Nolte’s THE HUMAN BRAIN
IN PHOTOGRAPHS AND DIAGRAMS
Todd W. Vanderah, PhD
Professor and Chair of Pharmacology
Department of Pharmacology, Anesthesiology, and Neurology
University of Arizona, College of Medicine Tucson, Arizona
1600 John F. Kennedy Blvd.
Ste 1800 Philadelphia, PA 19103-2899
NOLTE’S THE HUMAN BRAIN IN PHOTOGRAPHS AND DIAGRAMS, FIFTH EDITION
Copyright © 2020 by Elsevier, Inc. All rights reserved.
ISBN: 978-0-323-59816-3
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To Our Students
Whose enthusiasm excites me to be a better teacher
Whose inquisitiveness drives me to dig deeper for answers
Whose joy to learn thrusts my dedication towards the educational mission
Whose rich personalities demonstrate how the human brain has incredible capability and compassion
-John Nolte, PhD, Todd W. Vanderah, PhD, and Jay B. Angevine Jr., PhD
When it comes to learning the anatomy and basic functions of the human nervous system, John “Jack” Nolte has played a role as an author and/or a professor for hundreds of thousands of students, residents, and physicians. Jack viewed the human brain as an endlessly fascinating playground that is forever changing. His
lifetime goal was not only to educate students but to educate future teachers as well. He continually scoured the primary literature and behaved with childhood excitement when discovering new explanations for human brain function. His own love and excitement for the nervous system would naturally bleed over to his students and colleagues, encouraging them to explore and question the human nervous system.
In working with Jack for over 15 years, my career and take on life changed from teaching as a “job” to teaching as an enjoyable hobby with benefits. His ability to make teaching fun, telling jokes and giving examples, led to an enriched student environment that resulted in students wanting more. Our meetings most often included discussions of how we could better educate students. Jack was on the cutting edge of designing “case-based” instruction, showing videos of patients for teaching purposes, having patients present in the classroom, and pushing ideas of working and taking exams as groups, using innovative technology, including the virtual brain and interconnected vocabulary terms across multiple fields of science. Jack’s desire to create a textbook that was cutting edge yet to the point for learning purposes was his continual love. He shared with me chapters, images, and novel ideas while writing the next edition to continually produce a product that students would enjoy.
Our time together was not all work. Although most know him as a professor of the nervous system, Jack also enjoyed playing handball, woodworking, traveling, cooking, wonderful deep red wines, a martini with blue cheese olives, and the joy of eating oysters (things that often appeared in his textbook as examples of nervous system function). In closing, I dedicate this new edition to my teacher, colleague, and friend. I dearly miss Jack’s enthusiasm for teaching, his humor, his friendship, and of course his infamous Birkenstocks.
Learning about the functional anatomy of the human central nervous system (CNS) is usually a daunting task. Structures that interdigitate and overlap in three dimensions contribute to the difficulty, as does a long list of intimidating names, many with origins in descriptive terminology derived from Latin and Greek. Here we have attempted to make the task a little easier by presenting a systematic series of whole-brain sections in three different sets of planes (coronal, sagittal, and axial—similar to what is seen in medical imaging), by relating these sections to three-dimensional reconstructions, and by trying to restrain ourselves when indicating structures.
Unlabeled photographs are presented throughout the book, juxtaposed with faded-out versions of the same photographs with important structures outlined and labeled. This circumvents the common need to mentally superimpose a labeled drawing on a photograph or to inspect a photograph through a thicket of lead lines. Photos of the CNS are comprehensive sets in each plane; sections illustrating major structures or major transitions are shown in greater detail and at a higher magnification. Every labeled structure is discussed briefly in an illustrated glossary at the end of the book. For this edition, minor adjustments were made to sections and photographs throughout the book; the functional pathways in chapter 8 were redone in color; an important new imaging modality (diffusion tensor imaging) was added to Chapter 9; and a number of new illustrations were added to the glossary. Chapter 10 is brand new in this edition as an introduction to neuropathology. Common types of CNS derived tumors and
neuro-diseases/disorders are displayed as representative images of what might be detected upon diagnosis.
The methods used in this book inevitably involve compromises. We labeled only structures that we believe are important for the knowledge base of undergraduate and professional students, and we omitted others dear to our hearts but perhaps not critical for these students. Hence the fasciola cinerea so prominent in Figure 7.8 is not labeled, and the indusium griseum is mentioned only briefly in a footnote. In addition, explicitly outlining structures required some simplifications, and complex entities are sometimes indicated more simply as single structures. We think the resulting pedagogical utility for students justifies these anatomical liberties.
Current technological methods allowed us to approach the construction of this atlas differently than we could have when it was first discussed. All the photographs of brains and sections used in the book were retouched digitally. Mounting medium, staining artifacts, and small cracks, folds, and scratches were removed from the digitized versions of the sections. The profiles of many small blood vessels were removed as well. The color balance was changed as appropriate to make the sections as uniform as possible. These procedures improved the illustrations aesthetically while leaving their essential content unchanged. In addition, computer-based surface-reconstruction techniques made possible the beautiful three-dimensional images that appear in Chapter 4 and elsewhere in the book.
John Nolte and Todd W. Vanderah
This book could never have happened without the hard work and endless efforts of Jack Nolte. He loved to teach and mentor colleagues of which I am forever indebted. Many colleagues and friends have helped with previous versions of the book, and that work is presented in this edition, including the photographic expertise of Nathan Nitzky and Jeb Zirato in the UofA Biocommunications. Grant Dahmer and Dr. Norman Koelling of the UofA prepared the prosections shown in Chapter 1. The sections shown in Chapter 2 were cut by Shelley Rowley, and those in Chapter 3 by Pam Eller. John Sundsten produced the three-dimensional images shown in Chapter 4. Paul Yakovlev, as detailed shortly, was the central figure in the production of the sections shown in Chapters 5 through 7. Cody Thorstenson played a major role in retouching the images of these sections. Cheryl Cotman produced the threedimensional reconstructions of the limbic system shown in Chapter 8. Drs. Ray Carmody, Robert Handy, Elena Plante, and Joe Seeger provided the images shown in Chapters 9 and 10. Drs. Agamanolis and Carmody supplied many of the pathology images in chapter 10 and helped with the description of the neuropathology.
I thank the co-author on the first three editions of this atlas, Jay B. Angevine Jr., who passed away in October 2011. Dr. Angevine was responsible for producing the whole-brain sections in Chapters 5 through 7
Drs. Nolte and Angevine both had an infectious love for the central nervous system and its incredible capability. Their personalities and enthusiasm made learning about the nervous system fun
and exciting. I hope this enjoyment for the nervous system feeds forward to future students of the human nervous system.
Todd W. Vanderah
Jay B. Angevine Jr. June 29, 1928–October 18, 2011.
A NOTE ON THE WHOLE-BRAIN SERIAL SECTIONS AND THEIR ORIGIN
As crucial as computer technology is to our book, the whole-brain serial sections are its foundation. They were prepared during 1966–1967 in the Warren Anatomical Museum at Harvard Medical School. The work, in which I took part, was performed under the direction of Dr. Paul I. Yakovlev (1894–1983), who was curator of the museum from 1955 to 1961 and then Emeritus Clinical Professor of Neuropathology until 1969. Each brain, embedded whole in celloidin, was sectioned in coronal, horizontal, or sagittal planes on a giant microtome with a standing oblique 36-inch blade and a sliding brain holder. The sections, each 35 µm thick, were rolled and stored in test tubes in a console of 100 numbered receptacles. After processing pilot sections for suitability and quality, we stained every twentieth section with Weigert’s hematoxylin (Loyez method) for myelin and mounted it between sheets of window glass. Each preparation is thus about 4 mm thick, yet great depth and detail of cells and fibers are visible.
Such preparations illustrate the white matter and tracts of the brain by staining the myelin sheaths of axons black; gray matter and nuclei appear as more or less pale areas, depending on the number and caliber of myelinated fibers present. These sections, all from essentially normal brains, were added to an already huge collection representing more than 900 cerebra that Dr. Yakovlev had been building since 1930. Now a national resource known and available to neurological scholars worldwide, this priceless compilation known as the Yakovlev-Haleem Collection is graciously housed in the National Museum of Health and Medicine by the Armed Forces Institute of Pathology in Washington, DC. Today it comprises about 1600 specimens, normal and pathological, processed in a rigorously consistent manner from the start.
In mid-1967, with Dr. Yakovlev’s blessing, I took with me to The University of Arizona some 1000 of the 8741 sections cut from the three normal brains used in Chapters 5 through 7 of this book. I had left Boston to join the faculty of the University’s new College of Medicine in Tucson. Paul, my mentor from the time I came to Harvard in 1956, wanted to support me as I began teaching in a far-off land that he believed (perhaps correctly) to be a frontier: the “Wild West.” As with everything else he did, it was thoughtful, kind, and generous. How he would have loved to see students studying the sections illustrated on these pages!
Unlike the fairly simple task of sectioning the brainstem, cutting perfect gapless whole-brain serial sections is difficult. The procedure was never more carefully undertaken or widely employed than by Paul, who used it at or in association with Harvard Medical School for 40 years. A central theme for him was this holistic method (“every part of the brain is there, nothing is left out…”), but no aspect of neuroanatomy or neuropathology failed to intrigue him. Although such sections had been made since the late 19th century (they are found in small numbers at many medical schools and
in profusion at a few research institutes), Paul’s are unique—in uniformity of preparation at every step from fixation to mounting, and in unity of general neurological interest and comparability. Of this legacy (he called it “over 40 tons of glass”), Derek Denny-Brown, Emeritus Professor of Neurology at Harvard, wrote in 1972: “The perspective given by serial whole brain sections provides at once an arresting view of anatomical relationships in patterns of striking beauty. After working in the collection for years, one still finds every occasion to view it illuminating and rewarding.”
In 2000, artist-scientist Cheryl Cotman, computer programmer Kevin Head, and I, an anatomist, traced and digitized structures from the serial sagittal sections shown in this atlas. We made a computer reconstruction and large hologram (three by five feet) of the human limbic system. We are indebted to Cheryl for her help in selecting images from her large collection of color-coded overall and regional views of the system. We are enlightened by her discovery that several limbic structures are quite differently shaped than traditionally believed. Although Paul and I would find this hard to accept, we would accept her fantastic findings with glee and laughter.
-Jay B. Angevine Jr.
An autographed copy of an oil portrait of Paul
The original portrait was presented to the Warren Anatomical Museum at Harvard Medical School in 1978. (Courtesy the Warren Museum in the Francis A. Countway Library of Medicine, Boston, Massachusetts.)
Paul I. Yakovlev, MD 1894–1983.
Yakovlev by Bettina Steinke.
In Memoriam, v
Preface, vii
Acknowledgments, ix
A Note on the Whole-Brain Serial Sections and Their Origin, xi
1 External Anatomy of the Brain, 1
2 Transverse Sections of the Spinal Cord, 23
3 Transverse Sections of the Brainstem, 31
4 Building a Brain: Three-Dimensional Reconstructions, 49
5 Coronal Sections, 53
6 Axial Sections, 79
7 Sagittal Sections, 103
8 Functional Systems, 125
Long Tracts of the Spinal Cord and Brainstem, 125
Sensory Systems of the Brainstem and Cerebrum, 125
Cranial Nerve Motor Nuclei, 125
Visceral Afferents and Efferents, 125
Basal Ganglia, 125 Cerebellum, 125
Thalamus and Cerebral Cortex, 125
Hypothalamus and Limbic System, 125
Chemically Coded Neuronal Systems, 125
9 Clinical Imaging, 187
10 An Introduction to Neuropathology, 215
Primary Brain Tumors, 215 Astrocytomas, 215
Infiltrating Astrocytomas, 217
Oligodendrogliomas, 220 Ependymomas, 221 Medulloblastomas, 222 Meningioma, 224
Detection of an Abscess, 226
Demyelinating Syndromes, 227
Neurodegenerative Diseases, 230
Glossary, 235 Index, 273
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Sugar-works at Glasgow, ii. 455.
Summaries:
Reign of Mary, 1561-1565, i. 7; Regency of Moray, 1567-1570, 43; Regencies of Lennox and Mar, 1570-1572, 61, 62; Regency of Morton, 1572-1578, 82, 83; Reign of James VI. 1578-1585, 126-129; 1585-1590, 160, 161; 1591-1603, 219-221; 1603-1625, 379-381. Reign of Charles I., 1625-1637, ii. 1-3; 1637-1649, 105-113; Interregnum, 1649-1660, 174-177; Reign of Charles II., 1660-1673, 255-261; 1673-1685, 349-355; Reign of James VII., 469-475; concluding remarks, 496-499.
Sun, total eclipse of the, i. 296. Celebrated eclipse of, ii. 215.
Suns, curious appearance of three, ii. 9. Sunday, observance of, i. 329-333.
Superstitions and superstitious practices, i. 322-326.
Suppers, laudable custom of, revived, ii. 267.
Surgeons exempted from serving as jury-men, i. 42.
SUTHERLAND, Earl of, overtaken by a snow-storm, i. 363; contributions of tenantry to, 517.
SUTHERLAND of Duffus, his quarrel with Gordon of Enbo, ii. 5, 6.
Swans on Linlithgow Loch, anecdotes of, ii. 267, 268.
Swearing, fines for, i. 342.
Sweden, king of, troops levied in Scotland for, i. 445; unfortunate issue, 446.
Sword-dance, description of the, ii. 67, 68.
SYDSERF, Thomas, editor of the MercuriusCaledonius, ii. 271; his theatre, 324.
TAILIEFEIR, Bessie, sentenced to be brankit, i. 46.
Tailors, petition against outlandish, ii. 253, 254.
Tallow, laws against exporting, ii. 5.
Tarugo’sWiles, Sydserf’s play called, ii. 324.
Taxes, allocation of, to various towns, ii. 7.
Tay, remarkable flood in the, i. 525-527.
TAYLOR, John the Water-poet, his visit to Scotland, i. 493-500.
Tea, in Scotland, its first introduction, ii. 405.
TENNANT, Francis, hanged for his pasquils against the king and progenitors, i. 320.
Tercel called for by James VI., i. 391.
Test, magistrates of Peebles in a puzzle about the, ii. 429; burlesque of, 433.
Thanksgiving-day, on settlement between King and Estates, ii. 140.
Theatre, first, in Edinburgh established about 1679, ii. 400.
Theatricals in Scotland, toleration of, i. 306, 307.
ThirteenDriftyDays, Hogg’s account of the, ii. 365-367.
THOMSON, Annaple, and others, worried and burnt as witches, ii. 405, 406.
THOMSON, Gavin, assaulted by Thomas Pringle, i. 418.
THOMSON, Margaret, her complaint against Tutor of Calder, ii. 154.
Thumbikens, an instrument of torture so called, ii. 460.
Tide, remarkable swelling of the, at Leith, &c., i. 476.
Tobacco, Murray’s patent for importing, i. 531, 532. Licence for sale of, ii. 74; tax on, 332; first practitioner of tobacco-spinning in Leith, 346.
Toe-writing, singular instance of, ii. 253.
Toleration, want of, in Scotland, i. 244; imputation of toleration indignantly repudiated by King James, 533.
Declared against by the Presbyterian kirk, ii. 180; granted by James VII., 470; want of, at the Revolution, 498.
Tories, first introduction of the word into Scotland, ii. 227.
TORTHORALD, Lord, stabbed by William Stewart, i. 415.
Town-guard of Edinburgh, origin of the, ii. 438.
Trade, decree against freedom of, i. 458. Interesting particulars regarding, in Scotland, ii. 248, 249.
Transmigration of witches to distant places, &c., disputation on, i. 305.
Traquair, burning at Peebles of popish relics found at, ii. 499-501.
TRAQUAIR, Countess of, and her son, ii. 336.
——, first Earl of, anecdote of, ii. n.88; his death and character, 251, 252.
Travelling, anecdotes of, i. 299, 381, 493; ii. 218, 247, 391, 476.
TremblingExies, a disease so called, ii. 222.
Trough, Children of the (a singular anecdote), i. n.234.
Tulyiesor combats in Edinburgh, i. 47, 185, 258, 318.
TumblingLassieand Reid the mountebank, ii. 487.
TURNBULL and SCOTT, hanged for publishing a libel against Morton, i. 125.
TURNBULL, Andrew, beheaded, i. 320.
—— of Airdrie, abduction of his daughter, i. 419.
Turners, a base coin so called, ii. 128.
TWEEDIES and VEITCHES, feud between, i. 200-202; James VI. endeavours to suppress, 432.
Universities, order against receiving fugitive students at, i. 439.
URQUHART of Craigston, singular fortunes of his grandson, ii. 81-83.
USHER, Adie, a Border-thief, hanged; his son Willie, i. 546.
Usury severely punished, ii. 298.
VALLAM, James and George, hanged for robbery, i. 364.
VAUTROLLIER, a French Protestant, prints a volume of poems for James VI., i. 154.
VEITCHES and TWEEDIES, feud between, i. 200-202, 432.
Victory, naval, over the Dutch, rejoicings at, ii. 303.
Vintners and Butchers, outcry against extortion of, ii. 489, 490.
Visions in the air, ii. 313-315.
VOIS, Cornelius de, his gold and silver licence, i. 50.
Wages of skilled artisans in Scotland, ii. 235.
WALDEN, Lord, his journey of pleasure in Scotland, i. 454, 455.
WALKER, Patrick, his account of illusive psalm-singing, ii. 314; of visions of bonnets and weapons at Crossford, 485.
WALLACE, Margaret, worried and burnt for witchcraft, i. 527-529.
WALSINGHAM, Sir Francis, a councillor of Queen Elizabeth, his mission to James VI., i. 152.
Waly,waly!a popular ballad, composed on the Marchioness of Douglas, ii. 340.
Wame-illor land-ill, also called the PestilencebutMercy, i. 57.
Wappinshaw, why so called, i. 542.
Watch, a body of men appointed to keep peace in the Highlands, ii. 306.
WATSON, William, minister of Burntisland, i. 467.
WATT, John, shot dead on the Burgh-moor, i. 349.
WAUGH, Robert, hanged for rebuking the Regent Morton, i. 80.
Weather, the, i. 107, 112, 259, 286, 421, 431, 457, 458, 523, 541; ii. 4, 12, 17, 28, 61, 79, 83, 113, 115, 122, 134, 149, 199, 217, 222, 224, 234-236, 240, 253, 298, 299, 305, 313, 319, 324, 358, 365-367, 371-373, 426, 454, 462.
WEIR, Bessie, hanged as a witch, ii. 377-379.
——, John, tried for ‘incest,’ for marrying the relict of his granduncle, ii. 28.
WEIR, Major, strangled and burnt, ii. 332.
——, of Cloburn, a boy of fourteen, taken to Ireland, and married to a daughter of Laird of Corehouse, i. 454.
Wells of Edinburgh run dry, ii. 226.
WEMYSS, Countess of, death and extravagance of the, ii. 215.
WEMYSS of Logie, Mrs Margaret Twinstoun contrives his escape from confinement, i. 238.
West Indies, deportation of poor people to the, ii. 304, 305.
WESTERHALL, Laird of, slain by the Hamiltons, i. 99.
Whale captured by the English at Leith, ii. 218.
Whales, fourteen killed at Dornoch, i. 319.
Wheat, Council grants licence for exporting 4000 bolls, ii. 54.
Whig, origin of the term, ii. 171, 172.
Whilliwha’s, swindlers so called, i. 468.
WIGTON and CASSILLIS, Earls of, dispute between, ii. 30.
Wind, tremendous storm of, i. 421.
Wine, its importation into Western Isles restricted, i. 531.
WIRTEMBERG, Duke of, visits Scotland, i. 418.
WISHART, Janet, burnt for witchcraft, i. 278, 279.
Witchcraft, act against, i. 24;
William Stewart, Lyon King-of-arms hanged for, 60; witches of Athole, 70; Bessie Dunlop, burnt for, 107-110; Alison Peirson, burnt for, 183; trials of Lady Foulis and Hector Monro, 202-206; Bessie Roy tried for, 206; extraordinary trials for, 210-218; devil preaching to witches, illustration, 215; numerous cases of, 257; barbarous legal procedure in cases of, 273; remarkable trials in Aberdeen, 278-285; ‘the great witch of Balwery,’ 291; wood-cut of a witch seated on the moon, 378; the Broughton witches, 420; Margaret Barclay, executed for, 488; John Stewart, tried for, 488; Margaret Wallace, worried and burnt for, 527-529; Bessie Smith, of Lesmahago, 539; Thomas Grieve, strangled and burnt, 540; Privy Council’s doubts regarding, 548. Various cases of, ii. 31-34; John Balfour, a discoverer of, 61; William Coke and Alison Dick, burnt for witchcraft, their bill of expenses, 70, 71; case of Agnes Finnie and others, 149-154;
conference of ministers on, 180; several trials and burnings for, 186-189; presbytery of Lanark and the eleven witches, 194, 195; proceedings of Cromwell’s law-commissioners for Scotland, 219, 220; burnings for, 243, 244; numerous trials for, at the Restoration, 277-279; confessions of Isobel Gowdie and Janet Braidhead, 285-291; M‘Leans and others tortured for, 293-295; more cases of, 330; Jean Weir hanged, 333; curious cases of, 376-381; another witch-storm, 385, 386; anecdotes of, 393-395; Katherine Liddel persecuted for, 396; curious witch-trial at Borrowstounness, 405, 406; Marion Purdie imprisoned for, 462; books on, 475.
WOGAN, Captain, his daring march to the north, ii. 223; verses quoted from Waverleyon his death, 224.
WOOD, George, threatened arrestment of his corpse, ii. 328, 329.
WOOD, James, heir of Bonnington, beheaded, i. 350.
Wool, prohibition against exporting, &c., i. 475; Petition for dressing and refining of, ii. 346.
Wreckers of Dunbar and Western Islands, Council’s proceedings against, ii. 94, 95.
Writs, several persons hanged for making false, i. 260, 296.
YESTER, Master of, and Stewarts of Traquair, feud between, i. 168170.
YORK, James, Duke of. See JamesVII.
YOUNG, Isobel, burnt for witchcraft, ii. 31.
——, John, his attack on Richard Bannatyne, ii. 16.
YOUNG, Margaret, petitions Privy Council against false imprisonment, ii. 153.
END OF VOL. II.
Edinburgh: Printed
by W. and R. Chambers.
Half-glazed Window of Seventeenth Century.—See page 283.
Transcriber’s Notes:
The original accentuation, and spelling has been retained. Hyphenation has been made consistent as far as possible. New original cover art included with this eBook is granted to the public domain.
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