we Brainstem (Ventral and Dorsal View) & IV Ventricles eum VENTRAL ASPECT 02:20 ‘Ofactory Bub — taco Tet [PS~ Perna ye aah ic rita vr — Pe tes pear hen iodo Comer in ‘OpveTract | Boundary y E tapers Pons Genre [rca ee Moa — Ines Xn pyami & ove conreNts 4. infundibulum & Tube-Cinerum 2. Hamillary bodies 3. NV 4, Posterior perforating substances . ‘Active Space .RELATIONS OF APS Hediat > Optic chiasma Post > Optic Tract Lateral > Limen Insulae > Uncus DORSAL ASPECT OF B.S 36:40 = Floor of IV Ventral. > aka Rhomboid Fossa 2 gett? ace a vuiNe ‘scriptorius: © Nuclei (+) in the Floor of IV ventricle > VI, Vil, x &Xxil Internal Gena —» Result of Newrobiotaxie Motor il Nu migratos towards sensory V Nu for fastor Rolexes Injury to structure producing facia colliculus v Means LMNL of VII NV v Vt Facial Paralysis, ‘© Area postrema ~> vomiting center WW VENTRICLE 53:09 Boundary - SCP, ICP, Gracile Tubercle & Cuneate Tubercle Floor - Rhomboid fossa Roof ~ ‘Superior medullary velum (tito mater) I+Post. RECESS OF IV VENT f= Int medulary velum INon-Nervous structure] Active Spacees Aditory Pathway em AUDITORY PATHWAY 01:39 Gaurd c HGB-> Music > Auditory pathway LGB > Light > Visuok Pathway ‘Sup. Brachium Inf. Brachium ‘any cos [4 Hse cox Aud. radiations (0) —- inf. Thalamic Radiations cota) Gi Bach Lateral Lemmiscus ‘Trapezoid Body D Cochlear Nu [Pontomedular Deeenioo nur ry {se canon Inner hair celts (95%) ith saree . Active Space 7eee Trigeminothalamic Pathways omen ‘TRIGEMINOTHALAMIC PATHWAY 00:31 Sensory conex(3, 1.2} Thalamic Raton A tions @) ZA Taam VPM Nace) Lateral Lem Cit Hearing Loss ‘Spinal Lem 4 Ci. LOSS of Pain & Temp (Body) ‘Tigeminal Lem GL LOSS of Pain & Temp (face) Medial Lom -* Ci loss of conse. roprioception, Fine & crude Touch, Pressure, vibration & Storeognows . Active Space .MLF SYNDROME / INTERNUCLEAR OPHTHALMOPLEGIA 01:10 © Horizontal nystagmusis d/t repeated stimulation of {6% nerve nuclei (4/+ compensatory mechanism) MIDBRAIN SYNDROMES 10:44 Medial Lomniscus Pyramidal Tract Frontopontine Fibres aw) ‘iy (UMN'OF QIN NY] BENEDICT’S SYNDROME. 1731 Artery involved - Perforating branches of PCA HL ay C/L Loss of conse.prop. Brainstem Syndrome qn SL #y.C/L Loss of Pain & Temp (Body) TL ay.C/ Loss of Pain & Temp (Face) WNerve ey #1 ptosis * 1/L Dilated Pupit *1Divergent ——# I/L Loss of. squint ‘accommodation & Light Reflex WeBeR’s SYNDROME 22:56 ‘Artery involved - Post cerebral ‘A’ © TINY = do- © UMNof VIIN/V_# £/ paralysis of lover of face © Pyramidol tract_e.,C/L Hemiplegia NOTE -1/L il N/V palsy + C/L sensory loss of pain & ‘gmp from face &rest of Benedict's Syndrome = MALIIIN/Y palsy + C/L motor Loss / paralysis Active SpacePONTINE SYNDROME Pyramidal Tract MILLARD GUBLER’S SYNDROME (MGS) 30:21 Artery involved - Basilar ‘A’ VIN/V g/L convergent squint VIN/V_a, IM facial Paralysis Pyramidal tract _# ,C/L Hemiplegia ‘© Aka Alternating Abducent Hemiplegia INTOCEREBELLAR ANGLE SYNDROME (PAS)30:21 ‘© Couse —> Acoustic neuroma © VIIN/V ay I/ facial Paralysis © VIIN/V_ay I/L Progressive deafness © HCP /ICP_ay I/L Ataxia MEDULLARY SYNDROME 38:03 Vestibular Nuclo| Nu. Ambigus ‘Spinal Nu. of (V) ov ‘Spnial Lemniscus Inf olivary Nucleus Pyramid MEDIAL MEDULLARY SYNDROME 44:4 ‘Artery involved - Vertebral 'A’ + Ant, Spinal 'A’ © HL_a4C/L loss of conse. Propriaception © Xilnv__g I/L Tongue paralysis (tongue deviate. towards the side of Lesion) Pyramid # ,C/L Hemiplegia LATERAL MEDULLARY SYNDROME 44:14 = Aka Wallenberg syndrome = Artery involved : PICA © ICP_api/l Ataxia © Vestbular Nu_itp vertigo, vomiting ete © Nu. Ambigus _# pI/L Bulbar paralysis & Loss of Gag reflex Spinal Lemniscus _# ,C/L loss of pain, Temp (Body) © Spinal Nu_a,1/L Loss of Pain , Temp (Face)ee Cerelelli ea Lingula ‘Ant Lobe Pasterior lobe id Uvula Flocculus — Flocculonodular Lobe ‘Archaecerebolum Paleocorebellum —_Nederebellum [oldest] [Next to appear] {most recent + aka vestibular + oka spina + oka corobral Corobotum cerebellum ‘orebotlum T ‘ ‘ Notinry ever scp] Cortex White mater be Doep corebolar Nuclei roe [CORTEX]- 3 Layers (superficial to deep] © Cerebellar-cortex is the largest collection of Inhibitory Neurons © Only efferents from cortex & largest cells - Purkinje cells DEEP CEREBELLAR NUCLEI D~Dentate Nucleus Largest E ~ Emboliform Nucleus Nucleus Nu of Neocerebellum F -Fastigeal Nucleus [Nucleus of G - Globose Nucleus Paleocerebellum ‘Aka Nucleus of Archaecerebellum ‘Active SpaceAFFERENT FIBRES 29:50 —— iforent fibres —— [Giabing Toreg ‘Granule coll © erebollar Glomerall mossy Fibres Rest all other Tracts CEREBELLAR PEDUNCLES. 37:05 midbrain pons medulla -Cuneocerebellar ‘dorsal spinocerebellar T. = Largest peduncle — Purely afferent peduncle Active Space. $$meee Cerebrum — Homunculus & Histology em WoMUNCULUS 00:13 Head & Neck CEREBRAL CORTEX 05:50 ee cortex S Granular cortex ‘Agranular cortex Granular Layer >>> Pyramidal Layer >>> Pyramidal Layer Granutar Layer 1 Plexifomm Layer [5 =—S=Se Horizontal cols 2 Outer Granular ere 4 Inner Granular 5 Inner Pyramidal 6 Mute Layer [Polymorphic Layers)eee White matter Part | ee ite matter of the cerebrum] Association Commissural_ Projection Fibres Fibres Fibres v v v Connects diff Connects same Ascending & ‘areas of some areas of both descending cerebro cerebral Trocts Hemispheres Hemispheres AM =m Se arouse fageculas J (hp unguantewee (2)inf- Longitudinal Fasciculus */ (3)Fronto~ occipital Fasciculus (4) cingulum Fasei cus (5)Uncinate Fasciculus OsO @cingutum aka, Libic sociation Fibre] © Uncinale fasciculus 39,40) COMMISSURAL FIBRES 12:40 4. Corpus callosum ‘© Lorgest commissural fib. Genu (6) = e Splenium (5) ® 2. Anterior commissure 3. Posterior commissure Active Space .4, Habenular commissure 5. Hippocampal commissure ibpocaripar_, Connects Exterpal capsule External capsul Intomal capsule ‘Corpus callosum -Caudate Nu insula Thalamus {island of Rey Lentiform Nucieus Claustrum Connacs Faboruor eae! PINEAL GLAND Conede ho mos Staraniotorpon ‘(Gost coraije Connects 2 se Stomper es tonne aco {oka ntersial Nu of C Pot Tapas Cam Femi appar RANSVERSE SECTION Tapetu ‘Bulb of Posterior Horn Posterior Horn Ext, capsule Lentiform Nu Insula Extreme capsule Tapetun Active Spaceeee White matter Part? qa PROJECTION FIBRES 00:19 Tracts in internal capsule (1) Internal copsule 8 Corona radiata ——— Ascending Troct Descending Tract comps ‘Sup. Thalamic Radiation t Ant. Thala Intemalcapeulo Radiation Poet, Thales (2) Fornix int Thalamic ®@ (3) Fimbria INTERNAL CAPSULE 02:10 n= Limb 4. Ant=Limb 2. Geru Supecor amc 3. Post Limb hate 4, Retrolentiform part. Inferior Thalamic 5. Sublentiform part. Seen Aas Lon fom Nu Postoror Thane Radiatons ‘or iM i, Optic Radiation DESCENDING TRACT 11:45 pe + Corticopontine fibers Posteriori © Corticospinal tract extr troct Ls Subientitorm part Extrapyramidal * Corticonuclear tract Retrolentorm . Active Space .CORTICOPONTINE FIBRES: 4. Frontopontine Fibres 2. Parietopontine Fibres 3. Occipitopontine Fibres 4. Temporopontine Fibres Corticonucleare. Tr Coreticospinal Tr [Ant 2/8rd of PL] Corticonubral Tr Active SpaceLATERAL & THIRD VENTRICLES 00:14 ee | ateral & Third Ventricles omen oar eros Callosum pot caudate Sta Terminale om LATERAL VENTRICLE (CORONAL SECTION) 07:34 Optic chiasma Marnmtary Body Pesteror Peroraing Seb [SAGITTAL SEQ] ~ Ill VENTRICLE ‘Seplum Peltscidum + Corpus Callosum caudate Nut Foro J—+ Sta Terminals, Thalamostiate vein Thalamus in choroid Prous Floor -Fomix & Choroid Plexus | Root) Forni Habenular Comm | ‘Ant. Commissure Pineal Glond Lamina Termini: ‘oon Post comin “Aqueduct optic chiasma {infundibulum | ‘ane ‘Tegmentum Active Spacemeee Thhalamus and it’s connections em CONNECTIONS OF THALAMIC NUCLEI 12:38 ‘Ant. part Modial part ‘Non. spactic Thalamic Nu Lat port Thermal meduiary Lamina Bentate ‘Nu! i Rows ‘ie ei I SPECIFIC THALAMIC NUCLEI 24:41 ee Medial vertal Nu [HV Na Titerent Sina VPH | TLand solitaro=Thalam Tr | (3,4,2) Si Sap vPL MLaSL 4.2) w Dentatothalomic & 0 Dentatorubro - Thalamic Tract vA Glabus Palidum © HB ‘ud Fibres (4,42) — Visuot Fibres mmCINGULATE GYRUS Prefrontal Gy Sup. parietal lobule NON-SPECIFIC THALAMIC NUCLEI CONNECTION 32:51 Nuclei | Afferent Efferent Function AN MB Cingulate | Recent Gy memory & attention HN | Thalamic & | Prefrontal | Hood & HT Nu Area | Emotional aes Balance LDN | Ventral Tier | Cingulate | Integration Nuclei 6y LPN | Ventral Tier | Sup- | Integration Nuclei Parietal lobule Pulvinar | Ventral Tier | Association | Correlates nuclei areas | auditory & visual information with others —— — Active Space ——_—______________—_ee 8252/6202 "© Corpus Striatur * Claustrum = Amygdalld body ‘= Substantia Nigra + Subthalamus Anatomical component amygdlotd Body =. Corpus striatum © Lentiform (© Globus Polidum - Poleostriatum © Putamen I Neostriatum © Caudate Nu CONNECTIONS OF CORPUS STRIATUM 10:09 Afferents ‘© Corticostriate fibres ‘¢Thalamostriate fibres Nigrastriate fibres Nigto-Stiate Fibres EFFERENTS 15:47 |- Fasciculus Lenticularis [Al] Ansa Lenticularis . Active Space .Premotor area (Thalamus) © Batthalamic Nut "e Rod Nucious S Reticular formation ‘Substantia Nigra Functions of Basal Ganglia 4. Planning & Programming of voluntary movement 2. Speed & Range of movement . Alters muscle -> Prevents unwanted muscular activi sete Space eeVERTEBRAL ARTERY 09:39 4. Origin to Foramen - Transversarium 2. Within Foramen - Transversarium 3. From Foramen -Tr - of C1 o Foramen - magnum 4. Above Foramen ~ Hagnum ; = Qe 7 Teepe | SS ]@-muscuar br | @ Spinal branches °, & ch Muscular branches ‘st part of subclavian ‘A Blood Supply of Brain cn BASILAR ARTERY 17:32 vi [Post carebral‘a! Superior corebolar'A* Pontne br -AICA labyrinthine’ (AIGA > BA) Vertebral Ica 22:12 Ica> ()—Cervieal part (Cavernous part Gu) Petrous part (IV) Cerebral part Carotid Siphon Cavernous: sinus. Foramen Lacerum Sup & In Hypophyseal A ‘Arto sphoneid air sinus Meningeal at + Dura of MCF WV v.voin (A) Ophthalmic artery (4" branch] (2) HA (3) ACA Active Space(4) Ant ethmoidal ‘A’ (5) Post communicating 'A’ ‘ACA TYPES OF HEMORRHAGES 32:10 4. Extradural Hemorrhage > Ant div - of HHA 2. Subdural Hemorrhage > Superior cerebral. vein [Bridging vein] 3, Subarachnoid Hemorrhage -> Rupture of Berry Aneurysm 4, Intracerebral Hg -> Charcot’ art / Lenticulostriate artery ITE | Artery of cerebral thrombosis -> Ant - choroidal Active Spacemmm Sympathetic Chain - Ramus Communicans emu ator Horn Nuc Symp ou ow" Dorsal horaclumbarouttow on Sym = Ganglion 24-22 Pairs > Cervical 6> 3 Thoracic 6 > 11 Lumbar 6 > 4 Sacral 6 4-5 4 Pre. Ganglion Symp. )\\ Neuron [My] Vi Paraventicular Gang @ FToaanalionic Sy {coeliac 6) [Splanchnic NV NOTE]- Pathway of Sympathetic Fibres for Adrenah ‘medulla Pregang Symp Fibres via WRC] > Cliary Ganglion Ito Relay] > Retay in adrenak medulla Gen - Sensory from Ski(GSA) . Active Space .mame Conus Medullaris and Cauda Equina Syndrome qm ‘+ Incase of Cauda Equina syndrome ¥ Both saddle & perianal anesthesia (Come Meats Worobra Love Ltt, Sonal Segment 8; -Ca) CCAUOAEQUINA torea [AE EREROST—+ 8,88, FER IER J— Leu, NOTE - In case of conus medullaris syndrome v [ANKLE JERK is A 08:28" = wiescret cad egine smdeos BULBOCAVERNOUS REFLEX ¥ Pdendal Nowe (2-5) Mert ‘Both KNEE JERK =o 4 JANKLE JERK is Affected Pudendal Neve e if x80 SADDLE & PERIANAL INNERVATION 07:28 oLZRO els a ‘© Incase of conus medullaris syndrome v Perianot anaesthesia Sa Eien Spire Loss of Bubocavernous Reflex Active Spacerer CEES TS, PUTS Ree distal Poresis _|+Flaccid Conus — syndrome of Lover Limb | paralysis of Initiclly Bulbocavernous Reflex is Lost [due to spinal Lease ib shock] |+Atrophy is more common Recovery of Bulbocavernous Reflex Sphincter Urinary Urinary Retention, Retention overflow present late urinary incontinence, Fecal incontinence Sensory Numbness more | Numbness more localized in | localized to perianal Region | saddle region with possible Numbness in on = CAS ai pubic region DUA ra SINORO Impotence Frequent Less Frequent Vertebral level | L;~ Le vertebrae | L: - sacrum vertebrae Spinal level | S1-Co La Coccygeat Type CNS type Lesion | PNS type Lesion Spread Sudden & Groduol & Symmetrical | Asymmetrical (bilateral) DIR Ankle Reflex | Both ankle & affected knee affected BCR May be Lost preserved . Active Space‘TYPES OF SULCI 00:13, 4. Limiting Sulcus A © Suleus ubich separates dif areas atthe floor. Eq Central Sulcus (Rolandic), Calearine sulcus 2. Operculated Sulcus M ‘© st lke Limiting Sulcus but transition is atthe lip. q~Lunate sulcus > Separates striate & peristriate orea 3. Axio Sulcus Y ‘Sulcus around which different areas develops. Eq - Post-part of calcarine sulcus 4. Complete sulcus LEPenrdl LWCk Deep enough to indent the walls of ventricle Eg - Ant part of calcarin sulcus, (PH) ~ Collateral Sulcus (iH) PH (Calcar Avis) 7 (collateral Eminence) '* Other sulcus ore called as incomplete sulcus SUPEROLATERAL SURFACE OF BRAIN 11:16 [B} Supramarginal 6 [E} Angular 6 [A}- pars opercularis [B)- pars triangularis [C]- pars orbitatis Active Space3.4. 2|(Post central Gy) ‘Primary Sen. Area_#y.C/L Sen Loss 5,7] (Sup parietal lobule) ‘se Sen association area _#y Tactile agnosia ‘»Pre-cerebral Gyrus ‘© Origin of pyramidal tract ‘*Prim, Motor area ity C/L Hemiplegia [4] (sre. Hrs 6 Fe) ‘*Pre motor area_sy Apraxia Site of origin of extrapyramidal tract [5] (wre) Frontal eye field area ye C/L conjugate eye movement lost ‘Scanning ocular movement & independent of visual stimulus [M(ink - frontal Gyrus > (HH) Pars opercularis > (48) Pars Triangudaris '* Broca's area (Hotor speech area) _# , otor cophasia [e122 sup-temporat Gyrus) Primary Aud-cortex (Hescht’s cortex) dcsta) ‘Audit - association area B3.49 (Angular & Supramarginal Gy) s « Sen speech area (verniche's area) v 22, 34, 40 |. Sen - aphasia (Hotor + Sensory) aphasia _# Global aphasia 4 Tsote Active SpaceMEDIAL SURFACE OF CEREBRAL HEMISPHERE 38:00 Cotortral Sulcus Highest cantre for micturation & dee” cingulate. S para olfactory Gy paraterminal Gy nous \ aferimary oF. avon primary visual area (18, 19}- visual association area —___—_—_____— Active space. ———_________-smeee Spinal Cord- External Features quem SPINAL CORD 02:02 [Spinal Pamator modicatons Extent ~ Adults: C1 to Lower border of L1 Neonates: C1 to upper border of L3 Cervical Enlargement 03122 (Spinal cog, Lumbar Enlargement LTS Conus meduris ramatortArachnold mater Intomus -+ Piamator estas — Foun band : Lumbar Puncture ‘© Fibrous band is made up of Pia + arachnoid + dura mater EROS ‘Conus medullary Syndrome 4# Cauda equina Syndrome, |e . Active Space .mee Grey Matter - Nuclei and Relaxed Laminae eon Intrmadiate Ny e——< Spal x1 NV Phrenic Medal Ni iin ‘sae . Active Space .Ascending TractS DORSAL COLUMN TRACT 27:48 [Bersel Coun Tal ense Proprigcap: Fascicuve Grails LL) } Fine Toue, Pressure ‘asciculus Cung eration & Thalamic racsations. Th Fasccuve Cnet | vraiond rusts oral oan Tl] - none alanis (VELN) ; venta eee, H NS [at Spraiaore Ted] Pan& ompecaeo eda Laeiscus—t | [Bat Spinto 7 Crate Toven & Pressure SPINOTHALAMIC TRACT 11:56 Sonar eotes|3,1.21 corona rac | halamie Rad) ‘Yount Lerma) ois mea Larniscus ‘* Nucleus proprius & LN maintain reflex are Aon eT SPINOCERERELLAR TRACT 39: © DY cane ase tat st pr [NOTE = ighest carve Tor] q pain is tata Grane etn Highest center for pin: Thalamus fu nu, Dortalcias coun venga scr: ert Spacer Generalised ifmatin reise tncons ion sea ‘rom the Lower Limo compart function of © Cunoocerebotr Tact “creveum Precis uncons®.propriceaption ‘tom OL Active SpaceNOTE - FC _# W/L Loss of Conse. Proprioception, vibration etc + Unconse-propriaception from UL Active Space. ———_________________»Descending Pacts eas ‘Anterior corticospinal Tract cone ‘Skilled voluntary Lateral corticospinal Tact crossed) fmeverent [BuboanialTrac]—> Festa Flxcr & nae \.Faciitates Extensors & inhibits Flexors 4. Dorsal Tegmental decussation > Tectospinal Tract 2. Ventral Tegmental decussation -> Rubrospinal Tract PYRAMIDAL TRACT 18:58 motor cortex (4)