Neuroanatomy Basics 2024 PDF

l KEMENTERIAN PENDIDIKAN DAN KEBUDAYAAN UNIVERSITAS PEMBANGUNNAN NASIONAL VETERAN JAKARTA FAKULTAS KEDOKTERAN Neuroanatomy Basics dr. Ayodya Heristyorini, MSc, MSc Departemen Anatomi AKREDITASI “UNGGUL” ...

l KEMENTERIAN PENDIDIKAN DAN KEBUDAYAAN UNIVERSITAS PEMBANGUNNAN NASIONAL VETERAN JAKARTA FAKULTAS KEDOKTERAN Neuroanatomy Basics dr. Ayodya Heristyorini, MSc, MSc Departemen Anatomi AKREDITASI “UNGGUL”  l KEMENTERIAN PENDIDIKAN DAN KEBUDAYAAN UNIVERSITAS PEMBANGUNNAN NASIONAL VETERAN JAKARTA FAKULTAS KEDOKTERAN Today’s topics 01 02 Neuro basics CNS Cerebrum & medulla Intro to neuroanatomy spinalis 03 04 Meninges Neurocranium Dura, arachnoid, pia Bones bones bones mater AKREDITASI “UNGGUL”  l KEMENTERIAN PENDIDIKAN DAN KEBUDAYAAN UNIVERSITAS PEMBANGUNNAN NASIONAL VETERAN JAKARTA FAKULTAS KEDOKTERAN Neuro basics 01 Intro to neuroanatomy AKREDITASI “UNGGUL”  l KEMENTERIAN PENDIDIKAN DAN KEBUDAYAAN UNIVERSITAS PEMBANGUNNAN NASIONAL VETERAN JAKARTA FAKULTAS KEDOKTERAN Neuro Sensory function: Functions Motor function: initiate appropriate detect changes and feel sensations responses to Integrative changes function: organize information for immediate use and store it for future use AKREDITASI “UNGGUL”  l KEMENTERIAN PENDIDIKAN DAN KEBUDAYAAN UNIVERSITAS PEMBANGUNNAN NASIONAL VETERAN JAKARTA FAKULTAS KEDOKTERAN Neuro basics Nerve cells are called neurons, or nerve fibers. Cell body (soma) contains the nucleus and is essential for the continued life of the neuron. Dendrites are extensions that transmit impulses toward the cell body. Axon transmits impulses away from the cell body. Cell membrane of the dendrites, cell body, and axon carries the electrical nerve impulse. A neuron carries impulses in only one direction. AKREDITASI “UNGGUL”  l KEMENTERIAN PENDIDIKAN DAN KEBUDAYAAN UNIVERSITAS PEMBANGUNNAN NASIONAL VETERAN JAKARTA Neuron FAKULTAS KEDOKTERAN AKREDITASI “UNGGUL”  l KEMENTERIAN PENDIDIKAN DAN KEBUDAYAAN UNIVERSITAS PEMBANGUNNAN NASIONAL VETERAN JAKARTA FAKULTAS KEDOKTERAN Neuro basics A nerve is a bundle of hundreds to thousands of axons that is outside the cerebrum and medulla spinalis, serving a specific region of the body. A nerve tract is a group of neurons within the central nervous system. These tracts are often called substantia alba (white because of the myelin sheaths). A ganglion (plural = ganglia) is a small mass of neuron cell bodies, that are located outside the cerebrum and medulla spinalis. Ganglia are closely associated with cranial and spinal nerves. A nucleus (plural = nuclei) is a mass of substantia grisea (gray because the neurons are not sheathed with myelin). AKREDITASI “UNGGUL”  l KEMENTERIAN PENDIDIKAN DAN KEBUDAYAAN UNIVERSITAS PEMBANGUNNAN NASIONAL VETERAN JAKARTA FAKULTAS KEDOKTERAN Nervous system The nervous system has two divisions: The central nervous system (CNS) consists of the cerebrum and medulla spinalis. The peripheral nervous system (PNS) consists of cranial nerves and spinal nerves. The PNS is divided into three functional components: somatic nervous system, autonomic nervous system, and enteric nervous system AKREDITASI “UNGGUL” Nervous l KEMENTERIAN PENDIDIKAN DAN KEBUDAYAAN UNIVERSITAS PEMBANGUNNAN NASIONAL VETERAN JAKARTA FAKULTAS KEDOKTERAN system Sensory/afferent neuron Somatic (DMS) PNS Visceral (internal organs) information Receptor transmit impulse CNS integrates information, received as sensation initiates responses Somatic (skeletal muscle) Motor/efferent neuron PNS Visceral response (smooth & cardiac muscle, glands) → autonomic nervous system Effectors Muscle Glands AKREDITASI “UNGGUL”  l KEMENTERIAN PENDIDIKAN DAN KEBUDAYAAN UNIVERSITAS PEMBANGUNNAN NASIONAL VETERAN JAKARTA FAKULTAS KEDOKTERAN AKREDITASI “UNGGUL”  l KEMENTERIAN PENDIDIKAN DAN KEBUDAYAAN UNIVERSITAS PEMBANGUNNAN NASIONAL VETERAN JAKARTA FAKULTAS KEDOKTERAN Central Nervous System 02 Cerebrum & medulla spinalis AKREDITASI “UNGGUL”  l KEMENTERIAN PENDIDIKAN DAN KEBUDAYAAN UNIVERSITAS PEMBANGUNNAN NASIONAL VETERAN JAKARTA FAKULTAS KEDOKTERAN Central nervous system The central nervous system (CNS) is composed of the cerebrum and medulla spinalis. The cerebri is enclosed and protected by the cranium and contains about 100 billion neurons. The medulla spinalis is enclosed and protected by the bones of the columna vertebralis in the vertebral canal and contains about 100 million neurons. The CNS processes incoming sensory information. It is also the source of thoughts, emotions, and memories. AKREDITASI “UNGGUL”  Cerebrum l KEMENTERIAN PENDIDIKAN DAN KEBUDAYAAN UNIVERSITAS PEMBANGUNNAN NASIONAL VETERAN JAKARTA FAKULTAS KEDOKTERAN development Primary brain vesicles Prosencephalon Mesencephalon Rhombencephalon (forebrain) (Midbrain) (Hindbrain) Midbrain, Telencephalon Diencephalon Metencephalon Myelencephalon aqueductus cerebri Thalamus, Pons, cerebellum, Medulla oblongata, Cerebrum, hypothalamus, epithalamus, ventriculus quartus ventriculus quartus ventriculus lateralis pars superior pars inferior ventriculus tertius AKREDITASI “UNGGUL”  l KEMENTERIAN PENDIDIKAN DAN KEBUDAYAAN UNIVERSITAS PEMBANGUNNAN NASIONAL VETERAN JAKARTA FAKULTAS KEDOKTERAN AKREDITASI “UNGGUL”  l KEMENTERIAN PENDIDIKAN DAN KEBUDAYAAN UNIVERSITAS PEMBANGUNNAN NASIONAL VETERAN JAKARTA FAKULTAS KEDOKTERAN Forebrain 02 Cerebrum hemispheres & basal ganglia AKREDITASI “UNGGUL”  Cerebrum l KEMENTERIAN PENDIDIKAN DAN KEBUDAYAAN UNIVERSITAS PEMBANGUNNAN NASIONAL VETERAN JAKARTA FAKULTAS KEDOKTERAN The largest portion of the human brain. Consists of the cerebral hemispheres and the basal nuclei/ganglia. Hemisphere cerebri are the right and left halves of the cerebrum. The hemispheres are separated by a deep groove called the fissura longitudinalis that is occupied by the falx cerebri. AKREDITASI “UNGGUL”  Cerebrum l KEMENTERIAN PENDIDIKAN DAN KEBUDAYAAN UNIVERSITAS PEMBANGUNNAN NASIONAL VETERAN JAKARTA FAKULTAS KEDOKTERAN The folds are called gyrus (plural = gyri); the deepest grooves between gyri are known as fissura; the shallower grooves between gyri are termed sulcus (plural = sulci). The hemispheres are connected internally by the corpus callosum, a broad band of substantia alba containing axons. AKREDITASI “UNGGUL”  Cerebrum l KEMENTERIAN PENDIDIKAN DAN KEBUDAYAAN UNIVERSITAS PEMBANGUNNAN NASIONAL VETERAN JAKARTA FAKULTAS KEDOKTERAN Each cerebral hemisphere can be subdivided into 4 lobes named after the cranial bones that cover them. The sulcus centralis separates the lobus frontal from lobus parietal. The gyrus precentralis, anterior to the sulcus centralis, contains the primary motor area of the cerebral cortex. The gyrus postcentralis, posterior to the sulcus, contains the primary somatosensory area. The sulcus lateralis (Sylvii) separates the lobus frontal from the lobus temporal. The sulcus parieto-occipitalis separates the lobus parietal from the lobus occipital. AKREDITASI “UNGGUL” Homonculus cerebri l KEMENTERIAN PENDIDIKAN DAN KEBUDAYAAN UNIVERSITAS PEMBANGUNNAN NASIONAL VETERAN JAKARTA FAKULTAS KEDOKTERAN Illustrates how different body parts are mapped onto specific areas of the brain. Looks distorted because the representation of body parts is not proportional to actual size. Contralateral → left hemisphere controls right side of the body and vice versa. Two types of homunculi: motor & somatosensory AKREDITASI “UNGGUL” Motor homonculus l KEMENTERIAN PENDIDIKAN DAN KEBUDAYAAN UNIVERSITAS PEMBANGUNNAN NASIONAL VETERAN JAKARTA FAKULTAS KEDOKTERAN Located on the gyrus precentralis (Brodmann's Area 4). Represents the motor cortex à controls voluntary muscle movements. The size of each body part on the homunculus ≈ amount of brain tissue dedicated to controlling it. For example: the hands and mouth (fine motor control) have a larger representation. AKREDITASI “UNGGUL” Sensory homonculus l KEMENTERIAN PENDIDIKAN DAN KEBUDAYAAN UNIVERSITAS PEMBANGUNNAN NASIONAL VETERAN JAKARTA FAKULTAS KEDOKTERAN Located on the gyrus postcentralis (Brodmann's Areas 1, 2, 3). Represents the somatosensory cortex, à processes sensory information from the skin, muscles, and joints. Size of each body part ≈ sensitivity of that area. For example: the lips and fingertips (highly sensitive) have a larger representation. AKREDITASI “UNGGUL”  Basal ganglia l KEMENTERIAN PENDIDIKAN DAN KEBUDAYAAN UNIVERSITAS PEMBANGUNNAN NASIONAL VETERAN JAKARTA FAKULTAS KEDOKTERAN Interconnected nuclei deep within each hemisphere à basal nuclei/ganglia Controls automatic movements of skeletal muscles & muscle tone Help cognitive processes: attention, memory, planning, emotional behaviors AKREDITASI “UNGGUL”  Basal ganglia l KEMENTERIAN PENDIDIKAN DAN KEBUDAYAAN UNIVERSITAS PEMBANGUNNAN NASIONAL VETERAN JAKARTA FAKULTAS KEDOKTERAN Striatum: Nucleus caudatus: Involved in planning and initiating movement, cognitive functions like decision-making and attention. Putamen: Involved in motor control, particularly in regulating movement and learning motor skills. Nucleus Lentiformis: Globus Pallidus: regulate the basal ganglia. Putamen Subthalamic Nucleus (STN): Involved in motor control and learning. Substantia Nigra: Produces dopamine, particularly in motor control, reward, and inhibition. AKREDITASI “UNGGUL”  l KEMENTERIAN PENDIDIKAN DAN KEBUDAYAAN UNIVERSITAS PEMBANGUNNAN NASIONAL VETERAN JAKARTA FAKULTAS KEDOKTERAN Diencephalon 02 Thalamus, hypothalamus, & epithalamus AKREDITASI “UNGGUL”  Thalamus l KEMENTERIAN PENDIDIKAN DAN KEBUDAYAAN UNIVERSITAS PEMBANGUNNAN NASIONAL VETERAN JAKARTA FAKULTAS KEDOKTERAN The diencephalon includes the thalamus, hypothalamus, and epithalamus. Thalamus is the major relay station for sensory impulses (except smell) to appropriate sensory areas of the cerebral cortex for interpretation. Also involved in alertness and awareness (consciousness), memory, pain and emotional processing. AKREDITASI “UNGGUL”  Hypothalamus l KEMENTERIAN PENDIDIKAN DAN KEBUDAYAAN UNIVERSITAS PEMBANGUNNAN NASIONAL VETERAN JAKARTA FAKULTAS KEDOKTERAN Located inferior, hypothalamus has body control functions: Homeostasis: Regulate body temperature, hunger-thirst, circadian rhythm. Endocrine: Produce ADH and oxytocin, releasing hormones à stimulate hypophysis (glandula pituitaria) to secrete hormones. Integrate functioning of autonomic nervous system (heart, blood vessels, and intestines). Stimulate visceral responses in emotional situations. AKREDITASI “UNGGUL”  Epithalamus l KEMENTERIAN PENDIDIKAN DAN KEBUDAYAAN UNIVERSITAS PEMBANGUNNAN NASIONAL VETERAN JAKARTA FAKULTAS KEDOKTERAN The epithalamus is superior and posterior of thalamus, consists of: Glandula pinealis: secretes the hormone melatonin à contribute to the circadian rhythm by inducing sleep and helping the body adjust to light/dark/jet lag. Nuclei habenula: primarily involved in negative reinforcement & reward prediction errors, integrating sensory and emotional inputs to behavior such as emotional responses to odors. AKREDITASI “UNGGUL”  l KEMENTERIAN PENDIDIKAN DAN KEBUDAYAAN UNIVERSITAS PEMBANGUNNAN NASIONAL VETERAN JAKARTA FAKULTAS KEDOKTERAN Truncus cerebri 02 Midbrain, pons & medulla oblongata AKREDITASI “UNGGUL” Midbrain l KEMENTERIAN PENDIDIKAN DAN KEBUDAYAAN UNIVERSITAS PEMBANGUNNAN NASIONAL VETERAN JAKARTA FAKULTAS KEDOKTERAN Midbrain (mesencephalon) is about 2.5 cm long from pons to diencephalon where the aqueductus cerebri passes through. Pedunculi cerebri (anterior part) connect the cerebrum to truncus cerebri. Tectum (posterior part) are reflex centers for certain visual activities, part of the auditory pathway, and the startle reflex. Contains substantia nigra, a major source of dopamine. Dopamine helps smooth & coordinated movement (motor control), reward & motivation. AKREDITASI “UNGGUL”  Pons l KEMENTERIAN PENDIDIKAN DAN KEBUDAYAAN UNIVERSITAS PEMBANGUNNAN NASIONAL VETERAN JAKARTA FAKULTAS KEDOKTERAN Within the pons are respiratory centers that produce a normal breathing rhythm. Also contains nuclei associated with cranial nerves: Trigeminal (V) nerves. Abducens (VI) nerves. Facial (VII) nerves. Vestibulocochlear (VIII) nerves. AKREDITASI “UNGGUL” Medulla oblongata l KEMENTERIAN PENDIDIKAN DAN KEBUDAYAAN UNIVERSITAS PEMBANGUNNAN NASIONAL VETERAN JAKARTA FAKULTAS KEDOKTERAN Extends from medulla spinalis to the pons and is anterior to the cerebellum. Its functions are those of “vital signs”. Contains cardiac centers that regulate heart rate, vasomotor centers that regulate the diameter of blood vessels and blood pressure, and respiratory centers that regulate breathing. AKREDITASI “UNGGUL” Formatio reticularis l KEMENTERIAN PENDIDIKAN DAN KEBUDAYAAN UNIVERSITAS PEMBANGUNNAN NASIONAL VETERAN JAKARTA FAKULTAS KEDOKTERAN A broad region where substantia alba and substantia grisea exhibit a netlike arrangement. Extends from the superior part of medulla spinalis, throughout truncus cerebri, and into the inferior part of diencephalon. The ascending portion is called the reticular activating system (RAS) The most important function of the RAS is consciousness. AKREDITASI “UNGGUL” Limbic system l KEMENTERIAN PENDIDIKAN DAN KEBUDAYAAN UNIVERSITAS PEMBANGUNNAN NASIONAL VETERAN JAKARTA FAKULTAS KEDOKTERAN Components: Amygdala: Critical for processing emotions, particularly fear, and for emotional memory formation. Hippocampus: Essential for memory formation and learning; also important in spatial navigation. Cortex cinguli: Involved in emotion regulation, decision-making, and impulse control. Nuclei septalis: Associated with the reward system and emotional regulation. Thalamus Hypothalamus AKREDITASI “UNGGUL” Limbic system l KEMENTERIAN PENDIDIKAN DAN KEBUDAYAAN UNIVERSITAS PEMBANGUNNAN NASIONAL VETERAN JAKARTA FAKULTAS KEDOKTERAN Functions: 1. Emotion Regulation: allows us to react appropriately to different situations. The amygdala is pivotal for processing fear and pleasure. 2. Memory Formation: hippocampus is essential for forming new memories, particularly with emotional significance. This allows us to learn from experiences and recall past events. 3. Motivation and Reward: the septal nuclei contribute to feelings of reward and motivation. 4. Olfactory Processing: smells can evoke strong emotional responses and memories. AKREDITASI “UNGGUL” Limbic system l KEMENTERIAN PENDIDIKAN DAN KEBUDAYAAN UNIVERSITAS PEMBANGUNNAN NASIONAL VETERAN JAKARTA FAKULTAS KEDOKTERAN AKREDITASI “UNGGUL” Memory making l KEMENTERIAN PENDIDIKAN DAN KEBUDAYAAN UNIVERSITAS PEMBANGUNNAN NASIONAL VETERAN JAKARTA FAKULTAS KEDOKTERAN Brain Structures Involved in Memory 1. Hippocampus: Essential for forming new memories, particularly declarative memories (facts and events). Plays a role in spatial memory and navigation. Consolidates short-term memories into long-term memories. 2. Amygdala: Involved in emotional memory, particularly fear conditioning. Enhances memory formation for emotionally significant events. 3. Cortex cerebri: Cortex prefrontal: Working memory, decision-making, and planning. Lobus temporal: Declarative memory, including semantic (facts) and episodic (events) memory. Lobus parietal: Spatial memory and navigation. Lobus occipital: Visual memory. 4. Thalamus: Acts as a relay station for sensory information. Plays a role in attention and consciousness, which are essential for memory formation and retrieval. 5. Basal Ganglia: Involved in procedural memory, which is memory for skills and habits. AKREDITASI “UNGGUL” Memory making l KEMENTERIAN PENDIDIKAN DAN KEBUDAYAAN UNIVERSITAS PEMBANGUNNAN NASIONAL VETERAN JAKARTA FAKULTAS KEDOKTERAN Memory Processes and Neural Mechanisms Encoding: converting sensory information into a neural code that can be stored in the brain. Consolidation: stabilizing a memory trace, making it resistant to disruption. Storage: maintaining information in the brain over time. Retrieval: accessing stored information. Neural Mechanisms: Long-Term Potentiation (LTP): a process that strengthens synaptic connections, making it easier for neurons to communicate with each other. Neurotransmitter Systems: acetylcholine, dopamine, glutamate, and norepinephrine play important roles in memory formation and retrieval. AKREDITASI “UNGGUL”  l KEMENTERIAN PENDIDIKAN DAN KEBUDAYAAN UNIVERSITAS PEMBANGUNNAN NASIONAL VETERAN JAKARTA FAKULTAS KEDOKTERAN Ventriculi cerebri 02 AKREDITASI “UNGGUL”  Ventriculi cerebri l KEMENTERIAN PENDIDIKAN DAN KEBUDAYAAN UNIVERSITAS PEMBANGUNNAN NASIONAL VETERAN JAKARTA FAKULTAS KEDOKTERAN Cavities filled with liquor cerebri spinalis (LCS). 1 ventriculus lateralis in each hemisphere of the cerebrum, anteriorly separated by septum pellucidum. Ventriculus tertius is superior to the hypothalamus and between the right and left halves of the thalamus. Ventriculus quartus is between truncus cerebri and cerebellum. AKREDITASI “UNGGUL”  Ventriculi cerebri l KEMENTERIAN PENDIDIKAN DAN KEBUDAYAAN UNIVERSITAS PEMBANGUNNAN NASIONAL VETERAN JAKARTA FAKULTAS KEDOKTERAN Plexus choroid produces majority of LCS, The LCS functions: 1. Mechanical protection (shock-absorbing medium). 2. An optimal chemical environment for efficient neuronal signaling. 3. Circulation. Most of LCS circulates in the spatium subarachnoid around the surface of the cerebrum and medulla spinalis. A small amount of LCS passes down into the medulla spinalis AKREDITASI “UNGGUL”  l KEMENTERIAN PENDIDIKAN DAN KEBUDAYAAN UNIVERSITAS PEMBANGUNNAN NASIONAL VETERAN JAKARTA FAKULTAS KEDOKTERAN Cerebellum 02 AKREDITASI “UNGGUL”  Cerebellum l KEMENTERIAN PENDIDIKAN DAN KEBUDAYAAN UNIVERSITAS PEMBANGUNNAN NASIONAL VETERAN JAKARTA FAKULTAS KEDOKTERAN Cerebellum is separated from the medulla and pons by the ventriculus quartus and is inferior to lobus occipital. 3 pairs of pedunculi cerebellares attach the cerebellum to truncus cerebri. Many of the functions of the cerebellum are in movement: coordination, regulation of muscle tone, the appropriate trajectory and endpoint of movements, and maintenance of posture and equilibrium. AKREDITASI “UNGGUL”  l KEMENTERIAN PENDIDIKAN DAN KEBUDAYAAN UNIVERSITAS PEMBANGUNNAN NASIONAL VETERAN JAKARTA FAKULTAS KEDOKTERAN Medulla spinalis 02 AKREDITASI “UNGGUL”  Medulla spinalis l KEMENTERIAN PENDIDIKAN DAN KEBUDAYAAN UNIVERSITAS PEMBANGUNNAN NASIONAL VETERAN JAKARTA FAKULTAS KEDOKTERAN Extends from the foramen magnum to discus intervertebralis L1-L2. There are 31 pairs of spinal nerves. The nerves are named according to their respective vertebrae: 8 cervical pairs, 12 thoracic pairs, 5 lumbar pairs, 5 sacral pairs, and 1 very small coccygeal pair. The length of the adult medulla spinalis is 42 - 45 cm, diameter is about 2 cm. AKREDITASI “UNGGUL”  Medulla spinalis l KEMENTERIAN PENDIDIKAN DAN KEBUDAYAAN UNIVERSITAS PEMBANGUNNAN NASIONAL VETERAN JAKARTA FAKULTAS KEDOKTERAN Intumenscentia cervicalis (superior enlargement) extends from the C4 to T1, where nerves to and from the upper limbs arise. Intumenscentia lumbalis (inferior enlargement) extends from T9–T12, where nerves to and from the lower limbs arise. Inferior to the lumbar enlargement, the spinal cord terminates as a tapering, conical structure called the conus medullaris ending at the level of the discus intervertebral disc between L1–L2 in adults. AKREDITASI “UNGGUL”  Medulla spinalis l KEMENTERIAN PENDIDIKAN DAN KEBUDAYAAN UNIVERSITAS PEMBANGUNNAN NASIONAL VETERAN JAKARTA FAKULTAS KEDOKTERAN Arising from the conus medullaris is the filum terminale, an extension of the pia mater that extends inferiorly and fuses with the arachnoid mater and dura mater to anchor the spinal cord to the coccyx. The roots of these lower spinal nerves angle inferiorly alongside the filum terminale in the vertebral canal, named the cauda equina. AKREDITASI “UNGGUL”  l KEMENTERIAN PENDIDIKAN DAN KEBUDAYAAN UNIVERSITAS PEMBANGUNNAN NASIONAL VETERAN JAKARTA FAKULTAS KEDOKTERAN AKREDITASI “UNGGUL”  l KEMENTERIAN PENDIDIKAN DAN KEBUDAYAAN UNIVERSITAS PEMBANGUNNAN NASIONAL VETERAN JAKARTA FAKULTAS KEDOKTERAN Meninges 03 AKREDITASI “UNGGUL”  Meninges l KEMENTERIAN PENDIDIKAN DAN KEBUDAYAAN UNIVERSITAS PEMBANGUNNAN NASIONAL VETERAN JAKARTA FAKULTAS KEDOKTERAN The connective tissue membranes that cover the cerebrum and medulla spinalis are called meninges: the outer dura mater, the middle arachnoid mater, and the inner pia mater Three extensions of the dura mater separate parts of the brain: falx cerebri separates the two cerebrum hemispheres. falx cerebelli separates the two cerebellum hemispheres. tentorium cerebelli separates the cerebrum from the cerebellum. AKREDITASI “UNGGUL”  Meninges l KEMENTERIAN PENDIDIKAN DAN KEBUDAYAAN UNIVERSITAS PEMBANGUNNAN NASIONAL VETERAN JAKARTA FAKULTAS KEDOKTERAN Spatium epidurale is a potential space between the periosteal layer of the dura mater and cranium Between the arachnoid and the pia mater is the spatium subarachnoid, which contains LCS à reabsorbed through arachnoid villi into the blood in cranial venous sinuses (large veins within the double- layered dura mater) à LCS becomes blood plasma again. AKREDITASI “UNGGUL”  l KEMENTERIAN PENDIDIKAN DAN KEBUDAYAAN UNIVERSITAS PEMBANGUNNAN NASIONAL VETERAN JAKARTA FAKULTAS KEDOKTERAN Neurocranium 04 AKREDITASI “UNGGUL”  Scalp l KEMENTERIAN PENDIDIKAN DAN KEBUDAYAAN UNIVERSITAS PEMBANGUNNAN NASIONAL VETERAN JAKARTA FAKULTAS KEDOKTERAN Skin: outermost layer, contains hair follicles, sebaceous glands, and sweat glands. Connective tissue: dense layer rich in blood vessels and nerves. Aponeurosis: fibrous layer, connects the occipital and frontal muscles. Loose areolar connective tissue: allows movement of the scalp over the cranium. Pericranium/periosteum: thin connective tissue that adheres to the surface of the cranium. AKREDITASI “UNGGUL”  Neurocranium l KEMENTERIAN PENDIDIKAN DAN KEBUDAYAAN UNIVERSITAS PEMBANGUNNAN NASIONAL VETERAN JAKARTA FAKULTAS KEDOKTERAN The cranial bones form the cranium (lined with the meninges) that encloses and protects the brain, eyes, and ears. They are the frontal, parietal (2), temporal (2), and occipital bones. The sphenoid and ethmoid bones are part of the basis cranii (floor of the cranium) and cavitas orbitalis (sockets) for the eyes. AKREDITASI “UNGGUL”  l KEMENTERIAN PENDIDIKAN DAN KEBUDAYAAN UNIVERSITAS PEMBANGUNNAN NASIONAL VETERAN JAKARTA Cranium FAKULTAS KEDOKTERAN development AKREDITASI “UNGGUL”  l KEMENTERIAN PENDIDIKAN DAN KEBUDAYAAN UNIVERSITAS PEMBANGUNNAN NASIONAL VETERAN JAKARTA FAKULTAS KEDOKTERAN AKREDITASI “UNGGUL”  l KEMENTERIAN PENDIDIKAN DAN KEBUDAYAAN UNIVERSITAS PEMBANGUNNAN NASIONAL VETERAN JAKARTA FAKULTAS KEDOKTERAN AKREDITASI “UNGGUL”  l KEMENTERIAN PENDIDIKAN DAN KEBUDAYAAN UNIVERSITAS PEMBANGUNNAN NASIONAL VETERAN JAKARTA FAKULTAS KEDOKTERAN AKREDITASI “UNGGUL”  Cranial nerves l KEMENTERIAN PENDIDIKAN DAN KEBUDAYAAN UNIVERSITAS PEMBANGUNNAN NASIONAL VETERAN JAKARTA FAKULTAS KEDOKTERAN I. Olfactorius: Sense of smell VI. Abducens: Eye movement (M. rectus II. Opticus: Vision lateralis) III. Occulomotorius: Eye movement, pupil VII. Facialis: Facial expression, taste constriction sensation from anterior two-thirds of tongue IV. Trochlearis: Eye movement (M. obliquus VIII. Vestibulocochlearis: Hearing and superior) balance V. Trigeminus: IX. Glossopharyngeus: Taste sensation from Ophthalmicus (V1): Sensation to posterior one-third of tongue, swallowing, forehead, upper eyelid, and cornea. salivation Maxillaris (V2): Sensation to lower X. Vagus: Sensory and motor innervation of eyelid, cheek, upper lip, upper teeth, and pharynx, larynx, and internal organs nasal cavity. XI. Accessorius: Shoulder shrugging and Mandibularis (V3): Sensation to the head turning lower lip, lower teeth, chin, and part of the XII. Hypoglossi: Tongue movement tongue. Motor innervation to muscles of mastication. AKREDITASI “UNGGUL”  l KEMENTERIAN PENDIDIKAN DAN KEBUDAYAAN UNIVERSITAS PEMBANGUNNAN NASIONAL VETERAN JAKARTA FAKULTAS KEDOKTERAN AKREDITASI “UNGGUL”  l KEMENTERIAN PENDIDIKAN DAN KEBUDAYAAN UNIVERSITAS PEMBANGUNNAN NASIONAL VETERAN JAKARTA FAKULTAS KEDOKTERAN AKREDITASI “UNGGUL”  l KEMENTERIAN PENDIDIKAN DAN KEBUDAYAAN UNIVERSITAS PEMBANGUNNAN NASIONAL VETERAN JAKARTA FAKULTAS KEDOKTERAN AKREDITASI “UNGGUL”  l KEMENTERIAN PENDIDIKAN DAN KEBUDAYAAN UNIVERSITAS PEMBANGUNNAN NASIONAL VETERAN JAKARTA FAKULTAS KEDOKTERAN Cerebrovascular 05 AKREDITASI “UNGGUL”  Artery branches l KEMENTERIAN PENDIDIKAN DAN KEBUDAYAAN UNIVERSITAS PEMBANGUNNAN NASIONAL VETERAN JAKARTA FAKULTAS KEDOKTERAN AKREDITASI “UNGGUL”  Artery branches l KEMENTERIAN PENDIDIKAN DAN KEBUDAYAAN UNIVERSITAS PEMBANGUNNAN NASIONAL VETERAN JAKARTA FAKULTAS KEDOKTERAN AKREDITASI “UNGGUL”  Artery branches l KEMENTERIAN PENDIDIKAN DAN KEBUDAYAAN UNIVERSITAS PEMBANGUNNAN NASIONAL VETERAN JAKARTA FAKULTAS KEDOKTERAN AKREDITASI “UNGGUL”  Circulus Willisi l KEMENTERIAN PENDIDIKAN DAN KEBUDAYAAN UNIVERSITAS PEMBANGUNNAN NASIONAL VETERAN JAKARTA FAKULTAS KEDOKTERAN interconnected network of arteries at the base of the brain that provides alternative routes for blood, ensuring the brain gets continuous blood flow. primarily involves A. Cerebri anterior et posterior, A. Carotis interna, A. Basilaris, A. Communicans anterior et posterior. AKREDITASI “UNGGUL”  Venous system l KEMENTERIAN PENDIDIKAN DAN KEBUDAYAAN UNIVERSITAS PEMBANGUNNAN NASIONAL VETERAN JAKARTA FAKULTAS KEDOKTERAN AKREDITASI “UNGGUL”  Venous system l KEMENTERIAN PENDIDIKAN DAN KEBUDAYAAN UNIVERSITAS PEMBANGUNNAN NASIONAL VETERAN JAKARTA FAKULTAS KEDOKTERAN AKREDITASI “UNGGUL”  l KEMENTERIAN PENDIDIKAN DAN KEBUDAYAAN UNIVERSITAS PEMBANGUNNAN NASIONAL VETERAN JAKARTA FAKULTAS KEDOKTERAN AKREDITASI “UNGGUL”