Best book for Neuroanatomy for 1st Year MBBS

Though ‘Snell’s Clinical Neuroanatomy’ is one of the world's most popular neuroanatomy books for Medical students, but it is quite detailed for a student of 1st-year MBBS. So if you want to go easy with your Neuroanatomy in your 1st-year MBBS or time is a constraint, you can go for Vishram Singh or Inderbir Singh Neuroanatomy. They take care of basics in an easily digestible manner and cover the subject enough for 1st year MBBS. Also, you can supplement your study with video lectures of Dr. Najeeb.

Vishram Singh Neuroanatomy: 

• Good set of diagrams
• Very simple and easy to grasp

Inderbir Singh

• Well illustrated and easy to retain

Best Book for Neuroanatomy for NEET SS Neurosurgery Preparation

Best Book for Neuroanatomy from MCQ perspective for NEET SS Neurosurgery: Snell's Neuroanatomy

Why?

• Includes Clinical notes with neuroanatomy, covers many important mcq points
• MCQs and clinical problems with detailed explanations of the answers, many MCQs can be directly asked in the exams
• Additional online resources in the form of an interactive atlas and 450 USMLE-style review questions - again many of these MCQs are based on important high yield topics

Best Book for Neuroanatomy for MCh/ DNB Neurosurgery Residents/ FRCS Neurosurgery

Book for Basic Neuroanatomy for Neurosurgery Residents

Snell's Neuroanatomy

There are limited number of real human brains and sections. Most of the diagrams are schematics and not completely applicable to surgical practice.

Netter's Concise Neuroanatomy 

This interesting, far reaching book gives rich visual direction on all parts of neuroanatomy, along with fine art by ace clinical artist Frank H. Netter, MD. Brief tables feature significant parts of each structure, outfitting you with the basic information you have to ace this intricate control. Most of the diagrams are schematics, good for developing concepts.

Netter's Atlas of Neuroscience

• Coverage of both regional and systemic neurosciences 
• Netter and Netter-style illustrations to highlight key neuroanatomical concepts and clinical correlations.
• Reflects the current understanding of the neural components and supportive tissue, regions, and systems of the brain, spinal cord, and periphery.
• Easy to memorize overview of anatomy, function, and clinical relevance.
• The succinct and useful format utilizes tables and short text to offer easily accessible "at-a-glance" information.

More Info: 

Highlights cross-sectional brain stem anatomy and side-by-side comparisons of horizontal sections, CTs and MRIs.

Student Consult eBook version included with purchase. This enhanced eBook experience includes access -- on a variety of devices -- to the complete text, 14 videos, and images from the book.

Expanded coverage of cellular and molecular neuroscience provides essential guidance on signaling, transcription factors, stem cells, evoked potentials, neuronal and glial function, and a number of molecular breakthroughs for a better understanding of normal and pathological conditions of the nervous system.

Micrographs, radiologic imaging, and stained cross sections supplement illustrations for a comprehensive visual understanding.

Book for Surgical Neuroanatomy for Neurosurgery Resident

Rhoton's Cranial Anatomy and Surgical Approaches

• 2000 full-color illustrations
• the best book to understand microsurgical anatomy of the brain for neurosurgeons at any career stage

Operative Neurosurgical Anatomy

• This book presents neurosurgical cadaveric anatomy by detailing approaches in the same operative position patients would be placed in during a real operative procedure. 
• It includes:
• all commonly used cranial and cranial base approaches
• anterior, posterior, anterolateral, and posterolateral approaches to all segments of the spine
• all commonly performed procedures on peripheral nerves
• endoscopic approaches to cranial and spinal neurosurgery

Book for Radiological Neuroanatomy for Neurosurgery Residents:

Netter’s Correlative Imaging: Neuroanatomy

Interpret the complexities of neuroanatomy like never before with the unparalleled coverage and expert guidance from Drs. Srinivasan Mukundan and Thomas C. Lee in this outstanding volume of the Netter’s Correlative Imaging series. Beautiful and instructive Netter paintings and illustrated cross-sections created in the Netter style are presented side by side with high-quality patient images and key anatomic descriptions to help you envision and review intricate neuroanatomy.

Cranial Neuroimaging and Clinical Neuroanatomy: Atlas of MR Imaging and Computed Tomography

Detailed brain anatomy shown in the three orthogonal planes; two-page spreads showing imaging studies keyed to the graphics using numbers that are consistent throughout. Graphic representation of the major arterial and venous territories and CNS spaces, supra- and infratentorial It revealed in multiplanar parallel sections, including detail on the potential sites of lesions and corresponding neurologic deficits

New to the fourth edition:

All X-ray and CT-/MR images replaced with new high-resolution CT and MR images

High resolution 3-Tesla MR images of the brainstem, 7-Tesla-images, fractional anisotropy (FA) maps as well as quantitative susceptibility maps (QSM)

New material on temporal bone, brain maturation, neurofunctional systems

Clinical context updated and expanded

Neuroradiology: The Requisites (Requisites in Radiology) 

Highlights 1,200 great neuroimaging pictures. Makes it simple to find any topic of interest because of an intelligent association by ailments and areas.  Summarizes differential diagnoses in quick-reference tables to reinforce important facts. Focuses on essentials to pass the exams.

10/21/2020 07:30:00 AM

Contents

1. What is Blood Brain barrier?
2. What is a Neurovascular Unit?
3. Anatomy of Blood Brain Barrier
1. Cellular Components of Blood Brain Barrier
4. Function of Blood Brain Barrier
5. What are Circumventricular Organs?
6. Pathological States involving Blood Brain Barrier Breakdown
7. Blood Brain Barrier and Drug Delivery: Getting Drugs Across Blood Brain Barrier
8. Blood Brain Barrier Video

What is Blood Brain barrier?

• To maintain normal brain function, the neural environment must be preserved within a narrow homeostatic range
• This requires a tight regulation of transportation of cells, molecules and ions between the blood and the brain. 
• Such tight regulation is maintained by a unique anatomical and physiological barrier, called the Blood Brain Barrier.

What is a Neurovascular Unit?

• The term Blood Brain Barrier does not adequately encompass the wide range of morphological features and functional characteristics
• For this reason the term Neurovascular unit (Neuwelt,2004) is being used increasingly 
• It comprises of:  

-Endothelial cells
-Pericytes
-Microglia
-Astrocytes
-Basement membrane 

-Tight junction

---

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Anatomy and Physiology of Blood Brain Barrier

Sites of Blood Brain Barrier

• Blood-brain barrier (BBB) with Endothelium,Pericytes and Astrocyte foot processes
• Blood-CSF barrier (BCSFB) with the choroid plexus epithelium
• The arachnoid epithelium separating the blood from the subarachnoid CSF.

Cellular Components of Blood Brain Barrier

Endothelium: It has 3 structural features

• Tight intracellular junctions without fenestrations
• Less Pinocytic Intracellular Vesicles: Relative lack of vesicular transport 
• Abundant Mitochondria

Pericytes

• Reside adjacent to capillaries
• Have smooth muscle like properties
• Control cerebral blood flow by regulation of capillary diameter through actin

Astroglial Process or Astrocyte end feet : ensheath >95% of vessel surface

Physiology of Blood Brain Barrier

Mechanisms of transport of molecules across Blood brain barrier

1. Diffusion
2. Paracellular transport
3. Transport protein
4. Receptor mediated transcytosis
5. Adsorptive transcytosis
6. Efflux proteins

Functions of Blood Brain Barrier

Barrier function

1. Paracellular Barrier : Endothelial tight junctions restrict the free movement of H2O soluble compounds
2. Transcellular barrier : Low level of endocytosis and transcytosis
3. Enzymatic Barrier : Complex set of enzymes to degrade various compounds (eg acetylcholinesterase, monoamineoxidase)
4. Efflux Transporters : Cerebral Endothelium has large number of efflux transporters eg- ABC, ATP binding  cassette transporters

Carrier function

1. Nutrients to brain : Glucose and Amino acids require specific transporter proteins
2. Small lipid molecules diffuse freely
3. Diffusion of O2 and CO2 passively 
4. Removal of metabolites

What are Circumventricular Organs?

• Areas of brain where BBB is weak
• Leaky regions are isolated from the rest of the brain by specialized ependymal cells called Tanycytes, along the ventricular surface close to midline

Sensory Circumventricular organs

1. Area postrema
2. Vascular organ of the lamina terminalis
3. Subfornical organ (SFO)

Secretory Circumventricular organs

1. Posterior Pituitary gland
2. Pineal gland
3. Median eminence
4. Subcommissural organ

Pathological States involving Blood Brain Barrier Breakdown

Trauma

• Bradykinin is produced
• Stimulates release of IL6 from Astrocytes
• Leads to opening of BBB

Stroke

• Astrocytes secrete TGF Beta which downregulates brain endothelial expression of fibrinolytic enzyme tPA and anticoagulant thrombomodulin
• Proteolysis of vascular basement membrane
• Induction of Aquaporin 4 mRNA 

Infectious or Inflammatory Process

• Eg Meningitis, Encephalitis, Sepsis
• Bacterial lipopolysaccharides affect permeability of BBB tight junctions
• This mediated by production of free radicals, IL6, IL 1 Beta
• Interferon Beta prevents BBB disruption

Multiple Sclerosis

• Breakdown of BBB
• Downregulation of laminin in the basement membrane
• Selective loss of Claudin 1/3

HIV

• BBB tight junction disruption

Alzheimer’s Disease

• Upregulation of GLUT 1 transporter
• Altered Agrin levels
• Upregulation of Aquaporin 4 expression
• Accumulation of Amyloid beta due to decrease level of p-glycoprotein transporter expression
• Alteration in BBB-  Changes in basal lamina and Amyloid Beta clearance
• Parkinson’s Disease
• Dysfunction of the BBB by reduced  efficacy of P-glycoprotein

Epilepsy

• Transient BBB opening in epileptogenic foci
• Upregulated expression of P Glycoprotein in astrocytes and endothelium

Brain tumours

• Breakdown of BBB
• Downregulation of tight junctions

Blood Brain Barrier and Drug Delivery: Getting Drugs Across Blood Brain Barrier

An intact BBB is a major obstacle for the development of drugs for CNS disorders.

 

Approximately 98% of small molecule drugs and all large molecule neurotherapeutics, e.g., recombinant peptides, proteins, anti-sense-agents and genetic vectors, are normally excluded from the brain (Pardridge, 2007) 

Most psychiatric drugs are small molecules, lipid soluble compounds which are capable of crossing BBB

There is currently no way large enzymes can be delivered to the brain using gene therapy – for the disease for which gene and enzyme involved are known eg Alzheimer's disease, Parkinson’s disease, Huntington’s disease

Keywords: Blood Brain barrier, Neurovascular Unit, Anatomy of Blood Brain Barrier, Cellular Components of Blood Brain Barrier, Function of Blood Brain Barrier, Circumventricular Organs,  Blood Brain Barrier Breakdown, Blood Brain Barrier and Drug Delivery, Getting Drugs Across Blood Brain Barrier, Blood Brain Barrier Video

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 Video Link:Neurosurgery written board crash course - hypothalamus 




 

1. hypothalamus as the name suggests is directly underneath the thalamus and it's directly above the pituitary 
2. borders of the hypothalamus can be drawn by a triangle 
• line between the anterior commissure and a posterior commissure and it's called the ACPC line
• line between the anterior commissure and the optic chiasm roughly boarded by the lamina terminalis 
• line between the chiasm and the posterior commissure 

5/02/2020 09:39:00 PM

Q1. The “Nissl substance” represents which organelle of neuron?
A. Golgi complex
B. Nucleolus
C. Rough endoplasmic reticulum
D. Mitochondria

Ans: The cytoplasm of a neuron shows the presence of a granular material that stains intensely with basic dyes called Nissl substance (also called Nissl bodies or granules) . These bodies are rough endoplasmic reticulum

Q2. Which of the following provides myelin sheath to the axons of the CNS?
A. Astrocytes
B. Oligodendrocytes
C. Microglia
D. Ependymocytes

Ans: Oligodendrocytes form myelin sheath in CNS. Schwann cells form myelin sheath in PNS

Q3. The perivascular foot of the “blood–brain barrier” is an extension from the:
A. Oligodendrocyte
B. Ependymocyte
C. Astrocyte
D. Microglia

Ans: Astrocytes form the perivascular feet around a capillary. Astrocytes act as insulators, nourish the neurons, help form blood-brain barrier.

Q4. Sensation of pain is detected by:A. Mechanoreceptor
B. Chemoreceptor
C. Nociceptor
D. Thermoreceptor

Ans: Nociceptor

Q5. The cerebral aqueduct is developed from the cavity of:A. Rhombencephalon
B. Mesencephalon
C. Telencephalon
D. Diencephalon

Ans: The cavity of each telencephalic vesicle becomes the lateral ventricle. The cavity of  iencephalon (along with the central part of the telencephalon) becomes the third ventricle. The cavity of the mesencephalon remains narrow, and forms the cerebral aqueduct (aqueduct of Sylvius). The cavity of the rhombencephalon forms the fourth ventricle. Its continuation in the spinal cord is the
central canal

Q6. The failure of closure of the cranial end of neural tube gives rise to:A. Anencephaly
B. Hydrocephalus
C. Microcephaly
D. Meningomyelocoele

Ans: The neural tube remains open in the region of the brain because of nonclosure of the anterior neuropore. This results in anencephaly. Brain tissue, which is exposed, degenerates

Q7. By which week of intrauterine life does the neural tube close?

A. Fourth
B. Fifth
C. Sixth
D. Seventh

Ans: At 4 weeks the neural tube is normally completely closed (Ref: https://embryology.med.unsw.edu.au/embryology/index.php/Timeline_human_development#Neural)

Q8. The cervical flexure of the neural tube occurs:A. Between the forebrain and midbrain
B. In the midbrain
C. Between hindbrain and spinal cord
D. In the hindbrain 

Ans: The cervical flexure lies at the junction of the rhombencephalon and the spinal cord  

Q9:Rabies virus, from the site of bite, travels along nerves by 

A. Forward Axoplasmic Flow

B: Reverse Axoplasmic flow

C: Dendritic Flow

D: Along the Endoneurium of nerve fibres

Ans: Rabies virus, from the site of bite, travels along nerves by reverse axoplasmic flow.

Q10:Polio virus is also transported from the gastrointestinal tract through :

A. Forward Axoplasmic Flow

B: Reverse Axoplasmic flow

C: Dendritic Flow

D: Along the Endoneurium of nerve fibres

Ans: Polio virus is also transported from the gastrointestinal tract through reverse axoplasmic flow.

Q11:Tetanus bacteria, in contrast, travels from the site of infection to the brain by:

A. Forward Axoplasmic Flow

B: Reverse Axoplasmic flow

C: Dendritic Flow

D: Along the Endoneurium of nerve fibres

Ans: Tetanus bacteria travels from the site of infection to the brain along the endoneurium of nerve fibres

  

Reference:

Inderbir Singh's Textbook of Human Neuroanatomy (Fundamental and Clinical)  

4/11/2020 07:30:00 AM