Clinical Neuroanatomy and Neuroscience E-Book , livre ebook

Clinical Neuroanatomy and Neuroscience
Sixth Edition

MJ Turlough FitzGerald, MD, PhD, DSc, MRIA
Emeritus Professor of Anatomy, Department of Anatomy, National University of Ireland, Galway, Ireland

Gregory Gruener, MD, MBA
Director, Leischner Institute for Medical Education; Leischner Professor of Medical Education; Senior Associate Dean, Stritch School of Medicine; Professor of Neurology, Associate Chair of Neurology, Loyola University Chicago, Maywood, IL, USA

Estomih Mtui, MD
Associate Professor of Clinical Anatomy in Neurology and Neuroscience; Director, Program in Anatomy and Visualization, Weill Cornell Medical College, New York, NY, USA
Saunders
Front Matter

Clinical Neuroanatomy and Neuroscience
SIXTH EDITION
M J Turlough FitzGerald, MD, PhD, DSc, MRIA
Emeritus Professor of Anatomy
Department of Anatomy
National University of Ireland
Galway, Ireland
Gregory Gruener, MD, MBA
Director, Leischner Institute for Medical Education
Leischner Professor of Medical Education
Senior Associate Dean, Stritch School of Medicine
Professor of Neurology, Associate Chair of Neurology
Loyola University Chicago
Maywood, IL, USA
Estomih Mtui, MD
Associate Professor of Clinical Anatomy in Neurology and Neuroscience
Director, Program in Anatomy and Visualization
Weill Cornell Medical College
New York, NY, USA

Cover picture kindly provided by Dr. Alexander Leemans, Image Sciences Institute, University Medical Center, Utrecht, The Netherlands, via Dr. Dara Cannon, Co-Director, Clinical Neuroimaging Laboratory, Department of Psychiatry, National University of Ireland, Galway.
Commissioning Editor : Madelene Hyde
Development Editor : Joanne Scott
Editorial Assistant : Rachael Harrison
Project Manager : Alan Nicholson
Design : Charles Gray
Illustration Manager : Gillian Richards
Marketing Manager (US, ROW) : Jason Oberacker/Ian Jordan
Copyright

SAUNDERS an imprint of Elsevier Limited
© 2012, Elsevier Limited. All rights reserved.
First edition 1985
Second edition 1992
Third edition 1996
Fourth edition 2002 (Reprinted 2002, 2003)
Fifth edition 2007
Sixth edition 2012
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This book and the individual contributions contained in it are protected under copyright by the Publisher (other than as may be noted herein).


Notices
Knowledge and best practice in this field are constantly changing. As new research and experience broaden our understanding, changes in research methods, professional practices, or medical treatment may become necessary. Practitioners and researchers must always rely on their own experience and knowledge in evaluating and using any information, methods, compounds, or experiments described herein. In using such information or methods they should be mindful of their own safety and the safety of others, including parties for whom they have a professional responsibility.
With respect to any drug or pharmaceutical products identified, readers are advised to check the most current information provided (i) on procedures featured or (ii) by the manufacturer of each product to be administered, to verify the recommended dose or formula, the method and duration of administration, and contraindications. It is the responsibility of practitioners, relying on their own experience and knowledge of their patients, to make diagnoses, to determine dosages and the best treatment for each individual patient, and to take all appropriate safety precautions.
To the fullest extent of the law, neither the Publisher nor the authors, contributors, or editors, assume any liability for any injury and/or damage to persons or property as a matter of products liability, negligence or otherwise, or from any use or operation of any methods, products, instructions, or ideas contained in the material herein.
Main Edition
ISBN: 978-0-7020-3738-2
International Edition
ISBN: 978-0-7020-4042-9
British Library Cataloguing in Publication Data
A catalogue record for this book is available from the British Library
Fitzgerald, M. J. T.
Clinical neuroanatomy and neuroscience. – 6th ed.
1. Neuroanatomy. 2. Neurosciences. 3. Nervous system-Diseases. 4. Nervous system-Pathophysiology.
I. Title II. Gruener, Gregory. III. Mtui, Estomih.
611.8-dc22
Library of Congress Cataloging in Publication Data
A catalog record for this book is available from the Library of Congress
Printed in China
Last digit is the print number: 9 8 7 6 5 4 3 2 1
Preface
This textbook is designed as a vade mecum (‘go with me’) for medical students. While based on campus, the gross and microscopic structures of the nervous system take precedence, along with their great diversity of functions. A strong stimulus to understand normal structure and function is provided by clinical examples of the consequences of breakdowns of diverse kinds. While hospital-based, consultation of the book in a clinical setting recalls the functional anatomy studied on campus. Sequential fusion of descriptive structure, function, and malfunction is known as vertical integration and is highly recommended owing to its manifest logic.

Chapters and Pages
Following a brief account of nervous system development in Chapter 1 , the topography of the brain and spinal cord and their meningeal surrounds occupies Chapters 2 – 4 . Next ( Ch. 5 ) comes the clinically very important blood supply . Microscopic and ultramicroscopic anatomy of neurons (nerve cells) and neuroglia (their surrounding ‘nerve glue’) come to the fore in Chapter 6 , along with some compression effects of expanding neuroglial tumors.
Chapter 7 changes the context by describing electrical events underlying the impulses that are triggered at the point of origin of axons and speed along the axons and their branches to liberate excitatory or inhibitory molecules onto target neurons. These molecules, pillars of the science of neuropharmacology, are examined in Chapter 8 . Chapters 9 – 11 explore the structure and distribution of the peripheral nerves attached to the spinal cord and innervating the muscles and skin of the trunk and limbs. Electrical activity returns in Chapter 12 in the form of electromyography , a technique widely used in the detection of neuromuscular disorders of various kinds.
The autonomic nervous system ( Ch. 13 ) controls the smooth musculature of the vascular system and of the alimentary, urinary, and reproductive tracts. The spinal nerves ( Ch. 14 ) attached to the whole length of the spinal cord, are ‘mixed’ (both motor and sensory) and innervate all of the voluntary muscles and skin in the trunk and limbs. Description of the contents of the spinal cord itself occupies Chapters 15 and 16 .
The brainstem (medulla oblongata, pons, and midbrain) connects the spinal cord to the cerebral hemispheres, as described by means of transverse sections in Chapter 17 . The cranial nerves attached to it (nerves III to XII) are described in Chapters 19 – 23 . Chapter 24 is devoted to the reticular formation of the brainstem which, inter alia , links cranial nerves to one another.
The cerebellum ( Ch. 25 ) occupies the posterior cranial fossa. Its afferent ( L. ‘carry to’) connections from voluntary muscles and its efferent (‘carry out’) connections with the motor cortex in the brain are vital for control the smoothness of all voluntary movements.
The hypothalamus ( Ch. 26 ) can be traced back in nature as far as the reptiles. It still operates basic survival controls, including food and fluid intake, temperature control, and sleep. Above it are the thalamus and epithalamus ( Ch. 27 ), the former having numerous vital connections to cerebral cortex and spinal cord.
The Visual pathways chapter ( Ch. 28 ) lays out the largest of all horizontal pathways, stretching from the very front end of the brain – the retina – to the very back – the occipital cortex. Its clinical significance is obvious.
Chapter 29 examines the histological structure of the cerebral cortex, and provides a summary functional account of the different cortical areas. Electrical activities are examined by means of electroencephalogrophy ( Ch. 30 ) and evoked potentials ( Ch. 31 ). Functional inequalities between the left and right sides of the brain are the subject of Chapter 32 , hemispherical asymmetries.
The basal ganglia ( Ch. 33 ) are a group of nuclei at the base of the brain primarily involved in the control of movement. The most frequent failure of control takes the form of Parkinson’s disease .
The final anatomic structures, analyzed in Chapter 34 , are the olfactory (smell) system and the limbic system, the latter being of major emotional significance.
Chapter 35 is about cerebrovascular disease. The main purpose of this chapter is to highlight the functional defects that follow cerebral hemorrhage or thrombosis.

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