Guide to Using This Book

Neuroanatomy: Text and Atlas takes a combined regional and functional approach to teaching neuroanatomy: Knowledge of the spatial interrelations and connections between brain regions is developed in relation to the functions of the brain’s various components. The book first introduces the major concepts of central nervous system organization. Subsequent chapters consider neural systems subserving particular sensory, motor, and integrative functions. At the end of the book is an atlas of surface anatomy of the brain and myelin-stained histological sections, and a glossary of key terms and structures.

Each chapter begins with a clinical case to illustrate the connections and function of the key material. There are key questions in the case that the reader can answer based primarily on the chapter readings, but also on prior chapter material. Chapters also end with a series of multiple choice review questions. Answers both to the case and review questions are at the back of the book. Material on central nervous system development is included in the relevant individual chapters.

The general structural organization of the mature central nervous system is surveyed in Chapter 1. This chapter also introduces neuroanatomical nomenclature and fundamental histological and imaging techniques for studying brain structure and function. The three-dimensional shapes of key deep structures are also considered in this chapter. The functional organization of the central nervous system is introduced in Chapter 2. This chapter considers how different neural circuits, spanning the entire central nervous system, serve particular functions. The circuits for touch perception and voluntary movement control are used as examples. The major neurotransmitter systems are also discussed.

Central nervous system vasculature and cerebrospinal fluid are the topics of Chapter 3. By considering vasculature early in the book, the reader can better understand why particular functions can become profoundly disturbed when brain regions are deprived of nourishment. These three chapters are intended to provide a synthesis of the basic concepts of the structure of the central nervous system and its functional architecture. A fundamental neuroanatomical vocabulary is also established in these chapters.

The remaining 13 chapters examine the major functional neural systems: sensory, motor, and integrative. These chapters reexamine the views of the surface and internal structures of the central nervous system presented in the introductory chapters, but now from the perspective of the different functional neural systems. As these latter chapters on functional brain architecture unfold, the reader gradually builds a neuroanatomical knowledge of the regional and functional organization of the spinal cord and brain, one system at a time.

These chapters on neural systems have a different organization from that of the introductory chapters: Each is divided into two parts, functional and regional neuroanatomy. The initial part, on functional neuroanatomy, considers how the brain regions that comprise the particular neural system work together to produce their intended functions. This part of the chapter presents an overall view of function in relation to structure before considering the detailed anatomical organization of the neural system. Together with descriptions of the functions of the various components, diagrams illustrate each system’s anatomical organization, including key connections that help to show how the particular system accomplishes its tasks. Neural circuits that run through various divisions of the brain are depicted in a standardized format: Representations of myelin-stained sections through selected levels of the spinal cord and brain stem are presented with the neural circuit superimposed.

Regional neuroanatomy is emphasized in the latter part of the chapter. Here, structures are depicted on myelin-stained histological sections through the brain, as well as magnetic resonance images (MRIs). These sections reveal the locations of major pathways and neuronal integrative regions. Typically, this part examines a sequence of myelin-stained sections ordered according to the flow of information processing in the system. For example, coverage of regional anatomy of the auditory system begins with the ear, where sounds are received and initially processed, and ends with the cerebral cortex, where our perceptions are formulated. In keeping with the overall theme of the book, the relation between the structure and the function of discrete brain regions is emphasized.

Emphasis is placed on the close relationship between neuroanatomy and neuroradiology especially through use of MRI scans. These scans are intended to facilitate the transition from learning the actual structure of the brain, as revealed by histological sections, to that which is depicted on radiological images. This is important in learning to “read” the scans, an important clinical skill. MRI scans are presented either using the radiological convention of showing the ventral surface of the brain up or, when the focus is learning detailed regional anatomy, showing the ventral surface down together with corresponding myelin-stained sections. It should be recognized that there is no substitute for actual stained brain sections for developing an understanding of regional anatomy and localization of function. This is because current MRI resolution is not sufficient to reveal the breadth of brain and spinal cord structures whose functions need to be considered.

This book’s atlas, in two parts, offers a complete reference of anatomical structure. The first part presents key views of the surface anatomy of the central nervous system. This collection of drawings is based on actual specimens but emphasizes common features. Thus, no single brain has precisely the form illustrated in the atlas. The second part of the atlas presents a complete set of photographs of myelin-stained sections through the central nervous system in three anatomical planes.

With few exceptions, the same surface views and histological sections used in the atlas are also present in the chapters. In this way, the reader does not have to cope with anatomical variability and is thus better able to develop a thorough understanding of a limited, and sufficiently complete, set of materials. Moreover, brain views and histological sections shown in the chapters have identified only the key structures and those important for the topics discussed. In the atlas, all illustrations are comprehensively labeled as a reference. The atlas also serves as a useful guide during a neuroanatomy laboratory.

Selected topics that complement material covered in the chapters are presented in boxes. In many of the boxes, a new perspective on neuroanatomy is presented, one that has emerged only recently from research. The neuroscience community is enthusiastic that many of these new perspectives may help explain changes in brain function that occur following brain trauma or may be used to repair the damaged nervous system.

Each chapter begins with a clinical case, chosen to highlight a fascinating clinical feature of the neural system discussed in the chapter. Whereas some of these cases are rare and not apt to be seen in routine medical practice, they show how perception, motor behavior, or personality and emotions can change after a stroke or tumor damages the brain, or how brain structure and function change after a particular gene mutation. The case description is followed by an explanation of what structures and neural systems are damaged that produce the neurological signs. Questions are posed that can be answered on the basis of reading the case explanations and the chapter text. Detailed answers are provided at the end of the book.

Each chapter ends with a set of study questions. Answers are provided at the end of the book. A brief explanation of the more integrative and difficult questions also is provided.

The glossary contains a listing of key terms and structures. Typically, these terms are printed in boldface within the chapters. Key terms are defined briefly in the context of their usage in the chapters. Key structures are identified by location and function.

This book offers three features that can be used as aids in learning neuroanatomy initially, as well as in reviewing for examinations, including professional competency exams:

• Summaries at the end of each chapter, which present concise descriptions of key structures in relation to their functions.

• A glossary of key terms.

• The atlas of key brain views and myelin-stained histological sections, which juxtapose unlabeled and labeled views. The unlabeled image can also be used for self-testing, such as for structure identification.

These study aids are designed to help the reader assimilate efficiently and quickly the extraordinary amount of detail required to develop a thorough knowledge of human neuroanatomy.