T HE CENTRAL NERVOUS S YSTEM
P RE L ABORATORY R EVIEW OF THE B RAIN
The cerebrum is the largest and considered the most recently developed area of the
brain in human evolution. The cerebral hemispheres make up the superior portion
of the brain. The hemispheres contain characteristic ridges called gyri (plural for
gyrus) separated by shallow grooves called sulci. The deeper sulci are called
fissures. They increase the surface area of the brain tissue that can fit within the
cranium. The longitudinal fissure can be visualized from a superior view of the
cerebrum. It divides the cerebrum into a right and left hemisphere. Each hemisphere
can be further divided into 4 major lobes: the frontal, temporal, parietal, and
occipital lobes. The insula is often referred to as the fifth lobe of the brain. It is not
visible externally because it is buried deep within the temporal and frontal lobes. The
insula has several important roles including awareness of internal bodily functions,
such as the perception of having a full bladder. It also plays a role in basic emotions
such as anger, happiness, fear, and disgust. The frontal lobes control voluntary
motor functions, planning, mood, smell, and social judgment. The parietal lobes
receive and integrate sensory information. The occipital lobes are considered the
visual center of the brain. The temporal lobes are important for learning, hearing,
memory, and emotional behavior.
The central sulcus divides the hemispheres of the brain into anterior and posterior
halves. The central sulcus is bordered by the precentral gyus anteriorly and
postcentral gyrus posteriorly.
The four primary lobes of the cerebrum have both characteristic and predictable
functions. Structures anterior to the central sulcus are mostly related to either
cognitive or motor functions. The prefrontal cortex is the anterior portion of the
frontal lobes (Figure 9.4). It allows humans to solve complex problems. It is the
most evolved part of the brain; its roles include higher thought processes such as
judgment, working memory, personality, and abstract thinking. It is closely linked to
the limbic system, which plays a major role in emotions and involuntary responses to
them. The primary motor cortex is located on the precentral gyrus. Neurons in
this area of the brain control voluntary skeletal muscles needed for movement.
Different areas along this gyrus control different areas of the body. Broca’s area is
the portion of the frontal lobe that controls the muscles that are needed for speech
production. This includes muscles of the tongue and pharynx. The olfactory
association area is one of the few sensory areas of the cortex that is located in the
front of the brain. The olfactory cranial nerve has receptors that give the ability to
distinguish many different scents. It projects to the olfactory association area, which
provides associations with specific smells. The smell of homemade apple pie might
remind a person of their childhood because their grandmother used to make it for
them when they were young.
Structures that are posterior to the central sulcus are sensory in nature. The
primary sensory cortex is located on the postcentral gyrus. Like the primary
motor cortex, the primary sensory cortex is also a topographical map of the body.
This means specific areas along both the precentral and postcentral gyrus are
dedicated to either motor or sensory functions of a specific body part. This concept
will be covered in greater detail in the next laboratory.
The primary visual cortex is located in the occipital lobe of the brain. The images
created by the retina of the eyes will ultimately project to this area of the brain. The
primary visual cortex and its neighboring associative visual cortex will give
meaning to the images. Notice the enormous amount of cortex devoted to vision.
The sensory association cortex is located in the parietal lobes just posterior to the
primary sensory cortex and anterior to the visual association areas. This area is
responsible for the blending of the senses allowing humans to recognize specific
objects such as cars, people, and words. Without this area of the brain the world
would be perceived as basic shapes, colors, and pitches. Past events will influence
how an object is perceived. For example, when people think of the Mister Softee Ice
Cream truck, they can develop a picture of it from their visual association area.
Because of life experience, they can also remember the famous song that the truck
plays. The visual memory of the truck and its song will always be associated with
each other. If a person never saw or heard this ice cream truck before, it would not
have the same meaning.
The primary auditory cortex is located on the superior gyrus of the temporal lobe.
Sensory impulses from the cochleae are topographically mapped here allowing for
the interpretation of sound. The auditory association area functions in perception
and emotional response to sound. Wernicke’s area is located posterior to the
primary auditory cortex. It is particularly important in word recognition and
understanding language.
Clinical application: Damage to specific areas of the brain will result in predictable
functional deficits. The left side of the cortex is the location of both Broca’s and
Wernicke’s areas in 97% of the population. If Broca’s area was affected, the result
would be an inability to vocalize speech. This is a condition called expressive
aphasia. If Wernicke’s area was injured, the result would be an inability to
comprehend speech (language). This is called receptive aphasia. If both areas were
damaged, the person would have difficulty with both speaking and understanding the
words they are listening to. This is called global aphasia.
C ROSS S ECTION OF THE B RAIN AND R EGIONAL A NATOMY
Viewing the sagittal section of the brain is important for studying internal structures
(Figure 9.4). The corpus callosum is located in the midline just inferior to the
cerebrum. It is a thick, white collection of bidirectional myelinated fibers that allow
the two hemispheres to communicate. The pineal gland is located inferior and
posterior to the corpus callosum. It produces melatonin, which signals the body to
sleep. The thalamus is superior to the hypothalamus. The thalamus plays a major
role in relaying sensory and motor signals to and from the cortex. The hypothalamus
regulates many basic functions such as body temperature, thirst, hunger, sleep, and
hormone production. The hypothalamus also has specific nuclei for the autonomic
nervous system. The autonomic nervous system is important in regulating many
basic involuntary functions such as digestion and dealing with stress. The pituitary
gland is a small, pea-shaped gland that is located within a depression in the
sphenoid bone called the sella turcica described earlier in the skull exercise. It is
directly connected to the hypothalamus. It is often referred to as the master gland
because it secretes many hormones. Hormones act as chemical messengers that
play a role in regulating homeostasis of many bodily functions such as body
temperature, blood pressure, growth and development, reproduction, electrolyte
balance, and water regulation. All of the pituitary’s actions are governed by the
hypothalamus.
The brainstem consists of the midbrain, pons, and medulla oblongata. The
midbrain contains specific nuclei important for arousal because of its connection with
the reticular activating system (RAS). It produces dopamine, which is an
important neurotransmitter for movement control. The pons functions as a bridge
from the cortex to the cerebellum. Additional functions of the pons are related to
posture, sleep, hearing, balance, taste, eye movements, facial expression, facial
sensation, and respiration. This is because many of the cranial nerves that control
the above functions originate here. The medulla oblongata contains specific nuclei
that control cardiac functions. When stimulated by the sympathetic nervous system,
the medulla triggers neurons that increase blood pressure, heart rate, and increase
the heart muscle’s force of contraction. It can also decrease heart rate and force of
contraction when stimulated by the parasympathetic nervous system. The medulla
also has nuclei that form the primary respiratory centers. These control both the rate
and depth of breathing. The spinal cord is just inferior to the medulla oblongata.
The spinal cord functions as a collection of ascending and descending neuronal tracts
that allows the brain and the body to communicate. The spinal cord’s functions will
be covered in greater detail later in this laboratory.
The cerebellum (Greek translation: “little brain”) is the large round structure
posterior to the brainstem. The gray and white matter resembles a leaf (arbor vitae,
Greek translation: “tree of life”). This area integrates input from various areas of the
brain and spinal cord. This integration is critical for the timing of learned movements.
In short, it is critical for balance and coordination.
The autonomic nervous system (ANS) is a subdivision of the peripheral nervous
system. The ANS regulates the function of internal organs (viscera). These include
involuntary functions, such as the regulation of blood pressure, bowel, and bladder
functions. The ANS can be divided into two major divisions. The sympathetic
nervous system (SNS) is responsible for the fight-or-flight reaction in response to
stress. When the SNS is activated due to an external or internal stressor, the body
will down-regulate functions relating to maintenance and repair, such as the
digestive and urinary systems. Blood will be preferentially shunted away from the
organs of the gut toward the larger muscle groups, heart, and brain. The
parasympathetic nervous system (PNS), aka cranial sacral system, is
important for all things associated with recovery and restoration such as resting and
digesting food. It enhances the enteric nervous system, whose primary role is
digestion. The PNS influences the SNS to shift the body’s blood away from skeletal
muscles toward the mesenteric vessels, which supply the intestines and allow for
absorption of nutrients for digestion. Blood flow to the kidneys is also increased,
which is necessary for blood filtration and formation of urine.
S PINAL C ORD AND M ENINGES R EVIEW
The spinal cord extends off of the brainstem and exits from the cranial cavity via
the foramen magnum at the base of the occipital bone. The spinal cord’s primary
function is to communicate information in the form of impulses to and from the
brain. Ascending tracts send information from peripheral nerves to the brain,
allowing for sensory perception. The brain controls various bodily functions through
impulses sent down descending tracts. Descending tracts target muscles, glands, and
organs. The tracts will be covered in greater detail in future labs.
Find the vertebral foramen (spinal canal). Recall from a previous lab that this was
the opening within the vertebra for the spinal cord. Observe the model and orient
yourself to the anterior and posterior side.
Name an anatomical structure of the vertebra that would be found anterior to the
spinal cord.
______________________________________ Posterior:
______________________________________
Identify the epidural space. This is the outermost layer of the spinal canal. This
area contains fatty tissue, blood vessels, and lymphatic vessels. Moving centrally,
identify the three meningeal layers (dura mater, arachnoid mater, and pia
mater). The outermost meningeal layer (dura mater) is located just deep to the
epidural space and is continuous with the epineurium of the peripheral nerves. The
middle meningeal layer (arachnoid mater) creates the outermost border of the
subarachnoid space, which is located between the pia and arachnoid layers. The
cerebrospinal fluid circulates within this space. Locate the pia mater, which is in
direct contact with the spinal cord.
The cross section of the spinal cord reveals two distinct regions. The gray matter is
a butterfly-shaped structure in the center of the spinal cord. The outer white matter
is composed of the various ascending and descending tracts (myelinated axons) of
the spinal cord. The gray matter has both a posterior (dorsal) horn and an anterior
(ventral) horn bilaterally. Sensory neurons enter to the dorsal horn via the dorsal
roots of the peripheral nerves. Follow the dorsal roots laterally and identify the
dorsal root ganglion. This area of enlargement contains the cell bodies of the
sensory neurons. Motor neurons originate in the ventral horns of the spinal cord.
They exit via ventral roots before they combine with the dorsal roots to form a
spinal nerve. The spinal nerve projects to their target organs, glands, or muscles.
Interneurons are small neurons located in the gray matter. These neurons are
important for coordinating opposing muscle groups.
Clinical application: An epidural nerve block is a medical procedure in which a needle
is inserted into the epidural space to deliver medication to reduce inflammation
around a nerve or block the transmission of pain. Lumbar punctures are a medical
procedure in which a needle is introduced into the subarachnoid space to remove
cerebral spinal fluid. This is done to look for the presence of bacterial infections and
diagnosing diseases that affect the central nervous system, such as multiple
sclerosis.
The brain and spinal cord are covered by three layers collectively known as the
meninges (dura mater, arachnoid mater, and pia mater) (Figure 9.1). The dura
mater (Greek translation: tough mother) is the outermost meningeal layer that
protects both the brain and spinal cord. This layer lines the cranial cavity and the
inside of the vertebral foramen. Cranial dura mater contains various sinuses which
are important structures that collect venous blood from the brain and eliminate
excessive cerebral spinal fluid from its circulation. The middle meningeal layer is the
arachnoid mater, named because it resembles a spider web. It is a thin, transparent
membrane that cushions the central nervous system. The pia mater is located just
beneath this layer. It is in direct contact with the outer cortex. The subarachnoid
space is located between the pia and arachnoid layers. It contains the cerebral blood
vessels and circulating cerebrospinal fluid. This fluid-filled space protects the brain
and spinal cord from trauma and is necessary for regulating cerebral functions such
as blood flow distribution, nutrient and waste product regulation. The choroid
plexus in the brain’s ventricles contributes to some of the cerebral spinal fluid
production.
The cerebral cortex contains the brain’s gray matter. This area of the brain is
composed mostly of neuronal dendrites, cell bodies, and synapses. Cortical impulses
such as voluntary movement originate from the cortex, while sensory perception will
terminate here. The white matter represents the axons of the neurons. The white
appearance is due to the presence of myelin.
Clinical application: Meningitis (inflammation of the meninges) can be a lifethreatening problem. It is often a viral or bacterial infection. The inflammation can
put a tremendous amount of pressure on both the brain and spinal cord. The most
common symptoms include headache, neck stiffness, fever, and altered
consciousness.
There are also several types of bleeding injuries that can occur involving the
meninges. A subdural hemorrhage is a bleed that accumulates underneath the dura
mater. Important veins can be damaged resulting in a slow bleed. This may account
for the gradual onset of symptoms. Both epidural bleeds (blood accumulating
between the dura mater and the skull) and subarachnoid bleeds (blood accumulating
within the subarachnoid space) are arterial in nature. The arterial system blood
pressure is much higher resulting in greater blood loss following injury to these
vessels. A person would experience symptoms such as a severe headache and rapid
loss of consciousness, which would occur almost immediately.
S PINAL C ORD AND M ENINGES R EVIEW
The spinal cord extends off of the brainstem and exits from the cranial cavity via
the foramen magnum at the base of the occipital bone. The spinal cord’s primary
function is to communicate information in the form of impulses to and from the
brain. Ascending tracts send information from peripheral nerves to the brain,
allowing for sensory perception. The brain controls various bodily functions through
impulses sent down descending tracts. Descending tracts target muscles, glands, and
organs. The tracts will be covered in greater detail in future labs.
Find the vertebral foramen (spinal canal). Recall from a previous lab that this was
the opening within the vertebra for the spinal cord. Observe the model and orient
yourself to the anterior and posterior side.
Name an anatomical structure of the vertebra that would be found anterior to the
spinal cord.
______________________________________ Posterior:
______________________________________
Identify the epidural space. This is the outermost layer of the spinal canal. This
area contains fatty tissue, blood vessels, and lymphatic vessels. Moving centrally,
identify the three meningeal layers (dura mater, arachnoid mater, and pia
mater). The outermost meningeal layer (dura mater) is located just deep to the
epidural space and is continuous with the epineurium of the peripheral nerves. The
middle meningeal layer (arachnoid mater) creates the outermost border of the
subarachnoid space, which is located between the pia and arachnoid layers. The
cerebrospinal fluid circulates within this space. Locate the pia mater, which is in
direct contact with the spinal cord.
The cross section of the spinal cord reveals two distinct regions. The gray matter is
a butterfly-shaped structure in the center of the spinal cord. The outer white matter
is composed of the various ascending and descending tracts (myelinated axons) of
the spinal cord. The gray matter has both a posterior (dorsal) horn and an anterior
(ventral) horn bilaterally. Sensory neurons enter to the dorsal horn via the dorsal
roots of the peripheral nerves. Follow the dorsal roots laterally and identify the
dorsal root ganglion. This area of enlargement contains the cell bodies of the
sensory neurons. Motor neurons originate in the ventral horns of the spinal cord.
They exit via ventral roots before they combine with the dorsal roots to form a
spinal nerve. The spinal nerve projects to their target organs, glands, or muscles.
Interneurons are small neurons located in the gray matter. These neurons are
important for coordinating opposing muscle groups.
Clinical application: An epidural nerve block is a medical procedure in which a needle
is inserted into the epidural space to deliver medication to reduce inflammation
around a nerve or block the transmission of pain. Lumbar punctures are a medical
procedure in which a needle is introduced into the subarachnoid space to remove
cerebral spinal fluid. This is done to look for the presence of bacterial infections and
diagnosing diseases that affect the central nervous system, such as multiple
sclerosis.
The brain and spinal cord are covered by three layers collectively known as the
meninges (dura mater, arachnoid mater, and pia mater) (Figure 9.1). The dura
mater (Greek translation: tough mother) is the outermost meningeal layer that
protects both the brain and spinal cord. This layer lines the cranial cavity and the
inside of the vertebral foramen. Cranial dura mater contains various sinuses which
are important structures that collect venous blood from the brain and eliminate
excessive cerebral spinal fluid from its circulation. The middle meningeal layer is the
arachnoid mater, named because it resembles a spider web. It is a thin, transparent
membrane that cushions the central nervous system. The pia mater is located just
beneath this layer. It is in direct contact with the outer cortex. The subarachnoid
space is located between the pia and arachnoid layers. It contains the cerebral blood
vessels and circulating cerebrospinal fluid. This fluid-filled space protects the brain
and spinal cord from trauma and is necessary for regulating cerebral functions such
as blood flow distribution, nutrient and waste product regulation. The choroid
plexus in the brain’s ventricles contributes to some of the cerebral spinal fluid
production.
The cerebral cortex contains the brain’s gray matter. This area of the brain is
composed mostly of neuronal dendrites, cell bodies, and synapses. Cortical impulses
such as voluntary movement originate from the cortex, while sensory perception will
terminate here. The white matter represents the axons of the neurons. The white
appearance is due to the presence of myelin.
Clinical application: Meningitis (inflammation of the meninges) can be a lifethreatening problem. It is often a viral or bacterial infection. The inflammation can
put a tremendous amount of pressure on both the brain and spinal cord. The most
common symptoms include headache, neck stiffness, fever, and altered
consciousness.
There are also several types of bleeding injuries that can occur involving the
meninges. A subdural hemorrhage is a bleed that accumulates underneath the dura
mater. Important veins can be damaged resulting in a slow bleed. This may account
for the gradual onset of symptoms. Both epidural bleeds (blood accumulating
between the dura mater and the skull) and subarachnoid bleeds (blood accumulating
within the subarachnoid space) are arterial in nature. The arterial system blood
pressure is much higher resulting in greater blood loss following injury to these
vessels. A person would experience symptoms such as a severe headache and rapid
loss of consciousness, which would occur almost immediately.
C RANIAL N ERVES
The cranial nerves are considered part of the peripheral nervous system. They
control a variety of motor and sensory functions of the head and neck (Figure 9.6).
These include hearing, vision, facial sensation, muscles of mastication, and facial
expression. They also control numerous autonomic functions including the regulation
of digestion, blood pressure, heart rate, and urinary functions. Unlike nerves
projecting from upper cortical areas that control the opposite side of the body,
cranial nerves innervate the same side that they originate from. Refer to your
textbook for a more detailed description of the function of the cranial nerves.
Clinical application: It is critical for health care providers to familiarize themselves
with the 12 cranial nerves’ general functions. Health care practitioners such as EMT
first responders will test these cranial nerves because it gives them important insight
to a person’s current neurological status. Recall that most of the cranial nerves are
originating off the brainstem and exit the base of the skull through the various
foramina. Any trauma to the skull could cause an intracranial bleed. The bleed would
put pressure on the brain, compressing the cranial nerves in the base of the skull.
When nerves are compressed they can’t conduct their action potentials. This might
present as either paralysis or loss of sensation to innervated areas. In short, any
condition that puts pressure on the brain (i.e., stroke, tumor, or bleed) will affect the
cranial nerves. It is important for a practitioner to understand the origins of the
various cranial nerves. If a specific cranial nerve is dysfunctional this gives insight to
where pressure is originating.
Watch the Following videos and answer the following questions.
Acland Videos:
• 4.7.1 Brain: initial overview (0:44)
• 4.7.9 Cerebrum (4:00)
1. Which parts of the brain occupy the posterior cranial fossa?
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
2. The falx cerebre contains which anatomical structure?
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
3. What are the 3 layers of the meninges? Describe their
relationship to each other.
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
4. Name a major artery lining the outside of the dura mater.
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
Acland Videos:
•
•
•
•
4.7.6 Medulla, fourth ventricle (4:48)
4.7.7 Midbrain, cerebral peduncles (2:33)
4.7.8 Cerebellum (1:41)
4.7.10 Lateral and third ventricles, underside of the cerebrum (4:02)
4.7.11 Review of brainstem, cerebellum, cerebrum (2:29)
1. What are the main ventricles of the brain?
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
2. Which anatomical structures make up the brainstem?
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
3. Which part of the brain is superior to the pons?
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
4. What are the main functions of the cerebellum?
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
5. Which anatomical structure connects the 2 cerebral hemispheres?
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
6. What does the lateral sulcus separate?
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
7. What does the central sulcus separate?
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
A NATOMY OF THE MENINGES AND S PINAL C ORD
•
•
•
•
•
4.7.2
4.7.3
4.7.4
4.7.5
3.1.8
Lining of cranial cavity, falx, tentorium (3:02)
The meningeal layers: dura, arachnoid, pia (3:45)
Lining of middle cranial fossa (0:53)
Review of cranial cavity and meninges (1:31)
Spinal cord (cross section), spinal meninges, dural sac (3:11)
3.1.9 Spinal cord (from behind), nerve roots (4:22)
1. What level does the spinal cord terminate?
__________________________________________________________________________
__________________________________________________________________________
2. Describe the difference between the dorsal and ventral roots.
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
3. The nerve roots exit the vertebral canal through which anatomical
structure?
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
4. What is the difference between the posterior and anterior primary ramus?
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
5. How are cervical vertebra named? How does this change in the thoracic
region. (why)
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
The Nerves of the Head and Neck
• 4.8.9 Review of first six cranial nerves (1:40)
• 4.8.11 The last four cranial nerves (cranial nerves IX, X, XI, XII) in
the cranium (2:50)
• 4.8.14 Sympathetic trunk, cervical plexus (2:27)
• 4.8.15 Review of last six cranial nerves (1:28)
1. List the 12 cranial nerves and describe their general functions.
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
K EY S TRUCTURES OF THE B RAIN A ND S PINAL C ORD
Central Nervous
System Anatomy
Cerebral
Cortex/Autonomic
Terms
Inner/Inferior
Brain Structures
Meninges
Frontal lobe
Pineal gland
• Dura mater
• Olfactory association area
Brainstem
• Arachnoid mater
• Prefrontal cortex
• Midbrain
• Subarachnoid space
• Primary motor cortex
• Pia mater
•
Precentral gyrus
•
Reticular Activating System
(RAS)
Choroid plexus
Cerebrum
• Gray matter
• Sulci
• Broca’s area
• Pons
Insula
• Medulla oblongata
Parietal lobe
Thalamus
• Central sulcus
• Primary sensory cortex
• Fissures
•
Postcentral gyrus
• Longitudinal fissure
• White matter
Epidural space
Spinal cord
• Dorsal horn
• Ventral horn
• Dorsal root
• Ventral roots
Hypothalamus
Pituitary gland
Cerebellum
Occipital lobe
• Arbor vitae
• Primary visual cortex
Cranial nerves
Temporal lobe
• Olfactory (I)
• Primary auditory cortex
• Optic (II)
• Wernicke’s area
• Auditory association area
• Oculomotor (III)
• Trochlear (IV)
• Trigeminal (V)
• Abducens (VI)
• Facial (VII)
•
Vestibulocochlear (VIII)
•
Glossopharyngeal (IX)
• Vagus (X)
• Spinal Accessory (XI)
• Hypoglossal (XII)
CLINICAL CASE STUDIES
1. Critical thinking question: A person is admitted to the hospital with complaints of
a severe headache and double vision. An X-ray revealed a mass within the sella
turcica. What structure sits within this area?
_________________________________________________________________
_________________________________________________________________
Examine both the brain and cranial fossa anatomy to explain this person’s
symptomology.
_________________________________________________________________
_________________________________________________________________
_________________________________________________________________
_________________________________________________________________
_________________________________________________________________
_________________________________________________________________
_________________________________________________________________
_________________________________________________________________
_________________________________________________________________
_________________________________________________________________
_________________________________________________________________
_________________________________________________________________
_________________________________________________________________
_________________________________________________________________
2. A patient is admitted to the hospital with a traumatic brain injury. He is
conscious, but has paralysis on the left side of his face. He also has difficulty
standing on 1 foot with constant ringing in his ears. What cranial nerves may
have been involved in the injury? (Explain.) ______________________________
_________________________________________________________________
_________________________________________________________________
_________________________________________________________________
_________________________________________________________________
_________________________________________________________________
_________________________________________________________________
_________________________________________________________________
_________________________________________________________________
_________________________________________________________________
_________________________________________________________________
_________________________________________________________________
_________________________________________________________________
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