Contents

1. GROSS ANATOMY OF THE BRAIN
   Objectivas 1
   I. Introduction 1
   II. Divisions of the Brain 1
   Ill. Atlas of the Brain and Brainstem 10
   Review Test 22
2. MENINGES AND CEREBROSPINAL FLUID
   Objectivas 24
   I. Meninges 24
   II. Ventricles 28
   Ill. Cerebrospinal Fluid 30
   IV. Hydrocephalus 30
   V. Meningitis 31
   VI. Herniation 32
   VII. Circumventricular Organs 34
   Review Test 3&
   1
   24
3. BLOOD SUPPLY OF THE CENTRAL NERVOUS SYSTEM 39
   Objectives 39
   I. Arteries of the Spinal Cord 39
   II. Venous Drainage of the Spinal Cord 40
   Ill. Arteries of the Brain 41
   IV. Cerebral Arterial Circle (ofWillis) 45
   V. Meningeal Arteries 45
   VI. Veins of the Brain 45
   VII. Venous Dural Sinuses 46
   VIII. Angiography 48
   IX. Intracranial Hemorrhage 52
   Review Test 54
4. DEVELOPMENT OF THE NERVOUS SYSTEM
5. Objectives 58
6. I. Overview 58
7. II. Development of the Neural Tube 58
8. Ill. Neural Crest 59
9. IV. Placodes 61
10. V. Stages of Neural Tube Development 61
11. VI. Spinal Cord (Medulla Spinalis) 63
12. VII. Medulla oblongata (Myelencephalon) 64
13. VIII. Metencephalon 66
14. IX. Mesencephalon (Midbrain) 67
15. X. Development of the Diencephalon, Optic Structures, and Hypophysis 68
16. XI. Development of the Telencephalon 70
17. XII. Congenital Malformations of the Central Nervous System 71
18. Review Test 77
19. NEUROHISTOLOGY
20. Objectives 79
21. I. Overview 79
22. II. Neurons 79
23. Ill. Neuroglia 82
24. IV. Nerve Cell Degeneration and Regeneration 86
25. V. Axonal Transport 87
26. VI. Capillaries of the Central Nervous System 87
27. VII. Sensory Receptors 89
28. Review Test 91
29. SPINAL CORD
30. Objectives 93
31. I. Introduction 93
32. II. External Morphology 93
33. Ill. Internal Morphology 98
34. IV. Myotatic Reflex 101
35. Review Test 102
36. 58
37. 79
38. 93
39. TRACTS OF THE SPINAL CORD 104
    Objectives 104
    I. Ascending Tracts 104
    II. Descending Tracts 109
    Ill. Integrative Pathways 111
    IV. Clinical Correlations 112
    Review Test 114

8. LESIONS OF THE SPINAL CORD 117
   Obiectives 117
   I. Lower Motor Neuron Lesions 117
   II. Upper Motor Neuron Lesions (UMNs) 119
   Ill. Sensory Pathway Lesions 119
   IV. Peripheral Nervous System Lesions 120
   v. Combined Upper and Lower Motor Neuron Lesions 120
   VI. Combined Motor and Sensory Lesions 121
   VII. Intervertebral Disk Herniation 124
   Review lest 125
9. BRAINSTEM 129
   Obiectives 129
   I. Introduction 129
   II. Medulla Oblongata (Myelencephalon) 129
   Ill. Pons 134
   IV. Mesencephalon (Midbrain) 138
   v. Corticobulbar (Corticonuclear) Fibers 142
   Review lest 143
10. CRANIAL NERVES 145
    Obiectives 145
    I. Introduction 145
    II. Nervus Terminalis (NT; Cranial Nerve 0) 145
    Ill. Olfactory Nerve (CN I) 145
    IV. Optic Nerve ( CN II) 146
    v. Oculomotor Nerve ( CN III) 148
    VI. Trochlear Nerve ( CN IV) 149
    VII. Trigeminal Nerve ( CN V) 150
    VIII. Abducent Nerve (CNVI) 151
    IX. Facial Nerve (CN VII) 151
    X. Vestibulocochlear Nerve ( CN VIII) 154
    XI. Glossopharyngeal Nerve (CN IX) 154
    XII. Vagal Nerve ( CN X) 155
    XIII. Accessory Nerve ( CN XI) 156
    XIV. Hypoglossal Nerve (CN XII) 157
    Review lest 159
11. TRIGEMINAL SYSTEM 162
    Obiectives 162
    I. Trigeminal Nerve ( CN V) 162
    II. Ascending Trigeminothalamic Tracts 163

Ill. Trigeminal Sensory Nuclei 165
IV. Trigeminocerebellar Fibers 166
V. Trigeminal Reflexes 167
VI. Clinical Correlations 168
Review Test 170

12. LESIONS OF THE BRAINSTEM
    Objectives 172
    I. Introduction 172
    II. Vascular Lesions of the Medulla 172
    Ill. Vascular Lesions of the Pons 173
    IV. Lesions of the Midbrain 175
    V. Acoustic Neuroma (Schwannoma) 176
    VI. Internuclear Ophthalmoplegia 177
    VII. Jugular Foramen (Vernet) Syndrome 177
    VIII. Subclavian Steal Syndrome 178
    Review Test 179
    172
13. DIENCEPHALON: THALAMUS AND HYPOTHALAMUS 183
    Objectives 183
    I. Introduction: The Thalamus 183
    II. Boundaries of the Thalamus 183
    Ill. Primary Thalamic Nuclei and their Major Connections 184
    IV. Blood Supplyofthe Thalamus 187
    V. Internal Capsule 187
    VI. Blood Supply of the Internal Capsule 188
    VII. Clinical Correlations 188
    VIII. Overview: The Hypothalamus 189
    IX. Surface Anatomy of the Hypothalamus 189
    X. Hypothalamic Regions and Nuclei 189
    XI. Major Hypothalamic Connections 192
    XII. Major Fiber Systems 194
    XIII. Functional Considerations 195
    XIV. Clinical Correlations 196
    Review Test 197
14. AUDITORY SYSTEM
    Objectives 202
    I. Introduction 202
    II. Outer, Middle, and Inner Ear 202
    Ill. Auditory Pathway 204
    IV. Efferent Cochlear (Olivocochlear) Bundle 206
    V. Hearing Defects 206
    202

VI. 1.ming Fork Tests 207
VII. Brainstem Auditory Evoked Response (Baer) 207
Review Test 209

15. VESTIBULAR SYSTEM
    Obiectives 211
    I. Introduction 211
    II. Labyrinth 211
    Ill. Vestibular Pathways 213
    IV. Efferent Vestibular Connections 214
    V. Medial Longitudinal Fasciculus 214
    VI. Vestibulo-Ocular Reflexes 215
    VII. Decerebrate and Decorticate Rigidity 216
    VIII. Clinical Correlations 216
    Review Test 218
16. VISUAL SYSTEM
    Obiectives 220
    I. Introduction 220
    II. The Retina 220
    Ill. Visual Pathway 224
    IV. Pupillary Light Reflexes and Pathway 225
    V. Pupillary Dilation Pathway 227
    VI. The Convergence-Accommodation Reaction 227
    VII. Centers for Ocular Motility 228
    VIII. Clinical Correlations 229
    Review Test 232
    Contents xiii
    211
    220
17. OLFACTORY. GUSTATORY. AND LIMBIC SYSTEMS 236
    Obiectives 236
    I. Olfactory System 236
    II. Gustatory System 237
    Ill. Limbic System 239
    Review Test 245
18. BASAL NUCLEI AND THE EXTRAPYRAMIDAL
    MOTOR SYSTEM
    Obiectives 249
    I. Basal Nuclei 249
    II. Extrapyramidal Motor System 249
    Review Test 256
    249

19. CEREBELLUM
    Objectives 258
    I. Overview 258
    II. Major Divisions of the Cerebellum 258
    Ill. Cerebellar Cortex 260
    IV. Major Cerebellar Pathways 262
    V. Cerebellar Dysfunction 264
    VI. Cerebellar Lesions 264
    Review Test 266
20. AUTONOMOUS NERVOUS SYSTEM
    Objectives 268
    I. Overview 268
    II. Divisions of the Autonomic Nervous System 268
    Ill. Visceral Afferent Fibers and Pain 272
    IV. Autonomic Innervation of Selected Organs 273
    V. Clinical Correlations 275
    Review Test 276
21. NEUROTRANSMITTERS AND PATHWAYS
    Objectives 278
    I. Introduction 278
    II. Acetylcholine 279
    Ill. Dopamine 280
    IV. Norepinephrine (Noradrenalin) 281
    V. Serotonin (5-Hydroxytryptamine [5-HT]) 282
    VI. Opioid Peptides 283
    VII. Nonopioid Neuropeptides 284
    VIII. Amino Acids 284
    IX. Nitric Oxide 287
    X. Functional and Clinical Correlations 287
    Review Test 289
22. CEREBRAL CORTEX
    Objectives 293
    I. Overview 293
    II. Neocortex 293
    Ill. Functional Areas of the Cerebral Cortex 294
    IV. Cerebral Dominance 299
    V. Split-Brain Syndrome 301
    VI. Blood Supply to the Major Functional Cortical Areas 302

VII. Apraxia 303
VIII. Aphasia 304
IX. Dysprosodies 305
Review Test 306
Comprehensive Examination 311
Appendix: Table of Cranial Nerves 339
Glossary 342
Index 353
Contents XV

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