Brainstem

Question 1

What separates the two cerebral peduncles

Answer 1

interpeduncular fossa

Question 2

3 Axons in the cerebral peduncle

Answer 2

corticopontine, corticospinal, and corticobulbar

Question 3

Where do oculomotor (III) Emerge in the brainstem

Answer 3

From the midbrain between the peduncles in interpeduncular fossa

Question 4

Which Cranial Nerves exit medially?

Which Cranial Nerves exit laterally?

Answer 4

Motor neurons exit medially (III< IV, VI, XII)

Mixed Nerves exit laterally (V,VII,VIII, IX,X)

Question 5

Where do the CN5 fibers enter or exit

Answer 5

rostral pons

Question 6

Where do fibers of CN6,7,8 enter or exit

Answer 6

At the pontomedullary junction

Question 7

Where do the roots of CN9 and 10 enter or exit

Answer 7

Dorsolateral to the olive

Question 8

Where does cranial nerve 12 exit

Answer 8

Medial to olive and lateral to the pyramid

Question 9

Cranial nerve 4 is the only (2 things)

Answer 9

Only dorsally exiting and only fully crossed nerve

Question 10

What courses with the corticospinal tract and what does it synapse with?

Answer 10

Corticobulbar travels with corticospinal and innervates lower motor neurons in cranial nerve nuclei

Question 11

Track in anterolateral system that synapses in the pons?

Answer 11

Spinoreticuar Tract

Question 12

Tract running in anterolateral system that branches off in the midbrain?

Answer 12

SPinomesencephalic Tract

Question 13

Patients with Central Horner’s syndrome may also have?

Answer 13

loss of pain and temp contralateral

Question 14

MLF links which nuclei

Answer 14

8 with 6,4,3

Question 15

MLF is especially succeptible to

Answer 15

CNS diseases like MS and neurosyphilis

• intranuclear ophthalmoplegia that dirupts horizontal conjugate gaze and vestibulo-ocular reflex

Question 16

4 things found in every brainste section

Answer 16

Question 17

Unique fact about corticoblbar innervation of hypoglossal nucleus and ambiguus nucleus

Answer 17

both nuclie may have more of a contralateral innervation tha t predominates over an ipsilateral corticobulbar innervation

Question 18

In lesion of corticobulbar to hypoglossal nucleus what signs do you see

Answer 18

tongue muscle does not undergo fasciculations or atrophy. Deviate away from lesioned side.

Question 19

Lesion of corticobulbar to nucleus ambigusus resuts?

Answer 19

uvula may deviate towards the lesioned fibers. Normally away in vagus nerve lesion

Question 20

Unique factor of innervation of CN7

Answer 20

only eyes and forehead bilaterally innervated. So UMN lesion only affects lower contralateral face.

Question 21

Brainstem CS tract lesion symptoms?

Medial Lemniscus ?

Spinothalamic

Descending hypothalamic

• which CN deficits will yous see

Answer 21

Question 22

What divides motor and sensory in the spinal cord and brainstem

Answer 22

Question 23

Motor nuclei general organization

Answer 23

Skeletal Muscle, glands/smooth ucle/cardiac muscle, skeletal muscle of pharyngeal arches

Question 24

Sensory ncueli general organization in brainstem

Answer 24

touc/pain/prop

stretch, chemo, baro

taste and olfactory

retina, auditory, vestibular

Question 25

Bell's palsy

Answer 25

Lesion 7 skeletal muscles. paralysis of facial muscles ipsiltaeral. Hyperacusis, hypersensitiveity,

Question 27

When to think around the brainstem

Answer 27

Question 28

Consider the brainstem when?

Answer 28

Question 29

What is the 4-4-4 rule of the brainstem

Answer 29

Question 30

What is important about Corticospinal tract in determining brainstem lesions

Answer 30

Question 31

3 Steps in ventral to dorsal localization

Answer 31

Question 32

Medial to Lateral Localization 2 Features

Answer 32

Question 33

Vascular supply to the brainstem What supplies the medial hat supplies hte ventral lateral what supplies the dorsal lateral

Answer 33

Question 34

Internuclear Ophthalmoplegia (INO) What is it? What causes it?

Answer 34

Question 35

Internuclear Ophthalmoplegia cause in old and young

Answer 35

Question 36

Impaired Corneal Reflex Tests What does result show

Answer 36

Tests CN 5 and 7 If other eye cloess than corneal reflex is simpaired secondary to facial weakness (CN7) If the other eye does not close, then the corneal reflex is impaired secondary to facial numbness CN5 If both affected than neither eye would close when ouchign lesioned side.

Question 37

Common cause of Central Horner's Syndrome

Answer 37

Question 38

Common cause of second order Horner's Syndrome

Answer 38

Question 39

Common cause of third-order neuron lesion

Answer 39

Question 40

Fifth Nerve Palsy

Answer 40

Jaw deviates to the weak side

Question 41

9th and 10th nerve palsy observation

Answer 41

palate deviates away from lesion because of unopposed action of normal levator veli palatini

Question 42

12th nerve palsy

Answer 42

Tongue atrophy on same side of lesion. Tongue deviates tto the same side as the lesion