glabella, vertex and external occipital protruberance
The cranial fossae & their features
In the anterior cranial fossa
crista galli
cribriform plate of the ethmoid bone
optic canal
In the middle cranial fossa
superior orbital fissure
groove for the middle meningeal artery
pituitary fossa with anterior & posterior clinoid processes
foramen rotundum
foramen lacerum
carotid canal
foramen ovale
foramen spinosum
In the posterior cranial fossa
foramen magnum
jugular foramen
internal auditory meatus
hypoglossal canal
internal occipital protruberance
1.2
Be able to identify on a plain lateral skull radiogram
anterior, middle & posterior cranial fossae
pituitary fossa
orbits
vascular markings on vault (middle meningeal artery branches)
1.3
Be familiar with the 5 layers of the scalp, and with the tabular structure of the cranial vault.
1.4
Be familiar with the general origin, course and territory of supply of the middle meningeal artery (no detail necessary).
1.5
Be able to identify the major divisions and major gross features of the brain as below
Cerebrum
Cerebral hemispheres (= telecephalon)
median longitudinal fissure
corpus callosum
central sulcus & lateral sulcus
gyri
lobes
frontal
parietal
Temporal
Occipital
Diencephalon
thalamus
Hypothalamus
pituitary gland (=hypophysis)
optic chiasma
Brain stem
midbrain
pons
medulla
Cerebellum
cerebellar hemispheres
Vermis
folia
1.6
Know how the brain and each of its divisions is located within the brain case, including relation to surrounding bones, to the major cranial fossae and to the dural partitions.
1.7
Be able to identify the layers of the meninges and how they relate to the flow of CSF, and the arteries & veins of the brain.
Dura mater
epidural ‘space’
subdural space
falx cerebri
tentorium cerebelli & tentorial incisure
Arachnoid mater
subarachnoid space, including major enlargements (cerebellomedullary cistern, pontine cistern, interpeduncular cistern, superior cistern)
arachnoid granulations (location & function)
Pia mater
relation to sulci, gyri & blood vessels
1.8
Know the major arteries forming the Circle of Willis, and the origin and course of the internal carotid arteries and of the vertebral arteries as they ascend to the Circle.
1.9
Know, precisely, the origins of the following vessels from the Circle of Willis & the regions of cerebral cortex supplied by them:
anterior cerebral artery
middle cerebral artery
posterior cerebral artery
1.10
Be able to:
Identify: The main venous sinuses
Describe: The path the venous blood takes from the superior sagittal sinus, inferior sagittal sinus or cavernous sinus to the internal jugular vein.
1.11
Be able to:
Identify: Each cranial nerve by its number and name and to state its major function
Identify: Each cranial nerve at its attachment to the brain stem
Know: The foramina by which each nerve leaves or enters the cranium.
2.1
Be able to identify each of the divisions of the brainstem, and some of their major features:
Midbrain
cerebral peduncles
Pons
middle cerebellar peduncles
Medulla
pyramids
olives
open medulla vs closed medulla
2.2
Be able to identify each of the major parts of the ventricular system on the ventricular caste, in brain specimens and in radiographic images (in conjunction with lab 8):
Lateral ventricles & horns`
anterior horn
body
posterior horn
inferior horn
Interventricular foramen
Third ventricle
Cerebral aqueduct
Fourth ventricle
2.3
Be able to describe and identify the structures responsible for production and circulation of CSF in and around the brain, and for its resorption into the venous blood:
choroid plexus (location within each ventricle & function)
flow of CSF within ventricles
sites of outflow of CSF from IVth ventricle to sub-arachnoid space
sub-arachnoid space
arachnoid granulations (structure, site and function)
2.4
Be able to identify the major sub-arachnoid cisterns on brain specimens and in appropriate radiographic images:
cerebellomedullary cistern
interpeduncular cistern
pontine cistern
superior cistern
2.5
Know the major blood supply to each division of the brainstem, as follows:
Midbrain
branches of posterior cerebral arteries, including superior cerebellar arteries
Pons
pontine arteries from basilar artery
Medulla
lateral aspect
vertebral artery and its branches including posterior inferior cerebellar artery
medial aspect
anterior spinal artery and/or branches from vertebral arteries
2.6
Be able to identify the major surface features of the brainstem, IVth ventricle and cerebellum on suitable specimens or models, as follows:
Midbrain
superior & inferior colliculi
cerebral peduncles
substantia nigra
cerebral aqueduct
superior cerebellar peduncles
Pons
middle cerebellar peduncles
floor of the IVth ventricle
Medulla
gracile & cuneate tracts and tubercles
the pyramids and pyramidal decussation
olives
inferior cerebellar peduncle
open medulla versus closed medulla
IVth ventricle
median & lateral apertures of the IVth ventricle
superior medullary velum
inferior medullary velum
Cerebellum
arbor vitae
nodule & flocculus
primary fissure
3 pairs of cerebellar peduncles as above
understand its functional division (in conjunction with lectures)
2.7
Be able to identify the level of brainstem sections, from the gross anatomical features present, as follows:
Open medulla
floor of the fourth ventricle, olive (inferior olivary nucleus), pyramids
Mid pons
floor of the fourth ventricle, middle cerebellar peduncles, basal region with descending pyramidal (corticospinal) fibres crossed by ponto-cerebellar fibres
Midbrain (inferior colliculus)
inferior colliculus, cerebral aqueduct, cerebral peduncles (including the base/crus of the peduncle containing pyramidal fibres; substantia nigra)
2.8
Understand the organisation of the lower motor neurons within the ventral horn of the spinal cord and to identify them in appropriate sections, including:
Lateral motor columns
approximate spinal levels at which they are present
type of muscles innervated and approximate somatotopy of organization
Medial motor columns
spinal levels at which they are present
type of muscles innervated
2.9
Be familiar with the basic organisation of neurons within the cerebral cortex, and recognise pyramidal & granule (stellate) cells.
2.10
Be able to identify primary motor cortex, know how the body is mapped over it, and know the blood supply of all areas.
2.11
Be able to identify areas of cortex involved in planning motor activity (premotor area & supplementary motor area)
2.12
Be able to identify the parts of internal capsule carrying upper motor neuron axons, and the approximate somatotopic mapping of the motor fibres within the capsule
2.13
In sections of the brainstem or spinal cord, be able to locate the region occupied by fibres of the corticospinal tract.
2.14
Be familiar with the origin and approximate position in the spinal cord of the vestibulospinal, tectospinal and reticulospinal tracts (so-called ‘extrapyramidal’ motor tracts).
2.15
Be able to deduce the signs and symptoms likely to be seen in a basic corticospinal tract lesion, from the position of the lesion (especially to differentiate upper and lower MN lesions, or a mix of these).
2.16
Be familiar with the major structures in the CNS involved with autonomic motor function:
limbic region
Hypothalamus
reticular formation of the brainstem
descending reticulospinal tract (approximate position in the spinal cord)
lateral horn of the spinal cord (intermediolateral cell column)
approximate levels at which it is present
contains preganglionic parasympathetic neurons
sacral autonomic nucleus
2.17
From 2.16, be aware of why spinal injuries generally have severe consequences for autonomic functions such as control of blood pressure, sweating/temperature control, control of urination, defecation & sexual function.
3.1
On the whole brain or a single hemisphere, be able to recognise and name the major sulci and gyri which relate to the following major functional areas:
primary motor cortex
primary sensory cortex
motor speech (Broca’s area)
receptive speech (Wernicke’s area)
primary visual cortex
primary auditory cortex
olfactory cortex
3.2
Be familiar with the way in which the parts of the body are mapped over the precentral gyrus (primary motor cortex) and postcentral gyrus (primary sensory cortex), and to know the major cerebral artery supplying blood to all areas of these gyri.
3.3
Be able to list the major structures which form the diencephalon, and to identify them in whole or prosected brain specimens, in brain slices and in appropriate radiographic images (in conjunction with lab 8).
Thalamus
Hypothalamus
mamillary body
Epithalamus
pineal gland
3.4
To understand the major types of fibre systems which exist within the cerebral cortex, and to be able to identify the major examples of each type, in appropriate brain specimens and in radiographic images (in conjunction with lab 8).
Commissural fibres
corpus callosum (splenium, body, genu, rostrum)
anterior & posterior commisures
Association fibres (short & long)
superior longitudinal fasciculus (arcuate fasciculus)
short association fibres between neighbouring gyri
For the internal capsule, to be able to identify its relations to surrounding major nuclei and parts of the ventricular system, in brain specimens and in appropriate radiographic images (in conjunction with lab 8).
Anterior limb
lateral to caudate nucleus
medial to lentiform nucleus
Genu
lies at the level of the interventricular foramen
Posterior limb
lateral to thalamus
medial to lentiform nucleus
3.6
To be able to identify on the internal capsule the approximate positions at which the major functional groups of fibres run:
motor fibres for head, arm, leg
sensory fibres for head, arm, leg
fibres of the optic radiation (geniculocalcarine tract)
fibres of the auditory radiation
3.7
To be able to identify the major blood vessels supplying the internal capsule.
these are mainly fine arteries arising from the anterior parts of the Circle of Willis in general, known as the ‘central arteries’ specifically:
lateral striate arteries arising from start of middle cerebral artery
medial striate artery (arising from anterior cerebral)
3.8
To be able to identify the following structures in appropriate brain prosections, in coronal or horizontal brain slices, and in appropriate radiographic images (in conjunction with lab 9)
thalamus
caudate nucleus
lentiform nucleus (putamen & globus pallidus
3.9
To be able to identify in appropriate brain specimens or radiographic images: