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Central sulcus
Precentral sulcus
Postcentral sulcus
Parietooccipital
sulcus
Lobes
Frontal
Parietal
Temporal
Occipital
Preoccipital
notch
Lateral sulcus
Limbic
Insular
Central sulcus
Paracentral sulcus
Marginal sulcus (marginal
ramus of the cingulate
sulcus)
Cingulate sulcus
Corpus callosum
Parietooccipital
sulcus
Fornix
Diencephalon
Preoccipital notch
Calcarine
sulcus
Collateral sulcus
2-5 Lateral (A) and medial (B) views of the cerebral hemisphere
showing the landmarks used to divide the cortex into its main lobes.
On the lateral aspect, the central sulcus (of Rolando) separates
frontal and parietal lobes. The lateral sulcus (of Sylvius) forms the border between frontal and temporal lobes. The occipital lobe is located
caudal to an arbitrary line drawn between the terminus of the parietooccipital sulcus and the preoccipital notch. A horizontal line drawn
from approximately the upper two-thirds of the lateral fissure to the
rostral edge of the occipital lobe represents the border between parietal and temporal lobes. The insular cortex (see also Figs. 2-46 on page
45 and 3-1 on page 56) is located internal to the lateral sulcus. This part
of the cortex is made up of long and short gyri that are separated from
each other by the central sulcus of the insula. The insula, as a whole, is
separated from the adjacent portions of the frontal, parietal, and temporal opercula by the circular sulcus.
On the medial aspect, the cingulate sulcus separates medial portions
of frontal and parietal lobes from the limbic lobe. An imaginary continuation of the central sulcus intersects with the cingulate sulcus and
forms the border between frontal and parietal lobes. The parietooccipital sulcus and an arbitrary continuation of this line to the preoccipital notch separate the parietal, limbic, and temporal lobes from the
occipital lobe.
3,1,2
Precentral gyrus
5
Surpamarginal gyrus
Pars opercularis
8
40
Angular gyrus
39
19
Pars triangularis
18
22
45
44
17
41
42
Pars orbitalis
47
3,1,2
5
8
4
7
19
Cuneus
18
17
Calcarine sulcus
18
19
2-6 Lateral (A) and medial (B) views of the cerebral hemisphere
showing the more commonly described Brodmann areas. In general,
area 4 comprises the primary somatomotor cortex, areas 3,1, and 2 the
primary somatosensory cortex, and area 17 the primary visual cortex.
Area 41 is the primary auditory cortex, and the portion of area 6 in the
caudal part of the middle frontal gyrus is generally recognized as the
frontal eye field.
The inferior frontal gyrus has three portions: a pars opercularis, pars
Lingual gyrus
triangularis, and a pars orbitalis. A lesion that is located primarily in areas 44 and 45 (shaded) will give rise to what is called a Broca aphasia,
also called expressive or nonfluent aphasia.
The inferior parietal lobule consists of supramarginal (area 40) and
angular (area 39) gyri. Lesions in this general area of the cortex
(shaded), and sometimes extending into area 22, will give rise to what
is known as Wernicke aphasia, also sometimes called receptive or fluent aphasia.
Left
inferior
visual
quadrant
2-7 Lateral (A) and medial (B) views of the cerebral hemisphere
showing the somatotopic organization of the primary somatomotor
and somatosensory cortices. The lower extremity and foot areas are located on medial aspects of the hemisphere in the anterior paracentral
(motor) and the posterior paracentral (sensory) gyri. The remaining
portions of the body extend from the margin of the hemisphere over
the convexity to the lateral sulcus in the precentral and postcentral
gyri.
In general, the precentral gyrus can be divided into three regions:
the lateral third representing the face area, the middle third represent-
ing the hand and upper extremity areas, and the medial third representing the trunk and the hip. Lesions of the somatomotor cortex result in motor deficits on the contralateral side of the body while lesions
in the somatosensory cortex result in a loss of sensory perception from
the contralateral side of the body.
The medial surface of the right hemisphere (B) illustrates the position of the left portions of the visual field. The inferior visual quadrant
is located in the primary visual cortex above the calcarine sulcus while
the superior visual quadrant is found in the cortex below the calcarine
sulcus.
Longitudinal fissure
Superior frontal
gyrus (SFGy)
Middle frontal
gyrus (MFGy)
Superior frontal
sulcus (SFSul)
Precentral
sulcus (PrCSul)
Precentral
gyrus (PrCGy)
Central
sulcus (CSul)
Precentral
gyrus (PrCGy)
Postcentral
gyrus (PoCGy)
Central
sulcus (CSul)
Supramarginal
gyrus
Postcentral sulcus
Occipital gyri
Anterior
cerebral
arteries
MFGy
ACA
territory
SFGy
SFSul
PrCSul
CSul
PoCGy
PrCGy
Falx
cerebri
2-8 Dorsal view of the cerebral hemispheres showing the main gyri
and sulci and an MRI (inverted inversion recoverylower left) and a
CT (lower right) identifying structures from the same perspective.
Angular gyrus
Preoccipital notch
PrCGy
PrCSul
CSul
PoCSul
PoCGy
MFGy
LatSul
IFSul
OGy
PoP
PTr
POrb
MTGy
STGy
STSul
Olfactory tract
Temporal pole
Optic nerve
Infundibulum
Optic chiasm
Uncus (Un)
Optic tract (OpTr)
Mammillary
body (MB)
Interpeduncular
fossa (IPF)
Parahippocampal
gyrus
Inferior temporal
gyrus
Collateral sulcus
Cerebral
aqueduct (CA)
Colliculi (Col)
Lingual gyrus
Occipital gyri
Occipital pole
GyRec
OrbGy
OlfSul
Middle
cerebral
artery
OpTr
MB
Anterior
cerebral
artery
OpTr
Hypothalamus
Un
Un
IPF
CC
IPF
Col
Temporal lobe
CA
Col
Cerebellum
Longitundinal fissure
Olfactory sulcus (OlfSul)
Orbital sulci
Olfactory tract
Temporal pole (TPole)
Parahippocampal
gyrus
Occipitotemporal
gyri
Collateral
sulcus
Middle cerebellar
peduncle (MCP)
Glossopharyngeal
nerve
Flocculus
Facial nerve
Vagus nerve
Vestibulocochlear
nerve
Abducens nerve
Medulla
Olive (inferior);
olivary eminence
Decussation
of pyramids
Cerebellum (Cbl)
GyRec
OlfSul
OrbGy
Tpole
Trigeminal
nerve
BP
MCP
Fourth
ventricle
Cbl
BP
Olfactory tract
Optic nerve
(cranial nerve II)
Optic chiasm
Mammillary body
Optic tract
Interpeduncular
fossa
Basilar pons
Oculomotor nerve
(cranial nerve III)
Crus cerebri
Trochlear nerve
(cranial nerve IV)
Trigeminal nerve
(cranial nerve V)
Parahippocampal
gyrus
Abducens nerve
(cranial nerve VI)
Facial nerve
(cranial nerve VII)
Intermediate nerve
Flocculus
Olive (inferior);
olivary eminence
Retroolivary sulcus
(postolivary sulcus)
Choroid plexus
Vestibulocochlear nerve
(cranial nerve VIII)
Glossopharyngeal nerve
(cranial nerve IX)
Vagus nerve
(cranial nerve X)
Hypoglossal nerve
(cranial nerve XII)
Preolivary sulcus
(exit of XIIth Nr.)
Pyramid
Accessory nerve
(cranial nerve XI)
Decussation
of pyramids
the hypoglossal nerve on that side; the general position of the (spinal)
accessory nerve is shown on the right by the dark line.
Middle cerebellar
peduncle
Optic nerve
Infundibulum
Trigeminal nerve
motor root
Vestibulocochlear
nerve
Trigeminal nerve
sensory root
Facial nerve
Olive (inferior),
olivary eminence
Basilar pons
Abducens nerve
Pyramid
Retroolivary sulcus
(postolivary sulcus)
Preolivary sulcus
brainstem. Compare with Figure 2-24 on the facing page. The cerebellum and portions of the temporal lobe have been removed.
Olfactory tract
Medial olfactory stria
Optic nerve
Optic chiasm
Optic tract
Posterior perforated
substance
Trochlear nerve
Basilar pons
Trigeminal nerve
Abducens nerve
2-23 View of the ventral aspect of the diencephalon and part of the
brainstem with the medial portions of the temporal lobe removed.
Facial nerve
Pyramid
Note structures of the hypothalamus, cranial nerves, and optic structures, including the lateral geniculate body.
Cuneus (Cun)
Calcarine sulcus
(CalSul)
Lingual gyrus
(LinGy)
Sulcus of corpus
callosum (SulCC)
Isthmus of cingulate gyrus
Paraterminal gyri
Parolfactory gyri (ParolfGy)
Temporal pole
Occipitotemporal gyri
Parahippocampal gyrus
Uncus
Rhinal sulcus
APGy
PrCSul
ParCSul
CSul
PPGy
MarSul
SulCC
CinGy
PrCun
CinSul
ParolfGy
POSul
Cun
CalSul
LinGy
SFGy
MarSul
Corpus callosum
POSul
Colloid cyst
CalSul
Internal cerebral
vein
2-26 Midsagittal view of the right cerebral hemisphere and diencephalon, with brainstem removed, showing the main gyri and sulci
and two MRI (both T1-weighted images) showing these structures
from the same perspective. The lower MRI is from a patient with a
small colloid cyst in the interventricular foramen. When compared to
the upper MRI, note the enlarged lateral ventricle with resultant thinning of the corpus callosum.
A colloid cyst (colloid tumor) is a congenital growth usually discovered in adult life once the flow of CSF through the interventricular
foramina is compromised (obstructive hydrocephalus). The patient
may have headache, unsteady gait, weakness of the lower extremities,
visual or somatosensory disorders, and/or personality changes or confusion. Treatment is usually by surgical removal.
Splenium of corpus
callosum (SplCorC)
Cingulate sulcus
(CinSul)
Cuneus (Cun)
Lingual gyrus
(LinGy)
Genu of corpus
callosum (GCorC)
Calcarine sulcus
(CalSul)
Septum
Rostrum of corpus
callosum (RCorC)
Fornix (For)
Cerebellum (Cbl)
Medulla (Med)
PCSul
SFGy
CSul
APGy
PPGy
MarSul
PCun
BCorC
SulCorC
SplCorC
POSul
CinGy
Cun
CinSul
GCorC
CalSul
RCorC
LinGy
For
Cbl
MidTeg
BP
PonTeg
Med
Ton
2-29 A midsagittal view of the right cerebral hemisphere and diencephalon with the brainstem and cerebellum in situ. The MRI (T1weighted image) shows many brain structures from the same perspective.
Massa intermedia
Interventricular foramen
Column of fornix
Habenula
Anterior
commissure (AC)
Suprapineal
recess
Lamina terminalis
Posterior
commissure
Pineal (P)
Supraoptic recess
Superior
colliculus (SC)
Optic chiasm
(OpCh)
Quadrigeminal
cistern (QCis)
Hyth
Inferior
colliculus (IC)
Optic nerve
Cerebral
aqueduct (CA)
Anterior medullary
velum (AMV)
Fourth ventricle
(ForVen)
Infundibulum (In)
Infundibular recess
Mammillary body (MB)
Hypothalamic sulcus
Posterior inferior
cerebellar artery
Oculomotor nerve
Interpeduncular fossa (IpedFos)
Medulla
For
DorTh
Sep
AC
Tentorium cerebelli
Hypothalamus
QCis
OpCh
In
SC
IC
Pituitary gland
AMV
MB
ForVen
IpedFos
BP
CA
2-30 A midsagittal view of the right cerebral hemisphere and diencephalon with the brainstem in situ focusing on the details primarily
related to the diencephalon and third ventricle. The MRI (T1-weighted
image) shows these brain structures from the same perspective. Hyth
hypothalamus.
A
Midbrain
Anterior
quadrangular
lobule
Anterior
lobe (AntLb)
Posterior
quadrangular
lobule
Primary
fissure
Posterior
superior
fissure
E
Superior semilunar
lobule
Hemisphere
Bpon
Vermis (Ver)
AntLb
SCP
Fourth ventricle
Basilar pons (Bpon)
Medulla (Med)
Flocculus (Fl)
Tonsil (Ton)
Biventer
lobule
Med
Gracile
lobule
Ton
Inferior
semilunar
lobule
PostLb
Hemisphere
Vermis (Ver)
Ver
C
Cerebellar peduncles:
Superior (SCP)
Middle (MCP)
Inferior
Anterior
lobe (AntLb)
Colliculi:
Superior
Inferior
Primary fissure
AntLb
Horizontal
fissure
MCP
Fl
Flocculus (Fl)
Tonsil (Ton)
Posterior
lobe (PostLb)
Nodulus
Med
PostLb