A Guide to Brain Anatomy, Function and Symptoms Brain Structure Function The outermost layer of the cerebral hemisphere

Cerebral Cortex which is composed of gray matter. Cortices are asymmetrical. Both hemispheres are able to analyze sensory data, perform memory functions, learn new information, form thoughts and make decisions.

Associated Signs and Symptoms

Ventral View ( From bottom) Sequential Analysis: systematic, logical Left Hemisphere interpretation of information. Interpretation and production of symbolic information:language, mathematics, abstraction and reasoning. Memory stored in a language format. Holistic Functioning: processing multi-sensory Right Hemisphere input simultaneously to provide "holistic" picture of one's environment. Visual spatial skills. Holistic functions such as dancing and gymnastics are coordinated by the right hemisphere. Memory is stored in auditory, visual and spatial modalities. Connects right and left hemisphere to allow for Corpus Callosum communication between the hemispheres. Forms roof of the lateral and third ventricles.

Damage to the Corpus Callosum may result in "Split Brain" syndrome.

Frontal Lobe

Cognition and memory. Prefrontal area: The ability to concentrate and attend, elaboration of thought. The "Gatekeeper"; (judgment, inhibition). Personality and emotional traits. Movement: Motor Cortex (Brodman's): voluntary motor activity.

Impairment of recent memory, inattentiveness, inability to concentrate, behavior disorders, difficulty in learning new information. Lack of inhibition (inappropriate social and/or sexual behavior). Emotional lability. "Flat" affect. Contralateral plegia, paresis. Expressive/motor aphasia.

Ventral View (From Bottom) Premotor Cortex: storage of motor patterns and

voluntary activities. Language: motor speech

Side View Parietal Lobe

Processing of sensory input, sensory discrimination.

Body orientation.

Primary/ secondary somatic area. Occipital Lobe Primary visual reception area.

Inability to discriminate between sensory stimuli. Inability to locate and recognize parts of the body (Neglect). Severe Injury: Inability to recognize self. Disorientation of environment space. Inability to write. Primary Visual Cortex: loss of vision opposite field. Visual Association Cortex: loss of ability to recognize object seen in opposite field of vision, "flash of light", "stars".

Primary visual association area: Allows for visual interpretation.

Temporal Lobe

Auditory receptive area and association areas. Expressed behavior.

Hearing deficits. Agitation, irritability, childish behavior. Receptive/ sensory aphasia.

Language: Receptive speech. Memory: Information retrieval.

Olfactory pathways: Amygdala and their different pathways. Limbic System Hippocampi and their different pathways. Limbic lobes: Sex, rage, fear; emotions. Integration of recent memory, biological rhythms.

Loss of sense of smell. Agitation, loss of control of emotion. Loss of recent memory.

Hypothalamus.

Basal Ganglia

Subcortical gray matter nuclei. Processing link between thalamus and motor cortex. Initiation and direction of voluntary movement. Balance (inhibitory), Postural reflexes. Part of extrapyramidal system: regulation of automatic movement.

Movement disorders: chorea, tremors at rest and with initiation of movement, abnormal increase in muscle tone, difficulty initiating movement. Parkinson's.

Structures of the Diencephalon (within the cerebrum and continues with the midbrain). Brain Structure Function Associated Signs and Symptoms Processing center of the cerebral cortex. Altered level of Thalamus Coordinates and regulates all functional consciousness. activity of the cortex via the integration of the Loss of perception. afferent input to the cortex (except olfaction). Thalamic syndrome spontaneous pain opposite side of body. Contributes to affectual expression.

Hypothalamus

Integration center of Autonomic Nervous System (ANS): Regulation of body temperature and endocrine function. Anterior Hypothalamus: parasympathetic activity (maintenance function). Posterior Hypothalamus: sympathetic activity ("Fight" or "Flight", stress response. Behavioral patterns: Physical expression of behavior. Appestat: Feeding center. Pleasure center.

Hormonal imbalances. Malignant hypothermia. Inability to control temperature. Diabetes Insipidus (DI). Inappropriate ADH (SIADH). Diencephalic dysfunction: "neurogenic storms".

Internal Capsule

Motor tracts.

Contralateral plegia (Paralysis of the opposite side of the body).

Reticular Activating System Responsible for arousal from sleep, wakefulness, attention. (RAS)

Altered level of consciousness.

Brain Structure Cerebellum

The Cerebellum and the Brain Stem Function Coordination and control of voluntary movement.

Associated Signs and Symptoms Tremors. Nystagmus (Involuntary movement of the eye). Ataxia, lack of coordination.

Brain Stem: Midbrain

Nerve pathway of cerebral hemispheres. Auditory and Visual reflex centers.

Weber's: CN III palsy and ptosis (drooping) ipsalateral (same side of body). Pupils: Size: Midposition to dilated. Reactivity: Sluggish to fixed.

Cranial Nerves: CN III - Oculomotor (Related to eye movement), [motor]. CN IV - Trochlear (Superior oblique muscle of the eye which rotates the eye down and out), [motor].

LOC (Loss of consciousness): Varies Movement: Abnormal extensor ( muscle that extends a part). Respiratory: Hyperventilating. CN (Cranial Nerve) Deficits: CN III, CN IV.

Pons

Respiratory Center. Cranial Nerves: CN V - Trigeminal (Skin of face, tongue, teeth; muscle of mastication), [motor and sensory]. CN VI - Abducens (Lateral rectus muscle of eye which rotates eye outward), [motor]. CN VII - Facial (Muscles of expression), [motor and sensory]. CN VIII - Acoustic (Internal auditory passage), [sensory].

Pupils: Size: Pinpoint

LOC: Semi-coma "Akinetic Mute". "Locked In" Syndrome.

Movement: Abnormal extensor. Withdrawal.

Respiratory: Apneustic (Abnormal respiration marked by sustained inhalation). Hyperventilation.

CN Deficits: CN VI, CN VII. Movement: Ipsilateral (same side) plegia (paralysis). Pupils: Size: Dilated. Reactivity: Fixed.

Medulla Oblongata

Crossing of motor tracts. Cardiac Center. Respiratory Center. Vasomotor (nerves having muscular control of the blood vessel walls) Center Centers for cough, gag, swallow, and vomit. Cranial Nerves: CN IX - Glossopharyneal (Muscles and mucous membranes of pharynx, the constricted openings from the mouth and the oral pharynx and the posterior third of tongue.), [mixed]. CN X - Vagus (Pharynx, larynx, heart, lungs, stomach), [mixed]. CN XI - Accessory (Rotation of the head and shoulder), [motor]. CN XII - Hypoglossal (Intrinsic muscles of the tongue), [motor].

LOC: Comatose. Respiratory: Abnormal breathing patterns. Ataxic. Clustered. Hiccups.

CN Palsies (Inability to control movement): Absent Cough. Gag.

Blood Supply to the Brain

Arteria cerebri anterior Arteria cerebri media Arteria cerebri posterior Arteria chorioidea anterior Arteria basilaris

Cerebral angiograms

Carotid angiogram Anterior view

Carotid angiogram Lateral View

Vertebral angiogram Anterior view

Vertebral angiogram Lateral View

Abbreviations:

ACI - internal carotid artery ACA - anterior cerebral artery ACM - middle cerebral artery

BA - basilar artery VA - vertebral artery PCA - posterior cerebral artery PICA - posterior inferior cerebellar artery

More detail

1. Pericallosal artery 2. Callosomarginal artery 3. Anterior cerebral artery 4. Ophthalmic artery 5. Internal carotid artery 6. Anterior choroidal artery 7. Lenticulostrate arteries

Carotid angiogram Anterior view

Carotid angiogram Lateral View

Tracts of the Spinal Cord 1. Fasciculus gracilis (Goll) 2. Fasciculus cuneatus (Burdach) 3. Tractus spinocerebellaris dorsalis (Flechsig) 4. Tractus corticospinalis lateralis 5. Tractus spinothalamicus lateralis (Edinger) 6. Tractus spinocerebellaris ventralis (Gowers) 7. Tractus rubrospinalis 8. Tractus spinotectalis 9. Tractus corticospinalis anterior 10. Tractus olivospinalis 11. Tractus spinoolivaris 12. Tractus tectospinalis 13. Tractus reticulospinalis 14. Tractus vestibulospinalis 15. Tractus spinothalamicus anterior

Syndromes of the Spinal Cord Extent of lesion Structures damaged Myelitis Trauma Causes

Complete transsection

Hemisection

Brown-Squard syndrome

Central structures

Syringomyelia Hydromyelia Tumor

Posterior funiculus Posterior horn

Tabes dorsalis

Posterior funiculus Pyramidal tracts

Subacute combined degeneration

Posterior funiculus Pyramidal tracts Spinocerebellar tracts

Spinocerebellar degeneration

Pyramidal tracts Ventral horn

Amyotrophic lateral sclerosis

Ventral horn

Spinal muscular atrophy Poliomyelitis

Pyramidal tracts (crossed + uncrossed)

Familial spastic paraparesis

Dorsal one-third

Occlusion of the posterior spinal arteries

Ventral two-thirds

Occlusion of the anterior spinal artery

Syndrome Weber (hemiparesis alternans oculomotoria)

Crossed brainstem syndromes Site of lesion Ipsilateral side Oculomotor palsy

Contralateral side Hemiparesis

Benedikt

Oculomotor palsy

Hyperkinesis (athetosis,chorea) Rigor Disturbance of deep sensibility Hemiparesis Ataxia Hypesthesia Hemiparesis

Raymond-Cestan

oral pons

Internuclear ophthalmoplegia

Raymond (hemiparesis alternans abducens)

Abducent palsy

Millard-Gubler (hemiparesis alternans facialis)

Facial paresis

Hemiparesis

Brissaud-Siccard

Facial hemispasm Facial paresis Abducent paresis Horizontal gaze paralysis Signs of vagus lesion Paresis of m. trapezius and m. sternocleidomastoideus Hypoglossus palsy

Hemiparesis

Foville

Hemiparesis

Avellis (hemiparesis alternans vaga)

Hemiparesis

Schmidt (hemiparesis alternans accessoria) Jackson (hemiparesis alternans hypoglossa)

Hemiparesis

Hemiparesis

Djerine

Hypoglossus palsy

Hemiparesis Disturbance of deep sensibility

Anatomy and Functional Areas of the Brain