
Connections of reticular formation
) (Afferent ) (Efferent .
:Afferent Projections
-1 : -
) (Spinoreticular -2 : ) (Vestibular
) -3 .(Acoustic ) (Cerebelloreticular -4 .
- ) (Tectoreticular -5 .
-6 . ) -7 .(Corpus striatum
) (Sensoriomotor -8 . .
:Efferent connections
-1 : - ) (Reticulospinal
-2 . -3 . -4 .

) (Tectum -5 . -6 .
.

)(Clinical points
:Tumors of the posterior cranial fossa -1
Posterior cranial fossa
Foramen Magnum
XI X IX XII.
:Lateral Medullay syndrome of wallnberg -2
Posterior inferior cerebellar
Vertebral . Dysphagia :
Dysarthria Palatal Laryngeal
Ambiguus .
.
) (Horners syndrome .
) (Enophthalmia ) (Ptosis ) (miosis
) (.

.
- .
:Medial Medullary syndrome -3
Vertebral . Medullary
:
. Cortico spinal fibers
position ) (Two points dicrimination
.Medial Lemniscus
.(Hypoglossal Nerve) XII
Tumors of the pons -4


Abducent
.
Quadriparesis .Cortico spinal

. medial and spinal lemniscus

Corticoponto cerebellar .

: Pontine Hemorrhage -5
.
. Cortico spinal .
:Trauma of the Midbrain -6
Tentorial notch
Oculomotor Trochlear.
Blockage of the Cerebral Aqueduct -7
. ) (CSF

. .
.
-8 )(Vascular Disrders of the Midbrain
:Webers syndrome -
Weber .
oculomotor .
.
.
) (ptosis Edinger westphal .
Benedikts syndrome -
Benedikt Weber medial lemniscus
Hemianesthesia .
Cerebellum 4th Ventricle
:
. 150
1 20 1 8
.
) (Vermis
.

) :Superior surface ( 5-1

) (Cerebellar Tentorium
.
) (Superior Vermis
.
-
) (Anterior cerebellar notch
).(Posterior cerebellar notch
.
.
) (Tentorial notch .
) uncus (
.
) (Falx cerebelli .

) :(5-1 .

:Inferior surface
Valleculla (Inferior vermis
.
Valleculla
Posterior cranial fossa ) ..(5-2

) :(5-2
.

:Anterior surface

. ) .(5-3

) :(5-3 .

.
) (Horizontal fissure
.

) (Primary Fissure .
) (Posterolateral Fissure .

.
) .(5-4
:
-1 )(Flocculonodular Lobe
-2 )(Corpus cerebelli
Nodule Flocculus Nodule.
Floculus Nodule .
.

) :(5-4 .

) (Anterior Lobe )( Middle Lobe .

.

) (Archicerebellum ) Lingula (
) (Vestibulo cerebellum .

) (Paleocerebellum .

) (Neocerebellum
Cortico cerebellar .

Internal structure of cerebellum

)(Cerebellar cortex
.
.

"
. .
):( Cerebellar Peduncles
C.N.S
) . .( 5-5

) :(5-5 .

) : ( 5-6

.
. :
.1 - )(Posterior spinocerebellar tract

) (Thoracic Nucleus
extroceptive proprioceptive .
-2 - )(Cuneocerebellar Tract
)(Posterior external arcuate fibers

) (Accessory Cuneate Nucleus
.

-3 - )(Olivocerebellar Tract

.
.
-4 - )(Reticulocerebellar Tract
.
-5 )(Vestibulocerebellar Tract
- ) (8
. .

 :
) :(5-6 .

- .
) ( 5-5

) (Brachium pontis .
) (Pontine Nuclei ) (Basilar part
.
. -
) (Corticopontine fibers ) (
- - ) (Cortico- ponto- crebellar .

) ( 5-6

.
) (Superior medullary velum .
.
) (Dentatus Nucleus
globose , emboliform fastigial .

.
" .
:
-1 - ):(Ventral spinocerebellar Tract


.
-2 - ) :(Coeruleocerebellar Tract
) (Nucleus Coeruleus .
-3 - ):(Hypothalamocerebellar Tract
.

: .
) Cerebellar cortex (5-7

.
.
:

) :(5-7 .

-1 ):(Molecular Iayer
300-400m .
) (Purkinje cells
.
) (Folia .
).(5-7

. .
.
.
) (Stellate cells
) (basket cells .
.

-2 ):(Granular Layer
100 m 400-500 m
) (granular cells . ) ..(5-7

)(Intracerebellar Nuclei

Roof Nuclei )(Dentatus
globos, emboliform, .fastigial
fastigii -
emboliform globosus -
dentatus
- .
dentatus
. ) (hilum
.
) . (5-6 ) ( 5-9
emboliform dentatus
globosus .
fastigii globosus .
)(Fourth ventricle
) (Central canal
) . ( 5-8
.
.
.
.
):(Roof or dorsal wall
) (Superior medullary velum
.
Over Lap
Lingula .
.
.
) (Median aperture .
) (Tela choroidea
. Nodule
.
) . 5-9 ( 5-8

):(Openinges in the roof

. .
Nodule .
.
.
) . 5-9 ( 5-8

) :(5-8
.

)(Rhomboid fossa

Romboid fossa .
.
) (Lateral recess .
) (Median sulcus
.
) (Medial eminence ) (Limiting sulus
) . ( 4-2

) :(5-9 .

) (
) (facial colliculus ) ( ) (

) (
) (Hypoglossal Trigonum
) ( .

. ) (Locus coeruleus
.
Coeruleus .
Coeruleus .

.
.
) (Vestibular area .
) (Auditory tubercle .

) (Vagral Triangle
) (Area posterma .

)(Clinical points
Cerebellar dysfunction


.

The Diencephalon or interbrain
) (Slit like
.

.
) (Cerebral aqueduct
) (Hypothalamic sulcus . ) (dorsal
) (ventral ) . .(6-1

) :(6-1 .

) (pars dorsalis :
-1 ) Dorsal Thalamus .(Thalamus
-2 )(Epithalamus
-3 )(Metathalamus
) (pars ventralis :
-1 )(Hypothalamus
-2 ) Ventral thalamus (subthalamus

)(
. 4
.
.
) (pulvinar .
.
) (6-2
) (Stratum Zonale .
) (caudate Nucleus
) (Stia Terminalis ) (Thalmostriate ) . .(6-3
) (Fornix

.

) :(6-2 .

) (Steria Medullaris thlami .
) (Habenular trigone ) . .(6-3
) . .(6-2

) Interthalamic Adhesion
) (Interthalamic Connection .
) .(6-1

)(External Medullary Lamina .
) (Lentiform Nucleus .

) :(6-3
.

) ( 6-4
.
Y
) (Internal Medullary Lamina .
. ) (Anterior Y

.
) (dorsolateral ) (ventromedial .
.
:
The Anterior group of Nuclei
.
:
-1 .MamillothalamicTract
-2 .
) (Hypocampus
.

The Medial group of Nuclei

(MD)Medial Dorsalis
.
:
-1 ) (amygdaloid Nucleus )(Priform cortex
-2
-3 .
The Ventral group of Nuclei
: (VA)ventralis anterior )(VL
ventralis Lateral (VP) ventralis posterior
(VI)ventralis intermediate .
) (VPL )) .(VPM .(6-4
VA
-1 .
-2 .
VI
-1 .dentatus
-2
-3 .
VP
-1 VPL
-2 VPM ) (trigeminal Lemniscus
)(gustatory pathway
-3 .
The Lateral group of Nuclei
: (LD) Lateralis dorsalis )(LP
Lateralis Posterior .Pulvinar
:
-1
) (geniculate bodies .
-2 Associational ) . .(6-4
The Non specific groups of thalamic nuclei

.

The Epithalamus


) (stria medullary thalamus (Pineal gland) epiphysis Cerebri
) (Posterior Commissure .
(Pineal gland) epiphysis Cerebri

.

) . ( 6-1 ) .(6-3

) :(6-4

Habenular Trigone
.

) . .(6-3

habenular nucleus
. Stria medullaris thalami

.
The posterior Commissure
.
Interstitial Nucleus of posterior Commissure
dorsal nucleus of posterior Commissure
) (MLF .
The Metathalamus
.
- :Visual pathway
optic chiasma
.
.
Anterior Communicating artery
.
anterior perforated substance .


.
optic Tracts .
Tuber Cinereum
.
.

optic radiation
.
) .(6-5

) :(6-5

- :Geniculate bodies
.
) ( ) (
) . .(6-4
Medial geniculate body

.
.

) :(6-6

Lateral geniculate body

. .
The Hypothalamus
.
Lamina Terminalis
. Preoptic
.

. :
-1 -2 optic chiasma Tuber cinereum infundibulium
- 3 -4 .
) ..(6-6
Posterior perforated substance
.
.
Interpeduncular nucleus .
Retroflexus ) . .(6-6

Mamillary bodies


. fronix ) . (6-6
) .(6-7

) :(6-7 -
.

Tuber cinereum
. .
infundibulum
) (6-6 ) .(6-7
) (6-7
Medial Lateral
Intermediate
Retroflexus .
:

Preoptic
Suprachiasmatic
Infundibular
Posterior
Anterior
Dorsomedial
Ventromedial
:
Preoptic
Supraoptic
Lateral
Tuberomamillary
Lateral tuberal
.
) Ventral thalamus (subthalamus
Rostral
Substantia nigra
Red nucleus Subthalamic nucleus
Zona incerta .
) .(6-8

) :(6-8 ) IIIV (
) TM () TA () TL . (
IA ) ZI () F () NS () IC (
GPI ) GPE () P() EC () C .( ) I(.

The Subthalamic Nucleus

.
) .(6-8

.
Zona Incerta
thalamic fasciculus ) . .(6-8


) . .(6-8

The Third Ventricle

. ) (6-1
) (6-3
.
) ( . .
) ( . .
.
Tela choroid
Choroid plexus .
Lamina Terminalis
. Rostrum
. .
.
Anterior Commissure
.
.
Interventricular foramens
.
.

)(Clinical Points
Lesions of the thalamus -1
Sensory loss -
. ) (VPM
Ventral postero medial ) Ventral portrolateral (VPL
Two points diocrimination .
Thalamic Pain -
recovery
.
.
Hypothalamic lesion -2
: Genital Hypoplasia
Hypetermia Diabetes Insipidus Hypothermia .

The Telencephalon or Endbrain

The cerebral hemisphers
.

. Longitudinal Cerebral fissure
) .(6-9 falx cerebri
.
Corpus Callosum
.

) : (6-9

.
Superolateral Surface .
Medial Surface
.
inferior Surface :
Orbital Tentorial
.
.
Superomedial .
Inferolateral
Superciliary .

Medial
Medial Orbital
Medial Occtipital .

) :(6-10 .

Frontal Pole Occipital Pole

Temporal Pole .
gyri or convolution
sulci or fissures .
1
2200 .
3

.

) (6-10
Superolateral Surface of The Cerebral hemisphere
Lateral Sulcus Central sulcus .


Anterior Perforated substance

Stem

Anterior Horizontal 2/5

Antrior Ascending 2/5

Posterior 7
.
. 8 10
. .
Parietooccipital
5 5
occipital notch .

.
:
) .(6-11
Frontal Lobe
. .
Percentral Sulcus
.
. .
Precental gyrus .

.

) :(6-11
.

Pars orbitalis
Pars triangularis
Pars opercularis ) (6-11 ) ( 6-13

) (.
Tamporal Lobe

.


:

) (6-11 ) ( 6-13

) :(6-12

Circular Sulcus
Transverse Temporal gyri .

.
Parietal Lobe

.
Postcentral Sulcus .
Postcentral gyrus .
Intraparietal Sulcus
. Superior Parietal Lobule

Transverse occipital Sulus

Parieto occipital arcus .

inferior parietal lobule

.
:
Supramarginal gyrus
Angular gyrus
Posterior gyrus ) (6-11 ) . ( 6-13
Angular ) (Wernicks Speech Area .
Occipital lobe

. Transverse occipital sulcus

. Lateral occipital sulcus
) . ( 6-13
Insular Lobe
. Circular sulcus .
Insular Central Sulcus
) . ( 6-12

) : ( 6-13

Medial Surface of The Cerebral Hemisphere

.

.
Corpus Callosum ) .(6-14

) : ( 6-14

:
:


Paracentral lobule
.
Medial Frontal gyrus .
Cingulate gyrus .

Isthmus Parahyppocampal gyrus
) (6-15 ) .(6-14
isthmus
Calcarin Sulcus
isthmus .
Pre Cuneus gyrus
Cuneus gyrus ) (6-14
) .(6-15
Rhinal
.

uncus ) (6-15 ) .(6-14

) :(6-15 .

Inferior Surface of The Cerebral Hemispheres

: -
. - .

. Olfactory bulb
Olfactory tract Olfactory gyrus .
Olfactory gyrus .
Straight .
H
orbital ) 6-16 .( 6-17

) :(6-16

Tetorial .
Collateral sulcus
occipito temporal sulcus .
Collateral Calcarin Sulcus
Rhinal Sulcus
) . ( 6-15

.
) .( 6-15
Medial occipitotemporal gyrus
.
Lateral occipitotemporal gyrus

) (6-16 ) .(6-15

The Anterior Perforated Substance

stria
stria

.
) .(6-16

) : ( 6-17

The internal structure of cerebral Hemispheres

Cerebral Cortex
Basal Nuclei .
Lateral ventricle ) . ( 6-18

) :(6-18
. .

Cerebral Cortex
pallium .
:Neurons of The Cerebral Cortex
: Pyramidal cells Stellate cells
Fusiform cells Martinotti cells
Horizontal cells . Neuroglia form cells

10 m 100 m .
Giant pyramidal cells of Betz
Betz`s celles . Apical dendrite
basal dendrites
. Axon .

8-10 m . Granular celles
) . ( 6-19

) :(6-19

:The Cortical Layers

) : .(6-20
- I Molecular layer Plexiform layer .
- II External graular layer
.

- III Pyramidal layer External pyramidal layer

Associational Projectional
Commissural I .
-IV Internal granular layer

.
-V Ganglionic layer Internal pyramidal layer
.
Betzs cell .
-VI Multiform Layer .
.

) :(6-20

Cortical areas

Brodman 47
) .(6-21

) - A :(6-21
B

) :(6-22
.

White matter of cerebral hemispheres

:
- Projection fibers
.
- Association fibers
.
- Commissural fibers
.

semioval centrum .
Projectional fibers
afferent and efferent
. Radiating bundles
Corona Radiata .
Internal Capsule
). ( 6-23

: - Anterior limb - Posterior limb - .Genu
Caudate Putamen
.
.
.
Crus Cerebri .
- - .
- - Cortico- rubral
.
- ) . (6-18 ) .(6-22

) :(6-23

Optic Radiation ) .(6-18
external Capsule
Claustrum ) .(6-18
extrem Capsule
) .(6-18

Association fibers
.
Short association .
) .(6-24
Long association fibers
). ( 6-24
- uncinate fasciculus
- arcuate fasciculus
- cingulum
Inferior longitudinal fasciculus -
Superior longitudinal fasciculus -

) :(6-24

Commissural fibers
Corpus Callosum Anterior Commissure
.
:Corpus callosum

Longitudinal cerebral fissure
10

4 6
) (6-14 ) ( 6-15
:
-1 -2 Rostrum -3 genu -4 body Splenium

. .
fornix
.
Genu .
.
Rostrum
.
.
Splenium .

forceps minor
forceps major
) . .(6-25

) :(6-25

:Anterior Commissure

) .(6-26

) :(6-26

Fornix

Fimberia
Choroid fissure .
Crus of the fornix

Commissure of the fornix
Hippocampal Commissure .
Body of fornix .
.

.

.
Column of the fornix .
) (6-27 ) .(6-28

) : ( 6-27

Spetum Pellucidum

.

) :(6-28

.

.
) . .(6-26

The Basal Nuclei

Basomedial
. ) : 6-29 6-26 ( 6-18

) : ( 6-29

:Amygdala
) (Amygdaloid Nuclei complex
Archistriatum .
Dorsomedial
Caudate .
.
Stria Terminalis
.
.
Stria medullary thalami .

:Caudate Nucleus
C
.

Head
body
Tail
) .(6-29
:Lentiform Nucleus

Putamen Globus Pallidus
External Medullary Lamina ) ( 6-26
Corpus Striatum .

Neostriatum Striatum

Pallidum Paleopallidum .

:Putamen Nucleus
.
Claustrum
.
Striatum .
Cortiocostriate Thalmostriate
Nigrostriate .
.
:Globus pallidus Nucleus
Internal Medullary lamina
.


.
Striatopallidal .

Fasciculus Thalamicus Fasciculus Lenticularis Ansa Lenticularis Fasciculus Subthamicus
) .(6-8

:Claustrum

) . ( 6-18 ) . ( 6-26
Corpus striatum
.
.

Lateral Ventricle

.
) ) (6-30 ( 6-31 ) ( 6-32

) :(6-30

Central part Horn

) .(6-30 ) ( 6-31
:Central Part

.

Thalamostriate vein .
.
:Anterior horn
) .(6-31 Coronal
.
.
.

) :(6-31

:Posterior horn
) .(6-31
. Optic Radiation
.
.
:Inferior horn
) .(6-31
.
.

) :(6-32

Collateral eminence .
Fimbria
.

Collateral Sulcus .

)(Clinical Points
:Lesions of The Motor Speech Area of Broca -1

) (Expressive Aphasia
.
:Lesions of The sensory Speech Area -2
Wernicks Speech Area
.(Receptive Aphasia) . Broca
. . .
:Lesions of The Motor and Sensory Speech Areas -3
Wernicke Broca
)(Global Aphasia
:Lesions of The Dominant Angular Gyrus -4
angular gyrus ) Wernicke (
Visual Association Wernicke .
) (Alexia ).(Agraphia

:Lesions of The Prefrontal Cortex -5

Prefrontal Loss of Intelligence
. Prefrontal
. .Euphoria
.
:Lesions of The Primary Visual Area - 6
visual Field
(Crossed homonymous hemianopia).
Inferior quadrantic hemianopia
. Superior quadrantic hemianopia.
Central Scotomas.
.
:Lesions of The Secondary Visual Area-7
Visiual field .
.
:Lesions of The Primary Auditory Area -8

.
.
.
:Lesions of The Secondary Auditory Area -9

(Acoustic Verbal agnosia) Word deafness.

):(Limbic System
Limbic

.
Cringulate Subcallosal Parachippocampal
Amygdaloid . fimbria Alveus
mammillothalamic tract ,fornix Stria terminalis ). ( 7-1

) :( 7 -1

) ) :(Hippocampal formation ( 7-2

Dentate gyrus Hippocompus subiculum .
parahippocampal .
Hippocampus
coronal Hippocampus .
Pes hippocampus .
Alveus Alveus .
Fimbria Fimbria .
crus of the fornix . Splenum Indusium griseum
Stria ) (Medial and latral longitudinal stria

) . ( 6-25 Indusum griseum Subcallosal

.
Dentate grus Fimbria
Parahippocampal hippocampal .
Subiculum Entorhinal Entorhinal
cortex Subiculum.
) (Hipocampus Proper Dentate Gyrus )(Archicortex
Entorhinal cortex, Subiculelm Transiteional
5 ) ( 7-2 Septal Amygdaloid
.

) : ( 7-2

:Septal
septum Septum pellucidum . Septum Vera
Septum pelluuidcm .
Septum vera ) (True septum Septum pellucidum
Subcallosal Septal .
:Amygdaloid Nucleus
.

):(Structure of the Hippocampus

.
.
Molecular .
Pyramidal
Polymorphic Dentate gyus .
Granular Layer ) . ( 7-2
):(Connecting pathways of the Limbic system
Mammillothalamic tract ,fornnx , Fimbria, Alveus :
Stria Terminalis .
) (Mammillothalamic Tract
. .
Stria Terminalis
septal ) ( preoplic
.

) ) :(Afferent Connections ( 7-3

:
-1 .
-2 Septal Fornix .
-3 .
-4 ) indusium griseum (
.
-5 Entorhinal Olfactory association
.
-6 Dentate Parahippocampal .
.
) : Efferent Connections ( 7-3
Alveus
Fimbria Fornix .
Fornix :
-1 Fornix )(Retrocommissural filbers
.
-2 Fornix )(Precommissural filbers
Spetal Preoptic .
-3 Habenular .

Output

.

) : ( 7-3

Blood Circulation of Brain

):(Arteries of The Brain
.
)(Circleofwillis
.
) ) :(Internal Carotid Artery ( 7-4
Carotid
Canal Petrous Cavernous
Sphenoid Clinoid

.
):(Branches of The Cerebral Portion
-1 ) (ophthalmic artery
Cavernous .
-2 ) (Posterior Communicating Artery
Oculomotor
.

-3 ) (Choroidal Artery
. Choroidal .
Crus cerebri .
-4 ) (Anterior Cerebral Artery .
.

) (Anterior Communicating Artery .

.
) (Cortical branches Parietooccipital
. ) ( 2/5
. ) (Leg Area
Precentral .
) (Central branches
.
-5 ) (Middle cerebral Artery
.
) (Cortical Branches

.
) (Leg Area .
) (Central Branches .
) ) :(Vertebral Artery ( 7-4
Subclavian
Magum
.

) (Basilar Artery .

) :(7-4

) : (7-5

) : ( 7-6

) : (7-7
):(Branches of The Cranial portion
-1 .
-2 .
.
Radicular
.
-3
.
. Radicular
.
-4
.
-5 .
) ) :(Basilar Artery 7-5 ( 7-6
) (Basilar groove
.
):(Branches
-1 ) :(Pontine arteries .
-2 ) (Labyrinthine artery
.
-3 ) (Anterior Inferior Cerbellar artery
. .
-4 ) (Superior cerebellar artery
. .
-5 ) (Posterior Cerebral artery

.

) (Cortical Branches
) ( .
) (Central Branches
.
) (Choroidal branch .
) ) :(Cricle of willis 7-5 ( 7-6
.
) ( 7-5 ) .(7-6

.
.
.

.

:Arteries to specific Brain Area

.
.
.
.

.
.
)(Veins of The Brain
.
.
.
):(External Cerebral Veins
) (Supierior cerebral veins
.
) (Superficial middle cerebral Veins
.
) (Deep middle cerebral vein
) (Striate
) (great cerebral vein ) (Straight Sinus
.

):(Internal cerebral veins

) (Thalamostriate vein ) (Choroid vein

Great cerebral vein ) (Straight Sinus .
):(Veins of Specific Brain Area
.
.
.
.
) ) (MENINGES ( 7-8
.
.
)) (Dura mater (Pachymeninges
. Pia mater
.

Arachnoid mater Leptomeninges
.

) : ( 7-8

Dura mater
Periosteal layer
. Menineal layer
.
Venous Sinuses ) .(7-9

) :(7-9 .

.
Falx cerebri
Crista galli .
Tentorium cerebelli .
Posterior cranial fossa .
Tentorial incisure
) . (7-10
) .(7-11

) :(7-10 .

Falx cerebelli .
.
.

) :(7-11 .

Diaphragma sellae Sellae Turcica

infundibulum
Pitiutary stalk ) . ( 7-10

.
.
:
-1 Middle meningeal artery
.Internal maxillary artery
-2 Anterior meningeal artery
.Ophthalmic artery
-3 Posterior meningeal arteries
.

Epidural space
Subdural space .
Pia mater
Pia intima
.Epi pia
Pia intima .

Perivascular space
) .(7-8
. Epi pia
.
Epi pia
pia intima ) .(7-12
Leptomeningeal .

) :(7-12 .

Arachnoid

.

Subarachnoid space Cerebrospinal fluid .
) .(7-12
Leptomeniges .
Median

Ventricular system Central canal
.aperture
) (Foramen of magendie ) Lateral apertures
(Foramen of Luschka .


.
.
Cistern
.
) : (7-13 ) ( 7- 14
Cisterna magna
Cerebellomedullary cistern
.
Lumbar cistern
.

) : ( 7-13

) :(7-14 .

Arachnoid granulation

.
) . ( 7-8
.

.

)(Cerebral venous sinuses

.
.
- ) ( 7-10
-1 ):(Superior sagital sinus
) (Logitudinal cerebral fissure .
Foramen caecum
.
-2 ): (Inferior sagital sinus

.
-3 ):(Straight sinus

.
- ) ( 7-11
-1 ):(Transverse sinuses
.
- ):(Sigmoid sinuses

) (Jugular foramen (Internal
) Jugular vein.
-3 ):(Cavernous sinuses
Sphenoid
.

.
-4 ):(Petrosal sinuses
) (Superior petrosal sinus
.
) (Inferior pectrosal sinus
.

)(Clinical points
.A Malfunction of the limbic system
) Senil dementia ( .
.
.B :Interuption of the cerebral circultion
5-10 .
.

.
.
.C :
:
.Paracentral
- ) (Apathy
.D :
:
-1 )
(
-2 ) ( .
-3 Optic Radiation
.E :
:
.1 Calcarin
.2
.3
-F :

.
.1
.2 ) (
.
-G :

. .
:Blood Brain Barrier

- ) (Toxic .
.
.
Pineal body Luber
cinereum optic Recess Area posterma .
) (Tight Junction
. - .
.

)(Cranial Nerves
12 12 ) (I - XII
.
I ) (Olfactory II
XI ) (Accessory
9 . .
) (Superficial Origin
. X ) (Vagus
.
II I VIII ) (Special sensory Input .
IV III VI .
XI XII ) XI - XII
(.
IX VII V X .
IX VII III X .

) (Functional component . :

I ) :(Olfactory Nerve
) (olfactory mucous membrane
.
) (olfactory bulb
) . (8-1

) : ( 8-1

) (

) . .(8-2

) : ( 8-2

) (olfactory tract

) (medial and lateral olfactory stria
) . .(8-2
Lateral stria . medial stria
.
piriform
.

)(clinical points
-1
Neuroepithelum .
-2 )(Anosmia
: .
: .

:
Anosmia.

II )(Optic Nerve
) (optic pathway .
)(clinical points
) (visual field :

) (8-3 .

) (circumferential blindness .
.

) : ( 8-3

III )(Oculomotor Nerve

. ) (
) (
.

.
) (superior orbital fissure .

. (ciliary ganglion
) (Short ciliary Nerves
) .(8-4

) : ( 8-4 .

)(clinical points
-1 (complete oculomotor paralysis) III
III .
) (External strabismus
. .
) (Diplopia.
) (ptosis .
.
.
( Incomplete oculomotor Paralysis ) III

.

Internal ophthalmoplegia External ophthalmoplegia .
IV )(Trochlear Nerve
. Trochlear . .


) (superior oblique ) . (8-4
)(clinical point

.
)(Trochlear Nerve

. .
V )(Trigeminal Nerve
(V1) ophthalmic
(V2) Maxillary (V3) Mandibullar
) (Trigeminal .

.

) (Trigeminal ganglion ) (petrous
) (Temporal bone

. .


Mylohyoid Tensor Veli palatini Tensor tympani .

Petrous .
ophthalmic maxillary
mandibullar
.
) (ophthalmic

.
(V1) ophthalmic Nerve
) (Lacrimal Nerve ) (Frontal Nerve )) (Nasociliary Nerve (8-5

) : ( 8-5

) (Maxillary ) (V2
. .
) (Foramen Rotundum
Pterygopalatine Pterygopalatine
.
) (Inferior orbital fissure .
) (Infraorbital foramen .
) (Zygomatic
Pterygopalatine

Pterygopalatine ) .(8-5
(V2) Maxillary Nerve
Zygomatic Nerve superior Alveolar Nerve
) . . (8-6

) : ( 8-6

) (Mandibular Nerve V3
.
.
) (Foramen ovale .
Otic .
) (parotid gland .

.
) (Medial pterygoid Muscle
) (Ramus of mandible .
chorda tympani chorda tympani

) (submandibular ganglion .
) (sublingual .
inferior Alveolar

2
) (lingual Nerve lingual
3
2
chorda tympani ) (8-5
3

) . (8-6
)(Masseter, temporalis , medial & lateral pterygoid
Tensor Tympani Tensor Veli Palatini Mylohyoid

Digastric
) .(8-5

)(Clinical points

Tensor tympani .
:(Trigeminal Neuralgia) Tic Doulourex
.
VI ):(Abducent Nerve
.


) . (8-4

)(Clinical points

:
) :(strabismus .
) (Internal strabismus ) (External strabismus
.
-2 ) :(Diplopia
subjective .
-3 ) (Ptosis .
-4 ):(Abducend Nerve lesion
.
.
) ( .
VII ):(Facial Nerve


) (Facial Nerve proper ) (Intermediate Nerve
. Petrous
- ) (Stylomastoid Foramen .
) (Geniculate ganglion
.
) (Facial Nerve Proper
-
Platysma Stapedius . ) (Intermediate Never
Pterygopalatine

chorda typani sublingual

.
) (visceral afferent Geniculate
2
Chorda typani Solitary .
3
) (Somatic afferent
.
Trigeminal.
) (Visceral efferent
Pterygopalatin Submandibular
) . (8-7

) : ( 8-7

)(Clinical Points
) (Facial Nerve Paralysis :
Stylomastoid
.
Chorda typani
2
.
3

Stapedius
.
.

.

VIII )(Vestibulo cochlear Nerve

) (Vestibular Nerve
) (Cochlear Nerve
.
) :(Vestibular Nerve Utricle Saccule
) (Position ) ( semicircular Canals
.
) (Vestibular ganglion .

.
. ) (8-8
.

) : ( 8-8

) :(Cochlear Nerve Corti

) (Cochlea Spiral
.

Cochlear Nuclei
) (8-9 .

) : ( 8-9

)(Clinical Pionts

Vestibular ) Position (Movement.
Cochlear .
Vestibular .
Cochlear .
IX )(Glossopharyngeal Nerve

Jugular .
Jugular ) .(8-10

) : ( 8-10

) (Branchial Efferents Ambiguus

Stylopharyngeus . ) (Parasypathetic preganglionic
) (Inferior Salivatory nucleus tympanic
) (lesser petrosal ) (Otic ganglion
Postganglionic ) (Parotid gland .
) (Solitary .

) (Petrosal ganglion
)(Solitary tract
) (VPM .
1
) (Solitary
3
. ) (Sinus Nerve
) (Carotid body ) (Carotid sinus
. .
1

3
) (Superior ganglion
.
) :(8-11
2
.
3
1
.
3
) (Epiglottis .

)(Clinical Pionts
.
) (Gag Reflex ) (X

) ( .
X )(Vagus Nerve

.
) (Branchial efferent Ambiguus
) . (8-11
) (Recurrent laryngeal ) (Intrinsic
.
) (Dorsal Motor Nucleus
.
.
.
) (Somatic afferent fibers
) (jugular ganglion ) (auricular
.
) (Recurrent Meningeal ) (Posterior cranial fossa

.
.

) : ( 8-11

) (Visceral afferent fibers

) (Nodos ganglion
.

.

) . (8-11

Ambiguus Corticonuclear .
.

)(Clinical Points
.

.
.
.
.

.
XI )( Accessory Nerve
Accessory ) .(8-12
.
Ambiguus ) (Intrinsic
. Accessory
.

) ( Accessory
Magnum ) (Jugular foramen
. - - ) (SCM )(Trapezius
) .(8-12

) : ( 8-12 XI

)(Clinical Pionts
) (Accessory Nerve -
) (Trapezius . - - ) (SCM
. Trapezius
.
XII ):(Hypoglossal Nerve

.
) (Foramen Magnum ) . .(8-13

) : ( 8-13

Internal Jugular
) (Digastric
Mylohyiod .

) (Intrinsic Genioglossus , Styloglossus

Hyoglossus ) (Extrinsic .
) (C1
) (Ansa cervicalis
C2 C3 ) . (8-13
) (Proprioceptive
.

)(Clinical Pionts
.
.
-
)( Genioglossus
. -

Genioglosus .
:

1
2
) (.
3
3
.
. IX VII V X
.
) (Functional Components ) (Function
.

.
. .
2
2 .
. . .

.
.
.
3
.
.
.
.
. " "
.
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.
. .

.
:
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3 5 .
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.
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35 .
3 .
4 . 4 6 6
7 . 8 10
11 12 . 9

10 . 1
4 ) (.... 12
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15 .
.
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10 .
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.
5 4 .
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2 5 50 100 2000
. 2-3
.
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7 .
.
10-20
. .
.
.

) (CNS .
-1 -2.
-3.
.
: CNS CNS .

CNS . Na + K + .
. 2%
20% .
CNS : .
CNS .
.
.
.
: CNS .
CNS .
.
CNS .
.
:
CNS ) . (1

.

.

) ( .
.

. CNS
.
CNS .
.
CNS .

. CNS

. CNS

CNS
. .
CNS .
CNS .

:

ATP .
2
. GLUT-1 .
GLUT-3 ECF .
GLUT-1 .
ECF
.
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CNS
.
. .
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GABA .
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.
.
.
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.
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. .
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.
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:
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.
.
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. .

.

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) (PLP ) (MBP . PLP
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.
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.
cAMP .

.

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.
.
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.
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. .
.
.
. 9%
.
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. .
.
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.
.
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.



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.
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.
Ca 2+ .
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.
.
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. MAO
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MAO-B
.
MAO
.
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.
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18

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-
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.
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NO .
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:
CNS .

. CNS

.
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.
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.
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.
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.

.

.


Movement

) MOTOR SYSTEMS (

"
" . Somatic Motor Systems
.
.
:



.
.
.
.

.
. CNS
.
.
.
.

.
:

-1 CNS
-2

 -3
-4

:
:
.
.
:
.

Posture Reflexes Locomotion
Voluntary movement .

(Lower Motor Neurons) LMN .
Motor Unit :
). (Fig. 1

) Motor Unit (

.


)(Fig 2. -A,B

Fig 2

.1
.2
.3
.4

.A

Unit Motor Pool (Fig. 2-B) .

B ) (motor pool

(Final common path)Motor Unit .

.

.

 .
.
)(Fig. 3

Fig 3

: A Chromatolysis
: B CNS
: C
: D
: E
Degeneration Sprouting
Regeneration Reinnervation
Plasticity .

 : Size Principal
tonic : phasic

.

.

Motor Unite :
Gastrocenemius
) . ( 2000

) . 3 6 (

: ( MSR ) Muscle Stretch Receptors

Muscle Spindle ). (Fig. 4

(GTO) Golgi Tendon Organ
)(Fig.4-D

Fig 4

) (intrafusal
lextrafusal

) (

)(Golgi

Muscle Spindles
.
.
Intrafusal fibers Extrafusal fibers
) . (Fig. 4-A : Nuclear Bag

dynamic static
Nuclear Chain
). (Fig. 4-B
.
Bag fibers Chain fibers .

 )(Fig. 4-C
) ( DRG . Primary Ia
12 20 nuclospiral Nuclear Bag
Nuclear Chain .
secondry II 4 12 NB NC
Flower Spray .
.
3 8 NB NC ) . (
.
) (MS ) (
. :

gd
gs

):(MS
) (Tension ) (Tone .
tone
.
Ia DRG
) (interneurons
.
II . I
Propriospinal
) Extrafusal (
.
- ) (MS Ia gamma loop ) . (Fig. 5
.

Fig 5


(GTO) Golgi Tendon Organ
Ib
DRG .
Ib ) (
(Fig. 4-A, D) .)(Fig. 6
Ib
antagonist .

Fig 6

 :
.
, .
Reflex arc :

-1
-2
-3
-4
-5

) (
) ( CNS
) (
) (
) (

Stretch Reflex
Ia
) (Synergic . Ia

Stretch Reflex .
knee jerk reflex Myotatic Reflex
tone . ) (monosynaptic
).(Fig. 7, 8

Fig 7

CNS ) .(Spinal Stretch Reflex
hyper - reflexia .
CNS disinhibition
.

hypotonus .
hypertonus spastic paralysis .
strok Hypotonus
flaccid paralysis .

 : Withdrawal - Reflex

)(Fig. 9-A) (crossed reflex polysynaptic .

. .
) withdrawal ( Mass reflex
. polysynaptic
.
) ( ). (Fig. 9-B
Fig 9 -A

Fig 9 B

muscle stretch
Ia . reciprocal inhibition
. - Ib
GABA . Renshaw
. recurrent inhibition
collateral Glycine
. Ia
disinhibition . Renshaw
CNS (Fig. 10 A,B) .

Fig 10

 A B

Lower Motor Neuron :

Bell's
palsy )
( .
Currar Botulium .

) ( .


.
Spinal Shock
.
) ( apoptosis
Motor Unit (EMG) Electromyogram .
Motor Units
Motor Unit .

) (

.
LMN .
(UMN) Upper Motor Neurons
.
.
gamma loop
tone .
.
alpha rigidity .

. pyramidal tract
" "Extra Pyramidal System .
.

.
, . % 85

) (Cross ) (
interneurons .
% 15 cross
. Corticospinal .

. Corticobulbar Corticonuclear ).(Fig. 1

 .
-
.
Primary Motor area ) M1 ( % 30
% 2 Betz 5
.

) (Fig.2

.
) .(Fig.3
) .(Fig.4 % 30
) Supplementary Motor area (SMA ) Premotor aera (PMA .
).(Fig.5

Fig 3

) (

 (Fig. 6) :
: SMA
.
.
.
.


.

: PMA
6 .
.
. .

.

: Frontal Eye Field

8 6
.
. .

: Sensory Motor area

.
: Mirror Neurons
PMA
.



.

Fig 6

:
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) (UMN .

.
) (paralysis ) (Paresis
.
2 tone Hypertonocity Extensor Hypertonus
Flexor Hypertonus fixed postures . spasticity
.
Babinski Sign - 3 Plantar Reflex
.
) (Babinski

 ) . (Fig. 7
.
Fig 7

4
knee jerk passive .
5 Corticobulbar
.
.

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Basel Ganglia

.

) (

.
. .

Extrapyramidal
Pyramidal paralysis paresis
.


.

.


.
) ( .
.
frontal eye field cognitive .
.
) (
.
:
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D1 D2 .
) (SNe D1
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.
. .

-2 )(+ )(
) ( - )( .
-3 .
.

 VA-VL .
.
-4
.
) (Fig.3 .

VA-VL
.
D1 D2
.



.

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- . akinesia bradykinesia
mask resting tone ) (rigidity tremor
EMG 4 6
.
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.
.
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.
.
stereotyped Tics
.

L-Dopa BBB .
. .

.


) (
.

) (

CEREBELLUM

.
. ) Posture ( ) Balance (
.

.

:
.
.
.
.
.
Inferior Olive .

:
:
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.
.

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) ( .
) Spinocerubellum ( .
ipsilateral .

) ( ) ( fastigial
.

 globose emboliform
) VA-VL (
. PMA SMA
M1 .
gait ataxia .

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.
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.
.
)
( .
.
.
. Fig.2 .

Fig.1



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. .

.
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. l .
). (Fig.3B) ( posture

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( Fig 5 A , C ) dysmetria .

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.

:
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-2
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-4

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.

.

 -5
.

.

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.
B
.
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. .

) (RAS=Reticular Activating System .
.
.
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.
. .

. .
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.
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.
.

.
.
.
.
). .(1

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.

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.

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REM 5 30 90
. REM
. REM
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REM .

 -4 .
.
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:
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5 .
.

. 23 4
4
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:
1 2 70 100 3 4
. . 90

 . 3 4
REM . 80 50
. REM 25
. 4
.

:
.
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.
REM Reticularis Pontis .
REM .
) ( ) Raphe (
REM .
REM .
Muramyl Peptides
I D2 .
. E2 .

) (
.
. .
10

.
.

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.

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.

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) (Somnambulism ) (Nocturnal enuresis
. REM .
.
.
) (Narcolepsy
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REM . REM .
) (Sleep apnea .

. .
. .
.

.
REM
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.
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.

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autonomic nervous system .

.
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.


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.

.
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) (association .
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.

1- kandel, E.R, Schwartz, J.H, Jessel, T.M, Principle of Neural Science, 4 ed. 2000,
Mc. Graw Hill co.
2- Ganong WF., Review of Medical Physiology 21st ed. 2003, Lange Publisher.
-3 1999
-4 2006
& 5- SIEGEL A. and SAPRU H.N., Essential Neuroscience, Lippincott Williams
th

Wilkins, 2006.

87/3/12 .

:

. .
.1 .
.2 .
.3 .
.4 .
:
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Catecholamines (ChA) -2
-3
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Ader 1975 Cohen
SRBC
.

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.
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.
.
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.

.
.
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. .

.
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.
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NK
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.

.

.
.
) (10-6 M

.
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) (NE ChA .

.

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.
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.
) -4 (

.
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.
.
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CRF IL-1 ACTH .
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.
HPA
.
.
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.
.
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.
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.
IL-1 TNF- IL-1 IFN- . TNF- .

.
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IL-1 IL-1

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. :
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.
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.
.

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.
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.

.

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) (Acute inflammatory demyelinating polyneuropathy

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.
) (Multiple Sclerosis=MS
.
MS (Immunomodulatory
) therapy .
myasthenia gravis
.

.
.

ACTH:

Adrenocorticotropin Hormone

ChA :

Catecholamine

CNS

Central Nervous System

CRF:

Corticotropin- Releasing Factor

HCG:

Human Chorionic Gonadotropin

HPA :

Hypothalamic-Pituitary- Adrenocortical

IFN-s

Interferons

IL-1:

Interleukin-1

IL-6:

Interleukin-6

MS:

Multiple Sclerosis

NE :

Neurepinephrin

NK :

Natual Killer Cell

SRBC:

Sheep Red Blood Cell

TNF-

Tumor Necrotizing Factor-

.

. Egas Moniz 1927 ) ( Felix .
Bloch Edward Purcel 1952 2
Cormack . Hounsfield
3 1979 .

6
, 4 SPECT 5 PET .
Peter Mansfield Paul Lauterbur
2003 . 1990 7
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B

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MRI 0/5 3 .
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. Neuroimaging
. Nuclear Magnetic Resonance, NMR

. Computerized axial tomography, CT-Scan

1
2

3
4

. Single Photon Emission Computerized Tomography, SPECT

. Positron Emission Tomography, PET
6
. Magnetic Resonance Imaging, MRI
7
. Functional Magnetic Resonance Imaging, FMRI
8
. Precession
5

2 .
.
. 3 90 180
90 180 . 4 90
.

3 90 180

5 NMR NMR .

4 90

9 10 .
5
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. MRI
.
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.

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PD

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Muscle
Grey matter
White matter
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Fat
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Grey matter
CSF

.

.

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MRI .

17

MRI .

. " "18

1. Partial saturation
12
. Inversion recovery
13
. Spin echo
14
. Gradient echo
15
). Repetition time ( TE
16
). Echo time (TE
17
. MR Angiography
18
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.
.

19

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MRI .

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. 9 .
20

21
23

31

39

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13

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9 FMRI

10

.

. .
. 1
. 1
.
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19

. Functional MRI, FMRI

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21
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22
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20

. 24
.
.
.
.
25
1 26 . 1
.

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23

. Helical
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25
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26
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24

. 3 .

,
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. PET SPECT
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.


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123
. I -
99m
99mTc-hexamethyl propyleneamine oxime, HMPAO iodoamphetamine, IMP Tc-
ethyl cysteinate dimmer, ECD . SPECT
PET
CT-Scan MRI


. 1 PET CT-Scan .

.

. 2 . 3 SPECT
.

1 ) PET( ) CT-Scan ( ) (

3 SPECT

F .
) 80 ( PET
18F-2-fluoro-2-deoxy-D-glucose, 18F-FDG .
.
18

Normal Brain
Transaxial

Sagital

Glioma

Coronal

PD

T2

MR-Gd

FDG-PET

T1

T2

Acute cerebral infraction

PD

FDG

T2

CT

:

.
. :
.

.


.
.
.
.
.
.
.... .
.
.... .
.


. ) (
- ... .
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.
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. .
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.
.
.
) ( .

.
imaging .

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orientation attention span
) (judgment
.
.

.
.
.... .
.
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.
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.
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.
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Visual acuity Visual field
fundoscopy .
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snellen 6 .
.

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.
.
.
. .

scotoma .

.
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(lower bitemporal quadrantanopsia) .
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optic tract
) (homonymous hemianopsia
.
.

.
. .

. .

.
) . (Marcus-Gunn
.
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) (
.

. .
.
diplopia .
.
.
) ( .
) ( .
:
(1 .
(2 .

) ( .

.
.
: IV Trochlear nerve
.
. .
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.
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.
. .

.
.
.
jaw reflex .
.
.
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.
.
:VII :Facial Nerve
.
. .
... .
.
.
.

. ) (
. ) (
. .
.

.
.
:IIX - Vestibulocochlear Nerve
: cochlear Auditory Vestibular .

. ) (
. Rinnes test
. .

.
.
Webers test .
.
.
Caloric Position .
30
5-10 .
.
. position
.
45 30 .
.
.
:IX :Glossopharyngeal Nerve
.
stylopharynglus .

(Gag Reflex) .
.
.
:X :Vagus Nerve

. .
Ahh .
.
.
.
recurrent laryngal .

:XI :Spinal Accessory Nerve

.
.
- .
.
: XII :Hypoglossal Nerve
.
.
.
.
.
.
.
- :
.

.

. .

. :
(1
(2
(3
(4

(5
.
.
.
.

.

.

. :
(1 Two point Discrimination:
.
. .
4-5 3-4 .
(2 Stereognosis
: .... .
(3 Double Simultaneous Stimulations

.
.
(4 Graphes Thesia
.
(5 :Bares Thesia
) 1-3( .
.
(6 Tactile localization
.
. 2-3
.

. .
. .

.
) (Tone ) (passive .
.
.

) (relax .
.
) (Strenght
. hemiparesis .
.
.
(1 : .
. .
(2 :
.
(3 : .
(4 : .
(5
) (finger Abduction .

:
(1 : .
(2 :
.
(3 :
.
(4 :
.
:
.
. .


.
: :
(I ) Deep Tendon Reflexes (DTR

) Muscle Stretch Reflexes (MSR .

. .

.

(1 :
.
. C5 C6 .
(2 :
. C7 C8 .
(3 :
. . C5 C6
.
(4 .
. C7
C8 T1 . .
(5 : .
. .

. L3 L4 .
(6 : .
S1 S2 L5 .
. . . .
.
jendrassik Reinforcement
. .
. .
DTR .
.
.
:II :
.

. .
.
) ( .
. T6-9
T9-11 T11-L1 .
:III :
.
. .
L1-2 .

:IV :
.
.
Babinski .
:
(1 .
(2 : Oppenheim .
(3 :Schaefer .
(4 : Chaddock .
2 .
:V
.

. :
(1 :grasp
. .
(2 : snout
.
(3 : sucking .
.
(4 :Glabella .

.
(5 :Hoffmann .
C7 .
(6 : Chewing
.

Coordination
posture :
.
. .
) (wide-base-gait
. .
. :
(1

(2

(3

(4

(5

(6

(7

.
)(finger to nose to finger test
: heel-shin
.
.
intention tremor .
Heel-Toe walking : Tandem gait
.
.
:Rebound
.

.
: Adiodocho Kinesia
) (alternative movement
.
:Tremor
.
)(intention tremor
.

- :Stantion & Gait

.

... .

.
.
.
:
(1 :
.
. .
(2 : .
.
(3 :scissor gait
. .
) ( .
(4 )( : ) (wide base gait
.

(5
(6
(7

(8

(9
(10
(11

:Festinating gait .
.
) : (waddling gait
. .
) ( : Sensory ataxia

.
.
.
.
steppage :equine gait
.
. .
:Drunken gait staggering gait
. .
: Senile gait
. .
: Limping gait

. posture
.
.

.

CT MRI .
) (CSF=Cerebrospinal Fluid
.
:CSF
Quincke . CNS

.
.

.
3- 4/5 .

. .
10-20 .
CSF .
(I :
CSF .
. )
( .
(II :CSF
CSF
. CSF CSF .
.
CSF .
20-30 CSF
.
CSF . CSF
CSF .
CSF 1000
mgr/dl CSF .
CSF .
CSF CSF .
CSF .

. CSF 24
6 CSF .
(III : CSF
CSF 40-70 mgr/dl 40 mgr/dl
.
CSF .
(IV :CSF
CSF 15-45 mgr/dl 10-25 mgr/dl
5-15mgr/dl . CSF
.
1000 mgr/dl . CSF
1000 mgr/dl .
(V : CSF

.
CSF CSF
CSF CSF .
CSF CSF ) (.
CSF .
CSF .
:
.1
.2 CSF .
.3 CSF .
13-23 . 24
3-4 . CSF
. :
.1 .
.2 .
.3 .
.4
:Electroen cephalography=EEG
EEG
.
.
EEG

.
.
8-12
. .
.
12 .
EEG
.
) 5-7 ( . sleep spindles
. non-REM .
Vertex wave .
K-Complex
.
.

. 20 .
.1 EEG :
.2 sharp 70-200 .
.3 spike 70 .
.4 ) (sharp-slow )(spike-slow
EEG .
EEG .
(hyper
) ventilation .
EEG
. 3
.
EEG
. EEG .
.....
.
EEG . EEG
EEG
EEG .
:Evoked Potentials
.
.
. .
.
Visual evoked potential
.
.
.
Somatosensory Evoked Potential
. .
Brain Stem Auditory Evoked Responses .
.
.

) Electromyography (EMG) and Nerve Conduction Velocity (NCV
.
. .

.NCV

latency .
.
.
.
EMG
. EMG
.
. .
.
motor units
.

. EMG
2-3 .
EMG . :
.
Fasciculation
) (motor unit .
.
.
NCV EMG :
(1
(2
(3
(4
(5
(6
- Biopsy

. .
.
.

.
:

(I SGPT SGOT LDH CK CK

.
.
(II Tensiton
.
(III 24 .
(IV
.
(V
.
(VI
.... .