Brain Stem & Cranial Nerves Flashcards

1
Q

What are the 3 major anatomical divisions of the brainstem?

A
  1. Midbrain
  2. pons
  3. medulla
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2
Q

Describe the midbrain

A
  • 1.5cm long
  • from pons to mamillary bodies
  • has basis peduncles on ventral side
  • dorsal surface as superior and inferior colliculi (tectum)
  • 2 cranial nerves come out - III (medial) and IV (lateral)
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3
Q

Describe the Pons

A
  • anatomically distinct “bridge” wrapping around to cerebellum
  • 1 cranial nerve comes out the middle (V) & 3 come out the bottom (VI, VII, VIII)
  • part lateral to CNV becomes cerebellar peduncles
  • the dorsal aspect is the tegmentum
  • 2.5cm long
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4
Q

Describe the medulla oblongata

A
  • From bottom of pons to foramen magnum (where it pokes out of skull)
  • 3cm long
  • continuation of spinal cord
  • has pyramids on ventral surface, with inferior olive lateral to pyramids
  • 4 cranial nerves come off (IX, X, XI lateral to olive, XII lateral to pyramids)
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5
Q

What are the major ascending pathways passing through the brainstem?

A
  1. dorsal column medial lemniscus
    * touch, vibration, proprioception
    * synapses at the gracile/cuneate nuclei of medulla (before continuing up to cortex)
  2. Spinothalamic & spinotectal
    * pain, temp, touch
    * passes through, traversing lateral brainstem on the way to thalamus
    * combine to form spinal lemniscus
  3. spinoreticular & spinomesencephalic
    * pain
    * synapse in medullar & pontine reticular formation
  4. spinocerebellar tracts
    * proprioception
    * through pons into cerebellum
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6
Q

What are the major descending tracts passing through the brainstem?

A
  1. corticospinal tract
    * through midbrain basis peduncles, through medullary pyramids & down spinal cord - just passes through
    * motor control
  2. central tegmental tract
    * red nucleus to inferior olive
    * small projection continues down spinal cord as rubrospinal tract
  3. tectospinal tract
    * from superior colliculi to pons/medulla reticular formation
    * reflexive control of eyes
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7
Q

What are some important nuclei/structures/areas of the brainstem and their function/importance?

A
  1. pretectal area (in midbrain)
    * involved in reflex pathway constricting pupils at night
  2. tegmentum (midbrain)
    * includes red nucleus
  3. substantia nigra (midbrain)
    * dopaminergic area modulating movement
  4. red nucleus
  5. cranial nerve cell bodies (except CNI & CNII)
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8
Q

Name the 12 cranial nerves in order

A
  1. olfactory
  2. optic
  3. oculomotor
  4. trochlear
  5. trigeminal
  6. abducent
  7. facial
  8. vestibulocochlear
  9. glossopharyngeal
  10. vagus
  11. accessory
  12. hypoglossal
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9
Q

Identify whether each cranial nerve is sensory, motor or both

A
  1. Sensory
  2. Sensory
  3. Motor
  4. Motor
  5. Both
  6. Motor
  7. Both
  8. Sensory
  9. Both
  10. Both
  11. Motor
  12. Motor
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10
Q

What is the origin, function & implication of disease for cranial nerve I

A
  • Olfactory nerve
  • sensory
  • sense of smell
  • from olfavtory receptor cells to olfactory bulb
  • anosmia - loss of smell
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11
Q

What is the origin, function & implication of disease for cranial nerve II

A
  • optic nerve
  • sensory
  • sense of vision
  • from retinal ganglion cells to lateral geniculate nucleus of thalamus
  • impacted vision (due to MS, optic neuritis or lesions)
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12
Q

What is the origin, function & implication of disease for cranial nerve III

A
  • Oculomotor nerve
  • motor
  • eye movements & pupil constriction
  • emerges below mamillary bodiy, to extraocular muscles (4 of the 6)
  • oculomotor palsy, dilated pupil, loss of pupillary reflex
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13
Q

What is the origin, function & implication of disease for cranial nerve IV

A
  • Trochlear nerve
  • motor
  • eye rotation
  • from midbrain lateral to peduncles to extraocular uscle
  • eyeball cannot turn inferomedially
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14
Q

What is the origin, function & implication of disease for cranial nerve V

A
  • Trigeminal nerve
  • both sensory & motor
  • largest cranial nerve, sensation from face, motor (mastication)
  • from pons to skin of head & face, muscles for chewing, 3 branches (Va, V2, V3 which is the motor one)
  • inability to chew, loss of facial sense of touch/temp/pain
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15
Q

What is the origin, function & implication of disease for cranial nerve VI

A
  • Abducent nerve
  • motor
  • eye abduction (moving outwards)
  • from between pons & medulla to extraocular muscle
  • eye medial deviation
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16
Q

What is the origin, function & implication of disease for cranial nerve VII

A
  • Facial nerve
  • both sensory & motor
  • taste, motor (facial expressions)
  • fromj between pons & medulla to face/head and tongue, 5 branches
  • Bell’s palsy, facial droop, paralysis
17
Q

What is the origin, function & implication of disease for cranial nerve VIII

A
  • vestibulocochlear nerve
  • sensory
  • sense of hearing & balance
  • between pons & medulla to cochlea & vestibular apparatus
18
Q

What is the origin, function & implication of disease for cranial nerve IX

A
  • Glossopharyngeal nerve
  • both sensory & motor
  • taste, motor (pharynx), BP/blood gas info
  • from medulla (lateral to olive) to face, pharynx, carotid body
  • impaired taste, difficulty swallowing, inpaired gag reflex, dry mouth
19
Q

What is the origin, function & implication of disease for cranial nerve X

A
  • Vagus nerve
  • Both sensory & motor
  • Taste, chemo&baro receptors, parasympathetic innervation
  • from medulla (lateral to olive) to visceral organs (4 divisions)
  • digestive, breathing, cardio problems, autonomic dysfunction
20
Q

What is the origin, function & implication of disease for cranial nerve XI

A
  • Accessory nerve
  • motor
  • neck & trapezius muscle movements
  • from medulla (lateral to olive) down spinal cord a bit, to neck/trapezius
  • shoulder droop, neck weakness/paralysis
21
Q

What is the origin, function & implication of disease for cranial nerve XII

A
  • Hypoglossal nerve
  • motor
  • tongue motor control
  • from medulla (between pyramid and olive) to tongue
  • difficulty with speech and articulation
22
Q

What are the 5 types of fibres that can be carried in cranial nerves?

A
  • somatic motor
  • visceral motor
  • somatic sensory
  • visceral sensory
  • special sensory