Textbook of neuroanatomy

547 Pages·1969·126.016 MB·English

by  Elliott, Harry Chandler

A Textbook of Neuroanatomy
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
A Textbook of Neuroanatomy
Second Edition
Maria A. Patestas
Professor of Anatomy
Department of Anatomy
Des Moines University
Des Moines, Iowa
Leslie P. Gartner
Professor of Anatomy (retired)
Department of Biomedical Sciences
Baltimore College of Dental Surgery
Dental School
University of Maryland at Baltimore
Baltimore, Maryland
Copyright © 2016 by John Wiley & Sons, Inc. All rights reserved
Published by John Wiley & Sons, Inc., Hoboken, New Jersey
Published simultaneously in Canada
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, scanning, or otherwise, except as
permitted under Section 107 or 108 of the 1976 United States Copyright Act, without either the prior written
permission of the Publisher, or authorization through payment of the appropriate per-copy fee to the
Copyright Clearance Center, Inc., 222 Rosewood Drive, Danvers, MA 01923, [phone], fax (978) 750­
4470, or on the web at www.copyright.com. Requests to the Publisher for permission should be addressed
to the Permissions Department, John Wiley & Sons, Inc., 111 River Street, Hoboken, NJ 07030, [phone],
fax [phone], or online at http://www.wiley.com/go/permission.
Limit of Liability/Disclaimer of Warranty: While the publisher and author have used their best efforts
in preparing this book, they make no representations or warranties with respect to the accuracy
or completeness of the contents of this book and specifically disclaim any implied warranties of
merchantability or fitness for a particular purpose. No warranty may be created or extended by sales
representatives or written sales materials. The advice and strategies contained herein may not be suitable
for your situation. You should consult with a professional where appropriate. Neither the publisher nor
author shall be liable for any loss of profit or any other commercial damages, including but not limited to
special, incidental, consequential, or other damages.
For general information on our other products and services or for technical support, please contact our
Customer Care Department within the United States at [phone], outside the United States at (317) 572­
3993 or fax [phone].
Wiley also publishes its books in a variety of electronic formats. Some content that appears in print may not
be available in electronic formats. For more information about Wiley products, visit our web site at
www.wiley.com.
Library of Congress Cataloging-in-Publication Data
Names: Patestas, Maria Antoniou, author. | Gartner, Leslie P., 1943- , author.
Title: A textbook of neuroanatomy / Maria A. Patestas, Leslie P. Gartner.
Description: Second edition. | Hoboken, New Jersey : John Wiley & Sons Inc.,
[2016] | Includes index.
Identifiers: LCCN 2015039616 | ISBN 9781118677469 (pbk.)
Subjects: | MESH: Nervous System–anatomy & histology.
Classification: LCC QM451 | NLM WL 101 | DDC 611.8–dc23 LC record available at
http://lccn.loc.gov/2015039616
10 9 8 7 6 5 4 3 2 1
Contents

Preface viii
Chapter 7 Brainstem 95

About the Companion Website x
Internal Organization of the Brainstem 95

Medulla 99

Part I General principles of the nervous system 1
Pons 105

Midbrain 110

Chapter 1 Introduction to the Nervous System 3
Synonyms and Eponyms of the Brainstem 119

Cells of the Central Nervous System 5
Questions to Ponder 119

Central Nervous System 5

Peripheral Nervous System 8
Chapter 8 Meninges and Cerebrospinal Fluid 120

Questions to Ponder 9
Cranial Meninges 121

Spinal Meninges 128

Chapter 2 Development of the Nervous System 10
Venous Sinuses of the Cranial Dura Mater 129

Early Development 11
Cerebrospinal Fluid 133

Neurulation 13
Ventricles of the Brain 133

Early Development of the Spinal Cord and Brain 18
Synonyms and eponyms of the Nervous System 135

Development of the Spinal Cord 20
Questions to Ponder 135

Development of the Brain 22

Synonyms and Eponyms of the Nervous System 29
Chapter 9 Vascular Supply of the Central

Questions to Ponder 29
Nervous System 136

Vascular Supply of the Spinal Cord 137

Chapter 3 Histophysiology of the Nervous System 30
Arterial Supply of the Brain 138

Neurons 31
Venous Drainage of the Brain 151

Neuroglia 38
Synonyms and Eponyms of the Vascular Supply of the

Generation and conduction of Nerve Impulses 42
Central Nervous System 155

Synonyms and Eponyms of Nervous System
Questions to Ponder 155

Histopathology 46

Questions to Ponder 46
Chapter 10 Autonomic Nervous System 156

Sympathetic Nervous System 159

Chapter 4 Neurotransmitter substances 47
Parasympathetic Nervous System 166

Classification of Neurotransmitter Substances 50
Enteric Nervous System 169

Questions to Ponder 57
Neurotransmitters and Receptors of the Autonomic

Nervous System 170

Chapter 5 Spinal cord 58
Pelvic Autonomic Functions 171

Morphology of the Spinal Cord 59
Synonyms and Eponyms of the Autonomic

Internal Morphology of the Spinal Cord 65
Nervous System 174

Questions to Ponder 174

Vascular Supply of the Spinal Cord 68

Synonyms and Eponyms of the Spinal Cord 72

Chapter 11 Spinal Reflexes 175

Questions to Ponder 72

Components of Reflexes 175

Chapter 6 Gross Anatomy of the Brain 73
Lower Motoneurons 176

Skeletal Muscle Innervation 177

Cerebrum 74

Skeletal Muscle Receptors 177

Diencephalon 85

Muscle Stretch Reflex 179

Cerebellum 86

Reciprocal Inhibition 179

Brainstem 89

Autogenic Inhibition (Inverse Myotatic Reflex) 180

Synonyms and Eponyms of the Brain 94

Flexor Reflex (Withdrawal Reflex, Nociceptive Reflex) 180

Questions to Ponder 94
vi ● ● ● CONTENTS
Crossed Extension Reflex 181
Nuclei Associated with the Reticular Formation 307

Maintenance of Muscle Tone via the Gamma Loop 181
Input to and Output from the Reticular Formation 307

Alpha-Gamma Coactivation 182
Functions of the Reticular Formation 308

Synonyms and Eponyms of the Spinal Reflexes 184
Synonyms and Eponyms of the Reticular Formation 314

Questions to Ponder 184
Questions to Ponder 314

Part II Integrative Components of the Nervous
Chapter 17 Cranial Nerves 315

System 185
Olfactory Nerve (CN I) 320

Optic Nerve (CN II) 320

Oculomotor Nerve (CN III) 321

Chapter 12 Ascending sensory Pathways 187

Trochlear Nerve (CN IV) 323

Sensory Receptors 188

Trigeminal Nerve (CN V) 325

Anterolateral System 197

Abducent Nerve (CN VI) 332

Tactile Sensation and Proprioception 207

Facial Nerve (CN VII) 336

Sensory Pathways to the Cerebellum 212

Vestibulocochlear Nerve (CN VIII) 338

Modulation of Nociception 224

Glossopharyngeal Nerve (CN IX) 339

Neuroplasticity 226

Vagus Nerve (CN X) 342

Synonyms and Eponyms of the Ascending Sensory

Spinal Accessory Nerve (CN XI) 345

Pathways 226

Hypoglossal Nerve (CN XII) 346

Questions to Ponder 227

Synonyms and Eponyms of the Cranial Nerves 348

Questions to Ponder 349

Chapter 13 Motor Cortex and Descending Motor

Pathways 228

Chapter 18 Visual System 350

Cortical Areas Controlling Motor Activity 229

Eye 350

Descending Motor Pathways 231

Central Visual Pathways 355

Synonyms and Eponyms of the Motor Cortex and

Visual Reflexes 365

Descending Motor Pathways 248

Synonyms and Eponyms of the Visual System 375

Questions to Ponder 249

Questions to Ponder 375

Chapter 14 Basal Nuclei 250

Chapter 19 Auditory System 376

Components of the Basal Nuclei 251

Ear 376

Nuclei Associated with the Basal Nuclei 255

Auditory Transmission 381

Input, Intrinsic, and Output Nuclei of the

Basal Nuclei 257
Central Auditory Pathways 383

Connections of the Basal Nuclei 259
Synonyms and eponyms of the Auditory System 391

Circuits Connecting the Basal Nuclei, Thalamus, and
Questions to Ponder 391

Cerebral Cortex 265

Other Circuits of the Basal Nuclei 267
Chapter 20 Vestibular System 392

Neurotransmitters of the Basal Nuclei 268
Vestibular Apparatus 393

“Direct” and “Indirect” Loops (Pathways) of the Basal
Vestibular Nerve (CN VIII) 399

Nuclei 270
Central Pathways of the Vestibular System 400

Circuits that Modulate Activity of the Basal Nuclei 271
Control of Ocular Movements 403

Synonyms and Eponyms of the Basal Nuclei 277
Vestibular Nystagmus 406

Questions to Ponder 278
Caloric Nystagmus 408

Synonyms and Eponyms of the Vestibular System 409

Chapter 15 Cerebellum 279
Questions to Ponder 410

Morphology of the Cerebellum 281

Cerebellar Peduncles 289
Chapter 21 Olfactory System 411

Deep Cerebellar Nuclei 291
Olfactory Receptor Cells 412

Afferents (Input) to the Cerebellum 292
Olfactory Transduction 412

Efferents (Output) from the Cerebellum 296
Olfactory Nerve (CN I) 414

Functional Organization of the Cerebellum: Intrinsic
Central Connections of the Olfactory System 415

Circuitry 298
Synonyms and Eponyms of the Olfactory System 418

Synonyms and Eponyms of the Cerebellum 302
Questions to Ponder 419

Questions to Ponder 302

Chapter 22 Limbic System 420

Chapter 16 Reticular Formation 303
Limbic Lobe 421

Morphology of the Reticular Formation 304
Brainstem Centers Associated with Limbic

Zones of the Reticular Formation 305
System Function 432
CONTENTS ● ● ● vii
Pathways of the Limbic System
432 Thalamic Nuclei 469

Limbic Association Cortex
435 Synonyms and Eponyms of the Thalamus 477

Limbic System Input to the Endocrine, Autonomic,
Questions to Ponder 478

and Somatic Motor Systems
435
Synonyms and Eponyms of the Limbic System
437 Chapter 25 Cerebral Cortex 479

Questions to Ponder
438 Cells of the Cerebral Cortex 481

Types of Cortex 483

Chapter 23 Hypothalamus
439 Cell layers of the Neocortex 484

Borders
440 Vertical Columnar Organization of the Cerebral Cortex 485

Hypothalamic Zones and Component Nuclei
441 Afferents (Input) to the Cerebral Cortex 485

Hypothalamic Regions (areas) and Component Nuclei 446
Efferents (Output) from the Cerebral Cortex 486

Connections of the Hypothalamus
448 Internal Capsule and Corona Radiata 489

Pathways of the Hypothalamus
449 Lobes of the Cerebral Cortex 489

Functions of the Hypothalamus
452 Functional Organization of the Cerebral Cortex 490

Hypothalamohypophyseal Connections
455 Cerebral Dominance 498

Synonyms and Eponyms of the Hypothalamus
462 Synonyms and Eponyms of the Cerebral Cortex 504

Questions to Ponder
463 Questions to Ponder 506

Chapter 24 Thalamus
465 Questions to Ponder: Answers to Odd Questions 507

Borders
465
Anatomy
467 Index 517

Internal and External Medullary Laminae
468
Preface to the Second Edition

It is always gratifying to publish the second edition of a text­ it is the possession of a rich vocabulary that permits one to
book because it is an indication that our efforts were well communicate with speakers of that tongue. The second part
received, that our colleagues endorsed our work, and that of this textbook, Chapters 12–25, utilizes the vocabulary of
students have been well served by it. This new edition of the first part to detail information concerning the various
the Textbook of Neuroanatomy, as indeed was the first, was pathways and discrete systems that act in concert to
written with the student in mind in full knowledge of the perform the myriad of functions of the human nervous
trepidation with which he or she faces the prospect of learn­ system.
ing a subject matter that appears to be daunting and intimi­ We retained in this edition the well-liked special features,
dating. The material appears overwhelming because of the which include:
many eponyms that have been retained and add to the in­
herent complexity of the nervous system. Happily, for the • chapter opening outlines that provide a quick overview of
student the reports of being an overwhelming subject is an the chapter content and organizational logic;
unjust reputation, for neuroanatomy is a fascinating topic, • clinical cases in the beginning of each chapter, setting the
whose comprehension does not require amazing brilliance, stage for the relevance of that chapter’s context;
but merely a willingness to learn new words, the aptitude • key points in the chapter that are highlighted in the text;
for reading maps, and following pathways from one place to • clinical case questions that emphasize the relevance of the
another. In order to help the student more easily achieve chapter opening case at key points in the chapter – the
the goal of learning neuroanatomy we made this textbook answers appear on the related website;
complete, concise, yet easy to read, and well-illustrated • summary tables within each chapter that function as study
with many schematic diagrams to expound upon the con­ guides to assist students in learning and memorizing;
cepts being discussed. Presenting the material in a relevant • clinical considerations that underscore the medical condi­
context will make the learning experience simpler, more tions relevant to the topics;
enjoyable, and more memorable. • synonym/eponym tables that help organize the many
Every chapter of this edition was revised to include possible terms for each vocabulary word;
current material and to make it even easier to read than the • a follow-up to each clinical case at the end of each chapter
first edition. Two new chapters were added, one concerning that discusses the opening case, helping to correlate the
the Brainstem (Chapter 7) and the other Spinal Reflexes text and its medical application;
(Chapter 11), in order to stress the importance of those • questions to ponder at the end of each chapter to rein­
two topics and to enhance the student’s understanding of force the relevance of the material, with the answers to
their significance in the functioning of the central nervous even-numbered questions given on the website and the
system. answers to odd-numbered questions appearing at the end
We continued to highlight the interrelationships between of the book;
systems, structures, and the rest of the body as we describe the • an accompanying website that includes all the illustrations,
various regions of the brain. We think a broad understanding the even answers for questions to ponder, and all the an­
of neuroanatomy, supported with a basic understanding of swers for clinical case questions. It also features animations
its physiology, is critical so that students instead of merely of key processes and links to useful sources. The site can be
memorizing structures learn the principles thus establishing found at www.wiley.com/go/patestas/neuroanatomy2e.
the foundation for future studies in the health sciences and
for the logical forces that help drive it.
As with the first edition, this textbook is divided into ACKNOWLEDGMENTS
two sections. The first 11 chapters provide an overview
of neuroanatomy that introduces terms and should be We would like to thank the many individuals who helped
viewed as the vocabulary lessons that are necessary evils us bring this project to fruition, including our editors at
in the mastering of a new language. For no matter how John Wiley & Sons Publishing: Justin Jeffryes, our Editorial
well one understands the grammar of a foreign language, Director, who signed and oversaw the publishing process;