Brainstem 1 Flashcards

1
Q

What are the three main parts of the brainstem?

A

Midbrain, Pons, Medulla

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2
Q

What are the three main functions of the brainstem?

A
  1. ) Integrative function
  2. ) Cranial Nerve Function
  3. ) Conduit Funciton
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3
Q

The third ventricle is located in the

A

Diencephalon

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4
Q

In the hindbrain dorsal to the pons and upper medulla

A

4th ventricle

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5
Q

The brainstem has 3 exit points for CSF circulation. What are they?

A

2 Foramen of Luschka (lateral) and 1 Foramen of Magendie (medial)

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6
Q

Drains through magendi and luschka into big cistern

A

CSF

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7
Q

It is possible to obtain CSF from the subarachnoid space of the

A

Magna Cistern

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8
Q

In a lesion of the Pyramidal (corticospinal) tracts at the level of the midbrain, pons, or medulla shows

A

Contralateral deficits

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9
Q

Moves the body and travels through the brainstem

A

Corticospinal tract

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10
Q

Moves the face and has endings in the brainstem

A

Corticobulbar tract

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11
Q

Functions in descendingcontrol& modulationofsensory& motornucleiofcranial nerves

A

Corticobulbar tract

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12
Q

1st order axons of the corticobulbar tract are located in the widespread areas of the

A

Cerebral cortex

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13
Q

The 2nd order axons of the corticobulbar tract are located in the

A

Pontine and medullary reticular formation and nuclei of cranial nerves

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14
Q

Most corticobulbar innervation is

A

Bilateral

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15
Q

The corticobulbar tract in contralateral for

A

Nucleus of CNXII, lower nucleus of CN VII, and n. ambiguous innervation of soft palate and uvula (CNX)

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16
Q

The only place where the corticobulbar tract is ipsilateral is in the nucleus of

A

CNXI

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17
Q

The dorsal funiculus is also known as the

A

Dorsal columns

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18
Q

The first order axons for the DCMLS are large myelinated fibers of the

A

Dorsal Root Ganglia

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19
Q

The 2nd order axons of the DCMLS are

-Decussate as internal arcuate fibers

A

Nuclei gracilis and cuneatus

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20
Q

The 3rd order axons for the DCMLS are in the

A

VPL nucleus of thalamus

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21
Q

The DCMLS crosses in the

A

lower medulla (internal arcuate fibers)

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22
Q

Medial lesions at the level of the medulla will affect the

A

Medial Lemniscus

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23
Q

Medial lesions at the level of upper pons and midbrain will not affect

A

Medial Lemniscus

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24
Q

The 1st order axons of the anterolateral system (Spinothalamic pathway) are

A

Small myelinated and unmyelinated fibers of DRG

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25
Q

The second order axons of the STT are located in the

A

Dorsal horn layers I, II, and V

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26
Q

The 3rd order axons of the STT are in the

A

VPL nucleus of the thalamus

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27
Q

The STT crosses at the

A

Spinal segmental levels

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28
Q

Lateral lesions at the level of the medulla, pons, and midbrain will affect the

A

STT

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29
Q

What is the one motor and one sensory pathway that makes synapses in the medulla?

A

Corticobulbar (motor) and DCMLS (sensory)

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30
Q

What is the one motor and one sensory pathway that travels through the medulla without synapsing?

A

Corticospinal (motor) and Spinothalamic (sensory)

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31
Q

What are the three CN’s that are strictly sensory

A

I, II, and VIII

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32
Q

What are the 4 CN’s that are mixed motor and sensory?

A

V, VII, IX, and X

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33
Q

What are the 5 CN’s that are strictly motor

A

III, IV, VI, XI, and XII

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34
Q

What is the pneumonic for knowing the sensory and motor classification of the CNs?

A

Some Say Marry Money, But My Brother Says Big Brains Matter Most

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35
Q

What are the two cranial nerves in the midbrain?

A

CN’s III and IV

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36
Q

What are the 4 CN’s in the Pons

A

V, VI, VII, and VIII

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37
Q

What are the 4 CN’s in the medulla?

A

IX, X, XI, and XII

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38
Q

As a general rule, motor nerve nuclei tend to be located

A

Medially

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39
Q

As a general rule, sensory nerve nuclei tend to be located in the

A

Lateral brainstem

40
Q

LowermotorneuronsofCNXIInucleus extendthefulllengthofthemedullaasa

A

Cell Column

41
Q

The most important muscle used to protrude the tongue is innervated by CN XII, this is the

A

Genioglossus muscle

42
Q

Are NOT parallel to eachother

A

Genioglossus muscles

43
Q

You need bilateral activation of CN XII to

A

Protrude the tongue

44
Q

The corticobulbar tract is mainly contralateral for

A

CN XII

45
Q

Which genioglossus muscle is contracting if you stick the tip of your tongue to the right?

A

Left genioglossus

46
Q

Is controlled by both corticonuclear neurons and reticular neurons for automatic/reflex movements

A

CN XII nucleus

47
Q

The corticonuclear neurons innervating CN XII nucleus are for control of

A

Voluntary movements and articulation

48
Q

Used for control of sterotyped movements while eating and swallowing

A

Reticular neurons that innervat CN XII nucleus

49
Q

To execute voluntary face movement, we are using both

A

upper and lower motor neurons

50
Q

What is the upper motor neuron for tongue movement?

A

Corticobulbar

51
Q

What is the lower motor neuron for tongue movement?

A

CN XII

52
Q

With an UMN lesion of CN XII, the tongue deviates to

A

Opposite side of damage

53
Q

With a LMN lesion of CN XII, the tongue deviates to the

A

Same side a the damage

54
Q

Results in considerable disability in speaking and severe difficulty in swallowing food

A

Bilateral CN XII lesion

55
Q

The most common causes of CN XII lesions are

A

Motor neuron disease, demyelination, bleeding, and tumors of medulla and base of skull

56
Q

A motor nerve that moves the neck and shoulder

A

CN XI (spinal accessory nerve)

57
Q

Innervatesipsilateral sternocleidomastoid &trapezius muscles

A

Branchial motor part of CN XI (spinal part)

58
Q

Joins CN X to control the larynx

A

Visceral motor part of CN XI (accessory part)

59
Q

With a lesion of CN XI, the patient can not rotate the head to the

A

Healthy side (away from lesion)

60
Q

We also see ipsilateral shoulder drop and weakened voice or hoarseness with

A

Lesion of CN XI

61
Q

Made up of 2 efferent (motor) components and 3 afferent (sensory) components

A

Vagus Nerve (CN X)

62
Q

Function in swallowing and vocalization, and preganglionic parasympathetic output for organs throughout body

A

2 efferent (motor) components of CN X

63
Q

Motor efferents for the heart, lungs, and gastrointestinal to the splenic flexure

A

Preganglionic parasympatetic motor of CN X

64
Q

A major controller of the pharyngeal muscles for swallowing and the laryngeal muscles for vocalization

A

Motor efferents from CN X

65
Q

In CN X, multiple nuclei make up one

A

Cranial Nerve

66
Q

Thismulti‐functionalfeaturemeansthatseveral nucleiinsidebrainstem arecontributingtomakeanervebutallaxonsareformasinglebundleatthe

A

CN X level of the medulla

67
Q

The start of the preganglionic parasympathetic fibers for CN X

-For organs throughout the body

A

Dorsal Motor Nucleus of CN X

68
Q

The motor part of CNX for swallowing and vocalization

-for muscles from branchial arches

A

N. ambiguus

69
Q

Innervates nearly all pharyngeal and upper esophageal muscles (swallowing and gag reflex) and laryngeal muscles (vocalization)

A

N. ambiguus

70
Q

Provides touch, pain, and temperature from selected parts of the face:

  1. ) Pharynx and larynx
  2. ) Meninges of posterior fossa
  3. ) Small region of outer ear
A

CN X

71
Q

Special visceral sensory for taste from the epiglottis and posterior pharynx

-“Conscious sensory”

A

Nucleus Solitarius

72
Q

Also provides general visceral sensory from chemoreceptors (carotid body) , baroreceptors (carotid sinus), and cardiorespiratory system

-“Subconscious sensory”

A

Nucleus Solitarius

73
Q

The rostral and caudal parts of the N. solitarius are receiving

A

Different sensory input

74
Q

Receives taste signals coming from the tongue

A

Rostral n. solitarius

75
Q

Receives baroreceptor and chemoreceptor signals

A

Caudal part of n. solitarius

76
Q

The caudal part of the n. solitarius also receives visceral signals from the

A

Thoracic and abdominal viscera

77
Q

A complete bilateral lesion of the vagus nerve is

A

Fatal

78
Q

Shows widespread dysfunction of the palate, pharynx, and larynx

A

Unilateral lesion of the vagus nerve

79
Q

Will show a palatal arch sagging and deviation of the uvula

-also vocal muscle paralysis

A

Unilateral lesion of the vagus nerve

80
Q

The uvula will point away from the affected side with

A

Unilateral CN X lesion

81
Q

To test the vagus nerve, we say

A

AAAHHHH

82
Q

Named for innervation of posterior tongue and pharynx

A

Glossopharyngeal nerve (CN IX)

83
Q

Has preganglionic parasympathetic output to only ONE gland

A

CN IX

84
Q

CN IX has preganglionic parasympathetic output for the

A

Parotid gland

85
Q

Like CN X, has multi-functional features, which means that several nuclei inside of the brianstem are involved. But all axons form a single bundle at this nerves level of the medulla

A

CN IX

86
Q

Provides special sensory for taste to the posterior 1/3 of the tongue

A

Glossopharyngeal Nerve (IX)

87
Q

Provides sensory information from the posterioronethirdoftongue,middleear,tympanicmembrane,eustachiantube, smallregionofexternalear,tonsillarregion,upperpharynx(afferentportionofthegagreflex)

A

Glossopharyngeal nerve

88
Q

The inferior salivatory nucleus of the parotid gland is innervated by the

A

Glossopharyngeal nerve (IX)

89
Q

CN IX neurons form the inferior salivatory nucleus. This is placed in the

A

PONS (not medulla)

90
Q

What is the muscle that is innervated by CN IX and is responsible for elevating the pharynx during talking and swallowing?

A

CN IX (Glossopharyngeal)

91
Q

Can cause poliomyelitis, ischaemic lesions, intramedullary tumors, motor neuron disease, and myastenia gravis

A

Lesions of N. ambiguus

92
Q

Provides afferent sensory portion of gag reflex

A

CN IX

93
Q

These sensory fibers act on the nucleus ambiguus motor neurons of

A

CN X

94
Q

Due to the sensory actions of CN IX and motor actions of CN X, the gag reflex causes the

A

Palate to elevate symetrically, pharynx constricts, and larynx closes

95
Q

Episodes of severe throat and ear pain

A

Glossopharyngeal neuralgia