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Brain stem Flashcards

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1
Q

What are the 3 general functions of the brainstem?

A

Conduit for ascending and descending tracts connecting spinal cord to forebrain
Contains important reflex centers associated with respiration, cardiovascular system, and consciousness
Contains nuclei of CN III to XII

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2
Q

Where are the olives (inferior olivary nuclei) located?

A

Posterolateral of the pyramids on the medulla

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3
Q

Where the hypoglossal N emerge from the brainstem?

A

From groove between the pyramid and olive

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4
Q

What structure connects the medulla to the cerebellum, located posterior to the olive?

A

Inferior cerebellar peduncles

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5
Q

Where is the posterior median sulcus?

A

Dorsal medulla, inferior lateral part outside of 4th ventricle

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6
Q

Where is the gracile tubercle (gracile nucleus)?

A

On either side of the posterior median sulcus on the medulla

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7
Q

What is the location of the cuneate tubercles (nucleus)?

A

Lateral to the gracile tubercles on the medulla

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8
Q

What is the superomedial zone?

A

Form the caudal part of the 4th ventricle in the medulla

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9
Q

What 3 elevations are seen in the superomedial zone?

A

Hypoglossal trigone
Vagal trigone
Vestibular area

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10
Q

Where is the basilar groove?

A

Ventral midline of bones
Houses basilar artery

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11
Q

Where does the trigeminal N emerge from the brainstem?

A

Anterolateral surface of the pons - two roots

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12
Q

What CNs emerge from the groove between the pons and the medulla medial to lateral?

A

Abducent N
Facial N (two roots)
Vestibulocochlear N

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13
Q

What forms the upper part of the fourth ventricle?

A

Posterior surface of the pons

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14
Q

Where is the medial eminence?

A

On either side of the median sulcus on the dorsal pons

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15
Q

Where is the locus ceruleus?

A

Rostral to median sulcus of dorsal pons

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16
Q

What is the interpeduncular fossa?

A

Deep depression in midline of ventral midbrain

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17
Q

Where is the crus cerebri?

A

Also called cerebral peduncle
On either side of the interpeduncular fossa of ventral midbrain

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18
Q

What is found in the floor of the interpeduncular fossa?

A

Pituitary stalk
Mammillary bodies
Posterior perforated substance

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19
Q

What separates the lateral surface of the midbrain from the parahippocampal gyrus?

A

Trochlear N

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20
Q

Where are the superior colliculi?

A

Centers for visual reflexes
On dorsal midbrain, connected to lateral geniculate body

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21
Q

Where are the inferior colliculi?

A

Centers for auditory pathways
On dorsal midbrain, connected to medial geniculate body

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22
Q

Where does the trochlear N emerge from the brainstem?

A

Dorsal midbrain, below the inferior colliculi

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23
Q

What are the general functions of the reticular formation?

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A

Level of consciousness
Cardiovascular system
Respiratory system

24
Q

Where do corticobulbar fibers terminate?

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A

Midbrain, pons and medulla

25
What structures in the brainstem give rise to descending fibers to spinal cord?
Reticular formation Red nucleus Vestibular nuclei
26
What is the tectum?
Dorsal midbrain
27
What is the tegmentum?
Middle of midbrain Dorsal for pons and medulla
28
Where are the nuclei for CN III located in the brainstem?
Oculomotor nucleus and Edinger-Westphal nucleus both in midbrain
29
Where are the nuclei for CN IV located in the brainstem?
Trochlear nucleus in midbrain
30
Where are the nuclei for CN V located in the brainstem?
Trigeminal sensory: mesencephalic in midbrain Trigeminal sensory: primary in pons Trigeminal sensory: spinal in medulla Trigeminal nucleus in pons
31
Where are the nuclei for CN VI located in the brainstem?
Abducens nucleus in pons
32
Where are the nuclei for CN VII located in the brainstem?
Trigeminal sensory: mesencephalic in midbrain Trigeminal sensory: primary in pons Trigeminal sensory: spinal in medulla Facial nucleus in pons Superior salivatory nucleus in pons Nucleus of solitary tract in pons and medulla
33
Where are the nuclei for CN VIII located in the brainstem?
Vestibular nuclei and cochlear nuclei of pons and medulla
34
Where are the nuclei for CN IX located in the brainstem?
Inferior salivatory nucleus in pons Trigeminal sensory: primary in pons Trigeminal sensory: spinal in medulla Nucleus ambiguus in medulla Nucleus of solitary tract in pons and medulla
35
Where are the nuclei for CN X located in the brainstem?
Trigeminal sensory: primary in pons Trigeminal sensory: spinal in medulla Nucleus ambiguus in medulla Nucleus of solitary tract in pons and medulla Dorsal nucleus of vagus N in medulla
36
Where the nuclei for CN XI located in the brainstem?
Spinal accessory nucleus in medulla Also some from cervical spinal cord
37
Where are the nuclei for CN XII located?
Hypoglossal nucleus in medulla
38
What is the arterial supply to the medulla?
Anterior spinal A and PICA branches of vertebral A
39
What is the arterial supply to the pons?
Short and long circumferential branches of basilar A
40
What is the arterial supply of the midbrain?
Superior cerebellar A and quadrigeminal A branches of basilar A Also supplied by anterior and posterior choroidal arteries
41
What causes medial medullary syndrome?
Occlusion of branches of the anterior spinal A
42
What are symptoms of medial medullary syndrome?
Contralateral hemiplegia of body Contralateral loss of proprioception, vibration, and discriminatory touch of body Deviation of tongue to side of lesion
43
What causes lateral medullary syndrome?
Occlusion of PICA
44
What are symptoms of lateral medullary syndrome?
Contralateral loss of pain and temp of body Ipsilateral loss of pain and temp on face Dysphagia, hoarseness, soft palate paralysis, and diminished gag reflex Ipsilateral Horner's syndrome Nausea, vertigo, and nystagmus Ipsilateral ataxia
45
What causes lateral pontine syndrome?
Occlusion of AICA and SCA
46
What are symptoms of lateral pontine syndrome?
Contralateral loss of pain and temp of body Ipsilateral loss of pain and temp of face ipsilateral facial paralysis Ipsilateral paralysis of mastication Ipsilateral Horner's syndrome Nausea, vertigo, nystagmus, hearing loss, tinnitus Ipsilateral ataxia
47
What causes medial pontine syndrome?
Occlusion of paramedian branches of basilar A
48
What are symptoms of medial pontine syndrome?
Contralateral hemiplegia of body Contralateral loss of proprioception, vibration, and discriminatory touch of body Ipsilateral paralysis of lateral rectus - internal strabismus Paralysis of conjugate gaze toward side of lesion
49
What causes medial midbrain syndrome (Weber)?
Occlusion of paramedian branches of P1 segment of PCA?
50
What are symptoms of medial midbrain/Weber syndrome?
Contralateral hemiplegia of body Contralateral lower face muscle weakness Ipsilateral external strabismus, dilated fixed pupil and severe ptosis
51
What causes Benedikt syndrome?
Larger lesion of midbrain including both areas of Weber and Claude
52
What are symptoms of Benedikt syndrome?
Contralateral hemiplegia of body Ipsilateral paralysis of eye movement with dilated pupil Cerebellar and rubral tremor and ataxia
53
What causes Parinaud syndrome?
Usually a tumor in pineal region that impinges on the superior colliculi of midbrain
54
Why may hydrocephalus occur in Parinaud syndrome?
Pineal tumor may occlude the cerebral aqueduct
55
What are symptoms of Parinaud syndrome?
Paralysis of upward gaze Eventual failure of eye movement Nystagmus Hydrocephalus

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