A Textbook of Neuroanatomy

465 Pages·2009·25.8 MB·English

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A Textbook of Neuroanatomy
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Dedication
To my father, Antonios,
my mother, Garifalia, and
my sister Oursikía
for their contribution to my education
MAP
To my wife, Roseann,
my daughter, Jen, and
my mother, Mary
LPG
XXV
The brain within its groove
Runs evenly and true;
But let a splinter swerve,
‘T were easier for you
To put the water back
When floods have slit the hills,
And scooped a turnpike for themselves,
And blotted out the mills!
Emily Dickinson
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A Textbook of Neuroanatomy
Maria A. Patestas
Associate Professor of Anatomy
Department of Anatomy
Des Moines University
Des Moines, Iowa
Leslie P. Gartner
Professor of Anatomy
Department of Biomedical Sciences
Baltimore College of Dental Surgery
Dental School
University of Maryland at Baltimore
Baltimore, Maryland
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© 2006 by Blackwell Science Ltd
a Blackwell Publishing company
BLACKWELL PUBLISHING
350 Main Street, Malden, MA 02148-5020, USA
108 Cowley Road, Oxford OX4 1JF, UK
550 Swanston Street, Carlton, Victoria 3053, Australia
The right of Maria A. Patestas and Leslie P. Gartner to be identified as the Authors of this Work has been
asserted in accordance with the UK Copyright, Designs, and Patents Act 1988.
All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or
transmitted, in any form or by any means, electronic, mechanical, photocopying, recording or otherwise,
except as permitted by the UK Copyright, Designs, and Patents Act 1988, without the prior permission
of the publisher.
First published 2006 by Blackwell Publishing Ltd
Library of Congress Cataloging-in-Publication Data
Patestas, Maria A.
A textbook of neuroanatomy / Maria A. Patestas and Leslie P. Gartner.
p. cm.
Includes bibliographical references and index.
ISBN 1-4051-0340-X (paperback : alk. paper)
1. Neuroanatomy. I. Gartner, Leslie P. II. Title.
QM451.G285 2004
611.8–dc22 2003026897
A catalogue record for this title is available from the British Library.
Set in 9/11.5pt Palatino
by Graphicraft Limited, Hong Kong
Printed and bound in the United Kingdom
by Replika, India
The publisher’s policy is to use permanent paper from mills that operate a sustainable forestry
policy, and which hasbeen manufactured from pulp processed using acid-free and
elementary chlorine-free practices. Furthermore, the publisher ensures that the text paper
and cover board used have met acceptable environmental accreditation standards.
For further information on
Blackwell Publishing, visit our website:
http://www.blackwellpublishing.com
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Contents
Preface viii Follow-up to clinical case 67
Questions to ponder 67
Part 1 General Principles of the
Chapter 6 Gross Anatomy of the Brain 68
Nervous System 1
Clinical case 68
Cerebrum 69
Chapter 1 Introduction to the Nervous System 3 Diencephalon 77
Cells of the nervous system 3 Cerebellum 77
Central nervous system 5 Brainstem 80
Peripheral nervous system 7 Clinical considerations 82
Questions to ponder 9 Synonyms and eponyms 82
Follow-up to clinical case 82
Chapter 2 Development of the Nervous System 10 Questions to ponder 83
Clinical case 10
Chapter 7 Meninges and Cerebrospinal Fluid 84
Early development 11
Neurulation 12 Clinical case 84
Early development of the spinal cord and brain 18 Cranial meninges 85
Development of the spinal cord 19 Spinal meninges 92
Development of the brain 21 Venous sinuses of the cranial dura mater 93
Clinical considerations 26 Cerebrospinal fluid 95
Synonyms and eponyms 27 Ventricles of the brain 95
Follow-up to clinical case 27 Clinical considerations 97
Questions to ponder 27 Synonyms and eponyms 97
Follow-up to clinical case 97
Questions to ponder 98
Chapter 3 Histophysiology of the Nervous System 28
Clinical case 28
Chapter 8 Vascular Supply of the Central
Neurons 29
Nervous System 99
Neuroglia 35
Clinical case 99
Generation and conduction of nerve impulses 38
Vascular supply of the spinal cord 100
Clinical considerations 42
Arterial supply of the brain 101
Synonyms and eponyms 43
Venous drainage of the brain 112
Follow-up to clinical case 43
Clinical considerations 116
Questions to ponder 43
Synonyms and eponyms 117
Follow-up to clinical case 117
Chapter 4 Neurotransmitter Substances 44
Questions to ponder 117
Clinical case 44
Classification of neurotransmitter substances 47 Chapter 9 Autonomic Nervous System 118
Clinical considerations 52 Clinical case 118
Follow-up to clinical case 53 Sympathetic nervous system 119
Questions to ponder 53 Parasympathetic nervous system 126
Enteric nervous system 129
Chapter 5 Spinal Cord 54 Neurotransmitters and receptors of the
Clinical case 54 autonomic nervous system 130
Morphology of the spinal cord 55 Pelvic autonomic functions 131
Internal morphology of the spinal cord 60 Clinical considerations 132
Vascular supply of the spinal cord 63 Synonyms and eponyms 133
Clinical considerations 66 Follow-up to clinical case 133
Synonyms and eponyms 67 Questions to ponder 133
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vi === CONTENTS
Part 2 Integrative Components of the Chapter 14 Reticular Formation 241
Nervous System 135 Clinical case 241
Morphology of the reticular formation 241
Zones of the reticular formation 242
Chapter 10 Ascending Sensory Pathways 137
Nuclei associated with the reticular formation 245
Clinical case 137
Input to and output from the reticular formation 245
Sensory receptors 138
Functions of the reticular formation 245
Anterolateral system 146
Clinical considerations 250
Tactile sensation and proprioception 154
Synonyms and eponyms 251
Sensory pathways to the cerebellum 157
Follow-up to clinical case 251
Clinical considerations 161
Questions to ponder 252
Modulation of nociception 166
Neuroplasticity 168
Chapter 15 Cranial Nerves 253
Synonyms and eponyms 169
Clinical case 253
Follow-up to clinical case 170
Olfactory nerve (CN I) 256
Questions to ponder 170
Optic nerve (CN II) 256
Oculomotor nerve (CN III) 258
Chapter 11 Motor Cortex and Descending
Trochlear nerve (CN IV) 260
Motor Pathways 171
Trigeminal nerve (CN V) 261
Clinical case 171
Abducent nerve (CN VI) 266
Cortical areas controlling motor activity 172
Facial nerve (CN VII) 268
Descending motor pathways 174
Vestibulocochlear nerve (CN VIII) 272
Clinical considerations 187
Glossopharyngeal nerve (CN IX) 272
Synonyms and eponyms 188
Vagus nerve (CN X) 274
Follow-up to clinical case 189
Spinal accessory nerve (CN XI) 277
Questions to ponder 189
Hypoglossal nerve (CN XII) 277
Synonyms and eponyms 280
Chapter 12 Basal Ganglia 190 Follow-up to clinical case 280
Clinical case 190 Questions to ponder 281
Components of the basal ganglia 191
Nuclei associated with the basal ganglia 196 Chapter 16 Visual System 282
Input, intrinsic, and output nuclei of the basal ganglia 196 Clinical case 282
Connections of the basal ganglia 198 Eye 282
Circuits connecting the basal ganglia, thalamus, Central visual pathways 287
and cerebral cortex 205 Visual reflexes 291
Other circuits of the basal ganglia 207 Clinical considerations 298
Neurotransmitters of the basal ganglia 208 Synonyms and eponyms 302
“Direct” and “indirect” loops (pathways) of the Follow-up to clinical case 302
basal ganglia 209 Questions to ponder 303
Circuits that modulate activity of the basal ganglia 210
Clinical considerations 212 Chapter 17 Auditory System 304
Synonyms and eponyms 217 Clinical case 304
Follow-up to clinical case 218 Ear 304
Questions to ponder 218 Auditory transmission 308
Central auditory pathways 309
Chapter 13 Cerebellum 219 Clinical considerations 315
Clinical case 219 Synonyms and eponyms 316
Morphology of the cerebellum 220 Follow-up to clinical case 316
Cerebellar peduncles 227 Questions to ponder 317
Deep cerebellar nuclei 229
Afferents (input) to the cerebellum 231 Chapter 18 Vestibular System 318
Efferents (output) from the cerebellum 235 Clinical case 318
Functional organization of the cerebellum: Vestibular apparatus 319
intrinsic circuitry 236 Vestibular nerve (CN VIII) 325
Clinical considerations 238 Central pathways of the vestibular system 326
Synonyms and eponyms 240 Control of ocular movements 329
Follow-up to clinical case 240 Vestibular nystagmus 332
Questions to ponder 240 Caloric nystagmus 334
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CONTENTS === vii
Synonyms and eponyms 334 Clinical considerations 382
Follow-up to clinical case 334 Synonyms and eponyms 383
Questions to ponder 335 Follow-up to clinical case 383
Questions to ponder 384
Chapter 19 Olfactory System 336
Clinical case 336 Chapter 22 Thalamus 385
Olfactory receptor cells 336 Clinical case 385
Olfactory transduction 338 Borders 385
Olfactory nerve (CN I) 338 Anatomy 385
Central connections of the olfactory system 339 Internal and external medullary laminae 388
Clinical considerations 342 Thalamic nuclei 389
Synonyms and eponyms 342 Clinical considerations 395
Follow-up to clinical case 342 Synonyms and eponyms 396
Questions to ponder 343 Follow-up to clinical case 396
Questions to ponder 397
Chapter 20 Limbic System 344
Chapter 23 Cerebral Cortex 398
Clinical case 344
Clinical case 398
Limbic lobe 345
Cells of the cerebral cortex 400
Brainstem centers associated with limbic
Types of cortex 402
system function 355
Cell layers of the neocortex 402
Pathways of the limbic system 356
Vertical columnar organization of the cerebral cortex 404
Clinical considerations 358
Afferents (input) to the cerebral cortex 404
Synonyms and eponyms 359
Efferents (output) from the cerebral cortex 404
Follow-up to clinical case 359
Internal capsule and corona radiata 406
Questions to ponder 360
Lobes of the cerebral cortex 408
Functional areas of the cerebral cortex 408
Chapter 21 Hypothalamus 361
Cerebral dominance 417
Clinical case 361
Clinical considerations 417
Borders 362
Synonyms and eponyms 421
Hypothalamic zones and component nuclei 362
Follow-up to clinical case 422
Hypothalamic regions (areas) and component nuclei 368
Questions to ponder 423
Connections of the hypothalamus 370
Pathways of the hypothalamus 370
Questions to ponder: answers to odd questions 425
Functions of the hypothalamus 374
Hypothalamohypophyseal connections 376
Index 435
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Preface
This Textbook of Neuroanatomywas written with the student • clinical cases open each chapter, setting the stage for the
in mind in full knowledge of the apprehension with which relevance of that chapter’s context;
he or she faces the prospect of learning a subject matter that • key points in the chapter are highlighted in the text;
frequently intimidates the student population. The material • clinical case questions indicate the relevance of the chap-
appears daunting, not only due to its very nature of being ter opening case at key points in the chapter—the answers
associated with polysyllabic words, but also because there appear on the related website;
are so many eponyms and synonyms for the myriad of terms • summary tables within each chapter function as study
that are necessary for the proper description of the nervous guides to assist students in learning and memorizing;
system. The good news is that neuroanatomy is simply being • clinical considerations sections indicate the medical con-
maligned by its nefarious reputation, for it is a logical, relat- ditions relevant to the chapter topics;
ively benign subject, whose comprehension does not require • synonym/eponym tables help organize the many possi-
Einsteinian brilliance, but merely a willingness to learn the ble terms for each vocabulary word;
meaning of a large fistful of new words and the ability to read • a follow-up to each clinical case is given at the end of
a map and follow it from one place to another. In order to each chapter and discusses the opening case, helping tie
help the student easily achieve the goal of learning neuro- together the text and its medical application;
anatomy we made this textbook complete, concise, yet easy • questions to ponder at the end of each chapter reinforce
to read, and well illustrated with many schematic diagrams the relevance of the material, with the answers to even
to expound upon the concepts being discussed. Presenting questions given on the website and the answers to odd
the material in a relevant context will make the learning questions appearing at the end of the book;
experience simpler, more enjoyable, and more memorable. • an accompanying website includes all the illustrations,
We envisioned writing a book that was accessible and the even answers for questions to ponder, and all the
clear—one that students would not have to wade through in answers for clinical case questions. It also features anima-
order to discern key information of human neuroanatomy. tions of key processes and links to useful sources. The site
We have also highlighted the interrelationships between sys- can be found at www.blackwellpublishing.com/patestas.
tems, structures, and the rest of the body as we go through An instructor’s CD-ROM version is also available.
the various regions of the brain. We think a broad under-
standing of neuroanatomy, supported with a basic under-
standing of its physiology, is critical so that students do not ACKNOWLEDGMENTS
get bogged down memorizing structures but instead learn
the principles. This conceptual basis of the “big picture” We would like to thank the many individuals who helped
helps establish the foundation for future studies in the health us bring this project to fruition, including our editors
sciences and for the logic that helps drive it. at Blackwell Publishing: Nancy Whilton, our publisher, who
The text is divided into two sections. The first nine chap- signed and oversaw the publishing process; Elizabeth Frank,
ters provide an overview of neuroanatomy that introduces our assistant editor, who managed the flow and review of
terms, and should be viewed as the vocabulary lessons which multiple drafts; our desk editor, Jane Andrew, who scrut-
are necessary evils in the mastering of a new language. For no inized the fine detail; and our production editors Rosie
matter how well one understands the grammar of a foreign Hayden, Sarah Edwards, and Cee Pike, who ably managed
language, it is the possession of a rich vocabulary that the complex physical construction of this project. Our artist,
permits one to communicate with speakers of that tongue. Todd Smith, worked closely with us to ensure a first-rate art
The second part of this textbook, Chapters 10–23, utilizes the program, and Dr Scott Thompson wrote the clinical cases that
vocabulary of the first part to detail information concerning begin and close each chapter.
the various pathways and discrete systems that act in concert Additionally, we would like to thank the many reviewers
to perform the myriad of functions of the human nervous who commented on the manuscript in its development. Dr
system. Robert Sikes, in particular, was an invaluable reviewer, who
Special featuresinclude: provided specific and thorough comments on many draft
chapters, and the entire art program. We also would like to
• chapter opening outlines that provide a quick overview acknowledge the many helpful comments made by the
of the chapter content and organizational logic; reviewers: Stephen Lahr, Curt Anderson, Melody Harrison,
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PREFACE === ix
Lyn Turkstra, Angela Ciccia, Denise Johnson, Min Yu, John omissions, and shortcomings is ours. In view of that fact,
Stein, Mohammad Jamali, Robert Berry, and Judy Schotland. we welcome criticisms and suggestions for improvement of
Their help was instrumental in the crafting of this book. this text.
And finally, we would like to thank our respective families
for all the time we took away from them in the writing of this Maria A. Patestas ([email protected])
textbook. Leslie P. Gartner ([email protected])
While we appreciate all of the assistance that we received
from our editors and colleagues, the responsibility for errors,
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