Localization in neurology 1

Localization in Neurology- 1

Anatomical & pathological correlation

Brain functions

Extrapyramidal system Afferent- Caudate nucleus Globus pallidus Efferent- Putamen Substantia nigra Subthalamic nucleus

Cerebellum Coordination Vermis- axial &

Lobes- I/L appendicular 3 peduncles Superior- midbrain- efferent Middle- pons- afferent Inferior- medulla- afferent

Blood supply of brain Internal carotid MCA ACA Subclavian artery Vertebral artery-2Ant. spinal artery-1PICApost. spinal artery-2 Basilar artery-1AICASCAPCA Circle of Willis AC-ACA-MCA-PC-PCA

Blood supply

Blood supply

Venous drainage of brain

Blood supply to spinal cord Anterior 2/3rd-

ASA

Posterior 1/3rd- PSA

Cranial n.nuclei MidbrainIII, IV PonsV-VIII MedullaIX-XII

Motor pathways

Sensory pathways

Spinal tracts

Tracts Motor- Corticospinal- cross at medullaMedial Lateral- C.T.L.S

Sensory- Spinothalamic- pain & temperature-

cross at spinal levelMedial Lateral- C.T.L.S Posterior column- touch, position, vibration-

cross at medullaMedial Lateral- S.L.T.C

Motor & sensory units

Autonomic nervoussystem SympatheticThoraco-lumbar ParasympatheticCranio-sacral(III, VII, IX, X cranial n.have parasympathetic nuclei)

ANS Involuntary, independent Located outside cerebrospinal axis Most organs have both S & PS supply;

adrenal, hair follicles, sweat glands, blood vessels- S supply only

Lateral horn Ganglia Organ pregang. fibres postgang. fibres all Ach S-NE, PS-Ach Central regulation-

frontal lobe, limbic system, hypothalamus

CNS- pathology Vascular- infarct or

hemorrhage Infection- myelitis or

encephalitis Abscess Meningitis Trauma Demyelination

Degenerative Tumor/SOL Congenital or

hereditary Nutritional Metabolic Toxins/Poisoning Psychogenic

Practical localization Is CNS involved? At what level- cerebral cortexmuscle? What system(s) is/are involved? Consciousness, language, vision Motor function, coordination Pain/temperature, proprioception/vibration Process- focal/multifocal/diffuse? Lateralization- Left/Right/bilateral? Onset, progression & course?

Practical pathology Onset- Acute- vascular/electrical Subacute- demyelinating/inflammatory Chronic- structural/degenerative Course- Self-limiting- vascular Paroxysmal- electrical/demyelinating Progressive- compressive/degenerative Circumstances- Preceding viral infection- demyelinating Preceding trauma- structural Peripartum- venous thrombosis etc.