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The Brain II
                        Blood Supply of the CNS
                   and Sectional Anatomy of the Brain
                                  (for dental students)


                          Dr.Akram Abood Jaffar
                          Assistant Professor of Human Anatomy
                                   M.B.Ch.B., M.Sc., Ph.D.
Dr. Akram Jaffar




                                                                 Dr. Akram Jaffar
Objectives
                   Blood supply of the brain
                         Enumerate the branches of the internal carotid and vertebral arteries.
                         Map the areas of supply of the anterior, middle and posterior cerebral arteries.
                         Correlate areas of supply of cerebral arteries with functional cortical areas.
                         Describe the position, significance and formation of the circle of Willis.
                         Enumerate the veins draining the brain and the venous sinuses at which they drain.
                   Brain sections
                         Identify features of the cerebral hemispheres in coronal and axial sections at the level of the interventricular foramen.
                         Identify the boundaries of the third ventricle in a mid-sagittal section.
                         Describe the parts of the basal ganglia and their relation to the lateral ventricle.
                         Identify the parts and functions of the limbic system.
                         Describe the major functions of the thalamus and hypothalamus.
                         Describe how the hypothalamus controls the functions of the pituitary gland.
                         Identify the pineal gland, its function and clinical significance.
                         Describe the formation, circulation, and absorption of the CSF.
                         Discuss the properties and function of the CSF.
                         Describe the location and discuss the significance of the brain barriers: blood brain barrier & blood CSF barrier.


                        Further reading
                    •    Snell RS (2010): Clinical neuroanatomy. 7th ed. Lippincott Williams and Wilkins.
                         Baltimore.
Dr. Akram Jaffar




                                                                                                                                            Dr. Akram Jaffar
Blood supply of the brain
Dr. Akram Jaffar




                                               Dr. Akram Jaffar
Arterial supply



                                     Internal carotid a.


                                             Vertebral a.
Dr. Akram Jaffar




                                                            Dr. Akram Jaffar
Internal carotid artery
                      •    Enters the cranial cavity through the carotid
                           canal in the petrous temporal bone.
                      •    Traverses the cavernous sinus.
                      •    Pierces the roof of the cavernous sinus.
                      •    Divides into anterior and middle cerebral
                           arteries.




                   middle cerebral a.

                                                             Anterior cerebral a.




                                                               Internal carotid a.
Dr. Akram Jaffar




                                                                                     Dr. Akram Jaffar
Branches of the internal carotid artery

                        Anterior cerebral artery
                        •    Passes around the rostrum and genu of the corpus callosum.
                        •    Supplies the medial aspect of the frontal and parietal lobes as far back as the parieto-
                             occipital sulcus and a small part of the adjacent lateral surface.



                              Corpus callosum


                        Anterior cerebral a.                                                           Effect of occlusion
                                                                            Contralateral hemisenory loss


                                                                          Contralateral hemiparesis

                                                                     Personality changes

                                                                                                      Leg and foot
Dr. Akram Jaffar




                                                                                                                     Dr. Akram Jaffar
Branches of the internal carotid artery

                        Middle cerebral artery
                        •      Passes laterally into the lateral sulcus.
                        •      Supplies the inferior surface of the frontal lobe,
                               the insula, and all save the periphery of the lateral
                               surface of the hemisphere.

                                                                        middle cerebral a.
                            Contralateral hemisenory loss

                                                                        Lateral sulcus
                       Contralateral hemiparesis

                       Aphasia                      Face and arm

                     middle cerebral a.




                                                                      Effect of occlusion
Dr. Akram Jaffar




                                                                                             Dr. Akram Jaffar
Branches of the internal carotid artery

                        Other branches

                                                                   Ophthalmic a.
                        •    Ophthalmic artery  orbit
                        •    Anterior choroidal artery  choroid
                             plexus of the lateral ventricle
                        •    Posterior communicating artery 
                             posterior cerebral artery




                                                                     Post. communicating a.


                                                                           Ant. Choroidal a.


                                                                           Post. cerebral a.
Dr. Akram Jaffar




                                                                                               Dr. Akram Jaffar
Vertebral artery

                   •   Enters the cranial cavity through the
                       foramen magnum.
                   •   Unites with its fellow of the opposite
                       side at the lower border of the pons
                       to form the basilar artery




                                                                         Basilar a.

                                                                pons


                                                                       Vertebral a.
Dr. Akram Jaffar




                                                                                      Dr. Akram Jaffar
Branches of the vertebral artery
                   •   Anterior spinal artery
                        – Formed by the union of
                           branches from both vertebral
                           arteries.
                                                                                  Ant. spinal a.
                        – Descend in front of the medulla
                           to reach and supply the spinal
                           cord.
                   •   Posterior inferior cerebellar artery
                        – Supplies the medulla, lower
                           cerebellum, choroidal branch to
                           the fourth ventricle, and a        Ant. spinal a.
                           posterior spinal branch which
                           descends to the spinal cord.                    PICA
Dr. Akram Jaffar




                                                                         PICA
                                                                                                   Dr. Akram Jaffar
Branches of the basilar artery
                    •    Anterior inferior cerebellar artery
                    •    Pontine branches
                    •    Labyrinthine artery
                          – Pass through the internal
                             acoustic meatus  inner ear                  Post. Cerebral a.
                    •    Superior cerebellar artery
                    •    Posterior cerebral arteries.
                          – At the upper pons
                                                                            Ant. Inf. Cerebellar a.


                                                                                                      Pontine branches
                   Sup cerebellar a.

                                                                                 Sup cerebellar a.
                    Post. Cerebral a.




                                                               Pontine branches

                                                               Ant. Inf. Cerebellar a.
Dr. Akram Jaffar




                                                                                                                Dr. Akram Jaffar
Branches of the basilar artery

                       Posterior cerebral artery
                       •    Passes backwards around the cerebral
                            peduncles to reach and supply:
                             – Medial surface of the occipital
                                lobe.
                             – Inferior surfaces of the occipital
                                and temporal lobes and the          Post. Cerebral a.
                                adjacent lateral surface




                                                              Effect of occlusion
                    Impairment of memory
Dr. Akram Jaffar




                                              Blindness

                                                                                        Dr. Akram Jaffar
Circle of Willis
                   •   Anastomotic ring around the optic chiasma
                       and the pituitary gland.
                   •   Provides anastomosis between internal
                       carotid and vertebral system of arteries.                                   Optic chiasma

                   •   Formation:                                                                  Pituitary gland
                        – Anterior, middle and posterior cerebral
                           arteries
                        – anterior and posterior communicating
                           arteries
                   •   Central arteries enter the brain through the
                       anterior and posterior perforated substances.   Ant. communicating a.

                                     central
                                                                          Ant. cerebral a.
                                                central




                                                                              Middle cerebral a.



                                                                        Post. communicating a.
Dr. Akram Jaffar




                                                                       Post. Cerebral a.


                                                                                                               Dr. Akram Jaffar
Venous drainage of the brain
                   •   The veins draining the hemispheres may be divided into superficial and deep
                       veins.
Dr. Akram Jaffar




                                                                                                     Dr. Akram Jaffar
Superficial group of veins

                       Superior cerebral veins passing to the
                       superior sagittal sinus



                   Superficial middle cerebral vein
                   passing in the lateral sulcus to
                   the cavernous sinus




                                                                Inferior cerebral
                                                                veins passing
                                                                to the
                                                                transverse
                                                                sinus
Dr. Akram Jaffar




                                                                              Dr. Akram Jaffar
Deep group of veins
                                          Anterior cerebral vein


                                  Deep middle cerebral vein

                                                 Basal vein

                                       Great cerebral vein




                                           Internal cerebral vein

                                           Basal vein

                                           Great cerebral vein

                                           Straight sinus
Dr. Akram Jaffar




                                                                    Dr. Akram Jaffar
Sectional anatomy of the brian
Dr. Akram Jaffar




                                                    Dr. Akram Jaffar
Basal nuclei (ganglia)
                                                                                    claustrum

                                                                         Caudate nucleus




                                                                                                                       insula
                                                                                 putamen

                                                                        Globus pallidus

                                                                     Caudate nucleus
                   Amygdaloid
                     body


                     Masses of grey matter located deep to the cortex in each
                     cerebral hemisphere

                                                                                                 Basal ganglia

                     o   Corpus striatum: is involved in the
                                                                          Corpus striatum         Claustrum       Amygdaloid body
                         regulation of movement.
                     o   Amygdaloind body: is concerned
                                                               Caudate nucleus      Lentiform nucleus
                         with emotional behavior
                     o   Claustrum: uncertain function
                                                                                                   putamen
Dr. Akram Jaffar




                                                                                                Globus pallidus



                                                                                                                                Dr. Akram Jaffar
Ventricualr system
                                                                            Lateral ventricle
                                                                                                                                      rostrum
                                                                               Interventricular                                                                 Anterior horn
                                                        thalamus
                                                                                   foramen




                                                                                                                                 us
                                                                                 3rd ventricle




                                                                                                                              lam
                                                                                                                           tha
                                                                           Lateral ventricle
                                                                                                                                      splenium

                                                                                                                                                                   Posterior
                                                                                                                                                                   horn


                                                                                      Transverse section just below the level of the corpus
                       Lateral ventricle                                              callosum (at the level of the interventricular foramen)
                         Lateral ventricle




                                                                                                       Lateral ventricle




                                                                                                                                            Lateral ventricle
                            3rd ventricle
                                                            Cerebral
                                                            aqueduct

                                      4th ventricle
                                                        •    Lateral ventricle:
                                                              –    Anterior horn
                                                              –    Body
                                                              –    Posterior horn
                                                                                                                           3rd ventricle
                                     Interventricular
                                         foramen              –    Inferior horn
Dr. Akram Jaffar




                                                                                                                                4th ventricle

                                                                                                                                                                  Dr. Akram Jaffar
Internal capsule
                                                                                   claustrum
                   •   band of projection fibers, appears
                       in a horizontal section as V-         putamen
                       shaped.
                   •   Connects the cerebral cortex with    Globus
                       lower centers.                       pallidus




                                                                An
                   •   Has an anterior limb, apex




                                                                  te
                                                                    rio
                       (genu), and a posterior limb.




                                                                        rl
                                                                         im
                                                                             b
                                                                         genu




                                                                        P os

                                                                              us
                                                                             te
                                                                             lam
                                                                       rio
                                                                 rl

                                                                         t ha
                                                                    im
                                                                b
                                                                                               Caudate
                                                                                               nucleus
Dr. Akram Jaffar




                                                                                                Dr. Akram Jaffar
Caudate nucleus                                  Head
                                                                         of
                                                                       caudate
                                                                       nucleus




                                                                                  thalamus
                                         body
                                  head                                     tail
                                                tail




                                                                                   • Is C-shaped in three dimensions
                                                                • Lies within the concavity of the lateral ventricle.
                   •   Has an expanded head, a narrow body and a tail.
                   •   Thus in a horizontal section only the head and tail of the caudate nucleus appear.
                   •   The head of the caudate nucleus bulges into the medial wall of the anterior horn of the
                       lateral ventricle.
                   •   The body of the caudate nucleus is located in the floor of the body of the lateral ventricle
Dr. Akram Jaffar




                   •   The tail of the caudate lies in the roof of the inferior horn of the lateral ventricle
                                                                                                                Dr. Akram Jaffar
Corpus striatum                                                          claustrum
                                                                putamen
                   o   The head of the caudate nucleus and
                       the lentiform nucleus are connected by
                       fibers and grey matter across the        Globus
                       anterior limb of the internal capsule    pallidus
                       resulting in a striated appearance
                       (hence the name corpus striatum).




                                                                           An
                                                                             te
                                                                               rio
                                                                                rl
                                                                                   im
                                                                                     b
                                                                                   genu




                                                                                  P os
                                                                                       te
                                                                               rio
                                                                           rl
                                                                              im
                                                                           b
                                                                                                        thalamus


                                                                                                         Caudate
                                                                                                         nucleus
Dr. Akram Jaffar




                                                                                                           Dr. Akram Jaffar
Axial section of the brain
                                                                               insula



                                                putamen




                                                  Globus
                                                  pallidus




                                                             An
                                                                te
                                                                  rio
                                                                                         Head




                                                                  rl
                                                                                          Of




                                                                    im
                                                                        b
                                                                                        Caudate
                                                                        genu            nucleus




                                                                 Po
                                                                    st
                                                                      er
                                                             or         i
                                                                lim
                                                             b
                                                                                         thalamus
Dr. Akram Jaffar




                                                       MRI

                                                                                            Dr. Akram Jaffar
The limbic system

                                                         fornix
                   •   Limbic structures:                                           Cingulate gyrus
                        • Cingulate gyrus
                        • Hippocampal formation
                        • Amygdaloid nucleus (part                                            diencephalon
                            of the basal nuclei)
                                                             Mammilothalamic
                        •   Mammillary bodies (part of           tract
                            the hypothalamus)
                        •   Anterior thalamic nucleus
                            (part of the thalamus).
                   •   Fibre tracts:                                 Mamillary
                                                                      bodies                                 Anterior
                        • Fornix                                                                             Thalamic
                                                                                                              nuclei
                        • mammilothalamic tract                                  Parahippocampal
                                                                                      gyrus
Dr. Akram Jaffar




                                                                                                                        Dr. Akram Jaffar
Hippocampal formation
                    •    Consists mainly of the hippocampus and the
                         parahippocampal gyrus.
                    •    The hippocampus is a nuclear mass that lies
                         in the floor of the inferior horn of the lateral
                         ventricle.
                    •    The axons arising from the hippocampus lie
                         on its surface and form the alveus.
                    •    The fibers of the alveus form the fornix .
                                                                                        fornix




                                                                 Inferior horn of
                                                                 Lateral ventricle

                                     hippocampus

                                                      alveus
Dr. Akram Jaffar




                                                          Parahippocampal
                   Coronal section                             gyrus

                                                                                     Dr. Akram Jaffar
Functions of the limbic system
                   This system is widely connected, many of its functions are not clearly understood;
                       nevertheless the limbic system controls:
                   • Emotional behavior such as fear, anger, and the emotions associated with sexual
                       behavior
                   • Recent memory
                   • Olfaction




                                                                                            Fear




                                                                                   Anger
                                  Recent memory
                      Smell
Dr. Akram Jaffar




                                                      Emotions
                                                                                                        Dr. Akram Jaffar
Features of a coronal section of the hemispheres
                   •    Corpus callosum:
                   •    Lies in the depth of the median sagittal                                                          Body of lateral
                        fissure.                                                                                            ventricle

                   •    Forms a roof for the body of the lateral
                                                                                                                                 Body of
                        ventricle.                                                               Corpus callosum
                                                                                                                                 caudate
                                                                                                                                 nucleus
                   •    The body of the caudate nucleus lies in




                                                                                        men
                        the inferolateral boundary of the body of                                                        insula




                                                                                    puta
                        the lateral ventricle                                             Globus
                                                                                                                                  thalamus
                                                                                          pallidus
                   •    The tail of the caudate nucleus is
                                                                                                                                        tail
                        located at the roof of the inferior horn of
                        the lateral ventricle.                               3rd ventricle

                   •    Each thalamus lies on either side of the
                        midline forming a floor for the body of                                                                  Inferior horn
                        the lateral ventricle
                   •    The thalami lie on either side of the 3rd
                        ventricle.

                                                                                                                        body
Dr. Akram Jaffar




                                                                                                                          tail

                                                  The section passes through the body and inferior horn of the C-shaped lateral ventricle
                                                                                                                                  Dr. Akram Jaffar
Features of a coronal section of the hemispheres
                   •    The white matter of the internal capsule
                        is situated between the lentiform                                                Body of lateral
                        nucleus on lateral side and the                                                    ventricle
                        thalamus and caudate nucleus on the
                        medial side.                                                   Corpus callosum
                                                                                                              Septum
                   •    The body of the fornix is connected to                                               pellucidum
                        the undersurface of the corpus




                                                                              men
                        callosum by the septum pellucidum.




                                                                          puta
                                                                                Globus
                                                                                pallidus                          fornix
                   •    The septum pellucidum forms a septum
                        between the two lateral ventricles                                                           tail

                        (anterior horn and body).                  3rd ventricle



                                                          fornix                                              Inferior horn




                                                        Corpus
                                                       callosum
Dr. Akram Jaffar




                                                      Septum
                                                     pellucidum


                                                                                                               Dr. Akram Jaffar
The diencephalon
                                                                                                         thalamus

                   •   It consists of nuclear masses, mainly of the thalamus
                       and hypothalamus.
                   •   Its cavity is the third ventricle.
                   •   The thalamus:
                         – Is egg-shaped.
                         – Function :
                                                                                         3rd ventricle
                              • Mainly: a relay station of sensory impulses: It
                                 receives sensory afferents from the spinal
                                 cord and brain stem and projects efferents to
                                 the primary sensory cortex.
                              • Is also concerned with motor control.

                                                                          Interventricular
                                                                              foramen


                                                                            3rd ventricle


                                                                              thalamus
Dr. Akram Jaffar




                                                                                                         Dr. Akram Jaffar
The hypothalamus
                                                                     thalamus


                   •   Below the thalamus.
                   •   Forms the floor and the
                       inferior part of the lateral
                       wall of the 3rd ventricle.                               hypothalamus



                                                      hypothalamus
Dr. Akram Jaffar




                                                                                               Dr. Akram Jaffar
The hypothalamus
                   •   Behind the optic
                                                                    Optic
                       chiasma the floor of the                    chiasma
                       3rd ventricle gives rise
                       to the stalk
                                                                             infundibulum
                       (infundibulum) of the
                       hypophysis cerebri.                                      Hypophysis
                   •                                                              cerebri
                       The mamillary bodies
                       lie behind.                                            Mamillary body




                                                    Optic
                                                   chiasma

                                                   Hypophysis
                                                     cerebri

                                                   infundibulum
Dr. Akram Jaffar




                                                  Mamillary body

                                                                                               Dr. Akram Jaffar
The pituitary gland (hypophysis
                   cerebri)
                   •   Endocrine gland.
                   •   Situated in the hypophyseal fossa of
                       the body of the sphenoid bone.
                   •   Is closely related to the optic chiasma:
                         – Tumors may produce pressure
                            effects on the adjacent optic
                            chiasma  visual defects.             Hypophyseal fossa




                                                                          Optic
                                                                         chiasma

                                                                         Hypophysis
                                                                           cerebri
Dr. Akram Jaffar




                                                                                      Dr. Akram Jaffar
Functions of the hypothalamus
                   •   Regulation of the autonomic nervous
                       system.
                   •   Regulation of endocrine glands through the
                       hypophysis cerebri.
                   •   Temperature regulation.                                  thalamus

                   •   Regulation of food and water intake.
                   •   Control of sleep.
                                                                         hypothalamus




                                                          infundibulum

                                                          Hypophysis
                                                            cerebri
Dr. Akram Jaffar




                                                                                           Dr. Akram Jaffar
Parts of the ventricular
                   system ventricle
                       Lateral
                      Lateral to septum
                         pellucidum



                      Interventricular
                          foramen



                      3rd ventricle



                      Cerebral
                      aqueduct



                      4th ventricle



                      Central canal
Dr. Akram Jaffar




                                              Dr. Akram Jaffar
The choroid plexus

                                                                    Choroid plexus
                   •   The ventricles are lined with a single       Lateral ventricle
                       epithelial layer called the epindyma.
                   •   In each ventricle the lining of the cavity   Choroid plexus
                       comes to the surface, i.e. the lining         3rd ventricle

                       epindyma comes in contact with the pia
                       mater.                                         Choroid plexus
                                                                      Lateral ventricle
                   •   Blood capillaries invaginate at these
                       regions, covered by pia and epindyma
                       constitute the choroids plexus.
                   •   The choroid plexuses secrete the CSF
                       into each ventricle.




                                                                    Choroid plexus
                                                                     4th ventricle
Dr. Akram Jaffar




                                                                                          Dr. Akram Jaffar
Blood barriers in the CNS                Blood-CSF barrier



                   •   Blood-CSF barrier:
                         – A selective barrier of
                           substances formed by the
                           tight junctions between the
                           choroidal epithelial cells.
                   •   The blood brain barrier (BBB)
                         – A selective barrier between
                           the blood and the brain
                           tissue.
                         – Formed by the tight junctions
                                                                          BBB
                           between the endothelial
                           lining of the capillaries.
                   •   The function of the BBB & blood-
                       CSF barrier is to provide a stable
                       environment for the normal
                       function of the CNS.
Dr. Akram Jaffar




                                                                                Dr. Akram Jaffar
CSF circulation                         Dural venous sinus


                                                           Arachnoid granulations

                   •   The CSF is produced by the
                       choroid plexuses in all the         Choroid plexus
                                                           Lateral ventricle
                       ventricles of the brain but
                       mainly in the lateral ventricles.
                   •   Lateral ventricles                 Choroid plexus
                                                            3rd ventricle
                       interventricular foramen  3rd
                       ventricle  cerebral aqueduct
                        4th ventricle.                    Interventricular foramen

                   •   From the 4th ventricle some CSF
                       passes through the central          Cerebral aqueduct
                       canal of the spinal cord but the
                       majority passes through             Choroid plexus
                       foramina in the 4th ventricle        4th ventricle
                       which communicate with the
                       subarachnoid space.                 Foramina in
                                                           4th ventricle


                                                           Subarachnoid space
Dr. Akram Jaffar




                                                                                      Dr. Akram Jaffar
CSF circulation
                   •   From the subarachnoid
                       space the CSF finds its
                       way to the venous
                       circularion through
                       arachnoid villi which
                       project into the dural
                       venous sinuses
                       particularly the superior
                       sagittal sinus.
                   •   Collections of arachnoid     pits   Arachnoid granulations
                       villi form archnoid
                       granulations.
                   •    arachnoid granulations
                       produce pits on the inside
                       of the calvaria on either
                       side of the superior
                       sagittal sinus.
Dr. Akram Jaffar




                                                                        Dr. Akram Jaffar

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  • 1. The Brain II Blood Supply of the CNS and Sectional Anatomy of the Brain (for dental students) Dr.Akram Abood Jaffar Assistant Professor of Human Anatomy M.B.Ch.B., M.Sc., Ph.D. Dr. Akram Jaffar Dr. Akram Jaffar
  • 2. Objectives Blood supply of the brain Enumerate the branches of the internal carotid and vertebral arteries. Map the areas of supply of the anterior, middle and posterior cerebral arteries. Correlate areas of supply of cerebral arteries with functional cortical areas. Describe the position, significance and formation of the circle of Willis. Enumerate the veins draining the brain and the venous sinuses at which they drain. Brain sections Identify features of the cerebral hemispheres in coronal and axial sections at the level of the interventricular foramen. Identify the boundaries of the third ventricle in a mid-sagittal section. Describe the parts of the basal ganglia and their relation to the lateral ventricle. Identify the parts and functions of the limbic system. Describe the major functions of the thalamus and hypothalamus. Describe how the hypothalamus controls the functions of the pituitary gland. Identify the pineal gland, its function and clinical significance. Describe the formation, circulation, and absorption of the CSF. Discuss the properties and function of the CSF. Describe the location and discuss the significance of the brain barriers: blood brain barrier & blood CSF barrier. Further reading • Snell RS (2010): Clinical neuroanatomy. 7th ed. Lippincott Williams and Wilkins. Baltimore. Dr. Akram Jaffar Dr. Akram Jaffar
  • 3. Blood supply of the brain Dr. Akram Jaffar Dr. Akram Jaffar
  • 4. Arterial supply Internal carotid a. Vertebral a. Dr. Akram Jaffar Dr. Akram Jaffar
  • 5. Internal carotid artery • Enters the cranial cavity through the carotid canal in the petrous temporal bone. • Traverses the cavernous sinus. • Pierces the roof of the cavernous sinus. • Divides into anterior and middle cerebral arteries. middle cerebral a. Anterior cerebral a. Internal carotid a. Dr. Akram Jaffar Dr. Akram Jaffar
  • 6. Branches of the internal carotid artery Anterior cerebral artery • Passes around the rostrum and genu of the corpus callosum. • Supplies the medial aspect of the frontal and parietal lobes as far back as the parieto- occipital sulcus and a small part of the adjacent lateral surface. Corpus callosum Anterior cerebral a. Effect of occlusion Contralateral hemisenory loss Contralateral hemiparesis Personality changes Leg and foot Dr. Akram Jaffar Dr. Akram Jaffar
  • 7. Branches of the internal carotid artery Middle cerebral artery • Passes laterally into the lateral sulcus. • Supplies the inferior surface of the frontal lobe, the insula, and all save the periphery of the lateral surface of the hemisphere. middle cerebral a. Contralateral hemisenory loss Lateral sulcus Contralateral hemiparesis Aphasia Face and arm middle cerebral a. Effect of occlusion Dr. Akram Jaffar Dr. Akram Jaffar
  • 8. Branches of the internal carotid artery Other branches Ophthalmic a. • Ophthalmic artery  orbit • Anterior choroidal artery  choroid plexus of the lateral ventricle • Posterior communicating artery  posterior cerebral artery Post. communicating a. Ant. Choroidal a. Post. cerebral a. Dr. Akram Jaffar Dr. Akram Jaffar
  • 9. Vertebral artery • Enters the cranial cavity through the foramen magnum. • Unites with its fellow of the opposite side at the lower border of the pons to form the basilar artery Basilar a. pons Vertebral a. Dr. Akram Jaffar Dr. Akram Jaffar
  • 10. Branches of the vertebral artery • Anterior spinal artery – Formed by the union of branches from both vertebral arteries. Ant. spinal a. – Descend in front of the medulla to reach and supply the spinal cord. • Posterior inferior cerebellar artery – Supplies the medulla, lower cerebellum, choroidal branch to the fourth ventricle, and a Ant. spinal a. posterior spinal branch which descends to the spinal cord. PICA Dr. Akram Jaffar PICA Dr. Akram Jaffar
  • 11. Branches of the basilar artery • Anterior inferior cerebellar artery • Pontine branches • Labyrinthine artery – Pass through the internal acoustic meatus  inner ear Post. Cerebral a. • Superior cerebellar artery • Posterior cerebral arteries. – At the upper pons Ant. Inf. Cerebellar a. Pontine branches Sup cerebellar a. Sup cerebellar a. Post. Cerebral a. Pontine branches Ant. Inf. Cerebellar a. Dr. Akram Jaffar Dr. Akram Jaffar
  • 12. Branches of the basilar artery Posterior cerebral artery • Passes backwards around the cerebral peduncles to reach and supply: – Medial surface of the occipital lobe. – Inferior surfaces of the occipital and temporal lobes and the Post. Cerebral a. adjacent lateral surface Effect of occlusion Impairment of memory Dr. Akram Jaffar Blindness Dr. Akram Jaffar
  • 13. Circle of Willis • Anastomotic ring around the optic chiasma and the pituitary gland. • Provides anastomosis between internal carotid and vertebral system of arteries. Optic chiasma • Formation: Pituitary gland – Anterior, middle and posterior cerebral arteries – anterior and posterior communicating arteries • Central arteries enter the brain through the anterior and posterior perforated substances. Ant. communicating a. central Ant. cerebral a. central Middle cerebral a. Post. communicating a. Dr. Akram Jaffar Post. Cerebral a. Dr. Akram Jaffar
  • 14. Venous drainage of the brain • The veins draining the hemispheres may be divided into superficial and deep veins. Dr. Akram Jaffar Dr. Akram Jaffar
  • 15. Superficial group of veins Superior cerebral veins passing to the superior sagittal sinus Superficial middle cerebral vein passing in the lateral sulcus to the cavernous sinus Inferior cerebral veins passing to the transverse sinus Dr. Akram Jaffar Dr. Akram Jaffar
  • 16. Deep group of veins Anterior cerebral vein Deep middle cerebral vein Basal vein Great cerebral vein Internal cerebral vein Basal vein Great cerebral vein Straight sinus Dr. Akram Jaffar Dr. Akram Jaffar
  • 17. Sectional anatomy of the brian Dr. Akram Jaffar Dr. Akram Jaffar
  • 18. Basal nuclei (ganglia) claustrum Caudate nucleus insula putamen Globus pallidus Caudate nucleus Amygdaloid body Masses of grey matter located deep to the cortex in each cerebral hemisphere Basal ganglia o Corpus striatum: is involved in the Corpus striatum Claustrum Amygdaloid body regulation of movement. o Amygdaloind body: is concerned Caudate nucleus Lentiform nucleus with emotional behavior o Claustrum: uncertain function putamen Dr. Akram Jaffar Globus pallidus Dr. Akram Jaffar
  • 19. Ventricualr system Lateral ventricle rostrum Interventricular Anterior horn thalamus foramen us 3rd ventricle lam tha Lateral ventricle splenium Posterior horn Transverse section just below the level of the corpus Lateral ventricle callosum (at the level of the interventricular foramen) Lateral ventricle Lateral ventricle Lateral ventricle 3rd ventricle Cerebral aqueduct 4th ventricle • Lateral ventricle: – Anterior horn – Body – Posterior horn 3rd ventricle Interventricular foramen – Inferior horn Dr. Akram Jaffar 4th ventricle Dr. Akram Jaffar
  • 20. Internal capsule claustrum • band of projection fibers, appears in a horizontal section as V- putamen shaped. • Connects the cerebral cortex with Globus lower centers. pallidus An • Has an anterior limb, apex te rio (genu), and a posterior limb. rl im b genu P os us te lam rio rl t ha im b Caudate nucleus Dr. Akram Jaffar Dr. Akram Jaffar
  • 21. Caudate nucleus Head of caudate nucleus thalamus body head tail tail • Is C-shaped in three dimensions • Lies within the concavity of the lateral ventricle. • Has an expanded head, a narrow body and a tail. • Thus in a horizontal section only the head and tail of the caudate nucleus appear. • The head of the caudate nucleus bulges into the medial wall of the anterior horn of the lateral ventricle. • The body of the caudate nucleus is located in the floor of the body of the lateral ventricle Dr. Akram Jaffar • The tail of the caudate lies in the roof of the inferior horn of the lateral ventricle Dr. Akram Jaffar
  • 22. Corpus striatum claustrum putamen o The head of the caudate nucleus and the lentiform nucleus are connected by fibers and grey matter across the Globus anterior limb of the internal capsule pallidus resulting in a striated appearance (hence the name corpus striatum). An te rio rl im b genu P os te rio rl im b thalamus Caudate nucleus Dr. Akram Jaffar Dr. Akram Jaffar
  • 23. Axial section of the brain insula putamen Globus pallidus An te rio Head rl Of im b Caudate genu nucleus Po st er or i lim b thalamus Dr. Akram Jaffar MRI Dr. Akram Jaffar
  • 24. The limbic system fornix • Limbic structures: Cingulate gyrus • Cingulate gyrus • Hippocampal formation • Amygdaloid nucleus (part diencephalon of the basal nuclei) Mammilothalamic • Mammillary bodies (part of tract the hypothalamus) • Anterior thalamic nucleus (part of the thalamus). • Fibre tracts: Mamillary bodies Anterior • Fornix Thalamic nuclei • mammilothalamic tract Parahippocampal gyrus Dr. Akram Jaffar Dr. Akram Jaffar
  • 25. Hippocampal formation • Consists mainly of the hippocampus and the parahippocampal gyrus. • The hippocampus is a nuclear mass that lies in the floor of the inferior horn of the lateral ventricle. • The axons arising from the hippocampus lie on its surface and form the alveus. • The fibers of the alveus form the fornix . fornix Inferior horn of Lateral ventricle hippocampus alveus Dr. Akram Jaffar Parahippocampal Coronal section gyrus Dr. Akram Jaffar
  • 26. Functions of the limbic system This system is widely connected, many of its functions are not clearly understood; nevertheless the limbic system controls: • Emotional behavior such as fear, anger, and the emotions associated with sexual behavior • Recent memory • Olfaction Fear Anger Recent memory Smell Dr. Akram Jaffar Emotions Dr. Akram Jaffar
  • 27. Features of a coronal section of the hemispheres • Corpus callosum: • Lies in the depth of the median sagittal Body of lateral fissure. ventricle • Forms a roof for the body of the lateral Body of ventricle. Corpus callosum caudate nucleus • The body of the caudate nucleus lies in men the inferolateral boundary of the body of insula puta the lateral ventricle Globus thalamus pallidus • The tail of the caudate nucleus is tail located at the roof of the inferior horn of the lateral ventricle. 3rd ventricle • Each thalamus lies on either side of the midline forming a floor for the body of Inferior horn the lateral ventricle • The thalami lie on either side of the 3rd ventricle. body Dr. Akram Jaffar tail The section passes through the body and inferior horn of the C-shaped lateral ventricle Dr. Akram Jaffar
  • 28. Features of a coronal section of the hemispheres • The white matter of the internal capsule is situated between the lentiform Body of lateral nucleus on lateral side and the ventricle thalamus and caudate nucleus on the medial side. Corpus callosum Septum • The body of the fornix is connected to pellucidum the undersurface of the corpus men callosum by the septum pellucidum. puta Globus pallidus fornix • The septum pellucidum forms a septum between the two lateral ventricles tail (anterior horn and body). 3rd ventricle fornix Inferior horn Corpus callosum Dr. Akram Jaffar Septum pellucidum Dr. Akram Jaffar
  • 29. The diencephalon thalamus • It consists of nuclear masses, mainly of the thalamus and hypothalamus. • Its cavity is the third ventricle. • The thalamus: – Is egg-shaped. – Function : 3rd ventricle • Mainly: a relay station of sensory impulses: It receives sensory afferents from the spinal cord and brain stem and projects efferents to the primary sensory cortex. • Is also concerned with motor control. Interventricular foramen 3rd ventricle thalamus Dr. Akram Jaffar Dr. Akram Jaffar
  • 30. The hypothalamus thalamus • Below the thalamus. • Forms the floor and the inferior part of the lateral wall of the 3rd ventricle. hypothalamus hypothalamus Dr. Akram Jaffar Dr. Akram Jaffar
  • 31. The hypothalamus • Behind the optic Optic chiasma the floor of the chiasma 3rd ventricle gives rise to the stalk infundibulum (infundibulum) of the hypophysis cerebri. Hypophysis • cerebri The mamillary bodies lie behind. Mamillary body Optic chiasma Hypophysis cerebri infundibulum Dr. Akram Jaffar Mamillary body Dr. Akram Jaffar
  • 32. The pituitary gland (hypophysis cerebri) • Endocrine gland. • Situated in the hypophyseal fossa of the body of the sphenoid bone. • Is closely related to the optic chiasma: – Tumors may produce pressure effects on the adjacent optic chiasma  visual defects. Hypophyseal fossa Optic chiasma Hypophysis cerebri Dr. Akram Jaffar Dr. Akram Jaffar
  • 33. Functions of the hypothalamus • Regulation of the autonomic nervous system. • Regulation of endocrine glands through the hypophysis cerebri. • Temperature regulation. thalamus • Regulation of food and water intake. • Control of sleep. hypothalamus infundibulum Hypophysis cerebri Dr. Akram Jaffar Dr. Akram Jaffar
  • 34. Parts of the ventricular system ventricle Lateral Lateral to septum pellucidum Interventricular foramen 3rd ventricle Cerebral aqueduct 4th ventricle Central canal Dr. Akram Jaffar Dr. Akram Jaffar
  • 35. The choroid plexus Choroid plexus • The ventricles are lined with a single Lateral ventricle epithelial layer called the epindyma. • In each ventricle the lining of the cavity Choroid plexus comes to the surface, i.e. the lining 3rd ventricle epindyma comes in contact with the pia mater. Choroid plexus Lateral ventricle • Blood capillaries invaginate at these regions, covered by pia and epindyma constitute the choroids plexus. • The choroid plexuses secrete the CSF into each ventricle. Choroid plexus 4th ventricle Dr. Akram Jaffar Dr. Akram Jaffar
  • 36. Blood barriers in the CNS Blood-CSF barrier • Blood-CSF barrier: – A selective barrier of substances formed by the tight junctions between the choroidal epithelial cells. • The blood brain barrier (BBB) – A selective barrier between the blood and the brain tissue. – Formed by the tight junctions BBB between the endothelial lining of the capillaries. • The function of the BBB & blood- CSF barrier is to provide a stable environment for the normal function of the CNS. Dr. Akram Jaffar Dr. Akram Jaffar
  • 37. CSF circulation Dural venous sinus Arachnoid granulations • The CSF is produced by the choroid plexuses in all the Choroid plexus Lateral ventricle ventricles of the brain but mainly in the lateral ventricles. • Lateral ventricles  Choroid plexus 3rd ventricle interventricular foramen  3rd ventricle  cerebral aqueduct  4th ventricle. Interventricular foramen • From the 4th ventricle some CSF passes through the central Cerebral aqueduct canal of the spinal cord but the majority passes through Choroid plexus foramina in the 4th ventricle 4th ventricle which communicate with the subarachnoid space. Foramina in 4th ventricle Subarachnoid space Dr. Akram Jaffar Dr. Akram Jaffar
  • 38. CSF circulation • From the subarachnoid space the CSF finds its way to the venous circularion through arachnoid villi which project into the dural venous sinuses particularly the superior sagittal sinus. • Collections of arachnoid pits Arachnoid granulations villi form archnoid granulations. • arachnoid granulations produce pits on the inside of the calvaria on either side of the superior sagittal sinus. Dr. Akram Jaffar Dr. Akram Jaffar