Exam 1: Brainstem 1: Introduction and Medulla + CN nuclei origins for medulla and pons

Question 1

What is meant by the terms “modality” and “neuromodulation”?

Answer 1

Modality:

1) the method of application of a therapeutic agent or regimen.
2) a sensory entity, such as the sense of vision or taste.

Neuromodulation:

controlled stimulation of the peripheral or central nervous system with electricity.

Question 2

In broad terms, how are motion and balance regulated by the CNS?

What about the autonomic nervous system?

Answer 2

motion and balance are regulated by the CNS:

I am not sure what she expected us to answer for this slide? If you know you want to shoot me a message so I can update this? Thanks!

motion and balance are regulated by the ANS:

I am not sure what she expected us to answer for this slide? If you know you want to shoot me a message so I can update this? Thanks!

Question 3

MOTOR Basic Circuitry: There are ___ Neuron Pathways

And where is each motor neuron located and their pathways?

Answer 3

MOTOR Basic Circuitry: 2 Neuron Pathways

N1:

The upper motor neuron (UMN) is located in the precentral gyrus (motor cortex) and runs to the lower motor neuron

N2:

The lower motor neuron (LMN) is in the contralateral spinal cord and runs to the skeletal muscle

Question 4

The upper motor neuron (UMN) pathway decussates to the contralateral side in the _____ _____, then travels through the _____ _____ tracts until reaching the lower motor neurons (LMN).

Answer 4

The upper motor neuron (UMN) pathway decussates to the contralateral side in the pyamidal descussation, then travels through the lateral corticospinal tracts until reaching the lower motor neurons.

Question 5

2 Feedback Loops Involved in Modulation of the Motor System:

1) Cortex → ___ → ___ → ___ → Cortex
2) Cortex → ___ → ___ → Cortex

Answer 5

2 Feedback Loops Involved in Modulation of the Motor System:

1) Cortex → Pons → Cerebellum → Thalamus → Cortex
2) Cortex → Basal Ganglia → Thalamus → Cortex

Question 6

SENSORY Basic Circuitry: There are ___ Neuron Pathways

And where is each sensory neuron located and their pathways?

Answer 6

SENSORY Basic Circuitry: 3 Neuron Pathways

1ºsensory neuron

is the peripheral ganglion

2__º sensory neuron

is in the spinal cord, where the axons then move contralaterally before exiting the spinal cord

3º sensory neuron

is in the thalamus

Question 7

Integration and Relay of Sensory Input is done through the _____

Answer 7

Integration and Relay of Sensory Input is done through the thalamus

Question 8

Ipsilateral

Answer 8

same side

Question 9

Contralateral

Answer 9

Opposite side

Question 10

Cerebrum = _____ + _____

Answer 10

Cerebrum = Telencephalon + Diencephalon

Question 11

Cerebral Hemisphere = _____ + _____ _____

Answer 11

Cerebral Hemisphere = Telencephalon + Lateral ventricles

Question 12

Telencephalon = _____ _____ + _____ _____ + _____ _____

Answer 12

Telencephalon = Cerebral cortex + White matter + Basal nuclei

Question 13

Brain =

Forebrain ( _____ and _____ )

+ Midbrain

+ Hindbrain ( _____, _____, and _____ _____ )

Answer 13

Brain =

Forebrain ( cerebrum and diencephalon )

+ Midbrain

+ Hindbrain ( cerebellum, pons, and medulla oblongata)

Question 14

Brainstem = _____, _____, and _____ _____

Answer 14

Brainstem = Midbrain, pons, and medulla oblongata

Question 15

Identify the stucture

Answer 15

Brainstem

*** The attached image is a good image to use to study all of the landmarks on the medial view of the brain ***

Question 16

What are 3 functions of the brainstem?

Answer 16

The brainstem:

1) Conduit between spinal cord and brain

2) Reflex centers for breathing, cardiovascular, and consciousness

3) Location of cranial nerve nuclei (gray matter)*, reticular formation, nuclei for long tracts, and nuclei that connect to the cerebellum

*(most of, but not all)

Question 17

The brainstem is:

a conduit between _____ _____ and _____ (therefore, contains _____ matter fibers of both _____ and _____ pathways.

the location of important _____

Answer 17

The brainstem is:

is a conduit between spinal cord and brain (therefore, contains white matter fibers of both afferent and efferent pathways

It is location of important decussations

Question 18

The brainstem contains:

Reflex centers for_____, _____, and _____

and is evolutionarily the most _____ part of the human brain.

How is the cerebral cortex different?

Answer 18

The brainstem contains:

Reflex centers for breathing, cardiovascular, and consciousness

and is evolutionarily the most conservative part of the human brain.

[translation: human brainstem structure is still much like that of a lizard or a sheep.]

The human cerebral cortex is unique!

Question 19

Identify the main components of the brainstem

Identify A

Identify B

Identify C

Answer 19

Identify the main components of the brainstem

A is reticular formation

B are cranial nerves

C are long tracts

Question 20

Indentify the landmarks on the developing brainstem:

Identify A

Identify B

Answer 20

Indentify the landmarks on the developing brainstem:

A is Somatic motor nuclei

B is Somatic motor: GSE (hypoglossal nucleus)

Question 21

Indentify the landmarks on the developing brainstem:

Identify A

Identify B

Identify C

Answer 21

Indentify the landmarks on the developing brainstem:

A is Visceral motor nuclei

B is Parasympathetic: GVE (dorsal motor nucleus of CN X)

C is Branchial motor: SVE (nucleus ambiguus)

Question 22

Indentify the landmarks on the developing brainstem:

Identify A

Identify B

Answer 22

Indentify the landmarks on the developing brainstem:

A is Visceral sensory nuclei

B is Visceral sensory: SVA and GVA (nucleus solitarius)

Question 23

Indentify the landmarks on the developing brainstem:

Identify A

Identify B

Identify C

Answer 23

Indentify the landmarks on the developing brainstem:

A is Somatic sensory nuclei

B is Special somatic sensory: SSA (vestibular nuclei)

C is General somatic sensory: GSA (spinal trigeminal nucleus)

Question 24

Identify the landmark on the devoloping brainstem:

Identify A

Answer 24

Identify the landmark on the devoloping brainstem:

A is Sulcus limitans

Question 25

**_Identify the landmark on the devoloping brainstem_:** Identify **A**

Answer 25

**_Identify the landmark on the devoloping brainstem_:** **A** is an **Inferior olivary nuclei** **\*\*\***They are a landmark that shows you are **in the medulla**!\*\*\* The **inferior olivary nucleus consists of** a **gray folded lamina** arranged in the form of an incomplete capsule, **opening medially** by an aperture called the hilum.

Question 26

**_Paired sets of nuclei_:** **CN** nuclei ( ___ through \_\_\_) \_\_\_\_\_ **formation** Nuclei associated with _____ **tracts** Nuclei associated with _____ **circuitry**

Answer 26

**_Paired sets of nuclei_:** **CN** nuclei ( **III through XII** ) **Reticular formation** Nuclei associated with **long tracts** Nuclei associated with **cerebellar circuitry**

Question 27

Which **Cranial Nerves** have **nuclei** located **between several regions** of the **brainstem**?

Answer 27

**VII** (Facial) **VIII** (Vestibulocochlear)

Question 28

Be able to **identify the nuclei** where the **Cranial Nerves** originates, and **their positions** (related to each other and the landmarks on the brainstem). \*This slide is just for self study, as an overview. Their are also individual cards made for each of the 19 main nuclei shown on the left image attached, included later in this deck of cards.

Answer 28

Be able to **identify the nuclei** where the **Cranial Nerves** originate and their positions (related to each other and the landmarks on the brainstem). \*This slide is just for self study, as an overview. Their are also individual cards made for each of the 19 main nuclei shown on the left image included in this deck of cards.

Question 29

**Identify the nucleus** **Which Cranial Nerves originate** at this **nucleus**?

Answer 29

**Edinger-Westphal** nucleus | (**GVE: CN III**)

Question 30

**Identify the nucleus** **Which Cranial Nerves originate** at this **nucleus**?

Answer 30

**Oculomotor** nucleus | (**GSE: CN III**)

Question 31

**Identify the nucleus** **Which Cranial Nerves originate** at this **nucleus**?

Answer 31

**Trochlear** nucleus | (**GSE: CN IV**)

Question 32

**Identify the nucleus** **Which Cranial Nerves originate** at this **nucleus**?

Answer 32

**Trigeminal motor** nucleus | (**GSE: CN V**)

Question 33

**Identify the nucleus** **Which Cranial Nerves originate** at this **nucleus**?

Answer 33

**Superior salivatory** nucleus | (**GVE: CN VII**)

Question 34

**Identify the nucleus** **Which Cranial Nerves originate** at this **nucleus**?

Answer 34

**Facial** nucleus | (**SVE: CN VII**)

Question 35

**Identify the nucleus** **Which Cranial Nerves originate** at this **nucleus**?

Answer 35

**Abducens** nucleus | (**GSE: CN VI**)

Question 36

**Identify the nucleus** **Which Cranial Nerves originate** at this **nucleus**?

Answer 36

**Inferior salivatory** nucleus | (**GVE: CN IX**)

Question 37

**Identify the nucleus** **Which Cranial Nerves originate** at this **nucleus**?

Answer 37

Nucleus **ambiguus** | (**SVE: CN IX, X**)

Question 38

**Identify the nucleus** **Which Cranial Nerves originate** at this **nucleus**?

Answer 38

**Hypoglossal** nucleus | (**GSE: CN XII**)

Question 39

**Identify the nucleus** **Which Cranial Nerves originate** at this **nucleus**?

Answer 39

**Dorsal motor** nucleus of **CN X** | (**GVE: CN X**)

Question 40

**Identify the nucleus** **Which Cranial Nerves originate** at this **nucleus**?

Answer 40

**Spinal accessory** nucleus | (**SVE: CN XI**)

Question 41

**Identify the nucleus** **Which Cranial Nerves originate** at this **nucleus**?

Answer 41

**Trigeminal** nuclei (**GSA: CN V, VII, IX, X**) & **Mesencephalic** nucleus of **CN V**

Question 42

**Identify the nucleus** **Which Cranial Nerves originate** at this **nucleus**?

Answer 42

**Chief sensory** nucleus of **CN V** | (**GSA: CN V**)

Question 43

**Identify the nucleus** **Which Cranial Nerves originate** at this **nucleus**?

Answer 43

**Spinal trigeminal** nucleus | (**GSA: CN V, VII, IX, X**)

Question 44

**Identify the nucleus** **Which Cranial Nerves originate** at this **nucleus**?

Answer 44

**Vestibular** nuclei | (**SSA: CN VIII**)

Question 45

**Identify the nucleus** **Which Cranial Nerves originate** at this **nucleus**?

Answer 45

**Dorsal and ventral cochlear** nuclei | (**SSA: CN VIII**)

Question 46

**Identify the nucleus** **Which Cranial Nerves originate** at this **nucleus**?

Answer 46

nucleus **solitarius**, **rostral portion** | (**SVA: CN VII, IX, X**)

Question 47

**Identify the nucleus** **Which Cranial Nerves originate** at this **nucleus**?

Answer 47

nucleus **solitarius**, **caudal portion** | (**GVA: CN IX, X**)

Question 48

What are the **_efferent_ cranial nerves nuclei** that are **located in** the **_medulla_**?

Answer 48

**Hypoglossal** (**XII**) **Dorsal motor of vagus** (**X**) **\*Inferior salivitory** (**IX**) **\*\*Nucleus ambiguus** (**IX**, **X**) **\***parasympathetics to ottic ganglion; medial to N. ambiguous so difficult to see in cross sections) **\*\*****1 nucleus (Nucleus ambiguus) shares neurons**! They are**lower motor neurons**, upper motor neurons usually come from the cerebral cortex)

Question 49

What are the **_afferent_ cranial nerves nuclei** that are **located in** the **_medulla_**?

Answer 49

**\*Solitary** (**VII, IX, X**) **Vestibular** (**VIII**, **n=4\*\***) **Cochlear** (**VIII**, ventral and dorsal) **Trigeminal** (spinal) \*The **solitary nucleus** has a **rostral portion** (**gustatory**) which has **taste** sensations in CN VII, IX, and X. It also has a **caudal portion** which has inputs for control of **cardiorespiratory** and **digestive** functions \*\***Vestibular** **nucleus** is a **complex of 4 nuclei**

Question 50

**_Other important nuclei in the medulla_:** \_\_\_\_\_ **formation** nuclei \_\_\_\_\_ **tract** nuclei \_\_\_\_\_ **pathways**

Answer 50

**_Other important nuclei in the medulla_:** **Reticular formation** nuclei **Long tract** nuclei **Cerebellar** pathways

Question 51

**_Long tract nuclei in the medulla_:** **Nucleus \_\_\_\_\_**: **receives 1st-order somatosensory input** from **\_\_\_\_\_** **gracilis** in dorsal column of spinal cord) **Nucleus \_\_\_\_\_**: **receives 1st-order somatosensory input** from **\_\_\_\_\_** **cuneatus** in dorsal column of spinal cord)

Answer 51

**_Long tract nuclei in the medulla_:** **Nucleus gracilis**: receives 1st-order somatosensory input from **fasiculus gracilis** in dorsal column of spinal cord) **Nucleus cuneatus**: receives 1st-order somatosensory input from **fasiculus cuneatus** in dorsal column of spinal cord)

Question 52

**_Cerebellar pathways in the medulla_:** \_\_\_\_\_ _____ nucleus \_\_\_\_\_ _____ nucleus

Answer 52

**_Cerebellar pathways in the medulla_:** **Accessory cuneate** nucleus **Inferior olivary** nucleus

Question 53

Identify **which cranial nerve exits** at this location of the **medulla**

Answer 53

Roots of **trigeminal** nerve (**CN V**)

Question 54

Identify **which cranial nerve exits** at this location of the **medulla**

Answer 54

**Abducent** nerve (**CN VI**)

Question 55

Identify **which cranial nerve exits** at this location of the **medulla**

Answer 55

**Motor** root of **facial** nerve (**CN VII**)

Question 56

Identify **which cranial nerve exits** at this location of the **medulla**

Answer 56

**Sensory** root of **facial** nerve (**CN VII**)

Question 57

Identify **which cranial nerve exits** at this location of the **medulla**

Answer 57

**Vestibulocochlear** nerve (**CN VIII**)

Question 58

Identify **which cranial nerve exits** at this location of the **medulla**

Answer 58

**Glossopharyngeal** nerve (**CN IX**)

Question 59

Identify **which cranial nerve exits** at this location of the **medulla**

Answer 59

Roots of **vagus** nerve (**CN X**)

Question 60

Identify **which cranial nerve exits** at this location of the **medulla**

Answer 60

**Hypoglossal** nerve (**CN XII**)

Question 61

Identify **which cranial nerve exits** at this location of the **medulla**

Answer 61

**Accessory** nerve (**CN XI**)

Question 62

Identify **which cranial nerve exits** at this location of the **medulla**

Answer 62

**Cranial** roots of **accessory** nerve (**CN XI**)

Question 63

Identify **which cranial nerve exits** at this location of the **medulla**

Answer 63

**Spinal** roots of **accessory** nerve (**CN XI**)

Question 64

**_Caudal (“Closed”) Medulla_**: **Level of** _____ **Decussation** (roughly 90% of _____ corticospinal tract fibers) **Nucleus g**\_\_\_\_ and **nucleus c**\_\_\_\_ **Spinal nucleus** of **trigeminal nerve** (\_\_\_\_\_ and _____ of CN V) **Level of Medial** _____ \_\_\_\_\_ (**sensory pathways** to _____ from nucleus gracilis/cuneatus) **Accessory cuneate** nucleus (**input from** _____ \_\_\_\_\_ and _____ \_\_\_\_\_ organs)

Answer 64

**_Caudal (“Closed”) Medulla_**: Level of **Pyramidal Decussation** (roughly 90% of **lateral corticospinal tract fibers**) **Nucleus gracilis** and **nucleus cuneatus** Spinal nucleus of **trigeminal nerve** (**pain** and **temperature** of **CN V**) Level of **Medial Lemniscus Decussation** (**sensory pathways to thalamus** from **nucleus gracilis/cuneatus**) **Accessory cuneate** nucleus (input from **muscles spindles** and **Golgi tendon** organs)

Question 65

**_Rostral “Open” Medulla_**: **Cranial nerve nuclei** (in addition to _____ of **CN V**) \_\_\_\_\_ tracts (**descending** fibers) and _____ \_\_\_\_\_ _____ (**MLF**; **descending** and **ascending** fibers) (both **associated** with _____ \_\_\_\_\_ based on **visual inputs**) \_\_\_\_\_ **olivary** **nuclei** (**inputs from** _____ and _____ nucleus of **midbrain**, **outputs to** \_\_\_\_\_; **coordination** of _____ input to **allow for** _____ \_\_\_\_\_)

Answer 65

**_Rostral “Open” Medulla_**: **Cranial nerve nuclei** (in addition to **spinal nucleus** of **CN V**) **Tectospinal tracts** (**descending** fibers) and **medial longitudinal fasiculus** (MLF; **descending** and **ascending** fibers) (both **associated** with **head orientation** based on visual inputs) **Inferior olivary nuclei** (inputs from **spine** and **red nucleus** of midbrain, **outputs** to **cerebellum**; coordination of **sensory input** to allow for **smooth movements**)

Question 66

The level of the **Pyramidal Decussation** is **found in** the _____ ("\_\_\_\_\_") **Medulla**, and is **roughly 90% of** _____ \_\_\_\_\_ tract fibers

Answer 66

The level of the **Pyramidal Decussation** is found in the **Caudal** ("**Closed**") **Medulla**, and is roughly 90% of **lateral corticospinal tract** fibers

Question 67

The **Nucleus gracilis** and **nucleus cuneatus** are found in the \_\_\_\_\_("\_\_\_\_\_") **Medulla**

Answer 67

The **Nucleus gracilis** and **nucleus cuneatus** are found in the **Caudal** ("**Closed**") **Medulla**

Question 68

**Spinal nucleus** of **trigeminal nerve** (\_\_\_\_\_ and _____ of **CN V**) is found in the _____ ("\_\_\_\_\_") **Medulla**

Answer 68

Spinal nucleus of **trigeminal** nerve (**pain** and **temperature** of **CN V**) is found in the **Cauda**l ("**Closed**") **Medulla**

Question 69

The level of the **Medial Lemniscus Decussation** (**sensory pathways to** _____ from nucleus \_\_\_\_\_/\_\_\_\_\_) is found in the _____ ("\_\_\_\_\_") **Medulla**

Answer 69

The level of the **Medial Lemniscus Decussation** (sensory pathways to **thalamus** from nucleus **gracilis/cuneatus**) is found in the **Caudal** ("**Closed**") **Medulla**

Question 70

The **accessory cuneate nucleus** (input from _____ \_\_\_\_\_ and _____ \_\_\_\_\_ organs) is found in the _____ ("\_\_\_\_\_") Medulla

Answer 70

The **accessory cuneate** nucleus (**input** from **muscles spindles** and **Golgi tendon organs**) is found in the **Caudal** ("**Closed**") **Medulla**

Question 71

**Cranial nerve nuclei** (in addition to _____ **nucleus** of **CN V**) are found in the _____ ("\_\_\_\_\_") **Medulla**

Answer 71

**Cranial nerve nuclei** (in addition to **spinal** nucleus of **CN V**) are found in the **Rostral** ("**Open**") **Medulla**

Question 72

**Tectospinal tracts** (\_\_\_\_\_ fibers) and **medial longitudinal fasiculus** (MLF; _____ and _____ fibers) are **found in** the _____ ("\_\_\_\_\_") **Medulla** \***Both associated with** _____ \_\_\_\_\_ based on **visual inputs**

Answer 72

**Tectospinal** tracts (**descending fibers**) and medial longitudinal fasiculus (**MLF; descending** and **ascending fibers**) are found in the **Rostral** ("**Open**") **Medulla** \*Both **associated** with **head orientation** based on **visual inputs**

Question 73

**Inferior olivary nuclei** (inputs from _____ and _____ **nucleus of midbrain**, outputs to \_\_\_\_\_; **coordination of sensory input** to allow for _____ \_\_\_\_\_) are found in the _____ ("\_\_\_\_\_") **Medulla**

Answer 73

**Inferior olivary** nuclei (**inputs from spine** and **red nucleus** of midbrain, **outputs** to **cerebellum**; coordination of sensory input to allow for **smooth movements**) are found in the **Rostral** ("**Open**") **Medulla**