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1、间脑及相关临床问题Diencephalon&ClinicalCorrelations丘脑ThalamusFunctionalDivisionsofThalamusDependingontheanatomicconnections,thethalamuscanbedividedintofivefunctionalnucleargroups:sensory,motor,limbic,multimodal,andintralaminar(seeTable9-1).Thesensorynuclei(ventralposte
2、riorgroupandgeniculatebodies)areinvolvedinrelayingandmodifyingsensorysignalsfromthebody,face,retina,cochlea,andtastereceptors.Thethalamus(ratherthanthesensorycortex)isthoughttobethecrucialstructurefortheperceptionofsometypesofsensation,especiallypain,andthesen
3、sorycortexmayfunctiontogivefinerdetailtothesensation.Thethalamicmotornuclei(ventralanteriorandlateral)conveymotorinformationfromthecerebellumandglobuspallidustotheprecentralmotorcortex.ThenucleihavealsobeencalledmotorrelaynucleionthebasisoftheseconnectionsTher
4、earethreeanteriorlimbicnucleiinterposedbetweenthemamillarynucleiofthehypothalamusandthecingulategyrusofthecerebralcortex.Thedorsomedialnucleusreceivesinputfromtheolfactorycortexandamygdalaregionsandprojectsreciprocallytotheprefrontalcortexandthehypothalamus.Th
5、emultimodalnuclei(pulvinar,posterolateral,anddorsolateral)haveconnectionswiththeassociationareasintheparietallobe.Otherdiencephalicregionsmaycontributetotheseconnections.Other,nonspecificthalamicnucleiincludetheintralaminarandreticularnucleiandthecentrummedian
6、um;theprojectionsofthesenucleiarenotknownindetail.Interactionwithcorticalmotorareas,thecaudatenucleus,theputamen,andthecerebellumhasbeendemonstrated.ClinicalCorrelationsThethalamicsyndromeischaracterizedbyimmediatehemianesthesia,withthethresholdofsensitivityto
7、pinprick,heat,andcoldrisinglater.Whenasensationisfelt,sometimesreferredtoasthalamichyperpathia,itisdisagreeableandunpleasant.Thesyndromeusuallyappearsduringrecoveryfromathalamicinfarct;rarely,persistentburningorboringpaincanoccur(thalamicpainsyndrome).下丘脑Hypot
8、halamusFunctionsAlthoughthehypothalamusissmall(itweighs4gm—about0.3ofthetotalbrainweight),thehypothalamicregionhasimportantregulatoryfunctions.A.Eating:Atonicallyactivefeedingcente
