ANATOMY III MUDr. Ivana Hradilová Svíženská, Ph.D. Lectures Seminars 1. Anatomy of the nervous system, Spinal nerve Structure of the spinal cord Gross anatomy and structure of the spinal cord 2. Structure of the brain stem Gross anatomy and structure of the brain stem 3. Structure of the cerebellum and diencephalon Gross anatomy and structure of the cerebellum and diencephalon 4. Structure of the telencephalon Gross anatomy and structure of the telencephalon 5. Meninges, ventricles and vascular system of the CNS Cranial nerves 1 Meninges, ventricles and vascular system of the CNS Cranial nerves 1 6. Cranial nerves 2, Cervical plexus Intercostal nerves, Dorsal rami Cranial nerves 2, Cervical plexus Intercostal nerves, Dorsal rami 7. Autonomic nervous system Autonomic nervous system 8. Visual system Visual system 9. Regional anatomy of the head and neck Demonstration of topographical regions (head and neck) 10. Dissection course (head, neck) 11. Auditory system Auditory system 12. Regional anatomy of the body (except limbs) Demonstration of the topographical regions (except limbs) 13. Regional anatomy of the body (except limbs) Demonstration of the topographical regions (except limbs) 14. RTG anatomy RTG anatomy 15. Spare lectures Recommended literature: Liebgott, Bernard. The anatomical basis of dentistry. 3rd ed. Mosby, ISBN 0-323-06807-3 Dubový, Petr. Gross anatomy and structure of the human nervous system. Part I. Surface anatomy and structural arrangement of the central nervous system. 3rd ed. Brno: Masarykova univerzita, 2016. 92 s. ISBN 978-80-210-6125-5 Dubový, Petr. Instructions for anatomical dissection course. 3rd ed. Brno: Masaryk University, 2013. 71 s. ISBN 9788021062023 Stingl, J. et al. Regional anatomy. 1st ed. Galén-Karolinum, 2012. 123s. ISBN 9788072628797 Atlas of Anatomy Equipment: lab coat dressing forceps gloves Nervous system Nervous system ■ is a complex, sophisticated system that regulates and coordinates activities of the body ■ regulates the body's responses to internal and external stimuli ■ has three main functions, sensory input, integration of data and motor output ■ is composed of excitable nerve cells ■ conducts nerve impulses ■ is divided into two categories: the central nervous system- CNS and the peripheral nervous system - PNS ■ the basic structural and functional unit - neuron ■ cells providing support and protection for neurons – glial cells Basic function of NS Sensor Effector CNS Neuron ■ receives stimuli ■ transforms stimuli to nerve impulses ■ conducts nerve impulses ■ processes information ■ transmits the electro-chemical signal across a synapse > TYPES OF NEURONS Myelinization – node of Ranvier, internodal segment unmyelinated axon Schwann cell axon Schwann cell nucleus Ranvier node oligodendroglia Saltatory conduction http://ccdb.ucsd.edu/SAO/images/schwann_cell_sw_512x512.jpg Synapse Development of NS ■ from ectoderm (under influence of the notochord) arises the neural: plate groove tube + neural crest > > > 3.w i.u. Parts derived from the neural tube brain spinal cord Parts derived from the neural crest cranial nerve ganglia dorsal root ganglia and autonomic ganglia medulla of the suprarenal gland some bones, cartilages and connective tissue of the head pigment cells Cerebral vesicles from the rostral part of the neural tube 3. rhombencephalon (hindbrain) 2. mesencephalon (midbrain) 1. prosencephalon (forebrain) Spinal cord medulla spinalis > 3. 2. 1. Secondary vesicles myelencephalon medulla oblongata metencephalon pons, cerebellum mesencephalon midbrain diencephalon diencephalon telencephalon telencephalon > 3. 2. 1. 3. 2. 1. rostral > > > > B dorsal root ventral root skin muscle A Spinal nerve A B DRG sulcus limitans > Interneuron Skin Muscle Skeletal muscles Organs of motions Proprio- receptors Surface of the body Extero- receptors Viscera Intero- receptors Senses SENSOR EFFECTOR CNS PNS Afferent Efferent Glands Smooth muscles + myocardium SENSOR EFFECTOR Extero- receptors Proprio- receptors CNS Skeletal muscles Somato- sensory (SS) Somato + branchio- motor (SM) (BM) Intero- receptors Viscero- sensory (VS) Glands Viscero- motor (VM) Senses Sensory (S) Smooth muscles and myocardium Functional types of axons PNS Cranial nerves III. - XII. (I.- XII.) pass through the skull base pass through the intervertebral foramina Spinal nerves - 31 pairs CNS II. Spinal cord ■ medulla oblongata ■ pons ■ mesencephalon ■ cerebellum ■ diencephalon ■ telencephalon I. Brain Structure of the CNS Gray matter - nuclei White matter – nerve tracts: - tractus - fasciculus (lemniscus) Spinal cord ■ transmission of neural signals between the brain and the periphery ■ contains neural circuits that can control numerous reflexes and central pattern generators independently on the cortex MEDULLA SPINALIS Cauda equina Fila radicularia Kopie obr85 Kopie obr87 Intumescentia cervicalis C5 – T1 segments C4 – T1 vertebrae Intumescentia lumbalis L2 – S1 segments T9 – T12 vertebrae Slide13 Slide14 Segment C1 Segment C5 Segment C8 Segment Th2 Segment Th10 Segment L1 Segment L4 Segment S4 Segment C5 Segment C8 Segment Th2 Segment L4 Segment S4 Left – real stained magnified cross section through some segments of the spinal cord Right – diagrams of cross sections through the segments of the spinal sord SUBSTANTIA GRISEA – cornu anterius (columna anterior), cornu posterius (columna posterior), cornu laterale (columna lateralis), substantia intermedia, canalis centralis SUBSTANTIA ALBA – funiculus anterior, lateralis, posterior fissura mediana ant., sulcus medianus post., septum medianum posterius, sulcus anterolateralis, posterolateralis Kopie obr90 > p. cervicalis > > p. thoracica p. sacralis > > > [USEMAP] Dorsal horn Ventral horn Dorsal root Spinal nerve Ventral root > > Functional zones of the spinal cord GSA GVA GVE GSE Basal plate Alar plate Sulcus limitans Skeletal muscles Smooth muscles, glands Intero - receptors Extero+ proprio - receptors DORSAL HORN – afferent neurons SUBST. INTERMEDIA (lateral horn) motoneurons of the ANS VENTRAL HORN - motoneurons Gray matter > CC FR White matter Funiculus post. (fasc. gracilis et cuneatus) Funiculus ant. Funiculus lat. F. anterolateralis T1 - L2 - preganglionic sympathetic neurons below L2 - preganglionic parasympathetic neurons Functional zones in the spinal cord GSA GVA GSE GVE GVE zone Upozornit na nové barvení VM – musí být zelená – parasympatikus či žlutá – sympatikus (zahraniční literatura) sympatikus – jádro v rozsahu Th1-L2 Pod L2= parasympatikus Měl by tady být i FLM (obsahuje vlákna jdoucí z Ve jader, spojené se spinálními motoneurony a s neurony hlavových nervů). Silně myelinizované aferentní axony SG jsou lokalizovány v zadních kořenech mediálně. Vedou inf. o diskriminačním kožním čití a propriorecepci. Po vstupu vydávají ascendentní a descendentní kolaterály. Ascendentní tvoří f. gracilis et cuneatus. Laterálně jdou málo myelinizované a nemyelinizované aferentní axony, které vedou převážně nociceptivní informace a informace o teple a chladu. Tyto axony vstupují do tr. dorsolateralis (Lissaueri), kde se také dělí na ascendentní a descendentní větve a končí na neuronech zadnícho rohu míšního. Sestupné dráhy = řízení motoriky Tr. co-sp Tr. re, ru, ve, te-spinalis Ventral root Multipolar cells Ncl. intermedio-lat. tr. co-sp lat α,  Ncll. motorii fig1Uprav Cik cak Plné kosočtverce Plné kosočtverce Radix dorsalis Pseudounipol. neurons of the DRG Ncl. posteromarginalis + Subst. gelatinosa Rolandi Ncl. proprius Ncl. thoracicus (Stilling-Clark.) Tr. spinocerebellaris post. Tr. spinocerebellaris ant. Tr. spino-olivaris Tr. spino-thalamicus, -reticularis, -tectalis Ncl. intermediomedialis Tr. spino- bulbaris Fasc. gracilis Fasc. cuneatus ncl intermed-med dorsal root ncl proprius ncl thoracicus tr. sp-bulb ncl apicalis subst gel Rolandi tr. co-sp lat ncl intermedio-lat ncll motorii ventral root tr. sp-sp GSA GVA GSE GVE Ncl. apicalis interneurony propojující segmenty míšní ascendentně a descendentně Subst. gelatinosa Rolandi- vrstva šedé hmoty tvořena nakupením drobných interneuronů. Významným způsobem ovlivňují aferentní informace vstupující do míchy. Ncl. proprius – končí zde aferentní axony přenášející informaci o hrubé kožní citlivosti, teple a chladu. Ncl. thoracicus – končí zde aferentní axony převádějící proprioceptivní informace z DK a kaudální části trupu Ncl. intermediomedialis – končí zde aferentní axony převádějící informace z viscerálních orgánů (mechanické, teplo, bolest) Odtud do FR nebo na ncl. intermediolateralis Ncl. intermediolateralis – neurony vydávají pregangliová sympatická vlákna probíhající ve ventrálních kořenech spinálních nervů Ncl. motorii – obsahují alfa a gama motoneurony. Jsou somatotopicky uspořádány FR – soubor neuronů, interneuronů a jejich spojení. V míše omezený rozsah Illustrations and photographs were copied from: Atlas der Anatomie des Menschen/Sobotta. Putz,R., und Pabst,R. 20. Auflage. München: Urban & Schwarzenberg, 1993)