Netter's Atlas of Neuroscience

455 Pages·2016·67.88 MB·English

by  Felten D.L.

Netter’s
AtlAs of NeuroscieNce
Second Edition
David l. felten, MD, PhD
Vice President, Research
Medical Director of the Research Institute
William Beaumont Hospitals
Royal Oak, MI
Associate Dean for Research
Clinical Research Professor
Oakland University William Beaumont School of Medicine
Rochester, MI
Anil N. shetty, PhD

Chief, MR Physics
Diagnostic Radiology
William Beaumont Hospitals
Royal Oak, MI
Adjunct Assistant Professor of Radiology
Wayne State University School of Medicine
Detroit, MI
Illustrations by

frank H. Netter, MD

Contributing Illustrators
carlos A. G. Machado, MD
James A. Perkins, MS, MFA
John A. craig, MD
1600 John F. Kennedy Blvd.
Ste 1800
Philadelphia, PA 19103-2899
NETTER’S ATLAS OF NEUROSCIENCE ISBN: 978-1-4160-5418-4
Copyright © 2010, 2003 by Saunders, an imprint of Elsevier Inc.
All rights reserved. No part of this book may be produced or transmitted in any form or by any means,
electronic or mechanical, including photocopying, recording or any information storage and retrieval system,
without permission in writing from the publishers.
Permissions for Netter Art figures may be sought directly from Elsevier’s Health Science Licensing Department in
Philadelphia PA, USA: phone [phone], ext. 3276 or [phone]; or email [email protected].
Notice
Neither the Publisher nor the Authors assume any responsibility for any loss or injury and/or damage to
persons or property arising out of or related to any use of the material contained in this book. It is the
responsibility of the treating practitioner, relying on independent expertise and knowledge of the patient, to
determine the best treatment and method of application for the patient.
The Publisher
Previous edition copyrighted 2003
Library of Congress Cataloging-in-Publication Data
Felten, David L.
Netter’s atlas of neuroscience / David L. Felten, Anil N. Shetty ; illustrations by Frank H. Netter ; contributing
illustrators, Carlos A.G. Machado, James A. Perkins, John A. Craig. — 2nd ed.
p. ; cm.
Includes index.
Rev. ed. of: Netter’s atlas of human neuroscience / David L. Felten, Ralph Józefowicz. 1st ed. c2003.
ISBN 978-1-4160-5418-4
1. Nervous system—Atlases. I. Shetty, Anil Narsinha. II. Felten, David L. Netter’s atlas of human neuroscience.
III. Title. IV. Title: Atlas of neuroscience.
[DNLM: 1. Nervous System—anatomy & histology—Atlases. 2. Nervous System Physiological Phenomena—
Atlases. WL 17 F325n 2010]
QM451.F44 2010
612.8022’2—dc22 2009002530
Acquisitions Editor: Elyse O’Grady
Developmental Editor: Marybeth Thiel
Publishing Services Manager: Linda Van Pelt
Project Manager: Sharon Lee
Design Direction: Louis Forgione
Illustrations Manager: Kari Wszolek
Marketing Manager: Jason Oberacker
Printed in Canada
Last digit is the print number: 9 8 7 6 5 4 3 2 1
About the Authors
DAviD l. felteN, MD, PhD is Vice President for Research and Medical Director
of the Research Institute at William Beaumont Hospitals in Royal Oak, Michigan. He also is
the Associate Dean for Research at Oakland University William Beaumont School of Medi-
cine, a newly created allopathic medical school in Oakland County, Michigan. He previously
served as Dean of the School of Graduate Medical Education at Seton Hall University in South
Orange, NJ; the Founding Executive Director of the Susan Samueli Center for Integrative
Medicine; and Professor of Anatomy and Neurobiology at the University of California, Irvine,
School of Medicine; the Founding Director of the Center for Neuroimmunology at Loma
Linda University School of Medicine in Loma Linda, CA and the Kilian J. and Caroline F.
Schmitt Professor and Chair of the Department of Neurobiology & Anatomy; and Director
of the Markey Charitable Trust Institute for Neurobiology of Neurodegenerative Diseases and
Aging, at the University of Rochester School of Medicine in Rochester, NY. He received a
BS from MIT and an MD and PhD from the University of Pennsylvania. Dr. Felten carried
out pioneering studies of autonomic innervation of lymphoid organs and neural-immune
signaling that underlies the mechanistic foundations for psychoneuroimmunology and many
aspects of integrative medicine.
Dr. Felten is the recipient of numerous honors and awards, including the prestigious John D.
and Catherine T. MacArthur Foundation Prize Fellowship, two simultaneous NIH MERIT
Awards from the National Institutes of Mental Health and the National Institute on Aging,
an Alfred P. Sloan Foundation Fellowship, an Andrew W. Mellon Foundation Fellowship, a
Robert Wood Johnson Dean’s Senior Teaching Scholar Award, the Norman Cousins Award
in Mind-Body Medicine, the Building Bridges of Integration Award from the Traditional
Chinese Medicine World Foundation, and numerous teaching awards.
Dr. Felten co-authored the definitive scholarly text in the field of neural-immune
interactions, Psychoneuroimmunology (Academic Press, 3rd edition, 2001), and was the found-
ing co-editor of the major journal in the field, Brain, Behavior and Immunity, with Drs. Robert
Ader and Nicholas Cohen of the University of Rochester. Dr. Felten is the author of over
210 peer-reviewed journal articles and reviews, many on links between the nervous system
and immune system. His work has been featured on Bill Moyer’s PBS series and book, Heal-
ing and the Mind, on “20/20,” BBC’s “Worried Sick,” and many other programs on U.S.,
Canadian, Australian, and German National Public Television. He served for over a decade on
the National Board of Medical Examiners, including Chair of the Neurosciences Committee
for the U.S. Medical Licensure Examination.
Dr. Felten also has an active role in business activities related to medical science. He cur-
rently serves as Chairman of the Scientific and Medical Advisory Boards of The Medingen
Group and Clerisy Corp. He enjoys fostering clinical translational research and clinical trials
that advance the quality and standard of care for challenging clinical diseases, and enjoys
bringing new scientific innovations into the practical realm of product development and
commercialization.
ANil N. sHetty, PhD, is chief of MR Physics in the Department of Radiology
at William Beaumont Hospitals in Royal Oak, Michigan. He also is an Adjunct Assistant
Professor of Radiology at Wayne State University School of Medicine. Prior to joining William
Beaumont Hospitals, Dr. Shetty worked as a scientist in the research and development divi-
sion of Siemens Medical Solutions. He received his MA and PhD from Kent State University,
Kent, Ohio. Subsequently, he received an NIH Fellowship to continue postdoctoral work in
magnetic resonance imaging in the Department of Radiology of University of Pennsylvania,
Philadelphia, PA. He also held an Assistant Professor of Physics position at Hunter College of
City University of New York.
Dr. Shetty has been very active in the field of MRI, with over 50 peer-reviewed publications
and 3 patents. He has authored and co-authored chapters in several books. He is the vice presi-
dent of a start-up company, magneticmoments, LLC, that is developing and marketing one
of the intellectual properties for which he holds the key patent. Currently, he spends time in
clinical research in cardiovascular and neurovascular areas and teaches residents and fellows
at William Beaumont about magnetic resonance imaging.

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In memory of Walle J.H. Nauta, MD, PhD, Institute Professor
of Neuroscience at the Massachusetts Institute of Technology in
Cambridge, MA.
A distinguished, brilliant, and pioneering neuroscientist
An outstanding and inspirational teacher
A kind, supportive, insightful, and gracious mentor
An incredible role model and human being
and
To my wife, Mary (Maida) Felten, PhD
A wonderful wife, partner, and friend
My inspiration and motivation
A superb researcher, teacher, scientific innovator, and CEO
A woman who has it all—brains, beauty, kindness,
and accomplishment.
David L. Felten
In memory of Jalil Farah, MD, Chairman of the Department
of Radiology (1962–1996), William Beaumont Hospital, Royal
Oak, MI.
An outstanding and inspirational teacher and a visionary who had
the prudence to start an imaging center dedicated to basic MRI
research and development, in addition to routine clinical support.
His kind support and encouragement have been a tremendous source
of inspiration to me.
and
To Renu, a wonderful wife and a great partner, whose silent sacrifice
of nights and weekends allowed me to achieve our goal.
To my children, Nikhil, Rohan, and Tushar: I hope your lives will be
enriched by realizing your dreams, as mine has been.
Anil N. Shetty, Ph.D.
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Acknowledgments
For decades, Dr. Frank Netter’s beautiful and informative artwork has provided the visual
basis for understanding anatomy, physiology, and relationships of great importance in
medicine. Generations of physicians and health care professionals have “learned from
the master” and have carried Dr. Netter’s legacy forward through their own knowledge
and contributions to patient care. There is no way to compare Dr. Netter’s artwork to
anything else, because it stands in a class of its own. For many decades, the Netter Collec-
tion volume on the Nervous System has been a flagship for the medical profession and for
students of neuroscience. It was a great honor to provide the framework, organization,
and new information for the updated first edition of Netter’s Atlas of Human Neuroscience
and now, the second edition of Netter’s Atlas of Neuroscience. The opportunity to make a
lasting contribution to the next generations of physicians and health care professionals is
perhaps the greatest honor anyone could receive.
I also gratefully acknowledge Walle J.H. Nauta, MD, PhD, whose inspirational teach-
ing of the nervous system at MIT contributed to the organizational framework for this
Atlas. Professor Nauta always emphasized the value of an overview; the plates in the be-
ginning of Section II, Regional Neurosciences, on the conceptual organization of sensory,
motor, and autonomic systems especially reflect his approach. I am particularly honored
to contribute to the updated Netter Atlas of Neuroscience because I first learned neuro-
sciences as an undergraduate in Professor Nauta’s laboratory at MIT through his personal
mentorship, masterful insights, and explanations—using the first Nervous System “green
book” volume by Dr. Frank Netter. It is my hope that continuing generations of students
can benefit from the legacy of this wonderful teacher and great scientist.
I thank the outstanding artists, Jim Perkins, MS, MFA,. and John Craig, MD, for their
clear and beautiful contributions to the first edition of this revised Atlas, now continuing
in the second edition. Special thanks go to the outstanding editors at Elsevier: Marybeth
Thiel, Senior Developmental Editor, and Elyse O’Grady, Editor, Netter Products. They
helped to guide the process of the second edition and gave us the latitude to introduce
new components, such as the imaging plates and the clinical correlations. I also would
like to acknowledge my friend, colleague, and co-author on this atlas, Dr. Anil Shetty.
We spent many delightful hours of conversation and viewing of spectacular 3D images
and video sequences of images at Beaumont’s Imaging Center. His contributions to this
atlas and to the excellence of imaging at Beaumont for our many thousands of patients
are deeply appreciated.
And finally, to my wife, Mary—I again thank you for your unwavering support and
encouragement to continue this challenging project, and for your patience with the long
hours and the clutter of papers and folders you tolerated along the way. Just when you
thought the task was completed with the first edition, I launched into the Netter Neuro-
sciences Flash Cards, and now the second edition of this atlas. Your love and support are
deeply appreciated.
David L. Felten
First, I offer thanks to David Felten, MD, PhD, for suggesting that I collaborate with
him on this project. Second, I have deepest gratitude for the support I received from
my esteemed colleagues and predecessors in the Department of Radiology. In particu-
lar, I would like to thank Kenneth Matasar, MD, chairman, for being very supportive
in my research efforts, and chief of Neuroradiology, Ay-Ming Wang, MD, for supporting
me with many explanations of anatomic structures as seen in MRI. I am indebted to Ko-
staki Bis, MD, for many years of steady collaboration in many research projects; and Ali
Shirkhoda, MD, for supporting and encouraging me in many areas of imaging. Finally, I
am grateful to my wife, Renu, for her unconditional love, support, and understanding in
putting up with my nights and weekends spent working for most of my professional life.
Anil N. Shetty
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PPrreeffAAccee
As in the first edition, Netter’s Atlas of Neuroscience, 2nd Edition, combines the rich-
ness and beauty of Dr. Frank Netter’s illustrations with key information about the
many regions and systems of the brain, spinal cord, and periphery.
The first edition included cross-sectional illustrations through the spinal cord
and brain stem, as well as coronal and axial (horizontal) sections. The second
edition builds on the first edition, with several additional illustrations and exten-
sive new imaging utilizing computed tomography (CT), magnetic resonance imaging
(MRI), both T1- and T2-weighted, position emission tomography (PET) scanning,
functional MRI (fMRI), and diffusion tensor imaging (DTI), which provides pseu-
docolor images of central axonal commissural, association, and projection path-
ways. Full-plate MRIs have been included for direct side-by-side comparisons with
Dr. John Craig’s illustrations of the brain stem cross sections, axial (horizontal)
sections, and coronal sections.
More than 200 “clinical boxes” have been added to offer succinct clini-
cal discussions of the functional importance of key topics. These clinical discus-
sions are intended to assist the reader in bridging the anatomy and physiology
depicted in each relevant plate to important related clinical issues.
The second edition retains the organization of the first edition (I: Overview; II:
regional Neuroscience; III: Systemic Neuroscience), but further breaks these three
sections into component chapters for ease of use. Consistent with the first edition,
we have provided succinct figure legends to point out some of the major functional
aspects of each illustration, particularly as they relate to problems that a clinician may
encounter in the assessment of a patient with neurological symptoms. We believe that
it is important for an atlas of the depth and clarity of Netter’s Atlas of Neuroscience,
2nd Edition to let the illustrations provide the focal point for learning, not long and
detailed written explanations that constitute a full textbook in itself. However, the
figure legends, combined with the excellent illustrations and the additional clinical
discussions, provide content for a thorough understanding of the basic components,
organization, and functional aspects of the region or system under consideration.
Netter’s Atlas of Neuroscience, 2nd Edition provides a comprehensive view of the
entire nervous system, including the peripheral nerves and their target tissues, the
central nervous system, the ventricular system, the meninges, the cerebral vascu-
lar system, developmental neuroscience, and neuroendocrine regulation. We have
provided substantial but not exhaustive details and labels so that the reader can
understand the basics of human neuroscience, including the neural information usu-
ally presented in neuroscience courses, the nervous system components of anatomy
courses, and neural components of physiology courses in medical schools.
We are confronted with an era of rapid change in health care and exploding
knowledge in all fields of medicine, particularly with the revolution in molecular
biology. Medical schools are under enormous pressure to add many new areas of
instruction to the undergraduate medical curriculum, including cultural and social
aspects, business and economic aspects, robotics, simulation science, nanotechnol-
ogy, molecular biology (genomics, proteomics, and other new “-omics”), patient-
centered medicine, team building and treatment approaches, preventive medicine and
wellness, complementary and alternative medicine, and a seemingly endless array of
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