Pons/Cerebellum Flashcards

(42 cards)

1
Q

The facial colliculus is located ______, along the midline. It overlies _____. Damage here will affect the ____ and cause ______

A

On the floor of the 4th ventricle
Cr 6 nucleus and Cr 7 which loops around it
horizontal gaze center (i.e. paramedian pontine reticular formation)
horizontal nystagmus or loss of conjugate horizontal eye movements

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2
Q

The pons is mostly supplied by the ____ artery and the _____ branches from it but also receives some blood supply from the _____ and _____ on the dorsal lateral aspect.

A

Basilar
Pontine/penetrating branches
Superior cerebellar
AICA

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3
Q

The basis of the pons has longitudinal axons going from pontine nuclei to the _____ via the ____. These carry info from ____

A

Cerebellum
Middle cerebellar peduncle
The cortex

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4
Q

The inferior cerebellar peduncle carries ______. The middle cerebellar peduncle carries _____. The superior cerebellar peduncle carries _____.

A

Inf- axons from the medulla to the cerebellum
Middle- pons to cerebellum
Superior- output from the deep cerebellar nuclei to the brainstem and forebrain

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5
Q

The vestibular areas are at the border of the pons and medulla, at the _____. They are close to the ____

A

Ends of the widest point of the 4th ventricle

Inf Cerebellar Peduncle

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6
Q

You can see the paramedian pontine reticular formation _____ and the raphe nucleus _____ in the caudal pons. The locus coeruleus is visible in the rostral pons _____.

A

PPRF- Midline
RN- midline b/wn medial lemnisci
LC- on the dorsal aspect, by the ventricle and next to the superior cerebellar peduncle

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7
Q

The lateral lemniscus projects from the _____ to the _____. It is lateral to the medial lemniscus and in the rostral pons, is at a 90 degree angle to it, with the _____ tract at the “elbow”

A

superior olive
inferior colliculus
anterolateral tract

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8
Q

The medial longitudinal fasciculus allows you to…
It interconnects…
It is located…

A

look to 1 side with both eyes at the same time
Vestibular nuclei; Cr 3,4,6 nuclei; superior colliculus; cervical spinal cord
In the dorsal aspect of the pons, near the midline

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9
Q

In moving from the medulla to the pons, you can note the disappearance of the…

A

Pyramids and the inferior olive

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10
Q

The caudal pons contains nuclei for cranial nerves…

A

6,7 and 8 (spinal nucleus of 5 might be visible too)

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11
Q

For unilateral hearing loss to occur, there must be damage to…

A

Cr 8 or both cochlear nuclei on 1 side

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12
Q

At the level trigem enters the pons, you can see ____ and ____ which carry ____ and _____ info respectively. (proprioceptive info is carried to which nucleus?)

A

motor nucleus of 5- motor info for jaw muscles
chief sensory nucleus of 5- epicritic
Proprioceptive to the mesencephalic nucleus of 5- in the midbrain

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13
Q

The medial lemniscus contains ___ info from the ____. It shifts laterally and dorsally in the pons and eventually terminates in the _____

A

epicritic
Trunk and limbs
VPL of the thalamus

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14
Q

Axons of the pyramidal tracts appear as _____ in the pons (as compared to ____ in the medulla). These come to the pons by way of the ____ and the ____

A

Axon bundles/fascicles
Pyramids
Post limb internal capsule
Crus cerebri

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15
Q

Corticobulbar axons are _____ for cranial nerves. They mostly affect CNs on the ___ side

A

UMNs

Contralateral (no distinct decusation)

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16
Q

The vestibular nucleus is for ____. It receives sensory info about ____. It gives output to Cr 3,4, and 6 via the ______ for the VOR. It also gives output to _____ for maintaining posture and to the cerebellum via the ICP for ____

A
Cr 8
the position and movement of the head
MLF
the spinal cord
Balance and control of reflexive eye mvts
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17
Q

The facial nucleus ______. A lesion here results in ______

A

Innervates the muscles of the face via Cr 7

Ipsilateral face paralysis (entire half) and a loss of the efferent br of the corneal reflex. And eyes are dry

18
Q

The abducens nucleus ______. Pathology here leads to ____

A

innervates the ipsilateral lateral rectus muscle

the eye drifting towards the middle (internal strabismus) and diplopia

19
Q

Damage to what nucleus leads to a loss of the afferent br of the corneal reflex? What else occurs here?

A

The spinal nucleus of 5

Synapse of neurons from the face carrying protopathic info

20
Q

The chief sensory tract of 5 carries epicritic info across the midline and travels with the _____ to the _____

A
medial lemniscus (in the medial portion) 
VPM
21
Q

The ICP carries info about proprioception from ___, ____ and ____

A

The spinocerebellar tract (limb position and velocity)
The inf olivary complex (from the cortex, red nucleus and spinal cord)
The vestibular nuclei

22
Q

The superior cerebellar peduncle contains axons from deep cerebellar nuclei that target….

A

The pontine RF, the red nucleus, the ventral anterior and ventral lateral nuclei in the thalamus

23
Q

Name the 4 thalamic deep nuclei. The medial ones receive info about the ____ and the lateral ones are related to ____

A

Fastigial and globose (medial); embolliform and dentate (lateral)
Axial structures via the RF and vestibular nuclei
Limb control

24
Q

Midline pathology of the cerebellum usually affects _____ and causes _____ whereas lateral pathology of the cerebellum usually affects ____ and causes _____

A

The axial muscles and balance
Ataxia, a broad-based gait, horizontal gaze-induced nystagmus and hypotonia
Limb movement and fine motor control
Intention tremor, dysmetria (past-pointing), dysdiadochokinesia

25
Flocculus damage is associated with what symptoms?
Nystagmus and disturbances in balance
26
What arteries supply the cerebellum?
The superior cerebellar and the AICA from the basilar and the PICA from the vertebral
27
The horizontal gaze center is made up of the ____
Abducens nerve, the PPRF and the MLF
28
The crus cerebri and Cr 4 are visible in a myelin section of the ___
Rostral pons
29
In decorticate posturing, a lesion has occurred _____. This results in a loss of innervation from the corticospinal tract so the _____ tract takes over, causing flexion of the upper limb and extension of the lower limb.
rostral to the red nuclei/in the midbrain Rubrospinal tract Note: only seen in coma pts
30
In the corneal reflex, info about the stimulus is carried into the pons via ____. It then _____, synapses, and travels to both _____ in the pons. This causes both eyes to blink
Cr 5 Descends into the medulla with the spinal tract (protopathic sense) of 5 Facial nuclei
31
To localize a lesion in the caudal pons, look for _____ nerve involvement. In the mid pons, _____ involvement. In the rostral pons, _____ involvement
Cr 5,6,7 Cr 5- motor nucleus and chief sensory nucleus Cr 5, 4 but they're not good localizers
32
Horizontal nystagmus suggests a lesion _____, involving what structures?
At the pons-medulla junction | Vestibular nuclei, Cr 8, cerebellar input or cerebellum
33
How is it possible to get protopathic sensory loss on both sides of the face?
These fibers enter the pons with Cr 5, dive down into the medulla, decussate and climb with the anterolateral system on the contralateral side. A lesion just above the decusation would knock out fibers from the ipsilateral side descending and fibers from the contralateral side climbing (fibers are in close proximity)
34
LMN lesion to Cr 7 causes paralysis of ____
the entire 1/2 of the face
35
For horizontal nystagmus, resting or spontaneous nystagmus is likely from ____ whereas gaze-induced nystagmus is likely from _____
Vestibular nuclei | Cerebellum
36
How could you differentiate between a PICA and an AICA stroke?
The PICA will not affect Cr 7 b/c it only perfuses the medulla. The AICA supplies the pons so it will affect the facial nerve or it's nucleus if the stroke is big enough
37
A lesion to the vestibular nuclei will result in...
vertigo, tinnitus, horizontal nystagmus, loss of balance (esp when pt closes eyes), ipsilateral hearing loss
38
Protopathic sensation conveys info about
pain, temperature and pinprick sensation
39
A sensory deficit from head to toe (including the face) on 1 side of the body means a lesion is....
Above where trigem enters the pons (mid pons) because all info must have crossed over and must be ascending together
40
A stroke involving the superior cerebellar artery affects _____ which would cause Horner's syndrome
The HRST
41
A stroke involving the AICA will affect the dorsal lateral pons in addition to the cerebellum, causing...
hearing loss, facial nerve involvement (paralysis of 1/2 of the face)
42
A PICA stroke affects the dorsal lateral medulla and might cause...
Hoarseness, vertigo, crossed sensory signs (i.e. protopathic sensation on 1 side of the face and the opposite side of the body)