The fourth ventricle is located in the posterior cranial fossa between the cerebellum and brainstem. It has five recesses and communicates with the cerebral aqueduct and central canal of the medulla. The roof is formed by the superior cerebellar peduncles and medullary velum, which contains the choroid plexus. The floor is rhomboid-shaped and formed by the pons and medulla, containing important nuclei. The fourth ventricle plays a role in circulation of cerebrospinal fluid and can be affected in conditions like medulloblastoma and hydrocephalus.
1.Anatomy of the Medulla
2. Introduction to Brainstem Anatomy of the brainstem includes ( midbrain-pons-medulla ) is very complicated !! •It connects spinal cord to the cerebrum. • The mid brain pons, and medulla are connected to cerebellum posteriorly. •1 - ascending an descending tracts that connect brain to spinal cord. •2 - cranial nerves nuclei and their connections •3 - Reticular formation •4 - others e.g (olivarynucleus in MO tapizusbody in pons and red nucleus in MB )
3. Medulla oblongata •The medulla oblongata is the part of the brainstem between the pons and spinal cord •It extends through the foramen magnum to the level of the atlas. •Medulla is vital for our function, without medulla we die. •Above the foramen magnum it is embraced dorsally by the cerebellar hemispheres. 1.The lower end which contains the upward continuation of the central canal of the spinal cord is the ‘closed part of the medulla’, 2.The upper end, where the canal comes to the surface as the lower part of the floor of the fourth ventricle, is the ‘open part’.
4. Medulla contd….. MO is lowest 3 cm of the brainstem •it extend from the ponto- medullary junction until plane below foramina magnum for about 0.5 cm. •Medulla spinalis have a central canal which prolonged into its lower half to open in the fourth ventricle at its upper half. •CSF is encircle the MO from outside ( subarachnoid space ) and inside ( central canal ). •MO is between the two lobes of cerebellum ( anterior cerebellar notch )
5. EXTERNAL FEATURES AND RELATIONS • 3Cm long. • Located at the caudal portion of brainstem • Upper limit is cerebello-pontine angle • Transverse plane that above C1 (suboccipital) intersects upper border of atlas dorsally and centre of dens ventrally marks lower limit
6. VENTRAL SURFACE • Ventral median fissure extends from foramen coecum to caudal end of pyramid decussation • Lateral to median fissure is pyramid • Lat to pyramid is the ventrolateral sulcus (VLS) • Hypoglossal nerve rootlets emerge from VLS • Lat to VLS is olive which contains inf olivary nucleus • Inferior cerebellar peduncle connects medulla with cerebellum and forms side wall of caudal half of fourth ventricle
7. Ventral Surface Pyramid: Swelling on each side of anterior median fissure. • Composed of bundles of nerve fibers, (corticospinal fibers) originate from the precentral gyrus of the cerebral cortex. • The pyramids taper inferiorly and majority of the descending fibers decussate to the opposite side. Olive: • Olives are the anterolateral oval elevations produced by the underlying inferior olivary nuclei. • From the groove between the pyramid and the olive, the rootlets of the hypoglossal nerve emerge
8. LATERAL ASPECT • Roots of glossopharyngeal , vagus and cranial division of accessory nerves are attached to the medulla dorsal to olive.
9. Dorsal surface At dorsal surface of closed part of medulla, gracile and cuneate fasciculi continue from the spinal
1.Anatomy of the Medulla
2. Introduction to Brainstem Anatomy of the brainstem includes ( midbrain-pons-medulla ) is very complicated !! •It connects spinal cord to the cerebrum. • The mid brain pons, and medulla are connected to cerebellum posteriorly. •1 - ascending an descending tracts that connect brain to spinal cord. •2 - cranial nerves nuclei and their connections •3 - Reticular formation •4 - others e.g (olivarynucleus in MO tapizusbody in pons and red nucleus in MB )
3. Medulla oblongata •The medulla oblongata is the part of the brainstem between the pons and spinal cord •It extends through the foramen magnum to the level of the atlas. •Medulla is vital for our function, without medulla we die. •Above the foramen magnum it is embraced dorsally by the cerebellar hemispheres. 1.The lower end which contains the upward continuation of the central canal of the spinal cord is the ‘closed part of the medulla’, 2.The upper end, where the canal comes to the surface as the lower part of the floor of the fourth ventricle, is the ‘open part’.
4. Medulla contd….. MO is lowest 3 cm of the brainstem •it extend from the ponto- medullary junction until plane below foramina magnum for about 0.5 cm. •Medulla spinalis have a central canal which prolonged into its lower half to open in the fourth ventricle at its upper half. •CSF is encircle the MO from outside ( subarachnoid space ) and inside ( central canal ). •MO is between the two lobes of cerebellum ( anterior cerebellar notch )
5. EXTERNAL FEATURES AND RELATIONS • 3Cm long. • Located at the caudal portion of brainstem • Upper limit is cerebello-pontine angle • Transverse plane that above C1 (suboccipital) intersects upper border of atlas dorsally and centre of dens ventrally marks lower limit
6. VENTRAL SURFACE • Ventral median fissure extends from foramen coecum to caudal end of pyramid decussation • Lateral to median fissure is pyramid • Lat to pyramid is the ventrolateral sulcus (VLS) • Hypoglossal nerve rootlets emerge from VLS • Lat to VLS is olive which contains inf olivary nucleus • Inferior cerebellar peduncle connects medulla with cerebellum and forms side wall of caudal half of fourth ventricle
7. Ventral Surface Pyramid: Swelling on each side of anterior median fissure. • Composed of bundles of nerve fibers, (corticospinal fibers) originate from the precentral gyrus of the cerebral cortex. • The pyramids taper inferiorly and majority of the descending fibers decussate to the opposite side. Olive: • Olives are the anterolateral oval elevations produced by the underlying inferior olivary nuclei. • From the groove between the pyramid and the olive, the rootlets of the hypoglossal nerve emerge
8. LATERAL ASPECT • Roots of glossopharyngeal , vagus and cranial division of accessory nerves are attached to the medulla dorsal to olive.
9. Dorsal surface At dorsal surface of closed part of medulla, gracile and cuneate fasciculi continue from the spinal
4 th ventricle- Anatomical and surgical perspectivesuresh Bishokarma
4th ventricle connects the entire ventricular system of brain. Its connection with cisterns magna and cerebella pontine cistern via foramen of magenta and Luschka. CSF absorbs into the arachnoid granulation.
Lateral ventricle of Brain. By Dr.N.Mugunthan.M.Smgmcri1234
Lateral ventricle of brain. Lecture by Dr.N.Mugunthan.
Associate Professor,
Mahatma Gandhi Medical College & Research Institute,
Sri Balaji Vidyapeeth, Pondicherry.
CERVICAL PART OF SYMPATHETIC TRUNK
https://www.slideshare.net/DRCAPRICORN/slideshelf
VESSICO-BULLOUS DISORDER LECTURE : https://youtu.be/lgizglcWJ9I
HOOVER SIGN for leg paresis/ copd=
https://youtu.be/v-rT80AksZw
BEEVOR SIGN = https://youtu.be/QTBqQ31KqUA
ALL PERIPHERAL SIGN'S OF AORTIC REGURGITATION=
https://youtu.be/JZBQGsmK4dY
SUBSCRIBE US ON YOUTUBE : www.youtube.com/c/DrCapricorn
4 th ventricle- Anatomical and surgical perspectivesuresh Bishokarma
4th ventricle connects the entire ventricular system of brain. Its connection with cisterns magna and cerebella pontine cistern via foramen of magenta and Luschka. CSF absorbs into the arachnoid granulation.
Lateral ventricle of Brain. By Dr.N.Mugunthan.M.Smgmcri1234
Lateral ventricle of brain. Lecture by Dr.N.Mugunthan.
Associate Professor,
Mahatma Gandhi Medical College & Research Institute,
Sri Balaji Vidyapeeth, Pondicherry.
CERVICAL PART OF SYMPATHETIC TRUNK
https://www.slideshare.net/DRCAPRICORN/slideshelf
VESSICO-BULLOUS DISORDER LECTURE : https://youtu.be/lgizglcWJ9I
HOOVER SIGN for leg paresis/ copd=
https://youtu.be/v-rT80AksZw
BEEVOR SIGN = https://youtu.be/QTBqQ31KqUA
ALL PERIPHERAL SIGN'S OF AORTIC REGURGITATION=
https://youtu.be/JZBQGsmK4dY
SUBSCRIBE US ON YOUTUBE : www.youtube.com/c/DrCapricorn
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
Anti ulcer drugs and their Advance pharmacology ||
Anti-ulcer drugs are medications used to prevent and treat ulcers in the stomach and upper part of the small intestine (duodenal ulcers). These ulcers are often caused by an imbalance between stomach acid and the mucosal lining, which protects the stomach lining.
||Scope: Overview of various classes of anti-ulcer drugs, their mechanisms of action, indications, side effects, and clinical considerations.
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
2. Introduction…
• Brain develops from the enlarged cranial part
of the neural tube.
• At the end of 4th week, the enlarged cephalic
part shows 3 distinct dilatations- Primary
brain vesicles.
• Cavities of vesicles form the ventricular
system of the adult brain.
7. Cerebrospinal Fluid
• Cerebrospinal fluid (CSF) is similar to that of blood
plasma and interstitial fluid.
• Present in the ventricular system within the CNS and in
the subarachnoid space surrounding the CNS.
• Bathes both the external and internal surfaces of the
brain and spinal cord .
• Provides a protective cushion between the CNS and
the surrounding bones.
• In an adult, the total volume of CSF is about 150 ml,
out of which only 30 ml is in the ventricular system and
remainder in the subarachnoid space.
8.
9.
10. Introduction…
• Tent-like cavity of hindbrain.
• Site- Posterior cranial fossa
• Location-
Cerebellum in front.
Pons and upper part of medulla oblongata
behind.
• Lined with ependyma and filled with CSF
14. Introduction…
Cavity of the ventricle presents-
Triangular outline in sagittal section and
Rhomboidal in shape (lozenge-shaped) in
horizontal section.
• Continuous with…
Cerebral aqueduct of midbrain.
Central canal of medulla oblongata
17. 1.Recesses…
• 5 in no.
• Extensions from
the cavity.
2- lateral recesses
1- median dorsal
recess
2- lateral dorsal
recesses
18. Lateral Recesses
• One on each side, lies in the interval between…
Inferior cerebellar peduncle ventrally
Peduncle of flocculus dorsally.
• Lateral extremity reaches up to the flocculus
• Opens into the subarachnoid space of
cerebellopontine angle (CP angle) as the lateral
aperture (foramen of Luschka) through which
part of choroid plexus bulges out.
20. 1.Recesses…
Median dorsal recess-
• Extends into the white core of the cerebellum
• Lies just above (cranial) to the nodule.
Two lateral dorsal recesses-
• One on each side of median dorsal recess
• Project dorsally above the inferior medullary
velum
• Lies immediately lateral to the nodule.
21. 2.Angles
• 4 angles
Superior - is continuous above with the cerebral
aqueduct of midbrain.
Inferior - is continuous below with the central
canal of the closed part of the medulla oblongata.
2 lateral - one on each side is carried outwards
across the dorsal surface of the inferior cerebellar
peduncle as tubular pouches called lateral recess.
23. 4.Roof (posterior wall)
• Tent-shaped,has upper and lower sloping
surfaces.
• Apex of the tent extends posteriorly into the
white core of the cerebellum.
• Upper part of the roof is formed by the
convergence of two Superior cerebellar
peduncles and a thin sheet of white mater
bridging it.
25. Superior medullary velum
• Bridges the triangular gap between the two
superior cerebellar peduncles
Inferior medullary velum
• formed conjointly by the ventricular ependyma
and the pia mater (of tela choroidea)
26. 4.Roof…
Lower part is formed by…
Inferior medullary velum
a thin sheet of non-nervous tissue, the that
covers it posteriorly.
• intimately related to the nodule of the
inferior vermis of the cerebellum.
27. 4.Roof…
Foramen of Magendie –
• Large aperture in the median plane in lower
part of the inferior medullary velum
• Through which the cavity of fourth ventricle
communicates with the subarachnoid space of
the cerebellomedullary cistern (cisterna
magna).
28. Tela choroidea
• Double layered fold of pia mater
• Lies between the inferior vermis of the cerebellum and
lower part of the roof of the fourth ventricle.
• Layers-
1.Dorsal layer-
• lines the inferior vermis which on reaching the nodule
• is reflected upon itself to form its ventral layer.
• When traced laterally, the dorsal layer is continuous
with the pia mater covering the cerebellar hemisphere.
29. Tela choroidea
2.Ventral layer-
• lies over the roof of
lower part of
fourth ventricle
• continuous with
the pia mater
covering the dorsal
aspect of medulla
oblongata
30. Choroid plexuses
• Formed by capillary plexus of blood vessels
between the two layers of tela choroidea .
• Form the rich vascular fringe that projects
through the lower part of the roof of the fourth
ventricle to form the choroid plexus.
• Derived from the branches of posterior inferior
cerebellar arteries.PICA
31. Choroid plexus
• T’-shaped plx
• projects into the cavity through the lower part of
the roof.
• Vertical limb of ‘T’- is double with foramen of
Magendie intervening between the two limbs.
• Horizontal limb -on either side extends into the
lateral recess, protrudes through the lateral
aperture, foramen of Luschka
• Can be seen on the surface of brain, near the
flocculus.
32. 5.Floor (rhomboid fossa)
Formed by…
Posterior surfaces of the pons
Upper part of the medulla.
• Rhomboid in shape (diamond-shaped)
• Divisible into 3 parts
33. 5.Floor
Divisible into…
1.Upper part: is formed by the posterior surface
of the pons.
2. lower triangular part: is formed by the upper
part of the posterior surface of the medulla.
34. 5.Floor…
3.Intermediate part :
• At the junction of the medulla and pons
• Prolonged laterally on either side over the
inferior cerebellar peduncle as the floor of lateral
recess.
• Bounded above by base of upper triangular part
of the floor and below by a line joining the
horizontal parts of the taenia.
• Surface of intermediate part is marked by the
presence of delicate bundles of transversely
arranged fibres, the striae medullaris.
36. 5.Floor
• Median sulcus – divides floor into right and left symmetrical
halves.
• Medial eminence- longitudinal elevation on either side of
median sulcus
• Medial eminence is bounded laterally by sulcus limitans.
• Vestibular area- lateral to sulcus limitans, containing vestibular
nuclei.
• Vestibular area lies partly in the pons and partly in the medulla
oblongata.
• Superior fovea – widen triangular depression at the upper end
of sulcus limitans
38. Locus ceruleus
• Bluish grey area lies above the superior fovea
where the sulcus limitans flattens out
• Colour is imparted by the underlying group of
nerve cells containing melanin pigment which
constitute the substantia ferruginea.
• Neurons of locus ceruleus contain large
quantities of norepinephrine (noradrenaline).
39. Inferior fovea.
• lowermost part of sulcus limitans presents a
small depression
Facial colliculus
• An oval swelling present on either side, the
medial eminence in the pontine part of floor
at the level of superior fovea.
• Swelling is produced by the fibres from the
motor nucleus of facial nerve hooking around
the abducent nucleus (internal genu of facial
nerve).
40. Medullary part of the floor
• From inferior fovea the sulcus limitans
descends obliquely towards the median
sulcus.
• Sulcus divides the medial eminence in the
into two triangles -
Hypoglossal triangle above
Vagal triangle below.
41. Floor-Hypoglossal triangle
Divided by a faint oblique furrow into…
• Medial part which overlies the nucleus of
hypoglossal nerve
• lateral part overlying the nucleus intercalatus.
42. Floor-Intercalated nucleus
• Described by Rutilio staderini in 1894, Italian
neuroanatomist,also called as Staderini nucleus
• is a group of nerve cells in the medulla oblongata,
between the dorsal nucleus of vagus nerve(lateral
to it ) and the nucleus of hypoglossal
nerve (medial to it).
• Forming part of the Perihypoglossal nuclear
complex.
• Probably involved in the control of the vestibulo-
ocular reflex.
• May contribute to the vertical neural integrator.
43. Floor-Vagal triangle
• Overlies the nuclei of vagus, glossopha-
ryngeal and cranial accessory nerves.
• Crossed by a narrow translucent ridge called
funiculus separans.
44. Area Postrema…
• Small area between
the funiculus
separans above and
the gracile tubercle
below.
• consists of highly
vascular neuroglial
tissue.
45. • Taenia-Infero-lateral margins of the fourth
ventricle are marked by a narrow white ridge
• Two taenia meet at the inferior angle of the
ventricle to form a small fold called obex.
• Obex-roof of the inferior angle of the fourth
ventricle.
46. 6.Openings
• 5 openings -through which cerebrospinal fluid
can leave the cavity of 4th ventricle:
Central aperture in the roof (f.of Magendie)
Two lateral apertures in the roof (f.of Luschka).
Central canal of medulla oblongata.
Cerebral aqueduct of midbrain.
47. 7.Applied anatomy…
• Medullablastoma:
• Most common tumour in this region , mostly in
children.
• Arises from poorly differentiated primitive
neuroectodermal cells of cerebellar vermis and occur.
• highly malignant and produces the signs and
• symptoms of cerebellar lesions, or it may press upon
the vital centres located beneath the floor of the
ventricle causing cardiac irregularities, tachycardia,
irregular respiration, and vasomotor disturbances.
48. Hydrocephalus
• is an abnormal increase in the volume of the
cerebrospinal fluid within the skull.
• If the hydrocephalus is accompanied by a raised
cerebrospinal fluid pressure, then it is due to one of
the following: (1) an abnormal increase in the
formation of the fluid,(2) a blockage of the circulation
of the fluid, or (3) a diminished absorption of the fluid.
• Rarely, hydrocephalus occurs with a normal
cerebrospinal fluid pressure, and in these patients,
there is a compensatory hypoplasia or atrophy of the
brain substance.