Kluver-Bucy Syndrome.ppt affecting cerebral cortex

Kluver-Bucy Syndrome.ppt affecting cerebral cortex

1. DR NILESH KATE
MBBS,MD
ASSOCIATE PROF
ESIC MEDICAL COLLEGE, GULBARGA.
DEPT. OF PHYSIOLOGY
CEREBRAL CORTEX.

2. OBJECTIVES
•Cerebral cortex
•External features.
•Functional areas.
•Lobes.
•Connections , functions & applied.
•White matter of cerebrum.
•Association Fibres.
•Commissural
•Projection.
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3. Cerebral cortex
External features.
Cortical functional areas.
Phylogenetical division of cerebral
cortex.
Histological structure.
Areas , connections, functions &
applied aspects.
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4. External features.
•Poles.—
•Frontal
•Occipital
•Temporal.
•Surfaces
•Superolateral
•Medial
•Inferior.
•Borders.
•Superomedial
•Inferolateral
•Medial.
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5. CEREBRAL CORTEX
Sulci & Gyri.
Surface area of cortex–2200cm
2
Lobes of cerebral hemispheres.
Frontal –Motor.
Parietal –Sensory.
Temporal –Auditory.
Occipital –Vision.
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6. Cortical functional areas.
(Brodmann areas—47)
Motor area
•Primary motor area. (4)
•Premotor area. (6)
•Frontal eye field. (8)
•Supplementary motor area.
Sensory area
•Primary somaesthetic areas.
(3,1,2)
•Secondary somaesthetic areas.
•Somaesthetic association areas.
(5,7 & 40)
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7. Cortical functional areas.
(Brodmann areas—47)
Auditory area
•Primary auditory area. (41)
•Auditory association area. (42).
•Higher auditory association
area. (22)
Visual area.
•Primary visual area. Or
Visuostriate area.(17)
•Visual association area. Or
Peristriate area.(18)
•Visual association area. Or
Perastriate area.(19)
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8. Cortical functional areas.
(Brodmann areas—47)
Speech area
•Motor speech.
•Anterior area (44,45)
•Superior area.
•Sensory speech.
•Reading centre.(39)
•Area 40.
•Wernicke’s area. (22)
Smell & Gustatory area.•Area 28.
•Area 43.
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9. Wednesday, July 31, 2024

10. Wednesday, July 31, 2024

11. Phylogenetical division of cerebral cortex.
•Allocortex–10 % (also called Limbic Cortex)
•Archipallium –hippocampus & Dentate Gyrus.
•Paleopallium –Uncus & part of Parahippocampal gyrus.
•Mesocortex. –transitional zone.
•Neocortex. –Isocortex
•Rest of 90% of cerebral cortex.
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12. Histological structure.
•Cells
•Pyramidal cells. (2/3
rd
)
•Stellate cells or Granule cells.
(1/3
rd
)
•Fusiform cells.
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13. Histological structure.
•Laminae.
•Molecular / plexiform layer.
•Transverse nerve fibre –
apical dendrite of pyramidal
cells
•Horizontal cells. –CAJAL
•External granular layer.
•Granule cells & Pyramidal
cells
•Dendrite –to Molecular
layer.
•Axons –to deeper layer.
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14. Laminae.
•Outer pyramidal layer.
•Mainly pyramidal cells,
stellate cells & basket cells.
•Inner granular layer.
•Densely packed stellate
cells.
•Inner zone prominent
transverse fibres.” External
Band of Baillarger.
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15. Laminae.
•Inner pyramidal layer.
(Ganglionic)
•Large pyramidal cells.
•Developed in motor cortex.
•Inner Band of Baillarger.
•Polymorphous or
multiform layer.
•Modified pyramidal cells.
•Many fusiform cells.
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16. Types of Neocortex.
•Type I or agranular cortex.
•Granule cells & stellate cells
absent.
•Pyramidal cells –large, Betz cells.
•Seen in Motor cortex (4) & Broca’s
area. (44)
•Type II or frontal cortex.
•Triangular granular cells
•Seen in frontal lobe.
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17. Types of Neocortex.
•Type III or Parietal cortex.
•Depth & density of layer II & III
increased.
•Granule cells –round.
•Seen in parietal lobe & junction of
parietal, temporal & occipital lobe.
•Type IV or Polar Type.
•Cortex narrow
•All layers reduced depth.
•Seen in frontal & occipital pole.
•Type V or granular cortex.
•Excess granule cells
•Seen in sensory cortex & calcarine
region.
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18. Areas.
•Frontal lobe
•Parietal lobe
•Temporal lobe
•Occipital lobe.
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19. Frontal lobe.
•Precentral cortex.
•Also called Excitomotor area of
cortex.
•Stimulation causes activity in
discrete skeletal muscles
•Sensorimotor cortex.—sensory &
motor cortex.
•Prefrontal cortex.
•Also called prefrontal lobe or
Orbitofrontal cortex.
•Ant to area 8 & 44.
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20. Precentral cortex.
Areas.
•Primary motor area. (area 4) ,
Area 45
•Premotor area.
•Area 6
•Area 8
•Area 44 & 45 or Broca’s
motor speech area.
•Supplementary motor area.
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21. Primary Motor Area (4)
•Extent–from Precentral gyrus
to Paracentral lobule on medial
surface.
•Characteristics–
•6 layers of cortex.
•Giant pyramidal cells (Betz cells)
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22. Topographic Representation.
•Contra lateral half of body in
inverted order.
•Part of body for skilled movements
–larger area.
•Body represented upside down.
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23. Wednesday, July 31, 2024

24. Primary Motor Area (4)
•Electrical stimulation.–Motor
homunculus.
•Motor cortex organized in terms of
movements.
•Stimulation of points of face,
pharynx & vocal cords –bilateral
response.
•Functions –Centre for volition.
i.e. initiation of movements &
speech.
•Area 45–suppressor area.
•Inhibits movements initiated by
area 4.
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25. Sensory Homunculi Motor Homunculi.

26. Premotor area.
(6,8,44,45)
area 6
•Structurally similar except Giant
Pyramidal Cells.
•2 parts –Upper 2a, Lower 2b.
•Topographical representation –
same.
•Functions –Integration of
voluntary movements. Make
skilled movements accurate &
smooth.
•Lesions –Hemiplegia with Spastic
paralysis.
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27. Area 8
•Frontal Eye field.
•Location –ant to area 6.
•Function –control eye movements.
•Lesions –turn eye to opposite side.
•Conjugate movements --lost
•Afferent–occipital lobe &
Dorsomedial N. of Thalamus.
•Efferents–N. of III, IV & VI
Cranial nerves.
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28. Area 44 & 45.
•Broca’s motor speech area.
•Area44–pars Triangularis.
•Area 45 –pars Opercularis.
•Functions–in Dominant
Hemisphere concerned with
movements responsible for
production of voice &
articulation of speech.
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29. Supplementary Motor Area.
•Locations–medial surface of
frontal lobe behind primary
motor area.
•Topographical representation.–
upper body located dorsal to
lower body.
•Functions–with Premotor area
provide attitudinal movements.,
fixational movements &
positional movements of head
& eye.
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30. Connections of pre central cortex.
Afferents
Precentral
cortex.
Adjacent
region.
Opposite
side corpus
callosum.
Thalamus.
VL & VA.
Efferents.
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CORTEX.
Extra
pyramidal
ADJACENT
AREA
Brain Stem
RBR-VIP
Pyramidal tract.
Spinal cord.
Anterior horn
cells.

31. Prefrontal cortex.
•Major areas. (9-14, 23,24,29,32,
44-47.
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32. Prefrontal cortex.
•Afferents
•Dorsomedial nucleus of
thalamus.
•Anterior nuclei of thalamus.
•Form Papez circuit–close
circuit connection with
thalamus.
•Responsible for resting EEG
& genesis of Emotions.
•Efferents
•Thalamus. (V &M)
•Tegmental reticular formation.
•Pontine nuclei
•Caudate nucleus.
•Mammilary bodies.
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33. Functions.
•Centre of planned actions
•Centre for higher functions.
•Emotions, learning, memory & social
behaviour.
•Causes autonomic changes during
emotional conditions
•Seat of intelligence.
•Register short term memory
•Called An organ of mind.
•Control of intellectual activities.
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34. Control of Intellectual Activities.
•To prognosticate.
•Plan future.
•Concentrate –Central theme of
thought.
•Delay actions in response to
sensory signals.
•Consequences of motor action
before it.
•Solution of complicated
mathematical & philosophical
problems.
•Controls one’s activity according
to moral laws.
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35. Applied aspects.
Frontal lobe syndrome.
•Cause–ablation of prefrontal
cortex.
•Features. (FEEL –FILL)
•Flight of ideas.
•Emotional instability.
•Euphoria.
•Loss of moral & social sense.
•Functional abnormal—
•Hyperphagia.
•Sphincters control loss.
•Disorientation & tremors.
•Impairment of memory.
•Lack of attention &
concentration.
•Lack of initiative & decreased
intellectual activity.
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36. Parietal lobe
•Primary sensory area. (3,1,& 2)
•Secondary sensory area.
•Sensory association areas. (5, 7)
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37. Primary sensory area. (3,1,& 2)
•Location–Post central Gyrus &
Post wall of Central sulcus.
•Histo–dense stellate cells , few
pyramidal cells.
•Topographical representations.
–Sensory Homunculus.
•Lesion–without thalamus only
discriminative functions lost
•With thalamus –all sensation
from opp half of body.
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38. Secondary sensory area.
•Location–post central Gyrus
below 1
st
somatic sensory area.
•Topographical representation–
body represented twice in area I &
area II.
•Lesion –discriminative power lost.
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39. Sensory Association Areas. (5, 7)
•Post to area S1.
•Point to point representation.
•Lesion –Tactile Agnosia.
(Asteriognosis & Tactile Aphasia)
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40. Connections of Parietal Lobe
•Afferents.
•SI –Thalamus (VPM,VPL)
Exteroceptive & Proprioceptive from
opp side & both sides of face.
•SII –from SI & thalamus
•Sensory Association area. –SI & SII
•Efferents.
•Corticospinal
•Corticobulbar
•Corticonuclear tracts.
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41. Connections of Parietal Lobe
•Association fibres.
•To other cortical areas.
•Involve in somatic sensation.
•Commissural fibres.
•Mostly pyramidal cells connect
to opp hemisphere.
•Opp area SI & SII
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42. Functions of Parietal Lobe
•First somatic sensory area. (SI)
•Localize, analyze & Discriminate Cutaneous & Proprioceptive senses.
•Area 3 –touch, pressure, position & vibrations.
•Area 1 –Cutaneous & joint sense.
•Area 2 –deep sense from muscles & joints.
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43. Parietal Lobe
•Second somatic sensory area. (SII)
•From S1 & thalamus directly.
•Perception of sensation.
•Sensory association area. (5,7)
•Discriminate stimuli related to intensity.
•Warm, warmer, cold, colder
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44. Temporal lobe.
Primary auditory area.
•41, 42 Audio sensory Area.
•HEARING CENTRE.
•Middle of superior temporal
gyrus.
•From –MGB, Thalamus.
•To –MGB, Superior colliculus.
•Perceives –loudness, pitch,
source & direction of sound.
Auditory association area
•22,21 & 20
•22-Wernicke's area, also called
sensory speech area in dominant
hemisphere.
•Interpretation of meaning,
comprehension of spoken language
& formation of ideas.
•21,20 –interpretation & integration
of auditory impulses.
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45. AppliedAspects
•Unilateral removal of temporal
lobe
•Causes no deafness
•As ear bilaterally represented in
auditory pathway & project
equally to 2 cerebral
hemispheres.
•Temporal lobe syndrome.
(Kluver-Bucy syndrome)
•Bilateral removal of temporal lobe
with amygdala & Uncus.
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46. Temporal lobe syndrome. (Kluver-Bucy
syndrome)
•Features. (HHH-VADIA)
•Hyperphagia & omniphagia.
•Hyper sexuality.
•Hyper metamorphosis.
•Visual Agnosia.
•Aphasia.
•Dreaming states.
•Increased oral activity.
•Auditory disturbances.
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47. Occipital lobe
•Primary visual cortex. (17)
•Visual association area. (18)
•Visual association area or
occipital eye field. (19)
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48. Connections & functions.
•Afferents.
•LGB via optic radiations.
•Efferents.
•Frontal eye field for eye movements.
•Superior colliculus.
•Cortico geniculate projections.
•Thalamus.
•Functions
•Area 17–perception of visual impulses.
•Area 18, 19 –interpretation , recognition
& identification from memory.
•occipital eye field area.–movement of
eye ball.
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49. White matter of cerebrum.
•Association fibres.
•Commissural fibres.
•Projection fibres.
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50. Association fibres.
•Short.
•Between adjacent Gyri.
•Long.
•Superior longitudinal fasciculus.
•Inferior longitudinal fasciculus.
•Cingulum.
•Fronto-occipital fasciculus.
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51. Commissural fibres.
•Corpus callosum.
•Anterior commissure.
•Posterior commissure.
•Habenular commissure.
•Hippocampal commissure.
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52. Projection fibres.
•Afferents.
•Thalamic radiations
•Anterior.
•Posterior.
•Superior.
•Inferior.
•Efferents.
•Corticobulbar & corticospinal
tract.
•Cortico pontine
•Cortico Rubral
•Cortico Thalamic.
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53. Internal capsule
•Thick curved band.
•Fans out up as corona radiata
& down as crus cerebri.
•Most common part of Infarction
& Hemorrhage.
•Most common artery –Striate
branch of middle cerebral artery
so called Artery of cerebral
hemorrhage of Charcot’s
artery.
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54. Thank
You