THE CENTRAL NERVOUS SYSTEM

ANATOMICAL REFERENCES

Rostral/Anterior

Caudal/Posterior

Dorsal

Ventral

Rostral/Anterior

Caudal/PosteriorMedialLateral

MedialLateral

AXIAL

CORONAL

SAGITTAL

THE MENINGES

Insula

space

space

membrane

Artery

Brain

The meninges are filled with cerebrospinal fluid (CSF)

Whole Brain GM WM CSF

THE CNS

Cerebrum

BrainstemCerebellum

MAJOR SULCILongitudinal sulcus

MAJOR SULCICentral sulcus

Lateral (sylvian) fissure

CEREBRAL LOBESParietal

Temporal

Frontal

Occipital

CEREBRAL LOBES

Insula

CEREBELLUM

InsulaVermis

Left Cerebellar Hemisphere Right Cerebellar Hemisphere

WHITE MATTER TRACTS

InsulaVermis

Left Cerebellar Hemisphere Right Cerebellar Hemisphere

FUNCTIONAL CLASSIFICATION

BROADMANN’S CLASSIFICATION

Insula

THE CNS

Insula

Thalamus

Hypothalamus

Pineal body

Midbrain

Tegment

Tectum

Pons

Medulla

Cerebellum

Diencephalon

Telencephalon

THE VENTRICULAR SYSTEM

Insula

Lateral ventricles

thirdventricle

fourthventricle

Third ventricle

Fourth ventricle

Fourth ventricle

Fourth ventricle

Lateral ventriclesFourth ventricle

THALAMIC NUCLEI

Insula

CEREBRAL CIRCULATION

Insula

Anterior Cerebral Artery

Anterior Communicating Artery

Middle Cerebral Artery

Internal Carotid Artery

Basilar Artery

Posterior Communicating Artery

Posterior Cerebral Artery

Superior CerebellarArtery

Vertebral Arteries

CEREBRAL CIRCULATION

Insula

Terminal branches of Anterior Cerebral Artery

Middle Cerebral Artery Terminal branches of Posterior Cerebral Artery

CEREBRAL CIRCULATION

Insula

Anterior Cerebral Artery

Posterior Communicating Artery

Posterior Cerebral Artery

CEREBRAL CIRCULATION

Insula

Anterior Cerebral Artery

Posterior Cerebral Artery

Surface branches supply cortex and white matter of :1)inferior frontal lobe2)medial surface of the frontal and parietal lobes3)anterior corpus callosum

Surface branches supply cortex and white matter of: 1)medial occipital lobes2)inferior temporal lobes3)posterior corpus callosum

Middle Cerebral Artery

Surface branches supply cortex and white matter of: hemispheric convexity (all four lobes and insula).

CEREBRAL CIRCULATION

Middle Cerebral Artery Stroke

Most common stroke syndrome. Symptoms: -contralateral weakness (face, arm, and hand more than legs)-contralateral sensory loss (face, arm, and hand more than legs) -visual field cut (damage to optic radiations) -aphasia: language disturbances (more likely with L. Hemi. Damage)-impaired spatial perception (more likely after R. Hemi. Damage)

Insula

CEREBRAL CIRCULATION

Anterior Cerebral Artery

Posterior Cerebral Artery

- Motor disturbance contralateral distal leg - urinary incontinence- speech disturbance (may be more of a motor problem) - apraxia of left arm (sympathetic apraxia) if anterior corpus callosum is affected- if bilateral may cause apathy, motor inertia, and muteness

Visual disturbances:-contralateral homonymous hemianopsia (central vision is often spared) -L. Hemi: lesions alexia (with or without agraphia) -Bilateral lesions: cortical blindness : patients unaware they cannot see -Memory impairment if temporal lobe is affected

Insula

CRANIAL NERVES

InsulaPosterior Communicating Artery