WhatdoesWhitematterincludes?

Thecerebralcommissuresandtheinternalcapsule.

a. Cerebralcommissuresinterconnectthecerebralhemispheresandincludethefollowing
structures:

CorpuscallosumIthasfourparts,includingtherostrum,genu,body,and
splenium.

Anteriorcommissureinterconnectstheolfactorybulbswiththemiddleand
inferiortemporallobes.

Hippocampalcommissure(commissureofthefornix)locatedbetweenthe
fornicesandinferiortothespleniumofthecorpuscallosum.

.InternalcapsuleWhitematterlocaedbetweenbasalnucleiandthethalamus.Ithasfive
parts:

Anteriorlimblocatedbetweenthecaudatenucleusandputamenand
containsamixtureofascendinganddescendingfibers.
 Genulocatedbetweentheanteriorandposteriorlimbsandcontains
primarilythecorticonuclear(corticobulbar)fibers.

Posteriorlimblocatedbetweenthethalamusandlentiformnucleus
(comprisingtheputamenandtheglobuspallidus)andisprimarilymadeupof
corticospinalfibers.

Retrolenticularportionlocatedposteriortothelentiformnucleusandcontains
the opticradiations.

Sublenticularportionlocatedinferiortothelentiformnucleusandcontains
auditoryradiations.
Whatdoesdiencephalonreceivesandcontains?

Receivestheopticnerve(CNII)andconsistsof:

Epithalamus
(Dorsal)Thalamus
Hypothalamus
Subthalamus(ventralthalamus)
Thirdventricle.
WhatdoesMesencephalon(Midbrain)contains?

Itcontainsthecerebralaqueduct(Sylvius)

1. Anterior surface : Cerebral peduncle and Interpeduncular fossa that contains the
Oculomotor nerve (CN III)and Posterior perforated substancecreated by the penetrating
branchesoftheposteriorcerebralandposteriorcommunicatingarteries.

2.Posteriorsurface:Superiorcolliculus(visualsystem),Brachiumofthesuperiorcolliculus,
Inferiorcolliculus(auditorysystem),Brachiumoftheinferiorcolliculusandtrochlearnerve(CN
IV):theonlycranialnervetoexitthebrainstemfromtheposterioraspect.
WhatdoesPonscontains?

Anterior:

Baseofthepons
Cranialnerves:includingtrigeminalnerve(CNV),abducentnerve(CNVI),facial
nerve(CNVII),andvestibulocochlearnerve(CNVIII).

Posteriorsurface(rhomboidfossa):

Locusceruleus:containsthelargestcollectionofnorepinephrinergicneurons
intheCNS.
Facialcolliculus:containstheabducentnucleusandinternalgenuofthefacial
nerve.
Sulcuslimitans
Striaemedullares
Whatdoesthemyelencephalon(MedullaOblongata)contains?
Anteriorsurface:

Pyramid
Olive
Cranialnerves:Includingglossopharyngealnerve(CNIX),vagusnerve(CNX),
(spinal)accessorynerve(CNXI),andhypoglossalnerve(CNXII)

Posteriorsurface:

Graciletubercle
Cuneatetubercle
Rhomboidfossathatcontains:Striaemedullaresoftherhomboidfossa,Vagaltrigone,
Hypoglossaltrigone,SulcuslimitansandAreapostrema(vomitingcenter)
Brainstemiscomposedof?

Iscomposedofmidbrain,ponsandmedullaoblongata.
 EMBRIOLOGY

Howisneuroectodermfom?
Bcnotocordinduceectodermtoformneuronalplate(neuroecoderm)

Note:CNSandPNSarederivedfromneuroectoderm

WhogivesrisetoCNS?
Neuraltube givesrisetothreeprimaryvesicles(forebrain,midbrain,andhindbrain),which
developintosecondaryvesicles(telencephalon,diencephalon,mesencephalon,metencephalon,
andmyelencephalon).

BesidesfromCNS,neuraltubegivesrisetowhichstructures?

Skeletalmotorneurons
PreganglionicAutonomicneurons

Thebrainstemandspinalcordarecomposedof?

Analarplategivesrisetosensoryneurons.
 Abasalplategivesrisetomotorneurons
Interneurons(connectorneuronsarederivedfrombothplates.
 WheredoyoufindtheAFP,isanindicatorofwhat?andwhichpeoplehaveit
reduced?Andwhichpeoplehaveitelevated?

Isfoundintheamnioticfluidandmaternalserum.
Itisanindicatorofneuraltubedefects(e.g.,spinabifida,anencephaly).
AFPlevelsarereducedinmothersoffetuseswithDownsyndrome.
Elevated:Gatrochisisandonphalocele

Theneuronalcrestgivesriseto?

PNSPeripheralnerves(cranialandspinalnerve),sensoryandpostganglionic
autonomicneurons
Nonneuronalcelltypes

Whicharethenonneuronalcelltypethattheneuronalcrestgivesriseto?

Pseudounipolarcellsofthespinalandcranialnerveganglia
Schwanncells(whichelaboratethemyelinsheath)
Multipolarcellsofautonomicganglia
Cellsoftheleptomeninges(thepiaarachnoid),whichenvelopthebrainandspinal
cord
Chromafincellsofthesuprarenalmedulla(whichelaborateepinephrine)
Pigmentcells(melanocytes)
Odontoblasts(whichelaboratepredentin)
Cellsoftheaorticopulmonaryseptumoftheheart
Parafollicularcells(calcitoninproducingCcells)
Skeletalandconnectivetissuecomponentsofthepharyngealarches

AllgangliafoundinPNScontains?
Sensory
Postganglionicautonomicneurons
Failuretoclosecranialneuroporegivesyou?
Anencephaly(i.e.,failureofthebraintodevelop).

Failuretoclosecaudalneuroporegivesyou?

Resultsinspinabifida

FromwhereisAdenohypophysisderived?

Fromanectodermaldiverticulumoftheprimitivemouthcavity(stomodeum),
whichisalsocalledRathkepouch.
RemnantsofRathkepouchmaygiverisetoCraniopharyngioma.

FromwhereisNeurohypophysisderived?

Fromanevaginationofthehypothalamus(neuroectodermoftheneuraltube).

Whatiscraniumbifidum?
Defectintheoccipitalbonethroughwhichmeninges,cerebellartissue,andthefourth
ventriclemayherniate.

WhatisChiarimalformation?

Resultsfromelongationandherniationofcerebellartonsilsthroughtheforamen
magnum,therebyblockingCSFflow.Canbeaccompanyingbymeningomyelocele.
WhatisDandyWalkersyndrome?

Anenormousdilationofthefourthventricleresultsfromfailureofthelateralforamina
(ofLuschka)andmedianforamen(ofMagendie)toopen.
Thisconditionisassociatedwithoccipitalmeningocele,elevationoftheconfluenceof
thesinusesagenesisofthecerebellarvermis,andspleniumofthecorpuscallosum.
Mayresultfromriboflavininhibitors,posteriorfossatrauma,orviralinfection.

Whatisholoprosenchepaly?
Failureofleftandrighthemispherestoseparate;usuallyoccursduringweeks56.
Mayberelatedtomutationsinsonichedgehogsignalingpathway.
Moderateformhascleftlip/palate,mostsevereformresultsincyclopia.
Seenintrisomy13andfetalalcoholsyndrome

Whatishydranancephaly?

bilateralhemisphericinfarctionsecondarytoocclusionofthecarotidarteries
Thehemispheresarereplacedbyhugelydilatedventricles.
WhatistheAutonomicnervoussystem?Andinwhatitconsist?

Theautonomicnervoussystem(ANS)isageneralvisceralefferentmotorsystem
thatcontrolsandregulatessmoothmuscle,cardiacmuscle,andglands.
Consists of a twoneuron chain from the CNS to the effector: a pre and
postganglionicneuron.
Isgenerallyreflexiveandisinfluencedbythehypothalamus.

WhatarethedivisionsoftheANS?

Symphatethic
Parasympathetic
Enteric

Whataresymphateticnervoussystemcharacteristics?

Preparesthebodyforactionfightorflight
Usesalotofenergy.Functionisnonspecific.
PreganglioniccellbodiesinthespinalcordbetweenT1andL2,formthe
intermediolateralcellcolumnofthelateralhorn.
Postganglioniccellbodiesarefoundinthesympatheticchainprimarilyfor
innervationofthebodywall(i.e.,erectorpili,bloodvessels,andsweatglands)or
inprevertebralgangliaforinnervationofthegut.
Whatareparasymphateticnervoussystemcharacteristics?
 Responsibleforrestingstateofthebodyrestanddigest
Conservesenergy,functionsmorespecificallybecauseoftheshortpostganglionic
fibers(i.e.,itcanactivatetargetswithmorespecificity)
PreganglioniccellbodiesinthebrainstemassociatedwithCNsIII,VII,IX,and
X,andthesacralspinalcordS2S4
Postganglioniccellbodiesarefoundintheciliary,otic,pterygopalatine,or
submandibulargangliaforthehead
AllpostganglionicparasympatheticfibersintheheadruninbranchesofCNVto
reachtheirtargets,andinthewallsofthetargetorganforthebody.

Entericnervoussystemiscomposedof?

Theentericnervoussystemiscomposedoftheintramuralgangliaofthe
gastrointestinaltract,submucosalplexus,andmyentericplexus.

Cranialnerveswithparasymphateticcomponents?
IIIPreganglionic:accessoryoculomotornucleus;postganglionic:ciliaryganglion.

VIIPreganglionic:Superiorsalivatorynucleus;postganglionic:pterygopalatineand
submandibularganglia.
IXPreganglionic:inferiorsalivatorynucleus;postganglionic:oticganglion.

XPreganglionic:Dorsalmotornucleusofthevagus;postganglionic:intramuralganglia.
 Whatarethecommunicatingramiofsympatheticfibers?

WhiteRamiCommunicantes,whicharefoundbetweenT1andL2andare
myelinated.Carryvisceralafferentsandpreganglionicsympatheticfiberstothe
sympatheticchain.
GrayRamiCommunicantes,whicharefoundatallspinallevelsandare
unmyelinated.Carrypostganglionicsympatheticfiberstothespinalnerve.

TheneurotransmisersoftheANSinclude?

Acetylcholine neurotransmitter of the preganglionic and postganglionic

parasympathetics.
Norepinephrine which is the neurotransmitter of the postganglionic
sympatheticneurons.
Dopamine whichistheneurotransmitterofthesmall,intenselyfluorescent
(SIF)cells,whichareinterneuronsofthesympatheticganglia.

FamilialDysautonomia(RileyDaySyndrome)predominantlyaffectsJewish
children.Itisanautosomalrecessivetraitthatischaracterizedbyabnormal
sweating,unstablebloodpressure(e.g.,orthostatichypotension),difficultyin
feeding(asaresultofinadequatemuscletoneinthegastrointestinaltract),and
progressivesensoryloss.Itresultsinthelossofneuronsintheautonomicand
sensoryganglia.

b. RaynaudDiseaseisapainfuldisorderoftheterminalarteriesoftheextremities.
Itischaracterizedbyidiopathicparoxysmalbilateralcyanosisofthedigits(asa
resultofarterialandarteriolarconstrictionbecauseofcoldoremotion).Itmaybe
treatedbypreganglionicsympathectomy.

c. PepticUlcerDiseaseresultsfromexcessiveproductionofhydrochloricacid
becauseofincreasedparasympathetic(tone)stimulation.

d. HornerSyndrome(seeChapter14)isoculosympatheticparalysis.Characterized
byptosis,anhidrosis,miosis,andenophthalmos.
e. ShyDragerSyndromeinvolvespreganglionicsympatheticneurons.Itis
characterizedbyorthostatichypotension,anhidrosis,impotence,andbladder
atonicity.

f. Botulism.ThetoxinofClostridiumbotulinumblocksthereleaseofacetylcholine
andresultsinparalysisofstriatedmuscles.Autonomiceffectsincludedryeyes,dry
mouth,andgastrointestinalileus(bowelobstruction).

g. LambertEatonMyasthenicSyndromeisapreganglionicdisorderof
neuromusculartransmissioninwhichacetylcholinereleaseisimpaired,resultingin
autonomicdysfunction(suchasdrymouth)aswellasproximalmuscleweakness
andabnormaltendonreflexes.