Basjiruddin A

Bagian Neurologi FK-Unand

Anatomy
Anatomically, the human nervous system is
a complex of two division
1. CNS-The CNS, comprising the brain and spinal
cord, is enclosed in bone and wrapped in
protective covering (meninges) and fluid-filled
space.
2. Peripheral Nervous System (PNS)-The PNS
is formed by the cranial and spinal nerve (Fig
1.1)

Neurons
Neurons vary in size and complexity
For example, the nuclei of one type of small
cerebellar cortical cell (granule cell) are
only slightly larger than the nucleoli of an
adjacent large Purkinje cell
Motor neuron are usually larger than
sensory neurons

The cell bodies is the metabolic and genetic

center of a neuron (see fig 2-3)

Dendrites
Dendrites receive incoming synaptic
information and thus, together with the cell
body, provide the receptive pole of the
neuron
Most neuron have many dendrites (see fig.23)

A single axon arises from the most neurons

The axon is a cylindrical tube of cytoplasm
covered by a membrane, the axolemma

Synapses

Communication between neurons usually

occurs from the axon terminal of the
transmitting neuron (presynaptic side) to
the receptive region of the receiving neuron
(postsinaptic side)

Neuroglial cells outnumber neurons in the

brain and spinal cord
1.
2.
3.
4.

Macroglia
Astrocytes
Oligodendrocytes
Microglia

The central portion of the nervous system

consist of the brain and the elongated
spinal cord (fig 1-2)
The brain has a tiered structure and form a
gross point of view, can be subdivided into
the cerebrum, the brain stem, and the
cerebellum
The cerebrum (forebrain) consist of the
telenchepalon and the dienchepalon

The telenchepalon includes the cerebral

cortex (the most highly envolved part of the
brain, sometimes called gray matter)
Sub cortical white matter, and the basal
ganglia, which are gray masses deep within
the cerebral hemispheres
The white matter carries the name because,
in a freshly sectioned brain, it has a
glittening appearance as a result of its high
lipid-rich myelin content

The white matter consist of myelinated

fibers and does not contain neuronal
cell bodies or synapses
The major sub division of the
dienchepalon are the thalamus and
hypothalamus
The brain stem consist of the mid brain
(mesenchepalon), pons, and medulla
oblongata
The cerebellum includes the vermis and
two lateral lobes.
The brain which is hollow, contains a
system of spaces call ventricles

Anatomi Hemisfer Serebrum

Kedua hemisfer merupakan bagian terbesar
otak
Sulkus dan Fisura Utama
Permukaan hemisfer serebrum mengandung
banyak fisura dan sulkus yang memisahkan
lobus frontalis, parietalis, oksipitalis, dan
temporalis dari satu sama lain dan dari
insula.

Bagian-bagian otak yang terletak diantara

sulkus dinamakan konvolusi atau girus
Sulkus sentralis memisahkan lobus frontalis
dari lobus parietalis
Fisura kalkarina dimulai pada permukaan
medial hemisfer dekat kutub oksipitalis dan
membentang ke depan ke daerah sedikit di
bawah splenium dari korpus kalosum
Bagian dari korpus kalosum berbentuk
busur;bagian anteriornya yang melengkung,
genu berlanjut ke anteroventralis sebagai
rostrum.

Lobus frontalis
Lobus frontalis membentang dari kutub
frontal ke sulkus sentralis dan fisura
lateralis
Lobus parietalis
Lobus parietalis membentang dari sulkus
sentralis ke fisura parieto-oksipitalis, ke
arah lateral, lobus ini meluas sampai ke
fisura lateralis serebrum
Lobus Oksipitalis
Lobus Oksipitalis yang berbentuk limas
terletak di belakang fisura parietooksipitalis.
Insula adalah bagian korteks serebrum
yang tenggelam

The Peripheral Nervous System (PNS)

consist of spinal nerves, and their
associated ganglia (group of nerve cells
outside the CNS)
The nerve contain nerve fibers that conduct
information to (afferent) or from (efferent)
the CNS

THE SPINAL CORD AND THE ASCENDING

AND DESCENDING TRACTS
VERTEBRAL COLUMN
The vertebral column is the central bony pillar of the
body
The vertebral column is composed of 33 vertebrae: 7
cervical, 12 thoracic, 5 lumbar, 5 sacral (fused to
form the sacrum), and 4 coccygeal (the lower 3 are
commonly fused)

The spinal cord is composed of an inner

core of gray matter, which is surrounded
by an outer covering of white matter; there
is no indication that the cord is segmented.

GRAY MATTER

On cross section, the gray matter is seen

as an H-shaped pillar with anterior and
posterior gray columns, or horns united by
a thin gray commissure containing the
small central canal.

WHITE MATTER

The white matter, for purposes of

description, may be divided into anterior,
lateral, and posterior white columns or
funiculi
The anterior column on each side lies
between the midline and the point of
emergence of the anterior nerve root
The
lateral column lies between the
emergence of the anterior nerve roots and
the entry of the posterior nerve roots
The posterior column lies between the
entry of the posterior nerve roots and the
midline

Anatomi luar Sumsum Tulang Belakang

Sumsum tulang belakang (medula spinalis,
atau mielyn) merupakan massa jaringan
syaraf yang berbentuk silinder memanjang
dan menempati dua pertiga bagian atas
kanal spinal orang dewasa di dalam
kolumna vertebralis

Masing-masing segmen dari sumsum tulang

belakang mempunyai 4 akar
Ke
31 saraf spinal yang muncul dari
sumsum tulang belakang mempunyai satu
akar ventralis dan satu akar dorsalis

Akar ventralis
Akar ventralis mempunyai akson neuron
motorik

Akar dorsalis
Masing-masing akar dorsalis berisi serabut
aferen dari sel-sel saraf dalam ganglionnya
Dermatom
Komponen
sensorik dari masing-masing
saraf spinal didistribusikan ke suatu
dermatom, yaitu suatu bagian segmen dari
kulit dengan batas yang jelas
Pola
persarafan kulit biasanya mengikuti
distribusi segmental dari persarafan oto-otot
yang pokok

Zat Kelabu (Substansia Gricea)

Kolumna :
Suatu Potongan melintang
dari sumsum tulang belakang yang
memperlihatkan bagian dalam dari massa
zat kelabu yang berbentuk huruf H yang
dikelilingi oleh zat putih

Mengandung :

Sistem serabut Ascenden

Sistem serabut Descenden

The ascending tracts conduct afferent

information, which may or may not reach
consciousness. The information may be
divided into two main groups :
1. Exteroceptive
information,
which
originates from outside the body, such
as pain, temperature, and touch
2. Proprioceptive
information,
which
originates from inside the body, for
example, from muscle and joints.

Pain and Temperature Pathways

Lateral Spinothalamic Tract
The pain and thermal receptors in the skin and
other tissues are free nerve endings
Pain Reception
Pain can be divided into two main types : fast pain
and slow pain
Fast pain is experienced whitin about 0,1 second
after the pain stimulus is applied
Slow pain is felt 1,0 second or later after the
stimulation
Light (Crude) Touch and Pressure Pathways
Anterior Spinothalamic Tract
The axons enter the spinal cord from the posterior
root ganglion and proceed to the tip of the
posterior gray column.

The motor neurons situated in the anterior

gray columns of the spinal cord send axons
to innervate skeletal muscle through the
anterior roots of the spinal nerves

The supraspinal neurons and their tracts

are sometimes referred to as the upper
motor neurons, and the provide numerous
separate pathways that can influence motor
activity

The corticospinal tracts are the pathways

corcerned
with
voluntary,
discrete,
skilled
movement, especially those of the distal parts of
the limbs
CORTICOSPINAL TRACTS
Fibers of the corticospinal tract arise as axons of
pyramidal cells situated in the fifth layer of the
cerebral cortex
The descending fibers converge in the corona
radiata and then pass through the posterior limb
of the internal capsule

Cortex

Capsula
Interna
Basis
Pedunculi

Tractus corticobulbar (Nervus III)

Menyilang sebelum inti

Nuc. N V
Pons
Cortico spinal
lateral

Tractus corticobulbar
Decussatio pyramidal

Medula Spinalis

SISTEM PIRAMIDALIS

In the medulla oblongata, the bundles

become grouped together along the anterior
border to form a swelling known as the
pyramid (alternative name pyramidal tract)

At the junction of medulla oblongata and the

spinal cord, most of the fibers cross the
midline at the decussation of the pyramids
and enter the lateral white column of the
spinal cord to form the lateral corticospinal
tract

The remaining fibers do not cross in the

decussation but descend in the anterior
white column of the spinal cord as the
anterior corticospinal tract

ARTERIES OF THE BRAIN

The brain is supplied by the two internal
carotid and the two vertebral arteries. The
arteries lie within the sub arachoid space, and
their branches anastomose on the inferior
surface of the brain to form the circle of Willis
Internal Carotid Artery
The internal carotid artery begins at the
bifurcation of the common carotid artery,
where it usually possesses a localized
dilatation, called the carotid sinus

Branches of the Cerebral Portion

1. The ophthalmic artery
2. The posterior communicating artery
3. The choroidal artery
4. The anterior cerebral artery
5. The middle cerebral artery
Vertebral artery

The vertebral artery, a branch of the first part

of the subclavian artery, ascend the neck by
passing through the foramina in the transverse
processes of the upper six cervical vertebrae

At the lower border of the pons, it joins the

vessel of the opposite side to form the basilar
artery

Circle of Willis

The circle of Willis lies in the

interpeduncular fossa at th base of the
brain

It is formed by the anastomoses

between the two internal carotid
arteries and the two vertebral arteries

VEINS OF THE BRAIN

The veins of the brain have no muscular
tissue in their very thin walls, and the
possess no valves
External Cerebral Veins
The superior cerebral veins pass upward
over the lateral surface of the cerebral
hemisphere
Internal Cerebral Veins
There are two internal cerebral veins, and
they are formed by the union of the
thalamostriate vein and the choroid vein

CEREBRAL CIRCULATION
The blood flow to the brain must deliver
oxygen, glucose, and other nutrients to the
nervous tissue and remove carbon dioxide,
lactic acid, and other metabolic by-product
BLOOD SUPPLY OF THE SPINAL CORD
Artery of the spinal cord :
1. Posterior spinal artery
2. Anterior spinal artery

The ventricles are four fluid-filled cavities

located within the brain; these are the two
lateral ventricles, the third ventricle, and
the fourth ventricle

Lateral Ventricle
Third Ventricle
Cerebral Aqueduct
Fourth Ventricle

Lateral Ventricles
The lateral ventricles are the largest of the
ventricles
The anterior (frontal) horn is in front of the
inter ventricular foramen
The posterior (occipital) horn extends into
the occipital lobe
The inferior (temporal) horn transverses
the temporal lobe, whose white substance
forms its roof
The two inter ventricular foramens, or
foramens of Monroe, are apertures
between the column of the fornix and the
anterior end of the thalamus

Third ventricle
The third ventricle is a narrow ventricle cleft
between the two halves of the diencephalon
Fourth ventricle
The fourth ventricle is a pyramid-shaped
cavity bounded ventrally by the pons and
medulla oblongata its floor is also known as
the rhomboid fossa

Chusid. JG, Correlative neuroanatomy and

functional neurology
Jack de Groot, Neuroanatomy correlative
Snell, RS. Neuroanatomi klinik
Sukardi. E, Neuroanatomi medica
Waxman. SG, Clinical Neuroanatomy