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BMB Test 2 > B7-028 Brainstem Lesions > Flashcards

B7-028 Brainstem Lesions Flashcards

1
Q

what part of the brainstem?

A

midbrain

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2
Q

what part of the brainstem?

A

pons

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3
Q

what part of the brainstem?

A

medulla

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4
Q

supplies midline region of medulla

A

anterior spinal artery

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5
Q

supplies lateral regions of the medulla

A

posterior inferior cerebellar artery

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6
Q

primary blood supply to the medulla

A

vertebral arteries

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7
Q

primary blood supply to the pons

A

basilar artery

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8
Q

analogous to ventral horn motor neurons in the spinal cord

A

motor nuclei

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9
Q

axons exit in cranial nerves and innervate head and neck muscles

A

motor nuclei

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10
Q

includes parasympathetic preganglions

A

motor nuclei

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11
Q

which CNs have motor nuclei? [8]

A

III
IV
V
VI
IX
X
XI
XII

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12
Q

receive information from primary receptor neurons

A

sensory nuclei

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13
Q

analogous to dorsal column nuclei

A

sensory nuclei

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14
Q

which CNs have sensory nuclei? [6]

A

I
II
V
VII
IX
X

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15
Q

what long tract(s) lie medially in the brainstem?

A

corticospinal
DC/ML

(deficit will be contralateral)

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16
Q

what long tract(s) lie laterally in the brainstem?

A

spinothalamic

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17
Q

what cranial nerves are in the medulla?

A

IX
X
XI (but motor nuclei is in SC)
XII

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18
Q

what artery supplies the medial medulla?

A

anterior spinal artery

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19
Q

what head and neck deficit would you seen with damage to the medial medulla?

A

ipsilateral tongue movement

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20
Q

what body deficit would you seen with damage to the medial medulla?

A

corticospinal and DC/ML

contralateral hemiplegia, and loss of touch and proprioception

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21
Q

what CNs lie in the pons?

A

V
VI
VII
VIII

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22
Q

what artery supplies the medial pons?

A

basilar

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23
Q

what head and neck deficit would you seen with damage to the medial pons?

A

ipsilateral eye movement

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24
Q

what body deficit would you seen with damage to the medial pons?

A

corticospinal and DC/ML

contralateral hemiplegia, and loss of touch and proprioception

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25
Q

the posterior cerebral artery supplies the […]

A

midbrain

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26
Q

PICA supplies the […]

A

lateral medulla

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27
Q

the anterior spinal artery supples the […]

A

medial medulla

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28
Q

the medial lemnisus would be found […] in the brainstem and damage would cause loss of […] touch and proprioception

A

medial
contralateral

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29
Q

the spinothalamic tract would be found […] in the brainstem and damage would cause loss of […] pain and temperature sensation

A

lateral
contralateral

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30
Q

hallmark of a brainstem lesion

A

deficit in ipsilateral head and contralateral body

31
Q

when the hypoglossal nucleus is damaged, the tongue deviates […] the side of the lesion

A

toward

32
Q

CNs located in the forebrain

A

I
II

33
Q

CNs located in the midbrain

A

III
IV

34
Q

the oculomotor nuclei is located in the […]

A

medial midbrain

35
Q

the Edinger-westphal nuclei is located in the […]

A

medial midbrain

36
Q

the trochlear nuclei is located in the […]

A

medial midbrain

37
Q

the abducens nuclei is located in the […]

A

medial pons

38
Q

the superior salivatory nuclei is located in the […]

A

medial pons

39
Q

the motor trigeminal nuclei is located in the […]

A

lateral pons

40
Q

the motor facial nuclei is located in the […]

A

medial pons

41
Q

the principle sensory nuclei of trigeminal is located in the […]

A

lateral pons

42
Q

the spinal trigeminal nuclei is located in the […]

A

lateral pons/medulla (extends down)

43
Q

the hypoglossal nuclei is located in the […]

A

medial medulla

44
Q

the dorsal motor nuclei of vagus is located in the […]

A

medial medulla

45
Q

the inferior salivatory nuclei is located in the […]

A

medial medulla

46
Q

the nuclei ambiguus is located in the […]

A

lateral medulla

47
Q

the solitary nuclei is located in the […]

A

lateral medulla

48
Q

the vestibular nuclei is located in the […]

A

lateral pons/medulla (extends down)

49
Q

the cochlear nuclei is located in the […]

A

lateral medulla

50
Q

the spinal trigeminal nuclei is located in the […]

A

lateral medulla

51
Q

the accessory spinal nuclei is located in the […]

A

medial spinal cord

52
Q

label the cranial nerves

A
53
Q

lesion of CN III would cause what symptoms and signs?

A

symptoms: binocular double vision, eyelid drooping, vision blurry

signs: eye down and out, ptosis, mydriasis

54
Q

an intra-axial lesion affecting CN III could also affect what other structure?

A

cerebral peduncle: DC/ML and corticospinal, maybe spinothalamic as well

contralateral

55
Q

describe the neural pathway for horizontal eye movements

A

originates in upper eye field –> paramedian pontine reticular formation –> abducens nucleus –> CN VI –> medial longtidinal fasiculus –> occulomotor nucleus —> CN III

(recruits both lateral rectus and medial rectus)

56
Q

responsible for coordinating eye movements between nuclei for CN IV, VI, and III

A

medial longitudinal fasiculus

57
Q

problem with the connection from frontal eye fields to paramedian pontine reticular formation

A

supranuclear lesion (UMN of horizontal eye movement pathway)

58
Q

problem with the medial longitudinal fasciulus is called

A

internuclear lesion (of horizontal eye movement pathway)

59
Q

problem with CN in horizontal eye movement pathway is called

A

intranuclear lesion

60
Q

what can help differentiate between intra and extra axial lesions?

A

intra-axial lesions are likely to have involvement of the long tracts

61
Q

syndrome: horizontal diplopia
lesion: right extra-axial CN III
etiology: ??

A

posterior communicating artery aneurysm
(berry aneurysm)

(supplies area of optic chiasm)

62
Q

what symptoms/signs would a patient with a CN X lesion present with?

A

symptoms: difficulty swallowing, hoarseness

signs: decreased palatal elevation (deviation of uvula to opposite side), hoarseness

63
Q

an intra-axial lesion of the lateral medulla affecting CN X might also affect what other structures?

A

contralateral spinothalamic tract
ipsilateral facial numbness (descending nucleus of V)

64
Q

what nuclei are involved in the LMN corticobulbar tract? [3]

A

nucleus ambigous
hypoglossal nucleus
solitary nucleus

65
Q

damage to the UMN corticobulbar tracts is called

A

pseudobulbar palsy

bilateral

66
Q

damage to the LMN corticobulbar tracts is called

A

bulbar palsy

unilateral

67
Q

what region of the brainstem does the sympathetic chain travel through?

A

dorsolateral

(commonly affected by lesions nearby)

68
Q

syndrome: dysphagia
lesion: right lateral medulla
etiology: ??

A

vertebral dissection due to PICA infarct

69
Q

Horner’s syndrome is characterized by damage to the sympathetic innervation on the […] face

A

ipsilateral

70
Q

damage to the pretectal region of the midbrain would result in

A

dilation of both eyes

71
Q

anterior spinal artery supplies

A

medial medulla

72
Q

paramedian branches of basilar arteries supply

A

pons

73
Q

weak voice is characteristic of a stroke where?

A

posterior inferior cerebellar artery

BMB Test 2 (17 decks)

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