CONOCIMIENTO

NEUROCIENCIAS
BASICAS

TECNOLOGIA

Karlo J. Lizrraga, MD, MS

INVESTIGACION

PEDAGOGIA

TEMARIO
ORGANIZACION
EMBRIOLOGIA: NEURULACION, GRADIENTES
MOLECULARES
MEDULA ESPINAL
SISTEMA NERVIOSO PERIFERICO
TRONCO ENCEFALICO Y PARES CRANEALES
CEREBELO Y GANGLIOS BASALES

ORGANIZACIN DEL
SISTEMA NERVIOSO

Cerebro

Encfalo
SN Central

Cerebelo

Anterior

Diencfalo

Tronco cerebral

Medio

Mesencfalo

Mdula espinal
Nervios craneales

SN Perifrico

12

Nervios espinales
31

Simptico
SN Autnomo

Parasimptico

Posterior Protuberancia
Cervical
7 raqudeo
Bulbo
Dorsal o torcica 12
Lumbar
5
ISacra
Olfatorio 5
II
ptico
III
Motor ocular comn
IV
Pattico
V
Trigmino
CervicalesMotor ocular
8 externo
VI
Dorsales Facial
12
VII
LumbaresVestbulo coclear
5
VIII
5
IXSacros Glosofarngeo
1
XCoccgeo Vago
XI
Espinal
XII
Hipogloso

EMBRIOLOGIA
DEL SISTEMA
NERVIOSO

Aquel que vea las cosas crecer desde sus orgenes, tendr la mejor vista de ellas
Aristoteles

NEURULATION
Fertilized egg blastula (hollow, fluid-filled, 1-cell thick)
Burrowing of cells through blastopore 2-cell thick: Gastrulation
Gastrula: 2 layers (endo&ecto), then meso
Primitive streak forms @d13

DORSAL INDUCTION: Notochord (meso, @d17,n.pulposus) Induces

streak: neural plate in overlying ectoderm: neurulation (3-4wks) raised
edges (neural folds/groove) curl up centrally from head to tail fuse
@d22: neural tube, ant. neuropore closes @d24: lamina terminalis (1ry),
post. @d26: L1/L2 (2ry) CNS (4-5wks)
Pros(Fore)Tel-2+Die (VENTRAL IND) (8-12wks)
Mes(Mid)
Rhomb(Hind)Met+Myel
Germinal matrix forms @7wks, produces neurons & glia. Involutes
@30wks.
Neural crest cells migrate towards somites (PNS neurons, glia & ganglia)

PRIMARY NEURULATION

2 weeks

Blastocyst

Epiblast
Hypoblast

3 weeks
Primitive streak Prechordal plaque

Notochord (activin, FGF)

nucleus pulposus
*chordoma
(physaliphorous cells)

Ectoderm:
Neural plaque (chordin, noggin)
Epidermis
Day 17:
Neural folds
Neural groove
Days 21 - 23: (Neurulation)
Neural tube + 2 neural crests
* Primordial ganglia

Notocorda: Ncleo pulposo. Columna vertebral, crneo

Somitas 38 pares (das 20 a 30), 42 a 44 (final de 5ta sem)
Mesodermo paraxial
Craneocaudal: dermis, msculos
<= 26d:
2d later:

Rostral neuropore closure (13 somite)

Caudal neuropoer closure

Antes de fin 4ta semana circulacin sangunea del tubo

*Mltiples sitios de cierre (1 al 5)

Da 28:

PROLIFERACIN
Tubo neural: ceflico > >
Sistema ventricular canal central

flexin

SECONDARY NEURULATION

A
B

day 20
day 40

Sacral and coccygeal segments

NEURAL TUBE DEFECTS

Associated with altered development of
meninges, bone, muscles, skin
High levels of maternal serum AFP
~50% of NTDs could be prevented with
maternal consumption of sufficient amounts
of folic acid

NEURAL TUBE DEFECTS

Dysraphism
Anencephaly: Complete failure of ant. neuropore closure
(Open skull with little or no telencephalon)
Encephalocele: Partial failure of ant. neuropore closure
protrusion of meninges &/or neural structures through
cranium defect
Myeloschisis: Complete post. neuropore closure failure
Spina bifida: Failed post. neuropore closure + vertebral
arches fusion
Spina bifida oculta: Small sinus or hair tuft
Tethered cord: Abnl spinal cord adhering to meninges.
Prevents ascent of conus (Traction). Associated with lipoma

MUERTE EMBRIONARIA
5 semanas
6.5 semanas
7 semanas

Falta total de fusin

Abertura por sobre el rombencfalo
Defecto de regiones frontal y parietal

DEFECTOS DEL TUBO NEURAL (4ta semana)

*cido valproico 1 2%, dieta materna pobre en cido flico.
Seno drmico raqudeo: Con o sin cordn fibroso.
Espina bfida (4ta semana)
- Oculta: defecto slo de la columna vertebral (arco vertebral) (L5 o S1, hasta 10% de poblacin)
Qusticas 1/1000 R.N.
- Con meningocele: protrusin de meninges.
- Con mielomeningocele: protrusin de meninges y herniacin de mdula espinal y races (pared del
saco) Dficit neurolgico
- Con mielosquisis : No fusin de pliegues neurales. (Crecimiento local excesivo de la placa neural)
(Mero)Anencefalia: Neuroporo anterior
*Alfa-fetoproteina (AFP) en lquido amnitico despus de 4ta semana (amniocentesis), suero
materno.
*Ecografa: se detecta columna vertebral de la 8va a 10ma semanas.

CRANIOSCHISIS

ANENCEPHALY

ANENCEPHALY

RACHISCHISIS

RACHISCHISIS

ENCEPHALOCELE

1 = Tethered cord
2 = Lipoma

TUBO NEURAL: SNC

Neuroblastos:
*Ncleo mesenceflico
del trigmino.
No neuroblastos:
Cel. epndimo
Glioblastos: Neuroglia

NEURAL CREST: 4th germ layer

Neuroblasts:
* Ganglia
Post-ganglionic autonomic neurons
Spinal ganglia aferent neurons
(Unipolar *VIII)
Cranial ganglia af. (V,VII,VIII,IX,X)
* Adrenal medula (chromaffin cells)
Non-neuroblasts:

- BMP-4 lat. plaque:

express gene slug
migration
(integrins)
- Epithelial to mesenchymal
transformation
(Loss of N-CAM, Ncadherin)

*Schwann
*Satellite cells (ganglia)
*Leptomeninges (arachnoid, pia)
*Pigment cells
*Odontoblasts
*Melanocytes
*Branchial arch mesenchyma (cartilage)
*Parafollicular cells (C cells)
*Aorticopulmonary septum
*Endocardic cushions (Atrioventricular cushions)

Muscles innervated by CN XII &

hypopharyngeal muscles are the only
squeletal muscles derived from somites in
which connective tissues cells originate from
the neural crest.

DERIVATIVE

CRANIAL NEURAL CREST

TRUNCAL NEURAL CREST

(6th somite )

Peripheral NS

CNs V, VII, IX, X ganglia

Spinal ganglia

Autonomic NS

Parasymp ganglia: ethmoidal,

sphenopalatine, submandibular,
visceral
Schwann cells
Leptomeninges

Sympathethic chain
ganglia, collateral ganglia
(celiac, mesenteric)
Parasympathetic ganglia
(pelvic, visceral)
Enteric glial cells
Schwann cells

Pigment cells

Melanocytes

Melanocytes

Endocrine and paraendocrine

cells

Carotid body type I cells, thyroid

parafollicular cells

Adrenal medulla
(chromaffin cells)
Heart and lungs

Mesodermic cells (Bone)

Part of temporal & frontal

Nasal & orbital
Part of cartilages (ear, phar. arches)

None

Conective tissue

Cornea (fibroblasts and corneal

endothelium), odontoblasts, stroma:
thyroid, parathyroid, thymus, lacrimal,
salivatory
Truncus arteriosus, semilunar valves

None

Muscle

Dermis, vascular

None

PLACODES
Thickenings of the cranial ectoderm
Induced by underlying neural tube
Give rise to neural crest-like cells
DERIVATIVES:

Olfactory epithelium
Lens
Hair cells of inner ear
Part or all of CNs ganglia (V, VII, VIII, IX, X)

Piebaldism
White forelock multiple symmetrical
hypo/depigmented macules

Partial albinism?
Vision problems absent
Affected cells maintain ability to produce
pigment but its turned off.

Absent parasymp ganglia

 Waardenburg syndrome:
PAX3 mutations:

Heterochromia iridum or iridis

Piebaldism: Hair hypopigmentation (poliosis)
Congenital sensorineural hearing loss
Dystopia canthorum (lateral displacement of inner canthi)
AD: 1st-degree relative with WS

NEUROCRISTOPATHIES
MIGRATION OR MORPHOGENESIS
DEFECTS

PROLIFERATION DEFECTS
(TUMORAL)

TRUNK:
- Hirschsprungs

- Pheochromocytoma
- Neuroblastoma
- Thyroid medullary carcinoma
(calcitonin)
- Carcinoid tumors
(Enterochromaffin cell tumors)
- Neurofibromatosis

CRANIAL:
- Aorto-pulmonary septum defects
- Endocardic cushions defects
- Defects of anterior chamber of the eye
- Cleft palate/lip
- DiGeorge syndrome
- Dental anomalies

TRUNK AND CRANIAL:

- CHARGE association
- Waardenburg syndrome
GENETIC DEFECT: Albinism

DERMATOMES
LIMBS
5th week

MYOTOMES
3 preotic
4 occipitals

III,IV, VI
XII

NEURULATION
Fertilized egg blastula (hollow, fluid-filled, 1-cell thick)
Burrowing of cells through blastopore 2-cell thick: Gastrulation
Gastrula: 2 layers (endo&ecto), then meso
Primitive streak forms @d13

DORSAL INDUCTION: Notochord (meso, @d17,n.pulposus) Induces

streak: neural plate in overlying ectoderm: neurulation (3-4wks) raised
edges (neural folds/groove) curl up centrally from head to tail fuse
@d22: neural tube, ant. neuropore closes @d24 (1ry): lamina terminalis,
post. @d26 (2ry): L1/L2 CNS: 4-5wks
Pros(Fore)Tel-2+Die (VENTRAL IND)
Mes(Mid) / Rhomb(Hind)Met+Myel
Germinal matrix forms @7wks, produces neurons & glia. Involutes
@30wks.
Neural crest cells migrate towards somites (PNS neurons, glia &
ganglia)

PROSENCFALO

TELENCFALO

Hemisferios cerebrales

DIENCFALO

Tlamo, hipo, epi, sub

METENCFALO

Protuberancia, cerebelo

MIELENCFALO

Bulbo raqudeo

MESENCFALO
ROMBENCFALO

Vesculas cerebrales primarias (3)

Vesculas cerebrales secundarias (5)

4th week

5th and 6th weeks

2,5 8th week:
9th :

Embryo
Fetus

Flexures:
- Cervical
- Cephalic
- Pontine

Rhomb // Cord
Pros // Mesenc
Meten // Myelen

Flexures:
- Cervical
- Cephalic
- Pontine

Rhomb // Cord
Pros // Mesenc
Meten // Myelen

- Cerebral hemispheres begin as b/l outgrowths of

telencephalon that expand in all directions covering
diencephalon, midbrain and hindbrain. Roof and lateral
walls of each hemisphere thin and eventually form cortex
- Floor of expanding hemisphere is thick and contains
neuronal aggregation basal ganglia
- With further expansion, hemispheres fuse with
diencephalon via axonal projections which fill internal
capsule

*Bolsa de Ratke

mitad de 4ta sem

50% de neuronas mueren!

PRIMARY VESICLES
PROSENCEPHALON

SECONDARY
VESICLES

ADULT STRUCTURES

CAVITIES

TELENCEPHALON
Striatum
Lamina terminalis

Cerebral
hemispheres, basal
ganglia, cerebral
comisures,
hippocampi,
olfactory system

Lateral ventricles,
rostral portion of 3rd
ventricle (Monro)

DIENCEPHALON

Tlamo, epitlamo,
Caudal portion of
hipotlamo,
3rd ventricle
subtlamo,
neurohipfisis,
glndula pineal,
retina, nervio ptico,
cuerpos mamilares

MESENCEPHALON

MESENCEPHALON

Mesencephalon
(Midbrain)

Cerebral aqueduct
(Silvian)

ROMBENCEPHALON

METENCEPHALON

Pons & Cerebellum

4th ventricle

MYELENCEPHALON

Medulla

NEURODEVELOPMENTAL DISORDERS
Holoprosencephaly / septo-optic dysplasia
spectrum
Failure of forebrain development: incomplete
separation of hemispheres (normally at end of 5th
week fusion of lateral/3rd ventricle)
Alobar / semilobar / lobar
SOD: optic nerve hypoplasia, absent septum
pellucidum, hypoth-pituit abnl in 2/3
Maternal DM, EtOH, retinoic acid; trisomy 13
(Patau), SHH mutations

MIDLINE ABNORMALITIES OF BRAIN/SKULL

Cephaloceles
by location: cranial vault or skull base
by content: meninges only or also contain brain tissue
Nasal region
nasal dermoid
nasal glioma
nasal dermal sinus

Cerebral hemispheres
holoprosencephaly/septo-optic dysplasia spectrum
septo-optic dysplasia
lobar holoprosencephaly
semilobar holoprosencephaly
alobar holoprosencephaly
middle interhemispheric variant/syntelencephaly
Corpus callosum
corpus callosum agenesis
corpus callosum dysgenesis
Intracranial lipoma

MOLECULAR GRADIENTS

Basal plate
(close to sulcus limitans)
Intermediolateral zone

 DORSOVENTRAL AXIS:
SHH: Notochord, then floor plate basal plate (ventralizes
tube)
Mesencephalon: Tegmentum

BMPs: Non-neural ectoderm, then roof plate alar plate

(dorsalizes tube)
Diencephalon (ventral: hypothalamus /hypoth sulcus/ dorsal:
thalamus, subthalamus, epithalamus)
Mesencephalon: Tectum (Colliculi)

ROSTROCAUDAL AXIS:
HOX genes: craniocaudal segmentation
Expression modulated by retinoid acid

FGF, retinoid acid

Axons from alar plate

neuroblasts migrate
primarily to marginal layer

Axons from basal plate

neuroblasts migrate
primarily to periphery

MIGRATION AND
DIFFERENTIATION

TUBO NEURAL
Zona ventricular (capa ependimal) Neuroepitelio cilndrico pseudoestratificado

Zona intermedia (capa del manto)

Placa basal
Neuronas eferentes (motoras): asta anterior
(Surco limitante) Cisura ventral medial
Placa alar
Neuronas aferentes (sensitivas): asta posterior
Tabique dorsal

Zona o capa marginal

Sustancia blanca

Canal central (9 10 semanas)

Cajal-Retzius cells
release reelin

Neocortex: 6 layers,
growth: inside outside
Layer I: most superficial
layer, periventricular,
oldest. From marginal
zone
Cells migrate from
ventricular zone to outer
part of intermediate
(mantle) zone: develop
inside outside into
Layers 2-6: cortical plate
New neurons formed in
germinative zone lying
deep to ventricular zone:
subventricular zone

Radial glia as
scaffolding
(Youngest neurons
closest to surface)

VENTRICULAR ZONE

 Oldest and most primitive component of cerebral cortex:

rhinencephalon (olfaction)
Newest and most dominant part of cerebral cortex: neocortex
Neocortex expands ventrally and dorsally: C-shape as it rotates
around the future site of insula
Discrete circuits: axonal outgrowth guided by growth cone (axon
tip): reach and synapse with target. Synaptic connections refined:
apoptosis.
Filopodia of axon growth cones contain actin
Chemoattractants/repellants bound to other cells or extracellular
matrix guide axon growth cones
Synaptogenesis: Growth cone signaling to target cell to cluster
postsynaptic receptors and target cell signaling to growth cone to
form presynaptic terminal and synaptic vesicles: reciprocal
signaling

NEURODEVELOPMENTAL DISORDERS
Heterotopia (ectopic gray matter) = cortical
dysplasia
Diffuse, subcortical or PV
Isointense to cortex

Pachygyria
Abnormal THICK cortical mantel

Polymicrogyria
Excessive/redundant abnl folding or cortical mantle

Lissencephaly
Abnl smoothness (lack of normal gyral pattern)

NEURODEVELOPMENTAL DISORDERS
Porencephaly
Cyst, cleft or cavity LINED by WM
Cystic encephalomalacia (+ gliosis if insult @ >= III trim)
Dysrupts normal cortical architecture

Schizencephaly
Cyst, cleft or cavity LINED by HETEROTOPIC GM
From ependymal to piamater
Dysrupts normal cortical architecture (usually
polymicrogyria)
Posterior frontal and parietal lobe: 70%
Open and closed lip varieties

MALFORMATIONS OF CORTICAL DEVELOPMENT

1. Abnormal cell proliferation: neuronal and/or glial

Abnormal brain size
microcephaly with normal to thin cortex
microlissencephaly
microcephaly with extensive polymicrogyria
macrocephalies (megalencephaly/macrocephaly)
Abnormal cell proliferation
Non-neoplastic
cortical hamartomas of tuberous sclerosis
cortical dysplasia with balloon cells
hemimegalencephaly
focal cortical dysplasia
Neoplastic
gangliogliomas
gangliocytomas
dysembryoplastic neuroepithelial tumours (DNET)

MALFORMATIONS OF CORTICAL DEVELOPMENT

2. Abnormal neuronal migration

Lissencephaly type I - subcortical band heterotopia spectrum (a.k.a. band
heterotopia): undermigration
Lissencephaly type II (cobblestone complex): overmigration
Heterotopia
Subependymal heterotopia
Subcortical heterotopia (not including band heterotopia)
Marginal glioneuronal heterotopia

3. Abnormal cortical organization

Polymicrogyria and schizencephaly
Bilateral polymicrogyria syndromes
Schizencephaly
Polymicrogyria or schizencephaly as part of multiple congenital
anomaly/mental retardation syndromes
Cortical dysplasia without balloon cells
Microdysgenesis
4. Not otherwise classified
Malformations 2ry to inborn errors of metabolism
Mitochondrial and pyruvate metabolic disorders
Peroxisomal disorders
Other unclassified malformations: Sublobar dysplasia

DIFERENCIACIN
Clulas nerviosas
Neuroepiteliales: Neuroblastos (1ro)(pierden capacidad de divisin)
Migracin, desarrollo de prolongaciones y sinapsis
Clulas gliales
Neuroepiteliales: Glioblastos (2do) Macroglia:
Astroblastos: Astrocitos
Oligodendroblastos: Oligodendrocitos
* Microglia (mesnquima: monocitos)
Clulas ependimales (3ro)
Neuroepiteliales

MYELINIZATION
After neural circuits formed
16th wk
CNS tracts myelinate in orderly sequence: 1st
spinal and brainstem, 2nd cerebral axons
Babinsky(+) up to 2nd year (corticospinal tract
fully myelinated)
Associative neocortex up to 5th decade!

3-4 wks

Primary neurulation (dorsal induction)

*Anencephaly, myeloschisis, encephalocele, myelomeningocele, Chiari
4-7 wks
Secondary neurulation (dorsal induction)
*Spinal cyst, tethered cord, lipoma, teratoma, myelocystocele, meningocele,
2-3 mos
Prosencephalon development (ventral induction)
*Holoprosencephaly, SOD, agenesis of corpus callosum
3-4 mos
Neural and glial proliferation *Micro/macrocephaly
3-5 mos
Neuronal migration
*Schiz/lissencephaly, pachy/polymicrogyria
3 mos-birth
Neuronal organization (axonal outgrowth and proliferation)
6 mos-1 yr postnatal
Neuronal organization (dendritic outgrowth and synaptogenesis)
Birth-several years
Neuronal organization (synaptic rearrangements)
*MR, Downs, Fragile X, autism, Angelmans

38 wks-2 years postnatal

Corticospinal tract myelination
~32 years of age
Myelination of association bundle
(prefrontal cortex to temporal and parietal lobes)

MDULA ESPINAL

COLUMNA VERTEBRAL
Mdula espinal se extiende por toda longitud
de canal vertebral hasta la 8va semana.
Nervios raqudeos agujero intervertebral

Columna y duramadre crecen con

mayor rapidez!
Cono medular:
6 meses
Nacimiento
Adulto

S1
L2 - L3
L1 (borde inferior)
(T12 L3)

*Puncion lumbar
Races nerviosas oblicuas

Cola de caballo

Saco dural(Duramadre y aracnoides) S2

Piamadre
Filum terminale: Co1

8wks

24wks

The ascent of the conus

medullaris begins at 16wks

NB

Adult

COLUMNA MEDULA
C
T sup
T inf (7- 9)
T10
T11
T12
L1

+1
+2
+3
L1, L2
L3, L4
L5
S, Co

DESARROLLO DE LA MDULA ESPINAL

4ta semana
Caudal a 4to par de somitas

*Placa basal: asta intermedia (torcica, L2, L3)

*Hasta cerebro caudal y medio

1 Spinal canal
2 Roof plate
3 Alar plate
4 Basal plate
5 Floor plate
6 Matrix layer
7 Mantle layer
8 Marginal layer
9 Posterior funiculus
10 Lateral funiculus
11 Anterior funiculus
12 Dorsal root
13 Dorsal root ganglion
14 Ventral root
15 Spinal nerve
16 Ependymal cell, guiding
radially migrating
neuroblasts
17 Arcuate fibres, guiding
tangentially migrating
neuroblasts
18 Motoneurons

31 spinal cord segments

A pair of ventral (anterior) and dorsal (posterior) spinal nerve roots, each
Mediates motor and sensory function, respectively
Nerve roots combine on each side to form the spinal nerves
Exit from the vertebral column through the neuroforamina

ASG
AVG
EVG
ESG

CENTROS SENSITIVOS Y MOTORES EN LA

SUSTANCIA GRIS DE LA MDULA ESPINAL

CENTROS SOMATOSENSITIVOS

CENTROS INTEROCEPTIVOS
CENTROS VISCEROMOTORES

CENTROS SOMATOMOTORES

Rexed Laminae
I: marginal cells
II/III: substantia gelatinosa
IV: nucleus proprius
V/VI: propriospinal neurons
VIII: commisural neurons
IX: large motor neurons
X: central canal
I-IV: dorsal horn
V/VI: intermediate zone (axons from these
neurons terminate within the cord)
VII: contains Nucleus of Clarke: receives
proprioception, involved in dorsal
spinocerebellar pathway (uncons. proprio.)
VIII: Send axons into anterior white commisure

IX: give rise to ventral roots

SISTEMAS MOTORES

60% C. motora 1ria

40% C. somatosensorial
1ria y 2ria

80 90%

SISTEMAS SENSITIVOS

SISTEMAS SENSITIVOS

COLUMNA DORSAL LEMNISCO MEDIAL

Fibras
arciformes
internas

T5

II (A)

COLUMNA DORSAL LEMNISCO MEDIAL

Astereognosis
Signo de Romberg

ESPINOTALMICO LATERAL
(ANTEROLATERAL)

Lissauer

III (A)
IV (C)

ESPINOTALMICO LATERAL
(ANTEROLATERAL)

VAS ESPINOCEREBELOSAS

N. Cuneiforme externo

GTOs

T1-L2

GTOs

Ataxia de Friedreich

DERMATOMAS
C-2,
C-5,
C-6,
C-7,
C-8,
T-4,
T-10,
L-1,
L-5,
S-1,
S-2,3,4,

Dorso de la cabeza
Clavcula
Dedo Pulgar
Dedo medio
Dedo meique
Pezn
Ombligo
Ligamento Inguinal
Dedo gordo
Dedo pequeo
Regin perineal

SISTEMA NERVIOSO PERIFERICO

TRONCO CEREBRAL
Y
PARES CRANEALES

PHARYNGEAL ARCHES
Mesodermal outpouchings from pharynkx
@4wks
Endodermal: Pouch/Ectodermal: Groove(cleft)
Staggered development of 6 arches
In humans, 5th only exists transiently

(Aortic arches)

Larngeo
superior

VI

Larngeo
recurrente

4 somite
Neural plaque

6 somite
Neural
crest

Neural
plaque

Neural
crest

Branchial arches
Ectoderm

Mesenchyma

Cranial
ganglia

Neural
tube

MIDBRAIN
CN V

ROMBOMERS
CNs VII, VIII

CN IX

Branchial arches
Otic vesicle

ALAR
PLATE

IV
VENTRICLE

SULCUS
LIMITANS

BASAL
PLATE

Sd. Parinaud
Parlisis de la mirada hacia arriba + anormalidades pupilares bilaterales
Hidrocefalia no comunicante

COMPONENTES FUNCIONALES DE LOS NERVIOS CRANEALES

ASG, ASE, AVG, AVE
ESG, EVG, EVE
Somtico: cabeza, pared corporal y extremidades; Visceral: vsceras
General: amplias reas de distribucin en la cabeza y cuerpo
Especial: funciones especializadas (olfato, gusto, visin, audicin, equilibrio e
inervacin motora de msculos originados de los arcos branquiales).
Nervios aferentes especiales
I) Nervio olfatorio
AVE
II) Nervio ptico
ASE
VII) Nervio vestibulococlear
ASE
Nervios eferentes somticos generales (derivados de somitas)
III) Nervio oculomotor
ESG, EVG
IV) Nervio troclear
ESG
VI) Nervio abducens
ESG
XII) Nervio hipogloso
ESG
Nervios eferentes viscerales especiales (branquiomricos)
V) Nervio trigmino
EVE (1er arco), ASG
VII) Nervio facial
EVE (2do arco), EVG, AVG, AVE
IX) Nervio glosofarngeo
EVE (3er arco), EVG, AVG, AVE
X) Nervio vago
EVE (4to y 5to arcos), EVG, AVG, AVE
XI) Nervio accesorio
EVE (n. ambiguo), ESG

BULBO RAQUIDEO
(MYELENCEPHALON)

CHOROID PLEXUS

IV

OLIVARY
NUCLEUS

AFFERENT GROUP
- SSA: SPECIAL SOMATIC AFF
(Vestibular, cochlear)
- GSA: GENERAL SOMATIC AFF
(Spinal Trig IX, X)
(Gracilis & cuneatus)
- SVA: SPECIAL VISCERAL AFF
(NTS IX, X)
- GVA: GENERAL VISCERAL AFF
(Dorsal sens X X)

EFFERENT GROUP
- GSE: GENERAL SOMATIC EFF (XII)
- SVE: SPECIAL VISCERAL EFF
(Ambiguous IX, X, XI)
- GVE: GENERAL VISCERAL EFF
(Inf. saliv. IX, X)
(Dorsal motor X X)

PROTUBERANCIA
(METENCEPHALON)

RHOMBIC
LIPS

RHOMBIC
LIPS

BASAL
PLATE

PONTINE
NUCLEI

PONTINE
NUCLEI
EFFERENT GROUP

AFFERENT GROUP

- GSE: GENERAL SOMATIC

EFF (VI)
- SVE: SPECIAL VISCERAL
EFF (V, VII)
- GVE: GENERAL VISCERAL
EFF
(Sup. saliv., lacrimal VII)

- SSA: SPECIAL SOMATIC AFF

(Vestibular, cochlear)
- GSA: GENERAL SOMATIC AFF
(V, VII)
- SVA: SPECIAL VISCERAL AFF
(NTS VII)
- GVA: GENERAL VISCERAL AFF

*SPECIAL SENSORY CNs: I, II, VIII

MESENCEFALO
(MESENCEPHALON)

Sd. Parinaud
Parlisis de la mirada hacia arriba + anormalidades pupilares bilaterales
Hidrocefalia no comunicante

PICA

CORRELACIN CLNICA
Sndrome bulbar medial
(Vertebral, espinal anterior)

Parlisis ipsilateral de mitad de lengua + atrofia

Hemiparesia espstica contralateral de ambos miembros
Dficit contralateral de propiocepcin, tacto, presin, vibracin

CORRELACIN CLNICA
Sndrome bulbar lateral (Wallenberg)
(PICA)

Nistagmo (se aleja), vrtigo,

nausea, vmitos.
Alteracin gusto
Dficit ipsilateral de dolor y T (reflejo corneal ok)
Disfagia, disfona;
disminucin reflejo nauseoso

Dficit contralateral de dolor y T.

Sd. Horner ipsilateral
PCI: Ataxia ipsilateral

CORRELACIN CLNICA
Sndrome pontino medial

*PPRF: Parlisis de la mirada lateral.

(Ambos ojos dirigidos hacia lado de lesin)

(R. paramedianas A. basilar)

Paresia ipsilateral total de msculos de expresin,

gusto 2/3 ant., no lagrimeo, reflejo corneal
Estrabismo interno ipsilateral
*Diplopa al intentar mirada hacia lado de lesin
Dficit contralateral de propiocepcin, tacto, presin, vibracin
Hemiparesia contralateral espstica

CORRELACIN CLNICA
Sndrome pontino lateral
(AICA caudal, A. cerebelosa superior - rostral)
PCI: Ataxia ipsilateral
Paresia ipsilateral total de msculos de expresin,
gusto 2/3 ant., no lagrimeo, reflejo corneal
Nistagmo (se aleja), vrtigo,
nausea, vmitos.
Prdida ipsilateral de audicin
Dficit contralateral de dolor y T.
Sd. Horner ipsilateral

V
o

Dficit ipsilateral de dolor y T (reflejo corneal ok)

Anestesia total ipsilateral + paresia masticacin
desviacin de mandbula

CORRELACIN CLNICA
Sndrome mesenceflico medial (Weber)
(Ramas de A. cerebral posterior)

Parlisis oculomotora ipsilateral

Ptosis, midriasis, estrabismo externo (y abajo)
Alteracin de convergencia y acomodacin
Hemiparesia contralateral espstica
*predominio braquial.
Paresia contralateral espstica de hemicara
inferior

CEREBELO Y
GANGLIOS BASALES

MORFOLOGIA EXTERNA DEL CEREBELO:

Superficie Superior
Lbulo Anterior
Lbulo central

Lbulo cuadrangular
Cisura Primaria

Cisura Horizontal

Culmen

Lbulo Simple
Declive

Cisura Posterior superior

Lbulo Semilunar superior
Folium
Lbulo Semilunar Inferior

Lbulo Posterior

MORFOLOGIA EXTERNA DEL CEREBELO:

Superficie Inferior
Lbulo Anterior
Lbulo Floculonodular
Lngula

Lbulo Central

Flocculus

Ala del Lbulo Central

Pednculo cerebelo superior
Pednculo cerebeloso medio
Pednculo cerebeloso inferior
Cisura Posterolateral

IV Ventrculo
Amigdala
Lbulo Digstrico
Ndulo

Cisura Horizontal

Uvula

Lbulo Semilunar inferior

Pirmide
Tuber

Lbulo Posterior

Cisura secundaria

Cerebelo es formacin del techo:

lbulo anterior
lbulo posterior
lbulo floculonodular

PC Superior
PC Medio
PC Inferior

PEDUNCULOS CEREBELOSOS

CEREBELO
PEDUNCULOS CEREBELOSOS
SUPERIOR: mesencfalo
predominan las fibras eferentes.
MEDIO:protuberancia
predominan las fibras aferentes.
INFERIOR: bulbo raqudeo
predominan fibras aferentes.

CEREBELO
Ala

Lbulo cuadriltero

Lingula

Lbulo central

Lbulo Anterior

Culmen

Lbulo simple

Declive
L. Semilunar superior

Folium

Tuber
Piramide
L. Semilunar inferior

Lbulo Posterior

Uvula
Amigdala
Digstrico

Flocculus

Ndulo

Lbulo Floculonodular

organizacin funcional

NUCLEOS CEREBELOSOS

Regin

Vermis y zonas
intermedias
Hemisferios

Lbulo
floculonodular

Funcin

Principal
entrada
Mdula espinal

Ejecucin de
actividad motora
Planeamiento,
Corteza cerebral
coordinacin
y ncleo olivar
inferior
Equilibrio y
Ncleo
movimientos
vestibular
oculares

CLULAS DEL CEREBELO

Clula

Terminacin

Neurotransmi Funcin
sor
GABA
Inhibitoria

Purkinje

Ncleos
cerebelosos
profundos

Granulosa
Estrellada
En cesto

Purkinje
Purkinje
Purkinje

Glutamato
GABA
GABA

Excitatoria
Inhibitoria
Inhibitoria

Golgi

Granulosa

GABA

Inhibitoria

1.-CORTEZA CEREBELOSA
2.-C. MOLECULAR
3.-C. CELULAS PURKINJE
4.-C.CELULAS GRANULOSA

5.-SUSTANCIA BLANCA
6.- CLULA PURKINJE
7.- CLULA GRANULOSA
8.- FIBRAS EN PARALELO

9.-FIBRAS TREPADORAS
10.-CLULAS ESTRELLADA
11.-CLULAS EN CANASTO
12.-CLULAS MUSGOSAS
13.-AXN CLULA PURKINJE
14.-CLULA DE GOLGI
15.-TERMINAL C.MUSGOSA
16.-DENDRITA C.MUSGOSA
17.-AXN C. DE GOLGI
18.-GLOMRULO

corteza cerebelosa

PRINCIPALES AFERENTES DEL CEREBELO

Fibras

Tracto

Entrada

Funcin

Musgosas

Vestbulo-cerebeloso

PCI

Espino-cerebeloso

PCI y PCS

Terminal
excitatorio en
clulas granulosas

(Cortico)ponto-cerebeloso

PCM (decusan)

Olivocerebeloso

PCI (decusan)

Trepadoras

Terminal
excitatorio en
clulas de Purkinje

SPINOCEREBELLAR PATHWAYS
DORSAL (Flechsigs)
Propioceptors: Muscle spindle, Golgi tendon organ
DRG Clarkes (VII) I/L INF. PEDUNCLE
C8 L2/L3

VENTRAL (Gowers)
Double cross
Anterior white commissure (spinal cord)
Inside cerebellum

Below L2/L3
C/L spinal cord SUP. PEDUNCLE

PRINCIPALES EFERENTES DEL CEREBELO

rea cerebelosa

Ncleo cerebeloso
profundo

Eferente

Funcin

Vestbulocerebelo
(L. floculonodular)

Fastigial

Ncleo vestibular

Cambios
posicionales de ojos
y tronco en
respuesta a
movimiento de la
cabeza

Espinocerebelo
(Hemisferio
intermedio)

Interpsito

Ncleo rojo
Formacin reticular

Reticuloespinal y
rubroespinal:
ajustes de postura y
movimientos

Pontocerebelo
(Hemisferio lateral)

Dentado

Tlamo (VA, VL) Corteza

Corticoespinal:
secuencias,
precisin

LOBULO
FLOCULONODULAR

Aferencias
Eferencias

LOBULO
POSTERIOR

Aferencias
Eferencias

LOBULO
ANTERIOR

Aferencias
Eferencias

BASAL GANGLIA

BASAL GANGLIA
(Neo)striatum
- Caudate
- Putamen
- Accumbens
(Paleo)striatum
- Globus pallidus (GPe + GPi)
- Ventral pallidum (e + i)
Subthalamic nucleus (STN) - Luys
Sustantia nigra (SNc + SNr)
Ventral tegmental area
*Pedunculopontine nucleus
Lateral midbrain & pons
Output from STN, GPi balance, gait

*Zona Incerta
*Habenula
*Centrum medianum/parafascicular

+ indirecta
desinhibicin

D1: + directa
D2: - indirecta

NEUROTRANSMITER EQUILIBRIUM
DA

PATHOLOGY

ACh

NIGROSTRIATAL

MESOLIMBIC AND
MESOCORTICAL

TUBERO-INFUNDIBULAR

DA/ACh

HYPERKINETIC STATES:
HD, Tourette syndrome,
tardive dyskinesia,

Euphoria, paranoia,
psychoses

Hypoprolactinemia

DA/ACh

HYPOKINETIC STATES:
PD, acute EPS,

Hyperprolactinemia

CONOCIMIENTO

TECNOLOGIA

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