Transcript Neuroanatomy

Nervous System(신경계)
신경외과 장 경 술
The Nervous System
Major Subdivisions:
Central Nervous System(중추신경계): CNS
The brain(뇌)
The spinal cord.(척수)
Autonomic Nervous System: (자율신경계)
:ANS
Sympathetic nervous system(교감신경)
Parasympathetic nervous system(부교감신경)
Divisions of the Nervous System
Nervous Tissue(신경조직)
• Neurons(신경세포) - transmit impulses
– sensory (afferent, ascending)
– motor (efferent, descending)
• Neuroglia(신경아교세포) - support
neurons
Neuron
• Dendrites(가지돌기)rootlike structures that
receive impulses and
conduct them to the cell
body
• cell body(세포체) contains nucleus
• Axon(축삭)-extends away
from the cell body and
conducts impulses away
from the nerve cell
Neuron Anatomy
• Myelin sheath(말이집)– insulation
– accelerates impulse transmission
– appears as white covering
• myelin on axons in brain and spinal cord gives white
appearance
• unmyelinated fibers, dendrites, and nerve cell bodies
comprise gray matter of brain and spinal cord
Neuron Anatomy
(peripheral nerves)
• Schwann cell
– type of neuroglial cell
wrapped around axon
– forms the myelin sheath
• Neurolemma
(neurolemmal sheath)
– permits a damaged axon to
regenerate
– neurolemma NOT found in
Central nerves
Neuroglia(신경아교세포)
• gli/o or nerve glue
• neuroglia or glial cells
• Astrocytes(별아교세포) blood brain barrier
• Oligodendrocytes(희소돌
기아교세포) - facilitate
myelin development
• Microglia(미세아교세포)
- phagocytic properties
• Ependyma(뇌실막세포) assist in CSF circulation
Neuroanatomy
• The Study of Nervous System
– Two Levels
• General Structure(일반구조)
• Function of Structure(기능적 구조)
뇌(brain)
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대뇌(cerebrum)
중뇌(midbrain)
뇌교(pons)
연수(medulla)
소뇌(cerebellum)
Surface
• Gyrus(회,이랑)
– A convolution
• Sulcus(구,고랑)
– A small in-folding (small
groove)
• Fissure(틈새,열구)
– A large in-folding ( a
large groove)
Two-thirds of the cortex is hidden in the grooves
Major Structures of the Cortex
• 4 Lobes
Longitudinal
Fissure
Sylvian Fissure
– Frontal
Lobe(전두엽)
– Parietal
Lobe(두정엽)
– Occipital
Lobe(후두엽)
– Temporal
Lobe(측두엽)
• Major Fissures
– Central Sulcus
– Longitudinal Fissure
– Sylvian Fissure
• The lobes are distinguished both structurally and functionally
Cortical Function
• Frontal Lobe
– Higher thought
processing; decision
making; abstract
thinking
– Primary “precentral”
motor area
• Parietal Lobe
– Primary “postcentral”
somatosensory area:
sensation of muscles,
organs, and skin
Cortical Function
• Occipital Lobe
– Visual processing
• Temporal Lobe
– Auditory &
equilibrium processing
– Left temporal lobe
involved in speech and
comprehension of
language
뇌실질 (brain parenchyme)
• Gray Matter(회질):
Neural Cell Bodies(세포체)
– Nuclei – Collection of neural
cell bodies of similar shape
• White Matter(백질): Axons
– Tract - A bundle of axons
Basal Ganglia(기저핵) :운동기능
Basal Ganglia a collection
of subcortical nuclei
involved in the control of
movement
Basal Ganglia:
Caudate nucleus
Putamen
Globus pallidus
3 Major structures
Caudate nucleus
(미상핵)
Globus
pallidus(담창구)
Putamen(피각부)
Diencephalon(간뇌)
2 Major Structures
- Thalamus(시상)
터미널기능
Hypothalamus(시상하
부)
Diencephalon
Thalamus
- Two lobes that relay sensory
projection fiber info to the cerebral
cortex
Hypothalamus
- Lies at the base of the brain
- Controls and regulates the
endocrine system (hormones),
autonomic system, species survival
(the four Fs) and sleeping.
- Contains many nuclei and fiber
tracts
Thalamus
• All sensory modalities relay through the thalamus
Brain Stem:숨골
Surrounds the 4th
ventricle
• Mid brain(중뇌)
• Pons(뇌교)
• Medulla(연수)
Pons(뇌교)
• Fiber Tracts &
Nuclei
important in
sleep and
arousal
Medulla(연수)
– Regulates
cardiovascular
system,
respiration,
skeletal muscle
tonus
Cerebellum(소뇌)
– Two hemispheres
– Integrates and
coordinates
standing, walking,
coordinated
movements
cerebellum
The Brain: A Well-Protected Organ
(두개골)
(두피)
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(경막)
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The Skull(두개골)
• The First Line of Defense
Meninges(수막)
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Meninges
• 3 Tough Layers of
Connective Sheath
– Dura Mater (outer:경막)
– Arachnoid Mater
(middle:지주막)
– Pia Mater (inner:연막 )
Meninges
• Provide three layers of protection & padding around the brain & spinal
cord
• Enclose, protect blood vessels
• Contains CSF
임상
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Meningitis (뇌수막염)
Meninigioma(뇌수막종)
Epidural hematoma (경막외혈종)
Subdural hematoma (경막하혈종)
Craniotomy (두개골절개술)
Craniectomy (두개골절제술)
Duroplasty (경막성형술)
Cranioplasty(두개골성혈술)
The Cerebrospinal Fluid(CSF:뇌척수액)
• Liquid cushion for brain
and spinal cord;
reduces shock of head
movements (The brain
floats in a bath of CSF)
• Nourishes brain(영양)
• Removes waste
• Filtrate of blood
CSF Circulation
Total Volume: 70 – 120 ml
• Produced in Choroid
Plexus
– 500 ml/day
The Four Ventricles
Lateral Ventricles: 측뇌실
largest
Third Ventricle: 3뇌실
“wall” divides brain
into symmetrical
halves
Cerebral aqueduct: 도수관
long tube that
connects 3rd to 4th
ventricle
Fourth Ventricle: 4뇌실
임상
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Vetriculitis (뇌실염)
EVD (extra ventricular drainage) 뇌실외배액술
CSF study( 뇌척수액 검사)
V-P shunt( ventriculo-peritoneal shunt:
뇌실복강단락술 _
Spinal Cord(척수):
The Peripheral Nervous
System말초신경계
Spinal cord sections indicated by the exit point of nerves
Sensory and motor peripheral nerves connect to sensory
and motor neurons in the CNS
Major Divisions of the Peripheral Nervous System:
The Autonomic Nervous System
The Somatic Nervous System
Spinal Cord
Gross Anatomy
Four Major Regions
Cervical(경추)
Thoracic(흉추)
Lumbar(요추)
Sacral(천추)
임상
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Vertebra(척추)
Spinal stenosis(척추협착증
Spondylolisthesis(척추전방전이증)
Spondylolysis(척추분리증)
Spondylitis(척추염)
Laminectomy(협궁절제술)
Cerebrovascular Disease
• Arteriosclerosis
• cerebrovascular accident (CVA, apoplexy)
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ischemia
transient ischemic attack(TIA)
hemiparesis
hemiplegia
aphasia
ataxia
Oncology
• Intracranial tumors
– Astrocytoma ,globlastoma,oligodendroglioma,
– Ependymoma,
– metastatic sites
• Signs and Symptoms
– headaches
– papilledema
– personality changes
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cerebral palsy
closed head trauma
coma
Concussion
Huntington’s chorea
hydrocephalus
paraplegia
paresis
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Paresthesia
poliomyelitis
quadriplegia
sciatica
syncope
transient ischemic attack (TIA)
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Cerebral angiography
echoencephalography
electroencephalography (CCG)
myelography
computed tomography (CT scan)
• spinal puncture, spinal tap
• trephination
Pharmacology
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Analgesics
anticonvulsants
antidepressants
hyponotics
opiates
sedatives
tranquilizers
Abbreviations
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ALS
ANS
CP
CSF
CT scan
CVA
CVD
Abbreviations
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EEG
ICP
LP
MRI
MS
R/O
TIA