Pembimbing:

Dr Agus Yuda Wijaya

Sp.S
Oleh :
Hendra Utomo Mudito
Sinaga

 It is the largest part of the

forebrain.
It is highly developed in
human.
It is derived from the
telencephalon.
The 2 cerebral
hemisphere are
incompletely separated by
the median or greater
longitudinal fissure.
They are connected by
the corpus callosum.
Each hemisphere has a
cavity called the lateral
ventricle.

CEREBRUM

Each hemisphere has

3 surfaces,
3 poles,
4 borders,
4 Lobes.
Surfaces:

Lateral or
superolateral:

Convex and related to

the skull vault.

Medial:
Flat & vertical and
related to the falx
cerebri & median

longitudinal fissure.
Inferior:
Divided into orbital and
tentorial parts by the
stem of lateral sulcus.

CEREBRUM :
SURFACES

 Four borders:
1- Medial or
Superomedial
border:
border Between
lateral & medial
surfaces.
2- Inferolateral
border: Between
lateral & inferior
surfaces.
Its anterior part
may be called
superciliary border.
3- Medial orbital
border.
4- Medial occipital
border.

CEREBRUM:
BORDERS

CEREBRUM
3 POLES & 4
LOBES
Each hemisphere has
3 poles:
1- Frontal pole.
2- Occipital pole.
3- Temporal pole.
Also, each hemisphere
has 4 lobes:
1- Frontal lobe.
2- Temporal lobe
3- Parietal lobe.
4- Occipital lobe.
lobe

Lateral sulcus or fissure:

Separates the frontal and parietal
lobes from the temporal lobe.
Central sulcus:
Begins from the superomedial
border inch behind the midpoint
between the frontal and occipital
poles.
It descends downward & forward
making an angle about 70 with the
vertical line.
It stops slightly above the lateral
sulcus.
Pre-central: a finger breadth
anterior & parallel to the central
sulcus.
Post-central: a finger breadth
behind & parallel to the central
sulcus.
Superior & inferior frontal sulci
Superior & inferior temporal
sulci.
Interparietal sulcus.
Lunate sulcus

SULCI
ON THE LATERAL
SURFACE

 Pre-central gyrus:
Between central &
precentral sulci.
Postcentral
gyrus :
Between central &
post-central sulci.
Superior, middle &
inferior frontal gyri.
Superior, middle &
inferior temporal
gyri.
Superior & inferior
parietal lobules.
Angular gyrus

GYRI
ON THE LATERAL
SURFACE

 Callosal sulcus:
sulcus just above
the corpus callosum.
Cingulate sulcus:
sulcus one inch
above & parallel to the
callosal sulcus.
Parieto-occipital sulcus:
sulcus
begins in the upper border 4
cm in front of the occipital
pole
It ends at the meeting of
calcarine & postcalcarine
sulci.
Calcarine:
Begins below the splenium
then passes backwards and
upwards to meet the parietoocipital sulcus then
continuous as the
postcalcarine sulcus.
Postcalcarine sulcus: It is
an extension of the calcarine.

SULCI
ON THE MEDIAL
SURFACE

 Cingulate gyrus:
Between the
callosal & cingulate
sulci.
Paracentral lobule:
lobule
It is the continuation
of the precentral &
postcentral gyri.
Precuneus: behind
the paracentral
lobule.
Cuneus: between
the parieto-ocipital
& postcalcarine
sulci.

GYRI
ON THE MEDIAL
SURFACE

Olfactory sulcus:
Close & parallel to the
medial orbital margin.
Orbital sulcus:
Irregular H- shaped lateral
to olfactory sulcus.
Stem of lateral sulcus:
It divides the inferior
Surface into, orbital &
tentorial parts.
Rhinal sulcus:
A short sulcus on the
temporal pole.
Collateral sulcus:
Behind the rhinal sulcus and
extends to the occipital
pole.
Occipitotemporal sulcus:
Lateral to the collateral
sulcus
It extends from temporal to
occipital poles..

SULCI
ON THE INFERIOR
SURFACE

 Gyrus rectus:
rectus
Medial to the olfactory
sulcus.
Orbital gyri;
Anterior, posterior, medial
and lateral, orbital gyri.
Lateral occipitotemporal
gyrus: Lateral to
occipitotemporal sulcus.
Medial occipitotemporal
gyrus:
gyrus Medial to
occipitotemporal sulcus.
Parahippocampal gyrus:
Medial to collateral sulcus.
Lingual gyrus:
gyrus
Between collateral &
calcarine sulci.
Uncus: Anterior end of the
Parahippocampal gyrus
It is the smell center.

GYRI
ON THE INFERIOR
SURFACE

IMPORTANT CENTERS OF
THE CEREBRAL CORTEX
OR
MAIN FUNCTIONAL
AREAS OF THE
CEREBRAL CORTEX

The cerebral cortex is

important for:
Conscious awareness ,
Though,
Memory and
Intellect.
Most sensory modalities
ascend to the cortex
from the thalamus,
perceived & interpreted
in the light of the
previous experience.

Posterior part of
the cerebrum
receives sensory
information in:
1- Parietal lobe
(Somatosensory),
2- Occipital lobe
(Vision),
3- Temporal lobe
(Hearing).

 Information is
elaborated to the
association cortex,
( at the meeting of the
parietal, temporal &
occipital) for
identification by
touch, sight &
hearing.
The limbic
system (medial
part of cerebrum)
enable storage &
retrieval of the
information
processed in the
posterior cortex.

Storage & Retrieval

of information

 The frontal lobe

(anterior part of
cerebrum) is
concerned with
the organization
of movement:
1-Primary motor
area.
2-Premotor
area.
3Supplementary
motor area.
4- Prefrontal
area (guidance of
complex motor
behaviour).

MOTOR
AREA

 In precentral gyrus & anterior

part of the paracentral lobule.
It corresponds to
Brodmanns area 4 .
Body is represented upside
down.

Size of the functional area is

directly proportional to the
skilled movement, not to the
size of the muscle.
It is here that actions are
conceived and initiated.
The principal subcortical
afferent to PMC is from
Lateral ventral nucleus (LVN)
of thalamus.
LVN receives its input from
globus pallidus & dentate
nucleus.

PRIMARY MOTOR
CORTEX (PMC)

 Lesion: Upper 1/3 and paracentral lobule leads to

affection of voluntary control in lower limb & perineum of the
opposite side.
Lower 2/3rds: affection of voluntary control of the head, neck
& upper limb on the opposite side.
Isolated lesion of the premotor cortex leads to apraxia.
(Inability to perform skilled complex voluntary movement in
spite of absence of muscle paralysis)

 Lies anterior to
primary motor cortex.
Brodmanns area 6.
6
It includes the
posterior parts of
superior, middle &
inferior frontal gyri.
Function:
Programming &
preparing for
movement and
control of posture.
It receives its afferent
from ventral anterior
nucleus of thalamus.

PREMOTOR
CORTEX

 On the medial surface

of the premotor cortex.
The principle
subcortical input to
premotor and
supplementary motor
cortex is the ventral
anterior nucleus of the
thalamus.
This nucleus receives
its afferent from the
globus pallidus &
substantia nigra

SUPPLEMENTARY
MOTOR
CORTEX

 It lies in posterior
part of the middle
fontal gyrus.
It is corresponding to;
Brodmann's area 8
It controls conjugate
movement of the
eye.
Unilateral damage to
area 8 causes
conjugate deviation
of the eyes to the
side of the lesion.

FRONTAL EYE
FIELD

 In the inferior frontal gyrus

in the dominant (usually
left) hemisphere.
Brodmanns areas 44 &
45
It has connections with
ipsilateral temporal,
parietal, occipital lobes that
share in language function.
Lesion:
(Left middle cerebral
artery)
Expressive or motor
aphasia (inability to express
thought, answer or writing
inspite of a normal
comprehension)

MOTOR SPEECH
AREA
BROCAS AREA

 Lies anterior to
premotor area.
It has rich
connections with
parietal, temporal
and occipital cortex.
Functions:
Intellect.
Judgment.
Prediction.
Motivation
Planning of
behaviour.

PREFRONTAL
CORTEX

 In the postcentral gyrus &

posterior part of paracentral
lobule.
It correspond to
Brodmanns areas 1, 2
and 3).
Here thalamocortical
neurons terminate (3rd order
neuron).
Input comes from ventral
posterior nucleus (VPN) of
the thalamus.
Within the somatosensory
cortex the contralateral half
of body is represented
upside down.

PRIMARY
SOMATOSENSORY
CORTEX

 VPN receives:
1-Medial lemniscus
(Fine touch &
proprioception).
2-Spinal lemniscus
(coarse touch & pressure).
3-Spiothalamic tract
(pain & temperature).
4- Trigeminothalamic
tract (general sensation
from head)

 Lies in the superior bank

of the middle of the
superior temporal gyrus.
Hidden within the lateral
fissure.
Brodmann's 41, 42.
Its precise location is
marked by small
transverse temporal gyri
( Heschls convolutions).
Input to Primary auditory
cortex is from medial
geniculate nucleus (MGN)
of the thalamus.
Auditory radiation
undergoes partial
decussation in the brain
stem before it reaches the
(MGN).

PRIMARY AUDITORY
CORTEX

 Lies behind the

primary auditory
cortex.
Continuous posteriorly
with the second motor
speech (Wernickes)
area.
Here the heard sounds
or words are
interpreted.
Lesion:
Sensory aphasia;
(inability to recognize
the meaning of sounds
or words with hearing
unimpaired.

SECONDARY AUDITORY
CORTEX
or
AUDITORY ASSOCIATION
CORTEX

 Lies on medial surface of

the occipital lobe.
In close relation to the
calcarine sulcus.
It extends to the
occipital pole.
Brodmanns area 17
It receives optic
radiation from lateral
geniculate nucleus
(LGN) of the thalamus.
Each lateral half of the
visual field is
represented in the visual
cortex of the
contralateral
hemisphere.
Lesion: Homonymous
hemianopia.

PRIMARY VISUAL
CORTEX

 Brodmanns
areas 18,19 are
called visual
association
cortex.
They are
interpretive to
the visual image.
Lesion: visual
agnosia,
(inability to
recognize a seen
object).

VISUAL
ASSOCCIATION
CORTEX

SECOND MOTOR SPEACH AREA

(Wernickes area)
Also, known as language
area.
Lies in dominant
hemisphere.
Lies in the inferior
parietal lobule &
auditory association
area.
Lesion:
Sensory or receptive
aphasia
(Lack of comprehension
of words by vision or
hearing)

THANK YOU