Exam 2 Content Week 3 Flashcards
(150 cards)
1
Q
what cranial nerves comes out of what parts of the brainstem
A
midbrain (3 and 4)
pons (5-8)
medulla (9,10,12)
2
Q
where is the 4th ventricle
A
between the pons and the cerebellum
3
Q
what is the reticular formation
A
in the brainstem, it
- integrates sensory and cortical information
- regulates somatic motor activity (reticulospinal) and ANS
- regulates sleep and consciousness
- modulates nocioceptive information
4
Q
what are the 4 reticular nuclei
A
ventral tegmental area
pedunculopontine nucleus
locus coeruleus
rahphe nuclei
5
Q
describe the NT/MN and function of the VTA
A
dopamine
responsible for reward seeking behavior and motivation and decision making.
When too much activity: addiction, schizophrenia
6
Q
describe the NT/MN and function of the PPN
A
ACh
influences movement, like walking and gait. With Parkinson’s you loss this, so you get decreases in movement, sleep issues and cannot initiate walking.
7
Q
describe the NT/MN and function of the locus coeruleus
A
NE
directs attention. so when it is active, we can pay attention
8
Q
describe the NT/MN and function of the raphe nuclei
A
serotonin
mood!
antidepressants prolong the serotonin in the junction, so it inhibits the re-uptake
9
Q
which part of the brainstem are the reticular nuclei
A
rostral part
10
Q
what is the ascending reticular activating system
A
ARAS project to the thalamic nuclei, then project to the cortex.
regulates sleep/wake cycles, and consciousness (self awareness and surroundings) and attention while awake.
11
Q
what are the three reticular formation descending tracts
A
reticulospinal
ceruleospinal
raphespinal
12
Q
what is the reticulospinal
A
posture and gross limb movements
13
Q
what is the ceruleospinal
A
from the locus coeruleus. autonomic, physiologic responses to stress and panic, and alertness. Inhibits pain and nocioception
14
Q
what is the raphespinal
A
from raphe nuclei,
sensory, autonomic and motor. cardiovascular system, and inhibits pain signals.
15
Q
coma
A
un-arousable, no response to strong stimuli
16
Q
stupor
A
arousable only by a strong pinch
17
Q
obtunded
A
spelling more then awake
18
Q
vegetative state
A
complete loss consciousness, spontaneous eye opening, regular sleep wake cycles, normal respiratory patterns.
19
Q
minimally conscious state
A
following minimally simple commands, gestures to yes/no, intelligible speech,
20
Q
syncope
A
brief loss consciousness because of drop in BP
21
Q
delirium
A
reduced attention, orientation and perception. also agitation
22
Q
what is the Glasgow Coma Scale
A
eyes, are they already open, do you need a strong stimulus, soft, are they not opening.
verbal, can give name place and date, or not oriented or no words, just sounds, or none.
motor: can they move on command, is it normal or abnormal
23
Q
what are the red flags for brainstem dysfunction
A
dysphagia (swallowing, 5,7,9,10,12)
dysarthria (speaking, CN 5,7,10,12)
diplopia (double vision)
dysmetria (impaired control of movement, like missing a target)
24
Q
where are the pyramids on the medulla? whats laterally
A
anterior, and just lateral are the olives
25
where does CN 12 exit
between the pyramids and olives
26
where do CN 9 + 10 exit
lateral to the olives
27
which side of the medulla are the inferior cerebellar peduncles
the posterior side
28
the central canal is continuous with the SC and in the upper medulla widens and becomes the
4th ventricle
29
what cranial nerve nuclei are in the medulla
7,8,9,10,12
30
what cranial nerves make up the solitary nucleus
7,9,10: visceral afferents, and taste
31
what CN make up the nucleus ambiguous
motor fibers to the striated muscles in the phkyaryn, larynx and upper esophagus, so CN 9 + 10
32
what do the lateral corticospinal tracts do in the medulla
their axons decussate
33
where do the Doral columns decussate
medial lemniscus of the medulla
34
TF: the spinothalamic tracts run through the medulla
true
35
the spinocerebellar tracts get to the cerebellum via the
inferior cerebellar peduncle
36
what are the functions of the medulla
- eye and head movements and postural control (vestibular nuclei- CN 8)
- swallowing (nuclei ambiguous- CN9,10)
- cardio and respiratory (dorsal motor vagus, CN10)
- visceral activity/taste (solitary nucleus, 7,9,19)
37
what CN come from the pons
the trigeminal (5)- face sensation
abducens (6)- lateral eye movement
facial (7)- facial muscles and chewing
vestibulocochlear (8)- head and neck and ear
38
the anterior portion of the pons contains the
- descending tracts (corticospinal, corticobrainstem and corticopontine),
- pontine nuclei
- pontocerebellar axons.
39
the posterior portion of the pons is called the
tegmentum
40
what does the tegmentum of the pons contain
the sensory tracts,
- reticular formation,
- autonomic tracts and
- CN nuclei (5-8)
41
how does the pons communicate with the cerebellum
the cerebellar peduncles
42
what are the functions of the pons
```
face sensation (CN 5)
expressions and taste (7)
chewing (7 and 5)
lateral eye movement (6)
hearing, head position and neck position (8)
```
43
what is another name for the midbrain
the mesencephalon
44
the midbrain connects what two things
the diencephalon, and the pons
45
what structure passes through the midbrain
the cerebral aqueduct, which connects the 3rd and 4th ventricle
46
there are three parts of the midbrain, what are they from anterior to posterior
basal pedunculi
tegmentum
tectum
47
the basal pedunculi is the anterior portion of the midbrain. what is on this surface
- the cerebral peduncles (descending tracts from the cerebral cortex)
- substantia nigra (part of the BG)
48
the tegmentum houses what tracts
the vertical sensory tracts
49
there are lots of important things in the tegmentum... name them
- superior cerebellar peduncle (midbrain to the cerebellum, efferent info)
- red nucleus (from the cerebellum/cortex to the cerebellum or SC. rubrospinal tract and the reticular formation)
- PPN: regulates muscle tone, part of BG)
- CN 3 and 4 nuclei:
- periaqueductal gray
50
in the tegmentum, what does the oculomotor nuclei do
efferent to the extra-occular muscles, and PNS control of pupillary contraction and the ciliary muscle.
51
what does the trochlear nuclei do
superior oblique
52
what is the function of the periaqueductal gray
around the cerebral aqueduct, this coordinates somatic and ANS responses to pain, threats and emotions
starts the fight or flight, laughing and crying.
53
what is the tectum
the posterior midbrain
54
what is in the tectum
the pretectal area (reflexes of the eye)
| and the colliculi (superior and inferior )
55
what does the inferior colliculi do
relays auditory information from the cochlear nuclei to the superior colliculi and the medial geniculate body
56
what does the superior colliculi do
orientation and sensory and motor and reflex, orients the eyes and head to external stimuli and movements.
57
the vertebral artery branches from the
subclavian
58
where does the vertebral artery enter the skull
the foramen Magnum
59
the vertebral arteries join to form the ___ at the base of the ____
basilar,
| pons
60
the basilar artery will divide at the junction of the ___ and ___ to become the _____
pons and midbrain
| posterior cerebral artery
61
the posterior cerebral artery supplies the ____
inferior and middle portions of the posterior cerebellum
62
the basilar artery has two branches...
the superior cerebellar and the anterior inferior cerebellar
63
the superior cerebellar supplies the
the superior 1/2 cerebellum and some midbrain
64
the anterior inferior cerebellar artery supplies
the anterior and inferior cerebellum (at junction of pons and medulla)
65
the posterior inferior cerebellar artery is off what artery? and supplies what
the vertebral, supplies the post and inf part of the cerebellum
66
disruption of the posterior inferior cerebellar artery causes
lateral medullary syndrome.
67
disorders of the brainstem include CN's and tracts as well. how would each present
CN ipsilateral
| tracts: contralateral
68
when there is ischemia in the brainstem, what are some rapid symptoms
dizzy, visual disorders, weak, incoordination and somatosensation disruption
69
what happens when there is vertebrobasilar artery insufficiency
transient symptoms, (especially with head and neck extended and rotated)
70
the cerebellum is also known as the
little brain
71
there are __x as many neurons in the cerebellum, compared to the cortex
4
72
the cerebellum integrates information from the __ lobe, and compares it to actual movement
planned movement from the frontal lobe, with actual movements.
73
what are the functions of the cerebellum
compares actual motor output with intended movement, and coordinates and refines activity.
movement rhythm, timing and synchronization
74
is the cerebellum conscious or non conscious
non
75
are there direct connections between the cerebellum and motor neurons
no
76
if there are no connections, how can it influence movement.
it is connected to motor tract cell bodies int he motor, premotor cortex and the brainstem,
77
what happens if there is damage to the cerebellum
impaired coordination, postural control and decreases in emotional dan cognitive function
78
cerebellum controls/regulates ___ movements
ipsilateral
79
what is the cerebellum anatomy, outer and inner
outer is grey matter with output purjunkie fibers. inner is white.
80
where is the cerebellum in the head
in the posterior cranial fossa, posterior to the brainstem and inferior to the occipital lobe
81
what separates the cerebellum and the occipital lobe
the tentorium cerebelli (dura)
82
what are the three lobes of the cerebellum
the anterior posterior and flocculonodular.
83
what is the inferior part of the posterior lobe, and what is damage to this called
the tonsils, and damage here is when they herniate in the foramen Magnum, this is called the Arnold chari malformation, and it compromises breathing, cardio and the 4th ventricle.
84
each hemisphere of the cerebellum is attached to the brainstem by 3...
peduncles
85
what does the superior peduncle do
cerebellar output and efferents to the midbrain, then to the cortex and red nucleus
86
what does the middle peduncle do
input to the cortex by the pons, afferent
87
what does the inferior peduncle do
input from brainstem and SC, output to vestibular and reticular nuclei
88
what is the rule of 3s with the cerebellum
there are 3 of everything, hemispheres/lobes, regions, layers, arteries, peduncles.
89
what 3 branches give blood to the cerebellum
the superior cerebellar
the anterior inferior
the posterior inferior
90
what portions of the cerebellum are supplied by the superior cerebellar
superior cerebellum and a little bit of the pons (rostral lateral dorsal)
91
what portions of the cerebellum are supplied by the anterior inferior cerebellar
lateral caudal pons, and small part cerebellum
92
what portions of the cerebellum are supplied by the posterior inferior cerebellar
supplies the lateral medulla and inferior cerebellum
93
an infarct in which artery will cause unilateral hearing loss. why?
AICA, because it gives rise to the internal auditory artery
94
where are infarcts more common
the SCA and PICA
95
what can infarcts cause
swelling, brainstem compression
96
what is the patient presentation in someone with a cerebral artery infarct
vertigo, nausea, dizzy, nystagmus, limb ataxia, unsteady gait, HA.
97
what are the three functional regions of the cerebellum
the vestibulocerebellum, spinocerebellum, and cerebrocerebellum
98
the vestibulocerebellum is part of what lobe
flocculonodule
99
what is the purpose of the vestibulocerebellum
regulate equilibrium, coordination, postural control and eye and head movement.
100
what happens with damage to the vestibulocerebellum
unsteady while reaching for a book, trunk ataxia, and nystagmus
101
what regions make up the spinocerebellum
the vermis and paravermal region
102
what does the spinocerebellum portion of the cerebellum do
connects with the SC and coordinated gross limb movements.
103
what does injury to the spinocerebellum look like
jerky and inaccurate movement, tremor, ataxic gait, dysarthria, dysdiadochokinesia, dysmetria, and movement decomposition.
104
what regions make up the cerebrocerebellum
the lateral hemispheres.
105
what does the cerebrocerebellum in the cerebellum do
coordinates precise, distal voluntary movement. movement planning and timing
106
what happens with damage to the cerebrocerebellum
finger ataxia, dysarthria, and cannot correct movements, as they are going wrong.
107
the cerebellum is contra or ipsilateral movement
ipsilateral
108
what are some of the roles of the BG
goal directed behavior, social and emotional and motor control
109
where is the BG located
deep within the white matter of the cerebral hemispheres.
110
how does the BG control movement
it predicts the effects of an action, and makes and executes a motor plan.
111
TF: the BG is vital for normal motor function, sequencing of movements, and cognitive functions
true
112
what are the main components of he BG
the caudate nucleus, the putamen, globus pallidus, sub thalamic nucleus, and substantial nigra.
113
where is the substantia nigra located
the midbrain (basal pedunculi), dorsal to the cerebral peduncles
114
the caudate nucleus has a
head, body and tail
115
the putamen is what
a large nucleus, forming the lateral parts of the BG
116
what connects the caudate and the putamen
the striatum, which are cellular bridges.
117
where is the globus pallidus
just medial to the putamen "pale globe"
118
the globus pallidus and putamen together are known as the
lenticular nucleus
119
what is the ventral and dorsal portions of the substantia nigra called
ventral: substantia nigra pars reticulata
dorsal: substantia nigra pars compacta
120
the substantia nigra plays a big role in
parkinsons
121
inputs to the basal ganglia arrive via the
striatum (caudate nucleus, and the putamen.)
122
what NT/NM is associated with inputs to the BG
glutamate, from the cortical motor areas, this excites the striatum
123
outputs exit vie the
internal segment of the globus pallidus and the substantia nigra pars compacta.
124
the substantia nigra pars compacta (dorsal part) send neurons to where and cause the release of what
striatum (caudate nucleus and putamen) and release dopamine.
125
the release of dopamine from the striatum does what to the output signals,
it adjusts them, and inhibits target nuclei.
126
the globus pallidus internus inhibits
motor thalamus, pedunculopontine nucleus and midbrain locomotor region.
127
what does the basal ganglia motor circuit output regulate
muscle contraction, force, multi-joint movements, and sequencing.
128
does the BG have direct output to LMN
no
129
how does the BG get motor outputs out there
motor thalamus, PPN, midbrain locomotion region.
130
what are the BG loops, and what do they do
they all contribute to full BG functioning. they predict future events, control desired and undesired behaviors and motor leaning, shift attention and spatial working memory
131
what is the motor loop connection
links the putamen, globus pallidus and VL thalamic nucleus to the motor and premotor cortex.
132
what is the role of the motor loop
movement selection, action, regulating contraction, force, multi-joint movement and sequencing.
133
what is the oculomotor loop connections
links the frontal and supplementary eye fields with the caudate body, SN reticular and the VA thalamic nucleus.
134
what is the role of the oculomotor loop
regulate spatial attention, eye movements, and reactive prosaccades.
135
what are prosaccades
the eyes moving rapidly, to read a book or watch a train pass by
136
what is the goal directed loop links
the head of the caudate, globus pallidus and the VA of thalamic nucleus to prefrontal cortex.
137
what is the role of the goal directed loop
goal directed behavior, perpetual decision making, and plans and decides on actions, in context.
138
give an example of how the goal directed loop may work
you are running late and the light is turning red. You decide if you have time to run the red light. you also decide which is more important, the interview or going for beers.
139
what kind of deficits do we see with the goal directed BG loop
inattention, distracted, disoriented, poor concentration and short term memory issues.
140
what are the links in the social behavior loop
head caudate SN reticular and the mediodorsal thalamic nucleus to the VL prefrontal and lateral orbital cortex.
141
what is the role of the social behavior loop
recognize social disapproval, self control, discerning relevant and irrelevant information, maintaining attention, and stimulus response learning. if granny, in the passenger seat, does or doesn't want you to run that red light.
142
what happens if there is damage to the social behavior loop
violent and sexual behavior, and inappropriate. impulsive, frustrated, violent.
143
what are the links of the emotional loop of the BG
ventral striatum, ventral pallidum, and MD thalamic nucleus to the medial prefrontal cortex.
144
the ventral striatum links the ___, ____ and ___ systems
limbic, cognitive and motor
145
the emotional loop is responsible for what
reward seeking, addition, gambling.
146
what is the role of the emotional loop
determines the value of a stimulus, reward based behaviors, monitors predicted errors and pleasure seeking.
147
what are the types of movement disorders of the BG
hypo or hyper kinetic.
148
the BG inhibits the
motor nucleus, PPN, and the midbrain locomotor region.
149
if there is excessive inhibition
hypo kinetic,
parkinsons
150
if there is inadequate inhibition
hyper kinetic. Huntington's (jerky movements and dementia, and you move in your sleep), dystonia (sustained contraction, abnormal posture and testing, but disappears in sleep. THINK BRENDAN), Tourettes (vocal and tics), dyskinetic CP (abnormal muscle tone and posture and involuntary movement.)
