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🧠 Parts of the Brain - Exam-Oriented Notes
OVERVIEW: Major Divisions of the Brain
The brain is divided into 3 primary parts:
| Part | Latin Meaning | Key Function |
|---|
| Cerebrum | Largest, rostral-most | Thought, sensation, movement, consciousness |
| Cerebellum | "Little brain" | Movement coordination, balance |
| Brainstem | Stalk of the brain | Vital functions - breathing, consciousness, temperature |
1. CEREBRUM
Basic Structure
- Largest part of the brain (rostral-most)
- Divided by the deep sagittal fissure into:
- Right cerebral hemisphere - controls LEFT side of body (sensations + movements)
- Left cerebral hemisphere - controls RIGHT side of body
- Surface: Gyri (ridges), Sulci (grooves), Fissures (deep grooves)
Lobes of the Cerebrum (4 main lobes)
| Lobe | Location | Key Functions |
|---|
| Frontal | Anterior, behind forehead | Motor cortex, voluntary movement, speech (Broca's area), executive functions, personality |
| Parietal | Behind central sulcus | Somatosensory cortex, body awareness, spatial orientation |
| Temporal | Below lateral sulcus | Auditory cortex, memory (hippocampus), language comprehension (Wernicke's area) |
| Occipital | Posterior/back | Primary visual cortex - vision processing |
Exam tip: Broca's area (motor speech) = Frontal lobe. Wernicke's area (language comprehension) = Temporal lobe. Both typically LEFT hemisphere.
Key Landmarks
- Central sulcus - separates frontal (motor) from parietal (sensory)
- Lateral sulcus (Sylvian fissure) - separates temporal from frontal/parietal
- Primary motor cortex - precentral gyrus (frontal lobe)
- Primary somatosensory cortex - postcentral gyrus (parietal lobe)
Deep Structures of the Cerebrum
- Corpus callosum - connects right and left hemispheres (commissural fibers)
- Internal capsule - major white matter pathway; carries corticospinal tracts
- Basal ganglia - caudate, putamen, globus pallidus; involved in motor control
- Limbic system - hippocampus (memory), amygdala (emotion), cingulate gyrus
Cerebral Cortex
- Gray matter on the outside (neuronal cell bodies)
- Functional areas:
- Primary areas - direct sensory/motor processing
- Association areas - integration and higher-order processing
2. DIENCEPHALON (part of the "deep brain" / forebrain)
Often considered with the cerebrum:
| Structure | Function |
|---|
| Thalamus | Relay station - all sensory info (except smell) passes through here to cortex |
| Hypothalamus | Homeostasis - temperature, hunger, thirst, circadian rhythm, hormone regulation via pituitary |
| Epithalamus | Contains pineal gland (melatonin - sleep-wake cycle) |
| Subthalamus | Motor function (subthalamic nucleus - implicated in Parkinson's) |
Exam tip: "All roads lead to the thalamus" - it is the gateway to conscious perception.
3. CEREBELLUM
- Located posterior and inferior to the cerebrum, above the brainstem
- Contains as many neurons as both cerebral hemispheres combined (despite being much smaller)
- IPSILATERAL control - unlike the cerebrum, LEFT cerebellum = LEFT body side
Functions
- Coordination and fine-tuning of voluntary movement
- Balance and equilibrium (via vestibular connections)
- Motor learning and muscle tone
- Timing and sequencing of movements
Structure
- Two hemispheres + vermis (midline)
- 3 lobes: Anterior, Posterior, Flocculonodular
- Cerebellar cortex: 3 layers - molecular, Purkinje cell, granular
Cerebellar Connections (3 Peduncles)
| Peduncle | Direction | Connects to |
|---|
| Superior (SCP) | Efferent (mainly output) | Midbrain (red nucleus, thalamus) |
| Middle (MCP) | Afferent (input) | Pons (largest peduncle) |
| Inferior (ICP) | Both | Medulla + spinal cord |
Exam tip: Cerebellar lesion signs = DANISH - Dysdiadochokinesia, Ataxia, Nystagmus, Intention tremor, Slurred speech (dysarthria), Hypotonia
4. BRAINSTEM
- The most primitive but most vital part of the brain
- Damage is usually fatal
- Serves as relay between cerebrum, cerebellum, and spinal cord
3 Parts of the Brainstem (top to bottom):
| Part | Location | Key Structures/Functions |
|---|
| Midbrain (Mesencephalon) | Top | CN III, IV; superior/inferior colliculi (visual/auditory reflexes); red nucleus; substantia nigra (dopamine - Parkinson's) |
| Pons | Middle | CN V, VI, VII, VIII; respiratory center; connects to cerebellum via MCP |
| Medulla Oblongata | Bottom | CN IX, X, XI, XII; cardiac, respiratory, vasomotor centers; pyramidal decussation |
Exam tip: Cranial nerve nuclei 3-4 = Midbrain | CN 5-8 = Pons | CN 9-12 = Medulla
Key Brainstem Functions
- Reticular Activating System (RAS) - consciousness and arousal
- Vital centers in medulla: cardiac center, respiratory center, vomiting center
- Decussation of pyramids in medulla (motor fibers cross sides here)
5. VENTRICULAR SYSTEM (Frequently Tested)
| Ventricle | Location | CSF Flow |
|---|
| Lateral ventricles (1 & 2) | Cerebral hemispheres | → via foramen of Monro |
| 3rd ventricle | Diencephalon | → via cerebral aqueduct (Aqueduct of Sylvius) |
| 4th ventricle | Between brainstem and cerebellum | → Foramina of Luschka (lateral) and Magendie (medial) into subarachnoid space |
Exam tip: Blockage at cerebral aqueduct = obstructive hydrocephalus (commonest site)
🩸 BLOOD SUPPLY OF THE BRAIN
Two Circulations
The brain receives blood from two main sources:
| System | Arteries | Supplies |
|---|
| Anterior (Carotid) | Internal carotid arteries (ICA) | Anterior 2/3 of brain (frontal, parietal, temporal) |
| Posterior (Vertebrobasilar) | Vertebral arteries → Basilar artery | Posterior 1/3 (occipital, cerebellum, brainstem) |
Circle of Willis (Circulus Arteriosus)
The anastomotic ring at the base of the brain formed by:
Components (go around the circle):
Anterior Communicating Artery (ACoA)
|
ACA (left) --- ACoA --- ACA (right)
| |
ICA (left) ICA (right)
| |
PCoA (left) PCoA (right)
| |
PCA (left) --- Basilar --- PCA (right)
|
Vertebral arteries
| Artery | Abbreviation | Origin | Territory |
|---|
| Anterior Cerebral Artery | ACA | ICA | Medial surface of frontal & parietal lobes; leg area of motor/sensory cortex |
| Middle Cerebral Artery | MCA | ICA (largest branch) | Lateral surface of frontal, parietal, temporal; arm & face motor/sensory; Broca's & Wernicke's areas |
| Posterior Cerebral Artery | PCA | Basilar artery | Occipital lobe (visual cortex), medial temporal, thalamus |
| Anterior Communicating Artery | ACoA | Connects two ACAs | Anastomosis (most common site of Berry aneurysm) |
| Posterior Communicating Artery | PCoA | ICA to PCA | Connects anterior & posterior circulations |
| Basilar Artery | BA | Vertebrals unite | Pons, midbrain, cerebellum, PCA |
Arterial Territories - Stroke Mnemonics
ACA Stroke (leg symptoms dominant):
- Contralateral leg weakness/sensory loss (ACA supplies "leg homunculus" = medial cortex)
- Urinary incontinence, personality changes (frontal lobe)
MCA Stroke (most common - arm + face):
- Contralateral arm and face weakness/sensory loss
- Aphasia if left hemisphere (Broca's = motor aphasia, Wernicke's = sensory aphasia)
- Contralateral homonymous hemianopia
- Gaze deviation toward the side of lesion
PCA Stroke (visual symptoms):
- Contralateral homonymous hemianopia with macular sparing
- Visual hallucinations, alexia without agraphia
Vertebrobasilar System - Cerebellar Arteries
| Artery | Abbreviation | Origin | Supplies | Stroke Syndrome |
|---|
| Posterior Inferior Cerebellar A. | PICA | Vertebral | Posterior inferior cerebellum, lateral medulla | Wallenberg syndrome (lateral medullary syndrome) |
| Anterior Inferior Cerebellar A. | AICA | Basilar | Anterior inferior cerebellum, lateral pons | AICA syndrome (facial palsy + ipsilateral hearing loss) |
| Superior Cerebellar A. | SCA | Basilar | Superior cerebellum, pons | Cerebellar ataxia + CN IV palsy |
Exam tip: PICA = PICA = Posterior Inferior Cerebellar Artery = Wallenberg syndrome - ipsilateral facial loss of pain/temp + contralateral body loss of pain/temp + dysphagia + hoarseness + Horner's syndrome
Venous Drainage of the Brain
- Cerebral veins drain into dural venous sinuses
- Main drainage: Internal jugular veins (almost entirely)
| Sinus | Drains To |
|---|
| Superior sagittal sinus | Confluence of sinuses |
| Inferior sagittal sinus | Straight sinus |
| Transverse sinus | Sigmoid sinus → Internal jugular vein |
| Cavernous sinus | Important - drains orbit, receives CN III, IV, V1, V2, VI |
Exam tip: Cavernous sinus thrombosis = proptosis, periorbital edema, ophthalmoplegia (CN III, IV, VI), fever
Internal Capsule Blood Supply (High-Yield!)
- Anterior limb: Lenticulostriate arteries (MCA branches)
- Genu: Lenticulostriate arteries
- Posterior limb: Lenticulostriate (MCA) + anterior choroidal artery (ICA)
Exam tip: Lacunar infarcts in internal capsule (due to hypertension damaging small lenticulostriate arteries) = pure motor hemiplegia (most common lacunar stroke)
Autoregulation of Cerebral Blood Flow
- Brain autoregulates blood flow between MAP 50-150 mmHg
- Normal CBF: ~50 mL/100g/min
- Below 50 mmHg MAP: autoregulation fails → ischemia
- CO2 is the most potent vasodilator of cerebral vessels (hypercapnia → vasodilation → increased ICP)
- Blood-brain barrier maintained by tight junctions of endothelial cells
Quick Revision Table - High-Yield Points
| Topic | Key Fact |
|---|
| Largest part of brain | Cerebrum |
| Most vital part | Brainstem (medulla) |
| Relay station of sensory info | Thalamus |
| Regulates homeostasis | Hypothalamus |
| IPSILATERAL control | Cerebellum |
| CONTRALATERAL control | Cerebral cortex |
| Decussation of pyramids | Medulla |
| Most common stroke territory | MCA |
| Most common Berry aneurysm site | ACoA junction |
| Wallenberg syndrome artery | PICA |
| CSF obstruction common site | Cerebral aqueduct |
Sources: Neuroscience: Exploring the Brain (5th Ed.) | Neuroanatomy through Clinical Cases (3rd Ed.) | Medical Physiology (Boron & Boulpaep)