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Landmarks and Sectional Anatomy of the Brain
- 1. Surgical landmarks and Sectional anatomy of brain Dr. Sachit Koirala Resident, 2nd year Department of Surgery, KISTMCTH
- 2. Surface anatomy of cranium
- 5. Pterion • Region where the following bones are approximated: frontal, parietal, temporal and sphenoid (greater wing). • Estimated location: 2 finger-breadths above the zygomatic arch, and a thumb’s breadth behind the frontal process of the zygomatic bone
- 6. Asterion • Junction of lambdoid, occipitomastoid and parietomastoid sutures. • Usually lies within a few millimeters of the posterior-inferior edge of the junction of the transverse and sigmoid sinuses. • Not always reliable—may overlie either sinus.
- 7. • Vertex: the topmost point of the skull. • Lambda: junction of the lambdoid and sagittal sutures. • Stephanion: junction of coronal suture and superior temporal line. • Glabella: the most forward projecting point of the forehead at the level of the supraorbital ridge in the midline. • Opisthion: the posterior margin of the foramen magnum in the midline. • Bregma: the junction of the coronal and sagittal sutures. • Sagittal suture: midline suture from coronal suture to lambdoid suture. Although often assumed to overlie the superior sagittal sinus (SSS), the SSS lies to the right of the sagittal suture in the majority of specimens 10 (but never by > 11 mm)
- 8. Relation of skull markings to cerebral anatomy Taylor-Haughton lines • Taylor-Haughton (T-H) lines can be constructed on an angiogram, CT/MRI scout film, or skull X-ray. • They can be constructed on the patient in the O.R. based on visible external landmarks
- 10. Frankfurt plane, AKA baseline Line from inferior margin of orbit through the upper margin of the external auditory meatus (EAM)
- 11. Sylvian fissure Approximated by a line connecting the lateral canthus to the point 3/4 of the way posterior along the arc running over convexity from nasion to inion (T-H lines).
- 12. Central sulcus By connecting: The point 2cm posterior to the midposition of the arc extending from nasion to inion AND The point 5cm straight up from the EAM
- 18. Sectional anatomy of brain
- 19. Central sulcus Post central gyrus Pre central gyrus Sagittal fissure
- 22. Central sulcus Post central gyrus Pre central gyrus Sagittal fissure
- 25. Central sulcus Post central gyrus Pre central gyrus Sagittal fissure
- 26. Choroid plexus Corpus callosum Caudate nucleus (Body) Cingulate gyrus Lateral ventricle (Body)
- 29. Corpus callosum Caudate nucleus (Body) Cingulate gyrus Lateral ventricle (Body)
- 30. Internal capsule Corpus callosum Forceps major Caudate nucleus (Head) Cingulate gyrus Lateral ventricle (Body) Corpus callosum Forceps minor Putamen Septum pellucidum Middle cerebral artery branch
- 33. Internal capsule Corpus callosum Forceps major Caudate nucleus (Head) Cingulate gyrus Corpus callosum Forceps minor Putamen Septum pellucidum Insula Choroid plexus Third ventricle
- 34. Internal capsule Corpus callosum Forceps major Caudate nucleus (Head) Cingulate gyrus Corpus callosum Forceps minor Putamen Septum pellucidum Insula Choroid plexus Third ventricle Lateral ventricle Posterior horn Interventricular foramen (Monro) Optic radiation Thalamus
- 35. Internal capsule anterior limb Internal capsule posterior limb Fornix Corpus callosum Forceps major Caudate nucleus (Head) Cingulate gyrus Corpus callosum Forceps minor Putamen Insula Choroid plexus Third ventricle Lateral ventricle Posterior horn Optic radiation Thalamus
- 38. Hippocampus Lateral geniculate nucleus Medial geniculate nucleus Interthalamic adhesion Internal capsule anterior limb Internal capsule posterior limb Fornix-column Caudate nucleus (Head) Putamen Optic radiation Thalamus
- 39. Cerebellum vermis Posterior commisure Lateral geniculate nucleus Globus pallidus Hippocampus
- 42. Branches of anterior cerebral artery Cerebral aqueduct Interpeduncular fossa Posterior cerebral artery Substantia nigra Inferior colliculus Crus cerebri Hippocampus Mamillary bodies Red nucleus Decussation of superior cerebellar peduncles
- 45. Branches of anterior cerebral artery Cerebral aqueduct Middle cerebral artery Interpeduncular fossa Substantia nigra Inferior colliculus Crus cerebri Hippocampus Mamillary bodies Red nucleus Decussation of superior cerebellar peduncles Hypothalamus
- 46. Basilar artery Cerebral aqueduct Cerebral peduncles Internal carotid artery Interpeduncular fossa Lateral ventricles inferior horn Olfactory tract Optic tract Optic Nerve Posterior cerebral artery Superior cerebellar peduncle
- 47. Cerebral aqueduct Superior cerebellar peduncle Nucleus coeruleus Medial lemniscus
- 48. Fourth ventricle Middle cerebellar peduncle Inferior cerebellar peduncle Basilar pons Nucleus coeruleus Vermis Dentate nucleus
- 49. Fourth ventricle Middle cerebellar peduncle Inferior cerebellar peduncle Pons Vermis Dentate nucleus
- 52. Fourth ventricle Middle cerebellar peduncle Basilar pons Vermis Cerebellar tonsil
- 56. Thank you
Editor's Notes
- GWS= greater wing of sphenoid bone; stl = superior temporal line; ZYG= zygomatic. Sutures: cs = coronal, fn = frontonasal, fz = frontozygomatic, ls = lambdoid, nm= nasomaxillary, om= occipitomastoid, pm= parietomastoid, sm = squamomastoid, sp = sphenoparietal, sq = squamosal, ss = sphenosquamous, sz = sphenozygomatic, tz = temporozygomatic, zm = zygomaticomaxillary