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NeuroRehab > Brainstem/ Cerebellar > Flashcards

Brainstem/ Cerebellar Flashcards

(59 cards)

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1
Q

3 parts of brain stem

A

Midbrain
Pons
Medulla oblongata

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2
Q

Midbrain contains

A

Cerebellar peduncles (motor tracts to SC)
Super and inferior colliculi
Red nucleus

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3
Q

Midbrain nerves

A

III and IV
Inc ICP = dysfunction of nerve III -
Abnormal pupil size, poor reactivity to light

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4
Q

Pons has

A

Two resp. Centers in dorsal pons. Work w/ principle resp center in medulla

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5
Q

Reticular formation controls

A

Consciousness and attention
(Asleep, awake, alert, attending)
Also relays in an ascending pathway to thalamus, limbic, cerebral cortex

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6
Q

Medulla oblongata regulates

A

Cardiac
Vascular
Resp function

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7
Q

Medulla coordinates

A

Swallowing
Vomiting
Coughing
Sneezing

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8
Q

Medulla is decussation for

A

Dorsal column and CST

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9
Q

CN in medulla

A 
Part of VIII
IX
X
XI
XII
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10
Q

______ of the 12 CN pairs originate from nuclie in _______

A

10 of the 12 CN pairs originate from nuclie in brainstem

“If you have CN involvement, you know you are in the BS”

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11
Q

Initial BS dysfunction

A 
Gait distubrance
Diplopia
Focal weakness
HA
Vomit
Facial numb/weak
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12
Q

Dorsal midbrain involvement

A

Parinaud syndrome

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13
Q

Parinaud syndrome characterized by

A

Loss of upward gaze
Pupillary areflexia to light
Loss of convergence

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14
Q

Reticular formation involvement

A

Apnea
Hypoventilation or hyper
Orthostatic hypotension
Syncope

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15
Q

BS involvement management

A 
Equipment/orthotic evaluation 
– Functional training
• Bed mobility, transfers, wheelchair
– Gait training 
– Balance and coordination training 
– Family training
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16
Q

Cerebellum connects to rest of brain by

A

Superior, middle, inferior cerebellar peduncles

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17
Q

Inferior cerebellar peduncle

A

Carries afferent fibers coming mainly from SC

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18
Q

Middle cerebellar peduncles

A

Contains afferent fibers from the contralateral pontine nuclei

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19
Q

Superior cerebellar peduncle

A

Carries efferent fibers leaving cerebellum. Crossed afferent fibers from ventral spinocerebellar tract

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20
Q

There are a large number of axons projecting to cerebellum carying _____

A

Vestibular and proprioceptive info

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21
Q

Cerebellar nuclei

A

Dentate nucleus
Interposed nuclei
Fastigial nuclei

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22
Q

Biggest part of cerebellum formed by

A

Lateral hemisphere

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23
Q

Info from cerebullum goes to cortex. Used to

A

Plan and program voluntary movement, especially skilled, learned movement

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24
Q

Cerebellum:

SOS DEFTT

Study These Flashcards
A

Smooth
Orderly
Sequencing

Direction
Extent
Force
Timing
Tone
25
Vestibulospinal and reticulospinal tracts
Influence spinal motor pathways and influence posture and stereotyped movements which are regulated by BG
26
Flocculonodular lobe receives info from
Vestibulocerebellum | vestibular nuclei
27
Flocculonodular lobe primary role
Regulate balance, influencing eye movement needed for visual tracking
28
BG PASS
Basal Ganglia Postural Adaptation Semivoluntary Semiautomatic
29
Cerebellum and feedback control
Comparator and error detection mechanism | Controls onset, level, rate of force production of muscles
30
Peripheral feedback during motor repsonse given by
``` Muscle spindle GTO Joint Cutaneous receptors Vestibular apparatus External info through eyes and ears ```
31
Closed loop
Feedback used as references for correctness, compilation of error and subsequent correction in order to maintain desired state
32
Feed forward
Predictive compensatory modifications - cerebellum programs voluntary movement skill based on memory of previous sensory input and motor output * vital to anticipatory muscle activity
33
Stereotyped movements and rapid short duration movements
Controlled by open loop
34
Open loop system
Control system w/ preprogrammed instructions to effector that does not use feedback info and error detection processes -control from motor program memory/preprogrammed pattern of info for controlled movement
35
If cerebellum is damaged
Learned motor program cannot be used -movement guided by feedback systems -movement is slow and uncoordinated Inability to adapt to minor changes
36
Cerebellum - disturbed balance
Difficulty maintaining upright posture | Visual compensation not effective
37
Cerebellum hypotonicity
DTR normal | -decreased excitation from deep cerebellar nuclei to regions of brain that excite alpha and gamma motor neuron
38
Dysmetria
Deficit in reaching target Inability to judge distance or ROM Over or under shooting (hyper/hypo metric)
39
Disdiadochokinesia
Inability to perform rapidly alternating movements | -movements are irregular w/ rapid loss of range and rhythm esp as speed is increased
40
Movement decomposition (dyssynergia)
Movement performed in its component parts instead of one coordinated movement
41
Asynergia
Inability to associate muscle groups together for complex movements
42
Ataxia most often associated w/
UE/LE/trunk/head/mouth/trunk *Gait disturbances Wide BOS, steps irregular in direction and distance
43
Ataxia initation of LE movement
May start slow then extremity may unexpectedly be rapidly flung to hit floor - arms held out to improve balance - gait is generally instead, irregular, staggering
44
Asthenia
Generalized muscle weakness associated w/ cerebellar lesion | Muscle strength on involved side can be reduced by 50%
45
Intention tremor
Occur during voluntarily movement and ted to increase as extremity reaches its intended goal
46
Speech disturbances (dysarthria)
Rhythm of speech is changed. Syllables are slow, accents misplaced. Grammar and word selection not involved
47
Cerebellar involvement: control of eye movement and gaze
Deviate toward contralateral side, inability to move accurately to target in periphery - saccades either too large or too small - nystagmus is rhythmic, quick oscillatory movement of eyes
48
BS stroke AICA
Pontomedullary syndrome
49
Pontomedullary syndrome
``` Severe vertigo Dysarthria Altered precaution of vertical Ataxia *Loss of pain/temp ipsi face, contra body Oculomotor abnorm *Unilateral hearing loss ```
50
BS stroke PICA
Lateral medullary syndrome
51
Lateral medullary syndrome
``` Severe vertigo Dysarthria Altered perception of vertical Ataxia Loss of paintemp ipsi face, contra body Oculomotor abnormal *horners syndrome ```
52
Friedreich’s ataxia | Eti
Genemutation —> mitochondrial function Autosomal recessive
53
Friedreich’s ataxia characteristics
Gait unsteadiness: 5-15yo - UE ataxia, dysrarthirai, paresis (esp LE) - mental function decline - reflexes, vibration, position sense lost - clubfoot, scoliosis, progressive cardiomyopathy
54
Friedreich’s ataxia prognosis
- by late 20s, pt may be confined to W/C | - death , arrhythmia or heart failure, usually by middle age
55
Spinocerebellar ataxias (SCA)
Autosomal dominant Most common affect multiple areas in CNS and ONS: neuropathy, pyramidal signs, restless leg syndrome, ataxia Some SCA only cause cerebellar ataxia
56
SCA type 3/ machado-Jospeh disease
Most common inherited SCA worldwide | Ataxia, Parkinsonism, possibly dystopia, facial twitching, ophthalmoplegia, bulging eyes
57
AOA 1
Ataxia oculomotor apraxia Autosomal recessive Aprataxin Onset folder-adolescent
58
AOA 1 S/s
Horizontal and vertical oculomotor apraxia DTR disappear early Axonal neuropathy —> distal muscle wasting Dysarthria develops, choreoathetosis frequnent Possible pyramidal signs
59
AOA2
Autosomal recessive Senataxin Onset pre and early teens Progressive cerebellar ataxia followed by oculomotor apraxia and sensorimotor neuropathy

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