Anatomie mozku

Brain

The brain is composed of the cerebrum, cerebellum, and brainstem (Fig. 3).

Figure 3. The brain is composed of three parts: the brainstem, cerebellum, and cerebrum.
The cerebrum is divided into four lobes: frontal, parietal, temporal, and occipital.

• The cerebrum is the largest part of the brain and is composed of right and left hemispheres. It performs higher functions like interpreting touch, vision and hearing, as well as speech, reasoning, emotions, learning, and fine control of movement.
  
• The cerebellum is located under the cerebrum. Its function is to coordinate muscle movements, maintain posture, and balance.
  
• The brainstem includes the midbrain, pons, and medulla. It acts as a relay center connecting the cerebrum and cerebellum to the spinal cord. It performs many automatic functions such as breathing, heart rate, body temperature, wake and sleep cycles, digestion, sneezing, coughing, vomiting, and swallowing. Ten of the twelve cranial nerves originate in the brainstem.

The surface of the cerebrum has a folded appearance called the cortex. The cortex contains about 70% of the 100 billion nerve cells. The nerve cell bodies color the cortex grey-brown giving it its name – gray matter (Fig. 4). Beneath the cortex are long connecting fibers between neurons, called axons, which make up the white matter.

Figure 4. The surface of the cerebrum is called the cortex. The cortex contains neurons (grey matter), which are interconnected to other brain areas by axons (white matter). The cortex has a folded appearance. A fold is called a gyrus and the groove between is a sulcus.

The folding of the cortex increases the brain’s surface area allowing more neurons to fit inside the skull and enabling higher functions. Each fold is called a gyrus, and each groove between folds is called a sulcus. There are names for the folds and grooves that help define specific brain regions.

Right brain – left brain

The right and left hemispheres of the brain are joined by a bundle of fibers called the corpus callosum that delivers messages from one side to the other. Each hemisphere controls the opposite side of the body. If a brain tumor is located on the right side of the brain, your left arm or leg may be weak or paralyzed.

Not all functions of the hemispheres are shared. In general, the left hemisphere controls speech, comprehension, arithmetic, and writing. The right hemisphere controls creativity, spatial ability, artistic, and musical skills. The left hemisphere is dominant in hand use and language in about 92% of people.

Lobes of the brain

The cerebral hemispheres have distinct fissures, which divide the brain into lobes. Each hemisphere has 4 lobes: frontal, temporal, parietal, and occipital (Fig 3). Each lobe may be divided, once again, into areas that serve very specific functions. It’s important to understand that each lobe of the brain does not function alone. There are very complex relationships between the lobes of the brain and between the right and left hemispheres.

Frontal lobe

Personality, behavior, emotions

Judgment, planning, problem solving

Speech: speaking and writing (Broca’s area)

Body movement (motor strip)

Intelligence, concentration, self awareness

Parietal lobe

• Interprets language, words
• Sense of touch, pain, temperature (sensory strip)
• Interprets signals from vision, hearing, motor, sensory and memory
• Spatial and visual perception

Occipital lobe

• Interprets vision (color, light, movement)

Temporal lobe

• Understanding language (Wernicke’s area)
• Memory
• Hearing
• Sequencing and organization

Messages within the brain are carried along pathways. Messages can travel from one gyrus to another, from one lobe to another, from one side of the brain to the other, and to structures found deep in the brain (e.g. thalamus, hypothalamus).

Deep structures

Hypothalamus - is located in the floor of the third ventricle and is the master control of the autonomic system. It plays a role in controlling behaviors such as hunger, thirst, sleep, and sexual response. It also regulates body temperature, blood pressure, emotions, and secretion of hormones.

Pituitary gland - lies in a small pocket of bone at the skull base called the sella turcica. The pituitary gland is connected to the hypothalamus of the brain by the pituitary stalk. Known as the “master gland,” it controls other endocrine glands in the body. It secretes hormones that control sexual development, promote bone and muscle growth, respond to stress, and fight disease.

Pineal gland - is located behind the third ventricle. It helps regulate the body’s internal clock and circadian rhythms by secreting melatonin. It has some role in sexual development.

Thalamus - serves as a relay station for almost all information that comes and goes to the cortex (Fig. 5). It plays a role in pain sensation, attention, alertness and memory.

Figure 5. Coronal cross-section showing the basal ganglia.

Basal ganglia - includes the caudate, putamen and globus pallidus. These nuclei work with the cerebellum to coordinate fine motions, such as fingertip movements.

Limbic system - is the center of our emotions, learning, and memory. Included in this system are the cingulate gyri, hypothalamus, amygdala (emotional reactions) and hippocampus (memory).

Cranial nerves

The brain communicates with the body through the spinal cord and twelve pairs of cranial nerves (Fig. 6). Ten of the twelve pairs of cranial nerves that control hearing, eye movement, facial sensations, taste, swallowing and movement of the face, neck, shoulder and tongue muscles originate in the brainstem. The cranial nerves for smell and vision originate in the cerebrum.

Figure 6. The Roman numeral, name, and main function of the twelve cranial nerves.

Number	Name	Function
I	olfactory	smell
II	optic	sight
III	oculomotor	moves eye, pupil
IV	trochlear	moves eye
V	trigeminal	face sensation
VI	abducens	moves eye
VII	facial	moves face, salivate
VIII	vestibulocochlear	hearing, balance
IX	glossopharyngeal	taste, swallow
X	vagus	heart rate, digestion
XI	accessory	moves head
XII	hypoglossal	moves tongue

Meninges

The brain and spinal cord are covered and protected by three layers of tissue called meninges. From the outermost layer inward they are: the dura mater, arachnoid mater, and pia mater.

The dura mater is a strong, thick membrane that closely lines the inside of the skull; its two layers, the periosteal and meningeal dura, are fused and separate only to form venous sinuses. The dura creates little folds or compartments. There are two special dural folds, the falx and the tentorium. The falx separates the right and left hemispheres of the brain and the tentorium separates the cerebrum from the cerebellum.

The arachnoid mater is a thin, web-like membrane that covers the entire brain. The arachnoid is made of elastic tissue. The space between the dura and arachnoid membranes is called the subdural space.

The pia mater hugs the surface of the brain following its folds and grooves. The pia mater has many blood vessels that reach deep into the brain. The space between the arachnoid and pia is called the subarachnoid space. It is here where the cerebrospinal fluid bathes and cushions the brain.

Ventricles and cerebrospinal fluid

The brain has hollow fluid-filled cavities called ventricles (Fig. 7). Inside the ventricles is a ribbon-like structure called the choroid plexus that makes clear colorless cerebrospinal fluid (CSF). CSF flows within and around the brain and spinal cord to help cushion it from injury. This circulating fluid is constantly being absorbed and replenished.

Figure 7. CSF is produced inside the ventricles deep within the brain. CSF fluid circulates inside the brain and spinal cord and then outside to the subarachnoid space. Common sites of obstruction: 1) foramen of Monro, 2) aqueduct of Sylvius, and 3) obex.

There are two ventricles deep within the cerebral hemispheres called the lateral ventricles. They both connect with the third ventricle through a separate opening called the foramen of Monro. The third ventricle connects with the fourth ventricle through a long narrow tube called the aqueduct of Sylvius. From the fourth ventricle, CSF flows into the subarachnoid space where it bathes and cushions the brain. CSF is recycled (or absorbed) by special structures in the superior sagittal sinus called arachnoid villi.

A balance is maintained between the amount of CSF that is absorbed and the amount that is produced. A disruption or blockage in the system can cause a build up of CSF, which can cause enlargement of the ventricles (hydrocephalus) or cause a collection of fluid in the spinal cord (syringomyelia).

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