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Section 3 THE NERVOUS PATHWAYS ( 神经传导路 )

Section 3 THE NERVOUS PATHWAYS ( 神经传导路 ). A. The Sensory (Ascending) Pathways ( 感觉传导通路 ) B. The Visual and Pupillary Reflexes Pathways ( 视觉传导通路和瞳孔对光反射通路 ) C. The Acoustic Pathway ( 听觉传导通路 ) D. The Equilibratory Pathway ( 平衡觉传导通路 ) E. The Motor (Descending) Pathways ( 运动传导通路 ).

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Section 3 THE NERVOUS PATHWAYS ( 神经传导路 )

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  1. Section 3 THE NERVOUS PATHWAYS (神经传导路) A. The Sensory (Ascending) Pathways (感觉传导通路) B. The Visual and Pupillary Reflexes Pathways(视觉传导通路和瞳孔对光反射通路) C. The Acoustic Pathway (听觉传导通路) D. The Equilibratory Pathway (平衡觉传导通路) E. The Motor (Descending) Pathways (运动传导通路) Dept of Anatomy, Medical College, Qingdao University

  2. A. The Sensory (Ascending) Pathways 1. Deep & discriminatory sensation  Proprioceptive (deep) sense(本体感觉): body posture, movement, vibration and pressure. discriminatory sense (精细触觉):size, shape, texture and two point discrimination. Dept of Anatomy, Medical College, Qingdao University

  3.  1) Conscious proprioceptive sensory pathways (意识性本体感觉传导通路) cerebral centers Cortex of the sup. and middle parts of postcentral gyrus. Posterior part of paracentral lobule (中央后回上中部皮质,中央旁小叶后部) (内囊后肢) (丘脑腹后外侧核) III Med. Lemniscus (内侧丘系) 丘脑皮质束(丘脑中央辐射) (内侧丘系交叉) Receptors muscle spindles tendon spindles Pacini’s corpuscles (肌梭,腱梭,P小体) (脊神经节) (内弓状纤维) I (薄束核,楔束核) II Spinal nn.(脊N) (薄束T4,楔束T4) Dept of Anatomy, Medical College, Qingdao University

  4.  1) Conscious proprioceptive sensory pathways Dept of Anatomy, Medical College, Qingdao University

  5. 2) unconscious proprioceptive sensory pathway (非意识性本体感觉传导通路) cerebellar center cortex of cerebellum (小脑皮质) sup. cerebellar peduncle (小脑上脚) 脊 髓 小 脑 前 束 thoracic nucleus (胸核) (小脑下脚) (脊髓小脑后束) I (脊神经节) Receptors muscle spindles tendon spindles Pacini’s corpuscles (肌梭,腱梭,P小体) (脊N) (后根) ant. white commissure (脊髓白质前连合)  II (后角固有核) Dept of Anatomy, Medical College, Qingdao University

  6. 2. Superficial sensation 1) Pathway of Pain & Thermal sensation of the Trunk & Limbs(躯干和四肢痛温觉传导通路) cerebral centers Cortex of the sup. and middle parts of postcentral gyrus. Posterior part of paracentral lobule (中央后回上中部皮质,中央旁小叶后部) (内囊后肢) (丘脑腹后外侧核) III (脊髓丘系) (脊髓丘脑侧束) 丘脑皮质束 (丘脑中央辐射) Receptors free n. endings (痛) Krause's end bulbs (冷) Ruffini end organs (热) (脊髓前白连合) I (脊神经节) (脊髓后角固有核) Spinal nn.(脊N) 上升1-2节后外侧束 II Dept of Anatomy, Medical College, Qingdao University

  7. 1) Pathway of Pain & Thermal sensation of the Trunk & Limbs Dept of Anatomy, Medical College, Qingdao University

  8.  2) Pain & Thermal Sensation of Head and Face (头面部痛温觉) cerebral centers cortex of the inferior part of postcentral gyrus. (中央后回下部皮质) int. cap. 内 囊 后 肢 (V神经节) I (三叉神经脊束核)  Receptors free n. endings (痛) Krause's end bulbs (冷) Ruffini end organs (热) (三叉神经) (三叉神经脊束) II (丘脑腹后内侧核) III trigeminal lemniscus(三叉丘系) 丘脑中央辐射(丘脑皮质束) Dept of Anatomy, Medical College, Qingdao University

  9.  2) Pain & Thermal Sensation of Head and Face (头面部痛温觉) Dept of Anatomy, Medical College, Qingdao University

  10. Summary of Sensory Disturbance(感觉障碍小结) (损伤部位) 感觉障碍表现 Peripheral NS (周围神经) subcutaneous nerve (皮神经): 全部感觉消失,无汗 mixed nerve (混合神经): 全部感觉消失,支配肌肉软瘫 posterior root 后根): 节段性全部感觉消失 Spinal Cord (脊髓) posterior horn (后角): 同侧节段低1-2节痛温觉消失, Ant. commissure (白质前连合): 对称节段性痛温觉消失 Tract (传导束): 分离性感觉消失) (脑干延髓) (交叉性痛温觉消失:同侧面部,对侧躯体) Thalamus(丘脑) (偏身,多伴有自发性痛疼) Internal capsule (内囊) (对侧三偏: 硬瘫,痛、温、 本体、精细触觉消失, 视觉消失) Centers(中枢) (对侧相应区感觉消失) Dept of Anatomy, Medical College, Qingdao University

  11. 3) Tactile Pathway of Trunk and Limbs (躯干四肢触觉) CEREBRAL CENTERS cortex of the sup. and middle parts of postcentral gyrus. Posterior part of paracentral lobule (中央后回上中部皮质,中央旁小叶后部) 内 囊 后 肢 (丘脑腹后外侧核) III (脊髓丘系) (脊髓丘脑前束) 丘脑中央辐射(丘脑皮质束) (脊髓白质前连合) RECEPTORS free n. endings (毛囊周围神经末梢 tactile corpuscles (触觉小体) I (脊神经节) II spinal nn.(脊N) (脊髓后角固有束核) Dept of Anatomy, Medical College, Qingdao University

  12. 4) Tactile Pathway of Head and Face (头面部触觉) CEREBRAL CENTERS cortex of the inferior part of postcentral gyrus. (中央后回下部皮质) 内 囊 后 肢 (丘脑腹后内侧核) III trigem. lemniscus(三叉丘系) 丘脑中央辐射(丘脑皮质束) (脑桥内交叉) RECEPTORS free n. endings (毛囊周围神经末梢 tactile corpuscles (触觉小体) (V神经节) I II trigeminal n.(三叉N) (三叉神经脑桥核) Dept of Anatomy, Medical College, Qingdao University

  13. 3. Visual & pupillary reflexes1)  The visual pathway (视觉传导通路) (双极 细胞) RECEPTORS rod cells (视杆细胞) cone cells (视锥细胞) (节细胞) I bipolar c. (双极细胞) II optic n. (视N) 颞 侧 鼻 侧 (外侧膝状体)  (视交叉) III optic tract (视束) 内 囊 后 肢 后部 视辐射(膝距束) CEREBRAL CENTERS banks of the calcarine sulcus ( lingual gyrus & cuneus) (距状沟两侧皮质) (舌回和楔叶) Dept of Anatomy, Medical College, Qingdao University

  14. 3. Visual & pupillary reflexes1)  The visual pathway Dept of Anatomy, Medical College, Qingdao University

  15. 2) Pathway of the Pupillary Reflexes(瞳孔对光反射传导通路) RECEPTORS rod cells (视杆细胞 cone cells (视锥细胞 II ganglion cell (节细胞) I bipolar c. (双极细胞) Optic n. (视n) 鼻侧 颞 侧 Effectors sphincter pupillae ciliary muscle (瞳孔括约肌, 睫状肌) Optic chiasma (视交叉)  ciliary ganglion 睫状N节 Short ciliary nn (睫短神经) optic tract (视束) 侧 支 pretectal area (顶盖前区) EW核 (III副核) lat. br. oculomotor n. (动眼N) Dept of Anatomy, Medical College, Qingdao University

  16. 4. The acoustic pathway(听觉传导通路) RECEPTORS spiral organs (螺旋器) II cochlear nuclei (蜗n前,后核) I 螺旋N节 (蜗神经) 斜 方 体 trapezoid body (斜方体) (内侧膝状体)  (斜方体交叉) III lat. lemniscus (外侧丘系) acoustic radia.(听辐射) 内 囊 后 肢 CEREBRAL CENTERS transverse temporal gyri (颞横回) 下部 Dept of Anatomy, Medical College, Qingdao University

  17. 5. The equilibratory pathway(平衡觉传导通路) Effectors (效应器) II 前庭N核 med.longit.fasciculus(内侧纵束) III,IV, VI,XI 核 相应 神经 I vestibular ganglion (前庭N节) Effectors (效应器) vestibulospinal tract (前庭脊髓束) Receptors cristae ampullares (壶腹嵴) maculae of utricle & saccule (球椭圆囊斑) Cerebellar cortex (小脑皮质) inf. cerebellar peduncle(小脑下脚) III ventral nucleus of thalamus (丘脑腹侧核) sup. temporal gyrus cortex (颞上回皮质) Dept of Anatomy, Medical College, Qingdao University

  18. B. The Motor (Descending) Pathways(运动传导通路) 1. The pyramidal system (锥体系): 1) corticospinal tract (皮质脊髓束) 2) corticonuclear tract (皮质核束) 2. The extrapyramidal system (锥体外系) Dept of Anatomy, Medical College, Qingdao University

  19. 1. The pyramidal system (锥体系统) 1) Corticospinal Tract(皮质脊髓束) UPPER MOTOR 中央前回↑2/3 旁中央小叶 pyramidal cells (锥体细胞) (内囊后肢)  post.limb of int. Capsule Effectors trunk mm. (躯干肌) Effectors limbs mm. (四肢肌) 大脑脚中3/5 85% 皮质 脊髓 侧束 15% 皮质 脊髓 前束  pyramidal decussation (锥体交叉) 脊髓白质 前连合 spinal nn.(脊N) spinal nn.(脊N)  LOWER MOTOR 前角 内侧核 前角 外侧核 Dept of Anatomy, Medical College, Qingdao University

  20. 1) Corticospinal Tract(皮质脊髓束) Dept of Anatomy, Medical College, Qingdao University

  21.  2) Corticonuclear Tract(皮质核束) UPPER MOTOR NEURONS 中央前回1/3 pyramidal cells (锥体细胞) (内囊膝部)  genu of internal capsule Effectors 除舌肌, 下面肌外 全部肌 Effectors 全部 头面肌 咽喉肌 皮质 核束 双侧支配 大脑脚 中3/5内侧 皮质 核束 单侧 支配 脑干内交叉 LOWER MOTOR NEURONS  全部 脑干内 运动N核 除XII和 VII下1/3 XII核 VII核 1/3外 相应脑N 相应脑N Dept of Anatomy, Medical College, Qingdao University

  22. Summary of Paralysis of Pyramidal System (锥体系瘫痪小结) (损伤部位) (瘫痪类别) Centres (中枢) (对侧单肌群硬瘫) Internal capsule (内囊) (对侧三偏: 硬瘫,痛、温、 本体、精细触觉消失, 视觉消失) Brain stem (脑干) (交叉性瘫痪: 同侧面肌软瘫, 对侧四肢硬瘫) Spinal cord (脊髓) Lat. funiculus(侧索): 同侧伤面以下硬瘫, Ant. Horn (前角): 同侧伤平面软瘫) Peripheral nn. (周围神经) (单肌软瘫,感觉消失) Dept of Anatomy, Medical College, Qingdao University

  23. 2. The Extrapyramidal System(锥体外系) 1) Definition: All the somatic motor tracts to skeletal muscles except pyramidal system (除锥体系以外的全部躯体运动束). 2) Functions: a. to regulate the tonicity of the muscles (调节肌张力) Dept of Anatomy, Medical College, Qingdao University

  24. The Extrapyramidal System(锥体外系) b. coordinate the muscular activities (协调肌肉活动) c. maintain the normal body posture (维持体态姿势) d. produce habitual and rhythmic movements (产生习惯性动作) Dept of Anatomy, Medical College, Qingdao University

  25. 3) The corpus striatum-substantia-corpus striatum circuit (system)(纹状体-黑质-纹状体环路) 皮质纹状体纤维 Cerebral Cortex frontal lobe (额叶) parietal lobe (顶叶) globus pallidus (苍白球) Neo- striatum (新皮质) 纹状体苍 白球纤维 Brodmann 4, 6 areas  caudate nucleus + putamen (尾状核,壳) 黑质 Int. Caps. 内囊 ventral anterior nuc. ventral lateral nucleus (腹前核,腹外侧核) 苍白球丘脑纤维 Function: feedback regulation (反馈调节) Dept of Anatomy, Medical College, Qingdao University

  26. 4) The cortico-ponto-cerebellar circuit (system)(皮质-脑桥-小脑环路) CEREBRAL CORTEX (额叶,顶叶,颞叶) pontine nuc. (脑桥核) cerebellar cortex (小脑皮质) 皮质脑桥纤维 小脑中脚 (Brodmann 4,6) 脑桥 臂交叉 内囊 丘脑腹前核 丘脑腹外侧核 dentate nuc. (齿状核) 结合臂交叉 小脑上脚 被盖前 交叉 EFFECTORS skeletal mm. (屈侧骨骼肌) 前角 运动核 red nuc. (红核) 脊神经 红核脊髓束 Dept of Anatomy, Medical College, Qingdao University

  27. Section 4 MENINGES & BLOOD VESSELS OF THE BRAIN & SPINAL CORD; & THE CEREBROSPINAL FLUID (CSF) A. The Meninges of the Brain and Spinal Cord (脑和脊髓的被膜) B. The Blood Vessels of the Brain and Spinal Cord (脑和脊髓的血管) C. The Circulation of the Cerebrospinal Fluid (CSF) (脑脊液循环) D. The Brain Barriers (脑屏障) Dept of Anatomy, Medical College, Qingdao University

  28. A. The Meninges of the Brain and Spinal Cord 1. Meninges of the spinal cord(脊髓的被膜) 1) spinal dura mater (spinal dura) (硬脊膜) a. epidural space (硬膜外隙) b. subdural space (硬膜下隙) [peridural anesthesia 硬膜外麻醉] [extradural tumor 硬膜外肿瘤] Dept of Anatomy, Medical College, Qingdao University

  29. A. The Meninges of the Brain and Spinal Cord 2) spinal arachnoid mater: (脊髓蛛网膜) a. subarachnoid space (蛛网膜下隙) b. terminal cistern (终池) [lumbar puncture 腰椎穿刺] 3) spinal pia mater (软脊膜) denticular ligament (齿状韧带) Dept of Anatomy, Medical College, Qingdao University

  30. A. The Meninges of the Brain and Spinal Cord Dept of Anatomy, Medical College, Qingdao University

  31. A. The Meninges of the Brain and Spinal Cord 2. Meninges of the brain (脑的被膜) 1)  cerebral dura mater (硬脑膜) a. cerebral falx (大脑镰) Dept of Anatomy, Medical College, Qingdao University

  32. B. The Blood Vessels of the Brain Dept of Anatomy, Medical College, Qingdao University

  33. A. The Meninges of the Brain and Spinal Cord Dept of Anatomy, Medical College, Qingdao University

  34. A. The Meninges of the Brain and Spinal Cord [hernia of tentorial incisure 小脑幕切迹疝] b. cerebellar tentorium: (小脑幕) tentorial incisure (小脑幕切迹) c. cerebellar falx (小脑镰) d. diaphragma sellae (鞍隔) Dept of Anatomy, Medical College, Qingdao University

  35. A. The Meninges of the Brain and Spinal Cord  e. sinuses of dura mater (硬脑膜窦) sup. sagittal s. (上矢状窦) confluence of sinus (窦汇) transverse sin. (横窦) inf. sagittal s. (下矢状窦) straight sin. (直窦) sig- moid sin. (乙 状 窦) sup. petrosal sin. (岩上窦) Cavernous sinus (海绵窦) inf. petrosal sin. (岩下窦) int. jugular v. (颈内静脉) [cavernous sinus thrombosis 海绵窦血栓形成] Dept of Anatomy, Medical College, Qingdao University

  36. A. The Meninges of the Brain and Spinal Cord Dept of Anatomy, Medical College, Qingdao University

  37. A. The Meninges of the Brain and Spinal Cord 2)  cerebral arachnoid mater (脑蛛网膜) a. subarachnoid space (蛛网膜下隙) Dept of Anatomy, Medical College, Qingdao University

  38. A. The Meninges of the Brain and Spinal Cord b. subarachnoid cisterns (蛛网膜下池) i. cerebellomedullary cistern (小脑延髓池) [cisternal puncture 小脑延髓池穿刺] ii. interpeduncular cistern (脚间池) iii. chiasmatic cistern (交叉池) Dept of Anatomy, Medical College, Qingdao University

  39. A. The Meninges of the Brain and Spinal Cord iv. pontine cistern (桥池) v. circular cistern (环池) c. arachnoid granulations (蛛网膜粒) Dept of Anatomy, Medical College, Qingdao University

  40. A. The Meninges of the Brain and Spinal Cord 3) cerebral pia mater (软脑膜) choroid plexus (脉络丛) [meningitis 脑膜炎] Dept of Anatomy, Medical College, Qingdao University

  41. B. The Blood Vessels of the Brain 1. Arteries of the brain (脑的动脉): Volume of blood flow (血流量): 心脑:15%. 成人: 50-60ml/100g/min儿童: 96-126 ml/100g/min. O2 consumption (耗氧量): 20%. Dept of Anatomy, Medical College, Qingdao University

  42. B. The Blood Vessels of the Brain cortical branches (皮质支) 1)  internal carotid a. (颈内动脉) a. posterior communicating a. (后交通动脉) b. anterior choroidal a. (脉络膜前动脉) Dept of Anatomy, Medical College, Qingdao University

  43. B. The Blood Vessels of the Brain c. anterior cerebral a. (大脑前动脉) anterior communicating a. (前交通动脉) central branches (中央支) Dept of Anatomy, Medical College, Qingdao University

  44. B. The Blood Vessels of the Brain d. middle cerebral a. (大脑中动脉) central branches (中央支) aa. of lentiform nucleus and corpus striatum (豆状核纹状体动脉) (“bleeding a. 出血动脉” ) [cerebrovascular spasm 脑血管痉挛] [cerebrovascular accident 脑血管意外] [cerebral hemorrhage 脑出血] [cerebral embolism 脑血管栓塞] Dept of Anatomy, Medical College, Qingdao University

  45. B. The Blood Vessels of the Brain 2)  vertebral a. (椎动脉) a. anterior spinal a. (脊髓前动脉) b. posterior spinal a. (脊髓后动脉) Dept of Anatomy, Medical College, Qingdao University

  46. B. The Blood Vessels of the Brain c. posterior inferior cerebellar a. (小脑下后动脉) d. basilar a. (基底动脉) i. anterior inferior cerebellar a. (小脑下前动脉) ii. labyrinthine a. (迷路动脉) iii. pontine aa. (脑桥动脉) iv. superior cerebellar a. (小脑上动脉) Dept of Anatomy, Medical College, Qingdao University

  47. B. The Blood Vessels of the Brain v. posterior cerebral a. (大脑后动脉) 3) cerebral arterial circle (Willis’ circle) (大脑动脉环) Dept of Anatomy, Medical College, Qingdao University

  48. B. The Blood Vessels of the Brain 2. Veins of the brain (脑的静脉) 1) superficial veins (浅静脉) a. superior cerebral vv. (大脑上静脉) → superior sagittal sinus (上矢状窦) b. middle cerebral vv. (大脑中静脉) → cavernous sinus (海绵窦) Dept of Anatomy, Medical College, Qingdao University

  49. B. The Blood Vessels of the Brain c. inferior cerebral vv. (大脑下静脉) → transverse sinus (横窦) 2) deep vein (深静脉) great cerebral v.(大脑大静脉)→ straight sinus (直窦) Dept of Anatomy, Medical College, Qingdao University

  50. C. Blood Vessels of the Spinal Cord(脊髓的血管) 1. Arteries a. anterior spinal a. (脊髓前动脉) ← vertebral a. (椎动脉) b. posterior spinal a. (脊髓后动脉) ← vertebral a. (椎动脉) c. posterior intercostal aa. (肋间后动脉) d. lumbar aa. (腰动脉) Dept of Anatomy, Medical College, Qingdao University

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