Brainstem And Cerebellum

Question 1

Regions in the infratentorial compartment

Answer 1

Brainstem and cerebellum

Question 2

What on the brainstem do we test in neurological exams?

Answer 2

CN 3-12

Question 3

What do we test on the cerebellum in neurological exams

Answer 3

Motor coordination and balance

Question 4

Where does the central canal start?

Answer 4

In medulla, so its considered part of the infratentorial compartment

Question 5

Horizontal streaks on the pons

Answer 5

Formed by axon fibers from pons crossing midline to cerebellum. These fibers form the ventral bulge

Question 6

What connects the cerebral hemisphere and brainstem together

Answer 6

Crus cerebri (cerebral peduncles)

Question 7

Where is CN3-4?

Answer 7

Midbrain

Question 8

Where is CN 5-7?

Answer 8

Pons

Question 9

Where is CN 8-12?

Answer 9

Medulla

Question 10

What is the only CN that comes off back of brainstem

Answer 10

Trochlear nerve

Question 11

Where is the cerebellum attached to the brainstem

Answer 11

At the peduncles

Question 12

Midbrain features

Answer 12

Crus cerebri
Colliculi
Trochlear nerve

Question 13

Pons level features

Answer 13

Contours of 4th ventricle
Lateral recesses (foramen)

Question 14

Medulla features

Answer 14

Transition from 4th ventricle to central canal

Question 15

Things about the horizontal section through the pons

Answer 15

Contours of pons
Basilar pons (bulging)
Tegmetun of pons
4th V
Cerebellum
Middle cerebellar peduncle

Question 16

Notes about the horizontal section through medulla

Answer 16

Contours
Pyramids
Olivary eminence
Restiform body

Question 17

What are considered the ‘horizontal systems’

Answer 17

Cranial nerves

Question 18

Testing cranial nerves

Answer 18

High yield Dx tools
Testing horizontal levels
Sensory functions
Motor functions
Reflex circuits

Question 19

Input to cerebellum

Answer 19

Vestibular

Proprio motor

Question 20

Output of cerebellum

Answer 20

Regulates UMNs and LMNs, balance and coordination

Question 21

What do we mean when we talk about longitudinal systems

Answer 21

Long tracts

• corticospinal and cortconuclear
• dorsal column system
• anterolateral system

Question 22

What kind of motorneurons are in the brainstem?

Answer 22

Lower motor neurons

Upper are int he precentral gyrus

Question 23

Voluntary motor function

Answer 23

Corticospinal and corticobulbar systems

Question 24

Corticospinal system

Answer 24

• ventral position of tract until caudal to pyramidal decussation
• goes through cerebral peduncles
• through basilar pons
• through pyramids and decussation
• left side of body and face represented on right precentral gyrus

Question 25

Anterolateral tract

Answer 25

- lateral position of anterolateral tract all the way up spinal cord and brainstem - comes in dorsal root, synapses on dorsal horn, postsynaptic crosses anterior white commisure and goes to tract and then up the tract on the lateral side - right side of body and face represent on left postcentral gyrus Lateral brainstem damage-pain and temp problems in body

Question 26

Dorsal column (medial lemniscus system)

Answer 26

- fine touch/proprioception - comes in dorsal root and immediately up the tract, no synapse at cord level - synapses in caudal medulla and then crosses midline here. - second order neuron joins the medial lemniscus tract after rostral medulla (medially) - shifts laterally as it goes up - right side of body and face represented on left postcentral gyrus

Question 27

Long tracts: voluntary movement and somatosensory

Answer 27

- corticospinal system - anterolateral system - dorsal column-medial lemniscus system - spinocerebellar - other descending tracts to anterior horns - other descending regulatory systems

Question 28

Cranial nerve nuclei and systems

Answer 28

Hypoglossal (XII) to oculomotor (III) | -sensory, motor, reflexes

Question 29

Origins of ascending cerebral systems to cerebral cortex (conscious)

Answer 29

- somatosensory and viscerosensroy: from spinal cord and trigeminal system - auditory and vestibular systems - taste: generally not tested

Question 30

What does the primary fissure of the cerebellum divide?

Answer 30

Anterior and posterior lobe

Question 31

What does the horizontal fissure divide?

Answer 31

Nothing, it is on the inferior cerebellar surface, and above this is the superior cerebellar surface

Question 32

Superior cerebellar peduncles

Answer 32

Mostly ascending output to motor cortex (cerebral)

Question 33

Middle cerebellar peduncles

Answer 33

Mostly fibers enterinf with info from motor cortex

Question 34

Inferior cerebellar peduncles

Answer 34

Proprioceptive and vestibuloar input, output to brain stem descending systems that regulate spinal lower motorneurons

Question 35

Vestibulochocerebellar: vestibular sensation (semi circle canals)

Answer 35

Intricate reflex - goes to cerebellum/cerebrum about position, then sends to LMN about position - sensory guiding motor function

Question 36

Spinocerebellar system: prorpioception with muscle spindles and golgi tendon organs

Answer 36

Sensory guiding motor function Intricate reflex

Question 37

Cerebrocerebellar: motor cortex (precentral gyrus)

Answer 37

Optimizes UMN, optimizes coordination

Question 38

Vascular territory syndromes

Answer 38

Medial or lateral medulla Medial or lateral pons Various midbrain syndromes

Question 39

Arterial supply of medulla

Answer 39

Different arteries supply medial to lateral zones

Question 40

Difference between the spinal cord and the brainstem

Answer 40

Spinal cord is like a hotel, with even levels | Brainstem is like coal building with all different levels that each have their own function