A Textbook of Neuroanatomy - M. Patestas, L. Gartner (Blackwell, 2006) WW PDF
Preview A Textbook of Neuroanatomy - M. Patestas, L. Gartner (Blackwell, 2006) WW
·· A Textbook of Neuroanatomy ATOA01 3/17/06 9:53 AM Page i 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 ·· ATOA01 3/17/06 9:53 AM Page ii 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 ·· ATOA01 3/17/06 9:53 AM Page iii © 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 has been 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 ·· ATOA01 3/17/06 9:53 AM Page iv Contents Preface viii Part 1 General Principles of the Nervous System 1 Chapter 1 Introduction to the Nervous System 3 Cells of the nervous system 3 Central nervous system 5 Peripheral nervous system 7 Questions to ponder 9 Chapter 2 Development of the Nervous System 10 Clinical case 10 Early development 11 Neurulation 12 Early development of the spinal cord and brain 18 Development of the spinal cord 19 Development of the brain 21 Clinical considerations 26 Synonyms and eponyms 27 Follow-up to clinical case 27 Questions to ponder 27 Chapter 3 Histophysiology of the Nervous System 28 Clinical case 28 Neurons 29 Neuroglia 35 Generation and conduction of nerve impulses 38 Clinical considerations 42 Synonyms and eponyms 43 Follow-up to clinical case 43 Questions to ponder 43 Chapter 4 Neurotransmitter Substances 44 Clinical case 44 Classification of neurotransmitter substances 47 Clinical considerations 52 Follow-up to clinical case 53 Questions to ponder 53 Chapter 5 Spinal Cord 54 Clinical case 54 Morphology of the spinal cord 55 Internal morphology of the spinal cord 60 Vascular supply of the spinal cord 63 Clinical considerations 66 Synonyms and eponyms 67 Follow-up to clinical case 67 Questions to ponder 67 Chapter 6 Gross Anatomy of the Brain 68 Clinical case 68 Cerebrum 69 Diencephalon 77 Cerebellum 77 Brainstem 80 Clinical considerations 82 Synonyms and eponyms 82 Follow-up to clinical case 82 Questions to ponder 83 Chapter 7 Meninges and Cerebrospinal Fluid 84 Clinical case 84 Cranial meninges 85 Spinal meninges 92 Venous sinuses of the cranial dura mater 93 Cerebrospinal fluid 95 Ventricles of the brain 95 Clinical considerations 97 Synonyms and eponyms 97 Follow-up to clinical case 97 Questions to ponder 98 Chapter 8 Vascular Supply of the Central Nervous System 99 Clinical case 99 Vascular supply of the spinal cord 100 Arterial supply of the brain 101 Venous drainage of the brain 112 Clinical considerations 116 Synonyms and eponyms 117 Follow-up to clinical case 117 Questions to ponder 117 Chapter 9 Autonomic Nervous System 118 Clinical case 118 Sympathetic nervous system 119 Parasympathetic nervous system 126 Enteric nervous system 129 Neurotransmitters and receptors of the autonomic nervous system 130 Pelvic autonomic functions 131 Clinical considerations 132 Synonyms and eponyms 133 Follow-up to clinical case 133 Questions to ponder 133 ·· ATOA01 3/17/06 9:53 AM Page v Part 2 Integrative Components of the Nervous System 135 Chapter 10 Ascending Sensory Pathways 137 Clinical case 137 Sensory receptors 138 Anterolateral system 146 Tactile sensation and proprioception 154 Sensory pathways to the cerebellum 157 Clinical considerations 161 Modulation of nociception 166 Neuroplasticity 168 Synonyms and eponyms 169 Follow-up to clinical case 170 Questions to ponder 170 Chapter 11 Motor Cortex and Descending Motor Pathways 171 Clinical case 171 Cortical areas controlling motor activity 172 Descending motor pathways 174 Clinical considerations 187 Synonyms and eponyms 188 Follow-up to clinical case 189 Questions to ponder 189 Chapter 12 Basal Ganglia 190 Clinical case 190 Components of the basal ganglia 191 Nuclei associated with the basal ganglia 196 Input, intrinsic, and output nuclei of the basal ganglia 196 Connections of the basal ganglia 198 Circuits connecting the basal ganglia, thalamus, and cerebral cortex 205 Other circuits of the basal ganglia 207 Neurotransmitters of the basal ganglia 208 “Direct” and “indirect” loops (pathways) of the basal ganglia 209 Circuits that modulate activity of the basal ganglia 210 Clinical considerations 212 Synonyms and eponyms 217 Follow-up to clinical case 218 Questions to ponder 218 Chapter 13 Cerebellum 219 Clinical case 219 Morphology of the cerebellum 220 Cerebellar peduncles 227 Deep cerebellar nuclei 229 Afferents (input) to the cerebellum 231 Efferents (output) from the cerebellum 235 Functional organization of the cerebellum: intrinsic circuitry 236 Clinical considerations 238 Synonyms and eponyms 240 Follow-up to clinical case 240 Questions to ponder 240 Chapter 14 Reticular Formation 241 Clinical case 241 Morphology of the reticular formation 241 Zones of the reticular formation 242 Nuclei associated with the reticular formation 245 Input to and output from the reticular formation 245 Functions of the reticular formation 245 Clinical considerations 250 Synonyms and eponyms 251 Follow-up to clinical case 251 Questions to ponder 252 Chapter 15 Cranial Nerves 253 Clinical case 253 Olfactory nerve (CN I) 256 Optic nerve (CN II) 256 Oculomotor nerve (CN III) 258 Trochlear nerve (CN IV) 260 Trigeminal nerve (CN V) 261 Abducent nerve (CN VI) 266 Facial nerve (CN VII) 268 Vestibulocochlear nerve (CN VIII) 272 Glossopharyngeal nerve (CN IX) 272 Vagus nerve (CN X) 274 Spinal accessory nerve (CN XI) 277 Hypoglossal nerve (CN XII) 277 Synonyms and eponyms 280 Follow-up to clinical case 280 Questions to ponder 281 Chapter 16 Visual System 282 Clinical case 282 Eye 282 Central visual pathways 287 Visual reflexes 291 Clinical considerations 298 Synonyms and eponyms 302 Follow-up to clinical case 302 Questions to ponder 303 Chapter 17 Auditory System 304 Clinical case 304 Ear 304 Auditory transmission 308 Central auditory pathways 309 Clinical considerations 315 Synonyms and eponyms 316 Follow-up to clinical case 316 Questions to ponder 317 Chapter 18 Vestibular System 318 Clinical case 318 Vestibular apparatus 319 Vestibular nerve (CN VIII) 325 Central pathways of the vestibular system 326 Control of ocular movements 329 Vestibular nystagmus 332 Caloric nystagmus 334 vi === CONTENTS ·· ATOA01 3/17/06 9:53 AM Page vi Synonyms and eponyms 334 Follow-up to clinical case 334 Questions to ponder 335 Chapter 19 Olfactory System 336 Clinical case 336 Olfactory receptor cells 336 Olfactory transduction 338 Olfactory nerve (CN I) 338 Central connections of the olfactory system 339 Clinical considerations 342 Synonyms and eponyms 342 Follow-up to clinical case 342 Questions to ponder 343 Chapter 20 Limbic System 344 Clinical case 344 Limbic lobe 345 Brainstem centers associated with limbic system function 355 Pathways of the limbic system 356 Clinical considerations 358 Synonyms and eponyms 359 Follow-up to clinical case 359 Questions to ponder 360 Chapter 21 Hypothalamus 361 Clinical case 361 Borders 362 Hypothalamic zones and component nuclei 362 Hypothalamic regions (areas) and component nuclei 368 Connections of the hypothalamus 370 Pathways of the hypothalamus 370 Functions of the hypothalamus 374 Hypothalamohypophyseal connections 376 Clinical considerations 382 Synonyms and eponyms 383 Follow-up to clinical case 383 Questions to ponder 384 Chapter 22 Thalamus 385 Clinical case 385 Borders 385 Anatomy 385 Internal and external medullary laminae 388 Thalamic nuclei 389 Clinical considerations 395 Synonyms and eponyms 396 Follow-up to clinical case 396 Questions to ponder 397 Chapter 23 Cerebral Cortex 398 Clinical case 398 Cells of the cerebral cortex 400 Types of cortex 402 Cell layers of the neocortex 402 Vertical columnar organization of the cerebral cortex 404 Afferents (input) to the cerebral cortex 404 Efferents (output) from the cerebral cortex 404 Internal capsule and corona radiata 406 Lobes of the cerebral cortex 408 Functional areas of the cerebral cortex 408 Cerebral dominance 417 Clinical considerations 417 Synonyms and eponyms 421 Follow-up to clinical case 422 Questions to ponder 423 Questions to ponder: answers to odd questions 425 Index 435 CONTENTS === vii ·· ATOA01 3/17/06 9:53 AM Page vii Preface This Textbook of Neuroanatomy was written with the student in mind in full knowledge of the apprehension with which he or she faces the prospect of learning a subject matter that frequently intimidates the student population. The material appears daunting, not only due to its very nature of being associated with polysyllabic words, but also because there are so many eponyms and synonyms for the myriad of terms that are necessary for the proper description of the nervous system. The good news is that neuroanatomy is simply being maligned by its nefarious reputation, for it is a logical, relat- ively benign subject, whose comprehension does not require Einsteinian brilliance, but merely a willingness to learn the meaning of a large fistful of new words and the ability to read a map and follow it from one place to another. In order to help the student easily achieve the goal of learning neuro- anatomy we made this textbook complete, concise, yet easy to read, and well illustrated with many schematic diagrams to expound upon the concepts being discussed. Presenting the material in a relevant context will make the learning experience simpler, more enjoyable, and more memorable. We envisioned writing a book that was accessible and clear—one that students would not have to wade through in order to discern key information of human neuroanatomy. We have also highlighted the interrelationships between sys- tems, structures, and the rest of the body as we go through 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 get bogged down memorizing structures but instead learn the principles. This conceptual basis of the “big picture” helps establish the foundation for future studies in the health sciences and for the logic that helps drive it. The text is divided into two sections. The first nine chap- ters provide an overview of neuroanatomy that introduces terms, and should be viewed as the vocabulary lessons which are necessary evils in the mastering of a new language. For no matter how well one understands the grammar of a foreign language, it is the possession of a rich vocabulary that permits one to communicate with speakers of that tongue. The second part of this textbook, Chapters 10–23, utilizes the vocabulary of the first part to detail information concerning the various pathways and discrete systems that act in concert to perform the myriad of functions of the human nervous system. Special features include: • chapter opening outlines that provide a quick overview of the chapter content and organizational logic; • clinical cases open each chapter, setting the stage for the relevance of that chapter’s context; • key points in the chapter are highlighted in the text; • clinical case questions indicate the relevance of the chap- ter opening case at key points in the chapter—the answers appear on the related website; • summary tables within each chapter function as study guides to assist students in learning and memorizing; • clinical considerations sections indicate the medical con- ditions relevant to the chapter topics; • synonym/eponym tables help organize the many possi- ble terms for each vocabulary word; • a follow-up to each clinical case is given at the end of each chapter and discusses the opening case, helping tie together the text and its medical application; • questions to ponder at the end of each chapter reinforce the relevance of the material, with the answers to even questions given on the website and the answers to odd questions appearing at the end of the book; • an accompanying website includes all the illustrations, the even answers for questions to ponder, and all the answers for clinical case questions. It also features anima- tions of key processes and links to useful sources. The site can be found at www.blackwellpublishing.com/patestas. An instructor’s CD-ROM version is also available. ACKNOWLEDGMENTS We would like to thank the many individuals who helped us bring this project to fruition, including our editors at Blackwell Publishing: Nancy Whilton, our publisher, who signed and oversaw the publishing process; Elizabeth Frank, our assistant editor, who managed the flow and review of multiple drafts; our desk editor, Jane Andrew, who scrut- inized the fine detail; and our production editors Rosie Hayden, Sarah Edwards, and Cee Pike, who ably managed the complex physical construction of this project. Our artist, Todd Smith, worked closely with us to ensure a first-rate art program, and Dr Scott Thompson wrote the clinical cases that begin and close each chapter. Additionally, we would like to thank the many reviewers who commented on the manuscript in its development. Dr Robert Sikes, in particular, was an invaluable reviewer, who provided specific and thorough comments on many draft chapters, and the entire art program. We also would like to acknowledge the many helpful comments made by the reviewers: Stephen Lahr, Curt Anderson, Melody Harrison, ·· ATOA01 3/17/06 9:53 AM Page viii Lyn Turkstra, Angela Ciccia, Denise Johnson, Min Yu, John Stein, Mohammad Jamali, Robert Berry, and Judy Schotland. Their help was instrumental in the crafting of this book. And finally, we would like to thank our respective families for all the time we took away from them in the writing of this textbook. While we appreciate all of the assistance that we received from our editors and colleagues, the responsibility for errors, omissions, and shortcomings is ours. In view of that fact, we welcome criticisms and suggestions for improvement of this text. Maria A. Patestas (
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