6 Neuroanatomy: Brainstem I Flashcards
Midbrain
- What 2 structures does the midbrain serve as a link for?
- What cranial nerves have their nuclei completely in this structure?
- What cranial nerve has its nuclei partly in this structure?
- What are does the midbrain serve as a “center”? (4)
Pons
- What cranial nerve nuclei does this structure completely contain?
- What cranial nerve nuclei does this structure partly contain?
- What does this structure serve as a “relay station for”?
Medulla Oblongata
- What cranial nerve nuclei does it completely contain?
- What cranial nerve nuclei does it partly contain?
- What important tracts does this structure contain?
- What are the 3 important functions that have their relay centers/nuclei in the medulla oblongata?
Label each as
- Tectal lamina
- Diencephalon
- Pons
- Medulla Oblongata
- Cerebellum
- 4th Ventricle
- Rhomboid Fossa
- Mesencephalon
- Bulbopontine Sulcuse
Internal Organization of Brainstem
- What are the 3 main areas that the brainstem is divided into?
- Which one contains the cranial nerve nuclei?
- Which one is associated with long pathways?
- Which one is located in the midbrain?
- Which one contains the reticular formation?
Label
- Tectum
- Substantia Nigra
- Cerebral Aqueduct
- Tegmentum
- Cerebral Peduncle
- Red Nucleus
Label
- Tegmentum of Pons
- 4th Ventricle
- Basilar part of Pons
Label
- Central Canal
- Pyramids
Reticular Formation
- Where are these cell groups located? (What structure?)
- How would you describe them?
- What 2 important types of nuclei are located in this structure?
- What type of functions are is the reticular formation implicated in?
- What does the ventrolateral reticular area control?
- What do the raphespinal fibers have an important role in?
List the 6 main external features on the anterior and lateral medulla
Label A-L
- Pyramid
- Olivary Eminence
- CN VI
- Pyramidal (motor) Decussation
- CN VII
- CN V
- Preolivary Sulcus
- CN VIII
- CN X
- Postolivary Sulcus
- CN XII
- Anterior Median Fissure
Label A-G
- Pyramidal Decussation
- Olive
- Preolivary Sulcus
- Anterior Median Fissure
- Pyramid
- Postolivary Sulcus
- Basilar Pons
Posterior View of the Medulla
- What is superior to the lateral recesses of the rhomboid fossa? What is inferior?
- The medulla has open and closed portions.
- Is the caudal half of the rhomboid fossa the open or closed portion?
- Which portion contains the structures below the obex?
Posterior View of the Medulla
- What are the 6 main features that can be observed from this view?
TT dna is Very Inferior to GC
Posterior View of the Medulla
- In this figure, indicate where the following structures are
- Rhomboid fossa
- Trigone of CN 12
- Trigone of CN 10
- ICP (inferior cerebellar peduncle)
- Tubercle of nucleus cuneatus
- Tuberculum cinereum
- Tubercle of nucleus gracilis
Pathways (aka Fiber Tracts) in Medulla
- What are the 3 main ascending pathways?
- What are the 4 main descending pathways?
- Which ones originate in the midbrain?
- Which ones originate in the pons?
How do you navigate x-sections of the brainstem? (4)
Caudal Medulla: Level of Motor Decussation
- Anterior/Central Medulla
- What are the 2 most prominent features of this area?
- Caudal Medulla: Level of Motor Decussation
- Lateral Medulla
- What are the 2 most prominent features of this area?
Caudal Medulla: Level of Motor Decussation
- Posterior Medulla
- What are the 2 most prominent features of this area?
Caudal Medulla: Level of Motor Decussation
- Central Gray
- What does this area surround?
- What are the 2 most prominent features of this area?
Caudal Medulla: Level of Sensory Decussation
- Anterior/Central Medulla
- What are the 4 main features of this area?
Caudal Medulla: Level of Sensory Decussation
- Lateral Medulla
- What are the 3 main features of this area?
Caudal Medulla: Level of Sensory Decussation
- Posterior Medulla
- What are the 2 main features of this area?
Caudal Medulla: Level of Sensory Decussation
- Central Gray
- What are the 2 main features of this area?
Midmedullary Level
- What are the 3 features of the anterior/central medulla?
Midmedullary Level
- What are the 5 features of the lateral medulla?
Midmedullary Level
- What are the 5 features of the rhomboid fossa at this level?
Rostral Medulla
- How does this portion of the medulla compare to the other parts of the medulla in terms of size and spread?
- What is notable about the anterior and medial parts?
Rostral Medulla
- Lateral Medulla
- What are the 4 key features of this area?
Rostral Medulla
- Rhomboid Fossa
- What are the 2 key features of this area?
Pons-Medullary Junction
- Fibers from what 2 bodies create the ICP (inferior cerebellar peduncle)
- Which one of the 2 bodies enters the cerebellum?
- Where does the facial motor nucleus appear?
Pons-Medullary Junction
- What 2 structures appear adjacent to the facial nucleus and spinal trigeminal tract and nucleus?
- What structure disappears at this junction, and which structure appears at this junction?
Pons-Medullary Junction
- What happens to the medial lemniscus at this junction?
Arterial Supply to Medulla
- What are the 5 arteries that supply blood to the medulla?
AP x2
V
Label the arteries A through E
Medial Medullary Syndrome aka Dejerine Syndrome
- What causes this syndrome?
- Which artery is implicated?
- What 4 structures can be affected?
- Injury to what structure(s) cause contralateral hemiparesis?
- Injury to what structure(s) cause contralateral loss of proprioception and vibratory sense?
- Injury to what structure(s) cause ipsilateral deviation of the tongue (when protruded)?
If the artery that supplied the red highlighted area of the medulla was occluded, what syndrome could develop?
Dejerine Syndrome aka Medial Medulla Syndrome
Lateral Medullary Syndrome aka Wallenberg Syndrome
- Occlusion of what 2 arteries can result in this syndrome?
- What 7 structures can be affected by this occlusion?
- Injury to what structure could cause loss of pain/temp sensation in the body? Would this be a contralateral or ipsilateral loss?
- Injury to what s structure could cause loss of pain/temp sensation in the face? Would this be a contralateral or ipsilateral loss?
- Injury to what s structure could cause a loss of taste sensation in the tongue? Would this be a contralateral or ipsilateral loss?
- Injury to what s structure could cause vertigo or nystagmus?
- Injury to what s structures could cause hoarseness or dysphagia?
- Injury to what s structures could cause Horner syndrome?
- What 7 structures can be affected by this occlusion?
Which artery or arteries supply the red highlighted area of the medulla, and what syndrome can arise if it/they are occluded?
`Lateral Medullary Syndrome aka Wallenberg Syndrome
Posterior Inferior Cerebellar Artery or Vertebral Artery
Pons
- External Features
- On an anterior/lateral view, what are the 4 key features of this area?
Pons
- Label the following structures
- CN V
- CN VI
- CN VII
- CN VIII
- Basilar Pons
- Basilar Sulcus
- Pontomedullary Sulcus
- Middle Cerebellar Peduncle
Rhomboid Fossa of the Pons
- How does the Rhomboid Fossa relate to the 4th ventricle?
- What 2 structures form the lateral walls of the 4th ventricle?
Rhomboid Fossa of the Pons
- What 3 structures make up the roof of the 4th ventricle?
Internal Organization of Pons
- What are the 2 areas of the interj
Label A through E
Caudal Pons
- Anterior Pons
- What 3 structures make up this area?
Caudal Pons
- Posterolateral Tegmentum
- What 4 structures make up this area?
Caudal Pons
- Posterolateral Tegmentum
- What 7 structures make up this area?
Caudal Pons
- Anterolateral Tegmentum
- What 3 structures make up this area?
Caudal Pons: Facial Colliculus Level
- What 2 structures make up the facial colliculus in the caudal pons?
- Describe the path that the axons from each of these structures take when leaving their nucleus. Include where they exit the brainstem.
- What structure is the intermediate nerve associated with, and what additional nerve fibers to does it pick up before exiting the brainstem?
Midpontine Level
- In the Lateral Tegmentum
- What are the 3 prominent features?
- Surrounding the 4th ventricle
- What are the 3 prominent features?
Rostal Pons
- How does the size/position of the basilar pons and tegmentum differ compared to other areas of the pons?
- What 3 pontine features can you see at the base?
- What feature is especially obvious when viewing the rostral pons from a dorsal aspect?
Blood Supply to Pons
- What 3 arteries provide blood to the pons?
- Which artery are all the above arteries a branch of?
- Which artery supplies the
- Medial Areas
- Lateral Parts
- Tegmentum and part of the middle cerebellar peduncles
Inferior Medial Pontine Syndrome
- What arteries are occluded in this condition, and at what level?
- What structures are affected, how does this manifest in terms of deficits?
- What happens if the area of damage shifts laterally to include the root of the facial nerve?
What syndrome would a patient have if the red highlighted area had an occlusion to the arteries that supply it?
Inferior Medial Pontine Syndrome
Syndrome of the Midpontine Base
- What arteries are occluded in this condition, and at what level?
- What structures can be affected, and how would this manifest?
