Polycopié de neuro-morphologie

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Transcript of Polycopié de neuro-morphologie

  • Anne universitaire 2012/2013

    PCEM2 EIA NEUROLOGIE

    PSYCHIATRIE

    Anatomie morphologie

  • Neuroanatomie

    Morphologie

    Dominique Hasboun Avec la collaboration de Yoann Ehrhard Fabrice Bonneville Facult de Mdecine Pierre et Marie Curie Universit Pierre et Marie Curie

    Anne Universitaire 2012 - 2013

  • D. Hasboun - Introduction au systme nerveux

    - 2 -

    Sommaire

    I. Introduction au systme nerveux _____________________________________________ 5 A. Le systme nerveux somatique ______________________________________________ 5

    B. Le systme nerveux vgtatif ________________________________________________ 5

    II. Mninges _______________________________________________________________ 6 A. Introduction ______________________________________________________________ 6

    B. Les feuillets et espaces _____________________________________________________ 7

    C. Les expansions de la dure-mre ______________________________________________ 9 1. La faux du cerveau ________________________________________________________________ 9 2. La tente du cervelet _______________________________________________________________ 11 3. Vascularisation de la dure-mre _____________________________________________________ 13 4. Innervation de la dure-mre ________________________________________________________ 14

    D. Leptomninge ___________________________________________________________ 14

    E. Les espaces ______________________________________________________________ 16

    F. Les sinus veineux _________________________________________________________ 19 1. Le groupe Postro-suprieur ________________________________________________________ 19 2. Le groupe antro-infrieur _________________________________________________________ 21

    III. Moelle spinale _________________________________________________________ 24 A. Introduction _____________________________________________________________ 24

    B. Anatomie descriptive _____________________________________________________ 25 1. Forme, divisions et limites _________________________________________________________ 25 2. Configuration externe _____________________________________________________________ 27 3. Configuration interne _____________________________________________________________ 31 4. Variations rgionales ______________________________________________________________ 33 5. Rapports _______________________________________________________________________ 33 6. Anatomie fonctionnelle ____________________________________________________________ 36

    C. Vascularisation artrielle __________________________________________________ 37

    IV. Tronc crbral Nerfs crniens ___________________________________________ 39 A. Anatomie descriptive _____________________________________________________ 40

    1. Introduction _____________________________________________________________________ 40 2. Moelle allonge (Medulla oblongata, bulbe rachidien) : ___________________________________ 41 3. Pont (protubrance annulaire, Pont de Varole) __________________________________________ 42 4. Msencphale ___________________________________________________________________ 43

    B. Les citernes sous-arachnodiennes ___________________________________________ 44 1. La citerne crbellomdullaire (grande citerne, cisterna magna) ____________________________ 44 2. La citerne quadrigmine __________________________________________________________ 44 comprise entre la face infrieure du splnium du corps calleux en haut et la face suprieure du vermis crbelleux, la lame tectale et lpiphyse (glande pinale) en bas. _______________________________ 44 3. La citerne ambiante. ______________________________________________________________ 44 La citerne ambiante est essentiellement primsencphalique, entre le msencphale et la face mdiale du lobe temporal. _______________________________________________________________________ 44 Citerne du trigone (angle) pontocrbelleux ________________________________________________ 45 4. Les citernes pr-bulbaire, prpontique et chiasmatique. ___________________________________ 45

    C. tude systmatique des nerfs crniens ______________________________________ 46 1. Introduction _____________________________________________________________________ 46 2. Tableau des nerfs crniens _________________________________________________________ 46

    D. Vascularisation du tronc crbral ___________________________________________ 52

  • D. Hasboun - Introduction au systme nerveux

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    1. Les artres ______________________________________________________________________ 52 2. Les veines ______________________________________________________________________ 52

    V. Quatrime ventricule _____________________________________________________ 53 A. Introduction _____________________________________________________________ 53

    B. Embryologie du quatrime ventricule _______________________________________ 56 1. Stades trois et cinq vsicules crbrales ____________________________________________ 55 2. Dveloppement du rhombencphale __________________________________________________ 55

    C. Anatomie descriptive du V4 ________________________________________________ 57 1. Plancher du V4 : paroi antrieure du V4 _______________________________________________ 57 2. Bords du V4 ____________________________________________________________________ 59 3. Angles du V4 ___________________________________________________________________ 59 4. Toit duV4 ______________________________________________________________________ 59 5. Face postrieure du msencphale et de la moelle allonge ________________________________ 60

    D. Dynamique du Liquide CrbroSpinal _______________________________________ 61

    VI. Cortex crbral _________________________________________________________ 62 A. Introduction _____________________________________________________________ 62

    B. Embryologie ____________________________________________________________ 64

    C. Histologie _______________________________________________________________ 65

    D. Configuration externe du cerveau ___________________________________________ 67 1. Face externe ____________________________________________________________________ 68 2. Face interne _____________________________________________________________________ 74 3. Face infrieure ___________________________________________________________________ 76

    VII. Troisime ventricule ____________________________________________________ 78 A. Introduction _____________________________________________________________ 78

    1. Anatomie descriptive du V3 ________________________________________________________ 79 2. Paroi postrieure _________________________________________________________________ 80 3. Parois latrales __________________________________________________________________ 81 4. Plancher ________________________________________________________________________ 82 5. Toit du troisime ventricule ________________________________________________________ 83

    VIII. Ventricules latraux ___________________________________________________ 85 A. Gnralits ______________________________________________________________ 86

    1. Dfinition ______________________________________________________________________ 86 2. Situation _______________________________________________________________________ 86 3. Forme _________________________________________________________________________ 86 4. Communication __________________________________________________________________ 86 5. Dveloppement de lextrmit rostrale du tube neural : ___________________________________ 87

    B. Rotation de la vsicule et de ses consquences. ________________________________ 88

    C. Embryogense des noyaux gris centraux _____________________________________ 88

    B. Anatomie descriptive _____________________________________________________ 89 1. Corne frontale ___________________________________________________________________ 89 Corps ventriculaire ___________________________________________________________________ 90 2. Carrefour ventriculaire ____________________________________________________________ 91 3. Corne temporale _________________________________________________________________ 92 4. La corne occipitale _______________________________________________________________ 94

    C. Anatomie de coupe _______________________________________________________ 96 1. Cavits ventriculaires : ____________________________________________________________ 96 2. Noyaux : _______________________________________________________________________ 96 3. Substance blanche ________________________________________________________________ 97

  • D. Hasboun - Introduction au systme nerveux

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    IX. Vascularisation crbrale _______________________________________________ 103 A. Gnralits _____________________________________________________________ 103

    B. Les voies d'apport _______________________________________________________ 104 1. Systme carotidien ______________________________________________________________ 104 2. Systme vertbro-basilaire ________________________________________________________ 106 3. Polygone de Willis ______________________________________________________________ 107

    C. Artres crbrales _______________________________________________________ 108 1. Artre crbrale antrieure ________________________________________________________ 109 2. Artre communicante antrieure ____________________________________________________ 112 3. Artre crbrale moyenne (ACM) ___________________________________________________ 113 4. Artre crbrale postrieure _______________________________________________________ 116 5. Artre chorodienne antrieure ____________________________