Brain Stem

Question 1

What CN arrise from Midbrain

Answer 1

CN 3 and 4

(Oculomotor and Trochlear)

Question 2

What CN arrise from Pons

Answer 2

CN 5, 6, 7, and 8

(Trigeminal, Abducens, Facial, and Vestibulocochlear)

Question 3

What CN arrise from Medulla

Answer 3

CN 9, 10, and 11

(Glossopharyngeal, Vagus, and Hypoglossal)

Question 4

CN 5₃ (Mandibular) lesion results in

Answer 4

Jaw deviation toward weak side

Trigeminal neuralgia: Intractable pin in V2 or V3 territory

Question 5

Medial lemniscus contains

Answer 5

Axons from cell bodies found in the dorsal column cuclei (gracilis and cuneatus)

Question 6

Medial Lemniscus found in

Answer 6

Caudal medulla

Question 7

Ipsilateral Horner syndrome is a lesion of

Answer 7

Descending hypothalamic fibers

Question 8

Medial Longitudinal Fasciculus (MLF) are

Answer 8

fiber bundle interconnecting centers for:

Horizontal gaze

Vestibular Nuclei

CN 3, 4, and 6

Question 9

MLF lesion produces

Answer 9

Internuclear ophthalmoplegia and disrupt the vestibulo-ocular reflex

Question 10

Olivary nuclei send

Answer 10

Climbing fbiers into the cerebellum from the caudal medulla to the inferior cerebellar peduncle

Question 11

Solitary nucleus carries

Answer 11

all general and special visceral afferent fibers of CN 7, 9, and 10

Includes:

• Taste
• Cardiorespiratory
• GI sensations

Question 12

Nucleus ambiguus is

Answer 12

a column of large motoneurons that is situated dorsal to the inferior olives

Question 13

VPM relays what to cortex

Answer 13

Touch, pain and temperature via CN 5

Taste via CN 7 and 9

Question 14

Inferior colliculus send auditory information to

Answer 14

The medial geniculate body of the thalams

Question 15

Path of auditory system

Answer 15

1. Cochlear nucleus (in pons) cross at the Trapezoid body (in pons) then connect to Superior Oivary Nucleaus (In pons)
2. Then travel to Lateral lemniscus (in midbrain) to the inferior colliculus (in midbrain)
3. Then travel to Medial geniculate body (in Thalamus)
4. Then to Superior Temporal Gyrus

Question 16

Lesion of Vestibular nuclei or N results in

Answer 16

Vestibular nystagmus with a slow deviation of the eyes toward the lesion and fast correction back

Question 17

Ménière disease

Answer 17

Abrupt, recurrent attacks of vertigo lasting minutes to hours accompanied by deafness or tinnitus and is usually in 1 ear

Due to distention of fluid spaces in cochlear and vestibular parts of labyrinth

Question 18

Horizontal gase controlled by

Answer 18

Frontal eye field (contralateral gaze)

Paramedian Pontine Reticular Formation (Ipsilateral gaze)

Question 19

Anterior inferior cerebellar artery supplies

Answer 19

Lateral pons

Question 20

Superior cerebellar artery supplies

Answer 20

Lateral pons

Question 21

Posterior inferior cerebellar artery supplies

Answer 21

Lateral medulla

Question 22

Anterior spinal artery supplies

Answer 22

Medial medulla

Question 23

Posterior cerebral artery supplies

Answer 23

Medial medbrain

Question 24

Medial medullary syndrome leads to lesion of

Answer 24

• Hypoglossal N: ipsilateral paralysis of half the tong, tongue deviates toward side of lesion
• Both Medial Lemniscus: contra deficit of proprioception and touch, pressure and vibration
• Corticospinal tract: contra spastic hemiparesis of both limbs

Question 25

Medial medullary syndrome is a lesion of

Answer 25

Anterior Spinal Artery

Question 26

Lateral medullary syndrome is lesion of

Answer 26

PICA (**Wallenberg Syndrome**)

Question 27

Lateral medullary syndrome damages

Answer 27

1. Inferior Cerebellar peduncle: Ipsilateral limb ataxia 2. Vestibular nuclei: Vertigo, nausea/vomiting, **nystagmus** (away from lesion) 3. Nucleus ambiguus: ipsilateral paralysis of larynx, pharynx, palate 4. Spinal N. 5: ipsilateral pain/tem loss (**face**) 5. Spinothalamic tract: contralateral pain/tem loss 6. Descending hypothalamic: ipsilateral Horner

Question 28

Medial Pontine Syndrome is due to occlusion of

Answer 28

Paramedian branches of basilar artery

Question 29

Medial Pontine syndrome affects

Answer 29

1. Corticospinal tract: contra spastic hemiparesis 2. Medial lemniscus: contra loss of tactile/position/vibration sensation 3. Fibers of CN 6: Medial strabismus

Question 30

Lateral Pontine syndrome is occlusion of

Answer 30

AICA

Question 31

Lateral Pontine Syndrome affects

Answer 31

1. Middle cerebellar peduncle: ipsilateral ataxia 2. Vestibular nuclei: vertigo, nausea, vomiting, **nystagmus** 3. Facial nucleus and fibers 4. Spinal trigeminal nucleus/tract: ipsilateral pain/temperature loss of face 5. Spinothalamic tract: contra pain/temperture loss 6. Cochlear nucleus and fibers (**CN 8**): ipsilateral hearing loss 7. Descending hypothalamic: ipsilateral Horner syndrome

Question 32

Dorsal Midbrain Syndrome AKA

Answer 32

Parinaud syndrome

Question 33

Dorsal Midbrain syndrome due to

Answer 33

Tumor in Pineal region

Question 34

Dorsal midbrain syndrome affects

Answer 34

Superior colliculus/pretectal area: paralysis of upward gaze Cerebral aqueduct: noncommunicating hydrocephalus

Question 35

Medial midbrain syndrome AKA

Answer 35

Weber syndrome

Question 36

Medial medbrain syndrome is due to occlusion of

Answer 36

Branches of PCA

Question 37

Medial midbrain syndrome affects

Answer 37

1. CN3 fibers: ipsilateral oculomotor palsy (**lateral strabismus, dialted pupil, ptosis**) 2. Corticospinal tract: contra spastic hemiparesis 3. Corticobulbar tract: contra hemiparesis of lower face

Question 38

What degenerates in Alzheimers disease

Answer 38

Neurons of both **raphe and locus caeruleus**

Question 39

Raphe nuclei synthesize

Answer 39

Serotonin

Question 40

Locus caeruleus synthesize

Answer 40

Norepinephrine

Question 41

Pain modulation occurs in

Answer 41

Periaqueductal gray