GEOR RGETOWN NUNIVER RSITYMED DICALSCH HOOLGR RADUATEEDUCATI TION INTRO ODUCTIO ONTONEU UROSCIENCE LABORA ATORYMA ANUAL

SPR RING201 13

Prepare edbyI.Moc cchettiandM. M Riesenhu uber

TEACHINGFACULTY NAME
Nabil Azzam, Ph.D. Alessia Bachis, Ph.D. Mark Burns, Ph.D. Katherine Conant, MD Hyang-Sook Hoe, Ph.D. Kathleen Maguire-Zeiss, Ph.D. Italo Mocchetti, Ph.D. Charbell Moussa, PhD Josef Rauschecker, Ph.D. William Rebeck, PhD Max Riesenhuber, Ph.D. Michael Ullman, PhD

TITLE
Professor Neuroscience Assistant Professor Assistant Professor Neuroscience Assistant Proifessor Assistant Professor Neuroscience Associate Professor Neuroscience Professor Neuroscience Assistant Professor Professor Professor Associate Professor Neuroscience Professor

OFFICE
WP-08 Research Building EG17C Research Building WP-22A Research Building EP-16 Research Building EP-20 Research Building EP-08A Research Building WP-13 Research Building WP-09B Research Building WP-19 Research Building WP-10 Research Building WP-12 Research Building D237B Building D

EMAIL
[email protected] [email protected] [email protected] [email protected] [email protected] [email protected] [email protected] u [email protected] [email protected] [email protected] [email protected] [email protected]

IntrotoNeuroscienceLabManual2013

INTRODUCTION
The purpose of this laboratory is to provide you handson experience with a variety of human central nervous system (CNS) specimens, and to reinforce the important concepts of the lecture component of the course. These specimens include whole and half brains, brain dissections,plasticembeddedbrainsections,MagneticResonanceImages(MRIs). LABORATORYFORMAT Schedule: You will be assigned to one group (either Tuesday, May 7th or Wednesday, May 8th) who will be using rooms LE2A, LE2B, LF1A, or LF1B of the PreClinical Science Building. These rooms are equipped with safety features to handle human material. The laboratory will start promptly at 1:30 PM, with a brief introduction by a facultymember. About 3:40 PM, you will work with the instructor to review/solve the four questions listed at the end of this lab manual. LaboratoryRules: Eating and drinking are not permitted in the labs. Shoes should be closed (no sandals, flipflops,etc).Anyonenotwearingappropriateshoeswillbesentawaytochange. UsingtheLaboratoryMaterial: The brains are stored in plastic containers of fixative (50% alcohol). Wash the brains before you use them, and replace them in the containers once you are done with them. You shouldonly handle the brains if you are wearing gloves. Don'tforgettoclose the lid on the brainbucketafterremovingthebrain. AdditionalmaterialstobeusedareglassslidesinthewoodenboxandMRIsondisplayon the light box. Special dissections will be presented by the instructors. If you need to review specimensoutsidenormallaboratorytimespleasecontactthedirectorsofthecourse. Requiredtext There is no required text for this lab. This is why the manual contains several pictures taken from specimens used in the lab. In addition, BACC in the library has several different types of teaching aids that are available to help in learning the material that we cover in the laboratory. The Neuroscience Department together with the Library have developed a web sitecontainingmostoftheslidesandMRIusedinthelaboratoryinwhichnucleiandtractsare labeled. We encourage you to use the sets of glass slides provided. You can find this site on page of the Library: the Educational Software http://www8.georgetown.edu/dml/educ/neurolab/frameset.html (best viewed with Internet Explorer).SectionsthatarepresentedinthislaboratoryarelabeledGT. In addition to the Library Web Site, and to provide self directed guides for learning the three dimensional organization of the CNS, other material will be available on the library reserveshelforpostedonBlackboard.

IntrotoNeuroscienceLabManual2013

LABORATORYMANUAL
We encourage you to read this manual before class. The manual is devided into 7 sectionsthatprovideadetaileddescriptionofhowtolocalize/identifyagivenstructure.Each section contains figures of actual specimens that are labeled to help you in the identification. Please be aware that specimens in your bucket could be different from the figures of this manual. Therefore, compare your specimens with those of other tables, both to appreciate the variability between different brains and to find structures which may be missing on your specimens. Discuss questions that arise within your group. Your participation is essential in order to learn the material. If you need more help, ask a member of staff. There are no navequestionsinneuroanatomy! At the end of the manual you will find an appendix containing a description of the two main pathways that you need to study after the laboratory. This section is labeled independent studies because we believe that you can do it without the instructors. These pathways are important for the overall development of a 3D view of the brain and to appreciate how neuroanatomy can help clinicians in the diagnosis of neurological disorders. Theappendixalsocontainspotentialexamquestionsthatwillbereviewedwiththeinstructor attheendofthelaboratory.Athirdappendixincludesadescriptionofthebasicprinciplesof MRI. Although you are not going to be tested on these principles, a basic comprehension of howMRIworksisnecessary. Laboratoryexam There will be no exam for the lab. However, the final exam will contain at least four questionsbasedonthematerialthatyouhavelearnedinthelab.Unlessotherwiseindicated, all terms/structures in BOLD in this manual are examinable. For your convenience we have listedthenamesofstructuresthatmustbelearned. Listoftermstobelearned (inalphabeticalorder) abducensnerve accessorynerve agnosia tactile,visual Alzheimersdisease amydgala angulargyrus anteriorcommissure basalforebrain basalganglia brainstem Broca'sspeecharea Brodmannareas caudatenucleus centralsulcus IntrotoNeuroscienceLabManual2013
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cerebellum, cerebellarlobes anterior,posteriorandflocculonodularlobes cerebellarpeduncles Superior,middle,andinferiorpeduncles cerebralaqueduct cerebralcortex cerebralhemispheres cerebralpeduncles(orcruscerebri) cerebrospinalfluid(CSF) choroidplexus cingulategyrus corpuscallosum corticallobes frontal,parietal,occipital,andtemporallobes corticospinaltract(fibers) corticopontinefibers cuneus diencephalon expressiveaphasia facialnerve flocculus fornix fourthventricle frontalgyrus superior,middle,andinferiorfrontalgyri globuspallidus glossopharyngealnerve hippocampus hypoglossalnerve hypothalamus infundibulum internalcapsule lateralfissure lateralventricles linguallobe longitudinalfibers mammillarybodies mediallemniscus(dorsalcolumn) medulla(medullaoblongata) midbrain(mesencephalon) nucleusaccumbens occipitalgyrus superioroccipitalandinferioroccipitalgyri IntrotoNeuroscienceLabManual2013
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oculomotornerve olfactory olfactorybulbandolfactorytract olive optic opticnerve,opticchiasmandoptictract paracentrallobule Parkinsonsdisease pyramidaldecussation pyramids postcentralgyrus precentralgyrus precuneus premotorcortex primarycortex auditory,motor,somatosensory,visual putamen rednucleus spinalcord substantianigra superiorandinferiorcolliculi(orcorporaquadrigemina) supramarginalgyrus uncus telencephalon temporal superior,middleandinferiortemporalgyri thalamus thirdventricle transversefibers trigeminalnerve troclearnerve vagusnerve vestibulocochlearnerve Wernicke'sspeecharea

IntrotoNeuroscienceLabManual2013

CHAPTERINDEX 1.DefinitionsandTerms 2.SurfaceTopographyoftheCerebralHemispheres 2A.Lateralsurface 2B.Frontallobe 2C.Parietallobe 2D.Occipitallobe 2E.Temporallobe 3.VentralSurface 4.Brainstem 4A.Midbrain 4B.PonsandCerebellum 4C.Medulla 4D.Morecranialnerves 5.MidSagittalSection 5A.Corpuscallosumandsagittalgyri 5B.Visualcortex 5C.Lateralventricles 5D.Diencephalon 6.CoronalBrainSections 6A.Sectionthroughtheuncus,optictract,andhypothalamus 6B.Coronalsectionthroughthesupramarginalgyrus,caudalthalamusandpons 6C.Magneticresonanceimaging 7.SpinalCord 8A.Generalanatomy 8B.WhiteMatter 8C.GrayMatter Appendix I.Questions II.Majorpathways III.PrinciplesofMRI

IntrotoNeuroscienceLabManual2013

1.DEFINIT TIONSAND DTERMS

Thecen ntralnervoussystem(CN NS)iscompo osedoftheb brainandsp pinalcord.T Thebrainisoften subdivided (based on the em mbryological developme ent) into six x structures: telenceph halon, diencep phalon, mid dbrain (or mesencepha m alon), pons, cerebellum m, and med dulla (or me edulla oblonga ata). The te elencephalo on includes various v structures such as the cere ebral cortex x, the basal ganglia, g the e hippocam mpus and th he amydgal erstand the CNS la. In order to unde organiz zation,youshouldreview wsomebasicterminolog gyusedinneuroanatom my. The e first set of f terms desc cribes orient tations and d directions of the CNS. T The term ro ostral, which is derived fr rom the Lati in word for snout, alwa ays refers to o any projec ction in the brain pointing toward the nose. The e reverse is true for cau udal, which means towa ard the tail. The rostralcaudalaxisofthenervo oussystemisactuallya curvedline asindicated dinFigure1. .The terms ventral, v which means toward the belly, and d dorsal, which is away fr rom the belly or toward the back, are defined d with resp pect to the e curved rostralcaudal axis as sh hown. Additional terms are a anterior r, which ind dicates tow ward the fro ont, and po osterior mea aning towards the back. Anterior an nd ventral ar re not alway ys synonymo ous and neit ther is dorsa al and posterio or. In fact, while ventral and anterior can be used interch hangeably in n the spinal cord and bra ainstem as can c dorsal and posterior, the poste erior aspect of the cereb bral cortex i is not the sam me as the dorsal d aspec ct; likewise, with ventra al and ante erior regions s of the cer rebral cortex. Oth her terms th hat are used d to describe e locations i n the CNS a are superior, , meaning ab bove, and infe erior, meaning below (F Fig. 1). The term media al indicates t toward the m midline or ce enter andlate eralindicate esawayfrom mthemidline e.
Fig gure1.Gener ralterminolog gy

There are several refe erence plan nes that are e used to d describe the orientatio on of sectionsthroughth heCNS.Theplanesofse ectionusedmostfreque entlyinneur roanatomya are: Introto oNeuroscien nceLabMan nual2013
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coronal,horizontal(axial),andsagittal.Theseplanesareillustratedinfigure2.

Figure2.Planesofsections.

The reason why we are using different plans of sections to study neuroanatomy is because internal structures (e.g. thalamus) can be seen only by taking apart a portion of the cerebralcortex.Youwillseeseveralexamplesduringthislaboratory. Another important set of terms used in neuroanatomy describe connections within the CNS. The CNS is generally bilaterally symmetrical, and the two halves are joined largely (but not exclusively) by nerve fiber bundles referred to as commissures. Commissures interconnecthomologousareasonthetwosidesofthebrain. Anothertypeofcrossingisadecussation(Latinfor"xshapedcrossing")thatreferstothe intercrossing of homologous axonal pathways as each crosses to the opposite side of the CNS during the course of its ascent or descent through the CNS. A projection takes on various names according to the historical origin of their discovery. They may sometimes be called tract, such as the pyramidal tract, lemniscus tract (e.g., medial lemniscus), or fasciculus (e.g. fasciculus gracilis). Each tract/fasciculus contains fibers that originate and go to different portion of the CNS. In fresh tissues, myelinated fiber tracts have a white appearance, hence the name white matter, whereas areas of the CNS that contain predominately neuronal cell bodies and their processes (which constitute the neuropil) have a gray appearance and are called gray matter. To better evidentiate gray and white matter, neuroanatomists prefer to use fixed tissue and specific dyes that stain myelin dark. Therefore, in fixed tissue the white matterappearsdark(darkblue/darkbrown)whereasthegraymatterappearspale.

2.SURFACETOPOGRAPHYOFTHECEREBRALHEMISPHERES
2A.LateralSurfaceandCorticalLobes Use the whole brain and examine its lateral surface. The prominent external feature of the telencephalon, the cerebral cortex, is easily identified since it contains very characteristic sulciandgyri(Fig.3).Gyriarebumpsofthecorticalmantleandthegroovesarethesulci,or if particularly deep, are termed fissures. Gyri, in turn, form four distinct lobes: Frontal, Parietal, Occipital, and Temporal (Fig. 3). Each lobe may be concerned with a different IntrotoNeuroscienceLabManual2013
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function as described later. The gyri of the human brain are referred to both by name and also by a numbering system originated by Brodmann who subdivided the cerebralcortex into 52 areas based on cytoarchitectural criteria. You are required to know only those sulci and gyri and associated Brodmann areas that are specifically mentioned in lectures or are in bold in this manual. In order to understand the localization of higher cortical functions it is therefore essential that you develop a solid understanding of the anatomical subdivisions of the cerebral cortex. You should be aware that some lobules and gyri are given different names in different text books. For this course you are expected to use the nomenclature indicated on the illustrations and in the text ofthislabmanual.
Figure3.Nomenclatureofcerebralcortexlobes.

To appreciate the general nomenclature and function of gyri and lobes, begin by locating the following two fissures or sulci: the lateral fissure (or sulcus) and the central sulcus(Fig.4).Theseareimportantlandmarks because they form large portions of the boundaries of the four major lobes of each cerebral hemisphere. The lateral sulcus begins at the inferior surface of the hemisphere and extends in a posterior direction to partially demarcate the frontal, parietal and temporal lobes of the cerebrum (Fig. 4). The central sulcus is a deep (about 2 cm) groove located mainly on the lateral aspect of the cerebralhemisphere,withasmallportionextendingontothemedialsurface.Itbeginsonthe superior border of the hemisphere slightly (about 1 cm) behind the midpoint between the frontal pole (the rostral most tip of the hemisphere) and the occipital pole (the caudal most tip of the hemisphere). It slopes downward and forward across the hemisphere and ends above the lateral sulcus. In doing this, the central sulcus separates the frontal from parietal lobes.

2B.FrontalLobe The frontal lobe is the portion of the cortex rostral to the central sulcus and superior to the lateral fissure. The first major grove rostral (about 1.5 cm) to the central sulcus is the precentral sulcus. The gyrus that lies between the precentral and central sulci is the precentral gyrus. This gyrus forms the primary motor cortex, or Brodmann's area 4. The precentral gyrus contains an orderly motor map of the body (termed the homunculus), with the head represented laterally and inferiorly and the feet represented on the medial extension of primary motor cortex (i.e., the feet inside of the longitudinal fissure) and the tonguerepresentationextendinguptotheanteriorwallofthecentralsulcusneartheinferior frontalgyrus.Lesionsoftheprecentralgyrusresultinmotordeficitsonthecontralateralside ofthebody.

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Figure4.Lateralvie ewoftherig ghthemisphe ere Continue rostr rally. Two major m sulci are a present at right ang gles to the p precentral su ulcus. These horizontally h running sulci, the supe erior fronta l sulcus and d the inferio or frontal su ulcus, form th he boundaries between the superio or, middle, a and inferior r frontal gyr ri (Fig. 4). T These gyri ma ake up, from m caudal to o rostral, th he premoto or cortex (Brodmann's area 6) and d the ntal gyrus, which is the portion o prefron ntal cortex (or ( frontal pole). p The inferior fron of the frontal cortex near r to the late eral fissure, can c be furth her subdivid ded into thre ee portions: : the ,andparsop percularis. I Inapproxim mately98%o ofthepopula ation, parsorbitalis,parstriangularis, theleftparstriangu ularisandpa arsopercularisconstitut teanimport tantspeechcenterorBr roca's speech area. This area is often visibly larg ger than the e correspond ding region on the right t side s of Broca's s area resu lt in expres ssive aphasia, in which h the of the brain (Fig. 5). Lesions individu ual has a normal comp prehension of language e, but has d difficulty in or is unab ble to commu unicateverba allyduetothelossofne euronsthatc controlmot torspeechfu unctions. 2C.ParietalLobe Thi islobebegin nscaudallyto t thecentra alsulcus. Th hereareseve eralgyriin t thislobethatyou need to o identify be ecause they have import tant functio ns. You sho ould be able to recognize the postcen ntral gyrus (Brodmanns ( sareas3,1,and2),the gyrusimme ediatelycaud daltothece entral sulcus. This gyrusforms f the pr rimary soma atosensory cortex. As in the prima ary motor co ortex, the bod dy is mapped "upside do own" in a to opographica al fashion with the repre esentation o of the feet alo ong the med dial aspect of o the gryus, , and the to ongue repres sentation ex xtending into o the inferior r aspect up to t the latera al fissure. A lesion in th his area resu ults in sensory deficits on the contrala ateralside. Continue caud dally to the postcentral gyrus and y you will find d two additi ional lobes. The t superio or parietal lobe l (Fig. 4 4). This lobe is involv ved with sp patial most superior is the Introto oNeuroscien nceLabMan nual2013
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orientation.Theinferiorportionoftheparietallobeisformedbytwogyri:thesupramarginal gyrus and the angular gyrus (Fig. 4). The supramarginal gyrus can be identified by following the posterior portion of the lateral fissure starting at the point where it ascends; the tissue surrounding this fissure is the supramarginal gyrus. Lesions of this gyrus can result in tactile agnosia which is the inability to recognize common objects on the basis of tactile cues or stimuli. Using tactile cues alone, an individual can recognize general features of an object placed in the hand contralateral to the lesion (e.g., metallic, cold, round), but cannot name theobjectitself. The angular gyrus (Fig. 4) is adjacent to the supramarginal gyrus and surrounds the upturned posterior end of the superior temporal sulcus (see temporal lobe). Lesions of this gyrus in the dominant hemisphere can result in visual agnosia. There is impaired, or no, comprehension of the written word, although the word can be seen. Lesions of both the angular and supramarginal gyri lead to Gerstmann syndrome, a neurological disease characterized by deficiency in the ability to write (dysgraphia), difficulty in learning mathematics (dyscalculia), inability to distinguish the fingers on the hand (finger agnosia) and leftrightdisorientation.

Figure 5. Brocas and Wernickessareas.

2D.OccipitalLobe The occipital lobe (Fig. 3) is the area of the cerebral hemisphere that lies caudal to the parietal lobe (on the lateral surface trace an imaginary line extending from the preoccipital notch to the caudal portion of the superior parietal lobe). This lobe contains the visual processing center. The occipital lobe is composed mainly of primary visual cortex (area 17) and visual association cortex (areas 18 and 19). We will study more details about the visual cortexin5B. 2E.TemporalLobe

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The temporal lobe is separated from the frontal and parietal lobes by the lateral fissure (Fig. 3) and from the occipital lobe by the latter's imaginary rostral border. In the lateral surface, the temporal lobe is subdivided into three portions by two major sulci (the superior temporal sulcus and the inferior temporal sulcus) that run parallel to the lateral fissure (Fig. 4). These are the superior temporal gyrus, the middle temporal gyrus, and the inferior temporal gyrus. Lesionsinthetemporallobecausetemporallobeepilepsyaconditionwhich givesrisetorecurrentseizures. Hidden within the posterior aspect of the lateral fissure in the inner bank of the superior temporal gyrus are the transverse temporal gyri of Heschl (Brodmann's areas 41 & 42). This region constitutes the primary auditory cortex. The posterior part of the superior temporal gyrus, at its inner intersection with the angular and supramarginal gyri, contains Wernicke's speech area (Brodmann'sarea22,Fig.5).LesionsinWernicke'sareaonthedominantsideor bilaterally result in both a deficit in the understanding of the spoken word and the ability to expressoneselfverbally. Potentialexamquestionrelatedtothissection.Pleaseseequestion#1inappendix

3.VENTRALSURFACE
The cerebral cortex continues at the ventral surface (Fig. 6). Observe the gyrus that is adjacent (medially) to the inferior temporal gyrus. This is the parahippocampal gyrus. This gyrus surrounds the hippocampus (or hippocampal formation), a crucial structure for declarative memory, and thus the gateway for longterm memory retention. At the rostromedial aspect of the parahippocampal gyrus you should be able to see a bulge called the uncus. Beneath the uncus is an important telencephalic structure, the amygdala. Some nucleioftheamygdala(oramygdaloidcomplex)receiveolfactoryprojectionsfromtheventral cortex surrounding the uncus. Thus, this region of the temporal lobe is the primary olfactory cortex. How are odors processed? Examine the ventral surface of the gross brain (Fig. 6). Identify the olfactory bulb and the olfactory tract that run through the middle portion of the gyrus rectus. The olfactory tract contains fibers that arise from cells in the olfactory bulb, which in turn, is formed by axons of specialized receptor cells (neurons) located in the olfactory mucosa. The olfactory cells form the olfactory nerve which is responsible for the sense of olfaction. Follow the olfactory tracts until you see a bifurcation at the level of a region called anterior perforated substance; this is the olfactory stria. The lateral portion of the stria reaches the primary olfactory cortex. By this route, olfactory information is transmitted to the cortex. The anterior perforated substance is gray matter that is perforatedanteriorlybynumeroussmallbloodvesselsthatsupplyinternalstructures. The olfactory nerve is also called cranial nerve I. There are 12 pairs of cranial nerves emerging from the brain, each with a different function. They are named or simply abbreviated to CN followed by the Latin numbering IXII. CN II is the optic nerve. This nerve may not be present in your specimen because during the removal of the brain from the cranium, the optic nerve is often cut. However, you can appreciate its location by first identifying the optic chiasm. Look at the mid portion of the ventral surface. You will easily IntrotoNeuroscienceLabManual2013
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see the optic chiasm because it has a X shape (Fig. 6). The tract rostral to the optic chiasm is what remains of the optic nerve. The optic chiasm contains a partial decussation of the optic fibers that generate from ganglion cells in the retina and form the optic nerve. The axons in theopticchiasmcontinuecaudallyandformtheoptictract.

Figure6.Ventral view of the cerebral hemisphere. The pons,cerebellumandmedulla have beenremoved Caudal to the optic tract are the two mammillary bodies (Fig. 6), distinct swellings that belong to the hypothalamus. The hypothalamus and the thalamus form the diencephalon. The thalamus will be studied later when we will look at the hemisected brain. The region bounded by the mammillary bodies, optic chiasm, and the beginning of the optic tract is known as the tuber cinereum, which is the coneshaped protrusion from which the infundibulum extends. The pituitary gland is attached to the infundibulum (the pituitary is oftenmissinginyourspecimen). Caudaltothemammillarybodiesisadeepspacecalledinterpeduncularfossa(Fig.6).The name derives from the fact that it is limited on the right and left by the two cerebral peduncles (or crus cerebri). Whithin the interpeduncula fossa, you should be able also to locate the oculomotor nerve, or CN III (Fig. 7). The oculomotor nerve innervates several extraocular somatic muscles (inferior oblique, medial rectus, superior rectus and inferior IntrotoNeuroscienceLabManual2013
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rectus and the lev vator palpeb brae that ele evate the u pper eyelid). It also re egulates ref flexes (lightan ndaccommo odation).

4.BRAIN B STEM M
The bra ain stem is formed by the midbra ain, the pon ns and the medulla. T These struc ctures contain n several nuc clei and pathways that are importa ant for a num mber of functions. The e best waytostudythesenucleiandpathways p istousebrain nsections.F Forthisportionofyours study misected brai in, the glass s slides in th he wooden box as well l as the spe ecially you need the hem dissecte edspecimen nsfoundinthesmallpla asticcontain er. 4A.Mid dbrain The e midbrain(or ( mesence ephalon) sta arts after the e posterior e end of the d diencephalon n and termina atesattheenlarged e basilar(orventral)pons(Fiig.7,redline es).Dorsally y,themidbr rainis formed d by the sup perior and in nferior collic culi (or corp pora quadrig gemina, Fig. 7). The co olliculi take th heir name fo or the hill appareance e. The infe erior colliculus is a large nucleus o of the has direct c auditor ry pathway, whereas th he superior colliculus h connections with the v visual system.

Figure 7. 7 Hemisecte ed brain illus strating the location l of th the midbrain. The red lin nes demarcat te the midbrain. The blue line through the superior r colliculus an nd the cerebr ral aqueduct (cc) illustrate es the planeof fsectionused dtoobtainthetransversesectionillust ratedinFig.8 8. ayseethetro Lookat a thehemisectedbrain.Justbelowthe einferiorcoll iculusyouma oclearnerve orCN IV(Fig.9), 9 theonlycr ranialnerveexiting e fromthedorsalasp pectofthebrain.Thisner rvesuppliesthe

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superio oroblique,anextraocula armuscleoftheeye.Th ismuscleab bducts,depre essesandinte ernally

rotatesthe t eye.

The e space below the coll liculi is the cerebral aq queduct. T This opening g belongs to o the ventricu ular system m that carries the cere ebrospinal fluid (CSF). The CSF F fills all sp paces surroun ndingthebrainandspin nalcordandservesasa cushionto s supportand dprotectthe eCNS (morediscussion d ab bouttheven ntricularsyst temwillbe presentedla ater).Thece erebralaque educt divides the midbrain into a dorsal and ven ntral region (Fig. 7). Th he dorsal (or r roof) portion of dbrain (made up of the two pairs of f colliculi) is s named the e tectum. Th he portion o of the the mid mesenc cephalonven ntral(orfloo or)tothecerebralaqued ductisthetegmentum. The te egmentum is i occupied ventrolatera ally by the t two cerebra al peduncles s (Figs. 6 an nd 8). These peduncles p ca arry the des scending pathways from m the cereb bral cortex to o the rest o of the CNS. These T include e the cortico ospinal tract (so named d because it originates i in the cortex x and termina ates in the spinal s cord), and cortico opontine fibe ers (so named becasue they genera ate in thecort texandterm minateinthe epons). Additi ional structu ures that be elong to the tegmentu um of the m midbrain are e the subst tantia nigra, the t red nuc cleus. These e nuclei can be seen ei ther in the hemisected d brain or in n the special dissected specimens fo ound in the small plast ic container r or in sections mounte ed on glass. For instance e, look at fi igure 8 whic ch should b be matching g glass slide #10 or 11. The section is stained for f myelin, the main co omponent o of fiber tract ts. Fibers ap ppear black/ /dark blue, neuronal cell l bodies app pear white/pale. In thiis section, t the superior r colliculus is the most do orsal structu ure whereas s the most ventral v struc cture is the c cerebral ped duncle. Adja acent tothecerebral c ped duncleyoush houldbeabletoidentify ythesubsta antianigra(b blacksubsta ance). The sub bstantia nigr ra (Fig. 7) is a large nuc cleus that in n the fixed ti issue should d look black/ /dark brown.Thisiseasierifyouuse ethebrainstem s section ns.Theblackcoloriscausedbymel lanin, a bypro ine. The su oduct of the e metabolism m of the ne eurotransmit tter dopami ubstantia nig gra is included in the fun nctional system known as a basal gan nglia. The im mportance o of the subst tantia nigrain nmotorcont trolisappare entbecause eitsdegener rationisaca ardinalfeatu ureinParkinsons disease e (the clinica al signs of this t disease are muscul ar rigidity, s slow tremor and pover rty of movem ments).
Figu ure 8. Tr ransverse se ection thro ough thesupe eriorcolliculu us.A= cere ebral pedunc cle; B= subst tantia nigr ra; C= red nucleus; D= sup perior colliculus.

Look again n at the sec ctions he red nuc cleus, to identify th ich is situat ted in the mid whi ven ntral portion n of the sec ction. It runs th hroughout the dbrain.Therednucleusisan mid imp portant rel lay center for motoractivity. a Itre eceivesfiber rsfromthemotor m corte exandthece erebellumandgivesrise eto Introto oNeuroscien nceLabMan nual2013
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axonsthatterminateinthespinalcord. 4B.PonsandCerebellum The pons is especially large in humans because its fibers either run longitudinally (longitudinal fibers) or horizontally (transverse fibers). To see these fibers you need to use the sections mounted on glass slides present in your wooden box (glass slide #7) and the illustration below (Fig. 9). Examples of longitudinal fibers are the corticospinal tract at the base of the pons and the medial lemniscus above the corticospinal tract. The corticospinal tract carries axons that generate in the motor cortex and innervate motor neurons in the spinal cord. The medial lemniscus carries somatosensory information from the spinal cord to thecerebralcortex(seeappendix). Examples of transverse fibers are those generated from the pontine nuclei (Fig. 9), small groups of cells scattered among the longitudinal and transverse fasciculi, that receive axons from the motor cortex and, in turn, project to the contralateral cerebellum. Thus, the motor cortex influences the activity of the cerebellum through the relay in the pontine nuclei. The tract that carries these fibers is called the middle cerebellar peduncle (MCP) which can be located along the lateral aspect of the pons connecting the pons to the cerebellum (Fig. 9). Additional peduncles that connect the cerebellum to the brain stem are the superior and inferior cerebellar peduncles. These peduncles also carry fibers to and from the cerebellum. Cerebellarpedunclesalsohelpformingthelateralwallsofthefourthventricle(Fig.9)whichis anexpansionofthecerebralaqueductinitscaudalportion(Fig.7).Wewilldiscussthefourth ventricleinmoredetaillater.

Figure 9Leftpanel.Ventralviewofthebrain. The black line through the pons illustrates the plane of cutusedtoobtainthetransversesectionshownon the right. Right panel: A=descending longitudinal fibers; B=medial lemniscus; C=pontine nuclei;D=middlecerebellarpeduncle;E=fourthventricle;F=pontocerebellarfibers.

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The pons also contains several CN nuclei. We will not be learning the location of these nuclei in this course due to the time constraint. However, be aware of the fact that impaired functionsofcranialnerveareoftenusedinclinicalsettingstodiagnoseneurologicaldiseases. Locate the cerebellum. In the gross brain, the cerebellum can be easily recognized in the caudaldorsal portion of the whole brain for its typical transverse sulci and convolution called folia.Thereisnoneedforlearningthenamesofthesesulci.However,itisimportanttorecall thethreemainsubdivisionsofthecerebellarlobesbecausetheyareassociatedwithdifferent functions. From rostral to caudal we consider three lobes: anterior, posterior and flocculonodular lobes (Fig. 10). The lobes of cerebellum are localized by first identifying the primary fissure, which forms the boundary between the anterior lobe of the cerebellum and the posterior lobe. The posterior lobe is the largest area of the cerebellum. This lobe has majorconnectionwiththecerebralcortexandisimportantinplanningvoluntarymovements.

Figure10.Ventralviewofthecerebellum.

The flocculonodular lobe is made of the two lateral paired flocculi and the median nodulus. The flocculus can be seen on the ventral surface of the cerebellum projecting laterally for about 2 cm on each side of the medulla (Fig. 10). This lobe is mainly associated withvestibularfunctionsandisconcernedwithequilibrium. Now look at the ventral portion of the gross brain. In the lateral portion of the basilar pons,approximatelyatthemidline,youshouldbeabletoseethetrigeminalnerve(orcranial nerve V, Figs. 9 and 10). This is a very large nerve and contains both motor and sensory components. The sensory portion carries all types of sensations from the region of the face. Themotorpartinnervatesthemusclesofmastication. 4C.Medulla The medulla (or medulla oblongata) is a cone shape structure which is about 3/4 inch long. It contains many groups of fibers and nuclei that regulate the cardiac, respiratory, vomiting and vasomotor activities and deal with involuntary functions, such as breathing, heart rate and blood pressure. It begins after the pons at a region known as the pontomedullary junction, a prominent sulcus that runs transversely (Fig. 10). The medulla is easily recognizable for its most prominent features located in the ventral surface: the pyramids (Fig. 10). These are separated along the median plane by the anterior median fissure.Thepyramidscontainthecorticospinaltract.Canyoulocalizethistractonglassslide IntrotoNeuroscienceLabManual2013
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#4? Lateralto the pyramids is an elongated protuberance called theolive (Fig. 11). The olive is actually formed by the olivary nucleus, a large group of neurons that play a role in motor learning.Thisnucleuscanbeeasilyseenonlyinstainedsections(Fig.11).

Figure 11.Sectionoftheopenmedullathroughthe olive. Left panel, ventral view of the brain stem. The blue line shows where the cut was done to obtain the transverse section on the right panel. A=corticospinal trat; B=Olivary nucleus; C=medial lemniscus;D=fourthventricle. At its rostral end, the medulla widens and helps form the caudal floor of the fourth ventricle (see the hemisected brain in Fig. 7). This ventricle contains two apertures (foramen of Luska and Magendie) that allow the CSF to enter the subarachnoid space (the space between the arachnoid membrane and pia mater). From the arachnoid space the CSF is absorbedintothevenousdrainage. The caudal portion of the medulla does not contain the 4th ventricle and appears oval resembling the shape of the spinal cord (Fig. 11). See also glass slide #3. Indeed, the caudal portion of the medulla turns into the spinal cord after the pyramidal decussation (Fig. 11). The pyramidal decussation contains the majority of corticospinal fibers that decussate going into the lateral portion of the spinal cord, hence the name lateral corticospinal tract. This pathwayisinvolvedwithvoluntarycontroloflimbs. Potentialexamquestionrelatedtothissection.Pleaseseequestion#2inAppendix. 4D.Morecranialnerves(CN) Return to the rostral medulla at the level of the pontomedullary junction. You should be abletonoticeaseriesofrootsthatmarkvariousCNs.ThemostmedialistheabducensorCN VI (Figs. 10 and 11). This nerve innervates the lateral rectus muscle of the eye. Follow the junction laterally, you will encounter additional CNs. These are the facial (CN VII) and the IntrotoNeuroscienceLabManual2013
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Vestibulocochlear (CN VIII) nerves (Fig.12). Atfirstglancetheymayappearasonlyone.The more medial nerve is CN VII and the larger lateral nerve is the CN VIII. CN VII innervates the muscles of facial expression. CN VII also contains both autonomic components to the glands andsensoryfibersfortastefromtheanteriortwothirdsofthetongue.Thevestibulocochlear nerveisaspecialsensorynervewithauditory,hearingandvestibular,balancecomponents.

Figure 12. Representative section of closed medulla. Left panel, ventral view of the brain. The blue line illustrates where the section on the right was obtained. Right panel, A=Corticospinal; B=medial lemniscus; C=cuneate nucleus; D= gracilisnucleus. Follow the lateral aspect of the medulla and moving caudally along the lateral border of the olive you will find the roots of the glossopharyngeal (CN IX) nerve. This is a mixed nerve containing both motor and sensory components. The vagus nerve (CN X) consists of many rootlets which also exit from the posterolateral sulcus immediately caudal to the glossopharyngealnerve.CNIXandCNXarefunctionallyverysimilar.Theycarrythesenseof tasteandothertypesofsensationfromthemouthregion.Theyalsohavemotorcomponents thatinnervatethemusclesinvolvedinspeakingandswallowing. Additionalnerverootletsinserieswiththevagusnerverootlets,butplacedmorecaudally form the cranial component of CN XI or Accessory Nerve (Fig. 12). The spinal component emerges as a series of rootlets from the first five cervical segments of the spinal cord. The spinal component of CN XI innervates two skeletal muscles in the neck, the sternocleidomastoid and the trapezius. The last nerve, the Hypoglossal Nerve (CN XII) exits the rostral medulla oblongata at the anterolateral sulcus located between the olive and the pyramid(Fig.12).Thisnerveinnervatesthemusclesofthetongue. IntrotoNeuroscienceLabManual2013
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5.MIDSAGITTALSECTION 5A.Corpuscallosumandsagittalgyri Now that you have studied the external surface of the brain, we will concentrate on the internal structures. We will begin with a midsagittal cut of the brain (Fig. 13). Examine the half brain. The cerebral cortex consists of two hemispheres that are interconnected by the corpus callosum. The corpus callosum has a Cshape structure and is made of cortical fibers that connect the two hemispheres. The gyrus just above and surrounding entirely the corpus callosum is the cingulate gyrus. This gyrus plays a role in different functions, including attention, motivation and emotional responses. In its rostral portion, the cingulate gyrus is capped by the superior frontal gyrus. This gyrus appears to be involved in higher cognitive functions (working memory and selfawareness). The gyrus caudal to the superior frontal gyrus and above the mid portion of the cingulate gyrus is the paracentral lobule. The rostral portion of this lobule contains the primary motor cortex whereas the caudal region is the primary somatosensory cortex. This region of the cortex regulates movement of the contralateral lower limbs. The gyrus immediately caudal to the paracental lobule is the precuneus, an area of the parietal cortex that is involved in visuospatial imagery, episodic memoryretrievalandselfprocessingoperations. Figure13.Midsagittalviewoftheleftcerebralhemisphere. 5B.VisualCortex The gyri caudal to the precuneus belong to the occipital pole. As mentioned before, this isthevisualcortex.Youneedtolocalizetwoimportantareasofthevisualcortex:thecuneus whichistheareaofthe primary visual cortex, andthe lingual gyrus. Thecuneusisthegyrus

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immediately caudal to the precuneus. It is separated from the precuneus by the parietal occipital sulcus which begins in the lateral surface approximately 45 cm in front of the occipital pole and slopes medially downward and forward almost touching the posterior end of the corpus callosum. Approximately at the midline of this sulcus you should be able to identifyanothersulcusthatrunshorizontallyandjoinstheparietaloccipitalsulcus.Thisisthe calcarine fissure. The area ventral to the calcarine fissure is the lingual gyrus. The cuneus receives visual information from the contralateral superior retina representing the inferior visual field, and the lingual gyrus receives information from the contralateral inferior retina representing the superior visual field. Lesions of both primary visual cortices result in completeblindnessbilaterally.Destructionofoneprimaryvisualcortexresultsinblindnessin the contralateral visual field. Lesions in visual association cortex, which spare primary visual cortex, result in visual agnosia (the inability to identify an object by name or determine its functionthroughvisualcuesalone). 5C.LateralVentricles The hemisected brain allows you to further understand the relationship between the telencephalon, diencephalon and midbrain (or mesencephalon) and the ventricular system. Begin by locating again the corpus callosum which forms the roof of the lateral ventricles. The lateral ventricles are the largest of the CSF filled ventricular cavities that follow the natural curvature of the telencephalon and are, therefore, essentially Cshaped (Fig. 14). The paired lateral ventricles are divided into three branches or horns: the anterior (frontal), posterior (occipital) and inferior (temporal) horns, and a body region. You should be able to appreciate the size of the lateral ventricles by removing the septum pellucidum, the thin membrane that forms the medial wall of this ventricle (it may be missing or torn in some of the hemisected brains). In the floor of this ventricle, you should be able to identify the choroidplexus,aseriesofepithelialcells,capillariesandlooseconnectivetissuethatproduce theCSF.
Figure 14. General view of the ventricles. The direction of flow of CSF in the lateral ventricles is from the inferior horn through the body and out the interventricular foramen into the third ventricle, the cerebral aqueduct into the fourth ventricle. Please note the location of the choroidplexus.

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5D.Diencephalon The CSF of the lateral ventricle empties into the third ventricle (Figs. 13 and 14) via a structure called the foramen of Monro (interventricular foramen). The third ventricle marks the beginning of the diencephalon, that we previously described containing two major structures,thethalamusandhypothalamus.Thethalamusformsthelateralwallsofthethird ventricle(Fig.13).Thethalamusisarelaycenterforsensoryandmotorsignalstothecerebral cortex. It also controls sleep and awaken states. Ventrally to it, you will find the hypothalamuswhichalsohelpsformingaportionofthelateralwallsandthefloorofthethird ventricle. The hypothalamus controls certain homeostatic processes, including hormonal releaseandvariousactivitiesoftheautonomicnervoussystem. ThethintissueofwhitematterthatformstheroofoftheforamenofMonroisthefornix (Fig. 13), an important fiber tract that carries signals from the hippocampus to the hypothalamus. The hippocampal/hypothalamic circuit, via its connection with the cingulate cortex,isinvolvedinthecontrolofemotions.

6.CORONALBRAINSECTIONS
6A.Sectionthroughtheoptictract,hypothalamusanduncus We will now spend some time looking at various internal structures of the telencephalon and diencephalon that are visible in the coronal sections of the gross brain specimens (sections are already prepared because we do not have enough brain specimens to allow you to dissect them yourself). The objective of this portion of the laboratory is to expand your threedimensional understanding of the brain by evaluating internal structures. Be aware of the fact that these structures are often damaged by stroke, tumors, aging, or other types of lesions.Thus,theknowledgeoftheiranatomyhasaclinicalimportance. Locate a section that is closely represented in Fig. 15. Ask the instructor if you cannot locateit.Thesectionshouldhavebeencutthroughtheoptictract,hypothalamusanduncus and it should contain various structures of the telencephalon (e.g. cortex and caudate nucleus)aswellasofthediencephalon(e.g.thalamusandhypothalamus). Startattheventrolateralportionofthecortex.Thisisthetemporallobeandtheuncusis itsmostmedialportion.Embeddedintheuncusyouwillfindtheamygdala. Theamygdala is associatedwithemotions,learningandmemoryfunctions.Thetwoamygdalaeareconnected to each other by the anterior commissure. You should be able to see this commissure spanningventrallyfromonetemporallobetotheotherone(Fig.15).Nevertheless,itmaybe missing on same specimens due to the angle of dissection. Similarly, depending upon the plane of section, the amydgala may be missing and either the hippocampus or the inferior portion of the lateral ventricle is present instead of it. The area below the anterior commissurebelongstothebasalforebrain.NeuronallossinthisareacanleadtoAlzheimers disease. The midventral portion of the section just dorsal of the optic tract is occupied by the hypothalamus. The space surrounded by the hypothalamus is the third ventricle. Moving superiorly you may find the hypothalamic adhesion (or massa intermedia) which marks the beginning of the thalamus. The thalamus forms the floor of the lateral ventricles that in this IntrotoNeuroscienceLabManual2013
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section have a butterfly shape. The choroid plexus lie on top of the thalamus. The walls of the lateral ventricles are formed by the caudate nucleus whereas the roof is formed by the corpus callosum. You can clearly see that the two lateral ventricles are separated by the septumpellucidumandthefornix.

Figure15.Coronalsectionthroughthehypothalamus,optictractanduncus. Go back to the caudate nucleus. The caudate nucleus has a Cshape structure with an enlargement in the rostral portion (head of the caudate nucleus) and a tail at the end (tail in latin is cauda, therefore the name caudate nucleus). The section shown in Fig. 15 is through thebodyofthecaudate. The white matter immediately lateral to the caudate is the internal capsule, a group of fibersthatcarryinformationtoandfromthecerebralcortex.Adjacenttotheinternalcapsule slightly ventral to the caudate nucleus is the putamen. In this section the internal capsule separates the body of the caudate from the more ventral putamen and globus pallidus. The caudate,putamenandglobuspallidusarecomponentsofthebasalganglia, subcorticalnuclei thatcontrolvoluntarymovements. The caudate nucleus, in its ventral position (ventral striatum), contains a subdivision termed nucleus accumbens. The nucleus accumbens is the portion of the CNS that often is called the pleasure center. When someone craves a substance (including food), neural activity increases in this nucleus in anticipation of future pleasure. Thus, it has been IntrotoNeuroscienceLabManual2013
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suggest ted that the nucleus accumbens is respons ible for mo otivation, re eward and drug addictio on, including tobacco and a alchool. This nucle eus is also responsible for the pla acebo effect. The nucle eus accumbe ens can als so be seen using horiz zontal sectio ons obtaine ed by sectioningthebrain nthroughth heanteriorcommissure c (Fig.16).

Fig gure16.Hor rizontalsecti ionthroughtheventrals striatumand danteriorco ommissure. 6B. Coronal sectio on through the supram marginal gy yrus, caudal thalamus and pons. This section is more cau udal then th he previous one. o In this s section, yo ou should fin nd, in additio on to m and the la ateral ventricles, severall other struc ctures (Fig. 1 17). Begin a at the the corpus callosum m porti ion. The po osterior end of the forn nix (body of the fornix) will be seen n just dorsal medial rostral to the corp pus callosum m. The cau udate nucleu us still occu upies the wall of the la ateral les. At this level you sh hould be able e to identify y the interna al capsule th hat separate es the ventricl putame en from the e caudate nucleus. n De epending up pon the cut, , you could find the ca audal portion n of the glob bus pallidus. Caudal an nd more me edial to the caudate nucleus are se everal nuclei of o the thalamus. Most likely the pulvinar p will be the most evident. The thalam mus is separat ted from the e putamen by b the most posterior po ortion of the e internal ca apsule (post terior limb). In same spe ecimens you could see that t the inte ernal capsule e continues caudally to form fibersthatenterthepons.

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At the dorsocaudal border of the thalamus is located the posterior commissure. The posterior commissure is a convenient landmark for localizing the border between the diencephalon and the mesencephalon. It is believed that this commissure connects various structures involved in bilateral pupillary light reflex. The small opening ventral to the posterior commissure is the cerebral aqueduct which, in turn, marks the beginning of the midbrain. Therefore, you should be able to identify the substantia nigra lateral to the cerebral aqueduct. The red nucleus and the crus cerebri will be just above and lateral to the substantianigra,respectively.Intheventrolateralsurfaceofthetemporallobeyoushouldbe able to see the hippocampus (from latin seahorse), capping the inferior portion (horn) of the lateralventricle.

Figure17.Coronalsectionthroughthesupramarginalgyrus,caudalthalamusandpons. Potentialexamquestionrelatedtothissection.Pleaseseequestion#3inAppendix. 6C.MagneticResonanceImaging(MRI). To help you to develop a more precise threedimensional representation of subcortical structures and how they are related to each other anatomically, we have included MRI from thesameperspective(additionalMRIscansareondisplayinthelaboratory).MRIisamedical imaging technique used in radiology to visualize detailed internal structures of our body. The basic principles of MRI are presented in the appendix. MRI is especially useful in imaging the brainbecauseitprovidesgoodcontrastofthewatercontentbetweengrayandwhitematter. IntrotoNeuroscienceLabManual2013
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Please note that MRI is more sensitive to changes in tissue water content, therefore it can expose subtle pathological changes that escape detection with other methods of analysis. You should appreciate the degree of resolution of brain structures available with the MRI technique. For instance, in Fig. 18, you should be able to locate the following: corpus callosum, caudate nucleus, internal capsule, lateral ventricle, putamen, anterior commissure, hippocampus,thalamus,pons.Asktheinstructorifyouhaveproblems!

Figure 18. T1 weightedMRI obtained approximately at thelevel ofthebrain illustrated in Figs 15and17.White=fiberstracts,gray=nuclei,black=spaces. MRI is a poverful technique to detect abnormalities in human brain. The following picture (Fig. 19) illustrates the key features of a neurological disease observed in a 45 year old male individual with impaired cognitive function. Can you identify at least three major abnormalitiesbylookingatthefollowingT1weighetdMRI?

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Figure19.CoronalMRIofapatientwith???..showingatrophyof..???.....

7.SPINALCORD
7A.Generalanatomy. The closed medulla ends at the level of the pyramidal decussation but fibers and nuclei continue and help form the spinal cord. In the average adult the spinal cord is approximately 4245 cm in length and occupies about the upper 2/3 of the vertebral canal. Its caudal end is usually located at the level of the intervertebral disc between the first and second lumbar vertebrae (Fig. 20). The spinal cord is anchored to the meningeal sheath covering the spinal cordbyafinethreadcalledthefilumterminale(Fig.20). The spinal cord is the main pathway for information connecting the brain and peripheral nervous system by the spinal nerves. There are 31 pairs of spinal nerves and 31 spinal cord segments as follows: 8 cervical (C18), 12 thoracic (T112), 5 lumbar, 5 sacral, 1 coccygeal. The anatomical relationship between spinal levels and vertebral levels is an important one clinically. The spinal nerves leave the vertebral canal through the intervertebral foramina according to the following pattern: The first cervical nerve emerges ABOVE the first cervical vertebra.The8thcervicalnerveemergesfromtheintervertebralforamenbetweenvertebrae C7 and T1. All of the remaining (more caudal) spinal nerves emerge from the intervertebral foramen BELOW the vertebra of the same number. In spite of the fact that the spinal cord is

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not as long as the vertebral column, the roots of the spinal nerves exit from the vertebral canal through the intervertebral foramen at the proper vertebral level. This makes it necessary for the roots to become longer and longer at more caudal levels of the cord resulting in the large number of nerve roots below the level of the cord that form a structure shown in Fig. 20 called the cauda equina (from the Latin, meaning horse's tail). Thus, at the levels of lumbar vertebra 4/5, clinicians can insert a needle without worrying about puncturing the spinal cord. This is why the lumbar puncture is the preferred method of injectingmedicationsintotheCNSorwithdrawingCSFforanalysis.

Figure 20. Spinal cord cauda equina. The meningies covering the spinal cord were cut open to reveal thespinalcordandnerves,andthefilumterminale.

To better comprehend the importance of the spinal cord we will review some of the anatomicalpathwaysusingacrosssection.Moresectionsareavailableinthelaboratory. 7B.SpinalCordWhiteMatter The spinal cord is divided into an outer region of white matter, called funiculi, containing longitudinallyrunningnervefibers(myelinatedaxons)surroundinganHshapedcentralregion of gray matter (Fig. 21). The vertical limbs of the Hshaped gray matter form dorsal and ventral horns. These horns help separate the funiculi into three regions: dorsal (posterior), lateral,andtheventral(anterior)funiculi(Fig.21). These funiculi contain three types of fiber tracts: ascending (sensory), descending (motor) and segmental (providing sensorymotor connections within the spinal cord). The white matter in the region of the central canal is subdivided into anterior (ventral) and posterior (dorsal) white commissures overlying the gray commissural areas. In addition to these long ascending and descending pathways, all funiculi within the spinal cord contain a propriospinal tract that is located immediately external to the gray matter. This pathway contains axons that form the short intersegmental projections arising from interneurons withinthegraymatter. Majorascendingpathwaysarethedorsalcolumnmediallemniscalsystem(MLF)andthe IntrotoNeuroscienceLabManual2013
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anterolateral system (ALS). The MLF mediates a number of proprioceptive and cutaneous sensations including two point discrimination, stereognosis and limb position sense. The dorsalcolumnsareformedbythefasciculusgracilis(gracilefasciculus,Fig.21)whichcontrols the lower half of the body and the fasciculus cuneatus (cuneate fasciculus, Fig. 21), which controls the upper half of the body. The ALS carries information on pain and temperature as wellassomevarietiesoftouchforthebody. Motor descending pathways are localized in the lateral funiculus (lateral corticospinal and rubrospinal tracts) as well as in the ventral funiculus (reticulospinal and vestibulospinal tracts). The lateral corticospinal and rubrospinal tracts contain decussated fibers that have generated in the motor cortex and red nucleus, respectively that innervate motor neurons in the gray matter (see below). These are the most important fibers controlling voluntary movements in humans. Reticulospinal and vestibulospinal tracts originate from nuclei in the pons and medulla and are the main sources controlling involuntary movements, equilibrium andmuscletone.
Figure21.Coronalsectionofcervicalspinalcord. 7C.SpinalCordGrayMatter Look at the slides or pictures of spinal cord sections (Fig. 21). Note that the gray matter of the spinal cord has the shape of a butterfly, centered at the central canal. The dorsal (or posterior) columns ("horns") of the gray matter are usually smaller than the ventral (or anterior) columns ("horns"). This is because the ventral horn contains large motorneurons that innervate the muscles. This is particulary true in the cervical and lumbar enlargement portions of the spinal cord as they contain neurons that innervate the upper and lower limbs, respectively. The area between the two horns and surrounding the central canal is further termedtheanteriorandposteriorgraycommissures. Potentialquestionrelatedtothissection.Pleaseseequestion#4inAppendix.

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APPENDIX A X(examqu uestions)

on#1 Questio

The estructureindicatedby thestaristhe: A.superior s frontalgyrus B.middle m temp poralgyrus C.superior s tem mporalgyrus s D.postcentralgyrus N oftheabove E.None

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The estructurepointed p bythebluearro owisthe: A.Superior S colliculus B.Mammillary M body C.Amygdala A D.Uncus E.Olfactory O bu ulb

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The estructureindicatedby thestarbelongstothe: : A.dienchephal d lon B.mesencepha m alon C.cortex c D.basalganglia a E.basal b forebra ain

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Ale esioninthestructureindicatedbythe t arrowwiillmostlikely yresultin: A.Lossoftwopointdiscrim minationinthe t lowerlim mbs B.Loss L oftwopointdiscrim minationinthe t upperlim mbs C.Loss L ofmoto orcontrolof fupperlimbs D.Lossofmoto orcontrolof flowerlimbs s A inthelowerbody E.Anaesthesia

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APPENDIXII(Independentstudiesofmajorpathways)
Because all ascending and descending pathways are funneled into the spinal cord, lesionsinthespinalcordproduceseveremotorandsensorydeficits.Basedonthesiteofthe lesion (level of the spinal cord) a patient may loose the ability of moving and sensing in the upperorlowerpartofthebody.However,motorandsensoryabnormalitiescanalsobeseen inlesionsofthebrain.Thebestwaytodiagnoseaneurologicaldiseaseistoobservewhether deficitsofmotorandsensoryfunctionsarepresentandwhichportion(s)ofthebodyhasbeen affected. A basic understanding of the major motor and sensory pathways is necessary for a proper diagnosis. The following is an appendix that reviews the origins and terminations of twopathways:thedorsalcolumnmediallemniscalsystemandthelateralcorticospinaltract. The dorsal columnmedial lemniscal system originates with the central processes of dorsal root ganglia that enter the dorsal roots in the medial division. They give off collaterals that synapse in the dorsal horn and others that ascend in the ipsilateral dorsal funiculus towards the brainstem. Fibers from the lower half of the body give rise to the fasciculus gracilis (gracile fasciculus, Fig. 20); axons from upper thoracic and cervical ganglia form the fasciculus cuneatus (cuneate fasciculus, Fig. 20). The axons forming both of these pathways terminate on nuclei bearing the same names, nucleus gracilis and nucleus cuneatus, in the caudalmedulla(Fig.12). Axons of projection neurons in these nuclei (the second order neurons for this pathway) form the internal arcuate fibers that cross to the contralateral side of the brain stem to form the medial lemniscus. At the level of the open medulla, the medial lemniscus can be seen as a vertically elongated mass of heavily myelinated axons adjacent to the midline in the lower tegmentum, just above the pyramids and medial to the inferior olivary nuclei (Fig. 11). In the pons, the medial lemniscus is seen as a horizontally elongated fiber mass in the lower tegmentum extending laterally from the midline (Fig. 9). Axons representing the lower portion of the body are in the most lateral portion of the lemniscus. At the level of the superior colliculus in the midbrain, the medial lemniscus lies just laterally to the red nucleus. At the junction of the midbrain with the diencephalon, axons of the medial lemniscus pass into the thalamus and synapse on the third order neurons of this system. Axons from projection neurons of the thalamus travel in theinternal capsule to reach the somatosensory cortexofthepostcentralgyrus. The lateral corticospinal tract arises from axons of neurons located in layer V of the motor cortex. Axons are collected and funnelled within the posterior portion of the internal capsule. In the midbrain these fibers help forming the central portion of the cerebral peduncles (Fig. 8). At the level of the pons, these fibers can be seen as longitudinal fibers at the basis of the pons (Fig. 9). In the medulla, these longitudinal fibers become the pyramids. The lateral corticospinal tract decussates at the level of the pyramidal decussation and occupies the lateral funiculus in the spinal cord (Fig. 20) where they give off collaterals that synapsewithmotorneuronswithintheventralhorns.

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APPENDIXIII(PrinciplesofMRI)
WrittenbyJ.VanMeter The magnetic field in an MRI scanner is generated by surrounding a coil of superconductive wire with super cooling fluids (liquid helium) lowering the temperature to about 10oK. Medical MRI takes advantage of the high prevalence of hydrogen in the body and the magnetic properties of the proton in a hydrogen atom. Protons induce a small magnetic field duetotheirspinthatcanbemeasuredinMRI. TheMRImeasurementconsistsofthefollowingprocesses: 1. Alignment of the protons in the body with the large magnetic field of the MRI scanner. After a few seconds in the scanner the protons in the patient are aligned with the magneticfield. 2. Aradiofrequency(RF)pulseisusedtotiptheprotonsoutofalignmentwiththescanners magneticfield. 3. Onceoutofalignmentthemagneticmomentofthehydrogenprotonscanbemeasuredas theyrotatepastmeasurementRFcoils(loopsofwire)inducinganelectricalcurrent. 4. The protons are pulled back into alignment with the main magnetic field decreasing the measurablesignal.The rateatwhichthis occursdeterminestheT1 propertiesofa tissue. If the protons in a tissue return to alignment faster than all other tissues then this tissue willbebrightestonaT1weightedscan. 5. While rotating the protons gradually become out of phase with one another decreasing the measurable signal. The rate at which this dephasing occurs determines the T2 properties of a tissue. If the protons in a tissue remain in phase with one another longer thanallothertissuesthenthistissuewillbebrightestonaT2weightedscan. 6. A proton density (PD) scan minimizes both T1 and T2 contrast to produce an image in whichbrightnessisdeterminedbythenumberofprotonsinavoxel. Two controls determine tissue contrast: TR (repetition time) and TE (echo time) of the scan. Repetition time is the time between successive RF pulses. A long repetition time allows the protons in all of the tissues to relax back into alignment with the main magnetic field minimizing T1 contrast. A short repetition time will result in the protons from some tissues nothavingfullyrelaxedbackintoalignmentbeforethenextmeasurementismadedecreasing the signal from this tissue. Echo time is the time at which the electrical signal induced by the spinning protons is measured. A long echo time results in reduced signal in tissues like white matterandgraymattersincetheprotonsaremorelikelytobecomeoutofphase.Protonsina fluid will remain in phase for a longer time since they are not constrained by structures such as axons and neurons. A short echo time reduces the amount of dephasing that can occur in tissue like white matter and gray matter thus minimizing T2 contrast. The relationship betweenTRandTEandtissuecontrastareshowninthefigurebelow.

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