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W2 brainstem Flashcards

1
Q

Brainstem: Structures

A
  • Contains areas crucial to the maintenance
    of life
  • Sits superior to the spinal cord and inferior to the cerebrum
  • Contains 10 cranial nerve nuclei
  • Can be divided into 3 sections: medulla, pons, midbrain
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2
Q

Brainstem: Structures
Ventral and Sagittal view

A
  • Crus cerebri
  • Middle cerebellar peduncle
  • Pyramids of the medulla
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3
Q

Brainstem: Structures
Dorsal view:

A
  • Superior colliculi: Vision
  • Inferior colliculi: Auditory
  • Cerebellar peduncles
  • Superior * Middle * Inferior
  • Floor of the 4th ventricle
  • Fasciculus cuneatus & gracilis
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4
Q

Olfactory number, affrent or effrent? and connection to CNS & function

A

I
affrent
cerebellum
smell (can help w taste too)

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5
Q

optic number, affrent or effrent? and connection to CNS & function

A

II
afferent
cerebrum
vision & pupilillary light reflex

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6
Q

oculomotr number, affrent or effrent? and connection to CNS & function

A

III
efferent
midbrain
Movement of eyeball & elevation of upper eyelid
Parasympathetic for pupillary constriction and accommodation

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7
Q

trochlear number, affrent or effrent? and connection to CNS & function

A

Iv
efferent
midbrain
movement of eyeball for complex movements (superior oblique
muscle)

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8
Q

trigeminal number, affrent or effrent? and connection to CNS & function

A

V
both
pons
Trigeminal has 3 branches:
* Ophthalmic (CN V1) - Sensory
* Maxillary (CN V2) - Sensory
* Mandibular (CN V3) - Mixed
* Ipsilateral muscles of mastication
general sensation for face for all trigeminal

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9
Q

abduccens number, affrent or effrent? and connection to CNS & function

A

VI
efferent
pons
movement of eyeball to abduct the eyeball (lateral rectus) ABDUCTION

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10
Q

facial number, affrent or effrent? and connection to CNS & function

A

VII
both
pons
afferent fibers to the anterior 2/3rd of the tongue
(taste- sweet and sour).
* Afferent from posterior ear canal
Efferent fibers for the ipsilateral muscles of face
(expression and lip movement) and one of the
small middle ear muscles that helps in the auditory protective reflex
Parasympathetic efferent fibers to the
glands (e.g. tears & saliva)

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11
Q

vestibulocochlear number, affrent or effrent? and connection to CNS & function

A

VIII
afferent
pons
* Afferent head movement via
* Semicircular canals
* Utricle & Saccule
(aid balance)
* Afferent for Hearing via Cochlea

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12
Q

glossopharengeal number, affrent or effrent? and connection to CNS & function (afferent, autonomic, parasymp, efferent)

A

IX
both
medulla
(taste) for posterior 1/3rd of
the tongue
* General afferent (touch, pressure, pain) for
pharynx & posterior tongue
* Autonomic afferents from the carotid sinus and carotid body convey blood pressure
and chemical signals from the carotid artery.
* Parasympathetic efferent fibers to the parotid saliva gland
* Efferent fibers to stylopharyngeus that helps elevate the pharynx in swallowing

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13
Q

vagus number, affrent or effrent? and connection to CNS & function (afferent, autonomic, parasymp, efferent)

A

X
both
medulla
* General afferent from the pharynx,
larynx and external ear
* Efferent to pharyngeal muscles
(swallowing) and larynx (voice)
* Autonomic afferent from the pharynx,
larynx, thorax and abdomen
* Parasympathetic efferent to pharynx,
Larynx, thorax and abdomen

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14
Q

accessory number, affrent or effrent? and connection to CNS & function

A

XI
efferent
medulla
* Efferent to the trapezius and
sternocleidomastoid muscles.

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15
Q

hypoglossal number, affrent or effrent? and connection to CNS & function

A

XII
efferent
medulla
* General somatic efferent to the
ipsilateral muscles of the tongue
(intrinsic and majority of extrinsic)

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16
Q

acronym to remember order of CN

A

On Occasion Our Trusty Truck Acts Funny Very Good Vehicle Any How

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17
Q

acroynm to remember function of CN

A

Some Say Marry Money But My Brother Says Big Brains Matter More

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18
Q

Spinal Cord: Structures

A
  • Central nervous system protected by Bone
    (skull and vertebral column) and Meninges
  • Meninges:
  • Dura mater
  • Arachnoid
  • Pia mater
  • Blood supply
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19
Q

Spinal Cord: Structures
* Dorsal (posterior) horn

A

site of termination of
many afferent neurons via root

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20
Q

Spinal Cord: Structures Ventral (anterior) horn:

A

contains lower motor neurons (efferent) via root

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21
Q

Spinal Cord: Structures * Later horn:

A

Processes autonomic information
(only at T1–L2 spinal segments)

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22
Q

Spinal Cord: Structures
* Dorsal (posterior) ROOT: A

A

Afferent fibers with cell bodies located in dorsal root ganglia

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23
Q

Spinal Cord: Structures Ventral (anterior) root

A

Efferent fibers with cell bodies lying within the spinal grey matter.

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24
Q

Spinal Cord: White matter

A

Bilateral (mirror)
* Ascending tracts: Afferent
* Descending tracts: Efferent

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25
Spinal Cord: Spinal nerves
* 31 Spinal nerves * Exit vertebral canal through intervertebral foramina * Part of the peripheral nervous system * Contain both motor and sensory axons * Divided into segments: * 8 Cervical nerves * 12 Thoracic nerves * 5 Lumbar nerves * 5 Sacral nerves * 1-2 Coccyx nerves
26
* Ventral ramus:
Supplies muscles of back and overlying skin
27
* Dorsal ramus
Supplies muscles of trunk & limbs and overlying skin
28
Dermatomes
Area of skin (“Dermis”) innervated by a single spinal nerve * Afferent
29
Myotomes
Group of muscles innervated by a single spinal nerve * Efferent
30
C5 myotome
Elbow flexion
31
C6 myotome
wrist ext
32
C7 myotome
elbow extension
33
C8 myotome
flexion of tip of middle finger
34
T1 myotome
finger abduction
35
L2 myotome
hip flexion
36
L3 myotome
knee extension
37
L4 myotome
ankle dorsiflexion
38
L5 myotome
great toe extension
39
S1 myotome
ankle planterflexion
40
Spinal cord injury
damage to the spinal cord that may cause temporary or permanent change to function of the cord.
41
SPINAL CORD INJURIES pathophysiology
* Loss of all forms of sensation * Reduced or Inability to feel pain * Loss of ability to move * Partial loss of voluntary movement * Altered or lost sensation in a dermatome at and below the level of the lesion * Decreased or lost muscle power in a myotome at and below the level of the lesion * Decreased or lost stretch reflex * Altered or lost control of BP, blad * Altered or lost sensation in a dermatome at and below the level of the lesion * Decreased or lost muscle power in a myotome at and below the level of the lesion * Decreased or lost stretch reflex * Altered or lost control of BP, blad
42
complete spinal cord injury
Lack of sensory and motor function
43
incomplete spinal injury
Preservation of sensory and/or motor function
44
Quadriplegia
Injury of the cervical cord results in quadriplegia C1-C3 – paralysis of the diaphragm and respiratory muscles most common = C4-5
45
Paraplegia
Damage to the cord below the cervical level, sparing arm function causes paralysis in the lower limbs Most common level of injury T12/L1
46
Segmental nerve lesions causes
* Altered or lost sensation in a dermatome at that level * Decreased or lost muscle power in a myotome at that level * Decreased or lost stretch reflex
47
Vertical tract lesion is in the spinal cord vertical tracts, and result in:
Altered or lost sensation below the level of the lesion * Motor tract signs * Altered or lost control of BP, bladder, bowel control, and thermoregulation
48
Peripheral nerve lesions cause:
×Altered or lost sensation in a peripheral nerve distribution × Decreased or lost muscle power in a peripheral nerve distribution × Decreased or lost stretch reflex
49
Brown-Sequard syndrome
segmental : Ipsilateral loss of lower motor neurons and sensations below: Ipsilateral loss of voluntary motor control, conscious proprioception and light touch. Contralateral loss of nociceptive and temperature sensation.
50
Central cord syndrome
* Usually occurs at the cervical level as a result of trauma * Small lesion: Loss of nociceptive and temperature at the level of the lesion * Larger lesion: Impair upper limb motor
51
Anterior cord syndrome
* Damage to anterior spinal cord * Loss pain and temperature sensation * Loss of motor control * Preserved conscious proprioception and light touch
52
SPINAL CORD INJURIES: Shock
A temporary loss of all functions below the lesion due * Resulting in flaccid paralysis and sensory loss * Last about a day but can persist for up to a month * Reflexes gradually return, progressing from flaccid paralysis to spastic paresis * Muscle tone and tendon reflexes may take months to recover
53
ASIA A spinal cord injury
No sensory or motor function preserved in the sacral segments S4-5
54
ASIA B spinal cord injury
Preservation of sensory function in S4-S5
55
ASIA C spinal cord injury
Motor function preserved at the most caudal segments for voluntary anal contraction. OR the patient meets the criteria for sensory incomplete status and has some sparing of motor function more than three levels below the ipsilateral motor level on either side of the body.
56
ASIA D spinal cord injury
Motor Incomplete. Motor incomplete status as defined above, with at least half (half or more) of key muscle functions below the single NLI having a muscle grade ≥ 3.
57
ASIA E spinal cord injury
Normal motor and sensory function.
58
what are the 3 protective connective tissue layers of meninges
- dura mater - arachnoid mater - pia mater
59
what are the functions of meninges
- covers and protects CNS - protect blood vessles - form dural venous sinuses - house cerebrospinal fluid
60
dura mater
dura= tough outer most layer tough fibourous memebrane that is tightly adhered tov the inside of the skull
61
flax cerebri
seperates cerebrum
62
flax cerebelli
seperates cerebellum
63
tentorium cerebelli
seperates cerebellum and cerebrum
64
dural venous sinuses
number of blood- filled channels into which the cerebral veins empty to return blood from head to heart
65
dural sac
extends to spinal cord
66
arachnoid mater
arachnoid= cobweb closely apposed and loosely attached to the dura contains arachnoid granulations
67
subarachnoid space
- bw arachnoid and pia - filled w cerebrospinal fluid - protective role as it offers buoyancy and cushioning against sudden head movements - arachnoid trabeculae (fine fibrous connections bw arachnoid and pia) provide support that suspends brain
68
pia mater
pia= delicate innermost extremly thin and delicate, following the contours of brain dense rich blood supply of underlying neural tissue
69
ventricular system
lateral ventricle (two) third ventricle (bw thalamus 4th ventricle ( post. to pons and medulla
70
cerebrospinal fluid secreted where? flows where? reabsorbed where?
secreted mostly in choroid plexus flows through the lateral ventricles and enters the subarachnoid space flows around spinal cord and brain reabsorbs into venous sinuses
71
cerebrospinal fluid functions
clears waste, provides nutrients and buoyancy
72
hydrocephalus
if cerebrospinal fluid system is blocked, pressure builds in the ventricles causing hydrocephalus
73
hydrocephalus clinical signs in infants/ children
disproportionate large head, large anterior fontanel, poor feeding, inactivity, downward gaze of eyes
74
blood supply to brain functions
deliver O2 and glucose removes waste blood-brain barrier
75
circle of willis made up of
basilar artery and carotid arteries which link on the inferior surface
76
3 major paired cerebral arteries that arise from circle of willis are
anterior, middle and inferior cerebral arteries
77
anastomoses
multitude of arteries and veins serving the same tisse collateral circulation may be adequate to maintain brain function
78
anterior cerebral artery innervates
cortical branches: medial carotid surfaces of the frontal and parietal lobe, prefrontal cortex central branches:part of corpus callosum and basal ganglia, inf part of anterior internal capsule
79
middle cerebral artery innervates
cortical branches: nervous system that corrosponds w head upper limband thoracic areas of motor and sensory cortex, hearing areas, language areas, frontal cortex, part of basal ganglia
80
posterior cerebral artery innervates what reas
visual areas, subthalamic nuclei, hippocampus
81
what is the brainstems blood supply
vertebrobasilar sytem
82
what is the cerebellum blood supply
superior cerebellar arteries, anterior inferior cerebellar arteries, posterior inferior cerebellar arteries
83
cerebral veins drain into?
dural sinuses and eventually into the jugular veins
84
stroke def
sudden and unexpected damage to brain cells that causes symptoms that last for more than 24 hours in the part of the body controlled by those cells
85
transient ischemic attach
a breif, focal loss of brain function, w full recovery from neurological defects w/in 24 hours
86
completed stroke
symptoms that persists for longer than 1 day and are stable
87
progressive stroke
some ppl w ischemic stroke have deficits that increase intermittley over time
88
ischemic stroke
embolus lodges in a vessel obstructing blood flow. this deprives an area of blood flow leading to imediate onset of deficits
89
haemorrhagic stroke
burst, deprives the downstream vessles of the blood and extravascular blood exerts pressure on surrounding brain. this presents with worst defets w/in hours then gets better can cuase death w the increase in instracapsule pressure
90
subarachnoid haemorrhage
bleeding into the subarachnoid space, causes sudden excruciating headache with a brief loss of consciousness
91
stroke off anterior cerebral artery
loss of fine touch in contralateral limb contralateral gait difficulties lack of emotionsal expressiveness and impulsiveness inability to think of possibilites urinary incontinence
92
stroke cmiddle cerebral artery
contralateral homonymous hemianopia contralateral hemiplegia to face and upper limb motor impairment contralateral hemisensory to face and upper limb sensory impairment difficulty understanding spacial relationship neglect nonverbal communication
93
stroke posterior cerebral artery
difficulty w eyemovement and blindness visual agnosia memory loss
94
stroke basilar artery
complete occlusion causes death tetraplegia loss of sensation coma
95
stroke cerebrallar artery
ataxia difficulty coordinating movement
96
Which of the following is the outermost meningeal layer?
dura mater
97
The falx cerebri is responsible for:
Separating the two cerebral hemispheres
98
What is the function of the subarachnoid space?
Provides buoyancy and protection to the Cerebrum
99
Arachnoid granulations are involved in:
CSF reabsorption
100
Which of the following ventricles is located between the thalami?
Third ventricle
101
The choroid plexus is primarily responsible for:
form cerebrospinal fluid
102
The middle cerebral artery supplies
Lateral surface of the cerebral cortex, including Broca’s and Wernicke’s areas

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