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neuro anatomy 3 > Lesion I > Flashcards

Lesion I Flashcards

1
Q

paresis

A

weakness (partial paralysis)

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2
Q

hemiparesis

A

weakness of one side of the body (face, arm and leg)

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3
Q

palsy

A

weakness or no movement

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4
Q

paralysis

A

no movement

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5
Q

hemiplegia

A

no movement of one side of the body (face, arm and leg)

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6
Q

Weber syndrome deficits

A

MIDIAL MIDBRAIN SYNDROME

  • lesion in ROSTRAL MIDBRAIN basis
  • IPSILATERAL oculomotor nerve palsy
  • CONTRALATERAL hemiparesis
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7
Q

A lesion in the rostral midbrain basis on the LEFT, results in…

A
  • oculomotor nerve palsy on LEFT
  • Weak lateral pterygoid on RIGHT
  • Weak facial muscles on LOWER RIGHT
  • weak musculus uvulae on RIGHT
  • weak genioglossus on RIGHT
  • weak extremtiies on RIGHT
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8
Q

Claude syndrome deficits

A

CENTRAL MIDBRAIN SYNDROME

  • IPSILATERAL oculomotor nerve palsy
  • CONTRALATERAL ataxia and tremor of cerebellar origin
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9
Q

Benedikt syndrome deficits

A
  • MEDIAL MIDBRAIN + CENTRAL MIDBRAIN LESIONS
  • IPSILATERAL oculomotor nerve palsy
  • CONTRALATERAL hemiparesis
  • CONTRALATERAL ataxia, tremor, and inoluntary movements
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10
Q

blood supply to the medial portion of the midbrain

A
  • branches of POSTERIOR CEREBRAL artery (PCA)
  • Top of basilar artery
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11
Q

What structures are involved in Weber syndrome (medial midbrain syndrome)

A
  • Exiting root of OCULOMOTOR NERVE (contains GSE + GVE) = Ipsilateral
  • Corticonuclear fibers (basis pedunculi) = (UMN) weakness/paralysis (contralateral)
  • Corticospinal fibers in basis pedunculi (above the pyramidal decussation) = CONTRALATERAL weakness (hemiparesis) of the extremities
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12
Q

describe lesion to oculomotor nerve

A
  • contains GSE + GVE fibers
  • oculomoter NERVE innervates the IPSILATERAL eye

–> IPSILATERAL paralysis of the LPS (PTOSIS)

–> EYE cannot move medially or vertically (EYE DEVIATED DOWN and OUT)

–> IPSILATERAL DILATION of the pupil/fixed (MYDRIASIS), lens is flat

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13
Q

Describe lesion to Cortiocnuclear fibers

A
  • located in basis pedunculi (prior to their distribution
  • LESION that damages the corticonuclear (UMN) tract in the LEFT rostral midbrian RESULTS in WEAKNESS/PARALYSIS in CONTRALATERAL side
  • TRIGEMINAL MOTOR NUCLEUS = (midpons)
  • FACIAL NUCLEUS
  • NUCLEUS AMBIGUUS
  • HYPOGLOSSAL NUCLEUS
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14
Q

Lesion to the tigeminal motor nucleus

A
  • Affected in MEDIAL MIDBRAIN SYNDROME (WEBER SYNDROME)
  • located in midpons
  • receives BILATERAL UMN projections; EXCEPT for the LMN that innervate lateral pterygoid muscle (receive CONTRALATERAL projections)
  • CONTRALATERAL WEAKNESS/PARALYSIS of the lateral pterygoid muscle = RIGHT lateral pterygoid will be affected/weak, jaw will deviate to the RIGHT (weak side) on protrusion
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15
Q

Lesion to the facial nucleus

A
  • Damaged in Medial midbrain syndrome (weber syndrome)
  • upper 1/2 receives BILATERAL UMN projections
  • lower 1/2 receives CONTRALATERAL projections
  • CONTRALATERAL weakness/paralysis of the muscles of the LOWER FACE
  • RIGHT LOWER facial muscles will be affected and show weakness/paralysis
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16
Q

Lesion to the nucleus ambiguus

A
  • Damaged in medial midbrain syndrome (weber syndrome)
  • receives BILATERALY (primarily contralateral) UMN projections
  • CONTRALATERAL weakness/paralysis of MUSCULUS UVULAE
  • RIGHT MUSCULUS UBULAE will be affected, uvula will be PULLED to innervate/intact side to DEVIATE to left when saying AHHH
17
Q

lesion to the Hypoglossal nucleus

A
  • Damaged in Medial midbrain syndrome (webers syndrome)
  • Receives BILATERAL UMN projections, EXCEPT FOR LMN’s that INNERVATE GENIOGLOSSUS, which receives ONLY contralteral projections
  • CONTRALATERAL WEAKNESS/PARALYSIS of GENIOGLOSSUS MUSCLE

–> innervated/intact side PUSHES tongue to deviate toward the WEAK side (to the right if lesion on left) UPON PROTRUSION

18
Q

Occlusion of what vessels which result in Claude sydrome

A
  • Branches of posterior cerebral artery (PCA)
  • Top of basilar artery
19
Q

What structures are affected in Central midbrain syndrome (midbrain tegmentum)

A
  • Oculomotor nerve fascicles = oculomotor NERVE innervates the IPSILATERAL EYE
  • Red nucleus
  • Cerebellothalamic fibers = CONTRALATERAL ataxia and tremor of cerebellar origin
20
Q

Lesion to the oculomotor nerve fascicles

A
  • Affected in Central midbrain syndrome (Claude syndrome)
  • Oculomotor nerve innervates the IPSILATERAL EYE
  • IPSILATERAL PARALYSIS OF THE LPS = PTOSIS
  • Extraocular muscles (ipsilateral oculomotor nerve palsy) EXCEPT the LR6SO4

–> eye cannot move medially or vertically (EYE DEVIATED DOWN AND OUT, diplopia)

  • IPSILATERAL DILATION of the pupil/fixed (MYDRIASIS), lens is flat
21
Q

describe cerebellothalamic fibers

A
  • Cerebellum fibes rise to OUTPUT fibers called CEREBELLOTHALAMIC FIBERS
  • Exit the cerebellum and ASCEND to the midbrain via the SCP

–> DECUSSATE in the CAUDAL MIDBRAIN in the decussation of the SCP (at level of the inferior colliculus)

  • fibers continue to the thalamus which project to motor cortex
  • CONTROLS MOVEMENT OPPOSITE SIDE OF THE BODY
  • LESION just ROSTRAL to the SCP decussation on the RIGHT, damaging the cerebellothalamic fibers carrying informatino from the CONTRALATERAL (LEFT) cerebellum

–> DEFICITS INCLUDE = CONTRALATERAL ataxia and tremor of cerebellar origin

22
Q

substantia nigra

A
  • Output frmo the RIGHT basal ganglia and projected to the RIGHT thalamus which projects to the RIGHT motor cortex
  • Right motor cortex controls MOVEMENT of the LEFT SIDE
  • Movement of the left side of the body is INFLUENCED by the RIGHT BASAL GANGLIA
  • control contralateral INVOLUNTARY movement
23
Q

Lesion in CAUDAL MIDBRAIN

A
  • CAUSED BY DEMYELINATING DISEASE (Multiple sclerosis)
  • Cerebellothalamic fibers (from superior cerebellar peduncles) = DEFICITS IN RIGHT LIMBS)
  • LEFT TROCHLEAR NUCLEUS = RIGHT eye is deviated upward (HYPERTROPIC and slightly EXTORTED)
  • LEFT MEDIAL LONGITUDINAL FASICULUS (MLF) = LEFT INTERNUCLEAR OPHTHALMOPLEGIA (INO) (left eye does NOT turn medially on gase to the right)

neuro anatomy 3 (8 decks)

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