Professional Documents
Culture Documents
6.1
OUTLINE
I.
Development
of
the
CNS
a.
Spinal
Cord
b.
Medulla
Oblongata
c.
Pons
d.
Cerebellum
e.
Midbrain
f.
Forebrain
g.
Cerebral
Hemisphere
h.
Clinical
Correlation
II.
Meninges
a.
Types/Layers
b.
Septa
c.
Dural
Venous
Sinus
d.
Arachnoid
e.
Pia
Mater
f.
Meninges
of
the
Spinal
Cord
g.
Clinical
Considerations
III.
Ventricular
System
IV.
Cerebrospinal
Fluid
V.
Spinal
Cord
Barrier
(BBB)
Primary
Vesicle
Forebrain
Vesicle
Midbrain
Vesicle
Hindbrain
Vesicle
ENDODERM
MESODERM
ECTODERM
Development
Beginning
of
the
third
week
as
a
slipper-shaped
plate
of
thickened
ectoderm,
the
neural
plate,
in
the
middorsal
region
in
front
of
the
primitive
node
Elevation
of
lateral
edges
forming
neural
groove
and
neural
folds
Fusion
of
Neural
folds
forming
the
Neural
tube
o Neural
tube
closes
around
4
weeks
o Sinks
beneath
surface
of
ectoderm
(neural
crest
is
now
b/n
surface
ectoderm
and
neural
tube)
o Fusion
begins
in
the
cervical
region
to
the
caudal
positions
o Cranial
Neuropore(temporary
anterior
opening
formed
by
neural
tube
closes
at
25th
day)
o Caudal
Neuropores
(temporary
posterior
opening
formed
by
neural
tube
closes
at
27th
day)
Prosencephalon
(FOREBRAIN)
(5
Week
OLD
embryo)
Mesencephalon
(MIDBRAIN)
Rhombencephalon
(HINDBRAIN)
2 Division
Adult Structures
telencephalon
Cerebral
hemisphere,
basal
ganglia,
hippocampus
Thela
-/
hypothalamus,
pineal
body,
infundibulum
Tectum
Tegmentum
Crus
Cerebri
Pons
Cerebelum
Medulla
oblongata
diencephalon
Metencephalon
Myelencephalon
1 Division
Group 22 | Hidalgo, E., Hidalgo, J., Homol, H. Hugo, P.,Inandan, D., Inciong, M., Jeanjaquet, K., Jimenez, J.
Page
1
of
11
SPINAL
CORD
Neuroepithelial
cells
wall
of
the
closed
neural
tube
o Extends
over
entire
thickness
which
forms
a
thick
psuedostratified
epithelium
o During
closure
of
tube,
cells
divide
rapidly.
o Collectively
known
as
the
neuroepithelium
o Referred
to
as
the
ventricular
zone
o Nuclei
move
in
toward
the
cavity
of
the
tube
to
divide
and
out
toward
the
periphery
Neuroblast
o Large
round
nucleus,
pale
nuceloplasm
and
dark
staining
nucleus
o Primitive
nerve
cell
o Repeated
division
of
the
matrix
cell
o Migrates
peripherally
to
form
the
mantle
layer
which
later
forms
the
gray
mater
of
the
spinal
cord
(intermediate
zone)
o
As
the
neuroblast
grows
peripherally
and
gives
rise
to
nerve
fibers,
it
forms
the
marginal
zone,
which
becomes
the
white
mater
Matrix
cells
also
forms
astrocytes
and
oligodendrocytes
Microglia
cells
migrate
into
the
developing
spinal
cord
from
the
mesenchyme
along
with
the
blood
vessels
Ependymal
cells
formed
from
the
matrix
cells
that
line
the
neural
tube
st
Neural
Crest
Cells
1
afferent
sensory
neurons
o Migrate
into
a
posterolateral
postitionn
and
becomes
cell
clusters
Cell
clusters
will
become
neuroblast
Neuroblast
develops
o Peripheral
Process
-
Joins
the
anterior
root
to
form
the
spinal
nerve.
Grow
out
laterally
and
becoming
typical
axons
of
sensory
nerve
fibers
o Central
Process
-
Posterior
root
of
spinal
n.
Axons
that
grow
into
the
posterior
part
of
the
developing
spinal
cord
Either
ends
in
posterior
gray
column
or
ascends
through
the
marginal
zone
to
one
of
the
higher
brain
centers
Capsular
or
Satellite
cells
Surrounds
the
unipolar
nerve
cell
bodies
in
a
ganglion
Formed
by
some
of
the
neural
crest
cells
**Posterior
root
of
ganglion
=
unipolar
neurons
+
capsular
cells
Development
of
Meninges
o 3
layers
of
meninges
=
formed
from
the
mesenchyme
(sclerotome)
that
surrounds
the
neural
tube
o First
two
months
of
intra
uterine
life
=
spinal
cord
has
the
same
length
with
vertebral
column
**the
vertebral
column
grows
faster**
@
birth
=
coccygeal
end
of
cord
@
L3
Adult
=
lower
border
of
of
L1
Filum
Terminale
pia
mater
that
extends
downward
as
a
slender
fibrous
strand
from
the
lower
end
of
the
cord
to
the
coccyx
Cauda
Equina
anterior
and
posterior
spinal
nerves
+
filum
terminale
that
occupies
the
lower
end
of
vertebral
canal
(L3-L4,
L4-L5)
In
this
region,
below
the
level
of
the
lower
end
of
the
spinal
cord
that
a
spinal
tap
can
be
performed
Group 22 | Hidalgo, E., Hidalgo, J., Homol, H. Hugo, P.,Inandan, D., Inciong, M., Jeanjaquet, K., Jimenez, J.
Page 2 of 11
MEDULLA OBLONGATA
Pontline
nuclei
CN
of
Alar
+
CN
of
Basal
Axons
grow
transversely
to
enter
the
developing
cerebellum
of
the
opposite
side
Forms
transverse
pontline
fibers
&
middle
cerebellar
peduncle
PONS
CEREBELLUM
Group
22
|
Hidalgo,
E.,
Hidalgo,
J.,
Homol,
H.
Hugo,
P.,Inandan,
D.,
Inciong,
M.,
Jeanjaquet,
K.,
Jimenez,
J.
Page 3 of 11
FOREBRAIN
MIDBRAIN
Group 22 | Hidalgo, E., Hidalgo, J., Homol, H. Hugo, P.,Inandan, D., Inciong, M., Jeanjaquet, K., Jimenez, J.
Page 4 of 11
CEREBRAL
HEMISPHERE
External
capsule
cortical
projection
fibers
that
pass
lateral
to
the
lentiform
nuclei
CEREBRAL
CORTEX
COMMISSURES
Lamina
terminalis
bridge
b/n
two
cerebral
hemisphere;
enables
nerve
fibers
to
pass
from
one
cerebral
hemisphere
to
the
other
ANENCEPLAHLY
o w/o
cranial
vault
o large
and
ant.
Of
brain
is
absent
st
Anterior
commissure
1
commissure
to
develop
o runs
in
the
lamina
terminalis
o Connects
the
olfactory
bulb
and
the
temporal
lobe
of
the
cortex
Fornix
nd
o 2
to
develop
o Connects
the
cortex
of
the
hippocampus
in
each
hemisphere
Corpus
callosum
rd
o Largest
and
most
important
commissure,
3
o Connects
the
frontal
lobes
and
later
the
parietal
lobes
rd
o
Arches
back
over
the
3
ventricle
Septum
pellucidum
o remains
of
lamina
teminalis
o lie
b/n
corpus
callosum
and
fornix
o thin
septum
Optic
chiasma
o Formed
in
the
inferior
part
of
the
lamina
terminalis
o Contains
fibers
from
the
medial
halves
of
the
retinae
o Passes
to
lateral
geniculate
body
and
superior
colliculus
Group 22 | Hidalgo, E., Hidalgo, J., Homol, H. Hugo, P.,Inandan, D., Inciong, M., Jeanjaquet, K., Jimenez, J.
Page 5 of 11
CLINICAL
CORRELATION
Spinal
Bifida
Failure
of
mesenchyme
(located
bet.
surface
of
ectoderm
and
neural
tube)
to
form
vertebral
arches
and
spine.
Opening/Defect
in
the
Post.
Vertebral
canal
.
Meninges
,CSF
&
spinal
cord
herniates
Usually
found
in
lower
thoracic,
lumbar
&
sacral
regions
1. Occulta
Figure
14.
Occulta
ventral
canal
open
posteriorly
(arches
and
spine)
covered
by
posterior
vertebral
ms.
Manifestations:
usually
tuft
of
hair
in
lower
lumbar
region
or
fatty
tumor
Usually
symptomless
b/c
spinal
cord
&
cauda
equina
is
within
its
normal
location.
No
treatment
needed:
incidental
finding
on
xray
2. Meningocele
Figure
15.
Meningocoele
cystic
swelling
containing
meninges
o herniates
through
defect
o CSF
abundant
Spinal
cord,
nerves
usually
normal
Surgery
for
treatment
3. Myelomeningocele
Hydrocephalus
Noncommunicating
Hydrocephalus
th
Blockage
between
choroid
plexuses
and
the
apertures
of
the
4
ventricle.
aqueduct
stenosis
masses
haematoma,
intraventricular
tumors
abscesses
atresia
of
apertures
Communicating
Hydrocephalus
No
obstruction
CSF
reaches
the
subarachnoid
space
Irritation
of
meninges;
inc.
CSF
viscosity
Group 22 | Hidalgo, E., Hidalgo, J., Homol, H. Hugo, P.,Inandan, D., Inciong, M., Jeanjaquet, K., Jimenez, J.
Page 6 of 11
MENINGES
TYPES
OR
LAYERS
OF
MENINGES
SEPTA
Restricts
the
displacement
of
the
brain
associated
with
acceleration
and
deceleration
when
the
head
is
moved
1. Falx
cerebri
Sickle-shaped
fold
of
dura
mater;
extends
into
the
longitudinal
fissure
which
divides
the
cerebral
hemispheres
Attaches
to
crista
galli
of
the
ethmoid
bone
to
the
internal
occipital
protuberance
where
it
becomes
continuous
with
the
tentorium
cerebella
to
enclose
the
straight
sinus
2. Tentorium
cerebelli
Separates
the
occipital
lobes
from
the
cerebellum
Crescent
shape
fold
of
dura
mater
that
roofs
over
the
posterior
cranial
fossa
Transverse
membrane
that
attaches
o Posteriorly
and
Laterally
to
the
skull
at
the
transverse
sinuses
o Anteriorly
to
the
petrous
portion
of
the
temporal
bone;
clinoid
process
of
the
sphenoid
bone
Slopes
up
and
fuses
with
falx
cerebri
at
midline
Has
a
curved
free
anterior
border
w/c
leaves
a
large
opening,
incisura
tentorii
(tentorial
notch),
which
allows
the
passage
of
the
upper
brainstem,
aqueduct
and
vessels
Encloses
3
sinuses:
The
STRAIGHT
SINUS;
the
(L&R)
TRANSVERSE
SINUSES
and
(L&R)SUPERIOR
PETROSAL
SINUSES
FXN:
Support
the
occipital
lobe
of
the
cerebral
hemisphere
&
forms
a
roof
over
the
upper
surface
of
cerebellum.
3. Falx
cerebelli
Located
in
between
the
cerebellar
hemispheres
attached
to
the
internal
occipital
crest
Smaller
version
of
Falx
cerebri
;
sickle
shaped
From
internal
occipital
protuberance
to
foramen
magnum
Projects
from
the
inner
surface
of
the
occipital
bone
and
is
attached
below
the
tentorium
cerebella
Encloses
the
OCCIPITAL
SINUS
(posterior)
4. Diaphragma
sellae
Connects
the
clinoid
attachments
of
the
tentorium
cerebella
Roofs
over
the
sella
turcica;
Perforated
by
the
stalk
of
the
hypophysis
cerebri
DURAL
NERVE
SUPPLY
st
CN
5,10
and
1
3
cervical
spinal
nerves
Group 22 | Hidalgo, E., Hidalgo, J., Homol, H. Hugo, P.,Inandan, D., Inciong, M., Jeanjaquet, K., Jimenez, J.
Page 7 of 11
ARACHNOID
From
Greek
word
arachnes
meaning
spider
Web
-
like
membrane
made
up
of
reticular
fibers;
delicate
and
impermeable
Fuses
with
the
epineurium
Avascular;
gets
nutrition
from
the
CSF
Together
with
the
pia
mater
forms
the
leptomeninges
The
outer
and
inner
surfaces
are
covered
with
flattened
mesothelial
cells
Subarachnoid
cisternae
formed
in
situations
where
the
arachnoid
and
pia
are
widely
separated.
o Cisterna
cerebellomedullaris
-
lies
b/n
inferior
surface
of
the
cerebellum
and
the
roof
of
fourth
ventricle
Group 22 | Hidalgo, E., Hidalgo, J., Homol, H. Hugo, P.,Inandan, D., Inciong, M., Jeanjaquet, K., Jimenez, J.
Page 8 of 11
PIA MATER
Epidural
Hematoma
Subdural hematoma
VENTRICULAR
SYSTEM
2
Lateral
Ventricles
rd
3
Ventricle
th
4
Ventricle
Lined by ependyma
CLINICAL
CONSIDERATIONS
Epidural
Hematoma
Meningeal
artery
and
vein;
most
common
in
ant
div
of
middle
meningeal
artery
Blow
to
the
side
of
the
head
Spread
is
limited
Lens
shaped
between
dural
layers
Subdural
Hematoma
Tearing
of
the
superior
cerebral
veins
from
its
attachment
to
the
venous
sinuses.
Blow
on
the
front
or
back
of
head
Acute
and
chronic
forms
occur
Crescent
shape
between
dura
and
arachnoid
mater
Cerebral hemispheres
C-shaped
4 parts
Group 22 | Hidalgo, E., Hidalgo, J., Homol, H. Hugo, P.,Inandan, D., Inciong, M., Jeanjaquet, K., Jimenez, J.
Page 9 of 11
CEREBROSPINAL
FLUID
Physical
Characteristics:
Appearance
clear,
colorless
Vol.
130
ml
Rate
of
production
0.5ml/min.
Pressure
(lateral
recumbent)
60-150
mmH20
-
MAY
INCREASE
Composition:
Protein
15-45
mg/100ml
Glucose
50-85
mg/100ml
Chloride
720-750
mg/100ml
No.
of
cells
0-3
lymphocytes/cu.
mm.
Functions:
Group 22 | Hidalgo, E., Hidalgo, J., Homol, H. Hugo, P.,Inandan, D., Inciong, M., Jeanjaquet, K., Jimenez, J.
Page 10 of 11
Pontine
Chiasmatic
Interpenduncular
Virchow-Robin
Space
Perivascular
spaces
within
the
brain
substance
*There
is
a
space
known
as
the
perivascular
space
or
Virchow-Robin
space
which
is
a
space
within
the
brain
substance.
The
subarachnoid
space
extends
into
the
substance
of
the
nervous
system
through
extensions
around
the
blood
vessel,
and
these
extensions
are
known
as
the
perivascular
spaces.
In
this
area,
small
solutes
or
metabolites
from
the
brain
tissue
reaches
the
subarachnoid
space
through
diffusion
in
these
spaces
CSF
Absorption:
Main
site
for
absorption:
arachnoid
villi/granulations
Absorption
of
CSF
into
the
venous
sinuses
occur
when
the
CSF
pressure
>
venous
pressure
in
the
sinuses
*The
main
site
of
the
CSF
absorption
is
in
the
arachnoid
villi
that
project
into
the
venous
sinuses
especially
the
walls
of
the
superior
sagittal
sinuses.
The
arachnoid
villi
would
act
as
a
one-way
valve
that
allows
the
flow
of
CSF
from
the
subarachnoid
spaces
into
the
venous
blood.
The
arachnoid
villi
in
effect
act
as
a
diverticulum
of
the
subarachnoid
spaces
that
pierces
the
dura
where
the
sinuses
are
located.
Infections
Stroke
Brain tumors
Seizures
Trauma
Page 11 of 11