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Flashcards in Medulla Pathology Deck (36):
1

What is the effect of a lesion of the spinal nucleus of CN V?

- Loss of ipsilateral pain and temperature to the face

2

What is the effect of a lesion of the motor nucleus of CN XI?

- Ispi lateral LMNS of the SCM and upper traps

3

What is the effect of a lesion to the pyramidal tracts at above the level of the motor decussation?

Contralateral UMN hemiplegia

4

What is the effect of a lesion to the pyramidal tract in the middle of the motor decussation?

Crossed hemiplegia (Between crossing of UE and LE)

- Ipsilateral arm
- Contralateral leg

5

Does the UE or LE cross first at the motor decussation?

UE

6

What is crossed - analgesia?

- CN V and Spinothalamic tract involvement
- Ipsilateral face pain and temperature
- Contralateral body pain and temperature

7

What structures are typically affected in the medulla by an occlusion of the posterior spinal arteries? What is the effect of a lesion?

- The dorsal columns
- Ipsilateral loss of discriminitive sensation/ proprioception

8

What type of loss occurs with a lesioning of the medial lemniscus in the medulla?

Contralateral:
- Concious proprioception
- Discriminitive touch

9

What is the effect of a lesioning of the CN XII nucleus?

- LMN loss of ipsilateral tongue

10

To which direction will the tongue deviate in a lesioning of CN XII?

- To the affected side

11

What is alternating hypoglossal hemiplegia?

- LMN of ipsilateral tongue (CN XII)
- UMN of contralateral body (Pyramidal tracts)

12

What artery is responsible typically for alternating hypoglossal hemiplegia?

Anterior spinal artery

13

What will be the effect of lesioning the spinothalamic tract in the medulla?

- Contralateral loss of pain and temperature to body

14

What is the effect of a lesioning of the nucleus ambiguus?

- LMN lesion to ipsilateral larynx and pharynx

15

What are symptoms of a lesion to the nucleus ambiguus?

- Horseness of voice
- Dysarthria

16

What are 2 clinical tests for nucleus ambiguus lesioning?

- Hold tongue down with depressor, ask patient to say "ahhh", side that doesn't rise is lesioned
- Gag reflex

17

What CN does the "say 'ahhh'" test assess?

CN X

18

What CN does the gag reflex test?

CN X and XI

19

What artery supplies the nucleus ambiguus and spinothalamic tract?

Vertebral

20

What results from a lesioning/ occlusion of the posterior inferior cerebellar artery?

Death due to a loss of the vital reflexes

21

What is results from a lesioning/ occlusion of the posterior inferior cerebellar artery?

- Loss of pain + temp to face and contralateral body
- Loss of gag reflex, dysphagia, hoarseness, dysarthria
- Ipsilateral loss of coordination
- Vestibular symptoms such as (nystagmus, nausea, pursuing contralateral moving objects)
- Horner's syndrome
- Ocular lateropulsion

22

What arteries and structures are affected in dorsal medullary syndrome?

- Medial branch of PICA
- Vestibular nuclei
- Restiform body/ ICP

23

What are the signs of dorsal medullary syndrome?

- Ipsilateral limb or gait ataxia
- Vertigo, vomiting, and ipsilateral gaze-evoke nystagmus

24

What is bulbar palsy?

LMN of any of the cranial nerves

25

What causes pseudobulbar palsy?

Bilateral dysfunction of:
- Corticobulbar fibers
- Corticoreticulobulbar fibers
- Above the pons

26

What are the signs of pseudobulbar palsy?

- UMNL of cranial nerves
- Inappropriate outbursts of laughter and crying

27

What structures and artery are involved in medial medullary syndrome?

- Anterior spinal artery
- Medial lemniscus
- Pyramid
- Rootlets of CN XII

28

What nerve innervates taste in the anterior 2/3rds of the tongue?

- CN VII

29

What nerve innervates taste in the posterior 1/3rd of tongue?

- CN IX

30

What nerve provides GVA information from the posterior 1/3rd of the tongue?

- CN IX

31

What nerve provides GVA information for the anterior 2/3rds of the tongue?

- CN V

32

What nervous systems are CN V and CN VII related to?

Parasympathetic

33

What is the GVE portion of the CN IX and CN VII?

- Parotid gland (IX)
- Glands in mouth

34

What is the SVE component of CN IX?

- Motor innervation of pharynx and larynx

35

What nucleus uses CN VII to innervate the glands of the mouth (submandibular, sublingual, lacrimal, etc.)?

- Superior salivatory nucleus

36

What CN does the inferior salivatory nucleus use for its GVE component? What glands does it innervate?

- Use CN IX
- Parotid gland