JOHN HOPKINS MEDICINE

Brain Anatomy and How the Brain Works

Brain, Nerves and Spine

What is the brain?

The brain is a complex organ that controls thought, memory, emotion, touch, motor
skills, vision, breathing, temperature, hunger and every process that regulates our
body. Together, the brain and spinal cord that extends from it make up the central
nervous system, or CNS.

What is the brain made of?

Weighing about 3 pounds in the average adult, the brain is about 60% fat. The
remaining 40% is a combination of water, protein, carbohydrates and salts. The brain
itself is a not a muscle. It contains blood vessels and nerves, including neurons and
glial cells.

What is the gray matter and white matter?

Gray and white matter are two different regions of the central nervous system. In the
brain, gray matter refers to the darker, outer portion, while white matter describes the
lighter, inner section underneath. In the spinal cord, this order is reversed: The white
matter is on the outside, and the gray matter sits within.

Gray matter is primarily composed of neuron somas (the round central cell bodies),
and white matter is mostly made of axons (the long stems that connects neurons
together) wrapped in myelin (a protective coating). The different composition of
neuron parts is why the two appear as separate shades on certain scans.

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Each region serves a different role. Gray matter is primarily responsible for
processing and interpreting information, while white matter transmits that information
to other parts of the nervous system.

How does the brain work?

The brain sends and receives chemical and electrical signals throughout the body.
Different signals control different processes, and your brain interprets each. Some
make you feel tired, for example, while others make you feel pain.

Some messages are kept within the brain, while others are relayed through the spine
and across the body’s vast network of nerves to distant extremities. To do this, the
central nervous system relies on billions of neurons (nerve cells).

Main Parts of the Brain and Their Functions

At a high level, the brain can be divided into the cerebrum, brainstem and
cerebellum.

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Cerebrum
The cerebrum (front of brain) comprises gray matter (the cerebral cortex) and white
matter at its center. The largest part of the brain, the cerebrum initiates and
coordinates movement and regulates temperature. Other areas of the cerebrum
enable speech, judgment, thinking and reasoning, problem-solving, emotions and
learning. Other functions relate to vision, hearing, touch and other senses.

Cerebral Cortex

Cortex is Latin for “bark,” and describes the outer gray matter covering of the
cerebrum. The cortex has a large surface area due to its folds, and comprises about
half of the brain’s weight.

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The cerebral cortex is divided into two halves, or hemispheres. It is covered with
ridges (gyri) and folds (sulci). The two halves join at a large, deep sulcus (the
interhemispheric fissure, AKA the medial longitudinal fissure) that runs from the front
of the head to the back. The right hemisphere controls the left side of the body, and
the left half controls the right side of the body. The two halves communicate with one
another through a large, C-shaped structure of white matter and nerve pathways
called the corpus callosum. The corpus callosum is in the center of the cerebrum.

Brainstem
The brainstem (middle of brain) connects the cerebrum with the spinal cord. The
brainstem includes the midbrain, the pons and the medulla.

 Midbrain. The midbrain (or mesencephalon) is a very complex structure with

a range of different neuron clusters (nuclei and colliculi), neural pathways and
other structures. These features facilitate various functions, from hearing and
movement to calculating responses and environmental changes. The
midbrain also contains the substantia nigra, an area affected by Parkinson’s
disease that is rich in dopamine neurons and part of the basal ganglia, which
enables movement and coordination.
 Pons. The pons is the origin for four of the 12 cranial nerves, which enable a
range of activities such as tear production, chewing, blinking, focusing vision,
balance, hearing and facial expression. Named for the Latin word for “bridge,”
the pons is the connection between the midbrain and the medulla.
 Medulla. At the bottom of the brainstem, the medulla is where the brain
meets the spinal cord. The medulla is essential to survival. Functions of the
medulla regulate many bodily activities, including heart rhythm, breathing,
blood flow, and oxygen and carbon dioxide levels. The medulla produces
reflexive activities such as sneezing, vomiting, coughing and swallowing.

The spinal cord extends from the bottom of the medulla and through a large
opening in the bottom of the skull. Supported by the vertebrae, the spinal cord
carries messages to and from the brain and the rest of the body.

Cerebellum
The cerebellum (“little brain”) is a fist-sized portion of the brain located at the back of
the head, below the temporal and occipital lobes and above the brainstem. Like the
cerebral cortex, it has two hemispheres. The outer portion contains neurons, and the
inner area communicates with the cerebral cortex. Its function is to coordinate
voluntary muscle movements and to maintain posture, balance and equilibrium. New
studies are exploring the cerebellum’s roles in thought, emotions and social
behavior, as well as its possible involvement in addiction, autism and schizophrenia.

Brain Coverings: Meninges

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Three layers of protective covering called meninges surround the brain and the
spinal cord.

 The outermost layer, the dura mater, is thick and tough. It includes two
layers: The periosteal layer of the dura mater lines the inner dome of the skull
(cranium) and the meningeal layer is below that. Spaces between the layers
allow for the passage of veins and arteries that supply blood flow to the brain.
 The arachnoid mater is a thin, weblike layer of connective tissue that does
not contain nerves or blood vessels. Below the arachnoid mater is the
cerebrospinal fluid, or CSF. This fluid cushions the entire central nervous
system (brain and spinal cord) and continually circulates around these
structures to remove impurities.
 The pia mater is a thin membrane that hugs the surface of the brain and
follows its contours. The pia mater is rich with veins and arteries.

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Lobes of the Brain and What They Control

Each brain hemisphere (parts of the cerebrum) has four sections, called lobes:
frontal, parietal, temporal and occipital. Each lobe controls specific functions.

 Frontal lobe. The largest lobe of the brain, located in the front of the head,
the frontal lobe is involved in personality characteristics, decision-making and
movement. Recognition of smell usually involves parts of the frontal lobe. The
frontal lobe contains Broca’s area, which is associated with speech ability.
 Parietal lobe. The middle part of the brain, the parietal lobe helps a person
identify objects and understand spatial relationships (where one’s body is
compared with objects around the person). The parietal lobe is also involved
in interpreting pain and touch in the body. The parietal lobe houses
Wernicke’s area, which helps the brain understand spoken language.
 Occipital lobe. The occipital lobe is the back part of the brain that is
involved with vision.
 Temporal lobe. The sides of the brain, temporal lobes are involved in short-
term memory, speech, musical rhythm and some degree of smell recognition.

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Deeper Structures Within the Brain

Pituitary Gland
Sometimes called the “master gland,” the pituitary gland is a pea-sized structure
found deep in the brain behind the bridge of the nose. The pituitary gland governs
the function of other glands in the body, regulating the flow of hormones from the
thyroid, adrenals, ovaries and testicles. It receives chemical signals from the
hypothalamus through its stalk and blood supply.

Hypothalamus
The hypothalamus is located above the pituitary gland and sends it chemical
messages that control its function. It regulates body temperature, synchronizes sleep
patterns, controls hunger and thirst and also plays a role in some aspects of memory
and emotion.

Amygdala
Small, almond-shaped structures, an amygdala is located under each half
(hemisphere) of the brain. Included in the limbic system, the amygdalae regulate
emotion and memory and are associated with the brain’s reward system, stress, and
the “fight or flight” response when someone perceives a threat.

Hippocampus
A curved seahorse-shaped organ on the underside of each temporal lobe, the
hippocampus is part of a larger structure called the hippocampal formation. It
supports memory, learning, navigation and perception of space. It receives
information from the cerebral cortex and may play a role in Alzheimer’s disease.

Pineal Gland
The pineal gland is located deep in the brain and attached by a stalk to the top of the
third ventricle. The pineal gland responds to light and dark and secretes melatonin,
which regulates circadian rhythms and the sleep-wake cycle.

Ventricles and Cerebrospinal Fluid

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Deep in the brain are four open areas with passageways between them. They also
open into the central spinal canal and the area beneath arachnoid layer of the
meninges.

The ventricles manufacture cerebrospinal fluid, or CSF, a watery fluid that

circulates in and around the ventricles and the spinal cord, and between the
meninges. CSF surrounds and cushions the spinal cord and brain, washes out waste
and impurities, and delivers nutrients.

Blood Supply to the Brain

Two sets of blood vessels supply blood and oxygen to the brain: the vertebral
arteries and the carotid arteries.

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The external carotid arteries extend up the sides of your neck, and are where you
can feel your pulse when you touch the area with your fingertips. The internal carotid
arteries branch into the skull and circulate blood to the front part of the brain.

The vertebral arteries follow the spinal column into the skull, where they join together
at the brainstem and form the basilar artery, which supplies blood to the rear
portions of the brain.

The circle of Willis, a loop of blood vessels near the bottom of the brain that
connects major arteries, circulates blood from the front of the brain to the back and
helps the arterial systems communicate with one another.

Cranial Nerves
Inside the cranium (the dome of the skull), there are 12 nerves, called cranial nerves:

 Cranial nerve 1: The first is the olfactory nerve, which allows for your sense
of smell.
 Cranial nerve 2: The optic nerve governs eyesight.
 Cranial nerve 3: The oculomotor nerve controls pupil response and other
motions of the eye, and branches out from the area in the brainstem where
the midbrain meets the pons.
 Cranial nerve 4: The trochlear nerve controls muscles in the eye. It
emerges from the back of the midbrain part of the brainstem.
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 Cranial nerve 5: The trigeminal nerve is the largest and most complex of
the cranial nerves, with both sensory and motor function. It originates from the
pons and conveys sensation from the scalp, teeth, jaw, sinuses, parts of the
mouth and face to the brain, allows the function of chewing muscles, and
much more.
 Cranial nerve 6: The abducens nerve innervates some of the muscles in
the eye.
 Cranial nerve 7: The facial nerve supports face movement, taste, glandular
and other functions.
 Cranial nerve 8: The vestibulocochlear nerve facilitates balance and
hearing.
 Cranial nerve 9: The glossopharyngeal nerve allows taste, ear and throat
movement, and has many more functions.
 Cranial nerve 10: The vagus nerve allows sensation around the ear and the
digestive system and controls motor activity in the heart, throat and digestive
system.
 Cranial nerve 11: The accessory nerve innervates specific muscles in the
head, neck and shoulder.
 Cranial nerve 12: The hypoglossal nerve supplies motor activity to the
tongue.

The first two nerves originate in the cerebrum, and the remaining 10 cranial nerves
emerge from the brainstem, which has three parts: the midbrain, the pons and the
medulla.

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