Sugarman Slides

1
Sugarman Slides
2
Slide 1 - sacral level
1
substantia gelatinosa
2
3
fasciculus proprius
anterior white commisure
3
Slide 1 - lumbar level
2
cauda equina
1
fasiculus proprius
3
anterior white commisure
4
Slide 1 thoracic -level
dorsal lateral tract of Lisseur
5
7
1
fasciculus proprius
3
6
lateral corticospinal tract
4
anterior corticospinal tract
8
2
anterior white commisure
6. Nucleus dorsalis
7. Posterior spinocerebellar tract.
8.anterior spinocerebellar tract
5
Slide 1 - cervical level
dorsal lateral tract of Lisseur
3
substantia gelatinosa
6
1
lateral corticospinal tract
5
interneurons
8
Fibers fromLCS tr. Toflexor areaof
anteriorhorn
7
Fibers going to thecontra lateralventral horn
to extensor area
4
anterior white commisure
2
anteror corticospinal tract
6
Slide 2
fassiculus gracilis
spinal trigeminal tract
Highcervical cord
3
4
nucleus gracilis
7
5
8
fassiculus cuneatus
6
spinal nucleus of trigeminal tract
nucleus of trigeminal tract
10
post. spinocerebellar tract
2
lateral corticospinal tract
ant. spinocerebellar tract
9
1
anteror corticospinal tract
7
The large circled areas are the lateral
cortico-spinal tr. With fibers that came from
contralateral cortical areas of pre motor area.
The somatatopy is lettered for where fiberswill
innervate ventral horn andthen synapse on alpha
and gamma motor neurons (C. cervical, T.
thorasic, L. lumbar, S. sacral)
S
T
C
L
A
A
A. Prior site of pyramids, now areanterior
cortico spinal tr.
8
Slide 3
1
Decussation of pyramids
Fasciculus gracilis
2
Fasciculus cuneatus
3
nucleus gracilis
5
Spinal Trigeminal tract
4
Nucleus cuneatus
6
Ant. Spinocerebellar tr
Nucleus of Spinal trigeminal tract
Rubrolspinal tr
8
13
14
Post. Spinocerebellar tr
Rostral end of pyramidal decussation
A
12
Spinal accessory nuc.
Med. Longitud. fasciculus
9
7
Ventral gray horn
15
Vestibulospinal tr.
11
ALS(anterolateralsystem)
B
10
Tectospinal tr.
Pyramids (ant. Corticospinal tract)
9
Spinal nuc. Of trigeminal
These areas are remainderof prior pyramids
thathave now decussed to thecontralateral side
as the lateral cortico spinal tr.
10
Slide 4
Fasciculus gracilis
3
Closed medulla
4
Fasciculus cuneatus
1
Nucleus gracilis
2
5
Nucleus cuneatus
Nucleus ofspinal trigeminaltr.
8
13
Post. Spino-cerebellartr.
6
Decussation of pyramids
MLF
11
6
12
9
Spinal-accessory nuc.
10
Ant. Spino-cerebellar tr.
7
12.. Ant. Spinocerebellar tr.
pyramids
13. Post spinocerebellar tr.
11
17
Slide 5
Lateral cuneate nuc.
14
Nuclear gracilis
Closedmedulla
5
Nuclear cuneatus
6
1
Dorsal long. fasciculus
A
Int. arcuate fibers
Dorsal long. fasciculus
15
B
Dorsal motor nucleus of X
7
12
Spinaltrigeminalnuc.
Hypoglossal nu.
2
3
Medial longitudinal fasciculus
13
Reticular formation
11
Medial lemniscus
4
Tectospinal tr.
16
8
Nucleusambiguous
9
Inf. Olivarynucleus
10
Note 10 beginning ofdecussation, fibersare
crossing like arrows
Pyramid
16ant. Spinocerebellar tr.
15post. Spinocerebellar tr.
17.lat. Cuneate nucleus
12
Slide 6
Nucleus cuneatus
Open medulla rostral end
Nucleus gracilis
2
3
C
Dorsal motor nuc. Of X
9
Dorsal long.fasciculus
Lateral cuneate nuc.
D
Hypoglossal nuc.
4
4
Inferiorcerebellarpeduncle
6
5
8
Med. Long. fasciculus
Ant. Spinal cerebellartr.
7
Nuc. ambiguous
ALS (spinothalamic tract)
1
Inferior olivary nuc.
A
Pyramid
B
For 6 it was theposterior spinocerebellar tr.Up
to this point, now changes
13
V
Slide 7b
vermis
Open medulla
Hypoglossalnuc.
Dorsal vagal motor nuc
Tract ofsolitarius(dark area)
12
8
Inferior cerebellarpeduncle
16
A
7
9
17
6
Nucleussolitarius(light area)
1
13
Spinal trigeminal nuc.
2
14
Medial long.fasciculus
5
Nuc. ambiguous
7/8Medial andlateralvestibular nuc.
18
15
3
Spinal trigeminaltract
Tectospinal tr.
10
spinothalamic tr.(ALS)
4
Medial lemniscus
Old exam tags16 and 6
16.dorsal lat. fasciculus
11
Hypoglossal n.
17.lateral cuneate nuc.
B
B
B. Pyramids ( colored area fromsame side of
brain)
18.ant. Spinocerebellar tr.
A. Inferior vestibular nuc.
14
Slide 7c
Openmedulla
Close up same slide
15
Slide 8a
Openmedulla
16
Slide 8b
Open medulla
Dorsal lateralfasciculus
Inf. Cerebellar peduncle
14
Post. spino_-cerebellar tr.
Solitary nuc.
11
10
13
16
8
Solitary tr.(dark)
1
Hypoglossal nuc.
Spinal trigeminal tr.
7
3
Medial longit.fasciculus
17
2
15
Spinal trigeminal nuc.
6
Internal acurate fibers
Tectospinal tr.
(ALS)
12
4
Medial lemniscus
9
Inferior olivary nucleus
16. Lateral cuneate nucleus
pyramid
17. Nucleus ambiguous
5
Old test tag was 11
17
Slide 9a
Open medulla
18
Slide 9 b
Open medulla
2
vermis
Vestibulocochlearn.
Medial vestibular nuc.
7
8
Inferior vestibular nuc.
1
A
Solitary tract
B
4
5
Inferior cerebellar peduncle
6
Solitary nuc.
11
Posterior spino-cerebellar tr.
Medial longitudinalfasciculus
10
12
3
Nucleus ambiguous
9
Glossopharyngeal n.
Anterior spino-cerebellar tr.
A. Dorsal lateral fasciculus
B. Dorsal motor nucleus of X
19
Slide 10a
Open medulla
1
2
Nucleusinterpositus
Dentate nucleus
Inferiorcerebellarpeduncle
3
Nt. Spinocerebellartract
20
Slide 10a
Open medulla, lower end
12
Dentate nucleus
Inferior cerebellar peduncle
Medial vestibular nuc.
8
A
Lat. Vestibular nuc.
1
5
7
Cochlearnuc.
Inferior vestibular nuc.
6
MLF
3
Ventralcochlearnucleus
4
Spinal trigeminal nuc.
11
10
9
ALS
Vestibulo-cochlearnerve
2
Inferior olivary nuc.
A. Dorsal lateral fasciculus
B. Pyrimidal tracts (cortico spinal tr.NO
DECUSSATION AT THIS LEVEL)
B
B
21
Slide 11
Level of pons
Middlecerebellarpeduncle
Facial nerve
6
Superior cerebellar peduncle
Dorsal lateral fasciculus
3
Superior vestibularnucleus
7
15
Genu, facial nerve
14
A
11
Spinal trigeminal nucleus
12
(MLF)
Abducens nuc.
5
1
Spinal trigeminal tract
Facial nucleus
8
13
Central tegmental tract
Lateral lemniscus
16
Superior olivary nuc.
9
4
Medial lemniscus
2
ALS
Corticospinal/corticobulbar tracts
10
A. Medial vestibular nucleus
22
Slide 12a
Level of pons
Fastigial nucleus
11
Interpositus nuc.
14
Dentate nuc.
3
Superior cerebellarpeduncle
3
6
Inferior cerebellar peduncle
Superior vestibular nuc.
9
1
Mesencephalic nucleusof trigeminal
8
Medial vestibular nuc.
A
DLF
15
Genu,facial nerve
2
Motor nucleus oftrigeminal
10
10
7
13
13
Lateral lemniscus nuc.
16
5
ALS
4
Medial lemniscus
10. Reticular formation
13. Central tegmental tract
14
Corticospinal fibers
16. Middle cerebellar peduncle
15
Pontine nucleus (pink area inbetween)
23
Slide 12b
Level of pons
1
Area of cortico spinal path
24
Slide 13
rostralpons
vermis
11
Superior cerebellar peduncle
1
Lingula of cerebellum
2
Suprior medullary of velum
3
Locus corruleus
7
A
5
Mesencephalic root CN V
4
MLF
Reticular formation
9
10
Central tegmental tract
6
Tectospinal tract
8
Medial lemniscus
Corticospinal fibers
12
A. DLF
25
Slide 14a
Superior cerebellarpeduncle
Level ofpons
Mesencephalic tract of trigeminal
7
11
9
Periaqueductal gray
Lateral lemniscus
5
Locus coerulus
1
4
3
Raphe nucleus
12
Central tegmental tract.
14
2
ALS
6
Medial longitudinalfasciculus
8
Middle lemniscus
10
10
13
Pontine nuclei (pink area)
10.trigeminalnerve
6.ventral trgeminothalmic tract
9.mesencephalic nucleus of trigeminal
26
Slide 14b
Level of pons
27
6. Cerebral aqueduct
Slide 15a
Rostralmetencephalon
Periaqueductal gray (region around aqueduct)
1
Superior cerebellarpeduncle
6
10
8
2
4
Locus coeruleus
11
3
MLF
9
ALS
Central tegmental tr.
Med. lemniscus
7
5
Ventral trigeminothalmic tr.
A
DLF
12
Trigeminalnerve
4.Raphe nucleus
8. Mesencephalic nucleus/tract of trigeminal
28
Slide 15b level of basal pons
1
Site of cortico spinaltr.
29
Slide 16a
A
Dorsal longitudinal fasciculus
Periaqueductal gray
1
2
Locus coeruleus/trochlear nerve
mesencephalic nucleusTract of trigeminal nerve
6
7
8
4
Ventral trgeminalthalamic tract
5
Med lemniscus
3
Decussation of sup.Cerebellar peduncle
medial longitudinalfasciculus
8.central tegmental tract
30
1
Inf. colliculus
Basal ponsand inferiorcolliculus
2
PAG
6
A
Lateral lemniscus
9
Medial longitudinal fasciculus
3
4
Superior cerebellarpeduncle
Trochlear nerve
10
ALS
11
8
7
5
Med. lemniscus
Decussation of the superiorcerebellar peduncle
Corticospinal tract
12
A. Dorsal longitudinal fasciculus
8. Ventral trigeminalthalmic tract
9. Mesencephalic nucleus/ tract of trigeminal
31
6
Slide 18a
6
8
7
5
Cerebral aqueduct
1
Lateral lemniscus
2
ALS
4
tochlear nerve
Central tegmental tract
11
10
Medial longitudinal fasciculus
3
Medial lemniscus
9
Decussation of superior cerebellarpeduncle
6. Superior colliculus
7. PAG
8. Mesencephalic nuclei/tract of
trigeminal/trochlear nucleus
32
Slide 19 level of inferior colliculus
2
inferior colliculus
6
mesencephalic tract/nucleusof trigeminal
Cerebral aqueduct
3
5
Brachium ofinferiorcolliculus
8
ALS
Medial longitudinal fasciculus
10
11
Central tegmentaltract
4
Medial lemniscus
9
Decussation of superior cerebellarpeduncle
13
Middle 3/5 basis ped.(location of corticospinal
tr.)
1
Substantia nigra
Basal pons
12
Corticospinal tract(middle of basis pedunculus)
7
33
Midbrain
D
Pulivinar nucleus,(thalamus)
1
Pineal gland
Brachium of sup.colliculus
2
C
Superior colliculus
A
7
4
ALS
B
E
6
Medial lemniscus
Lateral geniculate nucleus (thalamus)
Central tegmental tract
8
Ocular motor nucleus
9
3
Red nucleus
G
Substantia nigra
5
Substantia nigra
8.
Corticocospinal tractin middle of basis
pedunculus
F
Middle 3/5 basis ped(cortico-spinal tr. Moving
thru here)
10
Ocular motor nerve
7. Mesencephalic tract/nucleus of trigeminal
A. Medial geniculate nucleus (thalamus)
B. edinger-westphal nucleus
34
Slide 20c
35
Transition btw. mid brainand thalamus
Corpus callosum
B
Crus of fornix
D
Stria terminalis
G
I
A
Pulivinar nuc.(thal)
7
Post. Lat. nucleus
F
Posteriorlateral nuc.(thalamus)
E
Site of posterior commesure
6
Habenula nucleus
12
Habenula nucleus
H
8
Centromedian nucleus
2
?
Cerebralaqued.
11
10
C
15
Internal medullarylamina (dark)
14
Lenticular nuc.
9
1
Red nucleus
3
Subthalmicnucleus
J
4
4
5
Basis pedunculus
13
Mammilary body
15. Zona incerta
4. Substantia nigra
I.reticular nucleus(thalamus)
E. External medullarylamina
9.habenulapenduncular tract
10.ventro-posterior medial nucleus
H.dorsal medial nuc(thal)
J. Middle 3/5 basis ped.
11.ventro posterior lateral nucleus
36
Slide 21 b
37
Slide 21c
38
Slide 21d
39
O
Fibers of corona radiata
Stria terminalis
K
F
Diencephalon
Body of corpus callosum
C
Crus of fornix
B
External medullary lamina
D
E
Dorsolateral nuc. (thal)
Reticular nuc.(thalamus)
6
Stria medullaris thalmi
Vent. Post. Nuc.
4
Thalmic fasciculus
I
14
G
Centromedian nuc. (thal)
Dorsomedialnuc (thal)
8
Globus pallidus
11
12
Zona incenta
Lenticular fasciculus
13
P
9
Post. Limb inter. cap
mamilothalmic tr.
3
Subthalmic nuc.
J
2
Optic tract
5.
Mamilothalmictract
1
Basis pedunculus(medial 3/5)
H.
amygdala
M
Column offornix
10
Mammilarybody
11. Third vent.
N
7
hypothalmus
N. Medial hypothalmic area
A
Lateral hypothalmic area
P approx area of cortco-spinal tr.
40
Slide 22b
41
Slide 22c
42
Slide 22d
43
Slide 22e
44
Butterfly
4
16
Body of corpus callosum
Coronaradiata
20
8
Septum pellucidum
Reticular nuc. (thal)
13
Dorsolateral nuc. (thal)
17
9
Body of fornix
Externalmedullary lamina
11
10
Internal medullary lamina
12
Ventral anterior nucleus (thal)
putamen
6
14
Dorsomedial nuc(thal)
19
3
Posterior limbinternal capsule
21
Stria medullaristhalami
Ant. Nucleus (thal)
15
Mamillothalmic tr.
1
5
5
18
Column of fornix
Globus padillus
7
Anterior white commisure
1. thalamus
20.stria terminalis
45
Slide 23b
46
Slide 23c
47
Slide 23d
48
Slide 23e
49
Slide 23e
50
Slide 23e
51
Cerebral Arterial Circle
Internal carotid terminates lateral to Pituitary
(note, in life sphenoid bone, cavernous sinus)
Anterior cerebral A. is in interhemispheric
fissure, between brain and falx cerebri.
Middle Cerebral A. is in lateral sulcus
Basilar A. is against basilar Pons
Posterior Cerebral A. medially under temporal lobe
AICA is at pontomedullary junction
Vertebral A. rests anterior to Medulla
PICA rises under cerebellum
52
THE END