Brainstem (2)

Question 1

What information does the brainstem integrate?

Answer 1

Sensory, auditory, vestibular, and cortical

Question 2

What does the brainstem regulate?

Answer 2

Somatic motor activity (Reticulospinal tracts for tone, balance, and posture)

Autonomic function (cardiac and vasomotor centers)

Question 3

What does the brainstem play an important role in?

Answer 3

Sleep and consciousness

Question 4

What are the red flags for brainstem dysfunction?

Answer 4

Dysphagia

Dysarthria

Diplopia

Dysmetria

Question 5

What are the reticular nuclei?

Answer 5

Clusters of cell bodies distributed throughout brainstem

Question 6

What are the types reticular nuclei?

Answer 6

Ventral tegmental area (dopamine)

Pedunculopontine nucleus (acetylcholine)

Locus coeruleus (norepinephrine)

Raphe nuclei (serotonin)

Question 7

What does the ascending reticular activating system regulate?

Answer 7

Consciousness (sleep/wake cycles and attention)

Question 8

What are the descending tracts from reticular formation?

Answer 8

Reticular tracts (raphe nuclei)

Cerulospinal tract (locus coeruleus)

Raphespinal tract (raphe nuclei)

Question 9

What is the role of the reticular tracts?

Answer 9

Posture and gross movement

Question 10

What is the role of the ceruleospinal tract?

Answer 10

Autonomic function- physiologic response to stress and panic

Alertness

Question 11

What is the role of the raphespinal tract?

Answer 11

Sensory, autonomic, and motor

(Influence on cardiovascular system and inhibition of pain)

Question 12

What are the altered states of consciousness?

Answer 12

Coma

Stupor

Obtunded

Vegetative state

Minimally conscious state

Syncope

Delirium

Question 13

Coma

Answer 13

Unarousabale (no response to strong stimuli)

Question 14

Stupor

Answer 14

Avoidable only by strong stimuli (strong pinching of Achilles)

Question 15

Obtunded

Answer 15

Sleeping more than awake (confused when awake)

Question 16

Vegetative state

Answer 16

Complete loss of consciousness, without alteration of vital functions

Question 17

What signs distinguish vegetative state from a coma?

Answer 17

Eye opening

Regular sleep/wake cycles

Normal respiratory patterns

Question 18

Minimally conscious state

Answer 18

Severely altered consciousness with at least 1 behavioral sign of consciousness

Question 19

What are behavioral signs of consciousness?

Answer 19

Following simple commands

Yes/no responses

Intelligible speech

Movements that are not reflexive

Question 20

Syncope

Answer 20

Brief loss of consciousness due to drop in BP

Question 21

Delirium

Answer 21

Reduced attention, orientation, and perception (associated with confusion and agitation)

Question 22

What responses do you look for in the Glasgow coma scale?

Answer 22

Eye

Verbal

Motor

Question 23

What does the superior Cerebellar arteries supply?

Answer 23

Superior half of cerebellum and part of midbrain

Question 24

What does the anterior inferior Cerebellar arteries supply?

Answer 24

Anterior inferior portion of cerebellum

Question 25

What does the posterior inferior Cerebellar arteries supply?

Answer 25

Posterior inferior portion of cerebellum

Question 26

What does disruption to the posterior inferior Cerebellar arteries result in?

Answer 26

Lateral medullary syndrome

Question 27

What is ischemia in the brainstem?

Answer 27

Rapid onset of symptoms (visual disturbance, weakness, incoordination, and somatosensory disturbances)

Question 28

What is a red flag of vertebrobasilar artery insufficiency?

Answer 28

Neck extended and rotated provokes symptoms

Question 29

Where is the corticospinal tract in the medulla?

Answer 29

Ventral portion

Question 30

Where is the spinothalamic tract located in the medulla?

Answer 30

Medial

Question 31

Where is the spinocerebellar tract located in the medulla?

Answer 31

Lateral

Question 32

Where are the trigeminal and medial lemniscus located in the medulla?

Answer 32

Ventral and medial

Question 33

What is the small hole in the middle of the midbrain?

Answer 33

Cerebral aqueduct

Question 34

What is the function of the red nucleus?

Answer 34

Unconscious coordination of motor activities

Question 35

What is the function of the pariaqueductal gray?

Answer 35

Somatic and autonomic reactions to pain (fight or flight)

Question 36

What is the function of the superior tectum?

Answer 36

Orienting eyes to external stimuli

Question 37

What is the function of the inferior tectum?

Answer 37

Hearing and relating auditory information to the superior colliculi

Question 38

What cranial nerves is the pons involved in?

Answer 38

5, 6, 7, and 8