Week 3 Lecture 6: Brainstem and Intro to Cerebellum Flashcards

1
Q

What is a conduit?

A

a natural or artificial channel through which something is conveyed e.g fluid

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2
Q

What does the reticular formation control?

A
  • consciousness
  • cardiovascular and respiratory functions
  • perception of pain
  • arousal
  • sleep wake cycle
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3
Q

What is the reticular formation?

A

diffused area of neurones that spans the whole area of brainstem

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4
Q

Which structure in the brain gives rise to cranial nerves 3-12?

A

brainstem

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5
Q

What are the 3 structures that the brainstem is composed of?

A

midbrain, pons and medulla oblongata

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6
Q

What structure sits above the midbrain?

A

diencephalon

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7
Q

What structure is found caudal to the medulla?

A

spinal cord - at the level of the foramen magnum

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8
Q

What is found dorsal and ventral to the brainstem?

A

dorsal - clivus of the occipital bone

ventral - cerebellum

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9
Q

Which components of the brainstem run through the ventricular system?

A
  • IVth ventricle - between the pons and medulla anteriorly and the cerebellum posteriorly
  • cerebral aqueduct (Caq) - at the level of the midbrain
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10
Q

What is the embryological origin of the structures that make up the brainstem?

A

mesencephalon (midbrain)

rhombencephalon - metencephalon and myelencephalon (pons and medulla oblongata respectively)

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11
Q

What is the internal structure of the brainstem composed of?

A
  1. tectum (most dorsal/ posterior to ventricular system)
  2. tegmentum (anterior to ventricular system)
  3. basal area (most ventral)
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12
Q

In locked in syndrome, how is the patient able to breath?

A

the stroke is at the level of the pons

the tegmentum is unaffected which explains why patients can breath and CVS is intact

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13
Q

What is the junction between the pons and the medulla called?

A

pontomedullary junction

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14
Q

What structure defines the midline of the medulla and seperates the two pyramids?

A

anterior median fissure

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15
Q

What are pyramids (in medulla)?

A

bumps on either side of the anterior median fissure

underneath is white matter fibres coming from the cortex that are sent down the CNS

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16
Q

Where is there crossing over of fibres contained in the medullary pyramids?

A

decussation of pyramids - this is where fibres from the left and right hemispheres meet so they can instruct the other side of the body

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17
Q

What structure separates the pyramids from the olives?

A

antero-lateral sulcus

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18
Q

Which cranial nerve fibres do we find at the antero-lateral sulcus?

A

hypoglossal nerve

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19
Q

Which cranial nerves emerge at the postero-lateral sulcus?

A

IX (glossopharyngeal), X (vagus), XI (spinal)

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20
Q

What is the rhomboid area/ fossa?

A

floor of the 4th ventricle

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21
Q

What two tubercles can we see on the dorsal aspect of the medulla?

A
  1. gracile fasciculus - either side of midline - bump that contains white matter fibres travelling from SC to brainstem
  2. cuneate fasciculus (lateral to gracile fasciculus)
22
Q

What is the name of the point that marks the end of the 4th ventricle?

A

obex

23
Q

How do we divide the medullas?

A
  • rostral or ‘open’ medulla

- caudal or ‘closed’ medulla

24
Q

What are the cuneate and gracile tubercles?

A

bumps in the gracile fasciculus and cuneate fasciculus because of the nucleis containing cell bodies underlying them

25
Q

What is the defining feature of the open medulla

A

is open dorsally to the 4th nucleus at the obex

26
Q

Which structures do we find in the closed (caudal) medulla?

A
  • gracile tubercle
  • cuneate tubercle
  • pyramid
27
Q

What is the name of the junction between the midbrain and pons?

A

pontomesencephalic junction

28
Q

Where does the basilar artery sit?

A

in the basilar groove

29
Q

What is the name of the junction between the cerebellum and the pons?

A

cerebellopontine angle

30
Q

Which cranial nerves emerge from the cerebellopontine angle?

A

CN VII and CN VIII - facial and vestibulochochlear

31
Q

What attaches the cerebellum to the midbrain?

A

superior cerebellar peduncle

32
Q

What attaches the cerebellum to the pons?

A

middle cerebellar peduncle

33
Q

What attaches the medulla to the cerebellum?

A

inferior cerebellar peduncle

34
Q

In what direction do the fibres run in the pons?

A

transverse

35
Q

Which structure forms the roof of the 4th ventricle?

A

superior cerebellar peduncle

36
Q

What are cerebral peduncles?

A

a collection of descending motor fibres coming from the cortex

37
Q

What lies in between the left and right cerebral peduncles?

A

interpeduncular fossa

38
Q

Which cranial nerves emerge from the midbrain?

A

CN III (from the interpeduncular fossa) and CN IV

39
Q

What are the names of the 2 paired bumps found on the dorsal aspect of the midbrain and what is the significance of each?

A

superior colliculus - important for the visual system

inferior colliculus - important for the auditory system

40
Q

What is the brachium of the superior colliculus and inferior colliculus?

A

colliculi have a projection that extends to connect with the thalamus

41
Q

Explain the key features of the anterior view of the midbrain

A

main feature - cerebral peduncle
seperated by interpeduncular fossa
oculomotor nerve emerges

42
Q

what are the key features of the dorsal view of the midbrain?

A
  • superior and inferior colliculi
  • trochlear nerve emerges
  • has cerebral aquaduct running through it
43
Q

Where is the reticular formation?

A

in the tegmentum of the brainstem

44
Q

Which arteries are involved in the blood supply to the brainstem?

A
  • PCA (midbrain/ occipital lobe)
  • basilar artery (pons)
  • SCA
  • AICA
  • PICA
  • vertebral artery (medulla)
45
Q

State where each of cranial nerve 3-12 emerge from?

A

3- oculomotor arises between left and right peduncle
5 - trigeminal emerges from middle of pons
6 - abducens in pontomedullary junction
7/8 - facial and vestibulocochlear at level of cerebellar pontine angle
9,10,11 - glossopharyngeal, vagus and accessory emerge lateral to olives
12 - hypoglossal emerges between pyramid and olives

46
Q

What is the cerebellum responsible for?

A

co ordination of movement, maintenance of balance and posture

47
Q

What is the anatomical location of the cerebellum?

A

found under the occipital lobes of the cerebral hemispheres and dorsal to brainstem

48
Q

What divides the anterior and posterior lobes of the cerebellum?

A

primary fissure

49
Q

What seperates the two hemispheres of the cerebellum?

A

vermis

50
Q

What is tonsillar herniation?

A
  • there are two tonsils seen in the ventral view of the cerebellum, just posterior to the medulla
  • if there is increased intracranial pressure the tonsils might herniate into the medulla