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Chapter 5. Neuroanatomy for the Psychiatrist

Katherine H. Taber, Ph.D., F.A.N.P.A.; Robin A. Hurley, M.D., F.A.N.P.A.
DOI: 10.1176/appi.books.9781585623402.338161

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As science and technology have improved with time, so has their application to psychiatry and mental illness. Conditions once believed to be the result of environmental influences are now understood for their biological basis and heritability. As structural and functional neuroimaging and genetics become more entwined in modern medicine, it has become more and more evident that practicing psychiatrists need to understand basic neuroanatomy and its relationship to psychiatric disease. The purpose of this chapter is to serve as a visual refresher. Medical informatics research has found that appropriate use of images and color-coding of information promote assimilation of large amounts of dense, detailed scientific knowledge. Thus, we have integrated colored visual graphics as a means to review neuroanatomical detail. The primary learning venue is thus the figures, with limited text to clarify some details. For more detailed anatomical maps and circuit drawings, the interested reader may refer to the reference list at the end of the chapter.

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FIGURE 5–1. Planes of section.Source. Used with permission from Mid-Atlantic Mental Illness Research, Education, and Clinical Center.

FIGURE 5–2. Anatomic orientations and directions.Source. Used with permission from Mid-Atlantic Mental Illness Research, Education, and Clinical Center.

FIGURE 5–3. Major divisions of the brain.Source. Used with permission from Mid-Atlantic Mental Illness Research, Education, and Clinical Center.

FIGURE 5–4. Lobes of the cerebral cortex.Source. Used with permission from Mid-Atlantic Mental Illness Research, Education, and Clinical Center.

FIGURE 5–5. Major gyri and sulci of the cerebral cortex.Source. Used with permission from Mid-Atlantic Mental Illness Research, Education, and Clinical Center.

FIGURE 5–6. Functions of the cerebral cortex.Source. Used with permission from Mid-Atlantic Mental Illness Research, Education, and Clinical Center.

FIGURE 5–7. Brodmann areas.Source. Used with permission from Mid-Atlantic Mental Illness Research, Education, and Clinical Center.

FIGURE 5–8. Variability in Brodmann areas.Source. Used with permission from Mid-Atlantic Mental Illness Research, Education, and Clinical Center.

FIGURE 5–9. Major subcortical structures.Source. Used with permission from Mid-Atlantic Mental Illness Research, Education, and Clinical Center.

FIGURE 5–10. Basal forebrain.Source. Used with permission from Mid-Atlantic Mental Illness Research, Education, and Clinical Center.

FIGURE 5–11. Sectional anatomy—axial atlas: dorsal frontal and parietal cortices.Source. Used with permission from Mid-Atlantic Mental Illness Research, Education, and Clinical Center.

FIGURE 5–12. Sectional anatomy—axial atlas: cingulate cortex.Source. Used with permission from Mid-Atlantic Mental Illness Research, Education, and Clinical Center.

FIGURE 5–13. Sectional anatomy—axial atlas: dorsal occipital and parietal cortices, caudate.Source. Used with permission from Mid-Atlantic Mental Illness Research, Education, and Clinical Center.

FIGURE 5–14. Sectional anatomy—axial atlas: insular cortex, basal ganglia, thalamus.Source. Used with permission from Mid-Atlantic Mental Illness Research, Education, and Clinical Center.

FIGURE 5–15. Sectional anatomy—axial atlas: orbital cortex, basal forebrain, hippocampus, midbrain.Source. Used with permission from Mid-Atlantic Mental Illness Research, Education, and Clinical Center.

FIGURE 5–16. Sectional anatomy—axial atlas: orbital cortex, hippocampus, amygdala, midbrain.Source. Used with permission from Mid-Atlantic Mental Illness Research, Education, and Clinical Center.

FIGURE 5–17. The limbic lobes.Source. Used with permission from Mid-Atlantic Mental Illness Research, Education, and Clinical Center.

FIGURE 5–18. Circuit of Papez.Source. Used with permission from Mid-Atlantic Mental Illness Research, Education, and Clinical Center.

FIGURE 5–19. Prefrontal cortex—surface anatomy and circuits.Source. Used with permission from Mid-Atlantic Mental Illness Research, Education, and Clinical Center.

FIGURE 5–20. Prefrontal cortex—sectional anatomy.Source. Used with permission from Mid-Atlantic Mental Illness Research, Education, and Clinical Center.
Table Reference Number
TABLE 5–1. Summary of functional anatomy pertinent to psychiatry
Table Reference Number

The dorsolateral prefrontal region is important for cognition, executive function, and focused attention.

The orbital prefrontal region is important for social conduct, insight, judgment, and mood.

The mesial region of the temporal lobe contains the hippocampus, the parahippocampus, and the amygdala.

The hippocampal complex is the key to memory formation and storage functions.

The parietal lobe is important for sensation, speech production/conduction, and deficit recognition.

The basal ganglia are critical for suppression/modulation of involuntary movements and contribute to memory, cognition, behavior, and mood.

The thalamus is the key "relay station" for memory, emotion, cognition, behavior, motor, and sensory functions.

The hypothalamus modulates physiological response to emotional stimuli, temperature control, sleep, water metabolism, hormone secretion, satiety, and circadian rhythms.

The pons contains the locus coeruleus (norepinephrine production) and portions of the reticular formation (alertness).

The cerebellum is important for equilibrium and fine motor coordination and is associated with cognition.

References

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Burruss JW, Hurley RA, Taber KH, et al: Functional neuroanatomy of the frontal lobe circuits. Radiology 214:227–230, 2000
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Dalgleish T: The emotional brain. Nat Med 5:582, 2004
 
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Middleton FA, Strick PL: Basal ganglia and cerebellar loops: motor and cognitive circuits. Brain Res Rev 31:236–250, 2000
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Taber KH, Strick PL, Hurley RA: Rabies and the cerebellum: new methods for tracing circuits in the brain. J Neuropsychiatry Clin Neurosci 17:133–139, 2005
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Sample questions:
1.
The basal ganglia are a group of small, interconnected subcortical nuclei. These nuclei serve a big role as a site for bringing emotions, executive functions, motivation, and motor activity together. Which of the subcortical nuclei listed below comprise the corpus striatum?
2.
Injury to the hippocampal formation and parahippocampal cortex primarily produces which of the following deficits?
3.
Which brain structure lies at the juncture of the tail of the caudate nucleus and the anteriormost ends of the parahippocampus and hippocampus?
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