Localization in Neurology- 1
Anatomical & pathological correlation
Brain functions
Extrapyramidal system Afferent- Caudate nucleus Globus pallidus Efferent- Putamen Substantia nigra Subthalamic nucleus
Cerebellum Coordination Vermis- axial &
Lobes- I/L appendicular 3 peduncles Superior- midbrain- efferent Middle- pons- afferent Inferior- medulla- afferent
Blood supply of brain Internal carotid MCA ACA Subclavian artery Vertebral artery-2Ant. spinal artery-1PICApost. spinal artery-2 Basilar artery-1AICASCAPCA Circle of Willis AC-ACA-MCA-PC-PCA
Blood supply
Blood supply
Venous drainage of brain
Blood supply to spinal cord Anterior 2/3rd-
ASA
Posterior 1/3rd- PSA
Cranial n.nuclei MidbrainIII, IV PonsV-VIII MedullaIX-XII
Motor pathways
Sensory pathways
Spinal tracts
Tracts Motor- Corticospinal- cross at medullaMedial Lateral- C.T.L.S
Sensory- Spinothalamic- pain & temperature-
cross at spinal levelMedial Lateral- C.T.L.S Posterior column- touch, position, vibration-
cross at medullaMedial Lateral- S.L.T.C
Motor & sensory units
Autonomic nervoussystem SympatheticThoraco-lumbar ParasympatheticCranio-sacral(III, VII, IX, X cranial n.have parasympathetic nuclei)
ANS Involuntary, independent Located outside cerebrospinal axis Most organs have both S & PS supply;
adrenal, hair follicles, sweat glands, blood vessels- S supply only
Lateral horn Ganglia Organ pregang. fibres postgang. fibres all Ach S-NE, PS-Ach Central regulation-
frontal lobe, limbic system, hypothalamus
CNS- pathology Vascular- infarct or
hemorrhage Infection- myelitis or
encephalitis Abscess Meningitis Trauma Demyelination
Degenerative Tumor/SOL Congenital or
hereditary Nutritional Metabolic Toxins/Poisoning Psychogenic
Practical localization Is CNS involved? At what level- cerebral cortexmuscle? What system(s) is/are involved? Consciousness, language, vision Motor function, coordination Pain/temperature, proprioception/vibration Process- focal/multifocal/diffuse? Lateralization- Left/Right/bilateral? Onset, progression & course?
Practical pathology Onset- Acute- vascular/electrical Subacute- demyelinating/inflammatory Chronic- structural/degenerative Course- Self-limiting- vascular Paroxysmal- electrical/demyelinating Progressive- compressive/degenerative Circumstances- Preceding viral infection- demyelinating Preceding trauma- structural Peripartum- venous thrombosis etc.