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==Anatomy== | ==Anatomy== | ||
===General=== | |||
* Central nervous system (CNS): Brain, spinal cord. | |||
*Cortex: | |||
**Cerebral lobes: Frontal, parietal, temporal, occipital, insula. | |||
*Diencephalon: Thalamus, hypothalamus. | |||
*Mesencephalon: Colliculi (superior, inferior). | |||
*Metencephalon: Pons, cerebellum. | |||
*Myelencephalon: Medulla. | |||
*Ventricular system: | |||
**Lateral ventricles, interventricular foramen, third ventricle, cerebral aquaeduct, fourth ventricle, subrachnoid space. | |||
*Meninges: | |||
**Outer Covering, CSF circulation, buoyancy of brain. | |||
**Falx cerebri (between hemispheres), Tentorium cerebelli (separates cerebellum). | |||
<gallery> | |||
File:Brain_autopsy_top_view.jpg | Brain: Top view | |||
File:Brain_autopsy_bottom_view.jpg | Brain: Bottom view | |||
File:Brain_autopsy_lateral_view.jpg | Brain: Lateral view | |||
File:Blausen 0104 Brain x-secs SectionalPlanes.png | Orientation planes (WC/blausen staff) | |||
File:1202_White_and_Gray_Matter.jpg | Gray and white matter | |||
</gallery> | |||
===Important=== | ===Important=== | ||
*Basal ganglia | |||
**Includes: Nucleus caudatus, putamen, pallidum, subthalamus, substantia nigra | |||
**Part of the forebrain. | |||
**Caudate nucleus + putamen = striatum. | |||
**Pallidum + putamen = lenticular nucleus. | |||
<gallery> | |||
File:Blausen_0076_BasalGanglia.png | Schematic overview (WC/blausen staff) | |||
File:Basal_ganglia_1.jpg | Section with descriptions (WC/SMH) | |||
</gallery> | |||
*Uncus (as in ''uncal herniation''). | *Uncus (as in ''uncal herniation''). | ||
<gallery> | |||
File:Uncus_animation_small.gif | Position of the uncus | |||
File:Slide2cuc.JPG | Uncus bottom view (WC/Anatomist90) | |||
</gallery> | |||
*Cerebellar tonsils (as in ''tonsillar herniation''). | *Cerebellar tonsils (as in ''tonsillar herniation''). | ||
*Hippocampus (as in ''hippocampal sclerosis''). | |||
<gallery> | |||
File:Hippocampus.png | Location of the hippocampus in the brain (WC/Washington irving) | |||
File:Human temporal lobe areas.png | Hippocampus is marked blue on this coronar section (PLoS/Talbot et al.) | |||
File:Hippocampus macroscopy.jpg| Macroscopic specimen after formalin fixation showing hippocampus in coronar section (WC) | |||
</gallery> | |||
*Longitudinal fissure - divides cerebrum into hemispheres. | *Longitudinal fissure - divides cerebrum into hemispheres. | ||
<gallery> | |||
File:Longitudinal fissure of cerebrum.gif| Animation showing position of longitudinal fissure in the brain (WC) | |||
File:Human brain longitudinal fissure.png | Superior view on longitudinal fissure (WC) | |||
</gallery> | |||
*Lateral sulcus (Sylvian fissure, lateral fissure) - separates temporal lobe from frontal lobe & parietal lobe. | *Lateral sulcus (Sylvian fissure, lateral fissure) - separates temporal lobe from frontal lobe & parietal lobe. | ||
<gallery> | |||
File:Lateral sulcus.gif | Animation showing position of lateral sulcus in the brain (WC) | |||
File:Human brain lateral view description.JPG | Fixated brain, lateral view. The sulcus centralis is marked with 5 (WC) | |||
</gallery> | |||
*Central sulcus - separate ''parietal lobe'' from ''frontal lobe''. | *Central sulcus - separate ''parietal lobe'' from ''frontal lobe''. | ||
<gallery> | |||
File:Central sulcus animation.gif|Animation displaying position of central sulcus (WC) | |||
File:Central sulcus superior view.png| Superior view on central sulcus (WC) | |||
File:Human brain lateral view description.JPG | Fixated brain, lateral view. The sulcus centralis is marked with 6 (WC) | |||
</gallery> | |||
*Brain stem = medulla oblongata, pons, mesencephalon (midbrain).<ref>{{Ref Martini6|466}}</ref> | *Brain stem = medulla oblongata, pons, mesencephalon (midbrain).<ref>{{Ref Martini6|466}}</ref> | ||
<gallery> | |||
File:1311 Brain Stem.jpg | The three distinct parts of the brainstem are colored in this sagital section of a human brain (WC) | |||
File:Slide2RAFA.JPG | Anterior view on a formalin fixated brainstem (WC). | |||
File:Human brain frontal (coronal) section.JPG | Coronal section through brainstem and hemispheres (WC) | |||
</gallery> | |||
===Less important=== | ===Less important=== | ||
====Glomeruli of Arnold==== | |||
*Over lies hippocampus. | |||
====Calcarine cortex==== | |||
*Occipital lobe. | |||
*Line of Gennari -- very thin white line in the grey matter. | |||
**Image: [http://library.med.utah.edu/WebPath/HISTHTML/NEURANAT/CNS227A.html Calcarine cortex (med.utah.edu)] as part of [http://www.gfmer.ch/selected_images_v2/detail_list.php?offset=15&cat1=3&cat2=13&cat3=0&cat4=2&stype=n CNS collection (gfmer.ch)]. | **Image: [http://library.med.utah.edu/WebPath/HISTHTML/NEURANAT/CNS227A.html Calcarine cortex (med.utah.edu)] as part of [http://www.gfmer.ch/selected_images_v2/detail_list.php?offset=15&cat1=3&cat2=13&cat3=0&cat4=2&stype=n CNS collection (gfmer.ch)]. | ||
==== | ====Nucleus accumbens==== | ||
*Abbreviated ''NAcc'' - inferior-medial to where the internal capsule ends; anterior of optic chiasm. | |||
<gallery> | |||
Image:Dopamine_and_serotonin_pathways.gif |NAcc - sagittal. (WC) | |||
Image:Nucleus_accumbens_MRI.PNG |NAcc - frontal. (WC) | |||
</gallery> | |||
====Nucleus basalis of Meynert==== | |||
*Abbreviated ''NBM''. | |||
*Inferior of the globus pallidus; makes acetylcholine. | |||
<gallery> | |||
Image:Nucleus_basalis_of_Meynert_-l-_very_low_mag.jpg | NBM - very low mag. (WC) | |||
Image:Nucleus_basalis_of_Meynert_-_intermed_mag.jpg | NBM - intermed. mag. (WC) | |||
</gallery> | |||
====Locus ceruleus==== | |||
:See also: ''[[Neurohistology#Locus_ceruleus]]''. | |||
*Blue dots - anterior to 4th ventricle in the pons. | |||
Images: | |||
*[http://isc.temple.edu/neuroanatomy/lab/atlas/micn/ Midbrain - interactive - shows locus ceruleus (temple.edu)]. | |||
===Other - trivia=== | |||
*Claustrum - thin band of grey mater in the external capsule; function uncertain.<ref>URL: [http://commons.wikimedia.org/wiki/File:Telencephalon-Horiconatal.jpg http://commons.wikimedia.org/wiki/File:Telencephalon-Horiconatal.jpg]. Accessed on: 22 September 2010.</ref> | *Claustrum - thin band of grey mater in the external capsule; function uncertain.<ref>URL: [http://commons.wikimedia.org/wiki/File:Telencephalon-Horiconatal.jpg http://commons.wikimedia.org/wiki/File:Telencephalon-Horiconatal.jpg]. Accessed on: 22 September 2010.</ref> | ||
*Nerve root vs. nerve:<ref>MUN. 25 November 2010.</ref> | *Nerve root vs. nerve:<ref>MUN. 25 November 2010.</ref> | ||
**Nerves have epineurium. | **Nerves have epineurium. | ||
**Nerve roots | **Nerve roots do ''not'' have epineurium. | ||
Notes: | |||
*Nerve anatomy:<ref>{{Ref Martini6|438}}</ref> | |||
**Nerve (surrounded by ''epineurium'') -> Fascicle (surrounded by ''perineurium'') -> Nerve fibre (surrounded by ''endoneurium''). | |||
===Vascular structures=== | ===Vascular structures=== | ||
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**Branch off ''vertebral arteries''. | **Branch off ''vertebral arteries''. | ||
Images | ====Images==== | ||
<gallery> | |||
Image:Circle_of_Willis_en.svg | Circle of Willis. (WC) | |||
</gallery> | |||
www: | |||
*[http://library.med.utah.edu/WebPath/HISTHTML/NEURANAT/CNS334A.html Interactive schematic (utah.edu)]. | *[http://library.med.utah.edu/WebPath/HISTHTML/NEURANAT/CNS334A.html Interactive schematic (utah.edu)]. | ||
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====DDx based on location<ref>URL: [http://www.nervous-system-diseases.com/spine-tumor.html http://www.nervous-system-diseases.com/spine-tumor.html]. Accessed on: 21 September 2010.</ref>==== | ====DDx based on location<ref>URL: [http://www.nervous-system-diseases.com/spine-tumor.html http://www.nervous-system-diseases.com/spine-tumor.html]. Accessed on: 21 September 2010.</ref>==== | ||
Intra-axial:<ref name=Ref_PSNP57>{{Ref PSNP|57}}</ref> | Intra-axial:<ref name=Ref_PSNP57>{{Ref PSNP|57}}</ref> | ||
* Glioma (astrocytoma, oligodendroglioma, ependymoma). | * Glioma ([[astrocytoma]], oligodendroglioma, ependymoma). | ||
* Non-glial tumours (hemangioblastoma, CNS lymphoma). | * Non-glial tumours (hemangioblastoma, CNS lymphoma). | ||
* Metastases. | * [[Metastases]]. | ||
* Non-tumour: | * Non-tumour: | ||
** Abscess. | ** Abscess. | ||
** Infarct. | ** [[Infarct]]. | ||
** Hematoma. | ** Hematoma. | ||
Intradural: | Intradural: | ||
* Meningioma. | * [[Meningioma]]. | ||
* | * [[Neurofibroma]]s. | ||
* Schwannoma. | * [[Schwannoma]]. | ||
* Arachnoid cyst. | * [[Arachnoid cyst]]. | ||
Extradural: | Extradural: | ||
* Chordoma. | * [[Chordoma]]. | ||
* Schwannoma. | * [[Schwannoma]]. | ||
* Sarcoma. | * [[Sarcoma]]. | ||
* Plasmacytoma. | * [[Plasmacytoma]]. | ||
* Primary bone | * Primary bone tumours - [[osteosarcoma]], osteochondroma, [[chondrosarcoma]]. | ||
* Mets (lung, breast, etc.). | * Mets (lung, breast, etc.). | ||
==Neuropathological dissection (autopsy)== | |||
Brain fixation after removal: Usually 14 days | |||
*Check brain for: | |||
** Lesions | |||
** edema (might be not visible but tissue is softer than normal) | |||
** hemorrhage | |||
** Discolorations | |||
** Asymmetry (midline shift) | |||
** herniation (subfalxial, uncal, tonsillar) | |||
** vascular abnormalities | |||
<gallery> | |||
File:MCA-Stroke-Brain-Human-2.JPG | Asymmetry (midline shift) indicating lesions (stroke, tumor) | |||
File:Brain_autopsy_hemorrhage_bottom_view.JPG | Brain hemorrhage | |||
File:Autopsy brain.jpg | Atrophy: widespread sulci, often seen in neurodegenerative diseases | |||
File:Alexander autopsy.jpg | Brown discolorations indicating demyelinisation | |||
</gallery> | |||
==Sampling - sections (autopsy)== | ==Sampling - sections (autopsy)== | ||
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Standard histologic sections: | Standard histologic sections: | ||
{| class="wikitable sortable" style="margin-left:auto;margin-right:auto" | {| class="wikitable sortable" style="margin-left:auto;margin-right:auto" | ||
! '''Site''' | |||
! '''Routine'''<ref name=Ref_HospAuto164>{{Ref HospAuto|164}}}}</ref> | |||
! '''Head injury'''<ref name=Ref_HospAuto174>{{Ref HospAuto|176}}}}</ref> | |||
! '''[[Epilepsy]]'''<ref name=Ref_HospAuto179>{{Ref HospAuto|179}}}}</ref> | |||
! '''[[Dementia]]'''<ref name=Ref_HospAuto180>{{Ref HospAuto|180}}}}</ref> | |||
|- | |- | ||
| Frontal cortex | | Frontal cortex | ||
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==References== | ==References== | ||
{{reflist|2}} | {{reflist|2}} | ||
==External links== | |||
*[http://www.med.univ-rennes1.fr/etud/pharmaco/media/alzheimerGB.htm Important nuclei (univ-rennes1.fr)] - discussed in the context of [[Alzheimer's disease]]. | |||
[[Category:Neuropathology]] | [[Category:Neuropathology]] |