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Neuro Test 2 > Lecture 11 > Flashcards

Lecture 11 Flashcards

1
Q

What are the 3 longitudinal divisions of the brainstem?

A

Basilar - front

Tegmentum - middle

Tectum - back

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2
Q

The tectum is only found in the….

A

Midbrain

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3
Q

What does the tectum consist of?

A

Superior + inferior colliculus and pretectum

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4
Q

What is inside of the tegmentum

A

Reticular Formation

CN V nuclei

medial longitudinal fasciculus (coordinates head and eye mvmt)

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5
Q

What is inside of the basilar division?

A

descending axons from cerebral cortex, corticospinal, corticobrainstem, corticopontine, and corticoreticular tracts

Motor nuclei from substantia nigra, pons, and inferior olive

Basically a bunch of motor stuff (all tracts that start with cortico-)

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6
Q

What is in the basis pedunculi?

A

Cerebral peduncles

substantia niagra nucleus

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7
Q

What does the superior colliculus do?

A

motor and sensory info to orient head and eyes

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8
Q

What does the inferior colliculus do?

A

relays info from cochlear nerve to superior colliculus and thalamus

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9
Q

The pretectal area of the midbrain does what?

A

mediates eye reflexes

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10
Q

What kind of matter is the red nucleus made out of?

A

Gray matter

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11
Q

What cranial nerve nuclei are found in the midbrain tegmentum

A

3 and 4

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12
Q

What 2 tracts synapse in the pons? Most of the tracts do not

A

corticopontine tract- Synapse on pontine nuclei -> pontocerebellar fibers -> middle cerebellar peduncle -> synapse in contralateral cerebellar hemisphere

corticobrainstem tract - synapses with trigeminal motor nucleus and facial nucleus

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13
Q
A
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14
Q

What kind of fibers are in the superior cerebellar peduncle?

A

Sensory fibers

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15
Q

What can you find in the basilar portion of the pons?

A

Descending tracts- corticospinal, corticobrainstem, corticopontine

Pontine nuclei

Pontocerebellar axons

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16
Q

What can be found in the tegmentum of the Pons?

A

Sensory Tracts

Reticular Formation

Autonomic pathways

CN 5,6,7,8 nuclei

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17
Q

What cranial nerve nuclei exits between the pyramid and inferior olive?

18
Q

What is the nucleus ambiguus for?

A

Motor output to swallowing/vocalization muscles

(Which would be CN 9, 10, 12)

19
Q

What is the only tract that enters the medulla from the cerebellum

(The rest enter medulla -> inferior cerebellar peduncle -> cerebellum)

A

Cerebellovestibular tract

20
Q

The DCML crosses in the inferior medulla ________ to the crossing of the corticospinal tract

21
Q

The anterior inferior cerebellar artery supplies the _____ whereas the Posterior inferior cerebellar artery supplies the _______

A

Pons

Medulla

22
Q

What are the 4 brain stem tracts?

A

Rubrospinal Vestibulospinal Reticulospinal Tectospinal

23
Q

What are the general brain stem functions

A

Modulates conciousness

Regulates vital signs

Conveys signal from cortex to spinal cord

24
Q

What are the 4 cardinal signs of brain stem dysfunction? 4 Ds

A

Dysphagia, Dysarthria, diplopia, dysmetria

25
Damage to brain stem could cause….
Heart to stop beating BP to fluctuate Breathing to stop
26
Disorders of conciousness are due to damage of_______
Reticular activating formation/ reticular formation People in vegetative or minimally concious states have loss of tissue in subcoritcal/thalamic/brainstem regions
27
Anteriormedial midbrain syndrome (webers) is caused by….
Blockage of PCA or Basilar artery
28
What are the primary structures affected by Anteromedial midbrain syndrome (webers)
Corticospinal tract- contralateral motor paralysis Occulomotor nerve nucleus- Ipsilateral loss of eye movements. Paralysis of eyelid, dilated pupil Red Nucleus- loss of motor coordination, ataxia, CONTRALATERAL, inappropriate laughing and crying. Lability
29
What does CN3 palsy look like?
Eye deviated down and out
30
Lateral inferior pontine syndrome is due to occlusion of the….
Anterior inferior cerebellar artery
31
What are the clinical manifestations of lateral inferior pontine syndrome What artery?
Cochlear nucleus- ipsilateral hearing loss Vestibular nucleus affected- dysequilibrium, nausea, vomiting Impaired descending sympathetic- ipsilateral Horner’s syndrome Trigeminal nerve- ipsilateral pain and temp loss of face Salivatory nucleus- decreased tears and salivation Spinothalamic tract- contralateral pain and temperature sensation to body Facial nerve- ipsilateral loss of facial muscles Remember, Trigeminal, Facial, And Vestibulocochlear nerve are all on the pons and the pons is supplied blood by AICA
32
Damage to what nerve causes Bell’s palsy How will Bell’s palsy differ from a facial weakness after stroke
Facial nerve Stroke is usually only lower facial weakness | (Upperface muscle preserved due to dual innervation of the upper face)
33
What is Horner’s syndrome?
Miosis- pupil constricted Ptosis- drooping eye lid Anhidrosis- drying of skin in the area Damage to sympathetic nerves
34
Locked in syndrome is due to damage of the….
Basiliar artery impacting the ventral pons bilaterally
35
What are the primary structures involved in locked in syndrome-
B corticospinal tracts- paralysis below the head B corticobulbar tracts- paralysis of facial muscles B abducens tracts- unable to move eyes to side Note: most of the time cranial nerve 3 is preserved but sometimes its impacted
36
What are spared in locked-in syndrome?
Reticular activating formation/ reticular formation Vertical gaze centers are spared.
37
Middle medullary syndrome is caused by a blockage in the ….
Anterior spinal artery
38
What is the 2nd most common place to have a stroke in the brainstem?
AICA
39
What are the primary structures affected by medial medullary syndrome
hypoglossal nerve- ipsilateral tongue protrusion DCML- contralateral loss of DCML senses Lateral corticospinal- contralateral hemiparesis Remember the hypoglossal nerve comes off of the medial medulla!
40
What is the most common brainstem stroke, and what artery causes it?
Lateral medullary syndrome (wallenberg) Due to blockage of PICA
41
What structures are affected due to Wallenberg syndrome (lateral medullary syndrome)
Vagus nerve/Solitary nucleus- elevated HR Vestibular nucleus- balance Vagus nerve nucleus- altered vitals Trigeminal Nerve Inferior cerebellar peduncle - ataxia/coordination ipsilateral Salivatory nucleus - unable to salivate or make tears Spinothalamic tract- contralateral Descending sympathetic- ipsilateral Horner syndrome Nucleus ambiguus (9 10) and 12 cranial nerve. Tongue/ larynx/pharynx affected. Lack of gag reflex
42
The reticular formation is in the _______ of the pons
tegmentum

Neuro Test 2 (19 decks)

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