Difference between revisions of "Neuroanatomy"

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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.
====Glomeruli of Arnold====
**Over lies hippocampus.
*Over lies hippocampus.
*Calcarine cortex - occipital lobe
 
**Line of Gennari -- very thin white line in the grey matter.
====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 (NAcc) - inferior-medial to where the internal capsule ends; anterior of optic chiasm.  
 
**Image: [http://commons.wikimedia.org/wiki/File:Dopamine_and_serotonin_pathways.gif NAcc - sagittal (WC)], [http://commons.wikimedia.org/wiki/File:Nucleus_accumbens_MRI.PNG NAcc - frontal (WC)].
====Nucleus accumbens====
*Nucleus basalis of Meynert (NBM) - inferior of the globus pallidus; makes acetylcholine.
*Abbreviated ''NAcc'' - inferior-medial to where the internal capsule ends; anterior of optic chiasm.  
**Images: [http://en.wikipedia.org/wiki/File:Nucleus_basalis_of_Meynert_-l-_very_low_mag.jpg NBM - very low mag. (WC)], [http://commons.wikimedia.org/wiki/File:Nucleus_basalis_of_Meynert_-_intermed_mag.jpg NBM - intermed. mag. (WC)].
 
====Trivia====
<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 does ''not'' have epineurium.
**Nerve roots do ''not'' have epineurium.


Notes:
Notes:
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**Branch off ''vertebral arteries''.
**Branch off ''vertebral arteries''.


Images:
====Images====
*[http://en.wikipedia.org/wiki/File:Circle_of_Willis_en.svg Circle of Willis (WP)] .
<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]].
* Neurofibromas.
* [[Neurofibroma]]s.
* Schwannoma.
* [[Schwannoma]].
* Arachnoid cyst.
* [[Arachnoid cyst]].
Extradural:
Extradural:
* Chordoma.
* [[Chordoma]].
* Schwannoma.
* [[Schwannoma]].
* Sarcoma.
* [[Sarcoma]].
* Plasmacytoma.
* [[Plasmacytoma]].
* Primary bone tumors - osteosarcoma, osteochondroma, chondrosarcoma.
* 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>
! '''Routine'''<ref name=Ref_HospAuto164>{{Ref HospAuto|164}}}}</ref>
| '''Head injury'''<ref name=Ref_HospAuto174>{{Ref HospAuto|176}}}}</ref>
! '''Head injury'''<ref name=Ref_HospAuto174>{{Ref HospAuto|176}}}}</ref>
| '''Epilepsy'''<ref name=Ref_HospAuto179>{{Ref HospAuto|179}}}}</ref>
! '''[[Epilepsy]]'''<ref name=Ref_HospAuto179>{{Ref HospAuto|179}}}}</ref>
| '''Dementia'''<ref name=Ref_HospAuto180>{{Ref HospAuto|180}}}}</ref>
! '''[[Dementia]]'''<ref name=Ref_HospAuto180>{{Ref HospAuto|180}}}}</ref>
|-
|-
| Frontal cortex
| Frontal cortex
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