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S. Andrew Josephson MD

Potential Confl

Interest

None

Associate Professor ofNeurology

Medical Director, InpatientNeurology

Carmen Castro Franceschi andGladyne Mitchell

Neurohospitalist DistinguishedProfessor

Department of Neurology, UCSFSchool of Medicine

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Learning Objec

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Learning Objectives

o Name the key divisions of the centra

nervous system and know their basfunction including lobes of the cereb

(frontal, temporal, parietal, and occi

thalamus, basal ganglia, brainstem spinal cord

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Learning Objectives

o Distinguish between the central and

peripheral nervous system

o Be able to trace the course of the m

motor pathway (corticospinal tract) a

two major sensory pathways (postecolumn and spinothalamic tracts)

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Learning Objectives

o Identify the neuroanatomic upper and

motor neurons and be able to draw thediagram of the nervous system

o Describe the path of cerebrospinal fluiflow from its production to the point of

resorptiono Name the three layers that make up th

meninges in order from the outermost closest to the brain

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Overview of Neuroan

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Organization of Neuroanato

o Central Nervous System (CNS)

Brain Brainstem

Spinal Cord

o Peripheral Nervous System (PNS)

Everything else- Peripheral Nerves

- Neuromuscular Junctions

- Muscles

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CNS: Grey and White Matte

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Terminology of Neuroanatom

CNS PNCollections of cell bodies Nuclei Ga

Collections of axons Tracts Ne

Quasar Jarosz at en.wikipedia

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CNS: Grey and White Matte

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The Meninges

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Layers of the Meninges

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The Case of Natasha Richard

oA 45F suffered a fall while skiing

o Initially she was well and refused medtreatment

o Three hours later she developed headand progressive confusion and was ta

local hospital before being airlifted to acenter

o She is declared dead hours later

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Layers of the Meninges

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Middle Meningeal Artery

H i i f E id l H

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Herniat ion from Epidural Hemat

T i M ki B

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Trepanation: Making a Burr

o Previous uses:

Migraines Seizures

Psychiatric Disease

Let evil spirits out

o Today Epidural and subdural hematomas

Intracranial Pressure Monitoring

Hiero

en.wikip

Th V t i l S t

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The Ventricular System

Ci l t i f C b l S i l Fl id

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Circulat ion of Cerebral Spinal Flu id

L b P t T h i

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Lumbar Puncture Technique

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Hydrocephalus

T T f H d h l

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Two Types of Hydrocephalus

o 1. Obstructive (non-communicating)

o 2. Non-obstructive (communicating)

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Obstructive Hydrocephalu