What are the convolutions of the brain. Convolutions of the brain

The date: 03.03.2020

– occlusion pulmonary artery or its branches with thrombotic masses, leading to life-threatening disorders of pulmonary and systemic hemodynamics. The classic signs of PE are chest pain, suffocation, cyanosis of the face and neck, collapse, and tachycardia. To confirm the diagnosis of pulmonary embolism and differential diagnosis with other conditions similar in symptoms, an ECG, chest x-ray, echocardiography, lung scintigraphy, and angiopulmonography are performed. Treatment of PE involves thrombolytic and infusion therapy, oxygen inhalations; in case of inefficiency - thromboembolectomy from the pulmonary artery.

General information

Thromboembolism of the pulmonary artery (PE) is a sudden blockage of the branches or trunk of the pulmonary artery by a thrombus (embolus) formed in the right ventricle or atrium of the heart, the venous bed of the systemic circulation and brought with the blood stream. PE cuts off the blood supply lung tissue. The development of PE is often rapid and can lead to the death of the patient.

PE kills 0.1% of the world's population every year. About 90% of patients who died from pulmonary embolism did not have a correct diagnosis at the time, and necessary treatment. Among the causes of death of the population from cardiovascular diseases, PE is in third place after coronary artery disease and stroke. PE can lead to death in non-cardiac pathology, occurring after surgery, injuries, childbirth. With timely optimal treatment of PE, there is high rate reducing the mortality rate to 2 - 8%.

Causes of PE

The most common causes of PE are:

deep vein thrombosis (DVT) of the lower leg (in 70 - 90% of cases), often accompanied by thrombophlebitis. Thrombosis of both deep and superficial veins of the lower leg may occur
thrombosis of the inferior vena cava and its tributaries
cardiovascular diseases predisposing to the appearance of thrombi and embolism in the pulmonary artery (CHD, active phase of rheumatism with the presence of mitral stenosis and atrial fibrillation, hypertension, infective endocarditis, cardiomyopathy and non-rheumatic myocarditis)
septic generalized process
oncological diseases (more often cancer of the pancreas, stomach, lungs)
thrombophilia (increased intravascular thrombus formation in violation of the hemostasis regulation system)
antiphospholipid syndrome - the formation of antibodies to phospholipids of platelets, endothelial cells and nervous tissue ( autoimmune reactions); manifested by an increased tendency to thrombosis of various localizations.

Risk factors

Risk factors for venous thrombosis and PE are:

a prolonged state of immobility (bed rest, frequent and prolonged air travel, trips, paresis of the limbs), chronic cardiovascular and respiratory failure, accompanied by a slowdown in blood flow and venous congestion.
reception a large number diuretics (massive loss of water leads to dehydration, increased hematocrit and blood viscosity);
malignant neoplasms - some types of hemoblastoses, true polycythemia (a high content of red blood cells and platelets in the blood leads to their hyperaggregation and the formation of blood clots);
long-term use of certain medications (oral contraceptives, hormone replacement therapy) increases blood clotting;
varicose veins (with varicose veins lower extremities conditions are created for the stagnation of venous blood and the formation of blood clots);
metabolic disorders, hemostasis (hyperlipid proteinemia, obesity, diabetes mellitus, thrombophilia);
surgery and intravascular invasive procedures (for example, a central catheter in a large vein);
arterial hypertension, congestive heart failure, strokes, heart attacks;
spinal cord injury, fractures of large bones;
chemotherapy;
pregnancy, childbirth, postpartum period;
smoking, elderly age and etc.

Classification

Depending on the localization of the thromboembolic process, the following variants of PE are distinguished:

massive (thrombus is localized in the main trunk or main branches of the pulmonary artery)
embolism of segmental or lobar branches of the pulmonary artery
embolism of small branches of the pulmonary artery (usually bilateral)

Depending on the volume of arterial blood flow cut off in PE, the following forms are distinguished:

small(less than 25% of the pulmonary vessels are affected) - accompanied by shortness of breath, the right ventricle is functioning normally
submassive(submaximal - the volume of the affected vessels of the lungs from 30 to 50%), in which the patient has shortness of breath, normal blood pressure, right ventricular failure is not very pronounced
massive(volume of disabled pulmonary blood flow is more than 50%) - there is a loss of consciousness, hypotension, tachycardia, cardiogenic shock, pulmonary hypertension, acute right ventricular failure
deadly(the volume of blood flow cut off in the lungs is more than 75%).

PE can occur in severe, moderate or mild form.

The clinical course of PE can be:

sharpest(lightning), when there is an instantaneous and complete blockage by a thrombus of the main trunk or both main branches of the pulmonary artery. Acute respiratory failure develops, respiratory arrest, collapse, ventricular fibrillation. The lethal outcome occurs in a few minutes, the pulmonary infarction does not have time to develop.
sharp, in which there is a rapidly increasing obturation of the main branches of the pulmonary artery and part of the lobar or segmental. It starts suddenly, rapidly progresses, symptoms of respiratory, cardiac and cerebral insufficiency develop. It lasts a maximum of 3-5 days, is complicated by the development of pulmonary infarction.
subacute(protracted) with thrombosis of large and medium branches of the pulmonary artery and the development of multiple pulmonary infarcts. It lasts for several weeks, slowly progresses, accompanied by an increase in respiratory and right ventricular failure. Recurrent thromboembolism may occur with exacerbation of symptoms, which is often fatal.
chronic(recurrent), accompanied by recurrent thrombosis of the lobar, segmental branches of the pulmonary artery. It is manifested by repeated pulmonary infarctions or repeated pleurisy (usually bilateral), as well as gradually increasing hypertension of the pulmonary circulation and the development of right ventricular failure. Often develops in postoperative period, against the background of already existing oncological diseases, cardiovascular pathologies.

Symptoms of PE

The symptomatology of PE depends on the number and size of thrombosed pulmonary arteries, the rate of development of thromboembolism, the degree of disturbances in the blood supply to the lung tissue, and the initial state of the patient. PE has a wide range of clinical conditions, from virtually asymptomatic to sudden death.

Clinical manifestations of PE are nonspecific, they can be observed in other pulmonary and cardiovascular diseases, their main difference is a sharp, sudden onset in the absence of other visible causes of this condition (cardiovascular insufficiency, myocardial infarction, pneumonia, etc.). For PE in the classical version, a number of syndromes are characteristic:

1. Cardiovascular:

acute vascular insufficiency. There is a drop in blood pressure (collapse, circulatory shock), tachycardia. The heart rate can reach more than 100 beats. in a minute.
acute coronary insufficiency(in 15-25% of patients). Manifested by sudden severe pain behind the sternum of a different nature, lasting from several minutes to several hours, atrial fibrillation, extrasystole.
acute cor pulmonale. Due to massive or submassive PE; manifested by tachycardia, swelling (pulsation) of the cervical veins, positive venous pulse. Edema in acute cor pulmonale does not develop.
acute cerebrovascular insufficiency. There are cerebral or focal disorders, cerebral hypoxia, in severe form - cerebral edema, cerebral hemorrhages. Manifested by dizziness, tinnitus, profound syncope with convulsions, vomiting, bradycardia, or coma. Psychomotor agitation, hemiparesis, polyneuritis, meningeal symptoms may be observed.

2. Pulmonary-pleural:

acute respiratory failure is manifested by shortness of breath (from a feeling of lack of air to very pronounced manifestations). The number of breaths is more than 30-40 per minute, cyanosis is noted, the skin is ash-gray, pale.
moderate bronchospastic syndrome is accompanied by dry wheezing.
lung infarction, infarct pneumonia develops 1-3 days after PE. There are complaints of shortness of breath, cough, pain in the chest from the side of the lesion, aggravated by breathing; hemoptysis, fever. Become audible small bubbling wet rales, pleural friction rub. Significant pleural effusions are observed in patients with severe heart failure.

3. Fever Syndrome- subfebrile, febrile body temperature. Associated with inflammatory processes in the lungs and pleura. The duration of the fever is from 2 to 12 days.

4. Abdominal syndrome due to acute, painful swelling of the liver (combined with intestinal paresis, peritoneal irritation, hiccups). Manifested by acute pain in the right hypochondrium, belching, vomiting.

5. immunological syndrome(pulmonitis, recurrent pleurisy, urticaria-like rash on the skin, eosinophilia, the appearance of circulating immune complexes in the blood) develops at 2-3 weeks of the disease.

Complications

Acute PE can cause cardiac arrest and sudden death. When compensatory mechanisms are triggered, the patient does not die immediately, but in the absence of treatment, secondary hemodynamic disorders progress very quickly. The patient's cardiovascular diseases significantly reduce the compensatory capacity of the cardiovascular system and worsen the prognosis.

Diagnostics

In the diagnosis of PE, the main task is to establish the location of blood clots in the pulmonary vessels, assess the degree of damage and the severity of hemodynamic disorders, and identify the source of thromboembolism to prevent relapses.

The complexity of diagnosing PE dictates the need to find such patients in specially equipped vascular departments, which have the widest possible possibilities for conducting special studies and treatment. All patients with suspected PE undergo the following examinations:

careful history taking, assessment of risk factors for DVT/PE and clinical symptoms
general and biochemical blood and urine tests, blood gas analysis, coagulogram and D-dimer analysis in blood plasma (method for diagnosing venous thrombi)
Dynamic ECG (to rule out myocardial infarction, pericarditis
Treatment of PE
Patients with thromboembolism are placed in the intensive care unit. In an emergency, the patient undergoes full resuscitation. Further treatment of PE is aimed at normalizing pulmonary circulation and preventing chronic pulmonary hypertension.
In order to prevent recurrence of PE, strict bed rest is necessary. To maintain oxygenation, a constant inhalation of oxygen is carried out. Massive infusion therapy is carried out to reduce blood viscosity and maintain blood pressure.
AT early period the appointment of thrombolytic therapy is indicated in order to dissolve the thrombus as quickly as possible and restore blood flow in the pulmonary artery. In the future, to prevent recurrence of PE, heparin therapy is performed. With the phenomena of heart attack-pneumonia, antibiotic therapy is prescribed.
In cases of massive PE and ineffectiveness of thrombolysis, vascular surgeons perform surgical thromboembolectomy (removal of a blood clot). As an alternative to embolectomy, catheter fragmentation of the thromboembolus is used. In recurrent PE, a special filter is placed in the branches of the pulmonary artery, the inferior vena cava.

Forecast and prevention
With early provision of full assistance to patients, the prognosis for life is favorable. With severe cardiovascular and respiratory disorders against the background of extensive pulmonary embolism, mortality exceeds 30%. Half of the recurrences of PE occur in patients who have not received anticoagulants. Timely, correctly performed anticoagulant therapy reduces the risk of recurrence of PE by half. To prevent thromboembolism, early diagnosis and treatment of thrombophlebitis, the appointment of indirect anticoagulants in patients at risk are necessary.

Furrows and gyrus of the brain superolateral surface

1 . Lateral furrow, sulcus lateralis (Sylvian furrow).
2 . Tire part, pars opercularis,
frontal tire, operculum frontale.
3 . Triangular part, pars triangularis.

4 . Orbital part, pars orbitalis.
5 . Inferior frontal gyrus, gyrus frontalis inferior.
6 . Inferior frontal sulcus, suicus frontalis inferior.
7 . Superior frontal sulcus, suicus frontalis superior.

8 . Middle frontal gyrus, gyrus frontalis medius.
9 . Superior frontal gyrus, gyrus frontalis superior.
10 . Lower precentral sulcus, sulcus precentralis inferior.
11 . Precentral gyrus, gyrus precentralis (anterior).
12 . Superior precentral sulcus, sulcus precentralis superior.
13 . Central sulcus, sulcus centralis (Roland's sulcus).
14 . Postcentral gyrus, gyrus postcentralis (gyrus centralis posterior).
15 . Intraparietal sulcus, sulcus intraparietalis.
16 . Upper parietal lobule, lobulus parietalis superior.
17 . Lower parietal lobule, lobulus parietalis inferior.
18 . Supramarginal gyrus, gyrus supramarginalis.
19 . Angular gyrus, gyrus angularis.
20 . Occipital pole, polus occipitalis.
21 . Inferior temporal sulcus, suicus temporalis inferior.
22 . Superior temporal gyrus, gyrus temporalis superior.
23 . Middle temporal gyrus, gyrus temporalis medius.
24 . Inferior temporal gyrus, gyrus temporalis inferior.
25 . Superior temporal sulcus, suicus temporalis superior.

Furrows and convolutions of the medial and lower surface of the right hemisphere of the brain.

2 - beak of the corpus callosum,

3 - knee of the corpus callosum,

4 - trunk of the corpus callosum,

5 - groove of the corpus callosum,

6 - cingulate gyrus,

7 - superior frontal gyrus,

8 - waist furrow,

9 - paracentral lobule,

10 - waist furrow,

11 - prewedge,

12 - parieto-occipital sulcus,

14 - spur furrow,

15 - lingual gyrus,

16 - medial occipitotemporal gyrus,

17 - occipital-temporal sulcus,

18 - lateral occipitotemporal gyrus,

19 - furrow of the hippocampus,

20 - parahippocampal gyrus.

Brain stem (sagittal section)

1 - medulla oblongata; 2 - bridge; 3 - legs of the brain; 4 - thalamus; 5 - pituitary gland; 6 - projection of the nuclei of the hypothalamic region; 7 - corpus callosum; 8 - pineal body; 9 - tubercles of the quadrigemina; 10 - cerebellum.

Brain stem (back view).

1. thalamus
2. anterior tubercle
3. pillow
4. medial geniculate body
5. lateral geniculate body
6. end strip
7. caudate nuclei of the hemispheres
8. brain strip
9. pineal gland
10. leash triangle
11. leash
12. III ventricle
13. soldering leashes
14. tubercles of the quadrigemina

Brain stem (back view)

A. medulla oblongata:
1. posterior median sulcus
2. thin beam
3. thin tubercle
4. wedge-shaped bundle
5. sphenoid tubercle
6. intermediate furrow
7. gate valve
8. inferior cerebellar peduncles
9. rhomboid fossa
10. posterolateral groove
11. choroid plexus

B. BRIDGE:
12. middle cerebellar peduncles
13. superior cerebellar peduncles
14. upper brain sail
15. bridle
16. auditory loop triangle

C. MIDBRAIN:
17. optic tubercles
18. auditory tubercles
19. legs of the brain

Brain stem (lateral side)

15. quadrigemina

16. leg of the brain
17. pillow of the thalamus
18. epiphysis
19. medial geniculate bodies (auditory)
20. medial roots
21. lateral geniculate bodies (visual)
22. lateral roots (handles)
23. optic tract

Brain stem (sagittal section)

7. anterior commissure
8. mastoid bodies
9. funnel
10. neurohypophysis
11. adenohypophysis
12. optic chiasm
13. prescient field
14. pineal gland

Sagittal section of the brain.

1.trunk of the corpus callosum
2. roller
3. knee
4. beak
5. terminal plate
6. anterior commissure of the brain
7. vault
8. vault pillars
9. nipple bodies
10. transparent baffle
11. thalamus
12. interthalamic adhesion
13. hypothalamic groove
14. gray bump
15. funnel
16. pituitary gland
17. optic nerve
18. Monroe hole
19. epiphysis
20. epiphyseal adhesion
21. posterior commissure of the brain
22. quadrigemina
23. sylvian aqueduct
23. sylvian aqueduct
24. leg of the brain
25. bridge
26. medulla oblongata
27. cerebellum
28. fourth ventricle
29. upper sail
29. upper sail
30. plexus
31. lower sail

Brain (cross section):

1 - islet;
2 - shell;
3 - fence;
4 - outer capsule;
5 - pale ball;
6 - III ventricle;
7 - red core;
8 - tire;
9 - aqueduct of the midbrain;
10 - roof of the midbrain;
11 - hippocampus;
12 - cerebellum

1 - internal capsule;
2 - islet;
3 - fence;
4 - outer capsule;
5 - visual tract;
6 - red core;
7 - black substance;
8 - hippocampus;
9 - leg of the brain;
10 - bridge;
11 - middle cerebellar peduncle;
12 - pyramidal tract;
13 - olive core;
14 - cerebellum.

Structure medulla oblongata

1 - olive cerebellar tract;

2 - olive core;

3 - the gate of the core of the olive;

4 - olive;

5 - pyramidal tract;

6 - hypoglossal nerve;

7 - pyramid;

8 - anterior lateral furrow;

9 - accessory nerve

Medulla oblongata (horizontal section)

11. seam
12. medial loop
13. lower olive
14. medial olive
15. dorsal olive
16. reticular formation
17. medial longitudinal bundle
18. dorsal longitudinal bundle

The structure of the cerebellum:

a - bottom view,

b - horizontal section:

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Lobes of the cerebellum

Worm segments

Lobes of the hemispheres

Front

11. uvula of the cerebellum

12. ligamentous gyrus

13. central

14. wings of the central lobule

15. top of the hill

16. anterior quadrangular

rear

18. back quadrangular

19. leaf

20. superior lunate

21. tubercle

22. inferior lunate

23. pyramid

24. thin, digastric (D)

26. tonsil

Klochkovo-nodular

25. sleeve

28. shred, leg, okolochok

27. knot

Cerebellar nuclei (on the frontal section).

A. Diencephalon
b. midbrain
C. Cerebellum

12. worm
13. hemisphere
14. furrows
15. bark
16. white matter
17. upper legs
18. core tent
19. spherical nuclei
20. cork kernels
21. jagged nuclei

1 - leg of the brain;
2 - the upper surface of the cerebellar hemisphere;
3 - pituitary gland;
4 - white plates;
5 - bridge;
6 - dentate core;
7 - white matter;
8 - medulla oblongata;
9 - olive core;
10 - the lower surface of the cerebellar hemisphere;
11 - spinal cord

Rice. 261. Cerebellum (vertical section):

1 - the upper surface of the cerebellar hemisphere;
2 - white plates;
3 - worm;
4 - white matter;
5 - tent;
6 - horizontal slot;
7 - lower surface of the cerebellar hemisphere

Thalamus and other parts of the brain on the median longitudinal section of the brain:

1- Hypothalamus; 2- Cavity of the III ventricle; 3- anterior (white soldering);

4- The fornix of the brain; 5- corpus callosum; 6- Interthalamic fusion;

7-Thalamus; 8- Epithalamus; 9- Midbrain; 10- Bridge; 11- Cerebellum;

12- Medulla oblongata.

The fourth ventricle (venticulus quartis) and the vascular base of the fourth ventricle (tela chorioidea ventriculi quarti).

View from above:

1-lingu of the cerebellum;

2-high cerebral sail;

3-fourth ventricle;

4-middle cerebellar peduncle;

5-vascular plexus of the fourth ventricle;

6-tubercle of the sphenoid nucleus;

7-tubercular nucleus;

8-posterior intermediate furrow;

9-wedge-shaped bundle;

10-lateral (lateral) cord;

11-thin beam;

12-posterior median sulcus;

13-posterior lateral groove;

14-median opening (aperture) of the fourth ventricle;

15-co-vascular basis of the fourth ventricle;

16-upper (anterior) cerebellar peduncle;

17-block nerve;

18-lower colliculus (roofs of the midbrain);

19-bridle of the upper medullary sail;

20-upper mound (roofs of the midbrain).

IV ventricle:

1 - roof of the midbrain;
2 - median furrow;
3 - medial elevation;
4 - superior cerebellar peduncle;
5 - middle cerebellar peduncle;
6 - facial tubercle;
7 - lower leg of the cerebellum;
8 - wedge-shaped tubercle of the medulla oblongata;
9 - thin tubercle of the medulla oblongata;
10 - wedge-shaped bundle of the medulla oblongata;
11 - thin bundle of the medulla oblongata

Superior surface of the cerebral hemispheres

(red - frontal lobe; green - parietal lobe; blue - occipital lobe):

1 - precentral gyrus; 2 - superior frontal gyrus; 3 - middle frontal gyrus; 4 - postcentral gyrus; 5 - upper parietal lobule; 6 - lower parietal lobule; 7 - occipital gyrus; 8 - intraparietal groove; 9 - postcentral furrow; 10 - central furrow; 11 - precentral furrow; 12 - lower frontal groove; 13 - upper frontal sulcus.

Inferior surface of the cerebral hemispheres

(red - frontal lobe; blue - occipital lobe; yellow - temporal lobe; lilac - olfactory brain):

1 - olfactory bulb and olfactory tract; 2 - orbital convolutions; 3 - lower temporal gyrus; 4 - lateral occipitotemporal gyrus; 5 - parahippocampal gyrus; 6 - occipital gyrus; 7 - olfactory groove; 8 - orbital furrows; 9 - lower temporal sulcus.

Lateral surface of the right cerebral hemisphere

Red - frontal lobe; green - parietal lobe; blue - occipital lobe; yellow - temporal lobe:

1 - precentral gyrus; 2 - superior frontal gyrus; 3 - middle frontal gyrus; 4 - postcentral gyrus; 5 - superior temporal gyrus; 6 - middle temporal gyrus; 7 - lower temporal gyrus; 8 - tire; 9 - upper parietal lobule; 10 - lower parietal lobule; 11 - occipital gyrus; 12 - cerebellum; 13 - central furrow; 14 - precentral furrow; 15 - upper frontal groove; 16 - lower frontal groove; 17 - lateral furrow; 18 - superior temporal sulcus; 19 - lower temporal sulcus.

Medial surface of the right cerebral hemisphere

(red - frontal lobe; green - parietal lobe; blue - occipital lobe; yellow - temporal lobe; lilac - olfactory brain):

1 - cingulate gyrus; 2 - parahippocampal gyrus; 3 - medial frontal gyrus; 4 - paracentral lobule; 5 - wedge; 6 - lingual gyrus; 7 - medial occipitotemporal gyrus; 8 - lateral occipitotemporal gyrus; 9 - corpus callosum; 10 - superior frontal gyrus; 11 - occipital-temporal groove; 12 - furrow of the corpus callosum; 13 - waist furrow; 14 - parieto-occipital sulcus; 15 - spur furrow.

Frontal section of the diencephalon

15. III-ventricle
16. interthalamic commissure
17. plates of white matter
18. front horns
19. median nuclei
20. ventrolateral nuclei
21. subthalamic nuclei

insular lobe

11. circular furrow
12. central sulcus
13. long gyrus
14. short convolutions
15. threshold

BRIDGE (cross section)

A. basilar part
B. axle tire
C. trapezoid body
IV v - fourth ventricle
20. medial longitudinal bundle
21. superior cerebellar peduncles
22. seam
23. transverse fibers
24. bridge core
25. longitudinal fibers
26. reticular formation
27. medial loop
28. lateral loop
29. rubrospinal put
30. tectospinal path

Cross section of the midbrain

K. roof
P. tire
N. brain stem
13. sylvian aqueduct
14. sylvian aqueduct

III. nucleus of the oculomotor n.
IV. trochlear nucleus
15. posterior longitudinal bundle
16. medial longitudinal p.
17. medial loop
18. lateral loop
19. red cores
20. black substance
21. tectospinal tract
22. rubrospinal tract
23. reticular formation
24. frontal bridge path
25. corticonuclear pathway
26. corticospinal tract
27. occipital-parietal-temporal-pontine
28. gray and white matter
29. pretectal nuclei
30. dorsal-thalamic tr.
31. oculomotor nerve

Topography of the bottom of the rhomboid fossa

1. top sail
2. lower sail
3. choroid plexus
4. superior cerebellar peduncles
5. middle cerebellar peduncles
6. inferior cerebellar peduncles
7. median sulcus
8. medial eminence
9. border furrow
10. cranial fossa
11. caudal fossa
12. bluish spot
13. vestibular field
14. brain strips
15. facial tubercle
16. triangle of the hyoid n.
17. triangle of wandering n.
18. independent cord
19. rearmost field

1 - superior cerebellar peduncle;
2 - pyramidal tract;
3 - leg of the telencephalon;
4 - middle cerebellar peduncle;
5 - bridge;
6 - lower leg of the cerebellum;
7 - olive;
8 - pyramid;
9 - anterior median fissure

hemispheres (Figure 10)

Furrows of the first order divide each hemisphere into lobes. Lateral (Sylvian) furrow separates the temporal and parietal lobes. Central (Roland's) furrow separates the frontal and parietal lobes. Occipito-parietal sulcus separates the occipital and parietal lobes. Furrows of the second order divide each lobe of the hemisphere into convolutions.

frontal lobe. It has precentral, superior, and inferior sulci, and, accordingly, the anterior central, superior, middle, and inferior frontal gyri. In addition, there are branches of the lateral sulcus - anterior and ascending, which divide the inferior frontal gyrus into orbital , triangular and tire parts .

parietal lobe. It has postcentral, interparietal grooves and, accordingly, the posterior central, superior and inferior parietal gyrus. The part of the inferior parietal gyrus that surrounds the lateral sulcus is called supramarginal gyrus , the other part goes around the upper temporal, is called supraangular gyrus .

temporal lobe. It has superior and inferior sulci and, correspondingly, superior, middle, and inferior temporal gyrus.

Occipital lobe. The main furrow is transverse (spur).

Island. It is located under the lateral groove, has the shape of a triangle (Figure 13).

Furrows and convolutions of the mediobasal surface of the hemisphere(pictures 11, 12)

Figure 11. Medial surface of the right hemisphere of the brain: 1 - paracentral lobule; 2 - prewedge; 3 - occipito-parietal sulcus; 4 - wedge; 5 - gyrus of the hippocampus (parahippocampal); 6 - hook; 7 - cingulate gyrus; 8 - transverse (spur furrow); 9 - corpus callosum

Olfactory brain(Figures 11, 12). Consists of peripheral and central sections. Peripheral - olfactory bulbs, tracts, triangles and anterior perforated substance. Central part - gyrus of Ammonovarog (hippocampus, sea horse), dentate, vaulted gyrus and hooks. The olfactory brain is part of the limbic system.

Figure 12. The lower surface of the brain: 1 - mastoid bodies; 2 - olfactory bulbs; 3 - olfactory tracts; 4 - olfactory triangles; 5 - anterior perforated space; 6 - gyrus of the hippocampus; 7 - hook; 8 - occipital-temporal lateral (piri-shaped) gyrus; 9 - occipital-temporal medial (lingual) gyrus

Lateral ventricles of the brain(Figure 13). Found in every hemisphere. First on the left, second on the right. Their parts form the anterior, inferior and posterior horns.

Basal nuclei of the hemispheres(Figure 13). The accumulation of gray matter in its thickness or "subcortex". Form the striatal system ( striatum ) and a system of pale balls ( pallidum ).

In addition to these nuclei, the basal nuclei include fence and almond-shaped nuclei . Each of these nuclei also has its own specific functions.

Tailed nuclei. Regulate the transition from one type of movement to another.

Shell. Pair education. Organizes motor activity, participates in the organization of eating behavior and in its integration with the functions of respiration and salivation.

Figure 13. Hemispheres of the brain at different levels of the horizontal section (on the right - below the level of the bottom of the lateral ventricle, on the left - above the bottom of the lateral ventricle): 1 - caudate nucleus; 2 - shell; 3 - pale balls; 4 - red nuclei; 5 - subthalamic body of Lewis; 6 - fence; 7 - almond-shaped nucleus; 8 - upper legs of the cerebellum; 9 - middle legs of the cerebellum; 10 - lower legs of the cerebellum; 11 - upper brain sail; 12 - cerebellum; 13 - diamond-shaped fossa; 14 - inner capsule; 15 - thalamus; 16 - islet bark; 17 - lower horn; 18 - brain strips; 19 - front horn

pale balls. They regulate the launch or activation of the orienting reaction, limb movements and eating behavior (chewing, swallowing).

Fence. Pair education. Participates in excitatory reactions to somatic, auditory, visual stimuli (orienting reactions, turning the head, chewing, swallowing, vomiting movements).

Almond nucleus. Pair education. Located deep in the temporal lobe. Participates in defensive, vegetative, motor and emotional reactions. The striopallidar system is part of the extrapyramidal system.

The frontal lobe is separated from the parietal by a deep central sulcus, sulcus centralis. It starts on the medial surface of the hemisphere, passes to its upper, goes along it a little obliquely, from back to front, and usually does not reach the brain (see Fig.,).

Approximately parallel to the central sulcus precentral sulcus, sulcus precentralis, but it does not reach the upper edge of the hemisphere. The precentral sulcus borders in front precentral gyrus, gyrus precentralis.

Upper and lower frontal sulci, sulci frontales superior et inferior, are directed from the precentral sulcus forward. They divide the frontal lobe into superior frontal gyrus, gyrus frontalis superior, which is located above the superior frontal sulcus and extends to the hemispheres; middle frontal gyrus, gyrus frontalis medius, which is limited by the upper and lower frontal grooves. The orbital segment of this gyrus passes to the frontal lobe. In the anterior sections of the middle frontal gyrus, the upper and lower parts are distinguished. Inferior frontal gyrus, gyrus frontalis inferior, lies between the lower frontal sulcus and the lateral sulcus of the brain and the branches of the lateral sulcus of the brain is divided into a number of parts (see below).

Lateral groove, sulcus lateralis, is one of the deepest sulci of the brain. It separates the temporal lobe from the frontal and parietal. The lateral furrow lies on each hemisphere and goes from top to bottom and anteriorly. In the depths of this furrow is a depression - lateral fossa, fossa lateralis cerebri, whose bottom is the outer surface of the island.

Small furrows, called branches, depart upward from the lateral furrow. The most permanent of these are ascending branch, ramus ascendens, and anterior branch, ramus anterior; the superior posterior part of the furrow is called posterior branch, ramus posterior(see fig.,).

The inferior frontal gyrus, within which the ascending and anterior branches pass, is divided by these branches into three parts (see Fig.): posterior - tire part, pars opercularis, bounded in front by the ascending branch; middle - triangular part, pars triangularis, lying between the ascending and anterior branches, and the anterior - orbital part, pars orbitalis, located between the horizontal branch and the inferolateral edge of the frontal lobe.

parietal lobe(see Fig.,) lies posterior to the central sulcus, which separates it from the frontal lobe. From the temporal lobe, the parietal lobe is delimited by the lateral groove of the brain, from the occipital lobe - by part parietal-occipital sulcus, sulcus parietooccipitalis.

Runs parallel to the precentral gyrus postcentral gyrus, gyrus postcentralis bounded behind post, sulcus postcentralis. From it posteriorly, almost parallel to the longitudinal fissure of the large brain, goes intraparietal sulcus, sulcus intraparietalis, dividing the posterior superior parts of the parietal lobe into two gyrus: superior parietal lobule, lobulus parietalis superior, lying above the intraparietal sulcus, and lower parietal lobule, lobulus parietalis inferior located down from the intraparietal sulcus. In the lower parietal lobule, two relatively small convolutions are distinguished: supramarginal gyrus, gyrus supramarginalis, lying anteriorly and closing the posterior sections of the lateral groove, and located posterior to the previous angular gyrus, gyrus angularis, which closes the superior temporal sulcus.

Between the ascending branch and the posterior branch of the lateral sulcus of the brain is a section of the cortex, designated as fronto-parietal tire, operculum frontoparietale. It includes the posterior part of the inferior frontal gyrus, the lower sections of the precentral and postcentral gyri, and the lower section of the anterior part of the parietal lobe.

Occipital lobe(see Fig.,) on the convex surface has no boundaries separating it from the parietal and temporal lobes, with the exception of the upper part of the parietal-occipital sulcus, which is located on the medial surface of the hemisphere and separates the occipital lobe from the parietal. All three surfaces of the occipital lobe: convex lateral, flat medial, and concave lower, located on the cerebellum, have a number of furrows and convolutions.

Furrows and convolutions of the convex lateral surface of the occipital lobe are unstable and often uneven in both hemispheres.

The largest of the furrows - transverse occipital sulcus, sulcus occipitalis transversus. Sometimes it is a continuation of the posterior intraparietal sulcus and in the posterior section passes into a non-permanent semilunar sulcus, sulcus lunatus.

Approximately 5 cm anterior to the pole of the occipital lobe on the lower edge of the upper lateral surface of the hemisphere there is a depression - preoccipital notch, incisura preoccipitalis.

temporal lobe(see Fig.,) has the most pronounced boundaries. It distinguishes between a convex lateral surface and a concave lower one. The obtuse pole of the temporal lobe faces forward and somewhat downward. The lateral sulcus of the large brain sharply delimits the temporal lobe from the frontal lobe.

Two furrows located on the upper lateral surface: superior temporal sulcus, sulcus temporalis superior, and inferior temporal sulcus, sulcus temporalis inferior, following almost parallel to the lateral groove of the brain, divide the lobe into three temporal gyrus: top, middle and lower, gyri temporales superior, medius et inferior.

Those parts of the temporal lobe, which, with their outer surface, are directed towards the lateral sulcus of the brain, are indented with short transverse temporal grooves, sulci temporales transversi. Between these furrows lie 2-3 short transverse temporal gyri, gyri temporales transversi associated with the convolutions of the temporal lobe and the insula.

insular lobe(island) (see fig.) lies at the bottom lateral fossa of the brain, fossa lateralis cerebri.

It is a three-sided pyramid, turned by its apex - the pole of the island - anteriorly and outwards, towards the lateral groove. From the periphery, the islet is surrounded by the frontal, parietal, and temporal lobes, which are involved in the formation of the walls of the lateral sulcus of the brain.

The base of the island is surrounded on three sides circular groove of the island, sulcus circularis insulae, which gradually disappears near the lower surface of the island. In this place there is a small thickening - islet threshold, limen insulae, lying on the border with the lower surface of the brain, between the islet and the anterior perforated substance.

The surface of the island is cut deep central sulcus of the islet, sulcus centralis insulae. This furrow divides the islet into anterior, larger, and posterior, smaller, parts.

On the surface of the island, a significant number of smaller insular gyri, gyri insulae. The front has several short insular gyri, gyri breves insulae, back - more often one long insular gyrus, gyrus longus insulae.

The cortex of the hemispheres is covered with furrows and gyrus. Among them, the most deeply lying primary formed furrows are distinguished, dividing the hemispheres of the brain into lobes. The Sylvian sulcus separates the lobe of the frontal region from the temporal region, Roland's is the border between the frontal and parietal lobes.

The furrow of the parietal-occipital region is located on the medial plane of the cerebral hemisphere and divides the occipital region with the parietal region. The superolateral plane has no such border and is not divided into lobes.

The medial plane has a cingulate sulcus on itself, which passes into the sulcus of the hippocampus, thereby delimiting the brain, designed to perform the function of smell, from other lobes.

Secondary furrows in their structure, in comparison with primary ones, are intended for dividing the lobes into parts - gyrus, which are located on the outside of this type of gyrus.

I distinguish the third type of furrows - tertiary or, as they are also called, nameless. They are designed to give concrete shape to the convolutions, while also increasing the surface area of the cortex.

At a depth, in the lower part of the lateral recess, there is a share of the island. It is surrounded on all sides by a circular furrow, and its area is completely riddled with folds and depressions. In its functions, the insula is connected with the brain of smell.

So, each hemisphere has three types of surface: medial, lower, upper-pateral.

The largest depression on the surface of this type is the lateral furrow. An adult has a very deep and wide depression in the lobes of the brain, the so-called insula. This furrow begins at the base of the brain, as soon as it reaches the upper-pateral surface, it begins to divide into a deep, short branch that goes upwards, and a long, backward branch that divides at the end of the descending and ascending branches. This branching complex separates the temporal lobe anteriorly from the frontal and posteriorly from the parietal region.

The island that forms the bottom of this recess has a protrusion that points downwards. This feature of the structure is called the pole. From the front, top, back, the island is separated by a deep annular groove from the frontal, parietal, and temporal regions bordering it. They, in turn, form a tire, which is divided into fronto-parietal, temporal and suprafrontal.

The covering of the insula is divided by the main recess, which runs obliquely in the center, into the anterior and posterior lobes. The anterior lobe of the insula in front of the main sulcus is crossed by the precentral sulcus. These grooves and gyrus are called the anterior central gyrus of the insula.

From the anterior part of the location of the anterior central gyrus of the brain, two or three short gyruses diverge, which are separated from each other by small grooves of the insula. Its posterior lobe is slightly smaller than the anterior one, it is divided by a furrow into several long folds, which are located behind the central depression. The lower section of the island creates the pole of the island, or the polar furrow. To the base of the brain, the polar gyrus descends to the threshold of the insula, after which it goes further to the frontal part, becoming narrower than the lower frontal sulcus.

There is another furrow located in the upper-pateral part of the hemisphere - this is the central (main) gyrus. It crosses the upper part of the hemisphere behind, slightly affecting the medial area. Then she stretches to the bottom and a little forward, without touching the bottom, thereby separating the frontal area from the parietal lobe. In the back of the head, the parietal region is in contact with the occipital region.

The distinction between them is the formed two convolutions and the furrows of the brain - from above - the furrow of the parieto-occipital region, which does not completely touch its upper-lateral surface. In general, it is located on its medial section, below - the occipital gyrus, which runs vertically, connects to the interparietal gyrus adjacent to it at an angle of ninety degrees.

The frontal area is represented by the central gyrus at the back and the lateral one from below. The anterior portion forms the pole of the frontal lobe. From the anterior part of the main gyrus, a pair of precentral sulci runs parallel to it: from above - the upper, from below - the lower. They are at a fairly large distance from each other, but in some places they intersect with each other. That gyrus, which is located between the main and precentral sulci, is called the "precentral gyrus".

At the base, it turns into a tire, after which it connects to the transcentral furrow. This happens due to the fact that the central gyrus does not touch the bottom of the lateral sulcus. There is also a connection with the transcentral gyrus in the upper part, but only in the medial area, on the paracentral lobule.

From the two precentral convolutions, the furrows of the frontal lobe, which have an arcuate shape, diverge almost at an angle of 90 degrees.

From the top - the upper frontal, from the bottom - the lower frontal. These sulci and convolutions of the brain separate the three convolutions of the frontal lobe. The upper one is located above in relation to the frontal sulcus and touches the medial part of the hemisphere. The middle sulcus in the anterior part merges with the fronto-marginal sulcus.

Slightly above this gyrus, the anterior part of the hemisphere is cut through by orbital sulci, which flow into the medial surface of the hemisphere into a sulcus called the cingulate. Frontal, which is located under the frontal lower groove, is divided into three:

opercular (located between the lower edge of the inferior sulcus of the brain and the branch of the ascending lateral gyrus);
triangular (located between the ascending and extreme branches of the lateral gyrus);
orbital (located to the front of the brain);

The superior frontal sulcus, located in the superior frontal gyrus, consists of three parts:

cover part. This indicates the location between the ascending branch in the anterior part of the lateral recess and the lower surface of the groove of the precentral destination;
triangular part. It is located between the ascending and horizontally lying branches of the furrow of the lateral destination;
ophthalmic part. It is located slightly lower than the horizontal branch of the lateral furrow;

The lower plane in its structure contains several convolutions of a small size. Along the edges of the medial lumen are straight convolutions. Further, they are joined by furrows intended for smell, small furrows of the orbital part, gyrus.

The lobe of the parietal part has a central sulcus in the anterior part, a lateral sulcus in the lower part, and a parieto-occipital and transverse occipital sulcus in the back.

Next to the central sulcus, near its posterior part, there is a postcentral sulcus, usually divided into an inferior and an superior gyrus. In the lower part, it, like the precentral gyrus, turns into a tire, and in the upper part - into the paracentral lobe.

The transcentral and main sulci and convolutions of the parietal region often merge into the interparietal sulcus. It is arcuate, goes back, parallel to the upper part of the hemisphere. The interparietal sulcus ends at the delimitation of the occipital lobe, while flowing in a large area into the transverse sulcus of the occipital part. The interparietal gyrus divides the parietal region into superior and inferior lobules.

The temporal region in the upper region is separated by a lateral formation, and the posterior region is delimited by a line that connects the posterior marginal surface of this brain of the sulcus with the underlying edge of the transverse sulcus of the occipital region. The border of the temporal region is separated by a line that connects two regions: the occipital-parietal and pre-occipital notches. The outer surface of the temporal region has temporal longitudinally lying folded formations, which are located parallel to the lateral one.

The temporal superior gyrus in the posterior part, however, like the lateral one, ends in a divergence into several branches, releasing two main ones - rising up and falling down. The branch, which is called ascending, flows into the lower part of the parietal lobule and is ringed by a gyrus, which is located at an angle. The middle fold of the temporal lobe consists of several, successive segments.

The inferior gyrus of the temporal region, in turn, is located on the lower lying part of the hemisphere. The temporal sulci of the brain distinguish three temporal folds located longitudinally. The temporal folded formation, located at the top, is located between the temporal region and the lateral region of the furrows. The middle one is located between the middle and upper recesses.

The lower one is laid between the lower groove and the middle one, a small part of it is located on the outer surface of the temporal region, the rest goes into the base. The lower wall of the lateral recess is formed by the upper part of the temporal gyrus, which, in turn, is divided into parts: the opercular part, which is covered by the operculum of the fronto-parietal part, and the smaller one, the anterior part, covering the insula.

The opercular part is presented in the form of a triangle, in its area the transverse folds of the temporal lobe diverge like a fan, which are separated by transverse recesses. One of the transverse convolutions is not interrupted, while the rest are formed in the form of transitional convolutions and lead to the upper and lower planes of the temporal part.

The occipital region ends with a pole, from the front it is delimited by the parietal lobe with the parietal and occipital transverse furrows. It does not have a clear border with the temporal region and the border between them is conditional. It passes approximately in descending order to the lower part of the transverse groove of the occiput, heading to the notch of the preoccipital region, which is presented as a depression at the site of the transformation of the upper-lateral plane into its lower plane. The channels of the occipital region on the upper-lateral plane of the cerebral hemisphere are very unstable, both in number and in terms of direction.

Most of it is still represented by a number of lateral convolutions of the occiput, among which the largest, unchanged and constant is considered to be the gyrus that runs along the upper part of the occipital region, passing over the interocciput groove. This gyrus is a continuation of the interparietal deepening. The bridge, which is listed as the transition of the parietal region to the occipital region, has several convolutions of the transition connecting both regions.

Medial

The main on the medial plane are two furrows, concentrated around the corpus callosum. One of these furrows, which is most closely adjacent to the corpus callosum, is called the "sulcus of the corpus callosum".

From the back, it smoothly passes into a furrow with the name "hippocampus". This groove deeply lowers the wall of the brain, protruding it into the space of the horn of the ventricle in the form of a horn. Hence the name hippocampus. Another groove extends over the deepening of the corpus callosum of the brain, which has an arched shape and is called the cingulate. The next, going to the back, is the furrow of the subtopic part.

In the inner space of the temporal cavity, the rhinal sulcus extends parallel to the hippocampal sulcus. All three furrows are in their own way a border with an arcuate region that stands out against the whole background due to the general functions of the marginal lobe.

Its upper section, which is located between the deepening of the corpus callosum, the furrows, is called the cingulate gyrus, or the superior limbic gyrus. Its lower part, located between two grooves - called the hippocampal and rhinal, is called the limbic, or it is also called the parahippocampal gyrus.

These two convolutions are connected in the back of the corpus callosum to each other by means of the isthmus of the gyrus called the cingulate. The limbic gyrus in its anterior plane forms a bend that extends to the back, having the appearance of a hook. Its small end forms the intralimbic gyrus.

The posterior part of the medial plane has two very deep-lying grooves: one of them is parietal-occipital, the second is spur. The first penetrates into the upper part of the cerebral hemisphere in the place where the border of the occipital region with the parietal passes. Its exit ends on the upper-lateral plane.

In its advantage, it is located on the outer plane of the medial region of the cerebral hemisphere, after which it descends, while the spur groove rises towards it. Between the furrows of the parietal-occipital and marginal parts of the cingulate recess there is a gyrus, which has the shape of a quadrangle. It belongs to the parietal region and is called the precuneus.

The longitudinal direction is inherent in the spur groove, which moves forward, moving away from the occipital pole. The spur groove often diverges into two branches - upper and lower, and then merges with the groove of the parieto-occipital region at a certain angle. In place, the horn of the lateral cerebral ventricle, there is a bird's spur, which explains the elevation of the spur groove. Its continuation forward from the place where it connects with the furrow of the parieto-occipital region is called the trunk.

The end of the trunk is located on the back of the corpus callosum, and at the end from the bottom and from the top it has a roller - the isthmus. It belongs to the cingulate gyrus. Between the spur and parietal-occipital recess there is a folded formation, which is presented in the form of a triangle and is called a wedge.

The limbic, as it is also called, the cingulate fold, completely wraps around the corpus callosum, or, to be more precise, the commissure, which serves as a connection for both hemispheres. Toward the end, this gyrus ends with a roller. Passing under, it is adjacent to its back and has the shape of an arc arch. Its lower part is presented in the form of a choroid plate.

This plate is a derivatory part of the wall, but in this place it is maximally reduced. The area it covers is called the choroid plexus, which protrudes into the space of the lateral cerebral ventricles, as a result of which a very early, according to ontogenetic indicators, furrow is formed. The triangle, which is formed between the column of the arch and, is turned to the bottom, has a transparent jumper in its structure.

From the place where the rostral plate touches the column of the fornix, an end plate extends downwards and reaches down to the decussation. In its structure, it has an anterior wall of the cerebral bladder, which is located in front, between two protruding bladders of the telencephalon and is the border with the cavity of the third ventricle.

From the end plate, a near-terminal (subcallosal) gyrus extends forward, located parallel to the plate.

The lower part of the cerebral hemisphere

The lower part is represented mainly by the lower parts of the temporal, frontal and occipital regions. Between them there is a border, which is formed by a recess emanating from the base, a lateral type. On the plane of the frontal area there is a furrow of smell, which has in its structure the bulb of smell and the tract of olfactory functions.

It extends deeply, through the anterior part it goes beyond the boundaries of the olfactory bulb, and in the posterior part it diverges in half - into the medial and lateral processes. A straight fold extends between the deepening of the sense of smell and the marginal part of the medial plane of the hemisphere. Toward the outer part, proceeding from the furrow of smell, the lower part of the frontal area is covered with recessed channels that are very variable in shape and appearance, which constantly fold into an “H” - a shaped letter and are called orbital recesses. The groove, which transversely crosses the plane and forms a jumper "H", is commonly called the transverse orbital.

The grooves of the longitudinal type that depart from it are called the medial and lateral orbital grooves. They are located between the recesses of the orbital fold and are called orbital sulci.

The lower surface of the temporal region in its structure allows you to see the temporal, which in some places enters the outer plane of the hemisphere. Closer to the deep lying part and approximately parallel to it, the collateral groove extends. In a place around the horn of the cerebral ventricle, it corresponds to an elevation called collateral. The fold that penetrates inward, from the location of the collateral, lying between this formation and the spur groove, is called reed.

Each of the convolutions is designed to perform certain functions. Any factor that precedes the disruption of the performance of functions defined for the gyrus must be immediately identified and eliminated, otherwise it promises disruption of the body as a whole.

Video

FUROWS AND CONTINUOUS BRAIN: SUPER-LATERAL SURFACE
[ sulci and gyri of the brain mantle: the superlateral surface ]

Anatomy

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Histology

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In the anterior section of each hemisphere of the brain is the frontal lobe, lobus frontalis. It ends in front with the frontal pole and is bounded from below by the lateral groove, sulcus lateralis (Sylvian groove), and behind by a deep central groove (Fig. 124, 125). The central sulcus, sulcus centralis (Roland's sulcus), is located in the frontal plane. It begins in the upper part of the medial surface of the cerebral hemisphere, cuts its upper edge, descends without interruption along the upper lateral surface of the hemisphere down and ends, slightly short of the lateral groove. Anterior to the central sulcus, almost parallel to it, is the precentral sulcus, sulcus precentralis. The latter ends at the bottom, not reaching the lateral furrow. The precentral sulcus is often interrupted in the middle part and consists of two independent sulci. From the precentral sulcus, the upper and lower frontal sulci, suici frontales superior et inferior, go forward. They are located almost parallel to each other and divide the upper lateral surface of the frontal lobe into convolutions. Between the central sulcus behind and the precentral sulcus in front is the precentral gyrus, gyrus precentralis (anterior). Above the superior frontal sulcus lies the superior frontal gyrus, gyrus frontalis superior, which occupies the upper part of the frontal lobe. Between the upper and lower frontal grooves is the middle frontal gyrus, gyrus frontalis medius. Down from the inferior frontal sulcus is the inferior frontal gyrus, gyrus frontalis inferior. The branches of the lateral groove protrude into this gyrus from below: the ascending branch, ramus ascendens, and the anterior branch, ramus anterior. These branches divide the lower part of the frontal lobe, overhanging the anterior part of the lateral sulcus, into three parts. Tire part (frontal tire), pars opercularis (operculum frontale), is located between the ascending branch and the lower part of the precentral sulcus. This part of the frontal lobe got its name because it covers the insular lobe (islet) lying deep in the furrow. The triangular part, pars triangularis, is located between the ascending branch at the back and the anterior branch at the front. The orbital part, pars orbitalis, lies downward from the anterior branch, continuing to the lower surface of the frontal lobe. In this place, the lateral sulcus expands, and therefore it is called the lateral fossa of the brain, fossa. lateralis (cerebraiis).

frontal lobe. In the back section outer surface this lobe runs sulcus precentralis almost parallel to the direction of sulcus centralis. Two furrows extend from it in the longitudinal direction: sulcus frontalis superior et sulcus frontalis inferior. Due to this, the frontal lobe is divided into four convolutions - one vertical and three horizontal. The vertical gyrus, gyrus precentralis, is located between sulcus centralis and sulcus precentralis.

Horizontal gyri of the frontal lobe the following:
1) upper frontal, gyrus frontalis superior which goes above sulcus frontalis superior, parallel to the upper edge of the hemisphere, also reaching its medial surface;
2) middle frontal gyrus, gyrus frontalis medius, stretches between the upper and lower frontal furrows and
3) inferior frontal gyrus, gyrus frontalis inferior, is placed between s ulcus frontalis inferior and lateral furrow.
The branches of the lateral sulcus, protruding into the inferior frontal gyrus, divide the latter into three parts: pars opercularis lying between the lower end sulcus precentralis and ramus ascendens sulci lateralis, pars triangularis, located between both branches of the lateral groove, and, finally, pars orbitalis, placed in front of ramus anterior sulci lateralis.

Rice. 22. Furrows and convolutions on the upper lateral surface.

1. central sulcus (Rolandov)
2. precentral sulcus and gyrus
3. superior frontal sulcus and gyrus
4. middle frontal gyrus
5. inferior frontal sulcus and gyrus
6. tire
7. triangular part
8. orbital surface
9. postcentral boron. and gyrus
10. intraparietal sulcus
11. upper parietal lobule
12. lower parietal lobule
13. supramarginal gyrus (supramarginal)
14. angular gyrus
15. lateral furrow (Silviev)
16. superior temporal sulcus and gyrus
17. middle temporal gyrus
18. inferior temporal sulcus and gyrus

Rice. 23. Furrows and convolutions on the medial surface

19. corpus callosum and its furrow
20. Gray matter corpus callosum
21. subcalcified field
22. paraterminal gyrus
23. belt boron. and gyrus
24. isthmus of the cingulate gyrus
25. hippocampal sulcus (dentate gyrus)
26. paracentral lobule
27. precuneus
28. wedge
29. parietooccipital sulcus
30. spur furrow
31. lingual gyrus
32. parahippocampal sulcus and gyrus
33. hook
34. nasal furrow
35. medial temporoccipital
36. lateral temporoccipital gyrus
37. temporoccipital sulcus

The cortex of the hemispheres is covered with furrows and convolutions ( , , ). Distinguish the deepest primary furrows, which divide the hemispheres into lobes. The lateral sulcus (Sylvieva) separates the frontal lobe from the temporal, the central sulcus (Roland) - the frontal from the parietal. The parietal-occipital sulcus is located on the medial surface of the hemisphere and separates the parietal and occipital lobes; there is no clear boundary between these lobes on the superolateral surface.

On the medial surface is the cingulate sulcus, which passes into the hippocampal sulcus, which limit the olfactory brain from the rest of the lobes.

The secondary furrows are less deep, they divide the lobes into convolutions and are located outside the convolutions of the same name. Tertiary (nameless) furrows give the convolutions an individual shape, increase the area of their cortex.

In the depth of the lateral groove () is the insular lobe. It is surrounded on three sides by a circular furrow, its surface is indented with furrows and convolutions. Functionally, the insula is associated with the olfactory medulla.

Fig.24. Furrows and convolutions of the lower surface of the cerebral hemispheres

1. olfactory groove
2. direct gyrus
3. orbital furrows
4. orbital gyri (variable)
5. inferior temporal sulcus
6. parahippocampal (collateral) sulcus
7. parahippocampal gyrus
8. temporoccipital sulcus
9. spur furrow