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The Development of Nervous System

Following fertilisation, the nervous system begins to form in the 3 rd week of development. It
continues after birth and for many years into the future.
Structurally, the nervous system is divided into two parts:
• Central nervous system – consists of the brain and the spinal cord.
• Peripheral nervous system – consists of cranial and spinal nerves, ganglia, plexuses,
and sensory receptors.
Early Stages
At the end of week two, a structure called the primitive streak appears as a groove in the
epiblast layer of the bilaminar disk.
Cells within the epiblast migrate downward through the primitive streak, giving rise to three
layers from the initial two. These three germinal layers form the trilaminar embryonic disk:
Endoderm – innermost layer
Mesoderm – middle layer
Ectoderm – outermost layer
The nervous system is derived from the ectoderm, which is the outermost layer of the
embryonic disc.

Formation of the three primary germ layers during the third week of development

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Neurulation
In the third week of development, the notochord appears in the mesoderm. The notochord
secretes growth factors which stimulate the differentiation of the overlying ectoderm into
neuroectoderm – forming a thickened structure known as the neural plate.
The lateral edges of the neural plate then rise to form neural folds. The neural folds move
towards each other and meet in the midline, fusing to form the neural tube (precusor to the
brain and spinal cord).
During fusion of the neural folds, some cells within the folds migrate to form a distinct cell
population – known as the neural crest. They give rise to a diverse cell lineage – including
melanocytes, craniofacial cartilage and bone, smooth muscle, peripheral and enteric neurons
and glia
The formation of neural tube is known as neurulation, and is achieved by the end of the
fourth week of development.

The formation of the neural tube from neuroectoderm

Later Development
Brain and Cerebellum
In the fifth week of development, swellings appear at the cranial end of the neural tube. Three
primitive vesicles appear first, and subsequently these develop into five secondary vesicles.
These vesicles will give rise to all the structures of the brain and cerebellum, as well as the
ventricular system.
Primary Vesicles Secondary Vesicles Neural Derivatives Cavity Derivatives
(Early Embryo) (Late Embryo) (Adult)
Prosencephalon Telencephalon Cerebrum Lateral ventricle
(forebrain)

Diencephalon Diencephalon Third Ventricle

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 (Thalamus,
hypothalamus and
epithalamus)
Mesencephalon Mesencephalon Mesencephalon Cerebral aqueduct
(midbrain) (midbrain)
Rhombencephalon Metencephalon Pons and cerebellum Upper part of 4th
(hindbrain) ventricle

Myelencephalon Medulla Oblongata Lower part of 4th

ventricle/central
canal

Meanwhile, neuroderm cells begin to differentiate into neurones and glial cells. Neurones
migrate throughout the brain, and once they have reached their final destination they develop
axons and dendrites, forming synapses.
Spinal Cord
Whilst the cranial end of the neural tube forms the brain and cerebellum, the caudal end
develops to form the spinal cord.
Cells on the dorsal side form the alar plate, which subsequently becomes the dorsal horn
(posterior). Cells at the ventral end form the basal plate, which then becomes the ventral horn
(anterior).
After Birth
Development of the central nervous system continues for many years after birth. Synapses
form and new connections appear, increasing in number throughout childhood and into
adulthood. Only synapses and pathways that are used survive into adulthood; the process of
synaptic pruning allows unused synapses to be eliminated.

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Classification of Nervous System
It may be classified into the followings: Central and Peripheral for descriptive purposes.
• The central nervous system CNS, consisting of the brain and the spinal cord
• The peripheral nervous system PNS, consisting of the cranial and spinal nerves.
The nervous system is a complex network of nerves and cells that carry messages to and from
the brain and spinal cord to various parts of the body. The proper functioning of these nerves
ensures that each organ system, such as the cardiovascular, gastrointestinal, and immune
systems, can adequately communicate with one another.
The nervous system includes the central nervous system (CNS) and peripheral nervous
system (PNS). The CNS is made up of the brain and spinal cord, whereas the PNS is made up
of the somatic and autonomic nervous systems.
The PNS comprises paired cranial and sacral nerves. Some of these are sensory (afferent),
transmitting impulses to the CNS, some are motor (efferent), transmitting impulses from the
CNS and others are mixes, with both sensory and motor fibres. It is useful to consider two
functional parts within the PNS, namely;
• The sensory
• The motor
The motor division has two parts:
• The somatic nervous system, which controls voluntary movement of the skeletal
muscles
• The autonomic nervous system, controlling involuntary processes such as heartbeat,
peristalsis and glandular activity. The autonomic nervous system has two divisions,
namely; sympathetic and parasympathetic.
Cells and Tissues of the Nervous System
Nerve Tissue
Although the nervous system is very complex, there are only two main types of cells in nerve
tissue. The actual nerve cell is the neuron. It is the “conducting” cell that transmits impulses
and the structural unit of the nervous system. The other type of cell is neuroglia or glial cell.
The word “neuroglia” means “nerve glue.” These cells are nonconductive and provide a
support system for the neurons. They are a special type of “connective tissue” for the nervous
system.
Nervous Tissue Location
The nerve tissue or the nervous tissue is the chief tissue component of the two major parts of
the nervous tissue – Central nervous system(CNS) formed by the spinal cord and the brain
and the branching peripheral nerves of the peripheral nervous system (PNS) that control and
regulate the functions of the body and their activities.
The nervous tissue is located in the peripheral nerves all through the body and also in the
organs of the central nervous system such as the spinal cord and the brain. The nervous tissue
consists of the nerve cells or the neurons. Neurons are specialized cells that react to stimuli
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by generating signals through the axons, which are elongated structures arising from the cell
body.
Neuron
Neuron or nerve cell, carry out the functions of the nervous system by conducting nerve
impulses. They are highly specialized and amitotic. This means that if a neuron is destroyed,
it cannot be replaced because neurons do not go through mitosis.

Each neuron has three basic parts: cell body (soma), one or more dendrites, and a single axon.
Cell Body
In many ways, the cell body is similar to other types of cells. It has a nucleus with at least one
nucleolus and contains many of the typical cytoplasmic organelles. It lacks centrioles,
however. Because centrioles function in cell division, the fact that neurons lack these
organelles is consistent with the amitotic nature of the cell.

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Dendrites
Dendrites and axons are cytoplasmic extensions, or processes, that project from the cell body.
They are sometimes referred to as fibers. Dendrites are usually, but not always, short and
branching, which increases their surface area to receive signals from other neurons. The
number of dendrites on a neuron varies. They are called afferent processes because they
transmit impulses to the neuron cell body. There is only one axon that projects from each cell
body. It is usually elongated and because it carries impulses away from the cell body, it is
called an efferent process.
Axon
An axon may have infrequent branches called axon collaterals. Axons and axon collaterals
terminate in many short branches or telodendria. The distal ends of the telodendria are
slightly enlarged to form synaptic bulbs. Many axons are surrounded by a segmented, white,
fatty substance called myelin or the myelin sheath. Myelinated fibers make up the white
matter in the CNS, while cell bodies and unmyelinated fibers make the gray matter. The
unmyelinated regions between the myelin segments are called the nodes of Ranvier.
In the peripheral nervous system, the myelin is produced by Schwann cells. The cytoplasm,
nucleus, and outer cell membrane of the Schwann cell form a tight covering around the
myelin and around the axon itself at the nodes of Ranvier. This covering is the neurilemma,
which plays an important role in the regeneration of nerve fibers. In the CNS,
oligodendrocytes produce myelin, but there is no neurilemma, which is why fibers within the
CNS do not regenerate.
Classifications of Neuron
Neurons vary in shape and size and can be classified by their morphology and function.
A. Structural classification
1. Unipolar neuron
2. Bipolar neuron
3. Multipolar neuron
4. Pseudounipolarneuron
Unipolar: single process
Bipolar: 1 axon and 1 dendrite
Multipolar: 1 axon and 2 or more dendrites
• Golgi I: neurons with long-projecting axonal processes; examples are pyramidal cells,
Purkinje cells, and anterior horn cells
• Golgi II: neurons whose axonal process projects locally; the best example is the
granule cell
Pseudounipolar: 1 process which then serves as both an axon and a dendrite
B. Functional classification
• Afferent neurons convey information from tissues and organs into the central nervous
system and are also called sensory neurons.

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 • Efferent neurons (motor neurons) transmit signals from the central nervous system to
the effector cells.
• Interneurons connect neurons within specific regions of the central nervous system.
Functionally, neurons are classified as afferent, efferent, or interneurons (association
neurons) according to the direction in which they transmit impulses relative to the central
nervous system. Afferent, or sensory, neurons carry impulses from peripheral sense receptors
to the CNS. They usually have long dendrites and relatively short axons. Efferent, or motor,
neurons transmit impulses from the CNS to effector organs such as muscles and glands.
Efferent neurons usually have short dendrites and long axons. Interneurons, or association
neurons, are located entirely within the CNS in which they form the connecting link between
the afferent and efferent neurons. They have short dendrites and may have either a short or
long axon.
Neuroglia
Glial cells are a type of cell that provides physical and chemical support to neurons and
maintain their environment. Located in the central nervous system and peripheral nervous
system, glial cells are sometimes called the “glue” of the nervous system, as well as neuroglia
or just glia.
Neuroglia cells do not conduct nerve impulses, but instead, they support, nourish, and protect
the neurons. They are far more numerous than neurons and, unlike neurons, are capable of
mitosis.
Types of Glial Cells
There are different types of glial cells and each one has a specific role in helping the central
nervous system (CNS). There are five types of glial cells in the CNS:
• Astrocytes
• Oligodendrocytes
• Microglia
• Ependymal cells
• Radial glia1
There also glial cells in the peripheral nervous system (PNS), which is made up of all the
nerves in the body.
The two types of glial cells in the PNS are:
• Schwann cells
• Satellite cells1
Astrocytes
The most common type of glial cell in the CNS is the astrocyte or astroglia. The “astro” part
of the name is because the cells have projections that make them look star-shaped.
There are different kinds of astrocytes. For example, protoplasmic astrocytes have thick
projections with lots of branches. Fibrous astrocytes have long, slender arms with few
branches.

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Protoplasmic astrocytes are generally found among neurons in the gray matter of the brain
while the fibrous ones are typically found in white matter.
While they’re found in different places, they do similar jobs, including:
• Forming the blood brain barrier (BBB): The BBB is like a strict security system for
the brain. It only lets in substances that are supposed to be in the brain while keeping
out things that could be harmful. This filtering system is essential for keeping the
brain healthy.
• Regulating neurotransmitters: Neurons communicate using chemical messengers
called neurotransmitters. Once the message is delivered, neurotransmitters hang
around until an astrocyte recycles them. This reuptake process is the target of many
medications, including antidepressants.
• Cleaning up: Astrocytes also clean up what’s left behind when a neuron dies, as well
as excess potassium ions (chemicals that play an important role in nerve function).
• Regulating blood flow to the brain: For the brain to process information properly, it
needs a certain amount of blood going to all of its different regions. An active region
gets more blood than an inactive one.
• Synchronizing the activity of axons: Axons are long, thread-like parts of neurons and
nerve cells that conduct electricity to send messages between cells.
• Brain energy metabolism and homeostasis: One of the most important roles of
astrocytes is to regulate metabolism in the brain by storing sugar (glucose) from the
blood and providing it as fuel for neurons.
Oligodendrocytes
Oligodendrocytes come from neural stem cells. The word is made up of a few Greek terms
that mean “cells with several branches.” The main purpose of oligodendrocytes is to help
information move faster along axons in the brain.
Oligodendrocytes look like spikey balls. On the tips of their spikes are white, shiny
membranes that wrap around the axons of nerve cells and form a protective layer, like the
plastic insulation on electrical wires. This protective layer is called the myelin sheath. The
sheath is not continuous, though. There’s a gap between each membrane that’s called the
“node of Ranvier.” This node helps electrical signals spread efficiently along nerve cells.
The signal actually hops from one node to the next and increases the velocity of the nerve
conduction while also reducing how much energy it takes to transmit it.
At birth, only have a few myelinated axons, but the number keeps growing until about 25 to
30 years old. Myelination is believed to play an important role in intelligence.
Oligodendrocytes also provide stability and carry energy from blood cells to the axons.
The term “myelin sheath” is often used when talking about multiple sclerosis (MS) because
this part gets damaged in the disease.
In people with MS, it’s thought that the body’s immune system attacks the myelin sheaths,
which leads to dysfunction of the neurons and impaired brain function. Spinal cord injuries
can also damage myelin sheaths.

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Other diseases associated with oligodendrocyte dysfunction include:
Oligodendrogliomas
Schizophrenia
Bipolar disorder
Microglia
Microglia are tiny glial cells. They act as the brain’s own dedicated immune system. The
brain needs its own immune system because the blood-brain barrier isolates the brain from
the rest of the body.
Microglia are alert to signs of injury and disease. When they detect a problem, they charge in
and take care of it, whether it means clearing away dead cells or getting rid of a toxin or
pathogen. When microglia respond to an injury, it causes inflammation as part of the healing
process.
Sometimes, the response causes problems. For example, in Alzheimer’s disease, microglia
are hyper activated and cause too much inflammation. The response may lead to amyloid
plaques and other brain changes related to Alzheimer’s.
Along with Alzheimer’s, other conditions linked to microglial dysfunction include:
Fibromyalgia
Chronic neuropathic pain
Autism spectrum disorders
Schizophrenia
Ependymal Cells
Ependymal cells make up the thin membrane lining the central canal of the spinal cord and
the passageways (ventricles) of the brain (ependyma). They also make cerebrospinal fluid
and have an important role in the blood-brain barrier.
Ependymal cells are very small and line up tightly to form the membrane. Inside the
ventricles, they have little hair like projections (cilia) that wave back and forth to keep the
cerebrospinal fluid circulating.
Cerebrospinal fluid delivers nutrients to and eliminates waste products from the brain and
spinal column. It also serves as a cushion and shock absorber between the brain and skull.
The fluid is also necessary to maintain homeostasis of the brain, which means regulating its
temperature and other features that keep it operating as well as possible.
Radial Glia
Radial glia is believed to be a type of stem cell. This type of cell can create other cells. In the
developing brain, stem cells are the “parents” of neurons, astrocytes, and oligodendrocytes.
During embryonic life, these cells also provided the “scaffolding” for developing neurons.
They provide the long fibers that guide young brain cells into place as the brain forms.

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Since they have an important role as stem cells, especially as creators of neurons, researchers
have looked at radial glia to learn more about how to repair brain damage from illness or
injury.
Schwann Cells
They function a lot like oligodendrocytes by providing myelin sheaths for axons. However,
Schwann cells are found in the peripheral nervous system (PNS) rather than the CNS.
Instead of being a central cell with membrane tipped arms, Schwann cells form spirals
directly around the axon. The nodes of Ranvier sit between them, just as they do with
oligodendrocytes, and assist in nerve transmission in the same way.
Schwann cells are also part of the PNS’s immune system. When a nerve cell is damaged, it
can “eat” the nerve’s axons and provide a protected path for a new axon to form.
There are a few diseases that involve the Schwann cells, such as:
Guillain-Barre’ syndrome
Charcot-Marie-Tooth disease
Schwannomatosis
Chronic inflammatory demyelinating polyneuropathy
Leprosy
Schwann cells might also be involved in some forms of chronic pain. The activation of the
cells after nerve damage might contribute to dysfunction in a type of nerve fibers called
nociceptors, which sense environmental factors such as heat and cold.
Satellite Cells
Satellite cells get their name from the way they surround certain neurons, with several
“satellites” forming a sheath around the cellular surface.
They’re similar to astrocytes. However, they’re found in the PNS, not the CNS.
Satellite cells’ main purpose appears to be regulating the environment around the neurons,
keeping chemicals in balance.
Satellite cells deliver nutrition to the neuron and absorb heavy metal toxins, such as mercury
and lead, to keep them from damaging the neurons.
It’s also thought that satellite cells help transport several neurotransmitters and other
substances, including:
Glutamate, GABA, Norepinephrine, Adenosine triphosphate, Capsaicin, Acetylcholine ETC.

Function of Nervous Tissue

• Neurons generate and carry out nerve impulses. They produce electrical signals that
are transmitted across distances; they do so by secreting chemical neurotransmitters.

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 • Responds to stimuli
• Carries out communication and integration
• Provides electrical insulations to nerve cells and removes debris
• Carries messages from other neurons to the cell body

Overview of the Brain

The brain is an amazing three-pound organ that controls all functions of the body, interprets
information from the outside world, and embodies the essence of the mind and soul.
Intelligence, creativity, emotion, and memory are a few of the many things governed by the
brain. Protected within the skull, the brain is composed of the cerebrum, cerebellum, and
brainstem.
The brain receives information through our five senses: sight, smell, touch, taste and hearing
– often many at one time. It assembles the messages in a way that has meaning for us, and
can store that information in our memory. The brain controls our thoughts, memory and
speech, movement of the arms and legs, and the function of many organs within our body.
The central nervous system (CNS) is composed of the brain and spinal cord. The peripheral
nervous system (PNS) is composed of spinal nerves that branch from the spinal cord and
cranial nerves that branch from the brain.

The Brain
On average, the brain weighs between 1.3 to 1.4 kg, which is about 2% of the total body
weight, with a volume of around 1260 cm3 in men and 1130 cm3 in women, with about 60%
of the brain consisting of fat. The remaining 40% of the brain consists of protein, water,
carbohydrates and salts.
Structure of the Brain
The brain is composed of the cerebrum, cerebellum, and brainstem
The cerebrum also known as Telencephalon, is the largest part of the brain, located
superiorly and anteriorly in relation to the brainstem. It consists of two cerebral hemispheres
(left and right), separated by the falxcerebri of the dura mater. Embryologically, the cerebrum
is derived from the prosencephalon.
The cerebrum is located within the bony cranium. It extends from the frontal bone anteriorly
to the occipital bone posteriorly. Within the skull, the cerebrum fills the anterior and middle
cranial fossae, and is located above the tentorium cerebelli inferoposteriorly.
Internally, the cerebrum is comprised of two different types of tissues, grey matter and white
matter:
Grey matter forms the surface of each cerebral hemisphere (known as the cerebral cortex),
and is associated with processing and cognition.

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White matter forms the bulk of the deeper parts of the brain. It consists of glial cells and
myelinated axons that connect the various grey matter areas.
Externally, the cerebrum has a highly convoluted appearance, consisting of sulci (grooves or
depressions) and gyri (ridges or elevations). It is divided into two anatomically symmetrical
hemispheres by the longitudinal fissure, a major sulcus that runs in the median sagittal plane.
The falxcerebri (a fold of dura mater) descends vertically to fill this fissure. The two cerebral
hemispheres are connected by a white matter structure, called the corpus callosum.
The main sulci are:

Central sulcus – groove separating the frontal and parietal lobes.

Lateral sulcus – groove separating the frontal and parietal lobes from the temporal lobe.
Lunate sulcus – groove located in the occipital cortex.
The main gyri are:
Precentral gyrus – ridge directly anterior to central sulcus, location of primary motor cortex.
Postcentral gyrus – ridge directly posterior to central sulcus, location of primary
somatosensory cortex.
Superior temporal gyrus – ridge located inferior to lateral sulcus, responsible for the
reception and processing of sound.

Lobes of the Cerebrum

The cerebral cortex is classified into four lobes, according to the name of the corresponding
cranial bone that approximately overlies each part. Each lobe contains various cortical
association areas – where information from different modalities is collated for processing.
Together, these areas function to give us a meaningful perceptual interpretation and
experience of our surrounding environment.

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Frontal Lobe
The frontal lobe is located beneath the frontal bone of the calvaria and is the most anterior
region of the cerebrum. It is separated from the parietal lobe posteriorly by the central sulcus
and from the temporal lobe inferoposteriorly by the lateral sulcus.
The association areas of the frontal lobe are responsible for: higher intellect, personality,
mood, social conduct and language (dominant hemisphere side only).
Parietal Lobe
The parietal lobe is found below the parietal bone of the calvaria, between the frontal lobe
anteriorly and the occipital lobe posteriorly, from which it is separated by the central sulcus
and parieto-occipital sulcus, respectively. It sits superiorly in relation to the temporal lobe,
being separated by the lateral sulcus.
Its cortical association areas contribute to the control of: language and calculation on the
dominant hemisphere side and visuospatial functions (e.g. 2-point discrimination) on the non-
dominant hemisphere side.
Temporal Lobe
The temporal lobe sits beneath the temporal bone of the calvaria, inferior to the frontal and
parietal lobes, from which it is separated by the lateral sulcus.
The cortical association areas of the temporal lobe are accountable for memory and language
– this includes hearing as it is the location of the primary auditory cortex.
Occipital Lobe
The occipital lobe is the most posterior part of the cerebrum situated below the occipital bone
of the calvaria. Its inferior aspect rests upon the tentorium cerebelli, which segregates the
cerebrum from the cerebellum. The parieto-occipital sulcus separates the occipital lobe from
the parietal and temporal lobes anteriorly.
The primary visual cortex (V1) is located within the occipital lobe and hence its cortical
association area is responsible for vision.

Lobes of the Cerebrum

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The cerebellum is located at the back of the brain, immediately inferior to the occipital and
temporal lobes, and within the posterior cranial fossa. It is separated from these lobes by the
tentorium cerebelli, a tough layer of dura mater. It lies at the same level of and posterior to
the pons, from which it is separated by the fourth ventricle.
The cerebellum consists of two hemispheres which are connected by the vermis, a narrow
midline area. Like other structures in the central nervous system, the cerebellum consists of
grey matter and white matter:
There are three ways that the cerebellum can be subdivided – anatomical lobes, zones and
functional divisions

Anatomical position of cerebellum

Anatomical Lobes
There are three anatomical lobes that can be distinguished in the cerebellum; the anterior
lobe, the posterior lobe and the flocculonodular lobe. These lobes are divided by two fissures
– the primary fissure and posterolateral fissure.

Lobes and zones of cerebellum

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Zones
There are three cerebellar zones. In the midline of the cerebellum is the vermis. Either side of
the vermis is the intermediate zone. Lateral to the intermediate zone are the lateral
hemispheres. There is no difference in gross structure between the lateral hemispheres and
intermediate zones
Functional Divisions
The cerebellum can also be divided by function. There are three functional areas of the
cerebellum – the cerebrocerebellum, the spinocerebellum and the vestibulocerebellum.
• Cerebrocerebellum – the largest division, formed by the lateral hemispheres. It is
involved in planning movements and motor learning. It receives inputs from the
cerebral cortex and pontine nuclei, and sends outputs to the thalamus and red nucleus.
This area also regulates coordination of muscle activation and is important in visually
guided movements.
• Spinocerebellum – comprised of the vermis and intermediate zone of the cerebellar
hemispheres. It is involved in regulating body movements by allowing for error
correction. It also receives proprioceptive information.
• Vestibulocerebellum – the functional equivalent to the flocculonodular lobe. It is
involved in controlling balance and ocular reflexes, mainly fixation on a target. It
receives inputs from the vestibular system, and sends outputs back to the vestibular
nuclei.

The Brain Stem

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The midbrain (also known as the mesencephalon) is the most superior of the three regions of
the brainstem. It acts as a conduit between the forebrain above and the pons and cerebellum
below.
The midbrain is the smallest of the three regions of the brainstem, measuring around 2cm in
length. As it ascends, the midbrain travels through the opening in the tentorium cerebelli.
It can be divided into two main parts:
• Tectum – located posterior to the cerebral aqueduct
• Paired cerebral peduncles – located anteriorly and laterally.
Internally, the cerebral peduncles are further separated by the substania nigra into the crus
cerebri (anterior) and the tegmentum (posterior).
Tectum
The tectum houses four rounded prominences named colliculi (collectively the corpora
quadrigemina) which sit directly inferior to the pineal gland. The colliculi are separated by
the cruciform sulcus; there are two superior and two inferior colliculi.
Extending laterally from each colliculi is the quadrigeminal brachium:
Superior quadrigeminal brachium forms a pathway between the superior colliculus and the
retina of the eye.
Inferior quadrigeminal brachium conveys fibres from the lateral lemniscus and inferior
colliculus to the medial geniculate body.
Inferior to the colliculi, the trochlear nerve (CN IV) emerges before sweeping across to the
anterior surface.
Cerebral Peduncles
The paired cerebral peduncles extend from the cerebral hemispheres to converge as they meet
the pons. They are separated anteriorly in the midline by the interpeduncular fossa, the floor
of which is termed the posterior perforated substance (as many perforating blood vessels can
be identified).
The oculomotor nerve (CNIII) is seen exiting from between the peduncles while the optic
tract runs around the superior border of the midbrain.

The Pons is the largest part of the brainstem, located above the medulla and below the
midbrain. It is a group of nerves that function as a connection between the cerebrum and
cerebellum (pons is Latin for bridge).
The pons develops from the embryonic metencephalon (part of the hindbrain, developed from
the rhombencephalon), alongside the cerebellum.
The pons is a horseshoe-shaped collection of nerve fibres located in the anterior part of the
posterior cranial fossa.
Its anatomical relations are as follows:

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Posteriorly – the cerebellum, separated by the fourth ventricle.
Inferiorly – the medulla oblongata.
Superiorly – the midbrain lies immediately above the pons.

Anterior Surface
The anterior or ventral surface of the pons is marked by a bulging formed by the transverse
pontocerebellar fibres. These fibres wrap around the otherwise vertically oriented brainstem.
It measures around 2.5 cm in adults.
The basilar groove demarcates the midline of the ventral surface and is where the basilar
artery is located.
The pontomedullary junction is an important anatomical landmark defined by the angle
between the lower border of the pons and the superior border of the medulla.
Several cranial nerves originate from the ventral surface of the pons:
Cranial nerve V: trigeminal – originates from the lateral aspect of mid pons
Cranial nerve VI: abducens – originates from the pontomedullary junction, close to the
midline
Cranial nerve VII: facial – originates from the cerebellopontine angle, the more lateral aspect
of the pontomedullary junction.
Cranial nerve VIII: vestibulocochlear – originates laterally to the facial nerve.
Posterior Surface
The pons is intimately related to the cerebellum and is connected to it by the middle
cerebellar peduncles. Removal of the cerebellum will reveal the underlying fourth ventricle.
The floor of the fourth ventricle is composed of the dorsal surface of the pons and the
medulla.
The angle formed at the junction of the pons, medulla, and cerebellum is an anatomical
landmark and is named cerebellopontine angle. Here, the cerebellar flocculus, the ventricular
choroid plexus and the emerging CNs VII and VIII surround the lateral apertures of the
fourth ventricle (the foramen of Luschka).
Internally, the pons is comprised of two major components – the ventral pons and the
tegmentum.
The ventral pons contains the pontine nuclei, which are responsible for coordinating
movement. Fibres from the pontine nuclei cross the midline and form the middle cerebellar
peduncles on their way to the cerebellum.
The tegmentum is the evolutionarily older part of the pons which forms part of the reticular
formation – a set of nuclei found throughout the brainstem that are responsible for arousal

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and attentiveness. Damage to this part of the pons may result in anosognosia for hemiplegia,
where patients are unaware of their paralysis.
The rest of the pons is made up of nerve tracts passing through the pons.

The medulla oblongata (medulla) is one of the three regions that make up the brainstem. It
is the most inferior of the three and is continuous above with the pons and below with the
spinal cord. The medulla houses essential ascending and descending nerve tracts as well as
brainstem nuclei.
The medulla is conical in shape, decreasing in width as it extends inferiorly. It is
approximately 3cm long and 2cm wide at its largest point.
The superior margin of the medulla is located at the junction between the medulla and pons,
while the inferior margin is marked by the origin of the first pair of cervical spinal nerves.
This occurs just as the medulla exits the skull through the foramen magnum.
It contains sensory and motor tracts, cranial nerve neclei, other related nuclei and part of the
reticular formation. Superficially, the spinal cord blends into the medulla, but internally
several differences exist. Discrete nuclei. Clusters of gray matter composed mostly of neuron
cell bodies and having specific functions are found in the medulla oblongata, whereas the
gray matter of the spinal cord extends as continuous mass in the centre of the cord. In
addition, the tract within the medulla do not have the same organization as those of the spinal
cord. Several medullary neclei function as centres for reflexes, such as those involved in the
regulation of heart rate, blood vessel diameter, respiration, swallowing, vomiting, hiccupping,
coughing, and sneezing.
Two prominent enlargements on the anterior surface of the medulla oblongata are called
pyramids because they are broader near the pons and taper toward the spinal cord. The
pyramids are descending tracts involved in the conscious control of skeletal muscles. Near
inferior ends, most of the fibers of the descending tracts cross to the opposite side, or
decussate (Decussate means to form an X in Latin) this accounts, in part for the fact that each
half of the brain controls the opposite half of the body.
Two rounded, oval structures called olives protrude from anterior surface of the medulla
oblongata just lateral to the superior ends of the pyramids. The olives are neclei involved in
functions such as balance, coordination, and modulation of sound from inner ear. Nuclei of
cranial nerves V (trigeminal), IX (glossopharyngeal). X (vagus) XI (accessory), and XII
(hypoglossal) also are located within the medulla oblongata.
Meninges
The meninges are the three membranes that envelop the brain and spinal cord and separate
them from the walls of their bony cases (skull and vertebral column). Based on their location,
meninges are referred to as the cranial meninges which envelop the brain, and spinal
meninges which envelop the spinal cord. However, the cranial and spinal meninges are
continuous with each other and consist of the same three meningeal layers. From superficial
to deep the meninges are the:

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 • Dura mater: This is the outer layer, closest to the skull.
• Arachnoid mater: This is the middle layer.
• Pia mater: This is the inner layer, closest to your brain tissue.
Together, the arachnoid mater and pia mater are called leptomeninges.
There are three spaces within the meninges:

The epidural space is a space between the skull and dura mater and the dura mater of the
spinal cord and the bones of the vertebral column. Analgesics (pain medicine) and anesthesia
are sometimes injected into this space along the spine. The spinal cord ends between the first
and second lumbar vertebra in the middle of your back, at which point, only cerebrospinal
fluid is present. This is the site where a lumbar puncture (“spinal tap”) is performed.
The subdural space is a space between the dura mater and the arachnoid mater. Under normal
conditions, this space isn’t a space, but can be opened if there’s trauma to the brain (such as a
brain bleed) or other medical condition.
The subarachnoid space is a space between the arachnoid mater and pia mater. It’s filled with
cerebrospinal fluid. Cerebrospinal fluid cushions and protects the brain and spinal cord.
Dura Mater

The dura mater is the outer, thick, strong membrane layer located directly under the skull and
vertebral column. In Latin, dura mater means “hard mother.” It consists of two layers of
connective tissue. One side of the dura attaches to the skull and the other adheres to the
middle membrane layer (arachnoid mater). The dura mater contains a drainage system, called
the dural venous sinuses, which allows blood to leave the brain and allows cerebrospinal fluid
to re-enter the circulation. The dura mater receives its blood supply from the middle
meningeal artery and vein, and the trigeminal nerve runs through it. The dura mater folds
inward onto itself to form four thin membrane layers called dural reflections. Each dural
reflection surrounds different sections (hemispheres) of the brain
Arachnoid Mater

The arachnoid mater, the middle layer of the meninges, lies directly below the dura mater.
It’s a thin layer that lays between the dura mater and pia mater. It doesn’t contain blood
vessels or nerves. It has a spiderweb-like appearance (“arachnoid” means spider) because it
has connective tissue projections that attach to the pia mater. Between the arachnoid mater
and pia mater is the subarachnoid space, which contains cerebrospinal fluid that helps
cushion the brain.

Pia Mater
Pia mater, the innermost layer, is a thin layer that’s held tightly — like shrink wrap — to the
surface of the brain and spinal cord. Many blood vessels pass through this layer to supply the
brain tissue with blood. It also helps contain cerebrospinal fluid. In the spinal cord, pia mater
helps maintain the stiffness of the cord.

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Function of the meninges

• Protect the CNS (central nervous system) from trauma injury to the brain, such as a
blow to the head by acting as a shock absorber. They anchor your CNS and keep the
brain from moving around within your skull.
• Provide a support system for blood vessels (including your middle meningeal artery)
that deliver blood to your CNS tissues, nerves (including your trigeminal and vagus
nerves), lymphatics (drainage system) and cerebrospinal fluid.
Medical conditions affecting the meninges

Two of the more common conditions that affect the meninges are:
Meningitis. This is an infection of the meninges. The infection can be caused by bacteria,
fungus or viruses. A lumbar puncture to get a cerebrospinal fluid sample is usually required
to diagnose this condition. Rarely, meningitis can occur by non-infectious causes such as
cancers, inflammatory disease, brain surgery or certain medicines.
Subdural hematoma. This is bleeding that occurs between the dura mater and arachnoid mater
due to a tear in a blood vessel.
Bleeding within other meningeal layers. Many blood vessels travel through the meninges.
Trauma to the head can cause bleeding between any of the layers of meninges, especially in
people who take blood thinners or have bleeding disorders.
Other medical conditions affecting the meninges include:

Meningiomas. These are tumors that grow in the meninges. They’re usually not cancerous,
but can grow large enough to be life-threatening and may require surgical treatment.

Meningeal carcinomatoses. This is cancer that has spread from its original tumor site to the
meninges.

There are many other conditions that can affect each specific meningeal layer. Because of the
important role of the meninges in protecting the brain, conditions that affect the meninges can
be potentially life-threatening.

Cerebrospinal fluid (CSF)

Cerebrospinal fluid (CSF) is a clear, colourless body fluid found within the tissue that
surrounds the brain and spinal cord of all vertebrates.
CSF is produced by specialised ependymal cells in the choroid plexus of the ventricles of the
brain, and absorbed in the arachnoid granulations. There is about 125mL of CSF at any one
time and about 500mL is generated every day. CSF acts as a shock absorber, cushion or
buffer, providing basic mechanical and immunological protection to the brain inside the skull.
CSF also serves a vital function in the cerebral autoregulation of cerebral blood flow.

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CSF occupies the subarachnoid space (between the arachnoid mater and the pia mater) and
the ventricular system around and inside the brain and spinal cord. It fills the ventricles of the
brain, cisterns, and sulci, as well as the central canal of the spinal cord. There is also a
connection from the subarachnoid space to the bony labyrinth of the inner ear via the
perilymphatic duct where the perilymph is continuous with the cerebrospinal fluid. The
ependymal cells of the choroid plexus have multiple motile cilia on their apical surfaces that
beat to move the CSF through the ventricles.
Functions of Cerebrospinal Fluid

Cerebrospinal fluid is an ultrafiltrate of plasma that surrounds the brain and spinal cord.
It serves three main functions:

• Protection – acts as a cushion for the brain, limiting neural damage in cranial injuries.
• Buoyancy – by being immersed in CSF, the net weight of the brain is reduced to
approximately 25 grams. This prevents excessive pressure on the base of the brain.
• Chemical stability – the CSF creates an environment to allow for proper functioning
of the brain, e.g. maintaining low extracellular K+ for synaptic transmission.
• Clearing waste – CSF allows for the removal of waste products from the brain and is
critical in the brains lymphatic system called the glymphatic system. Metabolic waste
products diffuse rapidly into CSF and are removed into the bloodstream as CSF is
absorbed. When this goes awry, CSF can be toxic such as in amyotrophic lateral
scelerosis, the commonest form of motor neuron disease.
Ventricles of the Brain

The ventricles are structures that produce cerebrospinal fluid and transport it around the
cranial cavity. They are lined by ependymal cells, which form a structure called the choroid
plexus. It is within the choroid plexus that CSF is produced.
Embryologically, the ventricular system is derived from the lumen of the neural tube. In total,
there are four ventricles; right and left lateral ventricles, third ventricle and fourth ventricle.
Lateral Ventricles

The left and right lateral ventricles are located within their respective hemispheres of the
cerebrum. They have ‘horns’ which project into the frontal, occipital and temporal lobes. The
volume of the lateral ventricles increases with age.
Third Ventricle
The lateral ventricles are connected to the third ventricle by the foramen of Monro. The third
ventricle is situated in between the right and the left thalamus. The anterior surface of the
ventricle contains two protrusions:

Supra-optic recess – located above the optic chiasm.

Infundibular recess – located above the optic stalk.

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Fourth Ventricle
The fourth ventricle is the last in the system – it receives CSF from the third ventricle via the
cerebral aqueduct. It lies within the brainstem, at the junction between the pons and medulla
oblongata.

From the 4th ventricle, the fluid drains into two places:
Central spinal canal – bathes the spinal cord

Subarachnoid cisterns – bathes the brain, between arachnoid mater and pia mater. Here the
CSF is reabsorbed back into the circulation.

Diagram of Brain Ventricles

Flow of Cerebrospinal Fluid

Cerebrospinal fluid is constantly produced at a secretion rate of 0.2-0.7 ml/min, meaning that
there is 600–700 ml of newly produced CSF per day. Since the total volume of CSF averages
around 150-270 mL, this means that the entire volume of CSF is replaced around 4 times per
day.
The pathway of the cerebrospinal fluid is as follows:

The CSF passes from the lateral ventricles to the third ventricle through the interventricular
foramen (of Monro).

From the third ventricle, the CSF flows through the cerebral aqueduct (of Sylvius) to the
fourth ventricle.

From the fourth ventricle, some CSF flows through a narrow passage called the obex and
enters the central canal of the spinal cord. However, the majority of CSF passes through the
apertures of the fourth ventricle; the median aperture (of Magendie) and two lateral apertures

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(of Luschka). Via these openings, the CSF enters the cisterna magna and cerebellopontine
cisterns, respectively.

From there, the CSF flows through the subarachnoid space of the brain and spinal cord.
It is finally reabsorbed into the dural venous sinuses through arachnoid granulations.

Diagram Showing Flow of Cerebrospinal Fluid

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Flow Chart Showing Circulation of Cerebrospinal Fluid

Production and Reabsorption of Cerebrospinal Fluid

Cerebrospinal fluid is produced by the choroid plexus, located in the lining of the ventricles.
It consists of capillaries and loose connective tissue, surrounded by cuboidal epithelial cells.
Plasma is filtered from the blood by the epithelial cells to produce CSF. In this way, the exact
chemical composition of the fluid can be controlled.

Drainage of the CSF occurs in the subarachnoid cisterns (or space). Small projections of
arachnoid mater (arachnoid granulations) protrude into the dura mater. They allow the fluid
to drain into the dural venous sinuses.

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Contents of CSF

CSF Blood
pH 7.33 7.41
Osmolarity 295 mOsm/L 295 mOsm/L
Glucose (fasting) 2.5 – 4.5 mmol/L 3.0 – 5.0 mmol/L
Protein 200 – 400 mg/L 60 – 80 g/L
Sodium 144 – 152 mmol/L 135 – 145 mmol/L
Potassium 2.0 – 3.0 mmol/L 3.8 – 5.0 mmol/L
Chloride 123 -128 mmol/L 95 – 105 mmol/L
Calcium 1.1 – 1.3 mmol/L 2.2 – 2.6 mmol/L
Urea 2.0 – 7.0 mmol/L 2.5 – 6.5 mmol/L

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