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OK, everyone. So again, I'm Pio. So um today we are gonna go through some more nehi and some radiology cases, but we've made the cases er relevant to um early years medical students. So again, this is just our disclaimer, like always, this is made by students for students. So there might be some inaccuracies. So don't use this as just the sole thing for medical school. Um We are, our aim is to help facilitate your learning. So we've got a lot of different objectives that we're gonna go through. Um So we are gonna try to talk about uh the three parts of the brain system and the gross anatomy of, of them. We are also gonna talk about the 12 cranial nerves um where they enter, where do they exit? What is their function? Er And essentially how do they come up in exams? We are also gonna talk about um how visual inflammation is processed in the brain. How does it er how is it transmitted to the brain and how again it comes up in exams as well and we're gonna talk about cerebellum. Um Also we'll talk about um how all of these structures will look on sagittal and different um anatomical planes. We'll also discuss um the limbic system and the basal ganglia and also we'll talk about the vertebral column, er, and the features of it, er, in addition to er the spinal nerves and the spinal cord and essentially talking and relating it all to um radiology and why are all of these really important for us to learn? So, um uh I assume that everyone can see me, everyone can hear me. But if you can't feel free to uh put in the chart, so we're gonna talk about this. So firstly, if we start by the brain stem, we've got the midbrain, midbrain pons medulla. So midbrain is divided into two sections, a posterior section that contains a superior and inferior colliculi and an anterior section that's got a lot of different. Um Things. Can anyone tell me what the posterior section is called? So the smaller section here, what is that one called? Anyone knows? Sorry, I just have to check the chat. So spot on. Yeah, absolutely. So tectum is right to spot on. Er what about the one that is in front? So the anterior one, what was that one called tegmentum? Spot on guys? Um Good job. So you're right. So there's a lot going on. So do not get overwhelmed by all the different nuclei. Where are they exactly located? The main important things in tectum are superior colliculi that are important with reflexes with visual stimuli and inferior colliculi that is important with auditory stimuli. But in tegmentum, we've got a lot more. So, certainly do know about substantia nigra. We're gonna talk about it in more, but it produces er, a lot of different things like dopamine, er, that we're gonna talk about in basal ganglia. Um We also have cerebral peduncles. So, er they're essentially the connection between cerebral means the cerebrum and um the midbrain also, we have the red nucleus. So do not actually worry about where the trochlear nucleus is where the red nucleus is. You just need to know red nucleus is involved in motor function. That's it, nothing more needed. It's not fully understood. Um As a structure, we've got periaquaductal. Great. It's not high yield in exams, but you might actually wonder what it is. It's actually uh a collection of neuron cells and it is involved in er modulation of pain. If, if uh if you need anything about it, that's pretty much it. What is more important is actually the nuclei involved there. So you don't need to know where they are, but you do need to know that oculomotor trochlear and adding vessel nuclei are in the midbrain. That could be an easy exam question. So, if you move on to pons, um there is different nuclear and pons as well. So, nuclear, very important. Can anyone tell me what a cranial nerve nuclei except for a pneumotaxic and Apne six center are in the pons. Any ideas? So, Neocid are essentially where the cell bodies are. So we're just talking about which cranial nerves have their cell bodies in the bones. Brilliant. Absolutely fine. So, you're absolutely right. Well done. So, 567 and eight is absolutely right. So, um, trigeminal abducens, facial and vesicular coclear. Um, and, yeah, absolutely. So, er, pneumotaxic and apneic senses are involved in breathing. So I used to remember it as pneumotaxic taxes you. So it reduces the depth of your breathing, but a new six centers increase it. It's not too high yield, but it's good to know. So there's only one cranial nerve that exits um, a brain stem posteriorly. Does anyone know which one? It is? It's a trick question. It's not independence but any idea which one it would be. So we had one person said five. So that's, that's close. Any other gut feelings, anyone else? No, absolutely fine. So we've got the trochlea, so trochlea comes posteriorly, the rest do not. So, again, if you find these one things that all out, they're a good easy exam question. So, um, essentially you don't need to know everything in this picture. They're not really important. I'll just put it here for you to be able to see different pictures you've not seen in your anatomy handbook. Er, but what is important in medulla is we've got the med medullary pyramids, er, which are essentially, er, involved in corticospinal tracts. Um And also you have some other things like medullary olives which are um essentially lateral to the pyramids. Um So there's, there's, I've mentioned er, corticospinal tract, but if we go a little bit posteriorly maybe to fasciculus, gracilis and er, cuneatus, what we do have is another tract, a spot and I didn't even need to ask well done. So D CML is absolutely right. So, um they've got corticospinal tract and D CML, which are really important. So we'll talk about them later. Um But again, you need to know about these tracts, what is their function? Where do they decussate? Um And then we'll talk about brown S syndrome as well. So again, as I mentioned, it's important to know the nuclei. So we've got glossopharyngeal vagus, accessory, hypoglossal. So, accessory nerve actually doesn't originate from, from the brain stem. It comes from um your cervical, um, essentially neurones and it comes in and goes back out. Er, but essentially it is um in the mela. So don't worry about it too much. So, you might actually wanna, why are all of these important? Because as foundation doctors, as future specialists, er, you will have different ct scans, things that you might actually need to interpret in emergency. So you can see on the left that we can see the pons cerebellum and we've identified it here. Er, and you might be able to a, er, see any abnormalities there. So, so we've got a question. So does, does it come in by the, from and magnum a spot on? It does, so it comes in V the, from and magnum but it goes out where er, the, like essentially juggler from and where everything else is going out spot on. So if we look at the left image that we've got here, is it ct do you guys think is it an X ray or is an MRI any ideas? C good anyone else has any ideas? What it could be? OK. Brilliant. So it is CT so well done. So the reason for why it is CT so whenever you see bones being white, it's either an X ray or it's act, uh MRI doesn't really like, identify bones that well. Er, an X ray is quite useless for the brain. Um in terms of, if you wanna see like the internal structure of the brain because it will only show you the bones, it can't penetrate anymore. So it's good for maybe maxillofacial fractures, not actually um analyzing the internal structures. So, um good question. So, t one T two doesn't come up in exams. So it's good to know what they are. I had a slide in it as well. I'll show, show them to you but it doesn't really come up in phase one exams. Um So we'll talk about it later. So we've got two pictures here. We've got the left picture and the right picture. These two, which one do you guys think is showing the medulla? So, I mean, one of them has a medulla, one of them doesn't? Which one do you guys think it is? Is it the left image or is it the right image? Got one vote for? Right? Anybody else?