This document provides an overview of the gross and salient features of the human brain. It describes the main parts and subdivisions of the brain including the forebrain (cerebrum, diencephalon), midbrain, and hindbrain (medulla oblongata, pons). Key structures within these areas like the cerebral hemispheres, lobes, sulci and gyri are defined. Important functional areas such as Broca's area, Wernicke's area and visual/auditory cortices are outlined. Structures in the brainstem like the pons, medulla oblongata and their functions are summarized. Blood supply and cerebrospinal fluid are also briefly mentioned.
Liliequist membrane may be understood as a projection formed by an arachnoid membrane extending from the dorsum sellae to the mammillary bodies coined after Liliequist (1956). It has surgical importance in Endoscopic third ventriculostomy and cisternostomy.
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Students are required to know the detailed anatomy of the cortex and also the lesions and their presentation in patients.Medicine in itself derived from a thorough understanding of the anatomy in the initial years of MBBS.Thus it is an iminantory part of this slideshare.
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Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
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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.
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NYSORA Guideline
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Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
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
MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdfJim Jacob Roy
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Atrioventricular conduction blocks ( AV blocks ) are classified into 3 types.
This document describes the acute management of AV block.
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.
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
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.
4. BRAIN STEM
MEDULLA OBLONGATA
PONS
BLOOD SUPPLY OF BRAIN
CEREBROSPINAL FLUID
BRAIN DISORDERS
SPINAL CORD
BLOOD SUPPLY OF SPINAL CORD
VENOUS SUPPLY OF SPINAL CORD
SOME NEURAL PATHWAYS
REFERENCES
5. INTRODUCTION
Human nervous system is responsible for judgement,
intelligent and memory.
Nervous system is the chief controlling and
coordinating system of the body.
The sensory part of the nervous system collects
information from surroundings and helps in gaining
knowledge and experience, whereas the motor part is
responsible for responses of the body.
6. PARTS OF THE NERVOUS SYSTEM
Two parts:
Central nervous system(CNS) :
Brain - occupies cranial cavity.
Spinal cord - occupies upper two-thirds of the
vertebral canal.
Peripheral nervous system :
Somatic (cerebrospinal) nervous system -
made up of 12 pairs of cranial nerves and 31
pairs of spinal nerves.
Autonomic nervous system – consists of
sympathetic and parasympathetic nerves.
8. The human brain is the central organ of the
human nervous system, and with the spinal
cord makes up the central nervous system.
Brain occupies in cranial cavity.
9. PARTS OF BRAIN
PARTS SUBDIVISION
1 FOREBRAIN
(Prosencephalon)
a) Cerebrum (Telencephalon)
b) Diencephalon (Thalamencephalon)
c) Thalamus
d) Hypothalamus
e) Metathalamus
f) Epithalamus
g) Sub thalamus
2 MIDBRAIN
(Mesencephalon)
a) Tectum
b) Tegmentum
3 HINDBRAIN
(Rhombencephalon)
a) Metencephalon (Pons & cerebellum).
b) Myelencephalon (medulla oblongata)
12. CEREBRUM
Made up of two cerebral
hemispheres which are
incompletely separated from
each other by the median
longitudinal fissure.
The two hemispheres are
connected to each other by
corpus callosum.
Each hemisphere contains
cavity, called the lateral
ventricle, which contains CSF.
Each hemisphere contains 3
surfaces, 4 borders and 3
poles.
13. 3 Surfaces : superolateral, medial and inferior
surfaces.
a) Superolateral surface: is convex and is related to
the cranial vault.
14. b) Medial surface: is flat and vertical surface. It is
separated from the corresponding surface of the
opposite hemisphere by falx cerebri and the
longitudinal fissure.
15. c) Inferior surface: is
irregular surface.
Divided into
Anterior part
(orbital surface)
Posterior part
(tentorial surface).
The two parts are
separated by a deep
cleft called stem of
the lateral sulcus.
16. 4 Borders :
a) Superomedial Border :
separates the superolateral
surface from the medial
surface.
b) Inferolateral Border :
separates the superolateral
surface from the inferior
surface.
c) Medial Orbital Border :
separates the medial surface
from the orbital surface.
d) Medial Occipital Border :
separates the medial surface
from the tentorial surface.
Coronal section of cerebrum
17. 3 Poles :
a) Frontal Pole : at the
anterior end.
b) Occipital Pole : at the
posterior end.
c) Temporal Pole : at the
anterior end of the
temporal lobe.
18. LOBES OF BRAIN
4 Lobes :
a) Frontal
b) Parietal
c) Occipital
d) Temporal
Their positions correspond, very
roughly, to that of the
corresponding bones.
19. CEREBRAL SULCI & GYRI
Cerebral cortex is folded into
gyri which are separated from
each other by sulci. This
pattern increases the surface
area.
In human brain , the total area
of the cortex is estimated to
be more than 2000cm2, and
approximately two-thirds of
this area is hidden from the
surface with in the sulci.
Gyri Sulcus
20. Central sulcus : begins at the
Superomedial border of
hemisphere a little behind
the midpoint between the
frontal and occipital poles.
Lateral sulcus : separates
the orbital and tentorial part
of the inferior surface.
Parieto-occipital sulcus : is a
sulcus of the medial surface.
Preoccipital notch : on the
Inferolateral border, about
5mm in front of the occipital
pole.
21. MAIN FUNCTIONAL AREA OF
CEREBRAL CORTEX
Cerebral cortex has been divided into 52 functional
area by Brodmann (1909).
Typical cortical areas are,
Motor Areas
Sensory Areas
Association Areas
22.
23. BROCA’S AREA
Also called Anterior Speech
Area.
Area located in the frontal lobe
of the left hemisphere only.
Broca's area is made up of
Brodmann’s areas 44 (pars
opercularis) & 45 (pars
triangularis) of the inferior
frontal gyrus.
Function is speech production.
24. Blood Supply: Superior division of middle cerebral
artery supplies latero-inferior frontal lobe (location of
Broca's area i.e. language expression).
25. Clinical Significances :
Broca’s Aphasia : partial loss of
the ability to produce language as
a result of brain damage.
MRI findings : Lesions to Broca's
area can cause temporary speech
disruption, they do not result in
severe speech arrest.
26. WERNICKE’S AREAS
Also called Posterior Speech
Area (Area 22).
It is one of the two parts of the
cerebral cortex that are linked
to speech (other is Broca's
area).
located in the temporal lobe on
the left side of the brain and is
responsible for the
understanding of speech,
while Broca's area is related to
the production of speech.
27. Blood Supply: Inferior division of middle cerebral artery
supplies lateral temporal lobe (location of Wernicke's
area i.e. language comprehension).
28. Clinical Significances :
Lesions or damage in the middle
of the left side of the brain
causes Wernicke’s aphasia.
Stroke is one potential cause of
this condition because it impairs
blood flow to the brain.
Conditions that may affect
Wernicke’s area of the brain
include head trauma, tumours,
infections, neurological
disorders.
Diagnosed by MRI or CT scan.
29. FUNCTIONAL AREAS OF FRONTAL LOBE
1) Primary motor area (Area 4) (to
generate neural impulses that
control the execution of
movements).
2) Premotor area (Area 6)
(performance of voluntary motor
activities)
3) Supplementary motor area
4) Frontal eye field- Area 8.
(control of visual attention and eye
movements)
5) Motor speech area of Broca
(Area 44 & 45) (speech area).
6) Pre frontal cortex (Area 9, 10,
11 & 12). (individual’s personality)
30. FUNCTIONAL AREAS OF PARIETAL LOBE
Primary Sensory Area (Area 3,1,2)
(Pain, touch, temperature).
Secondary Sensory Area (Pain).
Sensory Association Area (Area 5,7)
(Ability to recognize the object placed
in his / her hand without seeing).
Sensory Speech Area of Wernicke
(Area 39,40) (concerned with the
interpretation of language through
visual & auditory input).
Primary Auditory Area ( Area 41,42)
(reception of isolated impressions of
sound, quality & pitch of the sound).
31. The occipital lobe is divided into
several functional visual areas.
The first functional area is the
primary visual cortex. It contains a
low-level description of the local
orientation and colour properties
within small receptive fields.
Primary visual cortex projects to
the occipital areas of the ventral
stream (visual area V2 and visual
area V4), and the occipital areas of
the dorsal stream (visual area V3,
visual area MT (V5), and the
dorsomedial area (DM)).
FUNCTIONAL AREAS OF OCCIPITAL LOBE
32. FUNCTIONAL AREAS OF TEMPORAL LOBE
The temporal lobe holds the
primary auditory cortex, which is
important for the processing of
both speech and vision in humans.
Functional Areas :
Audito Sensory Area (Area 41.42).
Audito psychic area (Area 22).
Sensory speech (Wernicke's) area
(Area 39, 40).
33. DIENCEPHALON
It is a middle
structure which is
largely embedded
in the cerebrum, &
therefore hidden
from surface view.
34. Dorsal part divided into 3
parts:
Thalamus (dorsal
thalamus)
Metathalamus
Epithalamus
Ventral part divided into 2
parts:
Hypothalamus
Sub thalamus (ventral
thalamus)
35. THALAMUS
Is a large mass of grey matter situated in the lateral
wall of the 3rd ventricle & in the floor of the central
part of lateral ventricle.
Without thalamus, the brain cannot diagnose the
sensory information transmitted to it.
36. It has : anterior and
posterior ends ; superior,
inferior, medial & lateral
surfaces.
Anterior end : forms the
posterior boundary of
interventricular foramen.
Posterior end (pulvinar) :
overhangs the lateral and
medial geniculate bodies,
and the superior colliculus
with its brachium.
37. Sup. Surface : divided
into lateral ventricular
part & medial extra
ventricular part.
Inf. Surface : rest of
sub thalamus and
hypothalamus.
Medial surface : forms
posterosuperior part
of the lateral wall of
3rd ventricle.
Lateral surface : forms
medial boundary of
posterior limb of
internal capsule.
39. Also called mesencephalon.
Connect hindbrain with the forebrain.
The mesencephalon is considered part of the
brainstem.
Midbrain passes through the tentorial notch.
40. The midbrain serves important functions in motor
movement, particularly movements of the eye, and in
auditory and visual processing.
42. Also called rhombencephalon.
The lower part of the brainstem, comprising the
cerebellum, pons, and medulla oblongata.
An area of the brain that coordinates information
coming into and out of the spinal cord, and controls
the basic functions of life. (reflex centres of heart &
respiratory rates, coughing, swallowing, vomiting
etc).
43. BRAIN STEM
Connects the spinal cord to cerebrum.
Various ascending & descending tracts pass through
the 3 components of the brain stem.
Consists of –
medulla oblongata
Pons
midbrain
44. MEDULLA OBLONGATA
Lowest part of the brain stem,
where it is continuous with
the spinal cord.
It lies in the anterior part of
the posterior cranial fossa,
extending down to foramen
magnum.
45. External features :
The medulla is divided
into right & left halves by
anterior and posterior
median fissures.
Each halves further
divided into anterior,
lateral & posterior region
by the antero lateral &
postero lateral sulci.
46. Ant.region – in the form of
longitudinal elevation
called pyramid. (pyramid is
made up of cortico spinal
fibres.
The upper part lateral
region shows an oval
elevation called olive.
The rootlets of the
hypoglossal nerve emerges
from the anterolateral
sulcus between the
pyramid & olive.
47. The rootlets of cranial nerve IX
& X (ie, glossopharyngeal &
vagus nerve) and of the
accessory nerve emerges
through the posterolateral
fissure, behind the olive.
In the lower part of the
medulla there is another
elevation called tubercinerium.
48. Medulla is divided in 2 parts :
Lower closed part with a central canal.
Upper open part where the central canal
opens out to form the 4th ventricle.
49. Functions of medulla oblongata
It controls the Autonomic Nervous System (ANS
control).
It regulates the blood vessel dilation to reduce or
increase the flow of oxygen and respond to the heart
functions.
It regulates the digestive system and maintains the
levels of digestion within the body.
Maintaining the coordination between various body
movements.
50. It controls the respiratory and cardiovascular
activities in the body.
It looks after the blood pressure, regulates heart
rate, and check the respiratory rate.
All kinds of involuntary reflexes, like sneezing,
swallowing, and gag reflexes are controlled and
regulated by Medulla Oblongata.
Controls the voluntary movements of the body
(under conscious control such as exercising,
moving arms, kicking a ball or lifting a weight etc.)
51. Disorders of Medulla Oblongata
Medulla is responsible for controlling various
autonomic functions in the body, like heart
contraction, breathing, and more. So, any damage to
it can be causes to the brain and result in the death of
a person.
Major complication is “medullar abscess” :- a
condition of rapidly progressive numerous cranial
nerve clusters and diminished levels of consciousness.
52. Any damages or injuries in Medulla Oblongata may
result in various sensory problems. (like numbness, lack
of control over the movement of various body organs,
difficulty swallowing the food, and even paralysis.)
The multiple system atrophy is a major neurological
disorder that damages the nerves cells specified within
the brain areas including the medulla oblongata. This
can result in loss of control over various autonomic
diseases (like coordination, bladder control).
54. External features of pons:
Have 2 surfaces – ventral &
dorsal.
Ventral (anterior) surface : is
convex in both directions.
Trigeminal (cranial V) nerve
is attached to this surface at
the junction of pons with the
peduncle.
The abducent, facial &
vestibulo-cochlear nerves are
attached at the lower border
of the ventral surface.
55. Dorsal (posterior) surface :
is hidden by cerebellum, &
forms upper half of the
floor of the 4th ventricle.
56. Internal features of pons :
In transverse section, divided into ventral & dorsal
parts.
ventral (basilar) part : is continuous inferiorly with
the pyramids of medulla.
57. The dorsal (tegmental) part :
is a direct upward
continuation of the medulla
(excluding the pyramid).
58. CERBROSPINAL FLUID
Cerebrospinal fluid is a
modified tissue fluid.
It is contained in
ventricular system of
the brain & in the
subarachnoid space
around the brain &
spinal cord.
59. Formation :
The bulk of CSF is formed by the choroid plexuses of
the lateral ventricle, and lesser amounts by choroid
plexuses of the 3rd & 4th ventricle.
Also formed by the capillaries on the surface of the
brain and spinal cord.
Total quantity of CSF – 125 - 150 ml
It is formed at the rate of about 200 ml /hour or
5000 ml/day.
60. Circulation of CSF :
CSF passes from each lateral ventricle to 3rd ventricle
through the interventricular foramen.
From 3rd ventricle it passes to 4th ventricle through
the cerebral aqueduct.
From here the CSF passes to the sub arachnoid space
through the median & lateral apertures of 4th
ventricle.
61.
62. Absorption of CSF :
Absorbed chiefly through the arachnoid villi and
granulations, & is drained into the cranial venous
sinuses.
Also absorbed partly by perineural lymphatics around
the 1st (olfactory), 2nd (optic), 8th (vestibulo-cochlear)
cranial nerves.
Also absorbed by veins related to spinal nerves.
63. Functions of CSF :
Protects brain and spinal cord from trauma.
Supplies nutrients to nervous system tissue.
Removes waste products from cerebral
metabolism.
64. BLOOD SUPPLY OF THE BRAIN
Cerebral circulation is the movement of blood
through the cerebral arteries and veins supplying
the brain.
The rate of the cerebral blood flow in the adult is
typically 750 millilitres per minute, representing
15% of the cardiac output.
65. BLOOD SUPPLY :
Blood supply to the brain is
normally divided into anterior
and posterior segments.
The circle of Willis is formed
by two group of arteries - the
internal carotid arteries and
two vertebral arteries. These
arteries provide the anterior
and posterior circulation of
the brain respectively.
66. The anterior and posterior cerebral circulations
are interconnected via bilateral posterior
communicating arteries.
They are part of the Circle of Willis, which
provides backup circulation to the brain.
67. The Circle of Willis is a part of the
cerebral circulation & is composed of
:
Anterior cerebral artery (L&R)
Anterior communicating artery
(connects two anterior cerebral
artery)
Internal carotid artery (L&R)
(arises from common carotid
artery)
Posterior cerebral artery(L&R)
(arises from the basilar artery)
Posterior communicating
artery (L&R) (branch of the
internal carotid artery)
The middle cerebral arteries
supplying the brain, are not
considered part of the circle.
68. Clinical significance :
• Sub arachnoid haemorrhage : Is
bleeding into the subarachnoid
space.
• Subclavian steal syndrome : In
this syndrome, blood is stolen
from the circle of Willis to
preserve blood flow to the upper
limb. Subclavian steal syndrome
results from a proximal stenosis
(narrowing) of the Subclavian
artery.
70. CEREBRAL HEAMORRHAGE
Cerebral haemorrhage is a type of
intracranial bleed that occurs
within the brain tissue or
ventricles.
Symptoms :
Headache
Fever
One-sided weakness
Vomiting
Seizures
Decreased level of consciousness
Neck stiffness
71. Causes :
Brain trauma
Aneurysms (weakness in the wall
of a cerebral artery or vein causes
a localized dilation or ballooning
of the blood vessel)
Brain tumours
Diagnosed by CT scan.
Treatment :
Surgery(required if the
hematoma is greater than 3 cm).
Ventricular drain
72. TRANSIENT ISCHEMIC ATTACK
is a brief episode of
neurological dysfunction
caused by loss of blood flow
(ischemia) in the brain, spinal
cord, or retina, without tissue
death (infarction).
73. Signs & Symptoms :
Painless
Temporary loss of vision
One-sided facial droop
Unilateral weakness
Numbness on one side of
the body.
Diplopia (double vision)
Problems with balance
and spatial orientation
Diagnosed by MRI.
74. Treatment :
Antiplatelet medications : such as aspirin.
Anticoagulant medications : Anticoagulant therapy can
decrease the relative risk of ischemic stroke. Warfarin is
a common anticoagulant used.
Control Blood Pressure : SBP< 130mmHg & DBP<
90mmHg.
Control Cholesterol.
Control Diabetes. (RBS 80 – 160 mg/dl)
Surgery (carotid endarterectomy): In this, makes an
incision in the neck, opens up the carotid artery, and
removes the plaque occluding the blood vessel.
75. Epidural hematoma is when
bleeding occurs between the
duramater and the skull.
Lucid Interval : is a temporary
improvement in a patient's
condition after a traumatic brain
injury, after which the condition
becoming progressively worse.
A lucid interval is especially
indicative of an epidural
hematoma.
EPIDURAL HEMATOMA
76. Symptoms of epidural Hematoma :
Loss of consciousness
Head ache
Confusion
Vomiting
Inability to move parts of the body.
77. Males are more often affected than females.
Diagnosis is typically by a CT scan or MRI.
Treatment is generally by urgent surgery.
(craniotomy or burr hole surgery).
Without treatment leads to death.
78. SUBDURAL HEMATOMA
Subdural hematoma is a
type of hematoma, usually
associated with traumatic
brain injury.
Blood between the inner
layer of the duramater and
the arachnoid mater.
79. Signs & Symptoms
History of recent head injury
Loss of consciousness
Seizures
Pain
Headache
Disorientation
Amnesia
Weakness
Personality changes
Inability to speak
Difficulty to walk
• Nausea or vomiting
• Loss of muscle control
• Altered breathing patterns
• Hearing problems
• Blurred Vision
• Abnormal movement of the
eyes.
80. Diagnosed by CT scan or MRI.
Treatment depends on its size and
rate of growth.
Small size can be managed by careful
monitoring until the body heals itself.
Other small subdural hematomas can
be managed by inserting a temporary
small catheter through a hole drilled
through the skull and sucking out the
hematoma.
81. Large / symptomatic hematomas
require a craniotomy, the surgical
opening of the skull.
Postoperative complications :
Increased intracranial pressure.
Brain Edema.
New or recurrent bleeding.
Infection.
Seizure.
82. SUB ARACHNOID HEMORRHAGE
• Is bleeding into the subarachnoid
space.(Area between the
arachnoid membrane & pia mater
surrounding the brain).
• Symptoms :
• severe headache of rapid onset
• Vomiting
• decreased level of consciousness
• Fever
• sometimes seizures.
83. Diagnosed by CT scan.
Treatment option is
conservative treatment.
84. INTRAVENTRICULAR HEMORRHAGE
is a bleeding into the brain's
ventricular system, where the
cerebrospinal fluid is produced
& circulates through towards
the subarachnoid space.
Symptoms :
sudden onset of headache
nausea and vomiting
Alteration of the mental state
Focal neurological signs are
either minimal or absent.
Yellow-tinged CSF
85. Diagnosed by CT scan.
For Extreme cases - an open craniotomy may
be required.
86. PARKINSON’S DISEASE
Parkinson's disease is a long-
term degenerative disorder of
the central nervous system
that mainly affects the motor
system.
signs and symptoms:
Shaking
Slowed movement
Rigid muscles
balance problems
Loss of automatic movements
Speech and writing changes
87. Parkinson's disease is accompanied by some additional
problems like Thinking difficulties, Depression and
emotional changes
89. SPINAL CORD
Is the lower elongated,
cylindrical part of CNS,
responsible for establishing
contacts between the brain
& peripheral end organs.
It occupies the upper 2/3rd
of the vertebral canal.
Gives off 31 pairs of spinal
nerves.
90.
91. TRACTS OF SPINAL CORD
A collection of nerve fibres that connects two masses
of gray matter with in the central nervous system is
called a tract.
They may be ascending or descending tracts.
92. DESCENDING TRACTS
It have 2 type tracts :
A. Pyramidal or cortico spinal tracts : descends from the
cerebral cortex to spinal cord.
Consists of : lateral cortico spinal tract & anterior
cortico spinal tract.
B. Extrapyramidal tracts :
Rubro spinal tract
Medial & lateral reticulo spinal tracts
Olivo spinal tract
Vestibulo spinal tract
Tecto spinal tract
93. DESCENDING TRACTS
No. Name Function Spinal
Segment
Beginning 1st
termination
A1 Lateral
cortico
spinal.
(crosse
d)
Main
motor
tract
C1 to S5 Motor
area of
cortex
(upper
neuron)
Anterior grey
column cells
alpha motor
neurons
A2 Ant.
Cortico
spinal.
(uncros
sed)
Main
motor
tract
C1 to S5 Motor
area of
cortex
(upper
motor
neuron)
Anterior grey
column cells
alpha motor
neurons
94. No Name Function Spinal
Segment
Beginning 1st
termination
B1 Rubro-
spinal.
(crosse
d)
Efferent
pathway
for cere-
bellum &
corpus
stratum
C1 to C5 Red
nucleus of
midbrain
Anterior grey
column cells.
B2 Medial
reticulo
spinal.
(uncros
sed)
Extra
pyramidal
tract
C1 to S5 Reticular
formation
of grey
matter of
pons
Anterior grey
column cells
(inter
neurons).
95. No Name Function Spinal
Segment
Beginning 1st
termination
B3 Lateral
reticulo
spinal.
(crosse
d)
Extra
pyramidal
tract
C1to S5 Reticular
formation
of grey
matter of
medulla
oblongata
Anterior grey
column cells
(inter
neurons)
B4 Olivo-
spinal.
(uncros
sed)
Extra
pyramidal
tract
C1 to C5 Inferior
olivary
nucleus
Anterior grey
column cells
96. No Name Function Spinal
Segment
Beginning 1st
termination
B5 Vestibulo
spinal.
(uncrosse
d)
Efferent
pathway
for equi-
libratory
control
C1 to S5 Lateral
vestibular
nucleus
Anterior grey
column cells
B6 Tecto-
spinal.
(crossed)
Efferent
pathway
for visual
reflexes
C1 to C5 superior
colliculus
Anterior grey
column cells
97. ASCENDING TRACTS
No Name Function Spinal
Segment
Beginning 1st
termination
1 Lateral
spino
thalamic
(crossed
Pain &
temp.
from
opp.half
of body
C1 to S5 Substantia
gelatinosa
of post.
Grey
column
Postero-
lateral
ventral
nucleus of
thalamus
2 Anterior
spino
thalamic
(crossed
Touch &
pressure
from
opposite
half of
body
C1 to S5 Posterior
grey
column of
opposite
side
Postero-
lateral
ventral
nucleus of
thalamus
98. No Name Function Spinal
Segment
Beginning 1st
termination
3 Fasciculus
gracilis.
(uncrosse
d)
Conscious
proprio-
ception,
discrimi-
natory
touch
S5 to T7 Dorsal
root
ganglion
cells
Nucleus
gracilis
4 Fasciculus
cuneatus.
(uncrosse
d)
Vibratory
sense
stereo-
gnosis
T1 to T5 Dorsal
root
ganglion
cells
Nucleus
cuneatus
99. No Name Function Spinal
Segment
Beginning 1st
termination
5 Posterior
(dorsal)
spino
cerebe-
llar.
(uncross
ed)
Unconscious
proprio-
ception to
cerebellum
C1 to L2 Thoracic
nucleus of
posterior
grey
column
Vermis of
cerebellum
(via inf.
Cerebellar
peduncle).
6 Anterior
(ventral)
spino
cerebe-
llar.
(crossed)
Cerebellum
adjustments
of muscle
tone
C1 to L2 Posterior
grey
column
same side
Vermis of
cerebellum
(via sup.
Cerebellar
peduncle).
100. No Name Function Spinal
Segment
Beginning 1st
termination
7 Spino-
olivary.
(uncros
sed)
Proprio-
ceptive
sense.
C1 to S5 Posterior
grey
column.
Dorsal and
medial
accessory
olivary nuclei.
8 Spino-
tectal.
(crosse
d)
Afferent
limb of
reflex
movements
of eyes &
head
towards
source of
stimulation
C1 to C6 Posterior
grey
column of
opposite
side.
Tectum or
superior
colliculus of
midbrain.
101. The vertebral arteries are the main source of blood
to the spinal cord.
One anterior and two posterior spinal arteries are
supplying blood to the spinal cord (branches from
the vertebral arteries).
103. Clinical Anatomy :
Poliomyelitis : is a viral disease which involves
anterior horn cell leading to paralysis of affected
segment.
Syringomyelia : condition in which there is dilatation
of central canal of spinal cord beginning in cervical
region.
105. Pyramidal Tract.
Pain & Temperature Pathway.
Pathway of Touch.
Optic (Visual) Pathway.
Auditory (hearing) Pathway.
Taste Pathway.
106. PYRAMIDAL TRACT
This is a descending tract, extending
from cerebral cortex to various
motor nuclei of cranial & spinal
nerves.
Each pyramidal tract contains about
1 million fibres.
Origin : motor area (no.4) of cortex,
premotor area (no.6), & sensory
area (no.3,2,1).
Terminates : before termination, it
cross to opposite side. They
terminate through an interneuron,
in the motor nuclei of cranial nerves
& to the ant. horn cells of the spinal
cord.
107. Clinical Anatomy
If fibres of the pyramidal tracts are damaged, this will
give rise to an upper motor neuron syndrome.
If the cortico bulbar tract is damaged on only one side,
then only the lower face will be affected, however if
there is involvement of both the left and right tracts,
then the result is pseudo bulbar palsy. This causes
problems with swallowing, speaking, and emotional
lability.
108. PAIN & TEMPERATURE PATHWAY
Receptors :
free nerve endings for pain.
End bulbs Krause for cold.
Organs of Ruffini for warmth, &
Golgi – Mazzoni for heat.
1st Neuron – locates in the dorsal
root ganglia. Peripheral process of
neurons in the ganglia constitute
the sensory nerves. The central
processes of neuron passes
through the dorsal nerve root to
enter the spinal cord, where they
synapse with 2nd neuron.
109. 2nd Neuron : located in the grey
matter of spinal cord. Their axon
from lateral spinothalamic tract.
The tract is crossed. It ascends
through the lateral white column
of the spinal cord to enter the
brain stem. In the brain stem, this
tract is referred to as the spinal
lemniscus to end in the thalamus.
3rd Neuron : lies in the postero-
lateral ventral nucleus of the
thalamus. Fibres arising in this
nucleus pass through the internal
capsule and the corona radiata to
reach the somatosensory area
(Area 3,1,2).
110. PATHWAY OF TOUCH
The 1st Neuron is for pain &
temperature pathway. The 2nd
neuron are different for fine
touch & for crude touch.
PATHWAY OF FINE TOUCH :
The central processes of the
neurons in the dorsal nerve
root ganglia enter the
posterior white column of the
spinal cord & form the
fasciculus gracilis & the
fasciculus cuneatus.
111. 2nd neuron lies in the nucleus
gracilis or nucleus cuneatus. It
gives off the internal arcuate fibres
which cross to the opposite side
through the sensory decussation.
Reaching the other side they runs
upwards as the medial lemniscus.
The medial lemniscus ends in the
postero lateral ventral nucleus of
the thalamus.
Fibres starting in the thalamus
pass through the internal capsule
& the corona radiata & end in the
somato sensory area of the
cerebral cortex.
112. PATHWAY FOR CRUDE TOUCH :
The central process of neuron in
dorsal root ganglia terminate in
the grey matter of the spinal
cord.
2nd neuron lies in the spinal cord.
Axon of those neurons cross the
midline & form anterior spino-
thalamic tract. In the brainstem,
this tract merge with the medial
lemniscus.
3rd neuron terminate in the
somatosensory area of cerebral
cortex (Area 3, 1, 2).
113. OPTIC (VISUAL) PATHWAY
Structures in visual pathway :
Retina.
Optic nerve.
Optic chiasma.
Optic tract, with its lateral &
medial roots.
Lateral geniculate body.
Optic radiation.
Visual area in the cortex.
114. The visual system is the
part of the central nervous
system.
The visual system includes
the eyes, the connecting
pathways through to the
visual cortex and other
parts of the brain.
115. Information from the right
visual field (now on the left
side of the brain) travels in
the left optic tract.
Information from the left
visual field travels in the
right optic tract.
Each optic tract terminates
in the lateral geniculate
nucleus (LGN) in the
thalamus.
116. Optic radiation begins from
the lateral geniculate body,
passes through the
retrolentiform part of the
internal capsule, and ends in
the visual cortex.
The optic radiations in the
visual area (Area 17) where
the colour, size, shape,
motion, illumination, and
transparency are
appreciated separately.
117. EFFECT ON LESIONS OF DIFFERENT
PART OF VISUAL PATHWAYS
Ipsilateral blindness : lesion of
the optic nerve.
Bitemporal hemi anopia : mid-
sagittal of the optic chiasma.
Contralateral homonymous
hemi anopia : lesion of the optic
tract and optic radiation.
Contralateral homonymous
hemi anopia with macular
sparing : lesion of the visual
cortex.
118. PATHAWAY OF HEARING
The auditory system is the
sensory system for the sense
of hearing (Area 41,42).
Pathway :
1st Neurons – located in
spiral ganglion.
Peripheral processes
innervate the organ of corti,
while the central processes
terminate in the dorsal &
ventral cochlear nuclei.
119. 2nd Neurons – lie in the dorsal
& ventral cochlear nuclei.
Most of the axons arising in
these nuclei cross to the
opposite side.
Termination : in the superior
Olivary nucleus.
120. 3rd Neurons : lies superior
olivary nucleus.
Axons from lemniscus &
reach the inferior Colliculus.
4th Neurons : lies in the
inferior Colliculus.
Axons passes through the
inferior brachium to reach
the medial geniculate body.
121. 5th Neurons : lie in the
medial geniculate body.
Axons passes through the
sublentiform part of the
internal capsule to reach
auditory area (Area 41,42)
in the temporal lobe.
122. REFERENCES :
BD Chaurasia’s Human Anatomy – Head, Neck and Brain.
4th Edition.
Grey’s Anatomy for students.
Clinically Oriented Anatomy- Keith L.Moore.8th Edition