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NERVOUS SYSTEM

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DEVELOPMENT OF NERVOUS SYSTEM

NERVOUS SYSTEM

CONTENTS
DEVELOPMENT OF NERVOUS SYSTEM .......................................................................................................................... 8
ANATOMY OF NERVOUS SYSTEM ................................................................................................................................. 8
GENERAL FEATURES OF ANATOMY OF NERVOUS SYSTEM ....................................................................................... 8
ANATOMY OF BRAIN ................................................................................................................................................. 9
SULCUS OF BRAIN ................................................................................................................................................... 10
BLOOD SUPPLY OF BRAIN AND SPINAL CORD ......................................................................................................... 10
VENOUS SYSTEM OF BRAIN .................................................................................................................................... 11
LOBES OF BRAIN ...................................................................................................................................................... 11
AREAS OF BRAIN ..................................................................................................................................................... 11
THALAMUS .............................................................................................................................................................. 12
LIMBIC SYSTEM ....................................................................................................................................................... 13
HYPOTHALAMUS ..................................................................................................................................................... 13
VENTRICLES OF BRAIN ............................................................................................................................................ 14
CEREBELLUM ........................................................................................................................................................... 14
AFFERENT AND EFFERENT ....................................................................................................................................... 15
CRANIAL NERVE ...................................................................................................................................................... 16
SPINAL CORD ........................................................................................................................................................... 17
PHYSIOLOGY OF NERVOUS SYSTEM ............................................................................................................................ 18
GENERAL FEATURES OF PHYSIOLOGY OF NERVOUS SYSTEM ................................................................................. 18
NERVE FIBRES .......................................................................................................................................................... 19
CEREBROSPINAL FLUID ........................................................................................................................................... 21
MUSCLES ................................................................................................................................................................. 22
MUSCLE CONTRACTION .......................................................................................................................................... 23
NERVE AND ACTION POTENTIAL ............................................................................................................................. 25
NERVE CONDUCTION AND INHIBITION ................................................................................................................... 27
SYNAPTIC POTENTIALS ............................................................................................................................................ 28
BLOOD BRAIN BARRIER ........................................................................................................................................... 28
MEMORY ................................................................................................................................................................. 28
THERMAL REGULATION .......................................................................................................................................... 29
TEMPERATURE REGULATION IN NEONATES ........................................................................................................... 30
NEUROTRANSMITTERS............................................................................................................................................ 30
PAIN ........................................................................................................................................................................ 31

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DEVELOPMENT OF NERVOUS SYSTEM

NERVOUS SYSTEM

APPETITE ................................................................................................................................................................. 31
TRACTS IN NERVOUS SYSTEM ................................................................................................................................. 31
PYRAMIDAL TRACT .................................................................................................................................................. 32
REFLEX ..................................................................................................................................................................... 32
PHYSIOLOGY OF AUTONOMIC NERVOUS SYSTEM .................................................................................................. 33
BRAIN DEATH .......................................................................................................................................................... 33
HEADACHE .................................................................................................................................................................. 33
CLUSTER HEADACHE ............................................................................................................................................... 33
TENSION HEADACHE ............................................................................................................................................... 34
MIGRAINE ............................................................................................................................................................... 34
BASILAR MIGRAINE ................................................................................................................................................. 35
OPHTHALMOPLEGIC MIGRAINE .............................................................................................................................. 35
SYNCOPE ..................................................................................................................................................................... 35
APHASIA ...................................................................................................................................................................... 35
GENERAL FEATURES OF APHASIA ........................................................................................................................... 35
BROCAS APHASIA ................................................................................................................................................... 35
WERNICKES APHASIA ............................................................................................................................................. 36
SEIZURE ....................................................................................................................................................................... 36
GENERAL FEATURES OF SEIZURE ............................................................................................................................ 36
ABSENCE SEIZURE ................................................................................................................................................... 37
MYOCLONIC SEIZURES ............................................................................................................................................ 37
POST TRAUMATIC SEIZURES ................................................................................................................................... 38
FEBRILE SEIZURES .................................................................................................................................................... 38
STATUS EPILEPTICUS ............................................................................................................................................... 39
INFANTILE SPASM ................................................................................................................................................... 39
GENERAL TONIC CLONIC SEIZURES ......................................................................................................................... 39
PARTIAL SEIZURES ................................................................................................................................................... 39
NEONATAL SEIZURES .............................................................................................................................................. 40
INFANTILE TREMOR SYNDROME ............................................................................................................................. 40
ANTIEPILEPTIC DRUGS ............................................................................................................................................ 40
MOTOR NEURON DISEASES ........................................................................................................................................ 42
UPPER MOTOR NEURON DISEASE .......................................................................................................................... 42
LOWER MOTOR NEURON DISEASE ......................................................................................................................... 42
MOTOR NEURON DISEASE ...................................................................................................................................... 43

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DEVELOPMENT OF NERVOUS SYSTEM

NERVOUS SYSTEM

AMYOTROPHIC LATERAL SCLEROSIS ....................................................................................................................... 43


SPINAL CORD DISORDERS ........................................................................................................................................... 43
SENSATIONS ............................................................................................................................................................ 43
BROWN SEQUARD SYNDROME ............................................................................................................................... 44
CONUS MEDULLARIS ............................................................................................................................................... 45
SPINAL CORD COMPRESSION .................................................................................................................................. 45
FRIEDRICHS ATAXIA................................................................................................................................................ 45
SUBACUTE COMBINED DEGENERATION ................................................................................................................. 46
TABES DORSALIS ..................................................................................................................................................... 46
SYRINGOMYELIA ..................................................................................................................................................... 46
SPINAL MUSCULAR ATROPHY ................................................................................................................................. 46
SPINAL CORD EDEMA .............................................................................................................................................. 47
CEREBROVASCULAR DISEASES .................................................................................................................................... 47
GENERAL FEATURES OF CEREBROVASCULAR DISEASES ......................................................................................... 47
INTRACRANIAL ANEURYSM ..................................................................................................................................... 49
INTRACRANIAL HEMORRHAGE ............................................................................................................................... 49
HEMIBALLISMUS ..................................................................................................................................................... 50
LACUNAR INFARCT .................................................................................................................................................. 50
SUBARACHNOID HEMORRHAGE ............................................................................................................................. 50
CAROTID STENOSIS ................................................................................................................................................. 51
ANTERIOR CHOROIDAL ARTERY SYNDROME .......................................................................................................... 51
MILLARD GUBLER SYNDROME ................................................................................................................................ 51
LATERAL MEDULLARY SYNDROME .......................................................................................................................... 51
POSTERIOR INFERIOR CEREBELLAR ARTERY INFARCT ............................................................................................. 52
MEDIAL MEDULLARY SYNDROME ........................................................................................................................... 52
WEBER SYNDROME ................................................................................................................................................. 52
BENEDICT SYNDROME ............................................................................................................................................ 52
NOTHNAGEL SYNDROME ........................................................................................................................................ 52
CLAUDE SYNDROME................................................................................................................................................ 52
PARINAUD SYNDROME ........................................................................................................................................... 52
FOVILLE SYNDROME................................................................................................................................................ 53
MILLER GUBLER SYNDROME ................................................................................................................................... 53
BALINTS SYNDROME .............................................................................................................................................. 53
PONTINE STROKE .................................................................................................................................................... 53

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DEVELOPMENT OF NERVOUS SYSTEM

NERVOUS SYSTEM

EXTRAPYRAMIDAL SYMPTOMS ............................................................................................................................... 53


HEAD INJURY ............................................................................................................................................................... 53
GENERAL FEATURES OF HEAD INJURY .................................................................................................................... 53
GLASGOW COMA SCALE ......................................................................................................................................... 54
GLASGOW COMA SCALE ......................................................................................................................................... 54
FEATURES OF HEAD INJURY .................................................................................................................................... 55
FRACTURE ANTERIOR CRANIAL FOSSA ................................................................................................................... 55
FRACTURE MIDDLE CRANIAL FOSSA ....................................................................................................................... 55
BASILAR FRACTURE ................................................................................................................................................. 55
MANAGEMENT OF HEAD INJURY ............................................................................................................................ 55
FEATURES OF INCREASED INTRACRANIAL TENSION ............................................................................................... 55
MANAGEMENT OF INCREASED INTRACRANIAL TENSION ....................................................................................... 56
SUBDURAL HEMATOMA ......................................................................................................................................... 56
EXTRADURAL HEMORRHAGE .................................................................................................................................. 57
CSF LEAK .................................................................................................................................................................. 57
DIFFUSE AXONAL INJURIES ..................................................................................................................................... 58
HERNIATION ............................................................................................................................................................ 58
DISEASES OF NERVOUS SYSTEM ................................................................................................................................. 59
GENERAL FEATURES OF DISEASE OF NERVOUS SYSTEM ........................................................................................ 59
DEVELOPMENTAL DISEASES OF BRAIN AND CRANIUM .......................................................................................... 60
VEIN OF GALEN MALFORMATION ........................................................................................................................... 61
FEATURES OF PARKINSONISM ................................................................................................................................ 61
MANAGEMENT OF PARKINSONISM ........................................................................................................................ 62
HUNTINGTONS CHOREA ........................................................................................................................................ 63
PSEUDOTUMOUR CEREBRI ..................................................................................................................................... 63
HYDROCEPHALUS .................................................................................................................................................... 64
SUPRANUCLEAR PALSY ........................................................................................................................................... 64
INTRACRANIAL CALCIFICATION ............................................................................................................................... 64
MULTIPLE SCLEROSIS .............................................................................................................................................. 64
KLUVER BUCY SYNDROME ...................................................................................................................................... 65
CEREBELLAR DISEASES ............................................................................................................................................ 65
MENINGITIS AND ENCEPHALITIS ................................................................................................................................. 66
GENERAL FEATURES OF MENINGITIS ...................................................................................................................... 66
NEONATAL MENINGITIS .......................................................................................................................................... 66

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DEVELOPMENT OF NERVOUS SYSTEM

NERVOUS SYSTEM

MENINGOCOCCAL MENINGITIS .............................................................................................................................. 67


LISTERIA MENINGITIS .............................................................................................................................................. 67
HEMOPHILUS INFLUENZA MENINGITIS................................................................................................................... 67
CRYPTOCOCCAL MENINGITIS .................................................................................................................................. 68
NEISSERIA MENINGITIS ........................................................................................................................................... 68
STREPTOCOCCUS PNEUMONIA MENINGITIS .......................................................................................................... 68
TUBERCULAR MENINGITIS ...................................................................................................................................... 68
GENERAL FEATURES OF ENCEPHALITIS ................................................................................................................... 69
ENTEROVIRUS ENCEPHALITIS .................................................................................................................................. 69
HERPES SIMPLEX ENCEPHALITIS ............................................................................................................................. 70
NERVOUS SYSTEM TUMOURS ..................................................................................................................................... 70
GENERAL FEATURES OF NERVOUS SYSTEM TUMOURS .......................................................................................... 70
ASTROCYTOMA ....................................................................................................................................................... 72
MENINGIOMA ......................................................................................................................................................... 73
EPENDYMOMA ........................................................................................................................................................ 74
MEDULLOBLASTOMA .............................................................................................................................................. 74
HYDROCEPHALUS .................................................................................................................................................... 75
CRANIOPHARYNGIOMA .......................................................................................................................................... 75
STURGE WEBER SYNDROME ................................................................................................................................... 75
VON HIPPEL LINDEAU SYNDROME .......................................................................................................................... 76
NEUROFIBROMA ..................................................................................................................................................... 76
NEUROPATHY .............................................................................................................................................................. 77
GENERAL FEATURES OF NEUROPATHY ................................................................................................................... 77
TYPES OF NEUROPATHY .......................................................................................................................................... 78
DRUGS ASSOCIATED WITH NEUROPATHY .............................................................................................................. 78
AUTONOMIC NEUROPATHY .................................................................................................................................... 79
DIABETIC NEUROPATHY .......................................................................................................................................... 79
ENTRAPMENT NEUROPATHY .................................................................................................................................. 79
GULLIAN BARRE SYNDROME ................................................................................................................................... 79
MYOPATHY .................................................................................................................................................................. 80
GENERAL FEATURES OF MYOPATHY ....................................................................................................................... 80
MYASTHENIA GRAVIS .............................................................................................................................................. 81
LAMBERT EATON SYNDROME ................................................................................................................................. 82
THYMOMA .............................................................................................................................................................. 82

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DEVELOPMENT OF NERVOUS SYSTEM

NERVOUS SYSTEM

DUCCHNE MUSCULAR DYSTROPHY ........................................................................................................................ 82


MUSCULAR DYSTROPHIES ....................................................................................................................................... 83
MYOTONIC DYSTROPHY .......................................................................................................................................... 83
EPISODIC WEAKNESS .............................................................................................................................................. 84
CHANNELOPATHIES................................................................................................................................................. 84

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DEVELOPMENT OF NERVOUS SYSTEM

NERVOUS SYSTEM

KEY TO THIS DOCUMENT


Text in normal font Must read point.
Asked in any previous medical entrance
examinations
Text in bold font Point from Harrisons
text book of internal medicine 18th
edition
Text in italic font Can be read if
you are thorough with above two.

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DEVELOPMENT OF NERVOUS SYSTEM

NERVOUS SYSTEM

DEVELOPMENT OF NERVOUS SYSTEM


Maximum development of brain occurs during
Continuous development of neurons from stem cells
In Postnatal period, greatest growth in grey matter of
CNS
Myelination in cranial nerve starts at
Alar plate forms
Basal plate forms
Myelencephalon forms
Metencephalon forms
Dentate nucleus from
Germinal matrix, unique vascular bed
present in region of choroid plexus
regresses completely by
Derived from neuroepithelial cells

Infancy
Hippocampus & Olfactory bulb
Length of Axon
6 months (sensory nerves earlier)
Sensory area
Motor area
Medulla oblongata
Pons and cerebellum
Spongioblast of mantle zone
32 weeks

Astrocytes

ANATOMY OF NERVOUS SYSTEM


GENERAL FEATURES OF ANATOMY OF NERVOUS SYSTEM
Betz cells in
Cajal horizontal cells in
Mortinotti cells in
Mantle layer in
Marginal layer in
LMN involves
Arachnoid villi protrudes mainly in
D receptors are maximally seen in
Gate system for pain control is located at
Example for multipolar neuron
NOT form posterior surface of pons
Circle of Willis NOT formed by
Middle cranial fossa is supplied by
th
Branches of 5 nerve supplying durameter
Dura is supplied by
Dura NOT supplied by
NOT supplying durameter
Neuroglial cells

Compound granular corpuscle is derived from


Function of microglia in CNS
Microglia is stained with

Layer 5
Layer 1
Layer 6
Grey matter
White matter
Peripheral nerves, Anterior horn cells, Anterior nerve
root
Superior sagittal sinus
Nucleus acumbans
Substantia gelatinosa, Dorsal root ganglion
Purkinje cells
Inferior medullary velum
Anterior choroidal artery
Maxillary nerve, Mandibular nerve
Ant and post ethmoidal, Mandibular
5,10,12 nerve
4 nerve
Auriculotemporal nerve
Protoplasmic astrocytes are found in grey matter,
Oligodendrocytes are derived from ectoderm, Microglia
are mesodermal in origin
Microglial cell
Phagocytosis
Hortega carbonate

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ANATOMY OF NERVOUS SYSTEM

NERVOUS SYSTEM
Damage to nerve tissue is repaired by
Brain lipid binding proteins is expressed by
Myelin sheath in CNS is synthesized by
Gitter cells/hortega cells
NOT a neural cells
NOT true about neuropeptide
Citelli angle
Facial index is a rough index of development of
Transaction through lower end of medulla through
pyramids

Astrocyte
Mature astrocytes
Oligodendroglia
Microglia, Lipid laded microglial cell, Modified CNS
macrophages
Ependymal phagocytes
Its level decreases during starvation
Sinodural angle
Brain
Incoordination, Spasticity, Increased tendon reflex

ANATOMY OF BRAIN
Fibres passing through crus cerbri
Cells NOT present in cerebral cortex
Genu of internal capsule carries
Fibres passing through genu of internal capsule
Corticospinal fibers pass through which
part of internal capsule
Association fibres
NOT an association fibre
Splenial fibres connecting two occipital
lobes
Tapetum
Cistern ambiens
Ventral striatum contains
Corpus callosum

Induseum Griseum is
Sommer sector area
Areas of hippocampus
Hippocampal formation include
NOT a part of hippocampal complex
Area immediately lateral to anterior perforating
substance
Trapezoid body is present in
Interpeduncular fossa contains
Cortical representation of body in cerebrum is
Substances promoting growth and survival of neurons
Serotonin in brain mainly seen in
Biondi ring tangles are found in
Cranial structure insensitive to pain
Healthy female, got pregnant for first time. LSCS done
for fetal distress. Mild hypertension during pregnancy. 2
days after delivery she had headache and seizures. CT

Corticonuclear , Corticospinal
Bipolar
Sensory fibres to thalamus and brain
Corticonuclear
Anterior two third of posterior limb
Uncinate, Cingulum, Longitudinal fasciculus
Forceps major
Forceps major
Connects both parietal lobe
Between splenium of corpus callsoum and
tectum of midbrain
Nucleus acumbens, olfactory tubercle
Unite far area of two sides of brain, Connect two frontal
lobe, Unites two hemisphere, Superiorly related to
indusium griseum
Dorsal to Corpus callosum
CA1 area of hippocampus
Cornu ammonis, dentate gyrus
Dentate gyrus, Subicular complex, Entorhinal complex
Amygdaloid nucleus
Limen insulae
Pons
Mamillary body, Posterior perforated substance,
OCCULOMOTOR nerve, Trochlear nerve, Tuber cinerum
Vertical
Neurotrophins
Raphae nucleus
Choroid plexus cells
Choroid plexus
Sagittal sinus thrombosis

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ANATOMY OF NERVOUS SYSTEM

NERVOUS SYSTEM
shows 2*3 cm parasagittal hematoma. No proteinuria
NOT true about dural sinus

Below meningeal layer

SULCUS OF BRAIN
Limiting Sulcus of Cerebrum
Rolando fissure
Central Sulcus is a
Complete Sulcus
Complete sulcus
Sylvius
Structure lying in lateral sulcus

Central Sulcus
Central sulcus
Operculated sulcus
Calcarine sulcus
Collateral sulcus, calcarine sulcus
Lateral sulcus
Superficial middle cerebral vein

BLOOD SUPPLY OF BRAIN AND SPINAL CORD


Vertebral artery

Cranial branches of vertebral artery

Branches of basilar artery

Vertebral artery traverse


Foramen transversorium transmit
Anterior spinal artery is a branch of
Artery of adamkiewicz
Vertebral artery does NOT tranverse
Unpaired vessel in CNS
Branches of basilar artery
Posterior cerebral artery supply
Posterior cerebral artery does NOT supply
Visual area of cortex is supplied by
Occipital lobe is supplied by
Medulla oblongata is supplied by
NOT a blood supply of medulla
Nearest relation of optic nerve
Heubner artery

Branch of subclavian artery, Accompany sympathetic


ganglion, Passes through foramen transversorium of
cervical vertebrae
Posterior inferior cerebellar artery,
medullary artery, meningeal branches,
anterior spinal artery, posterior spinal
artery
Pontine arteries, labyrinthine arteries,
anterior inferior cerebellar artery,
superior cerebellar artery, posterior
cerebellar artery, cortical branches,
central branches, choroidal branch
Foramen magnum, Subarachnoid space, Foramen
transversorim
Vertebral artery
Vertebral artery
Radicular vessels to anterior spinal artery (T11 L2)
Intervertebral foramen
Basilar artery
Pontine, Labyrinthine, Posterior cerebral artery
Midbrain, thalamus, striate cortex
Pons
Posterior cerebral artery
Posterior cerebral artery
Anterior spinal artery, Basilar artery, Posterior inferior
cerebellar artery, Vertebral artery
Superior cerebellar artery, Bulbar artery
Internal carotid artery
Recurrent branch of anterior cerebral
artery

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ANATOMY OF NERVOUS SYSTEM

NERVOUS SYSTEM

VENOUS SYSTEM OF BRAIN


Deep venous system of brain
Superior Cerebral Vein drains into
Superficial middle cerebral vein drains
into
Inferior cerebral vein drains in to
Great cerebral vein
Basal vein is formed by

Internal cerebral vein, Great cerebral vein, Basal vein


Superior Sagittal Sinus
Superior sagittal sinus and transverse
sinus
Superior sagittal sinus
2 cm
Deep middle cerebral vein and anterior
cerebral vein

LOBES OF BRAIN
Neurophysiological defects present in right lobe
involvement are
NOT a Neurophysiological defects present in right lobe
involvement
Left lobe is responsible for
Left paracental lobule injured. Paresis of
Lobe of brain associated with psychiatric
illness
Witzelsucht syndrome (pathological joking)
Euphoria, uncontrolled laugh, joking,
making pun
MRI feature of Mesial temporal sclerosis
PET feature of mesial temporal lobe
epilepsy
Lesion of medial temporal lobe is associated with
Lesion for Prosopagnosia
Prosopagnosia is characterized by
Occipital lobe is a part of
Stria of Gennari in

Visuospatial defect, Anosognosia, Dysgraphia


Dyscalculia
Written and spoken language
Right leg and perineum
Frontal lobe
Frontal lobe tumors
Right prefrontal cortex
Atrophy of mamillary body, atrophy of fornix, atrophy
of hippocampus
Hypometabolism on interictal PET
Auditory amnesia
Inferior temporal lobe
Inability to identify faces
Cerebrum
Occipital lobe

AREAS OF BRAIN
Brocas area
Brocas area
Motor area of brodmans area
Frontal eye motor area
NOT frontal eye motor area
Area of brain responsible for self stimulation reward on
induction
Primary motor area of cerebral cortex
First centre activated by voluntary skillful movements
Most important area in organising and planning

Inferior frontal lobe


44,45
4
6,8,9
2
Medial forebrain bundle
Precentral gyrus
Neocortex
Supplementary motor area

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ANATOMY OF NERVOUS SYSTEM

NERVOUS SYSTEM
complex sequential skilled movements
Sensory impairment in extensive damage to primary
somatosensory area
Pain sensation
Increased baroreceptor discharge
Skilled voluntary movement is initiated at
Swallowing centre is located in
Sudden onset of dysphagia ,vomiting, vertigo, horners
syndrome
Presence of ataxic nystagmus indicates a lesion in
Gustatory cortex is situated in
Field of Forel H2
Copper is present in
Iron in
Zinc in
Calamus scriptoris
Red nucleus is situated at

Pressure, Sensory localization, Exact weight


determination
Secondary somatosensory area
Inhibits Rostral ventro lateral medulla
Cortical association areas
Medulla
Medulla
Medial longitudinal fasciculus
Inferior parietal gyrus
Lenticular fasciculus
Locus cereleus
Red nucleus
Hippocampus
Similar to fountain pen, lower part of 4th
ventricle
Midbrain at superior colliculus

THALAMUS
Basal ganglia nucleus
Nucleus of basal ganglia
NOT a basal ganglia nucleus
NOT a part of basal ganglia
Major afferent to Basal Ganglia to
Highest density of glutamate receptors in basal ganglia
Functions of basal ganglia
Role of basal ganglia in motor function
Primarily glutaminergic
Efferent bundle of substantia nigra transmits dopamine
to
Major neurotransmitter in substantia nigra
Selective lesion of globus pallidus causes
Thalamic nuclei are
Solitario thalamic
Sensory nucleus of thalamus
Motor nucleus of thalamus
Region for memory in thalamus
Region for emotion in thalamus
Region for visual memory in thalamus
Epithalamus
NOT a part of epithalamus
Ventral posterior nucleus of thalamus

Caudate nucleus, Amygdaloid nucleus, Lentiform


nucleus
Caudate nucleus
Dentate nucleus
Thalamus
Striatum
Putamen
Skilled movements
Planning
Subthalamic nucleus>putamen
Corpus striatum
Dopamine
Hypokinesis
Relay centre
Ventral posteromedial thalamic nuclei
Ventral posterolateral and ventral
posteromedial
Ventral anterior and ventral lateral
Anterior nucleus
Medial nucleus
Lateral nucleus (pulvinar nucleus)
Pineal body, Posterior commissure, Trigonum
habenulae
Geniculate bodies
Medial lemniscus, spinal leminscus, spinothalamic tract,
trigeminothalamic tract

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ANATOMY OF NERVOUS SYSTEM

NERVOUS SYSTEM
Thalamic nuclei projecting to neocortex
Thalamic nuclei NOT projecting into neocortex
B/L Babinsky is associated with
Injury to thalamus does NOT cause

Intralaminar nuclei, Pulvinar nuclei, Anterior thalamic


nuclei
Reticular nuclei
Thalamic Hemorrhage
Miosis

LIMBIC SYSTEM
Window of limbic system
Nucleus that lies immediately medial and
deep to uncus
Main output of amygdala is conveyed
through
Function of limbic system
Reward centre
Involved in emotion
Hippocampus lesion affect

Amygdala
Amygdala
Stria terminalis
Emotion, Memory, Higher function
Medial forebrain bundle
Limbic system, Hippocampus
Explicit memory/declarative memory, Transformation
of short term to long term memory

HYPOTHALAMUS
Site of synthesis of vasopressin
Key regulators of sleep are located in
Special sense NOT having relay in hypothalamus
NOT a function of hypothalamus
Osmoreceptors are located in
OVLT
First response of osmoreceptors to
hyperosmality
Osmometer is based on
Area posterema is associated with
Subfornical organ is associated with
Substance having effect on thirst
mechanism
Thirst centre is stimulated by
Cell bodies of orexinergic neurons present in
Feeding centre
Feeding centre is stimulated by
Satiety centre
Satiety centre is stimulated by
Lesion affecting ventromedial hypothalamus manifest
with
Part of hypothalamus most closely related to sexual
activity in males
Drinking can be induced by
Sham range

Hypothalamus
Hypothalamus
Smell
Increase in heart rate with exercise
Anterior Hypothalamus
Osmoreceptor
Vasopressin secretion
Freezing point depression
Vascular tonicity
Thirst
Angiotensin
OVLT, subfornical organ
Lateral hypothalamic area
Lateral hypothalamus
Neuropeptide Y, orexin A and B, ghrelin
Ventromedial nucleus
Leptin, peptide XY, POMC
Hyperphagia
Preoptic nucleus
Osmotic stimulation of supraoptic nucleus
Caused by hypothalamic stimulation, NOT abolished by
decortications, Pathological rage reaction, Association

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ANATOMY OF NERVOUS SYSTEM

NERVOUS SYSTEM

Sham rage occurs due to lesion in


Lesion of anterior hypothalamus causes
Lesion of posterior hypothalamus causes

with sympathetic stimulation


Diencephalon
Hyperthermia
Hypothermia

VENTRICLES OF BRAIN
Cavity of telencephalon
Cavity of diencephalon
Cavities of diencephalon
Cavity of mesencephalon
Cavity of rhombencephalon
CSF from lateral to third ventricle
Lateral Ventricle is connected to third ventricle by
Floor of third ventricle formed by
NOT seen in floor of third ventricle
Cerebral aqueduct of sylvius
Obstruction to flow of CSF at aqueduct of sylvius will
lead to enlargement of
Fourth ventricle
th
Nucleus found in floor of 4 ventricle
Floor of fourth ventricle is formed by

Lateral ventricle
Third ventricle
Interthalamic adhesions join lateral walls, Lamina
terminalis contain anterior communicating artery
Aqueduct
Fourth ventricle
Foramen of munro
Interventricular Formen of Monro
Infundibulum, Mamillary body, Optic chiasma
Occulomotor nerve
rd
th
Connects 3 to 4 ventricle
Both lateral and third ventricle
Rhomboid fossa forms floor
Abduscens, Dorsal vagal nuclei, Facial , Hypoglossal
Post surface of pons, Sulcus limitans, Post surface of
medulla

CEREBELLUM
Cerebellum
Phylogenetically older cerebellum
Phylogenetically newer cerebellum
NOT true about cerebellum
Glomeruli are present in
Somata of golgi cells of cerebellum are located in
Flocconodular lobe is a component of
Flocconodular lobe has direct connections with
Flocculonodular lobe has direct connection with
Vetibuloocular reflex concerned with
Efferent tracts from cerebellum arise from
Most lateral and deep cerebellar nucleus
Dentate nucleus is a part of
Neocerebellum to Ventral lateral nucleus of thalamus
through
Two main afferent to cerebellar cortex
Cerebellar component that would be
abnormal in a degenerative disease that
affects spinal sensory neuron

3 layers, 4 nucleus and 5 cells. Climbing fibres and


afferent input. Climbing fibres excite purkinje cells
Vestibulocerebellum
Neocerebellum
Mossy fibres inhibit purkinje cells
Cerebellum
Granular Layer
Archicerebellum
Vestibular nucleus
Vestibular nucleus
Flocconodular node
Deep cerebellar nuclei
Dentate
Cerebellum
Dentate nucleus
Climbing fibres & Mossy fibres
Mossy fibers

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14

ANATOMY OF NERVOUS SYSTEM

NERVOUS SYSTEM
Cerebellar rosette
Only output from cerebellar cortex
Cells particularly sensitive to ischemic damage in brain
Cerebellar connection to other parts of brain
All cerebral cells are inhibitory except
Purkinje cells from cerebellum end in
Axons of Purkinje cells and efferents from Cerebrum
NOT a cell in cerebellum
Cerebellar peduncle connects cerebellum to
Largest & most lateral cerebellar peduncle
Afferent tract to middle cerebellar peduncle
Middle cerebellar peduncle transmits
Efferents in superior cerebellar peduncle
arise mainly from
Inferior cerebellar peducle
NOT passing through inferior cerebellar peduncle
Vestibulocerebellar tract terminates at
Function of Spinocerebellar tract
Cerebellum
Role of cerebellum in motor function
Lesion of Cerebellum is associated with
Lesions of lateral cerebellum
Focal cerebellar lesion is associated with
NOT a feature of cerebellar disease
NOT a cerebellar sign

Mossy fibres, granule cells, golgi cells


Purkinje cells
Purkinje cells of cerebellum
Purkinje cells
Granule cells
Cerebellar nuclei
Cerebellum
Bipolar
Midbrain, Pons, medulla
Middle cerebellar peduncle
Pontocerebellar
Pontocerebellar fibres
Dentate nucleus (deep nucleus)
Posterior spinocerebellar, Cuneocerebellar,
Vestibulocerebellar, Olivocerebellar
Pontocerebellar, Anterior spinocerebellar
Flocculus, Nodulus
Smoothens and coordinate movements
Coordination, Planning of movements, Decreased tone,
Excitatory effect from deep nuclei
Smoothens and coordinates ongoing movements
Incoordination, Intention tremor, Ataxia
Intention tremor, incoordination,ataxia
HIV,PML
Hypertonia
Staccato speech

AFFERENT AND EFFERENT


Somatic efferent / general somatic efferent
Does NOT contain somatic efferent
Visceral Efferents carried by
General visceral efferent
General visceral efferent
GVE is absent in
Special Visceral Efferent
Special visceral efferent nuclei
Bronchial efferent/ special visceral efferent
Efferent of Cranial nerve from
Somatic afferent arise from
General somatic afferent
Special somatic afferent
General visceral afferent/Special visceral
afferent

Occulomotor, trochlear, abduscent, hypoglossal


Facial
Nucleus ambigus, Salivatory Nucleus, Edinger Westphal
Nucleus
Dorsal nucleus of vagus
Occulomotor, facial, glossopharyngeal, vagus
Edinger westphal nucleus
Nucleus ambiguous (Branchial muscles)
Nucleus tractus solitarius, Nucleus anbiguous, CVLM,
RVLM
Trigeminal, facial, glossopharyngeal, vagus, cranial
accessory
Basal Plate
Alar Lamina of Neural tube
Trigeminal nerve
Vestibulocochlear nerve
Nucleus tractus solitarius

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ANATOMY OF NERVOUS SYSTEM

NERVOUS SYSTEM

CRANIAL NERVE
Cranial nerves in posterior fossa
Cranial nerves in pontomedullary
junction
Cranial nerves present in apex of petrous temporal
bone
Site of lesion affecting 5,6,7 cranial nerves
Nerve arising from medulla
th
th
th
7 , 9 and 10 cranial nerves end in
Nucleus common to 9,10,11 cranial nerve
Fibres from nucleus ambiguous joins with
Brain stem nuclei derived from alar plate
Brain stem nuclei NOT derived from alar plate
Cranial nerve carrying parasympathetic fibres
MC nerve involved in intracranial aneurysm
Neuroepithelium type of sensory receptors
Neuroepithelim type of sensory receptors NOT seen in
Neuroepithelium is a type of receptor in
Olfactory epithelium is
Olfactory nerve first relays in
Nerve having receptors as dendrite
Information from olfactory bulb travels
via the lateral olfactory stria to
Lesion developed from Olfactoty Mucosa
Optic tract related to
Largest intracranial course
Smallest cranial nerve
Cranial nerve decussating with brain
Only cranial nerve to emerge from dorsal aspect of
brain stem
Does NOT carry parasympathetic outflow
Trochlear nerve supplies
Number of trigeminal nucleus
Ends in Posteromedial ventral nucleus of Thalamus
Trigeminal nerve extends lower down up to Level of
Trigeminal nerve
Branches of fifth nerve supplying duramater
Recurrent Tentorial nerve is a branch of
Recurrent branch of ophthalmic nerve
Nucleus of masseteric reflex
Afferent component of corneal reflex by
Passes through meckel cave
Unilateral trigeminal nerve palsy
Unilateral trigeminal nerve injury tested by
Not supplied by trigeminal nerve
Between labyrinthine artery and anterior
inferior cerebellar artery

3 to 12
6, 7 and 8
5,6
CP angle, Pons
Glossopharyngeal, Vagus, Dorsal horn of grey matter
Nucleus tractus solitaries
Nucleus ambiguous
IX, X, XI cranial nerves
Inferior olivary, Substantia nigra, Dentate
Hypoglossal
3,7,9,10
Occulomotor, Abduscent
Visual, olfactory, gustatory
Auditory
Olfactory
Pseudostratified
Temporal Cortex
Olfactory nerve
Piriform cortex, amygdala, entorhinal
complex
Esthesioneuroepithelioma
Lateral geniculate body
Trochlear
Trochlear nerve
Trochlear
Trochlear nerve
Trochlear
Contralateral superior oblique
4
Trigeminal nucleus
C2
Four nuclei, Carries sensation from face and scalp,
Composed of spinal nerve root, Has motor branch
Anterior ethmoidal, posterior ethmoidal, mandibular
Ophthalmic branch of Trigeminal nerve
Tentorium cerebelli
Mesencephalic nucleus of trigeminal nerve
Trigeminal nerve
Trigeminal nerve
Mandible deviates to same side
Elevation and lowering of jaw
Stylohyoid
Abduscent artery

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ANATOMY OF NERVOUS SYSTEM

NERVOUS SYSTEM
Cranial nerve passing through petrous
apex
Cranial nerve NOT containing parasympathetic fibres
Vestibular nerve
Efferents from cochlear nucleus arise for
Concerned with auditory pathway
Facial colliculus seen in
Vestibular Evoked Myogenic Potential (VEMP) detects
Glossopharyngeal Nerve supplies
Glossophayngeal nerve gives
Glossopharyngeal nerve does NOT supply
Vagus nerve carry
Vagus nerve innervates

Better predictor of vagal tone


Vagus nerve stimulation does NOT cause
NOT true about vagus
Muscle spared by complete transection of cranial part
of accessory nerve
In complete unilateral damage to Hypoglossal nerve

VI
VI
Nucleus supplied by PICA, anastomotic connection with
facial nerve, Vestibular ganglion aka scarpa ganglion
Superior olivary nucleus
Trapezoid body
Lower pons
Inferior vestibular nerve
Posterior one-third of tongue
Tympanic Nerve, Pharyngeal plexus, Tonsillar branches
Constrictors of Pharynx
Preganglionic parasympathetic fibres
Right two thirds of transverse colon,
stimulates peristalsis and relaxes
sphincter
Heart rate
Bronchodilatation
Carries postganglionic parasympathetic fibres
Stylopharyngeus
Atrophy on affected side, Deviation of tongue towards
the site of lesion, Deviation of Larynx to the
contralateral side during swallowing

SPINAL CORD
Nucleus pulposus is a remnant of
Length of human adult spinal cord
Spinal cord

Spinal cord

Spinal cord normally ends at


In adult spinal cord ends at
Spinal cord of infants end at
Subarachnoid space ends at
Spinal nerve pairs
These ventral spinal rootlets are more prone to injury
during decompressive operations because they are
shorter and exit in a more horizontal direction
Posterior column of spinal cord
Cell bodies of second order neuron of pain located in
Regions of spinal cord involved first in
Prominent spine
Part of vertebral canal showing secondary curves with
concavity backwards

Notochord
46 cm
In adults spinal cord ends at lower of L1 vertebra. In
newborn may extend up to L3. Cauda equina extends
from lumbar vertebra to coccyx
Central canal lies in grey matter, Efferents leave from
anterior horn, Denticulate ligaments suspend medulla
in subarachnoid space
Lower border of L1
L1, L2
L3
S2
31
C5

Nucleus gracilis, Nucleus cuneatus


Spinal cord
Dorsal root ganglion
C7
Cervical

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