Nervous system: brain, spinal cord Dr. L. Kiss Anna Department of Human Morphology and Developmental Biology, Semmelweis University 2015

MACROSCOPY Enlargements: Cervical enlargement (C4-T1) Lumbosacral enlargement (L2-S3) Conus terminalis Cauda equina Filum terminale Central nervous system Brain Spinal cord Peripheral nervous system Nerves Ganglia

cauda equina

Lumbal punction

MENINGES Dura mater Arachnoid Pia mater: Denticulate ligament

Meningeal layers of the spinal cord ganglion spinale arachnoidea fila radicularia dorsalia dura mater ligamentum denticulatum

Meningeal layers Dura mater: outer layer: endorachis inner layer Arachnoid layer Pia mater Epidural spce Subdural space Subarachnoid space

MENINGES Epidural space Subarachnoid space Denticulate ligament

Blodd supply of the spinal cord radicular arteries vertebral artery subclavian artery radicular arteries Aortic arch pathway of the vertebral artery

Vasocorona medullaris Vertebral artery: a.spinalis anterior a spinalis posterior Radicular arteries: cervical: vertebral a. ascending. cerv. a. deep cerv. a. thoracal: intercostal aa. lumbal: lumbal aa. sacral: lateral sacr. art.

CROSS SECTION Dorsal median sulcus Gray matter White matter Ventral median fissure Central canal

Cross section of the spinal cord post. (dors.) median sulcus post. (dorsalis)horn intermediate zone (Th and L2-L3): lat. horn central canal ant. (ventral) horn ant. (ventr.) median fissure

SPINAL CORD SEGMENT

SPINAL NERVES Dorsal branch Ventral branch

SPINAL CORD SEGMENTS Spinal cord ends at the level of the L1 vertebra in adults Lumbar and sacral roots travel several vertebrae down: cauda equina

SPINAL NERVES

SPINAL CORD SEGMENTS Number of segments: 8 cervical (!) 12 thoracic 5 lumbar 5 sacral 1 coccygeal

SEGMENTAL INNERVATION Dermatomes: segmental symptomes

CERVICAL PLEXUS AND BRACHIAL PLEXUS Cervical plexus (C1-4): Lesser occipital nerve Greater auricular nerve Transverse nerve of the neck Supraclavicular nerves Ansa cervicalis Phrenic nerve Branchial plexus (C5-T1): Superior trunk (C5-6) Middle trunk (C7) Inferior trunk (C8-T1)

CERVICAL PLEXUS AND BRACHIAL PLEXUS Branchial plexus (C5-T1): Lateral cord (C5-7) Lateral pectoral nerve Musculocutaneus nerve Median nerve (lateral root) Medial cord (C8-T1) Medial pectoral nerve Medial cutaneous n. of arm Medial cutaneous n. of forearm Ulnar nerve Median nerve (medial root) Posterior cord (C5-T1) Subscapular nerves Thoracodorsal nerve Axillary nerve Radial nerve

LUMBOSACRAL PLEXUS Lumbar plexus (T12-L4): Iliohypogastric nerve Ilioinguinal nerve Genitofemoral nerve Lateral cutaneous nerve of thigh Obturator nerve Femoral nerve Sacral plexus (L4-S3): Muscular branches Superior gluteal nerve Inferior gluteal nerve Posterior cutaneous nerve of thigh Sciatic nerve Tibial nerve Common peroneal nerve Pudendal nerve

Brain

Brain Brain stem Medulla oblongata Pons Midbrain (mesencephalon) Cerebellum Diencephalon (thalamus, hypothalamus, hypophysis) Cerebrum Brain stem

MEDIANSAGITTAL SECTION OF THE BRAIN STEM M M Mo P Mo

Meningeal layers of the brain Dura mater: falx cerebri, tentorium cerebelli, falx cerebelli sinuses: venous blood Aracnhoir layer: cisterns CSF Pia mater: blood vessels

VENTRICLES Lateral ventricle 3rd ventricle 4th ventricle

CEREBROSPINAL FLUID Production: choroid plexus: into ventricles Absorption: arachnoid villi: from subarachnoid space into superior sagittal sinus

BRAIN: Cerebrum SUPERIOR VIEW Frontal lobe Longitudinal cerebral fissure Parietal lobe Occipital lobe

BRAIN: MEDIANSAGITTAL CUT Longitudinal cerebral fissure Parietal lobe Corpus callosum Occipital lobe Frontal lobe Transverse cerebral fissure Temporal lobe Cerebellum

BRAIN: LATERAL VIEW Parietal lobe Central sulcus Frontal lobe Occipital lobe Transverse cerebral fissure Lateral cerebral sulcus Cerebellum Temporal lobe Pons Medulla oblongata

praecentral gyrus central sulcus postcentral gyrus

3rd and 5th layers-pyramidal cells

BRAIN: INFERIOR VIEW Longitudinal cerebral fissure Frontal lobe Olfactory nerve (I) Optic nerve (II) Optic chiasm Temporal lobe Optic tract Diencephalon Pons Medulla oblongata Cerebellum Occipital lobe

BLOOD SUPPLY: ARTERIES Arterial supply: Vertebral artery Internal carotid artery internal carotid artery vertebral artery

CIRCLE OF WILLIS Anterior communicating a. Anterior cerebral a. Internal carotid a. Middle cerebral a. Posterior communicating a. Posterior cerebral a. Basilar a. Vertebral a.

BLOOD SUPPLY: VEINS Venous drainage: Internal jugular vein: Sinuses Cerebral veins

BRAIN STEM: MEDULLA Glossopharyngeal n. (IX) Vagus n. (X) Olive Accessory n. (XI) Pyramid Hypoglossal n. (XII)

Midbrain (cross section) tectum: sup and inf colliculi Crus cerebri

BRAIN STEM Cerebral aqueduct Cerebellum Midbrain Pons Fourth ventricle Medulla Central canal

CEREBELLUM Cerebellar hemisphere Vermis Tonsil

CEREBELLUM Fastigial nucleus Cerebellar cortex Globose nucleus Emboliform nucleus White matter Dentate nucleus

CEREBELLUM Superior cerebellar peduncle Middle cerebellar peduncle Inferior cerebellar peduncle

Functional division of the nervous system Somatic Autonomic voluntary - unvoluntary starts and stops functions - regulates the functions (slow down-speed up) segmental - network sympathetic parasympathetic thora-columbar cranio-sacral

Autonomic nervous system: efferent part Sympathetic Parasympathetic - speeds up the functions - slows down the functions (except for digestive system) (except for the digestive system) - empties the stores - filles in the stores - adrenalin, noradrenalin - acetylcholine (sympatho-adrenal system) - last longer - shorter effect general effect - local effect short praeganglionic fibers -longer praeganglionic fibers longer postganglionic fibers shorter postganglionic fibers

Dr. Nándor Nagy picture

References Lecture and pictures of Dr. Nandor Nagy Sobotta atlas Wikipaedia