2006 2007Mm Medicinos Studijų Programos Anatomijos Anatomijos Dalyko CNS Skyriaus Studijų

2006 2007Mm Medicinos Studijų Programos Anatomijos Anatomijos Dalyko CNS Skyriaus Studijų

2018 Faculty of Medicine

nervous system

Basics of neuroanatomy

Nervous tissue. Structural parts of the neurons and their types by shape and function. Synapses, their morphological types, neuromediators. Neuroglia, central and peripheral gliocytes, their importance. Nervefibers, their morphological and functional types.
Nerve tissue formations.Central nervous systems (CNS): grey and white matter, cortex, nuclei, fibers, tracts, fascicles and pathways. Peripheral nervous systems (PNS): ganglia, their functional types, neuronal receptors, nerves, nerve plexuses.
Functional parts of the nervous system. Anatomy of the reflex circuit, its types according to the structure and function. Functional division of the nervous system.

Parts of nervous system. Central Nervous system – Spinal Cord and Brain. Peripheral Nervous system – Somatic and Autonomic subdivisions. Somatic nervous system – Sensory (Afferent) and Motor (Efferent) ones. Autonomic nervous system – Sympathetic and Parasympathetic ones.

Central nervous system

Meninges of the central nervous system. Meningeson the spinal cord: dura mater, arachnoid and pia mater.Epiduraland subdural spaces. Meninges on the brain: dura mater, arachnoid and pia mater. Falx cerebri and tentorium cerebeli. Venal sinuses. Arachnoid villi, granulationes arachnoideae. Liquor or cerebrospinal fluid (CSF). Choroid plexus and Tela charoidea.

Brain ventricles: Lateral, Third and Fourth ones. Interventricular foramen. Cerebral aqueduct. Lateral and median apertures 4th ventricle.

Spinal cord

External anatomy of the spinal cord. Upper and lower boundaries, anterior median fissure, grooves (sulci)- posterior median, posterior and anterior lateral ones, spinal cord enlargements. Conus medullaris, filum terminale. Anterior and posterior roots of spinal nerves, spinal ganglia, cauda equina (horse tail), spinal nerves, their location and function.
Anatomy of the grey matter. The parts of the grey matter in the longitudinal and in the transverse aspects. Characteristics of the nuclei in the horns and columns. Central intermedial substance. Central canal. Spinal grey matter laminae by Bror Rexed (I-X).Spinal cord segment.
Anatomy of the white matter. Fascicles of nerve fibers, their characteristics according to the orientation of the nerve fibers: loop (lemniscus, ansa), decussatio, chiasma, stria.

The origin, function and location of the nerve fascicles in the anterior, posterior and lateral funiculae. Fasciculus gracilis and cuneatus. Tracts: spinothalamic, anterior and posterior spinocerebellar, pyramidal (corticospinal) and extrapyramidal (rubrospinal, tectospinal and vestibulospinal).

Brain

Phylogeny and ontogeny of the brain. Evolutionary factors which contributed to the emergence of the prosencephalon, mesencephalon and rhombencephalon.Differentiation of the rhombencephalon into the myelencephalon and the metencephalon (pons and cerebellum).Differentiation of the prosencephalon into the diencephalon and telencephalon. Evolutionary conservatism of the mesencephalon and its functional reduction.

The parts of the brain or encephalon: Hindbrain or Rhombencephalon: medulla oblongata and metencephalon (pons and cerebellum).Midbrain or Mesencephalon.Forebrain or Prosencephalon: diencephalon (or interbrain) and telencephalon.Brain stem: medulla oblongata (bulbus, myelencephalon), pons and midbrain.

Brain stem.Ascending and descending neural pathways, and nuclei of ten cranial nerve (III-XII). Reticular formation. 4th ventricle and the cerebral aqueduct. Choroid plexuses and the apertures of 4th ventricle. Myelencephalon: anterior median fissure, sulci (anterolateral and posterolateral); pyramid, olive, roots of the cranial nerves (VI, VII, VIII, IX, X, XI, XII).Pons:basilar sulcus, middle cerebellar peduncles, roots of trigeminal nerve (V).Rhomboid fossa.Superior and inferior medullary velum. Median sulcus, medial eminence, hypoglossal and vagal trigones, facial colliculus, vestibular area.Mesencephalon: Cerebral peduncles, posterior perforated substance, roots of cranial nerves (III, IV). Corpora quadrigemina seu lamina tecti: superior and inferior colliculi and their brachii.

Levels of the brain stem:anterior (ventral) – Basis, middle- Tegmentum, posterior (dorsal) –Tectum. Brain stem basis: pyramidal tract, nuclei of the pons. Brain stem tegmentum: gracile and cuneate fasciculi, tubercula and their nuclei. Medial lemniscus and its decussation.Anterior and posterior spinocerebellar tracts.Anterolateral fasciculus (ALF) or spinothalamic tract. Nuclei of the cranial nerves (III-XII): sensory and motor (somatic, visceral and special). Trapezoidal body and lateral lemniscus. Cochlear nuclei and superior olivary nuclei. Trigeminal lemniscus. Medial longitudinal fasciculus. Reticular formation. Cerebral aqueduct, substantia nigra, crura of cerebral peduncles. Red nucleus. Corticospinal and corticonuclear tract.

Cerebellum: peduncles (inferior, middle, superior), hemispheres and vermis. Lobes (anterior, posterior, flocculonodular) and fissures (primary, horizontal and posterior) of cerebellar hemispheres. Deep nuclei of the cerebellum:fastigial, interposed: emboliform and globose, and dentate. Cortex of cerebellum: molecular and granular layers, Purkinje and granular cells, parallel, climbing and mossy fibers. Spinocerebellum, vestibulocerebelum, cerebrocerebellum (paleo-, archi-, neo- cerebellum).

Diencephalon or interbrain: thalamus, metathalamus, epithalamus, hypothalamus. Thalamus: interthalamic adhesion, hypothalamic sulcus, pulvinar; anterior, medial, lateral parts and nuclei.Epithalamus: pineal body, habenular and posterior commissure.Hypothalamus: optic chiasm, tuber cinereum, infundibulum, mammillary bodies, pituitary gland or hypophysis (neuro- and adenohypophysis); hypothalamic nuclei:Anterior, median, and posterior nuclei, mammilo-thalamic tract and fibers to fornix. Anterior and median hypothalamic nuclei and their neuronal projections into neurohypophysis. Centrifugal and centripetal nerve fibers of hypothalamic nuclei. Metathalamus: medial and lateral geniculate bodies; nuclei of geniculate bodies. Neuronal projections of thalamic and metathalamic nuclei into cerebral cortices.

Forebrain

Upper lateral surface of cerebral hemispheres.Cerebral hemispheres, longitudinal cerebral fissure, corpus callosum. Cortex, primary sulci and gyri. Lobes of hemispheres: frontal, parietal, occipital, temporal ones. Upper lateral surface of cerebral hemispheres. Isula.

Sulci.Interlobal sulci: central and lateral. Frontal lobe:inferior and superior frontal, and precentral.Parietal lobe: postcentral and superior ir intraparietal. Occipital lobe:transversal occipital.Temporal lobe: superior and inferior temporal.

Gyri: Frontal lobe:inferior, middle, superior frontal and precentral.Parietal lobe: postcentral, superior and inferior parietal, and angular lobules. Occipital lobe:Temporal lobe: superior, middle and inferior temporal.

Inferior and medial surface of cerebral hemispheres. Sulci:sulcus of corpus callosum, cingulate, parieto-occipital. Frontal lobe: central sulcus.Parietal lobe: parieto-occipital.Occipital lobe: calcarine sulcus.Limbic lobe: cingulate gyrus, para-hippocampal and dentate gyri. Uncus.Corpus callosum:rostrum, genu, trunk, splenium.Anterior commissure.

Principal schema of cytoarchitecture of the cerebral cortex. Functional areas of cerebral hemispheres (47 areas).

Basal part of cerebral hemispheres. Basal nuclei or ganglia.Amygdala. Claustrum. Caudate nucleus: head, body, tail. Lentiform nucleus: putamen and globus pallidus. Corpus striatum.

Neural fibers in forebrain, fibrae et fasciculi. Projective fibers (internal capsule), commissural (corpus callosum, anterior commissura), associative fibers. Fornix and other parts of limbic system.

Lateral ventricles (anterior, posterior and inferior horns, central part, choroid plexi).

Peripheral nervous system

General terms

Somatic, autonomic, myelinated, unmyelinated, afferent, and efferent nerve fibers. Structure of the peripheral nerve and its sheaths. Somatic and autonomic nerve plexuses, ganglia, types of peripheral nerves and their primary branches. Principles of segmental and peripheral innervation.

SOmatic subdivision

CRANIAL NERVES

Structural diversity and classification of cranial nerves. Sensory and motor nuclei of cranial nerves and their location. Sensory ganglia of cranial nerves, their locations, roots and topography of cranial nerves. Access of cranial nerves through the skull. First branches of cranial nerves, their extentions, innervation areas and organs (targets).

Nerves of special senses: olfactory, optic, and vestibulocochlear. Vestibular and cochlear (spiral) ganglia.

Motor nerves: oculomotor, trochlear, abducent, accessory, and hypoglossal ones, their courses, innervation targets.

Mixed nerves: trigeminal, facial, glossopharyngeal, and vagal ones. Innervation targets and course of sensory and motor nerve fibers of these nerves. Trigeminal nerve: its ganglion, sensory and motor roots. Principal branches of trigeminal nerve: ophthalmic, maxillary and mandibular. Ophthalmic nerve: frontal, nasocillary, and lacrimal nerves. Maxillary nerve: infraorbital, superior alveolar, zygomatic, palatine and ganglionic branches (nerves). Mandibular nerve: lingual, inferior alveolar, auriculotemporal, buccal, and its motor branches (deep temporal, lateral pterygoid, masseteric ones). Facial nerve: motor branches, geniculate ganglion, intermediate and chorda tympani nerves. Glossopharyngeal nerve: its inferior and superior ganglia, lingual, pharyngeal, tonsillar, carotid sinus, stylopharyngeal, and tympanic branches (nerves). Vagal nerve: its superior (jugular) and inferior (nodosal) ganglia, its auricular, pharyngeal, esophageal, laryngeal (superior and recurrent), cardiac, bronchial, gastric and celiac branches.

Spinal nerves

Structure, subdivision, topography of the spinal nerves. Description of their meningeal, posterior, anterior and white/grey communicating branches and their innervation areas. Intercostal nerves, their location, course, innervation areas.
Cervical plexus. Its source, principal structure, location, characterization of its branches and their innervation region. Innervation areas of the lesser occipital, great auricular, transverse cervical supraclavicular, phrenic nerves and ansa cervicalis.
Brachial plexus. Its source, principal structure, supraclavicular (superior, middle and inferior trunks) and infraclavicular (lateral, posterior and medial cords) parts. Innervation areas of the short branches of the brachial plexus. Origin, location, course and innervation areas and muscle groups by axial, musculocutaneous, radial median and ulnar nerves.

Lumbar plexus. Its source, principal structure, location, characterization of the main nerve branches and the area of their ​​innervation. Location, course and innervation areas and muscle groups of the iliohypogastric, ilioinquinal, genitofemoral, femoral and obturator nerves.
Sacral plexus. Its source, principal structure, location, branch characterization and the area of ​​the innervation. Location and innervation areas and muscle groups of the superior and inferior gluteal, tibial and (common, superficial, deep fibular) nerves.

Coccygeal plexus. Its structure and location.

Autonomic subdivision

Autonomic nervous system, its central and peripheral parts, sympathetic and parasympathetic nuclei.Preganglionic nerve fibres (axons) and their course. Paravertebral, prevertebral and terminal (intramural) ganglia. Postganglionic nerve fibers (axons), their course, plexi, neuromediators. Paraganglia and chromaffin cells.

Sympathetic part. Sympathetic nuclei in spinal cord. Sympathetic trunk, white and grey rami communicans (communicating branches), greater and lesser thoracic splanchnic, lumbar and sacral splanchnic nerves. Celiac, superior and inferior mesenteric, and superior and inferior hypogastric plexi and ganglia. Organs innervated by sympathetic postganglionic axons.

Parasympathetic part.Parasympathetic nuclei in the brain stem. Distribution of parasympathetic preganglionic axons within cranial nerves (III, VII, IX, and X). Greater and lesser petrosal nerves, chorda tympani, and tympanic (Jacobson) nerve. Parasympathetic cranial ganglia: ciliary, pterygopalatine, otic and submandibular ones. Links with cranial nerves and innervation targets of the parasympathetic postganglionic axons.

Spinal cord sacral parasympathetic nuclei, sympathetic trunk, white and grey rami communicantes (communicating branches), preganglionic axons, pelvic splanchnic nerves, hypogastric plexi and ganglia. Organs innervated by parasympathetic postganglionic axons.

Neuroanatomy of sensation

The somatosensory system

Classification of sensations. Receptors and their classification. Afferent pathways of somatosensory system: spinal ganglia, cuneate and gracile fascicles, their nuclei, subtantia gelatinosa and nucleus proprius, spinothalamic tract, spinocerebellar tracts, medial lemniscus, thalamic nuclei, postcentral gyrus. Trigeminal nerve, ganglion and nuclei.

The olfactory system

Olfactory region of nasal mucosa, olfactory bulbus, tract and trigonum, primary olfactory cortex.

The gustatory system

Lingual papilla, taste buds and neural pathways (facial, glossopharyngeal and vagal nerves, sensory ganglia and nuclei (solitary, thalamic) and primary gustatory cortex.

The visual system

Eye, eyeball, its capsule and nucleus. Eyeball capsule: fibrous layer, cornea, sclera, venal sinus of the sclera; vascular layer, choroid, iris, papilla, ciliary body, suspensory ligament; inner layer, retina, its blind and optic parts, macula lutea, central fovea, disc of optic nerve, optic nerve, chiasma and tract, lateral geniculate body, visual cortex. Anterior and posterior eyeball chambers, aqueous humor, lens, vitreous body. Accessory organsof the eye: superior and inferior eyelids, cilia, eyebrows. Conjunctiva, lacrimal lake, puncta, canaliculi, sac, nasolacrimal duct. External muscles of the eyeball.

The auditory and vestibular systems

External, middle, and inner ear. External ear: auricula and external auditory meatus. Middle ear: tympanic membrane, auditory ossicles (malleus, incus, stapes), auditory tube (Eustachian tube). Inner ear: bony labyrinth (vestibule, cochlea, semicircular canals), membranous labyrinth (saccule and utricle, cochlear duct, spiral organ, macula, semicircular ducts, ampullary crest). Auditory pathway: spiral ganglion, cochlear nerve, nuclei, trapezoid body, lateral lemniscus, inferior colliculus, medial geniculate body, primary auditory cortex. Vestibular pathway: vestibular ganglion and nerve, nuclei, vestibulocerebellar and vestibulospinal tracts, medial longitudinal fascicle, thalamic nuclei and primary vestibular cortex.

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