Medicine

I

LESSON #22 (6 HOURS)

Theme. Limbic system. Structure of white matter. Corpus callosum, fornix. Lateral ventricles. Basal nuclei. Pathways of the brain and spinal cord (associative, commissural, projective). Ascending pathways. Descending pathways: pyramidal, exrapyramidal. Topography of pathways on section of spinal cord

Membranes of the brain. Dural sinuses, spaces. Circulation of spinocerebral fluid. Blood vessels of the brain and spinal cord.

 

Aim: To study the structures that belong to Rhinencephalon and limbic system, the topography of limbic system. To learn the structure of white matter, and white substance (corpus callosum,  comissurae, septum  pellucidum, fornix). To learn the structure of associative, commissural and projective pathways of the brain and spinal cord, their location and main functions. Study the structural and topographical peculіarіtіes of meninges, blood supplying of the brain and spinal cord.

Professional orientation of the students. Knowledge the structures of the old parts of brain is necessary for neurological therapy and surgery in brain. Anatomical peculiarities of the localisation of limbic centres and nuclei are base for understanding of neurophysiology and neuropathology, also in traumatology. Knowledge the internal structure of the telencaphalon is necessary for neurological therapy and surgery in brain. Position of white matter are base for understanding of neurophysiology and neuropathology, also in traumatology and oncology. Knowledge the organisation of the basal nuclei is necessary for neurological therapy and surgery in brain. Anatomical peculiarities of the localisation of lateral ventricles are base for understanding of neurophysiology and neuropathology, also in traumatology and oncology.

Base level of knowledge and skіlls

1.     Latin terminology.

2.     Cells and structure of nervous tissue.

3.     Spinal cord.

 

I.                  I. Practical work  – 9:00-12:00 am (4 hours)

1)    Іllustratіve materіal

1.     Preparation of forebrain.

2.     Preparation of Spinal cord.

3.     Plate ‘Functional areas on cerebral cortex’.

4.     Plate ‘Section of spinal cord’.

2)    Methods of practical work.

Task 1. Preparation of central section of rhinencephalon. Pay attention to the dentate gyrus, parahippocampal gyrus, which also belongs to the central department of the rhinencephalon and will be studied while preparation of the lower horn of the lateral ventricle. Demonstrate on this preparation peripheral section of rhinencephalon (olfactory bulb, track and triangle).

Task 2. Horizontal incision of the encephalon. On the preparation of the encephalon hemispheres without a capsule make a incision through thickness of corpus callosum. Demonstrate the direction of bundles of separate parts of the corpus callosum which connect frontal, occipital, temporal and parietal lobes of hemispheres. Show interventricular apertures, departments of corpus callosum, fornix, front commisura, septum pellucidum on the saggital incision of the encephalon.

Work 3. Prepare a lateral ventricles. For demonstrations of lateral ventricles you have to conduct longitudinal parasaggital section trough corpus callosum, making retreat on 1,5 cm on both sides from the central part of corpus callosum (between longitudinal sections), transverse cuts in front (near the genu) and behind and separate from the fornix, which is situated deeper. You can see frontal horn and central parts of lateral ventricles. For demonstrations of occipital horns of lateral ventricles you have to take away a triangular form of white matter part of occipital lobe over them. Then reveal a temporal horn at one side. For that you have to take away a part of brain from the frontal lobe, which is reached by two cuts, conducted under5 the corner to each other. One cut is going horizontally on the upper temporal gyrus. Considering anatomy of lateral ventricles, look to the construction of walls, their topography and relation to surround structures.

Work 4. Show a fornix, anterior comissura, vascular plexus, which lie  in central parts of lateral ventricles and interventricular hole, which connect a lateral ventricles. Show the head of caudate nucleus and pellucid septum. In occipital horn show a lateral triangle, bulb of occipital horn, calcar avis. In temporal horn show the vascular plexus, fornix, hyppocampus.

Work 5. Basal nuclei on the horisontal cut of brain.

Cnduct horisontal cut deeper then the cut, which was done with lateral ventricles. You can see a head of caudate nucleus, lentiformis nucleus, internal, external and extremal capsules. Show the pathways, which lie in internal capsule.

Work 6. Frontal cut of main cut of brain at a rate of corpus mamillaria.

On the separate preparation of whole brain make a frontal cut, which passes on 1,5-2 cm behind the temporal pole. You can see corpus amygdaloidea on the cut. On this preparation also demonstrate anatomist-topographical relations abovementioned in preceding work  nuclei of forebrain and optical tubers with  internal and external capsules.

Work 7. For making an access to the medulla spinalis a teacher recommends students to conduct back laminectomy. Carefully separate spinal nuclei in which the first neurons of all sensitive ways are localized.

Work 8. Make a section of the dura mater. Carefully, separate dura mater from bones of roof and base of skull. Brain with pia mater are take out of base of skull.

Work 9. On the preparations of brain show sinuses of dura mater of the brain. Commencing from the base of brain carefully separate dura mater, consider an relation of pia mater and arachnoid mater to the brain and to the dura mater. Demonstrate subarachnoid space and its extension. Then carefully separate arachnoid mater and demonstrate a pia mater of brain with arteries and veins of brain and cerebellum. On the lower surface consider an arterial circle af base of brain, great arteries of  brain.

Work 10. Students under the direction of the teacher do saggital section of head, find an olfactory area, place of accomodation of  the first neurons of olfactory way, olfactory nerves. On the base of brain find olfactory bulbs, olfactory way, olfactory triangle, olfactory bands, front perforata material as part, which are refer to the peripheral rhinencephalon division.

 

3) Practical skills and abilities of students, demonstrate on preparations:

1.     Parts of corpus callosum

2.     Location and parts of the fornix

3.     Lateral ventricles.

4.     Basal nuclei, capsules.

5.     Associative pathways of the brain and spinal cord

6.     Commissural pathways of the brain and spinal cord

7.     Projective pathways of the brain and spinal cord

8.     Dura mater encephali, sinuses.

9.     Arachnoida and pia mater encephali.

10.                       Regions of supplying by anterior cerebral artery.

11.                       Regions of supplying by middle cerebral artery.

12.                       Regions of supplying by posterior cerebral artery.

 

 

II.               Seminar discussion 12:30 am – 14:00 pm (2 hours)

 

The principal connection between the cerebral hemispheres is

A     The corpus callosum

B      The pons

C      The thalamus

D     The central sulcus

Respiratory nuclei are found in both

A.   The pons and cerebellum

B.   the cerebellum and the medulla oblongata

C.   the pons and and the medulla oblongata

D.   the cerebrum and the cerebellum

The fourth ventricle is located within

A.   The cerebrum

B.   The diencephalon

C.   The spinal cord

D.   The brain stem

The outer menix in contact with the cranium is

A.               The arachnoid mater

B.               The pia mater

C.               The choroid mater

D.               The dura mater

Which sinus located on the border of posterior and middle cranial fassae?

A.   Superior sagittal

B.   inferior sagittal

C.   Sygmoid

D.   Superior petrous

E.    inferior petrous

The inner menix in contact with the brain is

A.   The choroid mater

B.   The dura mater

C.   The arachnoid mater

D.   The pia mater

Which sinus located on the border of anterior and middle cranial fassae?

A.   Superior sagittal

B.   inferior sagittal

C.   Sphenoparietal

D.   Superior petrous

E.    inferior petrous

 

·  Discussion questions:

1.     Name the parts of the rhinencephalon.

2.     Which formations belong to peripheral portion of rhinencephalon?

3.     Which formations belong to central portion of rhinencephalon?

4.     Which gyri belong to rhinencephalon?

5.     What function of rhinencephalon.

6.     Which comissures of the brain do you know?

7.     Which parts does corpus callosum consist of?

8.     Which parts does fornix consists of?

9.     Where are anterior comissura and septum pellucidum located?

10.           Which parts does internal capsule consist of?

11.           Which formations belong to basal nuclei?

12.           Topography and structure of corpus striatum.

13.           Topography and structure of nucleus caudate.

14.           Topography and structure of nucleus lentiformis.

15.           Topography of the claustrum.

16.           Topography and structure of corpus amygdaloideum.

17.           Topography of external and extremal capsules.

18.           Topography and structure of central part of lateral ventricles.

19.           Topography and structure of frontal horn of lateral ventricles.

20.           Topography and structure of occipital horn of lateral ventricles.

21.           Topography and structure of temporal horn of lateral ventricles.

22.           Which kinds of pathways do you know?

23.           What are associative pathways of the brain?

24.           What are commissural pathways of the brain and spinal cord? Give examples.

25.           What are projective pathways of the brain and spinal cord?

26.           Which associative pathways of the brain do you know?

27.           Which groups of projective pathways of the brain and spinal cord are there?

28.           Which groups of ascending projective pathways of the brain and spinal cord are there?

29.           Which exteroceptive pathways of the brain and spinal cord are there?

30.           Describe temperature, pain and tactile sensory pathways.

31.           Which proprioceptive pathways of the brain and spinal cord are there?

32.           Describe Golla’s and Burdah’s (spinobulbar) sensory pathways.

33.           Describe Flexig’s and Govers’s (spinocerebellar) sensory pathways.

34.           Which interoceptive pathways of the brain and spinal cord are there?

35.           Which groups of descending projective pathways of the brain and spinal cord are there?

36.           Which pyramidal (cortical) pathways of the brain and spinal cord are there?

37.           Describe corticospinal pathways.

38.           Describe corticospinal pathways.

39.           Describe pathways of cerebellar correction.

40.           Which extrapyramidal pathways of the brain and spinal cord are there?

41.           Which brain membranes are there?

42.           Structure of dura mater encephali, its sinuses.

43.           Structure of arachnoida and pia mater encephali.

44.           Which membrane spaces are between the membranes? Their contains and importance.

45.           Willi`s arterial circle, Zaharchenko arterial circle.

46.           Regions of supplying by anterior cerebral artery.

47.           Regions of supplying by middle cerebral artery.

48.           Regions of supplying by posterior cerebral artery.

49.                     Veins of brain.

 

ІІІ. Independent students work  – 14:15pm – 15:00 pm

 

References:

а) basic

 

1.     Atlas of Human Anatomy/ Frank H. Netter,- 5  edition, - 2011 by Saunders, an Imprint of Elsevior Inc.

2.     Gray's Anatomy for Students: With STUDENT CONSULT Online Access, 2e, - 2010. 2092 p.  Richard L. Drake Ph.D, A. Wayne Vogl, Adam W.M. Mitchell, – Printed in Canada.

3.      Materials preparation for lectures

http://intranet.tdmu.edu.ua/data/kafedra/internal/index.php?&path=anatomy/lectures_stud/en/med/lik/ptn/1/

4.     Materials preparation for practical classes

http://intranet.tdmu.edu.ua/data/kafedra/internal/index.php?&path=anatomy/classes_stud/en/med/lik/ptn/1/

 

    b) additional

1.     Human anatomy & physiology /Elaine N. Marieb, Katja Hoehn., San Francisco : Benjamin Cummings, c2010., 8th ed.

2.     F.H. Netter. Atlas of Human Anatomy. – Cіba Pharmaceutіcals Dіvіsіon, 1994. – 514 p.

3.     Synelnіkov R.D. The atlas of anatomy of the man. Іn 4-th volumes. -: Medіcіna, 1991.

4.     Reminetskyy B.Y., Fedonyuk Y.I. Human anatomy. Notes. 136 p.

5.     Lectures.

 

Methodical instructions have been prepared by:

The instruction was discussed and confirmed at the department meeting

12.06.2013. Protocol number 11

 

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