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Dental Neuroscience > brain stem lesions > Flashcards

brain stem lesions Flashcards

1
Q

common causes of brain stem lesions (6)

A
  1. strokes (most common)
  2. traumatic injuries
  3. inflammatory diseases and infectious diseases
  4. tumors
  5. degenerative disorders
  6. cranial nerve disorders
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2
Q

UMN lesion

A
  • upper motor neuron
  • a lesion that occurs in the upper portion of the motor neuron pathway (2nd order)
  • lesion on pathway that controls alpha motor neuron
  • near cortex, brainstem, medulla, spinal cord
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3
Q

LMN lesion

A
  • lower motor neuron
  • a lesion that occurs in the lower portion of the motor neuron pathway (1st order)
  • damage to the alpha motor neurons
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4
Q

paralysis by lesion of LMN

A
  • flaccid - the muscle does nothing (“dead”)
  • atrophy - wasting away of the muscle
  • fasciculation - spontaneous contraction (twitching)
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5
Q

paralysis by lesion of UMN

A
  • spastic - hypersensitive, reflexes, extra tone in the muscles
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6
Q

medial medullary lesion (alternating hypoglossal hemiplegia) can affect

A
  1. corticospinal tract
  2. medial lemniscus
  3. hypoglossal nerve
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7
Q

what are the symptoms caused by the medial medullary lesion affecting the corticospinal tract?

A

contralateral hemiplegia of the body (opposite side of the lesion)

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8
Q

what are the symptoms caused by the medial medullary lesion affecting the medial lemniscus?

A

contralateral loss of touch, pressure, vibration, and joint position sense in the limbs

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9
Q

what are the symptoms caused by the medial medullary lesion affecting the hypoglossal nerve?

A

ipsilateral wasting of tongue

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10
Q

overall: what are the symptoms (combined) of medial medullary lesion?

A
  • contralateral hemiplegia of the body (opposite side of the lesion)
    -contralateral loss of touch, pressure, vibration, and joint position sense in the limbs
  • ipsilateral wasting of tongue
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11
Q

lateral medullary lesion (wallenberg syndrome) can affect:

A
  1. descending V
  2. spinothalamic tract
  3. nucleus ambiguus
  4. inferior cerebellar peduncle
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12
Q

what symptoms are caused when there is a lateral medullary lesion affecting the descending V?

A

ipsilateral loss of pain and temperature sensation from face

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13
Q

what symptoms occur when there is a lateral medullary lesion affecting the spinothalamic tract?

A

contralateral loss of pain and temperature sensation from trunk and limbs

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14
Q

what symptoms occur when there is a lateral medullary lesion affecting the nucleus ambiguus?

A
  • dysarthria
  • hoarseness
  • dysphagia
  • loss of gag reflex
  • ipsilateral paralysis of laryngeal and pharyngeal muscles
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15
Q

what symptoms occur when there is a lateral medullary lesion affecting the inferior cerebellar peduncle?

A
  • ipsilateral dystaxia
  • ipsilateral dysmetria
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16
Q

overall: what are the symptoms of a lateral medullary lesion?

A
  • ipsilateral loss of pain and temperature sensation from face
  • contralateral loss of pain and temperature sensation from trunk and limbs
  • dysarthria
  • hoarseness
  • dysphagia
  • loss of gag reflex
  • ipsilateral paralysis of laryngeal and pharyngeal muscles
  • dystaxia
  • dysmetria
  • ipsilateral
17
Q

medial pontine lesion can affect:

A
  1. corticospinal tract
  2. corticobulbar tracts
  3. medial lemniscus
  4. abducent nerve roots (pathway)
  5. base of pons
18
Q

what symptoms occur when there is a medial pontine lesion affecting the corticospinal tract?

A

contralateral hemiplegia of trunk and limbs

19
Q

what symptoms occur when there is a medial pontine lesion affecting the medial lemniscus?

A

contralateral loss of touch, pressure, vibration, and joint position sense in limbs

20
Q

what symptoms occur when there is a medial pontine lesion affecting the abducent nerve root (pathway)?

A

ipsilateral paralysis of lateral rectus (eye cannot abduct)

21
Q

what symptoms occur when there is a medial pontine lesion affecting the base of pons?

A

ipsilateral ataxia of limbs and gait

22
Q

overall: what are the symptoms of a medial pontine lesion?

A
  • contralateral hemiplegia of trunk and limbs
  • contralateral loss of touch, pressure, vibration, and joint position sense in limbs
  • ipsilateral paralysis of lateral rectus (eye cannot abduct)
  • ipsilateral ataxia of limbs and gait
23
Q

a lateral pontine lesion can affect:

A
  1. motor nucleus of trigeminal
  2. chief sensory nucleus of trigeminal
  3. spinothalamic tract
  4. middle cerebellar peduncle
24
Q

what symptoms occur when there is a lateral pontine lesion affecting the motor nucleus of trigeminal?

A

ipsilateral paralysis of muscles of mastication, deviation of jaw

25
Q

what symptoms occur when there is a lateral pontine lesion affecting the chief sensory nucleus of trigeminal?

A

ipsilateral facial hemianesthesia

26
Q

what symptoms occur when there is a lateral pontine lesion affecting the spinothalamic tract?

A

contralateral loss of pain and temperature sensation from trunk and limbs

27
Q

what symptoms occur when there is a lateral pontine lesion affecting the middle cerebellar peduncle?

A

ipsilateral limb and gait dystaxia

28
Q

overall: what are the symptoms of a lateral pontine lesion?

A
  • ipsilateral paralysis of muscles of mastication, deviation of jaw
  • ipsilateral facial hemianesthesia
  • contralateral loss of pain and temperature sensation from trunk and limbs
  • ipsilateral limb and gait dystaxia (lack of muscle coordination in walking)
29
Q

a ventral midbrain lesion (weber syndrome, alternating oculomotor hemiplegia) can affect:

A
  1. corticospinal tract
  2. corticobulbar tracts
  3. oculomotor nerve roots
30
Q

what symptoms occur when there is a ventral midbrain lesion affecting the corticospinal tract?

A

contralateral hemiparalysis of trunk and limbs

31
Q

what symptoms occur when there is a ventral midbrain lesion affecting the cortibulbar tract?

A

contralateral weakness of lower face, tongue, palate

32
Q

what symptoms occur when there is a ventral midbrain lesion affecting the oculomotor nerve roots?

A

ipsilateral oculomotor nerve paralysis, eye abduction and depression, ptosis, dilated pupil

33
Q

overall: what are the symptoms of a ventral pontine lesion?

A
  • contralateral hemipareisis of trunk and limbs
  • contralateral weakness of lower face, tongue, palate
  • ipsilateral oculomotor nerve paralysis, eye abduction and depression, ptosis, dilated pupil
34
Q

impact of brain stem lesions on dental treatment

A
  • communication challenges
  • swallowing difficulties and risk of aspiration
  • patient positioning
  • oral hygeine

Dental Neuroscience (24 decks)

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