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The Brain I
                   Gross Anatomy and Functional
                           Localization
                               (for dental students)



                          Dr.Akram Abood Jaffar
                          Assistant Professor of Anatomy
                                M.B.Ch.B., M.Sc., Ph.D.
Dr. Akram Jaffar




                                                           Dr. Akram Jaffar
Objectives
                   he cerebrum

                   escribe the gross anatomical features of the cerebral cortex on the lateral, medial and inferior surfaces of the cerebral
                   hemishphere.

                   dentify the poles (frontal, occipital and temporal poles) and the lobes of the cerebral hemisphere: frontal, parietal, temporal, and
                   occipital. Locate the boundaries between the lobes.

                   numerate fissures of the brain and the main sulci and gyri in each lobe.

                   ifferentiate the central sulcus from the precentral and postcentral sulci.

                   dentify: superior and inferior frontal sulci, supeiror, middle and inferior frontal gyri; interparietal sulcus; superior and inferior
                   parietal lobules; superior and inferior temporal sulci; superior, middle and inferior temporal gyri; parahippocampal gyrus, collateral
                   sulcus, gyrus rectus, rhinal sulcus, uncus, olfactory sulcus, anterior perforated substance, preoccipital notch, calcarine sulcus,
                   parieto-occipital sulcus, cingulate gyrus, cingulate sulcus, paracentral lobule, H-shaped gyri.

                   dentify, define, and describe the parts of the corpus callosum sagittal and coronal sections of the brain.

                   escribe the position of the insula.

                   iscuss the location of main functional areas of the cerebral cortex and the effect of their damage: primary motor area, profrontal
                   area, motor speech area, sensory speech area, primary sensory area, visula area, olfactory area, auditory area.

                   ppreciate that the representation in the cerebral cortex is related to the functional importance.


                   Further reading
                   iscuss the concept of cerebral dominance and its relation to handedness.

                   he cerebellum:
Dr. Akram Jaffar




                   • Snell RS (2010): Clinical Neuroanatomy. 7th Ed. Lippincott, Williams and Wilkins.
                   escribe the position of the cerebellum and the connection of its peducles with the brain stem.
                         Baltimore.
                   efine gross features of the cerebellum: folia, sulci, vermis, tonsil, vallecula
                                                                                                                                                    Dr. Akram Jaffar
Gross anatomy of the cerebral hemisphere
                   •    The cerebral hemispheres are covered superiorly by the bones of the vault of the skull.
                   •    Inferiorly they lie on the bones of the                parietal
                        anterior and middle cranial fossae.
                   •    The tentorium cerebelli separates
                        the cerebral hemispheres posteriorly
                                                                                                        occipital
                        from the cerebellum.
                                                        frontal
                                                                                 temporal

                                             cerebrum


                                        cerebellum                                                      Posterior
                                                                                                         cranial
                                                                                                          fossa

                   Tentorium                                Anterior cranial
                    cerebelli                                   fossa
                                                                                 Middle cranial fossa

                   •    Thus the tentorium cerebelli forms a tent for the cerebellum (a roof) and a floor for
Dr. Akram Jaffar




                        the posterior part of the cerebral hemispheres.

                                                                                                             Dr. Akram Jaffar
Gross anatomy of the cerebral hemisphere
                   •   The cerebral hemispheres lie on
                       either side of the mid-sagittal plane.




                                                                                                                      Cerebral hemisphere
                   •




                                                                                Cerebral hemisphere
                       The hemispheres are partly
                       separated by the median
                       longitudinal fissure




                                                                                                      Mid-sagitta   Inferior view
                                             Median                                                   plane
                                             Longitudinal
                                             fissure
Dr. Akram Jaffar




                                                                Superior view
                                                                                                                                            Dr. Akram Jaffar
Median longitudinal fissure
                   •   A sickle-shaped fold of dura called the
                       falx cerebri lies in the median
                       longitudinal fissure.

                   •   The hemispheres are joined
                       together by a band of nerve fibers
                       called the corpus callosum.

                                                Corpus callosum
Dr. Akram Jaffar




                              Coronal section
                                                                  Dr. Akram Jaffar
Gross anatomy of the cerebral hemisphere


                   •   The hemispheres have an outer
                       layer of grey matter called the
                       cerebral cortex.
                   •   Most of the neurons in the CNS are
                       found in the cortex.

                                                                 cortex


                                                                nucleus




                   •   Collections of neurons situated deeply
                       are called nuclei.


                                                                                        White matter
Dr. Akram Jaffar




                                                                          grey matter


                                                                                                 Dr. Akram Jaffar
Sulci and gyri
                   •     The cortex is greatly convoluted: the grooves are called sulci (Sing. = sulcus).
                   •     The sulci separate ridges of brain tissue called gyri (Sing. = gyrus).
                   •     The convolutions of the cortex increase its surface area so that about 2/3rd of the
                         total surface area is hidden in the sulci.




                       sulcus



                                                                            gyrus

                                                                             gyrus
Dr. Akram Jaffar




                                                                                                               Dr. Akram Jaffar
Poles and surfaces of the hemisphere
                      •   Each hemisphere has frontal,                  •    Each hemisphere has lateral,
                          occipital and temporal poles.                      medial and inferior surfaces




                                                              Frontal
                                                               pole




                   occipital                       temporal
                     pole                            pole
                               Lateral surface
                                                                                         Medial surface
Dr. Akram Jaffar




                                                                 Inferior surface
                                                                                                            Dr. Akram Jaffar
Lobes of the hemisphere
                   •   Each hemisphere has frontal, parietal, occipital, and temporal lobes.
                   •   The lobes are named after the
                       closely related bones of the skull


                                                                                     Parietal lobe
                                                                Frontal lobe


                                                                                                     Occipital
                                                                                                     lobe
                                                                               Temporal lobe
                          Frontal       parietal
                          bone          bone


                                     temporal      occipital
                                     bone          bone
Dr. Akram Jaffar




                                                                                                                 Dr. Akram Jaffar
Features of the lateral surface
                   •    A deep lateral sulcus divides the frontal and parietal lobes from the temporal lobe.


                                                                                      Central sulcus



                   •    The central sulcus
                        divides the frontal
                        and parietal lobes.                    frontal                 parietal
                                                               lobe                    lobe




                                                                          temporal
                                                                          lobe
                                              Lateral sulcus
Dr. Akram Jaffar




                                                                                                               Dr. Akram Jaffar
Features of the lateral surface
                   •   Precentral gyrus
                        – anterior to the central
                           sulcus.
                        – in the frontal lobe.           frontal                parietal
                                                         lobe                   lobe




                                                                         r us

                                                                            s
                        – limited anteriorly by a




                                                                       gyru
                           precentral sulcus that




                                                                    al gy
                           runs parallel to the




                                                                 tr al
                           central sulcus.




                                                              ent r

                                                            tcen
                                                          Prec

                                                         Pos
                   •   Postcentral gyrus
                        – posterior to the central
                          sulcus.
                        – located in the parietal             temporal
                          lobe.                               lobe
                        – limited posteriorly by a
                          postcentral sulcus that
                          runs parallel to the central
                          sulcus.
Dr. Akram Jaffar




                                                                                           Dr. Akram Jaffar
Features of the lateral surface
                   •   The parietal lobe posterior to the postcentral sulcus is divided by the intraparietal
                       sulcus into a superior and inferior parietal lobules




                                                                                     r us

                                                                                        s
                                   Superior frontal                                          Su




                                                                                   gyru
                                                                                               pe
                                       gyrus                                                      r   io




                                                                                al gy
                                                                                                        rp
                                                                                                          ar
                                                                                                               ie
                                                                                            parietal              ta




                                                                             tr al
                                                        frontal                                                      l   lo




                                                                          ent r
                                   Middle frontal                                                                          bu
                                                        lobe                                lobe                             le




                                                                        tcen
                                      gyrus
                                                                                               Inferior




                                                                      Prec
                                                                                               parietal




                                                                     Pos
                                                                                               lobule

                                   Inferior frontal
                                        gyrus


                                                                          temporal
                                                                          lobe



                   •   In the frontal lobe, two horizontal sulci divide the surface into superior, middle, and
Dr. Akram Jaffar




                       inferior frontal gyri.

                                                                                                                                  Dr. Akram Jaffar
Features of the lateral surface
                   •   In the temporal lobe, the sulci divide the surface into superior, middle and inferior
                       temporal gyri.




                                                                                    r us

                                                                                       s
                                   Superior frontal                                         Su




                                                                                  gyru
                                                                                              pe
                                       gyrus                                                     r   io




                                                                               al gy
                                                                                                       rp
                                                                                                         ar
                                                                                                              ie
                                                                                           parietal              ta




                                                                            tr al
                                                       frontal                                                      l   lo




                                                                         ent r
                                  Middle frontal                                                                          bu
                                                       lobe                                lobe                             le




                                                                       tcen
                                     gyrus
                                                                                              Inferior




                                                                     Prec
                                                                                              parietal




                                                                    Pos
                                                                                              lobule

                                   Inferior frontal
                                        gyrus


                                                                         temporal
                                                                         lobe                                                    Superior
                                                                                                                                 temporal
                                                                                                 Middle                            gyrus
                                                                                                temporal
                                                                                                  gyrus
                                                                   inferior
Dr. Akram Jaffar




                                                                  temporal
                                                                    gyrus

                                                                                                                                    Dr. Akram Jaffar
The insula
                   •   The margins of the lateral sulcus overlap a
                       buried (deeply placed) area of the cerebral
                       cortex called the insula.

                                                                Lateral sulcus


                                                                                    Coronal section




                                                    •   The insula can be seen
                                                        only when the lips of the
                                                        lateral selcus are
                                                        separated away from
                                                        each other.

                                                                                               insula
Dr. Akram Jaffar




                           Horizontal section

                                                                                                        Dr. Akram Jaffar
Features of the medial surface
                   •   The corpus callosum is a band of nerve fibers joining the two cerebral hemispheres.



                   •   In midsagittal section,
                       the corpus callosum,
                       has the shape of a
                       hook lying horizontally.
                                                                     body


                                                         genu                 splenium

                                                          rostrum




                   •   The pointed portion is the rostrum (beak)
                   •   The bend is the genu (knee)
                   •   The horizontal part is the body
                   •   The expanded posterior end is the splenium
Dr. Akram Jaffar




                                                                                                       Dr. Akram Jaffar
Features of the medial surface
                   •   The cingulate gyrus lies above
                                                                          Central sulcus
                       and parallel to the corpus
                       callosum.

                   •   The central sulcus, unlike
                       the pre- and post-central
                       sulci, extends on the
                       medial surface.                             body


                                                        genu                splenium

                                                         rostrum
Dr. Akram Jaffar




                                                                                           Dr. Akram Jaffar
Features of the medial surface
                       •   The calcarine sulcus extends horizontally               Central sulcus   Parieto-
                           backwards from behind the splenium of the                                occipital
                           corpus callosum to the occipital pole.                                    sulcus




                                                                            body


                                                             genu                    splenium

                                                               rostrum
                                                                                                           occipital
                                                                                                             pole



                   •       The parieto-occipital sulcus passes obliquely
                                                                                                    Calcarine
                           upwards from about the middle of the calcarine
                                                                                                     sulcus
                           sulcus to the superior margin of the medial
                           surface.
Dr. Akram Jaffar




                                                                                                         Dr. Akram Jaffar
The pre-occipital notch
                        o    On the inferior margin there is a notch produced by the petrous temporal bone
                             called the preoccipital notch.
                        o    An imaginary line can be drawn from the superior margin (where the parieto-occipital
                             sulcus extends) to the preoccipital notch on the inferior magin.

                        o    This imaginary line divides the occipital lobe from the parietal and temporal lobes



                                                                                                                                    Parieto-
                                                                                                                                    occipital
                                                                                   Parieto-occipital                                 sulcus
                                                                                        sulcus

                                                                                                                             parietal
                                                                                                                             lobe

                                                                                                                      temporal
                                                                                                                      lobe              occipital
                                                                                                                                        lobe



                   Petrous temporal
                   bone                                       Preoccipital notch
                                                                                                       Pre-occipital notch
Dr. Akram Jaffar




                                                                                                                                  Dr. Akram Jaffar
Features of the inferior surface
                   •    The inferior surface is separated from the
                        midbrain by the hippocampal sulcus

                   •    The parahippocampal gyrus borders
                        the hippocampal sulcus.
                                                                                   uncus
                   •    The parahippocampal gyrus is
                        separated laterally by the
                        collateral sulcus from the rest
                        of the cortex of the temporal
                        lobe.                                                          midbrain

                   •    Anteriorly the parahippocampal                                            temporal
                        gyrus has a short recurved part                                           lobe
                        called the uncus.
                                                                     Hippocampal
                                                                        sulcus




                                                                        Collateral sulcus
Dr. Akram Jaffar




                                                                                                        Dr. Akram Jaffar
Functional localization in the cerebral cortex
                   •   Different areas of the cerebral cortex are functionally specialized.
                   •   The simple division of cortical areas into motor and sensory areas is not exactly true,
                       as these occupy only a small part of the total surface area.
                   •   The remaining areas are called association areas.
Dr. Akram Jaffar




                                                                                                           Dr. Akram Jaffar
Frontal lobe

                   Primary motor area
                   o   The primary motor area is the major source of projection fibers to the low lying brain
                       stem and spinal cord.



                   o   In the precentral




                                                                                  r us
                       gyrus and extends




                                                                             al gy
                       to the medial
                       surface of the
                                                       frontal




                                                                        ent r
                       cerebral
                       hemisphere.                     lobe




                                                                    Prec
Dr. Akram Jaffar




                                                                                                          Dr. Akram Jaffar
Frontal lobe

                   Primary motor area
                   •   Somatotopic representation in the primary motor area is in the form of an inverted
                       homunculus in which the size of the bodily regions is related to the motor skill
                       involved rather than to the bulk of the body region.


                   •   Thus the tongue, larynx, face
                       and hand areas are
                       disproportionately large.




                   •   The trunk and lower
                       extremities representation is
                       small in proportion to the
                       actual size and located
                       superiorly and on the medial
                       surface.
Dr. Akram Jaffar




                                                                                                            Dr. Akram Jaffar
Frontal lobe

                   Primary motor area
                   •   The primary motor area controls voluntary movements on the contralateral side of
                       the body




                   •   Destruction  paralysis




                   •   Excessive stimulation produces
                       epileptic convulsions.
Dr. Akram Jaffar




                                                                                                    Dr. Akram Jaffar
Frontal lobe

                   Prefrontal area
                   •   A large area in the anterior part of the frontal cortex.




                   •   Responsible for the
                       makeup of the




                                                   
                       personality,
                       behavior, feeling,
                       planning, and
                       judgment.
Dr. Akram Jaffar




                                                                                  Dr. Akram Jaffar
Frontal lobe

                   Motor speech area

                   •   Situated in the inferior frontal gyrus of the dominant
                       hemisphere, i.e. on the left side in right-handed individuals.

                                                                         Broca’s area
                   •   It forms the speech by its
                       connections with the                                             Paul Broca
                       adjacent motor areas for                                         1824 - 1880
                       the muscles of the mouth,
                       pharynx and larynx.


                   •   Its destruction results
                       in paralysis of speech
                       (motor aphasia) in
                       which the language is
                       understood but it
                       cannot be expressed in
                       speech or writing.
Dr. Akram Jaffar




                                                                                                  Dr. Akram Jaffar
Parietal lobe

                   Primary sensory area
                   •   Occupies the postcentral gyrus, extending to the medial side of the cerebral
                       hemisphere

                   •   Receives fibers originating from the contralateral side of the body.

                   o   The somatotopic




                                                                                              s
                                                                                         gyru
                       representation is in
                       the form of an
                                                                                                  parietal




                                                                                   tr al
                       inverted                         frontal
                       homunculus.                      lobe                                      lobe




                                                                              tcen
                                                                           Pos
                                                                         temporal
                                                                         lobe
Dr. Akram Jaffar




                                                  Destruction cause  loss of sensation

                                                                                                             Dr. Akram Jaffar
Parietal lobe

                   Sensory speech area
                   •   Is located in the inferior parietal lobule. It is also called Wernicke’s area.


                   •   Like the motor speech area, it exists
                       only on the dominant hemisphere.
                   •   It is concerned with
                       understanding of language,
                       written or spoken.                                              parietal
                                                                                       lobe
                                                                                          Inferior
                   •   It receives impulses
                       from the visual cortex                                             parietal
                       and the auditory                                                   lobule
                       cortex (input),
                       understand them                                 Auditory
                                                                                                            Visual
                                                                                                            cortex
                       (processing), and is                            cortex
                       connected to the                                  temporal
                       motor speech area                                 lobe
                       (output).


                   •   Its damage results in sensory aphasia: the inability to understand written and
Dr. Akram Jaffar




                       spoken language. The patient is able to see the words but is unable to understand
                       them or to copy them.
                                                                                                           Dr. Akram Jaffar
Temporal lobe

                   Primary auditory area
                   •   The primary auditory area is located on superior temporal gyrus.

                   •   It receives auditory input bilaterally; thus a unilateral damage produces some
                       (partial) deafness in both ears with the greater loss in the contralateral ear.
Dr. Akram Jaffar




                                                                                                         Dr. Akram Jaffar
Functional localization in the occipital lobe
                                            •   The primary visual area lies in the walls
                                                and floor of the posterior part of the
                                                calcarine sulcus extending to the occipital
                                                pole.
Dr. Akram Jaffar




                                                                                          Dr. Akram Jaffar
Primary visual area




                   •    There is an inverted representation of the visual fields:
                         –   the left visual field projects to the right visual cortex and vice versa.
                         –   the upper visual field projects to the lower part of the visual cortex and vice versa.
                   •    The region of the retina concerned with highest visual resolution (macula) has an
                        extensive representation and occupies the posterior third of the primary visual area.
Dr. Akram Jaffar




                                                                                                                      Dr. Akram Jaffar
Cerebral dominance                                   left   right
                   – Most of the functions of the cerebral cortex are
                     related equally to both cerebral hemispheres.

                   – Language tend to be lateralized: the
                     hemisphere that is more important for
                     the comprehension and production of
                     language is called the dominant
                     hemisphere.


                   – The non-dominant
                     hemisphere although inferior
                     in language functions is
                     superior in other functions.
Dr. Akram Jaffar




                                                                                       Dr. Akram Jaffar
Cerebral dominance                                       left   right
                   – In most individuals the left hemisphere is dominant.

                   – The dominant hemisphere is
                     concerned with handedness
                     (writing) and speech (more than
                     90% of people are right-
                     handed). But the majority of the
                     left handers are left dominant.


                   – The dominant hemisphere is
                     concerned with language,
                     mathematical and analytical
                     functions

                   – The non-dominant hemisphere
                     is concerned with spatial and
                     pictorial concepts and the
                     recognition of faces and music.
Dr. Akram Jaffar




                                                                                           Dr. Akram Jaffar
The Cerebellum
Dr. Akram Jaffar




                                    Dr. Akram Jaffar
Position & peduncles of the cerebellum


                   •   Lies in the posterior cranial
                       fossa inferior to the tentorium
                       cerebelli.                                        Tentorium cerebelli

                   •   Is attached to the back of the
                                                                          Cerebellum
                       brain stem by three paired
                       bundles of fibers: superior,
                       middle, and inferior cerebellar
                       peduncles.

                                                                                                4th ventricle
                                                   Superior cerebellar
                                                   peduncle

                                                   Middle cerebellar
                                                   peduncle

                                                   Inferior cerebellar
                                                   peduncle

                                                                                               Cerebellum
Dr. Akram Jaffar




                                                                                                   Dr. Akram Jaffar
Gross appearance of the cerebellum
                   •     Two cerebellar hemispheres joined by a narrow median vermis.
                   •     The inferior surface shows a deep groove, the vallecula, the floor of which is
                         formed by the inferior aspect of the vermis.
                   •     The tonsil is a partly detached lobule overhanging the inferior vermis on each
                         side.




                       vermis                                 vermis




                                                                                                       tonsil
Dr. Akram Jaffar




                                                                                           vallecula
                                                                            Ventral view
                                   Dorsal view
                                                                                                                Dr. Akram Jaffar
Gross appearance of the cerebellum
                     •   The cortex, which is greatly convoluted.
                     •   The sulci are parallel and the ridges between them are called the folia.
                     •   In some places deep fissures are present.
                     •   The cerebellum forms the roof for the fourth ventricle.




                                                                         4th ventricle

                                                                      cortex
                                           4th ventricle

                                                           sulcus



                                                             folium




                   Fissure
Dr. Akram Jaffar




                                                                      Horizontal section of the cerebellum at the middle cerebellar peduncle
                                                                                                                                  Dr. Akram Jaffar
Cerebellar nuclei
                   •   Four pairs of nuclei.
                   •   The largest is the dentate nucleus.
                   •   Cerebellar afferents project to the cerebellar cortex, whose output is mostly to the
                       cerebellar nuclei in which efferent fibers originate.




                                                                                                      Dentate nucleus
Dr. Akram Jaffar




                                                                                                              Dr. Akram Jaffar
Fissures & lobes of the cerebellum
                                                                                   Dorsal view
                   •    Primary fissure:
                       –    Located on the superior surface.    Primary fissure

                       –    Separates the anterior lobe from                       Anterior lobe
                            the middle (posterior) lobe.
                   •    Horizontal fissure
                       –    Located posteriorly within the                         Middle lobe
                            middle lobe.
                   •    The uvulo-nodular fissure
                       –    Located on the inferior surface.
                       –    Separates the middle lobe from
                            the flocculo-nodular lobe.                            Uvulo-nodular fissure



                                                                                                   Flocculo-nodular lobe




                                                   Horizontal fissure
Dr. Akram Jaffar




                                                                                  Ventral view
                                                                                                                 Dr. Akram Jaffar
Functional lobes of the cerebellum
                                                             Dorsal view

                   •   Vestibulocerebellum:
                        – Flocculonodular lobe mainly.
                                                            spinocerebellum
                        – Maintains equilibrium.
                   •   Spinocerebellum:
                        – Anterior lobe mainly.
                        – Concerned with unconscious        pontocerebellum
                           proprioception.
                   •   Pontocerebellum:
                        – Middle lobe mainly.
                        – Coordination of fine movements.



                                                                           vestibulocerebellum
Dr. Akram Jaffar




                                                            Ventral view
                                                                                          Dr. Akram Jaffar
Cerebellar control and dysfunction
                   •    Each cerebellar hemisphere controls the same side
                        of the body either because of ipsilateral projection       cerebellum
                        of some fibers or because other fibers cross twice.
                   •    Since the cerebellum is concerned with:
                         – Coordination of muscular activity ≠ ataxia
                             (in-coordination of movement)
                         – Proprioception ≠  hypotonia and tremor
                         – Equilibrium ≠  vertigo.




                                                                               Spinal cord
Dr. Akram Jaffar




                             Ataxia             Vertigo               Tremor

                                                                                             Dr. Akram Jaffar

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  • 1. The Brain I Gross Anatomy and Functional Localization (for dental students) Dr.Akram Abood Jaffar Assistant Professor of Anatomy M.B.Ch.B., M.Sc., Ph.D. Dr. Akram Jaffar Dr. Akram Jaffar
  • 2. Objectives he cerebrum escribe the gross anatomical features of the cerebral cortex on the lateral, medial and inferior surfaces of the cerebral hemishphere. dentify the poles (frontal, occipital and temporal poles) and the lobes of the cerebral hemisphere: frontal, parietal, temporal, and occipital. Locate the boundaries between the lobes. numerate fissures of the brain and the main sulci and gyri in each lobe. ifferentiate the central sulcus from the precentral and postcentral sulci. dentify: superior and inferior frontal sulci, supeiror, middle and inferior frontal gyri; interparietal sulcus; superior and inferior parietal lobules; superior and inferior temporal sulci; superior, middle and inferior temporal gyri; parahippocampal gyrus, collateral sulcus, gyrus rectus, rhinal sulcus, uncus, olfactory sulcus, anterior perforated substance, preoccipital notch, calcarine sulcus, parieto-occipital sulcus, cingulate gyrus, cingulate sulcus, paracentral lobule, H-shaped gyri. dentify, define, and describe the parts of the corpus callosum sagittal and coronal sections of the brain. escribe the position of the insula. iscuss the location of main functional areas of the cerebral cortex and the effect of their damage: primary motor area, profrontal area, motor speech area, sensory speech area, primary sensory area, visula area, olfactory area, auditory area. ppreciate that the representation in the cerebral cortex is related to the functional importance. Further reading iscuss the concept of cerebral dominance and its relation to handedness. he cerebellum: Dr. Akram Jaffar • Snell RS (2010): Clinical Neuroanatomy. 7th Ed. Lippincott, Williams and Wilkins. escribe the position of the cerebellum and the connection of its peducles with the brain stem. Baltimore. efine gross features of the cerebellum: folia, sulci, vermis, tonsil, vallecula Dr. Akram Jaffar
  • 3. Gross anatomy of the cerebral hemisphere • The cerebral hemispheres are covered superiorly by the bones of the vault of the skull. • Inferiorly they lie on the bones of the parietal anterior and middle cranial fossae. • The tentorium cerebelli separates the cerebral hemispheres posteriorly occipital from the cerebellum. frontal temporal cerebrum cerebellum Posterior cranial fossa Tentorium Anterior cranial cerebelli fossa Middle cranial fossa • Thus the tentorium cerebelli forms a tent for the cerebellum (a roof) and a floor for Dr. Akram Jaffar the posterior part of the cerebral hemispheres. Dr. Akram Jaffar
  • 4. Gross anatomy of the cerebral hemisphere • The cerebral hemispheres lie on either side of the mid-sagittal plane. Cerebral hemisphere • Cerebral hemisphere The hemispheres are partly separated by the median longitudinal fissure Mid-sagitta Inferior view Median plane Longitudinal fissure Dr. Akram Jaffar Superior view Dr. Akram Jaffar
  • 5. Median longitudinal fissure • A sickle-shaped fold of dura called the falx cerebri lies in the median longitudinal fissure. • The hemispheres are joined together by a band of nerve fibers called the corpus callosum. Corpus callosum Dr. Akram Jaffar Coronal section Dr. Akram Jaffar
  • 6. Gross anatomy of the cerebral hemisphere • The hemispheres have an outer layer of grey matter called the cerebral cortex. • Most of the neurons in the CNS are found in the cortex. cortex nucleus • Collections of neurons situated deeply are called nuclei. White matter Dr. Akram Jaffar grey matter Dr. Akram Jaffar
  • 7. Sulci and gyri • The cortex is greatly convoluted: the grooves are called sulci (Sing. = sulcus). • The sulci separate ridges of brain tissue called gyri (Sing. = gyrus). • The convolutions of the cortex increase its surface area so that about 2/3rd of the total surface area is hidden in the sulci. sulcus gyrus gyrus Dr. Akram Jaffar Dr. Akram Jaffar
  • 8. Poles and surfaces of the hemisphere • Each hemisphere has frontal, • Each hemisphere has lateral, occipital and temporal poles. medial and inferior surfaces Frontal pole occipital temporal pole pole Lateral surface Medial surface Dr. Akram Jaffar Inferior surface Dr. Akram Jaffar
  • 9. Lobes of the hemisphere • Each hemisphere has frontal, parietal, occipital, and temporal lobes. • The lobes are named after the closely related bones of the skull Parietal lobe Frontal lobe Occipital lobe Temporal lobe Frontal parietal bone bone temporal occipital bone bone Dr. Akram Jaffar Dr. Akram Jaffar
  • 10. Features of the lateral surface • A deep lateral sulcus divides the frontal and parietal lobes from the temporal lobe. Central sulcus • The central sulcus divides the frontal and parietal lobes. frontal parietal lobe lobe temporal lobe Lateral sulcus Dr. Akram Jaffar Dr. Akram Jaffar
  • 11. Features of the lateral surface • Precentral gyrus – anterior to the central sulcus. – in the frontal lobe. frontal parietal lobe lobe r us s – limited anteriorly by a gyru precentral sulcus that al gy runs parallel to the tr al central sulcus. ent r tcen Prec Pos • Postcentral gyrus – posterior to the central sulcus. – located in the parietal temporal lobe. lobe – limited posteriorly by a postcentral sulcus that runs parallel to the central sulcus. Dr. Akram Jaffar Dr. Akram Jaffar
  • 12. Features of the lateral surface • The parietal lobe posterior to the postcentral sulcus is divided by the intraparietal sulcus into a superior and inferior parietal lobules r us s Superior frontal Su gyru pe gyrus r io al gy rp ar ie parietal ta tr al frontal l lo ent r Middle frontal bu lobe lobe le tcen gyrus Inferior Prec parietal Pos lobule Inferior frontal gyrus temporal lobe • In the frontal lobe, two horizontal sulci divide the surface into superior, middle, and Dr. Akram Jaffar inferior frontal gyri. Dr. Akram Jaffar
  • 13. Features of the lateral surface • In the temporal lobe, the sulci divide the surface into superior, middle and inferior temporal gyri. r us s Superior frontal Su gyru pe gyrus r io al gy rp ar ie parietal ta tr al frontal l lo ent r Middle frontal bu lobe lobe le tcen gyrus Inferior Prec parietal Pos lobule Inferior frontal gyrus temporal lobe Superior temporal Middle gyrus temporal gyrus inferior Dr. Akram Jaffar temporal gyrus Dr. Akram Jaffar
  • 14. The insula • The margins of the lateral sulcus overlap a buried (deeply placed) area of the cerebral cortex called the insula. Lateral sulcus Coronal section • The insula can be seen only when the lips of the lateral selcus are separated away from each other. insula Dr. Akram Jaffar Horizontal section Dr. Akram Jaffar
  • 15. Features of the medial surface • The corpus callosum is a band of nerve fibers joining the two cerebral hemispheres. • In midsagittal section, the corpus callosum, has the shape of a hook lying horizontally. body genu splenium rostrum • The pointed portion is the rostrum (beak) • The bend is the genu (knee) • The horizontal part is the body • The expanded posterior end is the splenium Dr. Akram Jaffar Dr. Akram Jaffar
  • 16. Features of the medial surface • The cingulate gyrus lies above Central sulcus and parallel to the corpus callosum. • The central sulcus, unlike the pre- and post-central sulci, extends on the medial surface. body genu splenium rostrum Dr. Akram Jaffar Dr. Akram Jaffar
  • 17. Features of the medial surface • The calcarine sulcus extends horizontally Central sulcus Parieto- backwards from behind the splenium of the occipital corpus callosum to the occipital pole. sulcus body genu splenium rostrum occipital pole • The parieto-occipital sulcus passes obliquely Calcarine upwards from about the middle of the calcarine sulcus sulcus to the superior margin of the medial surface. Dr. Akram Jaffar Dr. Akram Jaffar
  • 18. The pre-occipital notch o On the inferior margin there is a notch produced by the petrous temporal bone called the preoccipital notch. o An imaginary line can be drawn from the superior margin (where the parieto-occipital sulcus extends) to the preoccipital notch on the inferior magin. o This imaginary line divides the occipital lobe from the parietal and temporal lobes Parieto- occipital Parieto-occipital sulcus sulcus parietal lobe temporal lobe occipital lobe Petrous temporal bone Preoccipital notch Pre-occipital notch Dr. Akram Jaffar Dr. Akram Jaffar
  • 19. Features of the inferior surface • The inferior surface is separated from the midbrain by the hippocampal sulcus • The parahippocampal gyrus borders the hippocampal sulcus. uncus • The parahippocampal gyrus is separated laterally by the collateral sulcus from the rest of the cortex of the temporal lobe. midbrain • Anteriorly the parahippocampal temporal gyrus has a short recurved part lobe called the uncus. Hippocampal sulcus Collateral sulcus Dr. Akram Jaffar Dr. Akram Jaffar
  • 20. Functional localization in the cerebral cortex • Different areas of the cerebral cortex are functionally specialized. • The simple division of cortical areas into motor and sensory areas is not exactly true, as these occupy only a small part of the total surface area. • The remaining areas are called association areas. Dr. Akram Jaffar Dr. Akram Jaffar
  • 21. Frontal lobe Primary motor area o The primary motor area is the major source of projection fibers to the low lying brain stem and spinal cord. o In the precentral r us gyrus and extends al gy to the medial surface of the frontal ent r cerebral hemisphere. lobe Prec Dr. Akram Jaffar Dr. Akram Jaffar
  • 22. Frontal lobe Primary motor area • Somatotopic representation in the primary motor area is in the form of an inverted homunculus in which the size of the bodily regions is related to the motor skill involved rather than to the bulk of the body region. • Thus the tongue, larynx, face and hand areas are disproportionately large. • The trunk and lower extremities representation is small in proportion to the actual size and located superiorly and on the medial surface. Dr. Akram Jaffar Dr. Akram Jaffar
  • 23. Frontal lobe Primary motor area • The primary motor area controls voluntary movements on the contralateral side of the body • Destruction  paralysis • Excessive stimulation produces epileptic convulsions. Dr. Akram Jaffar Dr. Akram Jaffar
  • 24. Frontal lobe Prefrontal area • A large area in the anterior part of the frontal cortex. • Responsible for the makeup of the  personality, behavior, feeling, planning, and judgment. Dr. Akram Jaffar Dr. Akram Jaffar
  • 25. Frontal lobe Motor speech area • Situated in the inferior frontal gyrus of the dominant hemisphere, i.e. on the left side in right-handed individuals. Broca’s area • It forms the speech by its connections with the Paul Broca adjacent motor areas for 1824 - 1880 the muscles of the mouth, pharynx and larynx. • Its destruction results in paralysis of speech (motor aphasia) in which the language is understood but it cannot be expressed in speech or writing. Dr. Akram Jaffar Dr. Akram Jaffar
  • 26. Parietal lobe Primary sensory area • Occupies the postcentral gyrus, extending to the medial side of the cerebral hemisphere • Receives fibers originating from the contralateral side of the body. o The somatotopic s gyru representation is in the form of an parietal tr al inverted frontal homunculus. lobe lobe tcen Pos temporal lobe Dr. Akram Jaffar Destruction cause  loss of sensation Dr. Akram Jaffar
  • 27. Parietal lobe Sensory speech area • Is located in the inferior parietal lobule. It is also called Wernicke’s area. • Like the motor speech area, it exists only on the dominant hemisphere. • It is concerned with understanding of language, written or spoken. parietal lobe Inferior • It receives impulses from the visual cortex parietal and the auditory lobule cortex (input), understand them Auditory Visual cortex (processing), and is cortex connected to the temporal motor speech area lobe (output). • Its damage results in sensory aphasia: the inability to understand written and Dr. Akram Jaffar spoken language. The patient is able to see the words but is unable to understand them or to copy them. Dr. Akram Jaffar
  • 28. Temporal lobe Primary auditory area • The primary auditory area is located on superior temporal gyrus. • It receives auditory input bilaterally; thus a unilateral damage produces some (partial) deafness in both ears with the greater loss in the contralateral ear. Dr. Akram Jaffar Dr. Akram Jaffar
  • 29. Functional localization in the occipital lobe • The primary visual area lies in the walls and floor of the posterior part of the calcarine sulcus extending to the occipital pole. Dr. Akram Jaffar Dr. Akram Jaffar
  • 30. Primary visual area • There is an inverted representation of the visual fields: – the left visual field projects to the right visual cortex and vice versa. – the upper visual field projects to the lower part of the visual cortex and vice versa. • The region of the retina concerned with highest visual resolution (macula) has an extensive representation and occupies the posterior third of the primary visual area. Dr. Akram Jaffar Dr. Akram Jaffar
  • 31. Cerebral dominance left right – Most of the functions of the cerebral cortex are related equally to both cerebral hemispheres. – Language tend to be lateralized: the hemisphere that is more important for the comprehension and production of language is called the dominant hemisphere. – The non-dominant hemisphere although inferior in language functions is superior in other functions. Dr. Akram Jaffar Dr. Akram Jaffar
  • 32. Cerebral dominance left right – In most individuals the left hemisphere is dominant. – The dominant hemisphere is concerned with handedness (writing) and speech (more than 90% of people are right- handed). But the majority of the left handers are left dominant. – The dominant hemisphere is concerned with language, mathematical and analytical functions – The non-dominant hemisphere is concerned with spatial and pictorial concepts and the recognition of faces and music. Dr. Akram Jaffar Dr. Akram Jaffar
  • 33. The Cerebellum Dr. Akram Jaffar Dr. Akram Jaffar
  • 34. Position & peduncles of the cerebellum • Lies in the posterior cranial fossa inferior to the tentorium cerebelli. Tentorium cerebelli • Is attached to the back of the Cerebellum brain stem by three paired bundles of fibers: superior, middle, and inferior cerebellar peduncles. 4th ventricle Superior cerebellar peduncle Middle cerebellar peduncle Inferior cerebellar peduncle Cerebellum Dr. Akram Jaffar Dr. Akram Jaffar
  • 35. Gross appearance of the cerebellum • Two cerebellar hemispheres joined by a narrow median vermis. • The inferior surface shows a deep groove, the vallecula, the floor of which is formed by the inferior aspect of the vermis. • The tonsil is a partly detached lobule overhanging the inferior vermis on each side. vermis vermis tonsil Dr. Akram Jaffar vallecula Ventral view Dorsal view Dr. Akram Jaffar
  • 36. Gross appearance of the cerebellum • The cortex, which is greatly convoluted. • The sulci are parallel and the ridges between them are called the folia. • In some places deep fissures are present. • The cerebellum forms the roof for the fourth ventricle. 4th ventricle cortex 4th ventricle sulcus folium Fissure Dr. Akram Jaffar Horizontal section of the cerebellum at the middle cerebellar peduncle Dr. Akram Jaffar
  • 37. Cerebellar nuclei • Four pairs of nuclei. • The largest is the dentate nucleus. • Cerebellar afferents project to the cerebellar cortex, whose output is mostly to the cerebellar nuclei in which efferent fibers originate. Dentate nucleus Dr. Akram Jaffar Dr. Akram Jaffar
  • 38. Fissures & lobes of the cerebellum Dorsal view • Primary fissure: – Located on the superior surface. Primary fissure – Separates the anterior lobe from Anterior lobe the middle (posterior) lobe. • Horizontal fissure – Located posteriorly within the Middle lobe middle lobe. • The uvulo-nodular fissure – Located on the inferior surface. – Separates the middle lobe from the flocculo-nodular lobe. Uvulo-nodular fissure Flocculo-nodular lobe Horizontal fissure Dr. Akram Jaffar Ventral view Dr. Akram Jaffar
  • 39. Functional lobes of the cerebellum Dorsal view • Vestibulocerebellum: – Flocculonodular lobe mainly. spinocerebellum – Maintains equilibrium. • Spinocerebellum: – Anterior lobe mainly. – Concerned with unconscious pontocerebellum proprioception. • Pontocerebellum: – Middle lobe mainly. – Coordination of fine movements. vestibulocerebellum Dr. Akram Jaffar Ventral view Dr. Akram Jaffar
  • 40. Cerebellar control and dysfunction • Each cerebellar hemisphere controls the same side of the body either because of ipsilateral projection cerebellum of some fibers or because other fibers cross twice. • Since the cerebellum is concerned with: – Coordination of muscular activity ≠ ataxia (in-coordination of movement) – Proprioception ≠  hypotonia and tremor – Equilibrium ≠  vertigo. Spinal cord Dr. Akram Jaffar Ataxia Vertigo Tremor Dr. Akram Jaffar