Brain Stem and Cranial Nerves Flashcards

1
Q

Brain stem overview

A
  • highway for long tracts: decending, ascending, autonomic
  • How many nuclei with projections
  • within the brain stem
    -to/from the cerebellum
    -to/from the rest of the brain
    -to/from the spinal cord
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2
Q

Parts of the spinal cord

A

All
* reticular formation
* medial leminscus, corticospinal, spinothalamic, and autonomic tracts

midbrain
* cerebral peduncle
* red nucleus
* substantia nigra
* superior collicus and inferior colliculus
* CN III, IV

Midbrain-pons
* superopr cerebellar peduncle

Pons
* middle cerebellar peduncle
* CN V, VI, VII, VIII

Pons-medulla
* inferior cerebellar peduncle
* cerebellopontine angle

Medulla
* pyramid/ pyramidal decussation
* olive
* dorsal columns - fasciculus/nucleus cuteantus, fasciculus/nucleus gracilis
*CN IX, X, XI, XII

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3
Q

mid brain - sagittal view

A
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4
Q

cerebral peduncle

A

axonal connections between midbrain and thalamus

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5
Q

superior colliculus

A

part of tectospinal pathway; visual superior reflex

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6
Q

Inferior colliculus

A

part of tectospinal pathway; auditory reflex

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7
Q

superior cerebellar peduncle

A

axonal connections between midbrain-pons and cerebellum

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8
Q

Ventral and dorsal views of the brainstem

A
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9
Q

midbrain - cross section

A
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10
Q

corticospinal pathway

A

voluntary motor function (more ventral)

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11
Q

red nucleus

A

start of rubospinal pathway
hypothesized roles in motor control and tremors

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12
Q

substantia nigra

A

part of the basal ganglia pathways

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13
Q

medial lemnicus

A

part of dorsal column medial lemniscus pathway - sensory (light touch, vibration, proprioception)

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14
Q

middle cerebellar peduncle

A

axonal connections between pons and cerebellum

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15
Q

Inferior cerebellar peduncle

A

axonal connections between pons-medulla and cerebellum

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16
Q

Pons cross section

A
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17
Q

pyramid of the medulla

A

white matter tracts affiliated with corticospinal and corticobulbar pathways (motor)
bulbar relates primarily to motor CNs

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18
Q

olive of the medulla

A

contains nuclei involved in spinocerebellar pathways (sensory)

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19
Q

Dorsal (posterior) columns

A

part of dorsal column medial lemniscus pathway

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20
Q

cerebellaopontine angle

A

point of entry for many neurosurgery techniques
risk of damaging nearby cranial nerves (CN, VI, VII, VIII, IX

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21
Q

pyramidal descussation

A

areas where axons of corticospinal pathways cross

22
Q

cross section of the medulla

23
Q

Spinocerebellar pathway

A

sensory (proprioception) nucleus gracilis ascending pathways. Becomes the medial lemniscus

24
Q

Reticular Formation

A
  • extends throughout posterior part of entire brainstem
  • part of reticulospinal pathway
  • Plays a role in sleep regulation, breathing control, mood, memory
  • includes reticular activating system (RAS) in midbrain portion
  • Maintains arousal and consciousness
25
Autonomic Nervous System
Efferent Information from CNs III, VII, IX, and X to eyes, salivary glands, heart, lungs, and pancreas Afferent Information from heart, great vessels, respiratory system, and GI tracts to CNs IX and X to the brain
26
Cranial Nerve Nuclei
27
Cranial Nerve Nuclei
28
CN I - olfactory associated which part of brain location of nuclei functions
- frontal lobe - olfactory bulb - olfaction (smell)
29
CN II Optic associated which part of brain location of nuclei functions
- thalamus - thalamus (lateral geniculate nucleus) - vision (acutiy, quadrants) pupulary light reflex (sensory)
30
CN III oculomotor associated which part of brain location of nuclei functions
- mid brain - midbrain - Eyelid movement – elevation Eye movements – adduction (MR), elevation and intorsion (SR), depression and extorsion (IR), elevation and extorsion (IO) Pupillary light reflex (motor)
31
CN IV Trochlear associated which part of brain location of nuclei functions
- midbrain - midbrain - Eye movement – depression and intorsion (SO)
32
CN V Trigeminal associated which part of brain location of nuclei functions
- pons - senspry - entired brainstem, promary pons. Motor- pons - Sensation of face, mouth, nasal sinuses, meninges, and anterior 2/3 tongue. Mastication
33
CN VI Abducens associated which part of brain location of nuclei functions
- Pons - Pons - Eye movement – abduction (LR)
34
CN VII Facial associated which part of brain location of nuclei functions
- Pons - Pons some in medulla - Facial expression, Taste of anterior 2/3 tongue, Sensation near EAM
35
CN VIII Vestibulocochlear associated which part of brain location of nuclei functions
- Pons - Vestibular - Pons Medulla Cochlear - Pons - Hearing, Vestibular sensation
36
CN IX Glossopharyngeal associated which part of brain location of nuclei functions
- Medulla - Medulla (some in pons) - Sensation of middle ear, pharynx, posterior 1/3 tongue, Taste of posterior 1/3 tongue, Stylopharyngeus muscle – elevates pharynx and larynx
37
CN X Vagus associated which part of brain location of nuclei functions
- Medulla, lateral/posterior olive - Medulla - Swallowing, Gag reflex, Voice, Sensation of pharynx, meninges, EAM, Taste from epiglottis and pharynx
38
CN XI Spinal Accessory associated which part of brain location of nuclei functions
- Medulla, Spinal Cord - Spinal Cord - Sternocleidomastoid muscle and upper part of trapezius – cervical lateral flexion and contralateral rotation
39
CN XII Hypoglossal associated which part of brain location of nuclei functions
- Medulla, anterior/medial olive - Medulla - Intrinsic muscles of tongue – protrude and deviate to opposite side
40
Vascular Circulation
41
Vasculature - Sagittal View
42
Vasculature - Ventral view
43
What is the mid brain arterial supply?
PCA primarily and Basilar dorasal
44
What is the pons arterial supply?
Anterior inferior cerebellat artery (dorsal) Basilar (ventral)
45
What is the arterial supply of the medulla?
PICA (dorsal) Vertebral artery (ventral)
46
What is dysphagia?
Impaired swallowing CN 10 glossopharengeal
47
What is vertigo?
Abnormal perception of movement; may feel like self or environment is spinning (cerebellum) CN8
48
What is Nystagmus?
Abnormal, involuntary eye movements that are rapid and repetitive (cerebellum especially)
49
Wallenberg Syndrome
(PICA stroke/ lateral medullary syndrome) Damage to posterolateral medulla
50
Coma
Damage to one or more of the following: *Reticular formation in upper brainstem (midbrain primarily) * Bilateral damage to thalamus * Extensive bilateral damage to cerebral cortex Associated clinical signs * Depends on area and severity of damage * Hallmark: Impaired consciousness and arousal
51
Locked in Syndrome
* Damage to ventral pons * Affects bilateral corticospinal and bilateral corticobulbar tracts * Associated clinical signs * Loss of all voluntary motor function except ocular * Intact sensory information, consciousness, and cognition
52
Cranial nerve palsies/lesions
CN II – Monocular vision loss CN II & III – Abnormal pupillary light reflex CN V – Trigeminal neuralgia CN VI – Abducen’s palsy, lateral gazy palsy CN VII – Bell’s/Facial palsy CN VIII – Vestibular hypofunction, sensorineural hearing loss CNs IX-XII – Bulbar palsy, pseudobulbar palsy