TBL Flashcards
1
Q
Rostral midbrain
A
Nuclei: • Oculomotor nuclei (CN III) • Red Nucleus • Mesencephalic Trigeminal Nucleus Tracts: • Spinothalamic tract • Medial lemniscus
2
Q
Caudal midbrain
A
Nuclei: • Trochlear nuclei (CN IV) • Mesencephalic Trigeminal Nucleus Tracts: • Spinothalamic tract • Medial lemniscus
3
Q
Pontomesencephalic junction
A
Nuclei: pontine nuclei
Tracts:
• Anterolateral system
• Corticospinal tract
4
Q
Rostral pons
A
Nuclei: • Chief sensory nucleus of Trigeminal n. (CN V) • Motor nucleus of Trigeminal n. (CN V) • Pontine nuclei Tracts: • Spinothalamic tract • Medial lemniscus • Corticospinal tract
5
Q
Caudal pons
A
Nuclei: • Pontine nuclei • Facial nuclei (CN VII) • Abducens nuclei (CN VI) • Vestibular nuclei • Cochlear nuclei • Spinal trigeminal nucleus (CN V) Tracts: • Spinothalamic tract • Medial lemniscus • Corticospinal tract • Spinal trigeminal tract
6
Q
Rostral medulla
A
Nuclei: • Inferior olivary nucleus • Hypoglossal nuclei (CN XII) • Nucleus ambiguous (CN IX, X) • Dorsal motor nucleus X • Nucleus solitarius (CN IX, X) • Spinal trigeminal nucleus (CN V) • Vestibular nuclei Tracts: • Spinothalamic tract • Medial lemniscus • Pyramidal/corticospinal tract • Spinal trigeminal tract
7
Q
Caudal medulla
A
Nuclei: • Gracilis and Cuneatus • Central Canal: hypoglossal nucleus, dorsal motor nucleus of X and solitary nucleus • Spinal trigeminal nucleus (CN V) Tracts: • Spinothalamic tract • Pyramidal/corticospinal tract • Medial lemniscus • Spinal trigeminal tract
8
Q
Cervicomedullary junction
A
Nuclei: Gracilis and Cuneatus
Tracts: Anterolateral system
9
Q
Cervical spinal cord
A
Nuclei: • Gracilis and Cuneatus • Accessory spinal nucleus (CN XI) Tracts: • Anterolateral system • Lateral corticospinal tract
10
Q
Vascular territories of PCA
A
- Midbrain
- Most of thalamus
- Medial occipital lobes
- Inferior medial temporal lobes
11
Q
Vascular territories of superior cerebellar a.
A
- Superior cerebellum
- Part of rostral laterodorsal pons
12
Q
Dorsal
A
Posterior
13
Q
Ventral
A
Anterior
14
Q
Caudal
A
Towards feet
15
Q
Rostral
A
Towards head
16
Q
Vascular territories of AICA
A
- Lateral caudal pons
- Small part of cerebellum
17
Q
Vascular territories of PICA
A
- Lateral medulla
- Inferior cerebellum
18
Q
Vascular territories of basilar a. (paramedian and circumferential branches)
A
- Medial pons (paramedian)
- Lateral pons (circumferential)
19
Q
Vascular territories of vertebral aa.
A
-Medulla
20
Q
Vascular territories of anterior spinal aa.
A
-Medial medulla
21
Q
Blood supply to midbrain
A
- PCA
- Basilar a. (top paramedian and penetrating branches)
22
Q
Blood supply to rostral pons
A
- Basilar a (circumferential and paramedian branches)
- Superior cerebellar a
23
Q
Blood supply to caudal pons
A
- Basilar a (paramedian and circumferential branches)
- AICA
24
Q
Blood supply to medial medulla
A
-Paramedian branches of vertebral and spinal arteries
25
Blood supply to lateral medulla
-Vertebral arteries and posterior inferior cerebellar a.
26
Clinical signs and associated neural structures of midbrain
- Corticospinal tract (CN III palsy, pupil dilation, flexor posturing)
- Cerebellum or cerebellar pathways (ataxia)
- Pontomesencephalic reticular formation or bilateral thalami (impaired consciousness)
27
Clinical signs and associated neural structures of pontine
- Corticospinal tract (generalized weakness, bilateral Babinski's sign, extensor posturing)
- Lack of blood flow from basilar a. to PCAs (bilateral upper/lower visual loss or blurring)
- Long somatosensory pathways or trigeminal system (perioral numbness, facial tingling)
- Respiration center of pons (irregular respiration)
- Supranuclear or infranuclear eye movement pathways (ocular bobbing)
- Central tegmental tract (shivering, palatal myoclonus)
- Abducens nucleus (abducens palsy/horizontal gaze palsy)
- Disruption of descending sympathetic fibers (bilateral small but reactive pupils)
- Pontomesencephalic reticular formation or bilateral thalami (impaired consciousness)
28
Clinical signs and associated neural structures of medulla
- Vestibular nuclei, cerebellum, or inner ear (vertigo, N/V)
- Cerebellum or cerebellar pathways (ataxia)
- Vestibular nucleus (nystagmus)
- Corticospinal tract (respiratory arrest, autonomic instability)
- Occlusion of PICA or one of the branches of vertebral (hiccups)
29
Medial medullary syndrome clinical features, affected neural structures, and blood supply
Clinical features and affected neural structures:
-contralateral arm or leg weakness (pyramidal tract)
-contralateral decreased position and vibration sense (ML)
-ipsilateral tongue weakness (hypoglossal nucleus)
Blood supply: paramedian branches of vertebral and anterior spinal aa.
30
Lateral medullary syndrome clinical features, affected neural structures, and blood supply (Wallenberg's)
Clinical features and affected neural structures:
-Ipsilateral ataxia, vertigo, nystagmus, nausea (inferior cerebellar peduncle, vestibular nuclei)
-Ipsilateral facial decreased pain and temp sense (trigeminal nucleus and tract)
-Contralateral body decreased pain and temp sense (spinothalamic tract)
-Ipsilateral Horner's (descending sympathetics)
-Hoarseness, dysphagia (nucleus ambiguus)
-Ipsilateral decreased taste (nucleus solitarius)
Blood supply: vertebral
31
Infarct of medial pontine basis (dysarthria hemiparesis and ataxic hemiparesis) clinical features, affected neural structures, and blood supply
Clinical features and affected neural structures:
-contralateral face, arm, and leg weakness; dysarthria (corticospinal/bulbar tracts)
-contralateral ataxia (sometimes ipsilateral) (pontine nuclei and pontocerebellar fibers)
Blood supply: paramedian branches of basilar a., ventral territory
32
AICA syndrome clinical features, affected neural structures, and blood supply
Clinical features and affected neural structures:
-ipsilateral ataxia (middle cerebral peduncle)
-vertigo, nystagmus (vestibular nuclei)
-ipsilateral facial decreased pain and temp sense (trigeminal nucleus and tract)
-contralateral body decreased pain and temp sense (spinothalamic tract)
-ipsilateral Horner's (descending sympathetics)
Blood supply: AICA
33
Infarct of midrbain basis (Weber's) clinical features, affected neural structures, and blood supply
Clinical features and affected neural structures:
-ipsilateral CN III palsy (oculomotor fascicles)
-contralateral hemiparesis (cerebral peduncle)
Blood supply: branches of PCA and top of basilar
34
Infarct of midbrain tegmentum (Claude's) clinical features, affected neural structures, and blood supply
Clinical features and affected neural structures:
-ipsilateral CN III palsy (oculomotor fascicles)
-contralateral ataxia (red nucleus, superiro cerebellar peduncle fibers)
Blood supply: branches of PCA and top of basilar a.
35
GSE
Oculomotor nucleus
Trochlear nucleus
Abducens nucleus
Hypoglossal nucleus
36
SVE
Motor nucleus of V
Facial motor nucleus
Nucleus ambiguus (IX, X)
Spinal accessory nucleus
37
GVE
Edinger-Westphal (III)
Superior salivatory nucleus (VII)
Inferior salivatory nucleus (IX)
dorsal motor nucleus of X
38
SVA
Rostral nucleus solitarius (gustatory) (VII, IX, X)
39
GVA
Caudal nucleus solitarius (cardiorespiratory) (IX, X)
40
GSA
Chief sensory nucleus
Mesencephalic nucleus
Spinal trigeminal nucleus (V, VII, IX, X)
41
SSA
Cochlear and vestibular nuclei (VIII)
