10. Brain stem overview and cranial nerve nuclei Flashcards

1
Q

Diencephalon made up of…

A

Thalamus and hypothalamus

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2
Q

Where does the brainstem lie?

A

IN the posterior cranial fossa

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3
Q

Relations of the brainstem?

A

Anterior:

  • Clivus
  • Nerves & vessels

Posterior:
- Cerebellum & attachments

Inferiorly:
-Foramen magnum & spinal
cord

Superiorly:
-Tentorium & diencephalon

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4
Q

What forms the structural link between the cerebellum and the brainstem?

A
Midbrain- Superior cerebellar
peduncle (SCP)
Pons- Middle cerebellar
peduncle (MCP)
Medulla- Inferior cerebellar
peduncle (ICP)
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5
Q

Which 3 structures link to brainstem?

A

Cerebellum
Spinal cord
Cerebral hemisphere

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6
Q

How are the 4 nuclei of the brain stem classified?

A
  1. Motor co-ordination
  2. Reticular formation
  3. Vital & non-vital centres
  4. Cranial nerves
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7
Q
What are the main tracts with the following functions:
Pain/temperature
Proprioception and stereognosis
Light touch
Unconscious proprioception
Motor
A

Pain/temperature: Spinothalamic tract
Proprioception and stereognosis: Posterior columns
Light touch: Posterior columns and spinothalamix
Unconscious proprioception: Spinocerebellar
Motor: Corticospinal tract

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8
Q

How do the increased reflexes of UMP lesions present?

A

Loss of:

  • UL extension
  • LL flexion
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9
Q

What are the sensory cranial nerves?

A

Olfactory CN I
Optic CN 2
Vestibulocochlear CN 8

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10
Q

Which are the motor cranial nerves?

A
Oculomotor CN 3
Trochlear CN 4
Abducens CN 6
Accessory CN 11
Hypoglossal CN 12
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11
Q

Which are the mixed cranial nerves?

A

Trigeminal CN 5
Facial CN 7
Glossopharyngeal CN 9
Vagus CN 10

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12
Q

CN I?

A

Olfactory CN I

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13
Q

CN 2

A

Optic CN 2

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14
Q

CN 3

A

Oculomotor CN 3

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15
Q

CN4

A

Trochlear CN 4

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16
Q

CN5

A

Trigeminal CN 5

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17
Q

CN6

A

Abducens CN 6

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18
Q

CN7

A

Facial CN 7

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19
Q

CN8

A

Vestibulocochlear CN 8

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20
Q

CN9

A

Glossopharyngeal CN 9

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21
Q

CN10

A

Vagus CN 10

22
Q

CN11

A

Accessory CN 11

23
Q

CN12

A

Hypoglossal CN 12

24
Q

A brainstem lesion will usually produce ____ effects

A

ipsilateral

25
How many CNs are from midbrain, pons and medulla?
Midbrain- 1-4 Pons- 5-8 Medulla- 9-12
26
Which CNs control the orbital muscles?
CN3 (Oculomotor) CN 4 (Trochlear) CN6 (Abducens)
27
Which CN controls the tongue?
Facial CN7
28
Where does the trigeminal nerve (CN 5) orginate from?
From the posterior horn of the spinal cord to the midbrain
29
What are the 3 nuclei of the trigeminal nerve and what do they detect?
1. The mesencephalic nucleus: Proprioception 2. The chief sensory nucleus (or "pontine nucleus" or "main sensory nucleus" or "primary nucleus"): For discriminative touch 3. The spinal trigeminal nucleus: for pain and temperature detection Hence overall the trigeminal is responsible for the head's somatic sensation
30
Where does the chief sensory nucleus receive it's inputs from?
Most of the sensory information crosses the midline and travels to the contralateral ventral posteriomedial (VPM) of the thalamus via the VENTRAL trigeminothalamic tract. However, information of the ORAL CAVITY travels to the ipsilateral Ventral Posteriomedial (VPM) of the thalamus via the DORSAL trigeminothalamic tract.
31
What is the difference between the ambiguous and solitarius nucleus?
aMbiguous = Motor (somatic motor: speech, swallowing) Solitarius = Sensory (visceral sensory: taste, gag, involuntary reflexes)
32
What is the result of the sympathetic output of the hypothalamus? Brainstem lesion will produce an ipsilateral...
Facial sweating, eyelid elevation, vasomotor and pupil dilation A brainstem lesion will produce an ipsilateral Horner’s syndrome
33
Lesions at which location could cause horner's syndrome?
Of the spinal root of D1 Of the cervical cord Of the cervical sympathetic chain Of the pathway in postero-lateral brainstem
34
Name 3 special sensations? and the CNs responsible for them?
hearing, balance and sight CN VIII/8 Vestibulocochlear CN II/2 Optic
35
Name 2 descending tracts?
Motor: Corticobulbar and corticospinal | Sympathetic
36
Name 3 asecnding tracts
Spino cerebellar Spino thalamic Medial lemniscus
37
Name 2 linking tracts?
Cerebellar peduncles | Medial longitudinal fasciculus
38
Where do the motor tracts cross?
Corticobulbar: at the level of the CN they want to innervate. Some do not decussate. Corticospinal: 90% cross in the medulla Hence a brainstem lesion in this pathway will produce contralateral UMN signs
39
What is the medial lemniscus? | Brainstem relation?
An axon tract originating in the cuneate and gracile nuclei, at the junction between the spinal cord and brainstem, and ascending to the ventral posterior nucleus of the thalamus. This lemniscus is a middle link in the circuit carrying somatic sensory information from the body to the primary sensory cortex. Brainstem is positioned mainly medially
40
Function of the medial lemniscus? | Effect of brainstem lesion?
Carry proprioception (JPS) + touch sensation to thalamus A brainstem lesion affecting the medial lemniscus will cause a contralateral loss of JPS
41
What is the spinal equivalence of the medial lemniscus?
Continuation fo the dorsal column
42
What is the spinal equivalence of the spinal lemniscus?
Continuation of the spino-thalamic tract
43
Function of the spinal lemniscus?
Carries pain, temperature and course touch to thalamus Fibres synapse and cross over in the spinal cord Ascend through the brainstem
44
Brainstem position in relation ot the spinal lemniscus?
Laterally (Side?)
45
Result of brainstem lesion i the spinal lemniscus?
Will cause a contalateral loss of pain and temperature
46
Function of the spino-cerebellar tract?
-Carries proprioceptirove information to the cerebellum Lower body via the posterior spino-cerebellar Upper body via the cuneo cerebellar
47
Lesion in the spino-cerebellar tract produces...
ipsilateral defect in proprioception
48
Which is the first pathway to demyelinate in MS?
Medial longitudinal fasciculus | --> Presents as inability to adduct eyes normally (slowed)
49
Name 3 tracts medial to the brainstem?
Medial lemniscus Motor tracts- Somatic Medial longitudinal fasciculus
50
Name 3 tracts at the side of the brainstem?
Spinocerebellar Spinothalamic Sympathetic