SPECIAL EMBRYOLOGY

( EMBRYOLOGIA SPECIALIS )

EMBRYOLOGY OF THE CENTRAL NERVOUS SYSTEM

Lecturer : Bernard SM Hutabarat, dr, PAK

This teaching material is copyrighted.

No part of this work may be reproduced, including photocopied, without written permission of Universitas Pelita Harapan .
 LEARNING OBJECTIVE

STUDENTS ABLE TO EXPLAIN EMBRYOLOGY AND THE

DEVELOPMENT OF:

1. CEREBRAL HEMISPHERES, BRAIN STEM, CEREBELLUM AND

SPINAL CORD .
2. THE BRAIN VENTRICLE SYSTEM AND SUBARACHNOID SPACE
3. SPINAL CORD
4. CONGENITAL MALFORMATION OF CENTRAL NERVOUS
SYSTEM

SKDI 2012:
AREA OF COMPETENTCY :5
LEVEL OF COMPETENTCY : 1 OR 2

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DEVELOPMENT OF THE CENTRAL NERVOUS SYSTEM

CENTRAL NERVOUS SYSTEM APPEARS AT THE BEGINNING OF

THE 3RD WEEK AS A DERIVATIVE OF ECTODERMAL GERM
LAYER.

CENTRAL NERVOUS SYSTEM :

1. BRAIN
2. SPINAL CORD

BRAIN IS ONE OF THE EARLIEST SYSTEM TO DEVELOP AND

THE LAST TO BE COMPLETED AFTER BIRTH.

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 DEVELOPMENT OF ECTODERM
EARLY WEEK 3 END OF WEEK 3 EARLY OF WEEK 4 END OF WEEK 4
ANTERIOR NEUROPORE

NEURAL PLATE
NEURAL FOLD
NEURAL TUBE

POSTERIOR NEUROPORE

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 FORMATION OF BRAIN VESICLES

PRIMARY ( 3 ) SECONDARY ( 5 )
TERMINAL PLATE
1.1. TELENCEPHALON
1. PROSENCEPHALON
1.2. DIENCEPHALON

2. MESENCEPHALON

3.1.METENCEPHALON

3. RHOMBENCEPHALON
3.2.MYELENCEPHALON
WEEK 4 SPINAL CORD
WEEK 5
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 ELONGATION OF BRAIN VESICLE

ANTEFLEXION MESENCEPHALIC ( CRANIAL )

BODY & HEAD FLEXURE
PONTINE
FLEXURE

CERVICAL
DAY 25 FLEXURE

DAY 40
DAY 35

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 FORMATION OF THE BRAIN VENTRICLE SYSTEM

TERMINAL PLATE
1. PROSENCEPHALON
1.1. TELENCEPHALON:
CEREBRAL HEMISPHERE
( LATERAL VENTRICLES )
1.2. DIENCEPHALON
( 3RD VENTRICLE )

2. MESENCEPHALON
( CEREBRAL AQUEDUCT )
EARLY 4 MONTHS
3. RHOMBENCEPHALON
( 4TH VENTRICLE )

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 FORMATION OF MENINGES

MESENCHYME SURROUNDING NEURAL TUBE

CONDENSATED
PRIMITIVE MENINX ( MENINX PRIMITIVA )

PACHYMENINX LEPTOMENINX

DURA MATER ARACHNOID MATER PIA MATER

SUBDURAL SPACE SUBARACHNOID SPACE

( BRIDGING VEINS ) ( ARTERY & LCS )
 DEVELOPMENT OF SPINAL CORD

CONUS MEDULLARIS
( L 1,2 )

DEVELOPED CRANIALLY

FILUM TERMINALE

S1
SPINE & DURAMATER GROW RAPIDLY THAN THE
SPINAL CORD
 CONGENITAL MALFORMATION
( MALFORMATIO CONGENITALIA )
FAILURE OF THE NEURAL TUBE CLOSURE
1. ANENCEPHALI
- NEUROPORUS ANTERIOR FAILED TO CLOSE
- FREQUENCY = 1 : 1000 , ♀ : ♂ = 4 : 1
- CALVARIA, SCALP & MAJOR PORTION OF THE
BRAIN ABSENT.
- EYES BULGED FORWARD ; NECK ABSENT
- CRANIOSCHIZIS : DEFECT INVOLVING SKULL
2. DEFECT OF SKULL BONE OSSIFICATION
- MOST AFFECTED : OCCIPITAL SQUAMOUS BONE
- MANIFESTED AS
-- MENINGOCELE
-- MENINGO-ENCEPHALOCELE
-- MENINGO-HYDRO-ENCEPHALOCELE
FAILURE OF THE NEURAL TUBE CLOSURE

3. SPINA BIFIDA
- DORSAL PORTIONS OF VERTEBRAE
FAILED TO FUSE.
- LOCATION : SACROLUMBAR
- COVERED BY SKIN, NOT
NOTICABLE ON THE SURFACE
EXCEPT THE PRESENCE OF
A SMALL TUFT OF HAIR OVER
THE AFFECTED AREA
( SPINA BIFIDA OCCULTA )
 FAILURE OF NEURAL TUBE CLOSURE

4. > 1 VERTEBRA INVOLVED

HAIR DURAMATER ARACHNOID MATER

SUBARACHNOID
SPACE

4.1.SPINA BIFIDA OCCULTA 4.2. MENINGOCELE

4.3. MENINGOMYELOCELE
 FAILURE OF NEURAL TUBE CLOSURE

RACHISCHIZIS ( GR : RACH = SPINE ; SCHIZIS = SPLIT ) : SEVERE

FORM OF SPINA BIFIDA ( COMPLETE SPINA BIFIDA ) : CERVICAL
TO SACRUM.
FOLDED NEURAL TISSUE
 MALFORMATION OF VENTRICULAR SYSTEM

4. HYDROCEPHALUS : CSF ( LCS ) VOLUME > NORMAL (± 90–150 CC)

SIZE OF HEAD > NORMALLY

MECHANISM:
1. EXCESSIVE PRODUCTION
2. OBSTRUCTION OF FLOWS
3. ABSORBTION DISTURBANCE
CONSISTS OF :
1. HYDROCEPHALUS EXTERNA
2. HYDROCEPHALUS INTERNA
3. HYDROCEPHALUS COMMUNICANS
 CONGENITAL MALFORMATION OF THE SPINAL CORD

NORMAL DEVELOPMENT

* NEURAL TUBE IMPROPER

GROWTH
NEURAL (TUBE
SPINAIMPROPER
BIFIDA )
* TISSUE ATTACHMENT
GROWTH ( SPINA BIFIDA )
* THICKENED FILUM TERMINALE
* TISSUE ATTACHMENT
* THICKENED FILUM TERMINALE

TETHERED CORD
 GLOSSARY

1. Anterior nueropore : neuroporus anteror

2. Brain stem : truncus encephalicus
3. Brain ventricle system : systema entricularis cerebri
4. Central Nervous System : Systema Nervosum Centrale
5. Cerebral hemisphere : hemispherium cerebralis
6. Cervical flexure : flexura cervicalis
7. Congenital malformation : malformation congenitalia
8. Fore brain : prosencephalon,
9. Fourth ( 4th ) ventricle : ventriculus quartus
10. Hindbrain : rhombencephalon
11.Lateral ventricle : ventriculus lateralis
12.Medullary cone : conus medullaris
13 Mesencephalis ( cranial ) flexure : flexura mesencephalicus ( cranialis )
14. Midbrain : mesencephalonNeural plate : lamina neuralis
15. Neural fold : plica neuralis
16. Neural tube : tubulu neuralis
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 GLOSSARY

17. Pontine flexure : flexura pontis

18. Posterior neuropore : neuroporus posterior
19. Primitive meninx : meninx primitiva
20. Spinal cord : medulla spinalis
21. Subarachnoidspace : spatium subarachnoideum
22. Subdural space : spatium subdurale
23. Terminal plate : lamina terminalis
24..Third ( 3rd ) ventricle : ventriculus tertius

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 REFERENCES
1. INDIANA UNIVERSITY SCHOOL OF MEDICINE :
THE DEVELOPING HUMAN
2. LANGMAN, JAN :MEDICAL EMBRYOLOGY
3. MARIEB, ELAINE N ; MALLAT, JON : HUMAN ANATOMY
4. MARINO, THOMAS A : DEVELOPMENT OF THE BRAIN AND
SPINAL CORD
5. 6. FEDERATIVE INTERNATIONAL PROGRAMME ON ANATOMICAL
TERMINOLOGIES ( FIFAT ), 2ND EDIT. : TERMINOLGIA ANATOMICA
6. UNSW : EMBRYOLOGY
7. PICTURES :
7.1. anatomystudentforum.blogspot.com
7.2. php.med.unsw.edu.au