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2. Thalamus and the Internal Capsule MHD - Neuroanatomy Course February 2, 2016
Gregory Gruener, MD, MBA
Vice Dean for Education, SSOM
Professor & Associate Chair, Department of Neurology
LUHS/Trinity and Catholic Health Care East

3. Outcomes you need to be able to demonstrate
List the major subdivisions of the diencephalon and the thalamus
Identify the internal medullary lamina and intralaminar nuclei
Define the three functional groups of the thalamus
Summarize the function of the reticular nucleus of the thalamus
List what “afferents” supply individual thalamic nuclei and where those thalamic nuclei project

4. “Basic” pathway of sensory information to the thalamus
Anterolateral tract
1. Information gets collected
2. Transmitted
3. Looked at & analyzed
4. Interpreted
Gray’s anatomy: The anatomical basis of clinical practice, 40th edition; Churchill Livingstone, London

5. Thalamus
Lancet Neurol 2014; 13: 100–12

6. General Anatomical Overview
Divisions of the Diencephalon
Epithalamus (pineal gland, habenula, stria medullaris)
Dorsal thalamus
Subthalamus (subthalamic nucleus, zona incerta)
Hypothalamus
Internal medullary lamina
Anterior division nuclei
Medial division nuclei
Lateral division nuclei
Intralaminar nuclei
Thalamic reticular nuclei
Midline nuclei

7. Nolte J and Angevine JB. The Human Brain in photographs and diagrams
Nolte J and Angevine JB. The Human Brain in photographs and diagrams. 3rd edition, 2007; Mosby Elsevier

8. Fitzgerald MJT, Gruener G, Mtui E
Fitzgerald MJT, Gruener G, Mtui E. Clinical Neuroanatomy and related Neuroscience, 56th Ed., W. B. Saunders 2012

9. Fitzgerald MJT, Gruener G, Mtui E
Fitzgerald MJT, Gruener G, Mtui E. Clinical Neuroanatomy and related Neuroscience, 6th Ed., W. B. Saunders 2012

10. Common functional principles
Thalamic nuclei “decide” what information passes
Classification of nuclei – location and input/outputs
Consist of projection (majority) and inhibitory neurons
Inputs into the thalamus
Specific – e.g., posterior column/medial lemniscus pathway
Use glutamate as their neurotransmitter
Regulatory – Majority (Cortex, thalamic reticular nucleus, reticular formation, aminergic projections)

11. Functional thalamic groups
Three groupings
Specific or relay nuclei
Well defined inputs and projections
Anterior, ventral anterior, ventral lateral, ventral posterior, lateral dorsal, medial and lateral geniculate
Association nuclei
Reciprocally connected to association cortex
Lateral posterior, pulvinar, medial dorsal nuclei
Non-specific nuclei
Not the same point-to-point connections like relay nuclei
Intralaminar and thalamic reticular nuclei

12. Specific or relay nuclei
Nolte J . The Human Brain, 6th edition, 2009; Mosby Elsevier

13. Specific or relay nucleus (specificity)
Fitzgerald MJT, Gruener G, Mtui E. Clinical Neuroanatomy and related Neuroscience, 6th Ed., W. B. Saunders 2012

14. Specific or relay nuclei
Dorsomedial
Lateral Posterior
VPL
VPM
Fitzgerald MJT, Gruener G, Mtui E. Clinical Neuroanatomy and related Neuroscience, 6th Ed., W. B. Saunders 2012

15. Functional thalamic groups
Three groupings
Specific or relay nuclei
Well defined inputs and projections
Anterior, ventral anterior, ventral lateral, ventral posterior, lateral dorsal, medial and lateral geniculate
Association nuclei
Reciprocally connected to association cortex
Lateral posterior, pulvinar, medial dorsal nuclei
Non-specific nuclei
Not the same point-to-point connections like relay nuclei
Intralaminar and thalamic reticular nuclei

16. Association nuclei
Nolte J . The Human Brain, 6th edition, 2009; Mosby Elsevier

17. Association nuclei Lateral Posterior Dorsomedial
Fitzgerald MJT, Gruener G, Mtui E. Clinical Neuroanatomy and related Neuroscience, 6th Ed., W. B. Saunders 2012

18. Functional thalamic groups
Three groupings
Specific or relay nuclei
Well defined inputs and projections
Anterior, ventral anterior, ventral lateral, ventral posterior, lateral dorsal, medial and lateral geniculate
Association nuclei
Reciprocally connected to association cortex
Lateral posterior, pulvinar, medial dorsal nuclei
Non-specific nuclei
Not the same point-to-point connections like relay nuclei
Intralaminar and thalamic reticular nuclei

19. Non-specific nuclei
Nolte J. The Human Brain: An introduction to its functional anatomy. 6th edition, 2009; Mosby Elsevier
Fitzgerald MJT, Gruener G, Mtui E. Clinical Neuroanatomy and related Neuroscience, 6th Ed., W. B. Saunders 2012

20. Non-specific nuclei
Nolte J. The Human Brain: An introduction to its functional anatomy. 6th edition, 2009; Mosby Elsevier
Fitzgerald MJT, Gruener G, Mtui E. Clinical Neuroanatomy and related Neuroscience, 56th Ed., W. B. Saunders 2012

21. Lateral
Posterior
Anterior
This is it
Internal capsule

22. Internal capsule
AL-Anterior limb, G-Genu, PL-Posterior limb, RL- Retrolentiform part
Fitzgerald MJT, Gruener G, Mtui E. Clinical Neuroanatomy and related Neuroscience, 6th Ed., W. B. Saunders 2007

23. (anterior, posterior, superior, inferior)
Thalamic peduncles
(anterior, posterior, superior, inferior)
Fitzgerald MJT, Gruener G, Mtui E. Clinical Neuroanatomy and related Neuroscience, 6th Ed., W. B. Saunders 2012

24. “The” thalamic nuclei to remember

25. Blood supply
Fitzgerald MJT, Gruener G, Mtui E. Clinical Neuroanatomy and related Neuroscience, 6th Ed., W. B. Saunders 2012

26. Vascular (stroke) anatomic lesions and syndromes
Powell R, et al. Pract Neurol 2014;14: