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3 Important Brain Systems for Movement: *They are derived from the same cell/same cellular
development.
1. Cerebral cortex – execution of movement *Separated by an internal capsule anteriorly.
2. Cerebellum – coordinates the motor activity
3. Basal Ganglia – plans the movement; tells the Lenticular nucleus – separated from the thalamus
cerebral cortex to execute the movement (biggest part of the diencephalon) by the internal capsule
1. Putamen
Basal Ganglia 2. Globus pallidus
Mechanism of Disinhibition:
Striatum is stimulated by Glutamate (outside the cortex)
= excited Striatum is inhibitory to Globus pallidus =
transient inhibition inhibition of the inhibitory (GABA
inhibits the Globus pallidus) becomes excitatory =
movement
Happens in patients with Hyperkinesia.
PARKINSON’S DISEASE
Substantia nigra pars compacta is degenerated = low
dopamine
Dopamine stimulates D1 and D2 receptors
- D1 receptors excitatory
- D2 receptors inhibitory
EPITHALAMUS
Dorsal wall of the posterior part of the 3rd Ventricle
beneath the splenium of the corpus callosum
Functionally related to the limbic system
Main Structure – Pineal Gland (circuit for controlling
circadian rhythms, sleep-wake cycle)
Other structures: habenular nuclei, posterior
commissure
Pineal Gland
- Consists of richly vascularized connective tissue
containing glial cells and pinealocytes but no true
neurons
- The production of melatonin by pinealocytes is
rhythmic and calibrated to the 24-hour cycle of photic
input to the retina (Circadian Rhythm)
Habenular Nuclei
- Anterior to the pineal gland
- Habenulointerpeduncular Tract (Fasciculus
Retroflexus)
Stria Medullaris Thalami
- Conveys input to habenular nuclei
- Habenular Commissure – connects the habenular
regions of the two sides
VENTRAL THALAMUS
Smallest subdivision of the diencephalon
Area at the mesencephalodiencephalic junction
Linked to the basal nuclei of the forebrain and functions
Includes the subthalamic nucleus (part of the basal
ganglia circuit)
Lesion – Hemiballismus: involuntary movements (1
side of the body)
Often compromised in accidents and trauma
Subthalamic Nucleus (Motor Activity)
- Receives input from motor areas of the cerebral cortex
- Projects to the substantia nigra
- Reciprocally connected with the globus pallidus
- Hemiballismus
Prerubral Area (Field H of Forel)
Intermediate Zone
Horizontal Cut through the Midbrain: (see drawing) o w/ truncal and limb problems
Landmarks
Primary Fissure: conspicuous fissure on the superior Lateral Zone
surface of the cerebellum o Pontocerebellar
Postero-Lateral Fissure: separates the cerebellum o Fibers from the brachium pontis enter the lateral zone
from the flocculo-nodular lobe o Ipsilateral dysmetria or Ipsilateral Limb ataxia
Structures in front of the Primary Fissure: Anterior o “Fast-Pointing” test
Lobe (“Paleocerebellum”)
Structure behind the Primary Fissure: Posterior
Lobe (“Neocerebellum”)
RETICULOCEREBELLAR PATHWAY
o Coming from the reticular formation
o Mossy fibers (come from many places) enter the Superior Cerebellar Peduncle
granule cell layer form a connection in the Main pathway for EFFERENT CEREBELLAR
glomerulus connect w/ the granule cell dendrites FIBERS to brainstem, red nucleus, ventral-anterior and
ventral lateral nucleus of the thalamus
Parts of the Nervous System Tested in Neurological FUNCTIONAL REGIONS OF THE CEREBELLUM
Examination Motor Pathways
Region Function
o Mental status Influenced
o Cranial nerves Lateral Motor planning Lateral
o Motor Hemispheres for extremities corticospinal tract
o Coordination Lateral
Intermediate Distal limb corticospinal
o Reflexes coordination tract, rubrospinal
Hemispheres
o Sensory tract
Anterior
Cerebellar Examination corticospinal
o Stance and gait tract,
Proximal limb
o Finger to nose test and heel to shin test reticulospinal
Vermis and trunk
o Alternating movements (Alternate Pronation- coordination
tract,
Supination Test) vestibulospinal
o Rebound tract, tectospinal
o Tongue movement tract
o Eye movement Balance and Medial
Flocculonodular
vestibulo-ocular longitudinal
Lobe
reflexes fasciculus
Heel to Shin Test = patient cannot run heel down leg
evenly; fragmented movements
CEREBELLAR LOBES AND SUBDIVISIONS
Finger to Nose Test = dysmetria
(See Table in PPT)
ARCHITECTONIC AREAS
BRODMANN AREA GROSS LANDMARK FUNCTION
3-1-2-5 Postcentral gyrus Somatosensory (General Sense)
7 Anterior Parietal area Sensory association
4 Precentral gyrus Motor
6 Posterior Frontal gyrus Motor organization
8 Superior Frontal gyrus Major part of Frontal Eye Field
17 Occipital pole, calcarine fissure Visual
18 – 19 Surround 17 Visual association, automatic eye motor
Superior Temporal gyrus, floor lateral
41 Auditory
fissure
42 Surrounds 41 Auditory association
Inferior Frontal gyrus, Pars Triangularis
44 Motor speech, LEFT
(Broca’s Area)
23-24 Gyrus cinguli Erotic experience
9-10-45 Anterior Frontal lobe Planning
4 & 6: medial Superior Frontal gyrus, sulcus cinguli Supplementary motor
Corona Radiata
“radiating crown”
Caused by the funneling of fibers into the internal
capsule
Fibers (capsule) flare out; distal to the basal ganglia
Converging corticofugal, diverging corticopetal
About 50% of intracranial problems are vascular in MCA: ICA to its termination
origin Supplies more parts
Brain: 2-3% of body weight; 15% of cardiac output; It is divided into 4 segments:
20% of oxygen; 25% of glucose - M1: medial portion of the Sylvian cistern
Blood Supply: Internal Carotid Artery and - M2: insular part
Vertebral Artery - M3: opercular part
Anterior Circulation: - M4: cortical branches
From the Internal Carotid system M1 is the largest and supplies most of the structures
Supplies 80% of the brain Supplies most of the convex surface (lateral part) of
Posterior Circulation: the brain
From the Vertebral (Vertebro-Basilar) system Deep tissue: basal ganglia, putamen, parts of the globus
Supplies 20% of the brain pallidus, caudate nucleus, and internal capsule
M1 Segment:
INTERNAL CAROTID SYSTEM ICA and the point where it branches at the
Cervical part – lies along the cervical area ventromedial aspect of the insula (the limen
insulae)
Petrous part
Branches serve the adjacent medial and rostral
Cavernous part – near the cavernous sinus
aspects of the temporal lobe (via lenticulostriate
Inferior hypophysial artery
arteries penetrating arteries that supply the deep
Meningeal artery
structures of the brain)
Cerebral part – contains majority of the important
Lenticulostriate arteries: supply the basal ganglia;
branches most commonly ruptured in patients w/
Ophthalmic artery: exits through the eyes; occlusion: hypertension
monocular blindness Bifurcates into superior and inferior trunks
Posterior communicating artery: connects the Aneurysm commonly arises from the bifurcation of
anterior circulation to the posterior circulation M1
Anterior choroidal artery
Superior hypophysial artery
Middle and Anterior Cerebral arteries: terminal VERTEBROBASILAR SYSTEM
branches (termination of the ICA)
Formed by the distal segments of the vertebral arteries
as they join to form the basilar artery (union of 2
Anterior Cerebral Artery
vertebral arteries)
ACA: ICA to its termination at about the
Primary source of supply to the brainstem
parietooccipital sulcus
It is divided into 5 segments: Vertebral Artery
- A1: Precommunicating segment
Passes through the transverse foramen
- A2: Infracallosal segment
Divided into 4 segments:
- A3: Precallosal segment
- V1: subclavian artery to the transverse foramen of
- A4: Supracallosal segment
the C6 (entrance)
- A5: Postcallosal segment
- V2: transverse foramina of C6 – C2
A1 and A2 are located basally
- V3: exit from C2 to atlantooccipital membrane
A3 – A5 are located medially (passes through C1)
Supplies the basal and medial aspects of the cerebral - V4: passes thru dura as it joins to form the basilar
hemispheres artery (intracranial)
Extends to the anterior 2/3 of the parietal lobe
Perforating branches supply the anterior caudate Basilar Artery
nucleus, parts of the internal capsule, putamen, and Branches:
anterior hypothalamus 1. Anterior Inferior Cerebellar Artery (AICA)
Lower 3rd of the basilar artery, passes thru CP
Middle Cerebral Artery cisterns
Usually (70% of the time) larger than ACA