Correct Answer: C. Fornix
The fornix is a C-shaped white matter tract that forms the primary efferent pathway of the hippocampus. It originates from the hippocampus as the fimbria, curves upward beneath the corpus callosum, and divides into the body and two crura. The fornix has three main divisions: the crus (posterior), body (middle), and columns (anterior). It projects to the mammillary bodies, anterior thalamus, and septal nuclei—critical for memory consolidation and limbic system integration. In coronal and sagittal brain sections, the fornix appears as a distinct arched structure running parallel to the corpus callosum. Its anatomical position—medial to the lateral ventricle, beneath the corpus callosum—makes it a consistent landmark in neuroimaging. Clinically, fornix damage results in memory deficits and Korsakoff syndrome when bilateral mammillary body connections are disrupted. In Indian medical education (per Bailey & Love and standard neuroanatomy texts), the fornix is consistently identified by its characteristic C-shaped course and relationship to surrounding limbic structures.
Why the other options are wrong
A. Falx cerebri — The falx cerebri is a dural fold (meningeal structure), not a neural tract. It lies between the cerebral hemispheres and appears as a linear dural reflection on imaging, not the curved white matter bundle seen in structure B. This is a common trap—confusing meningeal folds with neural structures in neuroanatomy questions. B. Pineal gland — The pineal gland is a small endocrine structure located in the midline posterior to the third ventricle, not a white matter tract. It produces melatonin and is visible as a small nodule on sagittal imaging. Structure B's elongated, arched morphology and location beneath the corpus callosum are incompatible with the pineal gland's anatomy. D. Pituitary gland — The pituitary gland sits in the sella turcica below the hypothalamus and is an endocrine organ, not a neural tract. Its location is inferior and anterior to the structures shown in typical sagittal brain sections where the fornix is clearly visible. This option exploits confusion between limbic endocrine structures and white matter pathways.
High-Yield Facts
- Fornix origin: Arises from the fimbria of the hippocampus and forms the primary efferent pathway of the limbic system.
- Fornix course: C-shaped structure that runs beneath the corpus callosum, dividing into crus (posterior), body (middle), and columns (anterior).
- Fornix projections: Connects to mammillary bodies, anterior thalamus, and septal nuclei—essential for memory and emotional processing.
- Fornix damage: Bilateral fornix/mammillary body lesions cause Korsakoff syndrome with anterograde and retrograde amnesia.
- Imaging landmark: Fornix is consistently visible on sagittal and coronal MRI as a white matter tract medial to the lateral ventricle.
Mnemonics
Fornix Function (F-M-S) From hippocampus → Mammillary bodies → Septal nuclei. Traces the major output pathway of the limbic system for memory consolidation. Fornix Parts (C-B-C) Crus (posterior) → Body (middle) → Columns (anterior). Helps recall the three anatomical divisions of the fornix.
NBE Trap
NBE often pairs the fornix with endocrine structures (pineal, pituitary) to exploit confusion between limbic white matter tracts and midline glandular structures. Students who memorize only "midline structures" without understanding neural vs. endocrine anatomy fall into this trap.
Clinical Pearl
In Indian clinical practice, fornix integrity is assessed in patients with suspected Wernicke-Korsakoff syndrome (common in alcoholic populations) and in pre-surgical evaluation for temporal lobe epilepsy. Damage to the fornix-mammillary body circuit is the pathological hallmark of Korsakoff syndrome, making fornix anatomy clinically relevant for neurology and psychiatry boards.
_Reference: Bailey & Love's Short Practice of Surgery (Neuroanatomy section); Robbins Pathology Ch. 28 (Limbic system and memory); Harrison's Principles of Internal Medicine Ch. 391 (Amnesia and Korsakoff syndrome)_