Skin and Fascia Face and scalp The superficial fascia of the scalp is firm, dense, fibroadipose, and closely adherent to the skin and to the underlying muscle, epicranius and the epicranial aponeurosis. Posteriorly, the fascia is continuous with the superficial fascia of the back of the neck, and laterally it is prolonged into the temporal region, where it is looser in texture. Three fascial layers (a…

The cerebral hemispheres are the largest part of the human brain: they consist of the telencephalon (cerebral cortex and underlying white matter), basal ganglia and diencephalon. Both hemispheres are interconnected by the corpus callosum and the anterior commissure. The cerebral cortex contains the motor and premotor regions, the highest level at which motor activities are controlled, and the primary sensory regions, which provide the first cortical…

The term basal ganglia is used to denote a number of subcortical nuclear masses that lie in the inferior part of the cerebral hemisphere, in close relationship with the internal capsule ( Fig. 31.1 ). The traditional definition of the basal ganglia included the corpus striatum, claustrum and amygdaloid complex. The term has now been restricted to the corpus striatum and, according to some authorities, other…

The diencephalon is part of the prosencephalon (forebrain), which develops from the most rostral primary cerebral vesicle that differentiates into the caudal diencephalon and the rostral telencephalon. The cerebral hemispheres, containing the lateral ventricles, develop from the telencephalon. The sites of evagination of the telencephalon become the interventricular foramina, through which the two lateral ventricles and the midline third ventricle communicate. The diencephalon corresponds largely to…

The cerebellum is the largest part of the hindbrain, recognized as a distinct division of the brain from the time of Herophilus (335–280 BC) and Galen (AD 131–200). It is situated in the posterior cranial fossa, beneath the tentorium cerebelli, the medial extension of the falx cerebri and the overlying occipital lobe and lies behind the pons and medulla, from which it is separated by the…

The brainstem is situated in the posterior cranial fossa, where it faces the clivus and dorsum sellae ventrally and the cisterna magna, fourth ventricle and cerebellum dorsally ( Fig. 28.1 ). It is approximately 6–7.5 cm in length and 3–4 cm in width at its widest portion. Its caudal border corresponds to the transverse plane immediately above the exit of the first cervical nerve roots. Its…

The spinal cord provides innervation for the trunk and limbs via spinal nerves and their peripheral ramifications. It receives primary afferent fibres from peripheral receptors located in widespread somatic and visceral structures, and sends motor axons to skeletal muscle. It also contains the cell bodies of all the preganglionic neurones responsible for the sympathetic innervation of cardiac and smooth muscle and secretory glands, and for the…

The brain is a highly vascular organ, its profuse blood supply characterized by a densely branching arterial network ( ). It has a high metabolic rate that reflects the energy requirements of constant neural activity. It receives about 15% of the cardiac output and utilizes 25% of the total oxygen consumption of the body. The brain is supplied by two internal carotid arteries and two vertebral…

The meninges consist of three concentric membranes that envelop the brain and spinal cord, supporting and protecting the delicate tissues they surround. The individual layers, from outside to inside, are the dura mater (pachymeninx), arachnoid mater and pia mater. The dura is an opaque, tough, fibrous coat that incompletely divides the cranial cavity into compartments and accommodates the dural venous sinuses. The arachnoid is much thinner…

The human nervous system is the most complex product of evolution. The activity of its billions of neurones constitutes the physical basis of sensory experience, motor behaviour, consciousness and self-awareness. Research to elucidate the mechanisms that underlie these functions is one of the most active areas of contemporary biology and medicine and is essential for the future treatment and prevention of neurological and psychiatric disorders. The…

Prenatal Stages Development of a human from fertilization to delivery at ‘full term’ averages 266 postfertilization days, or 9.5 lunar months (28 day units). It has long been customary to compute the length of a pregnancy, whether in a normal birth or an abortion, from the first day of the last menstrual period of the mother but, as ovulation usually occurs near the fourteenth day of…

Development of the Posterior Coelom Wall From stage 11 (29–30 days postfertilization; see Fig. 23.3 for comparison of postfertilzation days and the clinical scale of postmenstrual weeks) the dorsal region of the wall of the intraembryonic coelom is composed of a mesenchymal population termed intermediate mesenchyme. Predictive fates of epiblast cells that transform to mesenchyme on ingression through the primitive streak show temporally specified induction of…

Postpharyngeal Foregut The primitive gut is divided by head- and tail-folding into three main compartments. The foregut extends from the buccopharyngeal membrane to its continuation into the central midgut region via the cranial intestinal portal. The midgut extends between the intestinal portals and, in the early embryo, is in wide communication with the yolk sac. The hindgut extends from the caudal intestinal portal to the cloacal…

Development of the Respiratory Tree The development of the respiratory system can be conceptualized as the growth of six intertwined trees: the bronchial tree of conducting airways and terminal gas-exchanging sacs; the systemic arterial and venous trees that perfuse and drain the airways; the pulmonary arterial and venous trees that supply and drain the alveolar membrane, anastomose with the systemic and venous trees, and are pivotal…

Overarching concepts The limbs develop from permissive and instructive interactions between epithelium and mesenchyme at specified times and places along the lateral body wall. The outgrowths are initiated at defined positions along the embryonic axis where these cell lines continue to proliferate, giving rise to local thickenings that soon develop into limb buds ( ). The early limb bud elongates and, gradually, the different limb regions…

Vertebrae and their alternating intervertebral discs are one of the main manifestations of body segmentation or metamerism. A chain of segments arranged in sequence allows the overall structure to bend when it is moved by the associated muscles. The original body segments, the somites, are formed from paraxial mesenchymal populations found lateral to the neural tube and notochord in the early embryo ( Ch. 12 ).…

Head and neck development is distinct from that of the trunk, utilizing region-specific genes, signalling mechanisms and morphogenetic processes. The boundary between the head and trunk is not always clear. The neck is contiguous rostrally with the head but it also joins and shares developmental processes caudally with the back ( Ch. 18 ) and the upper limb ( Ch. 19 ). Studies of developmental gene…

Inner ear The production of a precisely positioned and functionally well-tuned inner ear depends on genetic patterning and a cascade of transcription signals expressed by numerous tissues, including the developing inner ear and its surrounding periotic mesenchyme, the adjacent hindbrain, neural crest and notochord ( , ). The first signs of inner ear development are visible shortly after those associated with the developing eyes. Two patches…