NEUROANATOMY
The virtual neuroanatomy room
Academic year 2020-2021
Department of Anatomy and Neurosciences
Faculty of Medicine
VU University medical center (VUmc)
Amsterdam UMC
1
, Aim of this practical course
During the lectures we familiarized with the most important anatomical and structural
components that together comprise the nervous system. You have probably already
realized how complex the organization of this system is. Brain, spinal cord, spinal and
cranial nerves, neurons, glia, ascending and descending pathways are only some of the
words we repeatedly used in our `virtual classroom`.
In this practical course we aim to expand these concepts providing some neuroanatomical
application by which you can learn more on the organization and function of the most
noble organ of our body: the brain, and, of course, its connections. You will have the
possibility to explore, compare, dissect and reassemble some of the most important
structures/regions of the central nervous system and understand their relevance for
physiological as well as pathological conditions.
Unfortunately the current pandemic prevents us from inviting visitors to the dissection
room, where real brains from donors are usually prepared for scientific experiments. At
the same time I believe you have the right to be instructed in this sense. Therefore. I
created a `virtual dissection room´ where you can have access to images of brain
dissections and preparations and practice with some basic as well as crucial
neuroanatomical concepts.
HOW TO PARTICIPATE TO THIS PRACTICAL:
• The online practical will take place on Tuesday 17november 2020. Your
coordinator will send you a zoom link;
• Starting from one week before the online practical (10 November) you will have
access to this practical document. You can start filling it up with the requested
information (assignments/questions etc…);
• Take notes of the aspects that are less clear to you or those you would like to
discuss during the online practicum;
• The day of the online practicum I will make breakoutrooms where you can discuss
these aspects with your peers for about an hour;
• The last part of the online practical will be dedicated to answer your questions and
provide you with the solution of the trickiest questions/assignments.
Additional information/instructions:
• The textbooks providing background knowledge for this course are ‘Neuroscience
(Purves)’ and optional reading ‘Neuroanatomy through Clinical Cases (Blumenfeld)’.
• This learning material is part of the final exam for this course.
• To fill the images with your answer you can use the word tools (e.g. draw a box on top
the white boxes in the image and add text to it).
• The vast majority of the images are taken from:
2
, • Official website of University of British Columbia (https://www.neuroanatomy.ca/)
• http://www.anatomie-amsterdam.nl/. Schematic representations are mainly (and
friendly) provided by Dr. Geert J. Schenk.
If you have further questions please do not hesitate to contact the lecturer of your
neuroanatomy class:
Antonio Luchicchi
a.luchicchi@amsterdamumc.nl
Have a nice experience!
3
,INTRODUCTION: OUR VIRTUAL DISSECTION ROOM
Hi everybody and welcome to our virtual dissection room. On your right you have a plant
of this room. I organized 5 different stations that you can visit during this practical session.
Each station is dedicated to a
particular topic of interest. We will
range from macroscopy to
microscopy and we will have the
opportunity to study some
interesting aspect of the nervous
system using images of
dissections and preparations.
Well, I guess we are ready to
start…virtually wash your hands
and get inside. We will proceed
following the numbers assigned to
the different station. In each
station you will be requested to:
• Read some introductory
material;
• Virtually investigate some
preparations;
• Answer some questions.
4
, STATION #1
Skull, meninges and blood supply
5
,Learning objectives:
i) Locate the main fossae and foramens through which the brain interacts with the rest of the
nervous system and body;
ii) Identify the main meningeal components and understand their role in physiology;
iii) Indicate the main structures involved in blood supply to the brain, blood drainage, and liquor
system.
SKULL
The human brain is protected
into the skull. To guarantee the
communication between brain
and spinal cord, to let the
cranial nerves leave the brain
to innervate the target regions Cribiform plate
and to let arteries and veins Optic canal
pass a number of foramina
(fissures and canals) are Optic groove
present in the skull.
Sella turcica
Assignment: study the Sup. Orb. fissure
different foramina and Foramen lacerum
Foramen rotundum
locate them in the two
pictures below. The first Foramen spinosum
Foramen ovale
provides an overview of the
Int. Ac. Meatus
foramina/fossa of the basal
cranium-top view, the Carotid canal Jugular foramen
second shows the same
structures but from a bottom
point-of-view. Hypoglossal canal
Refer to Acland’s video atlas of Foramen magnum
Human Anatomy
(https://vu.on.worldcat.org/oclc/919625863), section 4.2 ‘The Facial Skeleton and Base of Skull’
in particular ‘4.2.6 Openings in the base of the cranium’
6
, Inf. Orbital fissure
Foramen lacerum Foramen ovale
Hypoglossal canal Foramen spinosum
Stylomastoid foramen Carotid canal
Jugular foramen
Hypoglossal canal
Foramen magnum
Table 1 provides the
passages, spaces and
the involved structures.
passage Connects cranial cavity with: Structure/structures that pass this
opening:
foramen magnum vertebral canal dura mater
brain stem to spinal cord
left and right vertebral artery
anterior spinal artery
left and right accessory nerve (spinal roots of
nXI)
hypoglossal canal parapharyngeal space hypoglossal nerve (nXII)
jugular foramen parapharyngeal space sigmoid sinus to internal jugular vein
glossopharyngeal nerve (nIX)
vagus nerve (nX)
accessory nerve (nXI)
internal acoustic meatus inner ear facial nerve (nVII)
vestibular organ intermedius nerve (nVII)
vestibulocochlear nerve (nVIII)
labyrinthine artery
foramen lacerum
foramen spinosum infratemporal fossa medial meningeal artery
foramen ovale infratemporal fossa mandibular nerve (V3)
7
, foramen rotundum pterygopalatina fossa maxillary nerve (V2)
superior orbital fissure Orbita oculomotor nerve (nIII)
trochlear nerve (nIV)
abducens nerve (nVI)
ophthalmic nerve (V1)
ophthalmic artery
optic canal Orbita optic nerve (nII)
cribriform plate nasal cavity fila olfactoria (collectively called nI)
Carotid canal parapharyngeal space internal carotid artery
MENINGES
The brain and spinal cord
Falx cerebri
are protected by the bony
skull and vertebrae. Three
sheets of tissue, called Pia mater
meninges, and the presence
of cerebral spinal fluid arachnoid
around the brain and spinal
cord provide additional
protection. The three layers
Artery Tentorium cerebel
of meninges from outside to
inside are dura mater,
arachnoid, and pia mater. Transverse sinus
The dura mater thickens in
some parts, forming the falx
cerebri and tentorium
cerebelli.
To prepare for the
assignments below look at
Acland’s video atlas of
Human Anatomy
Arachnoid villi
Arachnoid mater
Dura mater
(https://vu.on.worldcat.org/oclc/919625863), section 4.7
‘The Brain and its Surroundings’. Of interest are: 4.7.2 Lining of cranial cavity, falx, tentorium,
4.7.3 The meningeal layers: dura, arachnoid, pia and 4.7.4 Lining of middle cranial fossa
8
,Assignment: Identify in the pictures on top the following structures:
a. pia mater b. dura mater
c. arachnoid d. tentorium cerebelli
e. falx cerebri f. arachnoid villi
Once you are done, please, answer these questions:
What are arachnoid granulations (villi)? What is their functional importance?
The arachnoid granulations are small protrusions of the arachnoid mater into the sinuses of the
brain. They allow csf to exit the subarachnoid space and enter into the blood stream. This ensures
the drainage of the csf.
Leptomeninx
The leptomeninx consists of the arachnoid and the pia mater. The arachnoid is an uninterrupted
membrane lying parallel to the dura mater. The subdural space is usually not present but develops
when blood or other fluids are collected between dura and arachnoid. Thin cytoplasmic processes
(trabeculae) extend from the arachnoid towards the brain. These trabeculae are in contact through
pediculi (‘small feet’) with the third membrane, the pia mater. The (sub)arachnoid space is the
9
, space between the arachnoid and the pia mater. In living persons this space contains
cerebrospinal fluid (CSF) or liquor.
The pia mater closely follows the contours of the brain, while the arachnoid is connected to the
dura and, therefore, follows the contours of the skull. At places where the brain deviates from the
skull, large caverns in the subarachnoid are formed, which are called cisterns (we did not talk
about them during our classes, so it is important to study it now ☺).
From a clinically point of view
the cisterna magna and lumbar
cistern are important (liquor
punction).
Assignment: Identify in the
picture on your right: Superior cister
a. cisterna magna
Chiasmatic cystern
b. lumbar cistern
Interpeduncular cystern
Cisterna magna
c. chiasmatic cistern
Pontine cystern
d. superior cistern
e. interpeduncular cistern
Lumbar cistern
f. pontine cistern
CSF
Liquor cerebrospinalis (cerebrospinal fluid, CSF) is produced by the choroid plexus, a specialized
derivative of the wall or roof of the neural tube with enriched blood supply. The medial wall of the
lateral ventricles and the roof of the third and fourth ventricles are sites where choroid plexus is
present. These epithelium-like organs secrete CSF at a rate of 500 ml/day into the ventricles.
CSF flows from the lateral ventricles via the interventricular foramen of Monro into the third
ventricle, and from there on via the cerebral aqueduct into the fourth ventricle.
Communication between the intracerebral liquor space and the subarachnoid space occurs via
three openings: an unpaired median aperture (foramen of Magendie) located in the posterior roof
of the fourth ventricle, and right and left lateral apertures (foramina of Luschka) located at the
lateral recessses of the fourth ventricle.
CSF is formed in relatively large quantities (500 ml/day) in a limited liquor-containing space (in
total about 125 ml). Therefore, it is obvious that CSF circulates from the ventricles into the
arachnoid space and has to be drained. Disturbance of this circulation may result in a condition
which is called a hydrocephalus.
Drainage of CSF occurs through the arachnoid granulations into the venous sinuses (mainly the
superior venous sinus), at the cribriform plate where the olfactory fila penetrate the dura (CSF
10
