IX.

BRAIN

SULCI

Limiting Sulcus Axial Sulcus Operculated Sulcus Secondary Sulcus Complete Sulcus
Separates two Develops in the Its lips separate Produced by factors Very deep to cause
Areas tong axis of a two areas and other than the elevations in the walls of
functionally & rapidly growing Contains a third exuberant growth in the lateral ventricle
Structurally homogenous area area in the walls the adjoining areas of
of the Sulcus the Cortex
*Eg.: *Eg.: Eg.: *Eg.: Eg.
Central Sulcus Post - Calcarine Lunate Sulcus Lateral & Parieto- Collateral & Calcarine
of Rolando Sulcus Occipital Sulci Sulci

MENINGES
The brain itself, the arachnoid mater, and the pia mater, does not contain sensory endings. These are restricted to
the dura mater and cerebral blood vessels.
• Layers of cranial dura: inner meningeal (continuous with the spinal dura through the foramen magnum) &
outer periosteal layer
• Greatest part of dura is supplied by: Middle meningeal artery.

DURAL PARTITIONS
• Falx cerebri-largest of the dural infoldings, partially separates the two cerebral hemispheres.
• Tentorium cerebelli - dura that separates the posterior part of cerebral hemispheres from cerebellum.
• Falx cerebelli - small midline projection of meningeat dura mater in the posterior cranial fossa, attached
posteriorly to the internal occipital crest of the occipital bone and superiorly to the tentorium cerebelli.
• Diaphragma sellae - small horizontal shelf of meningeal dura mater covers the hypophysial fossa in the sella
turcica of the sphenoid bone. There is an opening in the center (infundibulum) connecting the pituitary gland
with the base of the brain.

OTHERS:
• Granular foveolae - mark the location of arachnoid granulations
• Sella turcica - modified remainder of the body of the sphenoid, which consists of a deep central area (the
hypophysial fossa) containing the pituitary gland.
• The anterior wall of the sella -tuberculum sellae-a vertical wall of bone with its superior extent visible as a
slight elevation at the posterior edge of the chiasmatic sulcus.
• The posterior wall of the sella turcica is the dorsum sellae, a large ridge of bone projecting upwards and
forwards.

INNERVATION OF THE CRANIAL DURA MATER

• Major: from the three divisions of the trigeminal nerve, the first three cervical spinal nerves, and the cervical
sympathetic trunk.
• Minor: meningeal branches from the vagus, hypoglossal, facial and glossopharyngeal nerves.

Nerve Innervates
Meningeal branches of the anterior and Dura of anterior cranial fossa
posterior ethmoidal. N
Anterior filaments of the meningeal rami of the Dura of anterior cranial fossa, but largely distributed
maxillary (nervus meningeus medius) and mandibular to the dura of the middle cranial fossa, which also
(nervus spinosus) trigeminal divisions. receives filaments from the trigeminal ganglion.

Recurrent tentorial nerve(branch of ophthalmic Tentorium cerebelli

division of the trigeminal.N)
Ascending meningeat branches of the upper
cervical nerves, Meningeal branches of vagus
from the superior vagat ganglion
Meningeal branches from the hypoglossal nerve
Dura in the posterior cranial fossa
Diploe of the occipital bone, the dural walls of the
occipital and inferior petrosal sinuses, and much of the
floor and anterior wall of the posterior cranial fossa.

Nervus spinosus:
• Re-enters the cranium through the foramen spinosum with the middle meningeal artery.
• Also contains sympathetic postganglionic fibres from the middle meningeal plexus.
• The anterior branch communicates with the meningeal branch of the maxillary.N
• The posterior branch supplies the mucous lining of the mastoid air cells.

CISTERNS OF SUBARACHNOID SPACE

• Cerebellomedullary cistern/cisterna magna: largest cistern lying in the angle b/w medulla, cerebellum &
occipital bone.
• Cisterna Pontis: present on the ventral aspect of pons & contains the basilar artery.
• Interpeduncular cistern: contains circle of Willis.
• Cistern of lateral sulcus: contains middle cerebral arteries.
• Cisterna ambiens/cistern of great cerebral vein: contains pineal gland & great cerebral vein.
• Lumbar cistern: space between L3 & L4.

VENTRICLES OF THE BRAIN

• Lateral ventricles (1st and 2nd ventricles): largest cavities of the ventricular system.
• Each lateral ventricle opens through an interventricular foramen (foramen of Monro) into the 3rd ventricle.
• They each include two central portions (body and atrium) and three extensions (horns).
• Trigone of lateral ventricle: junction b/w anterior & posterior horns.
• There is no choroid plexus in the anterior and posterior horns.
• Tapetum of the corpus callosum separate the ventricle from the optic radiation, and form the roof and
lateral wall of the posterior horn.
• Third ventricle: a slittike cavity between the right and left halves of the diencephalon is continuous
posteroinferiorly with the cerebral aqueduct (aqueduct of midbrain/Sylvius), to the 4th ventricles.
• The 4th ventricle in the posterior part of the pons and medulla extends inferoposteriorly.
• It is continuous through the central canal in the inferior part of the medulla with the central canal in the
spinal cord.
• CSF drains from the 4th ventricle through a single median aperture (foramen of Magendie) and paired
lateral apertures (foramen of Luschka) into the subarachnoid space.
PONS
• Middle part of the brain stem connecting the midbrain with the medulla. Literally 'pons' means 'bridge'.
Basilar part of pons
Grey matter White matter
-Pontine nuclei Longitudinal fibres Transverse fibres
-Arcuate nucleus - Cortico-spinal tracts Ponto cerebellar fibres
-Pons to bulbar body. - Cortico-nuclear tracts
Fibres from all these nuclei go to the opposite 1/2 of - Cortico pontine fibres
cerebellum.

Tegmentum in the lower Part of Pons

Grey Matter White Matter
- Sixth nerve nucleus(beneath facial Colliculus) -Trapezoid body(Ventral Part of
- Seventh nerve nucleus(in reticular formation of Pons) Pons)
- Vestibular & Cochlear nuclei( in relation to Inferior Cerebellar Peduncle) - Medial lemniscus
-Spinal nucleus of the Trigeminal nerve - Lateral Spinothalamic tract
- Salivatory nuclei & Lacrimatory nuclei. - Inferior Cerebellar Peduncle
- Facial Colliculus

Tegmentum in the upper Part of Pons

Grey Matter White Matter
- Motor & Superior Sensory - Medial lemniscus, trigeminal lemniscus, Spinal lemniscus, Lateral lemniscus
nuclei of the Trigeminal nerve - Superior Cerebellar Peduncle
- Medial longitudinal bundle

ARTERIAL SUPPLY OF THE CEREBRAL

• The brain receives it arterial supply from two pairs of vessels, the vertebral and internal carotid arteries,
which are interconnected in the cranial cavity to produce an arterial circle (of Willis).
• The two vertebral arteries enter the cranial cavity through the foramen magnum and just inferior to the pons
fuse to form the basilar artery.

Anterior Cerebral. A Middle Cerebral. A Posterior Cerebral. A

A Strip of about 2cm wide
along the Supero-medial
border from the frontal Pole
to the Parieto Occipital
Sulcus
Medial Surface of the brain
Medial Part of orbital Surface
Areas that represent for leg
areas
Greater Part of the Superolateral Surface except a) Occipital lobe
• A 2cm wide strip from frontal Pole to the b) Inferior temporal gyrus
Parieto - occipital Sulcus c) Tentorial Surface
• Area belonging to Occipital lobe d) VISUAL CORTEX
• Inferior temporal gyrus
Lateral Part of orbital Surface
Temporal Pole
Main Somatic motor and Sensory areas except in their
uppermost Parts (leg areas)
AUDITORY CORTEX
FUNCTIONAL AREAS OF THE CEREBRAL CORTE
Lobe Area Location Function Effect of lesion
Motor area Precentral gyrus Controls voluntary activities of Contra lateral
4 and Para central the opposite half of body Paralysis and
lobule jacksonian fits
Pre motor area Posterior parts of Controls extra - pyramidal system Often mixed with
Frontal
6 superior, middle Pyramidal effect
Lobe and inferior frontal
gyri
Frontal eye field Posterior part of Controls horizontal conjugate Horizontal conjugate
6,8 middle frontal movements of the eyes movements are lost
gyrus
Motor speech Pars triangularis Controls the spoken speech Aphasia (motor)
area (Broca's and pars
area) opercularis
44,45
Prefrontal area The remaining Controls emotion, concentration, Loss of orientation
large, anterior part attention and judgment
of frontal lobe
 Parietal Sensory Post central gyrus Perception of exteroceptive Loss of appreciation
lobe (somesthetic) and paracentral (touch, pain and temperature) of the impulses
area lobule and proprioceptive impulses received
3,1,2
Parietal area Between sensory Stereognosis and sensory speech Astereognosis and
and visual areas sensory aphasias
Occipital Visuo sensory In and around the Reception and perception of the Homonymous
lobe area or striate post calcarine isolated visual impressions of hemianopia with
area sulcus colour,size , macular sparing
17 Form motion, illumination and
transparency
Visuopsychic Surround the Correlation of visual impulses Visual agnosia
area para striate striate area with past memory and recognition
and peristriate of objects seen and also the
areas 18,19 depth
Temporal Auditosensory Posterior part of Reception and perception of Impaired hearing
lobe area superior temporal isolated auditory impressions of
41,42 gyrus and anterior loudness, quality and pitch
transverse
temporal gyrus
Auditopsychic Rest of the Correlation of auditory Auditory agnosia
area superior temporal impressions with past memory
22 gyrus and identification (interpretation)
of the sounds heard

VENOUS DRAINAGE OF CEREBRUM

• External Cerebral Veins:

Superior Cerebral Vein

6-12 in number

Drain the Superolateral Surface of the hemisphere

Drains into Superior Sagittal Sinus
• Superficial middle Cerebral Vein

Drain the area round the Posterior ramus of lateral Sulcus

Drains into Cavernous Sinus or rarely into Spheno - Parietal Sinus

Also Communicates with the deep middle Cerebral Vein
• Deep middle Cerebral Vein

Drains the Surface of insula

Terminates into the basal Vein
• Inferior Cerebral Veins

Several in number, divided as orbital Et tentorial.V

Orbital Veins terminate in Superior Cerebral Veins

Tentorial Veins drain in the Cavernous Sinus
• Anterior Cerebral Veins

Drains Corpus Callosum

Terminate in the basal Vein

Internal Cerebral Veins:

• One Vein on each side
• Formed by the union of thalamo - Striate and Choroidal Veins
• Situated at the apex of tela Choroideo of IIIrd Ventricle
• The right & left Veins unite together to form the great Cerebral Vein of Galen below the Splenium of Corpus
Caltosum
Terminal Veins
Great Cerebral Vein (Vein of Galen): Terminates in the Straight Sinus. Tributaries are basal Veins and the Veins from
Pineal body, Colliculi, Cerebellum, Occipital lobes of Cerebrum
Basal Vein
• One Vein on each Side
• Formed at the anterior perforated Substance by the union of deep middle Cerebral Vein a striate vein
• Terminates into Great Cerebral Vein
Note: ULTIMATELY ALL VEINS DRAIN INTO THE VARIOUS CRANIAL VENOUS SINUSES WHICH, IN TURN DRAIN INTO
THE INTERNAL JUGULAR VEIN.

HISTOLOGY OF CERBRAL CORTEX

• Outermost molecular layer (I) contains nonspecific afferent fibers that come from within the cortex or from
the thalamus.
• The external granular layer (II) is a rather dense layer composed of small cells.
• The external pyramidal layer (III) contains pyramidal cells.
• The internal granular layer (IV) is a thin layer, receiving specific afferent fibers from the thalamus.
• The internal pyramidal layer (V) contains pyramidal cells that are fewer in number but larger in size. These
cells project to distal structures (eg, brain stem and spinal cord).
• The fusiform (multiform) layer (VI) consists of irregular fusiform cells whose axons enter the adjacent white
matter.
• In the Occipital cortex the external band of Baillarger (lamina IV) is well defined as the stria (white line) of
Gennari.

CEREBELLUM
Archicerebellum
Phylogenetically, Oldest part
Made up of Flocculonodular lobe &
the lingual
Chiefly vestibular in Connections
Controls the axial musculature
and bilateral movements (used
for locomotion and equilibrium)
Output passes directly to brain stem
Location of deep cerebellar nuclei: (medial to lateral): fastigial, globose, emboliform & dentate nuclei. Middle
Cerebellar Peduncle has only afferent tract (Ponto - Cerebellar tract)
Paleocerebellum Neocerebellum
Next to develop Newest part to develop
Made up of anterior lobe (without Made up of the middle lobe (largest part
lingula) and the pyramid and of cerebellum) without pyramid and
uvula uvula
Connections are chiefly
Spinocerebellar
Controls tone, posture and crude Concerned with the regulation of fine
movements of the limbs movements
Output to brainstem passes
Output goes to Venterolateral nucleus of
through Emboliform, fastigial or
thalamus through dentate nucleus
globose nuclei

Cerebellar Peduncle Afferent tract Efferent tract

Superior Cerebellar Peduncle
Middle Cerebellar Peduncle
Inferior Cerebellar Peduncle
Anterior Spino Cerebellar Cerebello rubral
Tecto - Cerebellar Dentato - thalamic
Dentato - Olivary
Fastigio - reticular
Ponto - Cerebellar -
Posterior Spino Cerebellar Cerebella - Vestibular
Cuneo Cerebellar Cerebella - Olivary
Olivo - Cerebellar Cerebello - reticular
Par - Olivo - Cerebellar
Reticulo - Cerebellar
Anterior external arcuate fibres
Striae medullares
Trigemino - Cerebellar
MEDULLARY NUCLEI
Several nuclei are seen in the upper part of the medulla (floor of the fourth ventricle). They are:
• Hypoglossal nucleus.
• Dorsal nucleus of vagus (lateral to XII nerve nucleus).
• Nucleus of tractus solitarius (Ventro lateral to the dorsal nucleus of vagus).
• Inferior and medial vestibular nuclei.
• Nucleus ambiguus lies deep in the reticular formation gives origin to motor fibres for cranial nrv IX, X & XI.
• Dorsal and ventral cochlear nuclei.
• Nucleus of the spinal tract of the trigeminal nerve.
• Inferior Olivary nucleus (largest mass of grey matter at this level, responsible for the producing the elevation
of the olive)
• Arcuate nucleus.
The visceral centres are:
• Respiratory centre.
• Cardiac centre
• Vasomotor centre
PINEAL GLAND (epiphysis cerebri)
• Small, conical organ situated between the 2 superior colliculi, consisting of a body and a stalk (Peduncle).
• Inferior to the splenium of the corpus catlosum, from which it is separated by the tela choroidea of the third
ventricle and the contained cerebral veins
• Composed of Pinealocytes and neuroglial cells.
• Calcareous concretions are constantly present in the pineal after the 17th year of life and may form
aggregations (brain sand/corpora arenacea)
• Sometimes, referred as "THE THIRD EYE"
• Produces hormones that may have an important regulatory influence on many other endocrine Organs.
• The best known hormone is melatonin(hormone of darkness) which causes changes in the skin colour.
• Pineal art. are branches of the medial posterior choroidal arteries, which are br of the Post. cerebral artery.
• A tumor in the pineal region may obstruct the cerebral aqueduct or cause inability to move the eyes in the
vertical plane (Parinaud's syndrome).
PITUITARY GLAND
• Also called as Hypophysis Cerebri or "Master of the Endocrines"
• Lies in hypophyseal fossa (Sella turcica) roofed by diaphragma Sellae
Subdivisions of Pituitary gland
• Adenohypophysis - develops as an outgrowth called Rathke's pouch from the ectodermal roof
• Neurohypophysis -outgrowth from the floor of diencephalon
Arterial Supply
• Supplied by the branches of Internal Carotid. A
• One Superior & One inferior hypophyseal artery on each side
Venous drainage:
• Short Veins emerge on the Surface of the gland and drain into dural Venous Sinuses
• The anterior lobe is supplied exclusively by Portal Vessels arising from Capillary tufts formed by the Superior
hypophyseal arteries.
• These Portal Vessels carry the hormone releasing factors from the hypothalamus to the anterior lobe.
ARTERY BRANCH OF
Anterior meningeal arteries Ethmoidal arteries
Posterior meningeal artery Terminal Br. Of ascending pharyngeal artery
Transverse facial artery, middle temporal artery Superficial temporal artery
Infra orbital artery, buccal artery, mental artery, Maxillary artery
inferior alveolar artery, deep auricular A, anterior
tympanic A, accessory meningeal A, masseteric A,
posterior superior alveolar A,
Sphenopalatine A Terminal Branch of Maxillary artery
Anterior superior alveolar A Infra orbital A
Angular A Facial A
Zygomaticotemporal artery & zygomaticofacial artery Lacrimal branch of ophthalmic artery