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DPT 503 > Brainstem > Flashcards

Brainstem Flashcards

1
Q

what are the structures in the brainstem?

A

CN nuclei and pathways

vertical tracts

connections w/cerebellum

major centers and nuclei

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2
Q

what are the vertical tracts in the brainstem?

A

sensory (ascending) tracts:
- DCML
- spinothalamic
- spinocerebellar
- trigeminal lemniscus

motor (descending) tracts:
- vestibulospinal
- corticospinal
- rubrospinal
- reticulospinal

autonomic (descending) tracts:
- lateral and medial corticospinal
- vestibulospinal
- rubrospinal
- reticulospinal

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3
Q

what does the DCML do?

A

light touch, conscious proprioception

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4
Q

what does the spinothalamic tract do?

A

crude touch, temp, fast nociception

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5
Q

what is the connection w/ the cerebellum?

A

peduncles

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6
Q

what are the major centers and nuclei?

A

autonomic function

reticular function

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7
Q

what are the longitudinal sections of the brainstem?

A

most ventral-basilar part (basis pedunculi)

middle-tegmentum

most dorsal-tectum

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8
Q

basis pedunculi

A

most ventral longitudinal section of the brainstem

lots of motor structures including motor nuclei and axons from cortex

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9
Q

tegmentum

A

middle longitudinal section of the brainstem

contains a lot of sensory nuclei and some ascending tracts

reticular formation, sensory nucleus, and medial longitudinal fasciculus (MLF)

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10
Q

tectum

A

most dorsal longitudinal section of the brainstem

midbrain only

involved in control of eye and head movement

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11
Q

rule of 4 in the brainstem

A

4 structures in the midline begin with M

4 structures in the side begin with S

4 CNs in medulla, 4 in pons, 4 above pons (2 in midbrain)

4 motor nuclei in midline that divide equally into 12 (except 1 and 2)
- CN 3, 4, 6, 12
- CN 5, 6, 7, 9, 10, 11 in lateral brainstem

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12
Q

rule of 4: medial and lateral organization of the BS

A

4 Ms:
- motor tracts
- MLF
- medial lemniscus
- motor nuclei
–> CN 3, 4 in midbrain
–> CN 6 in pons
–> CN 12 in medulla

4 Ss:
- sympathetic tract (hypothalamospinal and hypothalmobulbar tracts)
- spinothalamic tract
- spinocerebellar tract
- sensory nuclei
–> CNS: midbrain, pons, medulla (Trigeminal tract)
–> CN 7 in pons
–> CN 8 in pons and medulla
–> CN 9, 10 in medulla

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13
Q

rule of 4: CNs

A

1-4 above pons
5-8 in pons
rest in medulla w/exception of 8 and 11
- 8 starts in pons, ends in medulla
- 11 in SC

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14
Q

connection w/cerebellum

A

cerebellar function dependent on connection w/BS

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15
Q

what are the 4 parts of the midbrain?

A

basis pedunculi

tegmentum

tectum

medial longitudinal fasciculus

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16
Q

basis pedunculi

A

anterior structure of the midbrain

cerebral peduncles

SN

also part of basal ganglia

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17
Q

tegmentum

A

largest portion of midbrain

sensory tracts
-retiular formation: midbrain to medulla
- autonomic pathways (hypothalamospinal tract (sympathetic))
- MLF (coordination of eye and head movements)
- CN 5-8 nuclei

oculomotor complex

CN 4 nuclei - trochlear

PPN

red nucleus

PAG

trigeminal lemniscus

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18
Q

what is in the oculomotor complex?

A

CN 3 nuclei
Edinger-Westphal nuclei (parasympathetic s of CN 3)
- innervates ciliary muscles of eye that adjust thickness of lens and constrict pupil

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19
Q

what is the role of CN 4 (trochlear)

A

eye adduction

superior oblique muscle

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20
Q

what does the PPN do?

A

modulates reticulospinal activation

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21
Q

what does the red nucleus do?

A

controls upper extremity flexors

descending tract (rubrospinal)

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22
Q

what is the role of the PAG?

A

pain modulation

one of the key areas of the brain that can spread ascending pain signal

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23
Q

what is the role of the trigeminal lemniscus?

A

info from face about light touch and conscious proprioception

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24
Q

midbrain tectum

A

pretectal areas - part of visual system

superior an inferior colliculus - head and eye movements

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25
what is the role of pretectal areas
visual system eye reflexes located right in front of sup/info colliculus
26
what is the role of the superior and inferior colliculus?
superior: reflexive eye and head movements in response to tactile info inferior: auditory info contributing to visual attention
27
MLF
located near midline bilaterally ascending and descending fibers coordinate eye movement - connects CN 3, 4, 6 - integrates eye movement w/head movement (CN 8)
28
what does damage to the MLF result in?
gaze palsy-can't move eyeballs
29
pons
major motor processing center higher level respiratory control most descending tracts pass through anterior pons (basilar part) tegmentum (post, bordering 4th ventricle)
30
most descending tracts pass through the basilar part of the pons. what are the 2 exceptions to this?
corticopontine tract: cortex to pons corticobulbar tract: cortex to CN nuclei innervating face, head, and neck muscles - facial expressions, muscles of mastication, pharynx, larynx, and tongue
31
medulla
vasoconstricts/dilated, coughing, swallowing needed for survival functions ventrally located pyramids: rubrospinal and lateral corticospinal go through pons here olive: lateral to pyramids posteriorly is inferior peduncle connecting medulla and 4th ventricle
32
pontomedullary junction
connection b/w pons and medulla cochlear and vestibular nuclei medial and lateral vestibulospinal tracts pontomedullary reticular formation
33
what do the cochlear and vestibular nuclei do?
auditory and vestibular inputs to CN 8 output to medial and lateral vestibulospinal tracts
34
what do the medial and lateral vestibulospinal tracts do?
postural muscles activity head and eye movements-MLF
35
what does the pontomedullary reticular formation do?
coughing, hiccuping, sneezing, yawning, shivering, gagging, vomitting, swallowing, laughing, crying
36
what does the superior olive contribute to?
locating sounds
37
what is in the rostral medulla?
nucleus ambiguus hypoglossal nucleus (CN 12) solitary nucleus inferior olivary nucleus
38
what is the nucleus ambiguus and what does it do?
motor efferent controls muscles in pharynx and larynx via CN 9 and 10 shared motor nuclei for CN 9 and 10 damage=difficulty swallowing, dysphonia, and instability of HR CN 9-soft pallette and pharynx CN 10-vagus-slows HR (cardiac parasympathetic activity)
39
what is the solitary nucleus and what does it do?
visceral sensory nucleus visceral and taste efferents (CN 7) cardiorespiratory centers (inputs from baroreceptors in carotid body and aortic arch -CN 9 and 10) lesion=loss of taste and instability of BP
40
what is the inferior olivary nucleus and what does it do?
irregularly shaped nucleus perception of time and control of movement (olivocerebellar tracts) afferent from motor and sensory corticies efferent connection going out of cerebellum timing of movement
41
what is in the caudal medulla?
pyramids (corticospinal tract axons) - lateral corticospinal is most important voluntary movement tract spinothalamic tracts DCML CN 5 MLF
42
what are the pathways to the medulla?
cerebrovestibular tract
43
what are the pathways from the medulla?
spinocerebellar tract olivocerebellar tract vestibulocerebellar tract reticulocerebellar tract
44
what is in the reticular formation?
4 reticular nuclei -VTA - PPN - raphe nuclei - locus coeruleus and medial reticular zone (MRZ) ascending/descending projections - reticulospinal tracts (2) - raphespinal tract - ceruleospinal tract
45
what are the functions of the reticular formation?
integrates sensory and cortical info regulates motor activity, autonomic function, and consciousness modulates nociceptive info-always ascending info
46
what is the ventral tegmental area (VTA), where is it located, and what does it do?
midbrain dopamine released (SN in midbrain also released dopamine) motivation, decision-making, pleasure/reward
47
where is most dopamine released into the CNS from?
midbrain (SN and VTA)
48
what is the PPN, where is it located, and what does it do?
caudal midbrain releases ACh (excitatory/inhibitory), GABA (inhibitory), and glutamate (excitatory) motor control - GP, STN influence reticulospinal tract neurons - reticulospinal tract-posture and gross limb movement - limbic system lesion=issues w/initiation of movement
49
what is the raphe nuclei, where is it located, and what does it do?
midbrain, pons, and medulla releases serotonin pontine raphe nuclei project mainly to cerebrum and modulate activity throughout cerebral cortex - arousal and mood medulary raphe nuclei are involved in pain modulation and provides serotonin to dorsal horn of SC inhibiting nociceptive info - sensory and autonomic activity - decreases pain-one of the fastest routes to decrease pain
50
what is the locus coeruleus (LC) and medial reticular zone (MRZ), where are they located, what do they release, and what do they do?
pons LC and MRZ: NE MRZ: E arousal, attention, autonomic regulation LC: direct attention to food and enemies; inhibits spinothalamic neuron to modulate pain signals nonspecific excitation of motor and interneurons in SC MRZ: psychological responses to stress and panic- (related to sympathetic response)
51
what are the 4 descending tracts of the reticular formation?
medial reticulospinal tract lateral reticulospinal tract raphespinal tract ceruleospinal tract
52
what does the medial reticulospinal tract do?
postural control pons
53
what does the lateral reticulospinal tract do?
gross limb movement medulla
54
what does the raphespinal tract do?
pain modulation (dorsal horn) cardiac influence (lateral horn) nonspecific activation of interneurons and motor neurons in SC (ventral horn)
55
does the ceruleospinal tract do?
enhances activity of motor neuron pool and interneuron pool throughout SC do same as ventral raphespinal w/different mechanism
56
what structures are involved in the regulation of consciousness?
reticular formation ascending reticular activating system (ARAS) cerebral consciousness system
57
what is the ARAS?
formation and cerebral consciousness system actively induces sleep
58
what are the structures of the cerebral consciousness system?
basal forebrain thalamus cerebral cortex
59
what would a lesion in the structures that regulate consciousness result in?
difficulty controlling consciousness and wakefulness
60
what is the blood supply of the midbrain?
posterior cerebral artery (branch of basilar artery)
61
what is the blood supply of the pons?
anterior inferior cerebellar artery (AICA) superior cerebellar artery
62
what is the blood supply of the medulla?
basilar artery (paramedian and circumferential branches) posterior inferior cerebellar artery (PICA) anterior spinal artery posterior spinal artery

DPT 503 (22 decks)

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