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Describe the role of the hypothalamus in the regulation of below the spinal cord lesion finpecia 1 mg without prescription hair loss gastric sleeve. This produces goose bumps cheap 1mg finpecia amex hair loss in men kilts, cold the autonomic nervous system and endocrine system. The rise in blood pressure re- What structures are involved in this response? Autonomic Nervous © The McGraw−Hill Anatomy, Sixth Edition Coordination System Companies, 2001 Chapter 13 Autonomic Nervous System 451 longata. In response to this sensory input, the medulla oblongata directs a reflex slowing of the heart and vasodilation. Because de- Clinical Case Study Answer scending impulses are blocked by the spinal lesion, however, the The syndrome of organophosphate toxicity consists of symptoms of dan- skin above the lesion is warm and moist (because of vasodilation gerously enhanced parasympathetic activity. Death may result from suf- and sweat gland secretion), whereas it is cold below the level of focation if the victim is unable to clear his airway secretions. You ask about his health in general and learn he has lost 15 pounds in the last year, and he has a long-standing cough that he can’t seem to get rid of. You also no- tice his left eyelid droops, and his left pupil is constricted. He’s surprised when you order a chest X-ray to most likely cause of the indicated lung 3. How do you explain the drooping confirm a problem that seems to be in density indicated with an arrow on the eyelid and the constructed pupil? Preganglionic neurons of the sympathetic functional division of the nervous system; (b) Myocardial cells are interconnected (thoracolumbar) division originate in the it is composed of portions of the central by electrical synapses, or gap spinal cord (T1–L2). Smooth muscle, cardiac muscle, and smooth muscles have few, if any, in peripheral ganglia; included in glands receive autonomic innervation. Autonomic Nervous © The McGraw−Hill Anatomy, Sixth Edition Coordination System Companies, 2001 452 Unit 5 Integration and Coordination (c) Some preganglionic neurons activates the body to “fight or flight” 6. In organs without dual innervation (such innervate the adrenal medulla, which through adrenergic effects; the as most blood vessels), regulation is secretes epinephrine (and some parasympathetic division conserves and achieved by increases or decreases in norepinephrine) into the blood in restores the body’s energy through sympathetic nerve activity. All preganglionic autonomic neurons are Control of the Autonomic Nervous originate in the brain and in the sacral cholinergic (use acetylcholine as a System by Higher Brain Centers levels of the spinal cord. Visceral sensory input to the brain may neurons contribute to the neurons are cholinergic. The centers in the brain that (b) Preganglionic neurons of the vagus norepinephrine at their synapses). The medulla oblongata of the brain stem postganglionic neurons then cholinergic. Cholinergic effects of parasympathetic (b) The hypothalamus orchestrates of the large intestine. The activity of the hypothalamus is lower half of the large intestine, the parasympathetic divisions can be influenced by input from the limbic rectum, and the urinary and antagonistic, complementary, or system, cerebellum, and cerebrum; these reproductive systems. The effects of sympathetic and regulation of salivary gland secretion; parasympathetic activity, together with they are cooperative in the regulation those of hormones, help maintain of the reproductive and urinary homeostasis. Parasympathetic ganglia are located (c) the first cervical (C1) to the first 1. Which of the following statements about (a) in a trunk parallel to the spinal cord. The neurotransmitter of preganglionic (a) preganglionic parasympathetic (d) It contains postganglionic sympathetic neurons is neurons sympathetic neurons. The preganglionic neurons of the (d) postganglionic parasympathetic (c) parasympathetic ganglia that receive sympathetic division of the autonomic neurons in sweat glands neurons from the vagus nerves. Autonomic Nervous © The McGraw−Hill Anatomy, Sixth Edition Coordination System Companies, 2001 Chapter 13 Autonomic Nervous System 453 7. Imagine yourself at the starting block of parasympathetic neurons are 1. The cooperative in parasympathetic divisions in terms of gun is about to go off in the biggest race of (a) the heart. How would you characterize (a) increased movement of the GI tract cholinergic stimulation on the his pulse?

It occurs in about 3% of male infants and should be treated before the infant has reached the age of 5 to reduce the likelihood of infertility or other complications order 1 mg finpecia with mastercard hair loss cure break through. The causes of impotence may be physical finpecia 1mg with visa hair loss zinc dosage, involving, for example, ab- normalities of the penis, vascular irregularities, neurological dis- Pelvic cavity orders, or certain diseases. Occasionally, the cause of impotence 1 is psychological, and the patient requires skilled counseling by a sex therapist. The most common 3 cause of male infertility is inadequate production of viable sperm. This may be due to alcoholism, dietary deficiencies, local injury, Penis variococele, excessive heat, hormonal imbalance, or excessive exposure to radiation. Many of the causes of infertility can be Scrotum treated through proper nutrition, gonadotropic hormone treat- (c) ment, or microsurgery. If these treatments are not successful, it may be possible to concentrate the spermatozoa obtained FIGURE 20. Turner, American endocrinologist, pelvic wall, (2) at the root of the penis, or (3) in the perineum, in the 1892–1970 thigh alongside the femoral vessels. Male Reproductive © The McGraw−Hill Anatomy, Sixth Edition Development System Companies, 2001 Developmental Exposition Externally, by the sixth week a swelling called the genital The Reproductive System tubercle is apparent anterior to the small embryonic tail (future coccyx). The mesonephric and paramesonephric ducts open to the outside through the genital tubercle. The genital tubercle EXPLANATION consists of a glans, a urethral groove, paired urethral folds, and paired labioscrotal swellings (see exhibit II). As the glans portion Sex Determination of the genital tubercle enlarges, it becomes known as the phallus. Early in fetal development (tenth through twelfth week), sexual Sexual identity is initiated at the moment of conception, when distinction of the external genitalia becomes apparent. The male, the phallus enlarges and develops into the glans of the ovum is fertilized by a spermatozoon containing either an X or a Y penis. The urethral folds fuse around the urethra to form the body sex chromosome. The urethra opens at the end of the glans as the ure- it will pair with the X chromosome of the ovum and a female thral orifice. The labioscrotal swellings fuse to form the scrotum, child will develop. A spermatozoon carrying a Y chromosome re- into which the testes will descend. In the female, the phallus sults in an XY combination, and a male child will develop. The urethral groove is retained as a longitudinal cleft sex hormones during late embryonic and early fetal development known as the vestibule. Descent of the Testes Embryonic Development The descent of the testes from the site of development begins be- The male and female reproductive systems follow a similar pattern of tween the sixth and tenth week. Descent into the scrotal sac, development, with sexual distinction resulting from the influence of however, does not occur until about week 28, when paired in- hormones. A significant fact of embryonic development is that the guinal canals form in the abdominal wall to provide openings sexual organs for both male and female are derived from the same from the pelvic cavity to the scrotal sac. The process by which a developmental tissues and are considered homologous structures. The gonadal ridge continues to testis descends, it passes to the side of the urinary bladder and an- grow behind the developing peritoneal membrane. It carries with it the ductus defer- week, stringlike masses called primary sex cords form within the ens, the testicular vessels and nerve, a portion of the internal enlarging gonadal ridge. The primary sex cords in the male will abdominal oblique muscle, and lymph vessels. All of these struc- eventually mature to become the seminiferous tubules. In the fe- tures remain attached to the testis and form what is known as the male, the primary sex cords will contribute to nurturing tissue of spermatic cord (see fig. Each gonad develops near a mesonephric duct its position in the scrotal sac, the gubernaculum is no more than and a paramesonephric duct. During further development, the connecting tubules become the During the physical examination of a neonatal male, a seminiferous tubules, and the mesonephric duct becomes the effer- physician will palpate the scrotum to determine if the testes ent ductules, epididymis, ductus deferens, ejaculatory duct, and semi- are in position. The paramesonephric duct in the male degenerates possible to induce descent by administering certain hormones.

Bilateral lesions of the Xth nerve are life- of pain purchase finpecia 1mg without prescription hair loss in men 501, temperature discount finpecia 1mg fast delivery hair loss cure in asia, and touch on the ipsilateral face and in the oral threatening because of the resultant total paralysis (and closure) of the and nasal cavities; 2) paralysis of ipsilateral masticatory muscles ( jaw de- muscles in the vocal folds (vocalis muscle). Abbreviations AbdNu Abducens nucleus SpTNu Spinal trigeminal nucleus ALS Anterolateral system SpTTr Spinal trigeminal tract BP Basilar pons SSNu Superior salivatory nucleus DVagNu Dorsal motor nucleus of vagus TecSp Tectospinal tract FacNr Facial nerve TriMoNu Trigeminal motor nucleus FacNu Facial nucleus TriNr Trigeminal nerve GINr Glossopharyngeal nerve VagNr Vagus nerve HyNu Hypoglossal nucleus ISNu Inferior salivatory nucleus Ganglia MesNu Mesencephalic nucleus 1 Pterygopalatine ML Medial lemniscus 2 Submandibular MLF Medial longitudinal fasciculus 3 Otic NuAm Nucleus ambiguus 4 Terminal and/or intramural PSNu Principal (chief ) sensory nucleus Review of Blood Supply to TriMoNu, FacNu, DMNu and NuAm, and the Internal Course of Their Fibers STRUCTURES ARTERIES TriMoNu and Trigeminal Root long circumferential branches of basilar (see Figure 5–21) FacNu and Internal Genu long circumferential branches of basilar (see Figure 5–21) DMNu and NuAm branches of vertebral and posterior inferior cerebellar (see Figure 5–14) Motor Pathways 203 Cranial Nerve Efferents (V, VII, IX, and X) Position of Nucleus and Internal Route of Fibers TriMotNu MesNu MLF PSNu TecSp Motor root Structures Innervated ALS of TriNr Masticatory muscles and ML tensor tympani, TriMotNu tensor veli palatini, Motor root mylohyoid, BP of TriNr digastric (ant. Also illustrated is the somatotopy of those fibers originating ataxia one might expect to see in patients with a spinal cord hemisection from the spinal cord. These fibers enter the cerebellum via the resti- (as in the Brown-Sequard syndrome) is masked by the hemiplegia resulting form body, the larger portion of the inferior cerebellar peduncle, or from the concomitant damage to lateral corticospinal (and other) fibers. After these fibers Friedreich ataxia (hereditary spinal ataxia) is an autosomal recessive dis- enter the cerebellum, collaterals are given off to the cerebellar nuclei order the symptoms of which usually appear between 8 and 15 years while the parent axons of spinocerebellar and cuneocerebellar fibers of age. There is degeneration of anterior and posterior spinocerebellar pass on to the cortex, where they end as mossy fibers in the graunular tracts plus the posterior columns and corticospinal tracts. Although not shown here, there are important ascending spinal tive changes are also seen in Purkinje cells in the cerebellum, in poste- projections to the medial and dorsal accessory nuclei of the inferior rior root ganglion cells, in neurons of the Clarke column, and in some olivary complex (spino-olivary fibers). The axial and appendicular ataxia seen (as well as the principal olivary nucleus) project to the cerebellar cor- in these patients correlates partially with the spinocerebellar degener- tex and send collaterals into the nuclei (see Figure 7-18 on page 206). Abbreviations ACNu Accessory (external or lateral) cuneate PSCT Posterior (dorsal) spinocerebellar tract nucleus PSNu Principal (chief ) sensory nucleus of ALS Anterolateral system trigeminal nerve AMV Anterior medullary velum Py Pyramid ASCT Anterior (ventral) spinocerebellar tract RB Restiform body Cbl Cerebellum RSCF Rostral spinocerebellar fibers CblNu Cerebellar nuclei RuSp Rubrospinal tract CCblF Cuneocerebellar fibers S Sacral representation DNuC Dorsal nucleus of Clarke SBC Spinal border cells FNL Flocculonodular lobe SCP Superior cerebellar peduncle IZ Intermediate zone SpTNu Spinal trigeminal nucleus L Lumbar representation SpTTr Spinal trigeminal tract MesNu Mesencephalic nucleus T Thoracic representation ML Medial lemniscus TriMoNu Trigeminal motor nucleus PRG Posterior (dorsal) root ganglion VesNu Vestibular nuclei Review of Blood Supply to Spinal Cord Grey Matter, Spinocerebellar Tracts, RB, and SCP STRUCTURES ARTERIES Spinal Cord Grey branches of central artery (see Figure 5–6) PSCT and ASCT in Cord penetrating branches of arterial vasocorona (see Figure 5–6) RB posterior inferior cerebellar (See Figure 5–14) SCP long circumferential branches of basilar and superior cerebellar (see Figure 5–21) Cerebellum posterior and anterior inferior cerebellar and superior cerebellar Cerebellum and Basal Nuclei (Ganglia) 205 Spinocerebellar Tracts Position of SCP AMV ASCT SCP MesNu TriMoNu ML PSNu ASCT on SCP Lobules II-IV Lobules II-IV Ant. Lobe Lobule V Lobule V Recrossing ASCT fibers in Cbl CblNu CblNu RB RB FNL Post. Lobe CCblF Lobule VIII Lobule VIII ACNu RSCF PRG Somatotopy Position Lamina VII VesNu at C4-C8 PSCT RB ASCT SpTTr & Nu DNuC ASCT ALS + RuSp Intermediate zone (IZ) and "spinal border" Py cells (SBC) PRG DNuC PSCT PSCT T L S IZ ASCT L T ASCT SBC 206 Synopsis of Functional Components, Tracts, Pathways, and Systems Pontocerebellar, Reticulocerebellar, Olivocerebellar, Ceruleocerebellar, Hypothalamocerebellar, and Raphecerebellar Fibers 7–18 Afferent fibers to the cerebellum from selected brainstem ar- ticotropin ( )-releasing factor are present in many olivocerebellar eas and the organization of corticopontine fibers in the internal capsule fibers. Ceruleocerebellar fibers contain noradrenalin, histamine is and crus cerebri as shown here. The cerebellar peduncles are also indi- found in hypothalamocerebellar fibers, and some reticulocerebellar cated. Pontocerebellar axons are mainly crossed, reticulocerebellar fibers contain enkephalin. Serotonergic fibers to the cerebellum arise fibers may be bilateral (from RetTegNu) or mainly uncrossed (from from neurons found in medial areas of the reticular formation (open LRNu and PRNu), and olivocerebellar fibers (OCblF) are exclusively cell in Figure 7–18) and, most likely, from some cells in the adjacent crossed. Raphecerebellar, hypothalamocerebellar, and ceruleocerebel- raphe nuclei. Although all af- Clinical Correlations: Common symptoms seen in patients with ferent fibers to the cerebellum give rise to collaterals to the cerebellar lesions involving nuclei and tracts that project to the cerebellum are nuclei, those from pontocerebellar axons are relatively small, having ataxia (of trunk or limbs), an ataxic gait, dysarthria, dysphagia, and dis- comparatively small diameters. Olivocerebellar axons end as climbing orders of eye movement such as nystagmus. These deficits are seen in fibers, reticulocerebellar and pontocerebellar fibers as mossy fibers, and some hereditary diseases (such as olivopontocerebellar degeneration, ataxia hypothalamocerebellar and ceruleocerebellar axons end in all cortical telangiectasia, or hereditary cerebellar ataxia), in tumors (brainstem layers. These latter fibers have been called multilayered fibers in the lit- gliomas), in vascular diseases (lateral pontine syndrome), or in other con- erature because they branch in all layers of the cerebellar cortex. Abbreviations AntLb Anterior limb of internal capsule PonNu Pontine nuclei CblNu Cerebellar nuclei PO Principal olivary nucleus CerCblF Ceruleocerebellar fibers PPon Parietopontine fibers CPonF Cerebropontine fibers PRNu Paramedian reticular nuclei CSp Corticospinal fibers Py Pyramid DAO Dorsal accessory olivary nucleus RB Restiform body FPon Frontopontine fibers RCblF Reticulocerebellar fibers Hyth Hypothalamus RetLenLb Retrolenticular limb of internal capsule HythCblF Hypothalamocerebellar fibers RNu Red nucleus IC Internal capsule RetTegNu Reticulotegmental nucleus LoCer Nucleus (locus) ceruleus SCP Superior cerebellar peduncle LRNu Lateral reticular nucleus SubLenLb Sublenticular limb of internal capsule MAO Medial accessory olivary nucleus SN Substantia nigra MCP Middle cerebellar peduncle TPon Temporopontine fibers ML Medial lemniscus NuRa Raphe nuclei Number Key OCblF Olivocerebellar fibers 1 Nucleus raphe, pontis OPon Occipitopontine fibers 2 Nucleus raphe, magnus PCbIF Pontocerebellar fibers 3 Raphecerebellar fibers PostLb Posterior limb of internal capsule Review of Blood Supply to Precerebellar Relay Nuclei in Pons and Medulla, MCP, and RB STRUCTURES ARTERIES Pontine Tegmemtum long circumferential branches of basilar plus some from superior cerebellar (see Figure 5–21) Basilar Pons paramedian and short circumferential branches of basilar (See Figure 5–21) Medulla RetF and IO branches of vertebral and posterior inferior cerebellar (see Figure 5–14) MCP long circumferential branches of basilar and branches of anterior inferior and superior cerebellar (see Figure 5–21) RB posterior inferior cerebellar (see Figure 5–14) Cerebellum and Basal Nuclei (Ganglia) 207 Pontocerebellar, Reticulocerebellar, Olivocerebellar, Ceruleocerebellar, Hypothalamocerebellar, and Raphecerebellar Fibers Position of Associated Tracts and Nuclei AntLb (FPon) PostLb (PPon) IC SubLenLb Hyth (TPon) RetLenLb (OPon) CPonF HythCblF LoCer ML RetTegNu CerCblF RNu SCP SN PPon MCP OPon 1 TPon FPon PonNu NuRa PCblF 3 2 CblNu RetTegNu OCblF MCP ML DAO RB CPonF PCblF RCblF CSp PO LRNu PonNu PRNu MAO PRNu RB OCblF LRNu PO Py OCblF PCblF CerCblF 208 Synopsis of Functional Components, Tracts, Pathways, and Systems Cerebellar Cortioconuclear, Nucleocortical, and Corticovestibular Fibers 7–19 Cerebellar corticonuclear fibers arise from all regions of the Lesions involving midline structures (vermal cortex, fastigial nu- cortex and terminate in an orderly (mediolateral and rostrocaudal) se- clei) and/or the flocculonodular lobe result in truncal ataxia (titubation quence in the ipsilateral cerebellar nuclei. These patients may also have a fibers from the vermal cortex terminate in the fastigial nucleus, those wide-based (cerebellar) gait, are unable to walk in tandem (heel to toe), from the intermediate cortex terminate in the emboliform and globo- and may be unable to walk on their heels or on their toes. Generally, sus nuclei, and those from the lateral cortex terminate in the dentate nu- midline lesions result in bilateral motor deficits affecting axial and cleus. Also, cerebellar corticonuclear fibers from the anterior lobe typ- proximal limb musculature. Cerebellar corticovestibu- emboliform, and dentate nuclei results in various combinations of the lar fibers originate primarily from the vermis and flocculonodular lobe, following deficits: dysarthria, dysmetria (hypometria, hypermetria), dysdi- exit the cerebellum via the juxtarestiform body, and end in the ipsilat- adochokinesia, tremor (static, kinetic, intention), rebound phenomenon, un- eral vestibular nuclei. One of the more Nucleocortical processes originate from cerebellar nuclear neurons commonly observed deficits in patients with cerebellar lesions is an in- and pass to the overlying cortex in a pattern that basically reciprocates tention tremor, which is best seen in the finger-nose test. The finger-to-fin- that of the corticonuclear projection; they end as mossy fibers. Some ger test is also used to demonstrate an intention tremor and to assess nucleocortical fibers are collaterals of cerebellar efferent axons. The heel-to-shin test will show dysmetria in the lower cerebellar cortex may influence the activity of lower motor neurons extremity. If the heel-to-shin test is normal in a patient with his/her through, for example, the cerebellovestibular-vestibulospinal route.

However cheap finpecia 1 mg mastercard hair loss 8 months after giving birth, the nurse stated that lavage fluid was draining out of the chest tube 1mg finpecia hair loss in men39 s warehouse. From what you know about how the various body cavities are organized, do you suppose FIGURE: Radiographic anatomy is this phenomenon could be explained based on normal anatomy? What might have caused it to important in assessing trauma to bones and occur in our patient? If it does not, explain why in terms of the relationship of the various organs to the membranes within the abdomen. Body Organization and © The McGraw−Hill Anatomy, Sixth Edition Organization, and the Anatomical Nomenclature Companies, 2001 Human Organism Chapter 2 Body Organization and Anatomical Nomenclature 23 Notochord Dorsal hollow CLASSIFICATION AND nerve cord Primitive eye CHARACTERISTICS OF HUMANS Humans are biological organisms belonging to the phylum Chor- data within the kingdom Animalia and to the family Hominidae within the class Mammalia and the order Primates. Objective 2 List the characteristics that identify humans as chordates and as mammals. Pharynx Objective 3 Describe the anatomical characteristics that set Pharyngeal humans apart from other primates. Our scientific name translates Umbilical bud cord from the Latin to “man the intelligent,” and indeed our intelli- gence is our most distinguishing feature. It has enabled us to Limb bud build civilizations, conquer dread diseases, and establish cultures. We have invented a means of communicating through written Creek symbols. We record our own history, as well as that of other or- ganisms, and speculate about our future. The ever more ingenious ways for adapting to our changing environ- three diagnostic chordate characteristics are indicated in boldface type. At the same time, we are so intellectually specialized that we are not self-sufficient. We need one another as much as we need the recorded knowledge of the past. We are constantly challenged to learn more about our- ferred to as a taxon. As we continue to make new discoveries about our struc- most specific taxon is the species. Humans are species belonging ture and function, our close relationship to other living organisms to the animal kingdom. Phylogeny (fi-loj′˘-nee ) is the science that becomes more and more apparent. Often, it is sobering to realize studies relatedness on the basis of taxonomy. As human organisms, we breathe, eat and digest food, excrete bodily Phylum Chordata wastes, locomote, and reproduce our own kind. These chordate characteristics are development is found throughout nature. The fundamental pat- well expressed during the embryonic period of development and, terns of development of many nonhuman animals also characterize to a certain extent, are present in an adult. Recent genetic mapping of flexible rod of tissue that extends the length of the back of an the human genome confirms that there are fewer than 35,000 embryo. A portion of the notochord persists in the adult as genes accounting for all of our physical traits. By far the majority the nucleus pulposus, located within each intervertebral disc of these genes are similar to those found in many other organisms. The dorsal hollow nerve cord is positioned above the In the classification, or taxonomic, system established by notochord and develops into the brain and spinal cord, which biologists to organize the structural and evolutionary relation- are supremely functional as the central nervous system in the ships of living organisms, each category of classification is re- adult. Body Organization and © The McGraw−Hill Anatomy, Sixth Edition Organization, and the Anatomical Nomenclature Companies, 2001 Human Organism 24 Unit 2 Terminology, Organization, and the Human Organism L4 L5 S1 (a) (b) FIGURE 2. In other chordates, such as humans, embryonic pha- Order Primates ryngeal pouches develop, but only one of the pouches persists, becoming the middle-ear cavity. Spinal nerves exit between vertebrae, and the discs maintain the spacing to avoid nerve damage. A “slipped disc,” resulting from straining the back, is Family Hominidae a misnomer. What actually occurs is a herniation, or rupture, because of a weakened wall of the nucleus pulposus.

Internal Morphology of the Brain in Slices and MRI Brain Slices in the Axial Plane with MRI Orientation to Axial MRIs: When looking at an axial MRI using MRI (or CT) in the diagnosis of the neurologically impaired image discount 1mg finpecia amex hair loss medication results, you are viewing the image as if standing at the patient’s patient generic finpecia 1 mg hair loss in men red. So, when looking at the slice, the observer’s ages, the observer’s right is the left side of the brain in the MRI right is the left side of the brain slice. It is absolutely essential to relates exactly with the orientation of the brain as seen in the ac- have a clear understanding of this right-versus-left concept when companying axial MRIs. The plane of the section just touches the upper identified in the brain slice. The terminal vein is also called the superior portion of the body of caudate nucleus. Axial Brain Slice—MRI Correlation 75 Cingulate gyrus Anterior cerebral arteries Genu of corpus calllosum Head of caudate nucleus (HCaNu) Anterior horn of lateral ventricle (AHLatVen) Stria terminalis and terminal vein Body of fornix Anterior nucleus of Anterior tubercle thalamus Corona radiata (CorRad) Ventral anterior nucleus of thalamus Lateral thalamic nuclei Tail of caudate nucleus Dorsomedial nucleus of thalamus Lateral ventricle (LatVen) Tail of caudate nucleus Crus of fornix Splenium of corpus callosum Caudate AHLatVen nucleus LatVen HCaNu Putamen CorRad Internal capsule Septum pellucidum Dorsal thalamus Atrium of lateral ventricle 4-11 Ventral surface of an axial section of brain through the splenium sion recovery—left; T2-weighted—right) are at a comparable plane of corpus callosum and the head of the caudate nucleus. This plane includes and show some of the structures identified in the brain slice. The two MRI images (inver- minal vein is also called the superior thalamostriate vein. The arrowheads in the brain slice the corpus callosum, head of caudate nucleus, centromedian nucleus, and dor- and in the MRIs are pointing to the mammillothalamic tract. The two MRI images (inversion recovery— minal vein is also called the superior thalamostriate vein. MGNu thalamic nuclei Tap Pul Hip Dorsomedial nucleus SC ALatVen Crus of fornix PHLatVen OpRad SpCorCl 4-13 Ventral surface of an axial section of brain through the anterior can be discerned on the right side of the brain. The MRI images (both commissure, column of fornix, medial and lateral geniculate nuclei, and supe- T2-weighted) are at approximately the same plane and show many of rior colliculus. The medial and lateral segments of the globus pallidus are vis- the structures identified in the brain slice. The lateral and medial segments of the globus pallidus 78 Internal Morphology of the Brain in Slices and MRI Hypothalamus (HyTh) Anterior cerebral arteries (ACA) Head of Lamina terminalis caudate nucleus Third ventricle (ThrVen) Nucleus accumbens Optic tract (OpTr) Anterior perforated substance Uncus Crus cerebri (CC) Amygdaloid nuclear complex Inferior horn of lateral ventricle (IHLatVen) Mammillary body (MB) Interpeduncular Hippocampal fossa (IPF) formation Lateral geniculate Substantia nucleus nigra (SN) Tail of caudate nucleus Decussation of superior Hippocampal formation (Hip) cerebellar peduncle Choroid plexus in inferior horn Inferior colliculus (IC) Periaqueductal gray Cerebellum (Cbl) Cerebral Aqueduct (CA) ACA OpTr ThrVen HyTh ThrVen Un MB CC SN IPF IHLatVen Hip CA IC Posterior cerebral artery Posterior horn lateral ventricle Cbl 4-14 Ventral surface of an axial section of brain through the hypo- planes and show many of the structures identified in the brain slice. The three MRI images (inverted inversion For details of the cerebellum see Figures 2-31 to 2-33 on pp. Axial Brain Slice—MRI Correlation 81 Basilar artery Basilar pons Anterior median fissure (AMF) Pyramid (Py) Preolivary sulcus (PreOIS) Olivary eminence (OlEm) Vestibulocochlear nerve Vagus and glossopharyngeal nerves Retroolivary sulcus (Postolivary sulcus) (PoOIS) Restiform body (RB) Medial lemniscus Tonsil of cerebellum (TCbl) Hemisphere of posterior lobe Fourth ventricle (ForVen) of cerebellum (HCbl) Vermis of posterior lobe of cerebellum (VCbl) AMF Py PreOlS OlEm PoOlS RB TCbl TCbl ForVen HCbl VCbl OlEm Lesion-Lateral medullary syndrome RB ForVen 4-17 Ventral surface of an axial section of brain through portions of show many of the structures identified in the brain slice. Note the lateral the medulla oblongata, just caudal to the pons–medulla junction and the medullary lesion (lower), also known as the posterior inferior artery posterior lobe of the cerebellum. The three MRI images (T1-weighted— syndrome or the lateral medullary syndrome (of Wallenberg). For de- upper left and right; T2-weighted—lower) are at the same plane and tails of the cerebellum see Figures 2-31 to 2-33 on pp. CHAPTER 5 Internal Morphology of the Spinal Cord and Brain in Stained Sections Basic concepts that are essential when one is initially learning how and the lateral corticospinal tract (grey). In the brainstem, these to diagnose the neurologically impaired patient include 1) an un- spinal tracts are joined by the spinal trigeminal tract and ventral derstanding of cranial nerve nuclei and 2) how these structures re- trigeminothalamic fibers (both are light green). The importance of these relationships is clearly color-coded on one side only, to emphasize 1) laterality of function seen in the combinations of deficits that generally characterize le- and dysfunction, 2) points at which fibers in these tracts may de- sions at different levels of the neuraxis. First, deficits of only the cussate, and 3) the relationship of these tracts to cranial nerves. This key identifies the var- the same, or opposite, sides are indicative of spinal cord lesions ious tracts and nuclei by their color and specifies the function of (e. This approach not only emphasizes istically have motor and sensory levels; these are the lowest functional anatomical and clinical concepts, but also lends itself to a variety levels remaining in the compromised patient. In these examples cranial nerve signs are better localizing and CT (myelogram/cisternogram) images are introduced into signs than are long tract signs. A localizing sign can be defined as an the spinal cord and brainstem sections of this chapter (see also objective neurologic abnormality that correlates with a lesion (or Chapter 1). To show the relationship between basic anatomy and lesions) at a specific neuroanatomical location (or locations).