Preface

vi

Acknowledgments

x

1

Gross Anatomy of the Brain

1

I

Introduction: The Brain

1

II

Divisions of the Brain

1

III

Atlas of the Brain and Brainstem

10

Review Test

22

2

Meninges and Cerebrospinal Fluid

24

I

Meninges

24

II

Ventricles

28

III

Cerebrospinal Fluid

30

IV

Hydrocephalus

30

V

Meningitis

31

VI

Herniation

32

VII

Circumventricular Organs

32

Review Test

36

3

Blood Supply of the Central Nervous System

40

I

Arteries of the Spinal Cord

40

II

Venous Drainage of the Spinal Cord

40

III

Arteries of the Brain

41

IV

Arterial Circle of Willis

46

V

Meningeal Arteries

46

VI

Veins of the Brain

46

VII

Venous Dural Sinuses

47

VIII

Angiography

48

IX

Intracranial Hemorrhage

50

Review Test

55

4

Development of the Nervous System

59

I

Overview

59

II

Development of the Neural Tube

59

III

Neural Crest

60

IV

Placodes

61

V

Stages of Neural Tube Development

62

VI

Spinal Cord (Medulla Spinalis)

64

VII

Medulla Oblongata (Myelencephalon)

65

VIII

Metencephalon

67

IX

Mesencephalon (Midbrain)

68

X

Development of the Diencephalon, Optic Structures, and Hypophysis

69

XI

Development of the Telencephalon

71

XII

Congenital Malformations of the Central Nervous System (CNS)

72

Review Test

78

5

Neurohistology

80

I

Overview: Nervous Tissue

80

II

Neurons

80

III

Neuroglia

83

IV

Nerve Cell Degeneration and Regeneration

86

V

Axonal Transport

88

VI

Capillaries of the Central Nervous System

90

VII

Sensory Receptors

90

Review test

94

6

Spinal Cord

96

I

Introduction: Spinal Cord

96

II

External Morphology

96

III

Internal Morphology

101

IV

Myotatic Reflex

103

Review Test

105

7

Tracts of the Spinal Cord

107

I

Introduction: Tracts of the Spinal Cord

107

II

Ascending Spinal Tracts

107

III

Descending Spinal Tracts

111

IV

Clinical Correlations

115

Review Test

117

8

Lesions of the Spinal Cord

120

I

Overview: Lesions of the Spinal Cord

120

II

Lower Motor Neuron Lesions

120

III

Upper Motor Neuron Lesions

121

IV

Sensory Pathway Lesions

123

V

Peripheral Nervous System Lesions

123

VI

Combined Upper and Lower Motor Neuron Lesions

124

VII

Combined Motor and Sensory Lesions

124

VIII

Intervertebral Disk Herniation

127

Review Test

129

9

Brainstem

133

I

Introduction: The Brainstem

133

II

Medulla Oblongata (Myelencephalon)

133

III

Pons

138

IV

Mesencephalon (Midbrain)

140

V

Corticobulbar (Corticonuclear) Fibers

146

Review Test

147

10

Trigeminal System

149

I

Trigeminal Nerve (CN V)

149

II

Ascending Trigeminothalamic Tracts

150

III

Trigeminal Sensory Nuclei

152

IV

Trigeminocerebellar Fibers

153

V

Trigeminal Reflexes

154

VI

Clinical Correlations

154

Review Test

157

11

Auditory System

159

I

Introduction: The Auditory System

159

II

Outer, Middle, and Inner Ear

159

III

Auditory Pathway

161

IV

Efferent Cochlear (Olivocochlear) Bundle

162

V

Hearing Defects

163

VI

Tuning Fork Tests

163

VII

Brainstem Auditory Evoked Response (BAER)

165

Review Test

166

12

Vestibular System

168

I

Introduction: The Vestibular System

168

II

Labyrinth

168

III

Vestibular Pathways

170

IV

Efferent Vestibular Connections

171

V

Medial Longitudinal Fasciculus

171

VI

Vestibulo-Ocular Reflexes

171

VII

Decerebrate and Decorticate Rigidity

173

VIII

Clinical Correlations

173

Review Test

175

13

Cranial Nerves

177

I

Introduction: Cranial Nerves

177

II

Olfactory Nerve (CN I)

177

III

Optic Nerve (CN II)

177

IV

Oculomotor Nerve (CN III)

178

V

Trochlear Nerve (CN IV)

181

VI

Trigeminal Nerve (CN V)

182

VII

Abducent Nerve (CN VI)

182

VIII

Facial Nerve (CN VII)

183

IX

Vestibulocochlear Nerve (CN VIII)

185

X

Glossopharyngeal Nerve (CN IX)

186

XI

Vagal Nerve (CN X)

187

XII

Accessory Nerve (CN XI)

188

XIII

Hypoglossal Nerve (CN XII)

189

Review Test

191

14

Lesions of the Brainstem

193

I

Introduction: Lesions of the Brainstem

193

II

Vascular Lesions of the Medulla

193

III

Vascular Lesions of the Pons

194

IV

Lesions of the Midbrain

196

V

Acoustic Neuroma (Schwannoma)

197

VI

Internuclear Ophthalmoplegia (INO)

198

VII

Jugular Foramen (Vernet) Syndrome

198

VIII

Subclavian Steal Syndrome

199

Review Test

200

15

Cerebellum

204

I

Overview: The Cerebellum

204

II

Major Divisions of the Cerebellum

204

III

Cerebellar Cortex

206

IV

Major Cerebellar Pathways

208

V

Cerebellar Dysfunction

210

VI

Cerebellar Lesions

210

Review Test

214

16

Thalamus

216

I

Introduction: The Thalamus

216

II

Boundaries of the Thalamus

216

III

Primary Thalamic Nuclei and their Major Connections

216

IV

Blood Supply of the Thalamus

220

V

Internal Capsule

220

VI

Blood Supply of the Internal Capsule

220

VII

Clinical Correlations

221

Review Test

222

17

Visual System

224

I

Introduction: The Visual System

224

II

The Retina

224

III

Visual Pathway

227

IV

Pupillary Light Reflexes and Pathway

229

V

Pupillary Dilation Pathway

230

VI

The Convergence-Accommodation Reaction

231

VII

Centers for Ocular Motility

232

VIII

Clinical Correlations

232

Review Test

236

18

Autonomic Nervous System

240

I

Overview: The Autonomic Nervous System (ANS)

240

II

Divisions of the Autonomic Nervous System

240

III

Visceral Afferent Fibers and Pain

244

IV

Autonomic Innervation of Selected Organs

245

V

Clinical Correlations

247

Review Test

248

19

Hypothalamus

250

I

Overview: The Hypothalamus

250

II

Surface Anatomy of the Hypothalamus

250

III

Hypothalamic Regions and Nuclei

250

IV

Major Hypothalamic Connections

253

V

Major Fiber Systems

255

VI

Functional Considerations

256

VII

Clinical Correlations

258

Review Test

259

20

Olfactory, Gustatory, and Limbic Systems

262

I

Olfactory System

262

II

Gustatory System

263

III

Limbic System

265

Review Test

271

21

Basal Ganglia and the Striatal Motor System

274

Basal Ganglia

274

Striatal Motor System

274

Review Test

281

22

Neurotransmitters and Pathways

283

I

Introduction

283

II

Acetylcholine

284

III

Dopamine

285

IV

Norepinephrine (Noradrenalin)

286

V

Serotonin (5-Hydroxytryptamine [5-HT])

287

VI

Opioid Peptides

288

VII

Nonopioid Neuropeptides

289

VIII

Amino Acids

289

IX

Nitric Oxide

292

X

Functional and Clinical Correlations

292

Review Test

294

23

Cerebral Cortex

298

I

Overview: The Cerebral Cortex

298

II

Six Layers of the Neocortex

298

III

Functional Areas of the Cerebral Cortex

299

IV

Cerebral Dominance

304

V

Split-Brain Syndrome

306

VI

Blood Supply to the Major Functional Cortical Areas

307

Review Test

310

24

Apraxia, Aphasia, and Dysprosody

314

I

Apraxia

314

II

Aphasia

314

III

Dysprosodies

316

Review Test

317

Comprehensive Examination

319

Appendix

Table of Cranial Nerves

349

Glossary

353

Index

365