Neuro

Question 1

Fine touch
Vibration
Proprioception

Answer 1

Dorsal column

Medial lemniscus pathway

Question 2

Dorsal column - Medial lemniscus decussates?

Answer 2

Medulla

Question 3

Where does medial lemniscus relay in the thalamus?

Answer 3

Ventral posterolateral nucleus (body sensation)

Question 4

Pain

Temperature

Answer 4

Spinothalamic Tract

Question 5

Where does spinothalamic tract decussate?

Answer 5

Anterior white commissure

Question 6

Do CN decussate?

Answer 6

No

Question 7

Motor

Answer 7

Lateral corticospinal tract

Question 8

Where does the lateral corticospinal tract decussate?

Answer 8

caudal medulla

Question 9

Red nucleus

Answer 9

Rostral Midbrain

Question 10

CN III

Answer 10

Rostral Midbrain

Question 11

CN IV

Answer 11

Caudal Midbrain

Question 12

Damaged in patients with Parkinson’s

Answer 12

Substantia nigra

Question 13

Superior colliculus

Answer 13

Rostral Midbrain

Question 14

Inferior colliculus

Answer 14

Caudal Midbrain

Question 15

Medial Pons

Answer 15

MLF / medial lemniscus / Abducens (CN VI) nucleus / Corticospinal tract

Question 16

Blood supply of Medial Pons

Answer 16

Paramedian & Median branches of the Basilar a.

Question 17

Blood supply of Lateral Pons

Answer 17

Anterior Inferior Cerebral a.

AICA

Question 18

Lateral Pons

Answer 18

Lateral spinothalamic tract / Facial (CN VII) nucleus / Vestibular (CNVIII) nucleus / Spinal Trigeminal (CN V) nucleus & tract

Question 19

CN V, VI, VII, VIII

Answer 19

Pons

Question 20

How to tell if you’re in Medulla?

Answer 20

Inferior olivary nucleus / Medullary pyramids

Question 21

Medial Medulla

Answer 21

Medullary pyramids / medial lemniscus / Hypoglossal (CN XII) nucleus

Question 22

Blood supply to Medial Medulla

Answer 22

Anterior spinal a.

Question 23

Blood supply to Lateral Medulla

Answer 23

Posterior Inferior Cerebellar a.

PICA

Question 24

Lateral Medulla

Answer 24

Lateral spinothalamic tract / Spinal trigeminal (CN V) tract & nucleus / Inferior cerebellar peduncle / vesticular (CN VIII) nuclei / Nucleus ambiguus (CN IX, X)

Question 25

Swallowing and speech

Answer 25

Nucleus Ambiguus (CN IX, X)

Question 26

CN X (vagus) contributors

Answer 26

Nucleus ambiguus / Dorsal motor nucleus / Nucleus of solitary tract

Question 27

Dorsal motor nucleus

Answer 27

Parasympathetic to GI tract, Heart, Lungs | *** NOT MOTOR!!

Question 28

Where are the sympathetic nervous system?

Answer 28

``` Spinal cord Horner sydrome (ptosis, miosis, anhidrosis) ```

Question 29

Hallmark sign of brainstem lesion?

Answer 29

ALTERNATING SYNDROME: | long tract symptoms on one side (hemiparalysis) and CN symptoms on the other

Question 30

The Rule of Fours

Answer 30

- 4 medial/midline structures, beginning with M - 4 side/lateral structures, beginning with S - 4 CNs originate in the pons, 4 below the pons, 4 above the pons - 4 motor CN nuclei in the MIDLINE are those that divide evenly into 12 (except CN I and CN II)

Question 31

Weakness of contralateral arm and leg. Deficit?

Answer 31

Motor pathway - (medial) corticospinal tract

Question 32

Loss of vibration / proprioception / fine touch (contralateral arm/leg). Deficit?

Answer 32

Medial Lemniscus

Question 33

Ispsilateral internuclear ophthalmoplegia. Deficit?

Answer 33

Medial Longitudinal Fasciculus (MLF)

Question 34

Ipsilateral arm and leg ataxia. Deficit?

Answer 34

Spinocerebellar tract

Question 35

Alteration of pain/temperature in contralateral arm and leg. Deficit?

Answer 35

Spinothalamic tract

Question 36

Ipsilateral alteration of pain/temperature on face. Deficit?

Answer 36

Sensory nucleus of CN V

Question 37

Ipsilateral Horner syndrome

Answer 37

Sympathetic pathway

Question 38

Hoarse voice and difficulty swallowing Loss of pain and temp in right arm and leg Ataxia in left arm Uvula deviates to the right

Answer 38

Left Lateral Medulla "Wallenberg syndrome" ``` Spinothalamic Spinal Trigeminal nucleus Nucleus ambiguus Sympathetic tract Vestibular nucleus - vertigo / nystagmus / n/v Inferior Cerebellar peduncle ``` PICA

Question 39

Weakness in right arm and leg Numbness in right arm and leg Decrease vibration and proprioception on right Tongue deviates to the left

Answer 39

Left Medial Medulla "Medial Medullary syndrome" Anterior Spinal Artery

Question 40

Left facial droop Loss of pain and temp on left face Loss of pain and temp in right arm and leg

Answer 40

Left Lateral Inferior Pons "Lateral Inferior Pontine Syndrome"

Question 41

Inability to abduct or adduct right eye Nystagmus in the left eye when looking left Left arm and leg weakness Loss of fine touch, vibration, and proprioception in the left arm and leg

Answer 41

Right Medial Pons "Medial Pontine Syndrome"

Question 42

Multiple Sclerosis Medial Pontine strokes Risk for?

Answer 42

INO (lesion of MLF)

Question 43

Can only move eyes

Answer 43

Locked-in-Syndrome - basilar artery stroke - rapid hyponatremia correction (CPM)

Question 44

dysphagia , dysphonia, dysarthria (corticobulbar tract damage) contralateral spastic hemiparesis (corticospinal tract damage) CN III palsy --> ipsilateral ptosis, pupillary dilation, and lateral strabismus (eye looks down and out

Answer 44

Weber Syndrome ANTERIOR MIDBRAIN infarction resulting from occlussion of paramedian branches of posterior cerebral artery