Transcript No Slide Title

Unit 5
Introduction
Unit 5
8 Sagittal MRI Images of the Head
15 Transaxial MRI Images
15 Coronal MRI Images
On campus students must draw and identify the anatomy on the linedrawings on the next three slides. Students in the degree completion
course should have an understanding of basic anatomy that makes testing on
the drawings unnecessary. But if you need a refresher try the drawings. The
ability to visualize is important to the study of cross sectional anatomy.
First page number in parenthesis is Netter’s 3rd edition
Second page number in parenthesis is Netter’s 4th edition
Circle of Willis Drawing
See plates 131-134
(138-141)
8
Can you draw (or visualize)
these anatomical structures:
An exercise in cross sectional
anatomy recognition of the
Circle of Willis
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6
5
Rt
Lt
4
10
1. Vertebral arteries
2. Common carotid arteries
3. Basilar artery
4. Anterior communicating artery
5 Anterior cerebral arteries
6. Middle cerebral arteries
7. Internal carotid arteries
8. External carotidl arteries
9. Posterior cerebral arteries
10. Posterior communicating arteries
9
3
1
2
9
Can you draw (or visualize)
these anatomical structures:
An exercise in cross sectional
anatomy recognition of the
Venous Sinuses
See plates 97-98
(103-104)
Venous Sinuses Drawing
1
2
1.
2.
3.
4.
5.
6.
7.
8.
9.
Superior sagittal sinus
Inferior sagittal sinus
Great cerebral vein (of Galen)
Straight sinus
Confluence of sinuses
Occipital sinus
Transverse sinus
Sigmoid sinus
Internal jugular vein
4
3
8
5
7
6
9
Can you draw (or visualize) these anatomical structures:
An exercise in cross sectional anatomy recognition of the Ventricles of the Brain
1. Frontal (anterior) horn of
Lateral ventricle
2. Body (central part) of
lateral ventricle
1
3. Trigone of lateral ventricle
(not in Netter)
6
4. Occipital (posterior) horn
of lateral ventricle
7
5. Temporal (inferior) horn
of lateral ventricle
6. Interventricular foramen (of
Monro)
7. Interthalamic adhesion
8. 3rd ventricle
9. Cerebral aqueduct (of Sylvius)*
10. 4th ventricle
11. Foramen of Luschka
12. Lateral recess
13. Median aperture (Foramen of Magendie)
14. Central canal of spinal cord
See plate 102-103
(108-109)
2
8
4
3
9
5
10
11
12
13
Ventricular System Drawing
14
Sagittal Images 1 & 2
These sagittal sections are from right to left. The images
presented here, one to seven, go to midline. Because all
the anatomy seen is on the right side or in the midsagittal
plane, right is not labeled and need not be labeled for
testing purposes.
5
3
4
2
1
9
7
8
11
10
Reference
1.
2.
3.
4.
5.
External jugular vein
External auditory canal (or meatus)
Mastoid process of the temporal bone (4)
Adipose (fat)
Zygomatic process of the temporal bone
6. Internal jugular vein
7. Frontal process of the zygoma (2)
8. Sulci of brain* (99)(105)
9. Gyrus of brain**
10. Convolutions of brain**
11. Facial muscles (50)(54)
* The depressions in the surface of the brain (sulcus = singular)
** Raised area between the sulci (gyri = plural)
*** The twisted course the gyri take
6
Sagittal Images 1-4
Reference
1.
2.
3.
4.
5.
Sagittal Images 3 & 4
2
6. Lens of eye
7. Maxillary sinus (45)(49)
8. Internal carotid artery
9. External carotid artery
10. Facial artery (65)(69)
11. Temporal horn of the lateral ventricle
12. Trigone of the lateral ventricle**
13. Occipital horn of the lateral ventricle***
* The lateral wall is seen on image 2, but the internal
jugular is large, and seen in these two sections.
** Although Netter did not label the section where the
body, occipital, and temporal horns converge, it
is evident on sagittal images.
***The ventricles of this patient are not as prominent
as are sometimes seen.
5
4
Internal jugular vein*
Zygomatic bone (4)
Cerebellum
Vitreous humor in eyeball
Lateral sulcus (Sylvian fissure) (99)(105)
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1
12
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13
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9
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10
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2
1
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17
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1.
6 2.
3.
4.
5.
6
7.
Roots of teeth* (52)(56)
Internal carotid artery
Scalp
Outer table of the skull
Diploe layer of the skull
Inner table of the skull
Optic nerve (80, 81)(84,85)
Reference
Sagittal Images 5 & 6
8. Frontal sinus
9. Corpus callosum
10. Body of the lateral ventricle
11. Inferior nasal concha (turbinate) (33)(37)
12. Middle nasal concha (turbinate)
13. Middle nasal meatus
14. Nasopharynx (33, 59)(37, 63)
15. Soft palate
16. Oropharynx
17. Siphon of the internal carotid artery (carotid siphon)**
18. Ethmoid air cells
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15
13
11 14
16
* Of mandible. Maxilla directly above.
** Not labeled in Netter, but the siphon (the S shaped terminal
portion of the internal carotid) is nicely illustrated in
plate 130 (136).
Sagittal Images 5 & 6
#6
Reference
Sagittal Image 7A
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6
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7
15
3
2
4
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16
1
10
13
9
12
#7A
8
Image 7A, 7B, & 7C are the same image, in the midsagittal plane
Plate 100 (106) is an excellent correlation to this image
Plate 101 (107) is also good for structures around the base
1. Tongue
2. Nasal septum
3. Sphenoid sinus
4. Sphenoid bone (6)
5. Genu of the corpus callosum (100)(106)
6. Body (trunk) of the corpus callosum
7. Splenium of the corpus callosum
8. Epiglottis
9. Body of C2
10. Odontoid process (dens)
11. Anterior tubercle of C1 (15)(17)
12. Posterior tubercle of C1
13. Cerebellar tonsil (107)(113)
14. Body of the lateral ventricle*
15. Occipital lobe of the cerebrum
16. Confluence of sinuses
* Just lateral to the septum pellucidum
Sagittal Image 7
Reference
2
1.
2.
3.
4.
5.
6.
Superior sagittal sinus
Inferior sagittal sinus
Straight sinus*
Great cerebral vein (Vein of Galen)
Stalk of the pituitary gland (Hypophysis)**
Chiasmatic (suprasellar) cistern*** (103)
(109)
7. Spinal cord
8. Medulla oblongata****
9. Pons
10. Cerebral peduncle
1
4
10
5
6
9
8
3
*
7
Sagittal Image 7B
#7B
In the tentorium cerebelli (98, 100)
(104,106)
** The pituitary gland is in this section, but
is difficult to differentiated from the
bone of the sella turcica
*** Fluid filled space surrounding the stalk
of the pituitary
****The medulla, pons, and midbrain
(mesencephalon) make up the brain stem.
See 7C for parts of the midbrain.
Sagittal Image 7C
1. Thalamus
2. 3rd ventricle*
3. Optic chiasm
4. Mammillary body
5. Interpeduncular cistern
6. Prepontine cistern
7. Cerebral aqueduct (aqueduct of Sylvius)
8. Quadrigeminal plate (lamina)*
9. Pineal body (gland)
10. Quadrigeminal cistern
11. 4th ventricle
12. Cisterna magna
1
9
2
8
10
3
4
5
6
Reference
7
11
12
#7C
* The (midbrain) mesencephalon is the
most superior part of the brain stem. It
is comprised of the cerebral peduncles
(see 7B #10), the cerebral aqueduct (of
of Sylvius), and the quadrigeminal plate.
Sagittal Image 7
1
2
Axial Images 1 & 2
Reference
Transaxial sections from base of skull to vertex of cranium.
1.
2.
3.
4.
Alveolar process of the maxilla*
Rt masseter muscle (57)(61)
Cisterna magna
Rt & Lt vertebral arteries** (17, 130)(21,136)
4
5. Rt lobe of the cerebellum
6. Lt cerebellar tonsil
7. Medulla oblongata***
8, Rt maxillary sinus
9. Rt ramus of the mandible
10. Internal occipital protuberance (inion) (9)
3
8
9
* Black holes are sockets are the teeth
** On exiting the vertebral foramen in the 1st cervical vertebra
(image #1) the vertebral arteries turn posterior (image #3)
and enter the cranium through the foramen magnum
***On image #2 the spinal cord (image 1) is in transition
to the medulla. The shape of the medulla is clearly seen
on image 3.
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7
6
5
10
Axial Images 1-4
1
Reference
Axial Images 3 & 4
2
1.
2.
3.
4.
5.
Rt inferior nasal concha (turbinate) (33, 43)(37,47)
Nasopharynx* (59)(63)
Rt & Lt vertebral arteries
Inferior vermis of the cerebellum (107)(113)
Rt mastoid process
6. Rt & Lt petrous portion of the temporal bone
7. Lt facial artery
8. Posterior cerebellar notch** (107)(113)
3
3
5
4
* The boundary between the oropharynx and nasopharynx
would be close to image 2, where the hard and soft palate
can be seen. Image 1 shows a semi lunar appearance to
the anterior wall of the pharynx, which is the encroachment
of the soft palate, nearing the uvula.
** Space between cerebellar hemispheres.
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8
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3
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5
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15
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12
1.
2.
3.
4.
5.
6.
Anterior nasal nares
Axial Images 5 & 6
Reference
Bony nasal septum*
Coronoid process of the left mandible (4)
Left vertebral artery**
Rt external auditory (acoustic) meatus (canal)
Head of the condylar process of the Lt mandible
(Rt and Lt mandibular condyles)
7. Unidentified bright object (UBO). An MRI artifact.
8. Lt occipital lobe of the cerebrum
9. Cartilaginous nasal septum
10. Rt transverse sinus
11. Confluence of sinuses
12. 4th ventricle (102, 109)(108,115)
13. Lt middle nasal concha (turbinate) (33)
14. Rt superior nasal concha (turbinate)
15. Internal carotid arteries in carotid canals*** (8, 9, 130)(8, 9, 136)
* Comprised of the vomer bone and the perpendicular plate of the
ethmoid bone, both of which would be seen on this section (6)
** Seen as a streak or line on the left side, unlike the spot we
have seen to this level. This is due to the left vertebral
heading for midline to anastomose with the Rt vertebral to
form the basilar artery. The right is doing the same, but appears
differently due to asymmetry or rotation of the part.
***Enters the external carotid opening (8) turns medially and
anteriorly as it runs through the canal, then turns superiorly at
foramen lacerum.
Axial Images 5-8
Reference
1.
2.
3.
4.
5.
6.
Axial Images 7 & 8
Sphenoid sinus*
Rt cerebellopontine angle cistern
Lt internal carotid artery**
Superior sagittal sinus
Straight sinus
Pons***
7. Pituitary gland (hypophysis)
8. Rt internal carotid artery in the cavernous sinus (98, 130, 133)
(104, 136, 140)
9. Mesencephalon (midbrain)
10. Basilar artery****
11. Occipital (posterior) horn of the Lt lateral ventricle
12. Superior vermis of the cerebellum (107)(113)
* On image 5 we saw the nasopharynx in approximately this
position. On image 6 the nasopharynx is replaced by the body
of the sphenoid bone that makes up the floor of the sphenoid sinus.
Notice the septum in the sphenoid, which is common.
** Just emerged from the canal, above foramen lacerum.
***In front of the pons and between the cerebellopontine angle cisterns
is the prepontine cistern.
***It is difficult to see exactly which image the basilar first appears on,
but the anastomosis occurs near the most superior part of the
medulla oblongata.
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2
6
3
5
4
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8
12
10
9
11
1
2
Reference
1. Retrobulbar fat of the Lt eye (79)(83)
2. Ethmoid air cells (44, 45)(48,49)
3. Temporal horn of the Lt lateral ventricle
4. Cerebral aqueduct (aqueduct of Sylvius) (101)(107)
5. Rt ambient cistern
6. Lt internal carotid artery in the cavernous sinus
7. Chiasmatic (suprasellar) cistern
8. Interpeduncular cistern (103)(109)
9. Rt & Lt cerebral peduncles (cerebral crus)(101, 109) (107,115)
10. Straight sinus
6
7
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5
3
4
10
12
11
17
Lt optic nerve
Medial rectus muscle of the Rt eye (79)(83)
Rt & Lt mammillary bodies (101)(107)
Stalk of the pituitary gland (hypophysis)
Lt middle cerebral artery (132)(139)
Quadrigeminal cistern
Optic chiasm
15
14
13
16
11.
12.
13.
14.
15.
16.
17.
Axial Images 9 &
10
Axial Images 9-12
Reference
2
1. Rt middle cerebral artery
2. Rt anterior cerebral artery
3. Choroid plexus in the trigone of the Lt lateral ventricle
4. Rt lateral sulcus (Sylvian fissure) (99)(105)
5. 3rd ventricle
6. Splenium of the corpus callosum (100, 104) (106,110)
Axial Images 11 & 12
1
3
4
5
6
Reference
3
1
2
5
1
4
6
7
9
8
9
1. Frontal (anterior) horn of the
Rt lateral ventricle
2. Rt & Lt interventricular foramen
(Foramen of Monro)
3. Frontal sinus
4. Body (central part) of the Rt
lateral ventricle
5. Genu of the corpus callosum
6. Inferior sagittal sinus*
7. Superior sagittal sinus
8. Falx cerebri** (97)(103)
9. Longitudinal fissure
10. Septum pellucidum
* Close to the level of the splenium
of the corpus callosum is the
anastomosis of the straight sinus
and inferior sagittal sinus
**Reflection of dura mater In the
longitudinal fissure
Axial Images 13-15
1
Reference
Coronal sections from anterior to posterior
2
1.
2.
3.
4.
3
Superior sagittal sinus
Rt optic foramen
Superior, middle, & inferior nasal concha (turbinates) (44)(48)
Tongue
4
5. Frontal (anterior) horn of the left lateral ventricle
6. Genu of the corpus callosum
7. Lt temporal lobe of the cerebrum
6
5
7
Coronal Images 2 & 3
Coronal Images 2-5
Reference
Coronal Images 4 & 5
1. Inferior sagittal sinus
2. Lt lateral sulcus (Sylvian fissure)
3. Rt & Lt internal carotid arteries
4.
5.
6
7.
1
2
Septum pellucidum
3rd ventricle
Optic chiasm
Throat (nasopharynx and oropharynx)
3
4
6
5
7
Reference
Coronal Images 6 & 7
1. Chiasmatic (suprasellar) cistern
2. Body (central part) of the Lt lateral ventricle
1
3. 3rd ventricle
4. Rt & Lt interventricular foramen (Foramen of Monro)(102 bottom)
(108 bottom)
5. Interpeduncular cistern
6. C2-C3 intervertebral disk space
4
5
2
4
3
6
Coronal Images 6-9
Reference
1.
2.
3.
4.
5.
Odontoid process of C2 (dens)
Rt & Lt vertebral arteries
Rt atlantoaxial articulation (joint)
Lt atlantooccipital articulation (joint)
Choroid plexus in the body (central part) of the Lt lateral ventricle
5
4
1
6.
7.
8.
9.
Choroid plexus in the temporal horn of the Lt lateral ventricle
Body of the corpus callosum*
Rt external auditory (acoustic) meatus (canal)
Pons
3
* Close to the splenium of the corpus callosum, but note that the
communication between the right and left cerebral hemispheres
persists through image 10 and 11.
2
7
6
Coronal Images 8 & 9
8
9
Reference
1
1. Falx cerebri*
2. Spinal cord
3. Choroid plexus in the 3rd ventricle
4. Rt superior colliculus* (colliculi = plural) (108 & 109 top)
(114 & 115 top)
5. Cerebral aqueduct (aqueduct of Sylvius)
6. 4th ventricle
7. Tentorium cerebelli
8. Inferior sagittal sinus
2
8
7
3
4
5
6
Coronal Images 10 & 11
Coronal Images 10-13
Reference
Coronal Images 12 & 13
3
1. Choroid plexus
2. 4th ventricle
3. Splenium of the corpus callosum
1
2
4 Longitudinal fissure*
5. Straight sinus
* Behind the corpus callosum
4
5
Reference
3
1. Rt cerebellar hemisphere
2. Occipital (posterior) horn of the
lateral ventricles
3. Superior sagittal sinus
1
2
Coronal Images 14-16
Coronal Images 14-16