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DPT 503 > Brainstem > Flashcards

Brainstem Flashcards

1
Q

what are the structures in the brainstem?

A

CN nuclei and pathways

vertical tracts

connections w/cerebellum

major centers and nuclei

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2
Q

what are the vertical tracts in the brainstem?

A

sensory (ascending) tracts:
- DCML
- spinothalamic
- spinocerebellar
- trigeminal lemniscus

motor (descending) tracts:
- vestibulospinal
- corticospinal
- rubrospinal
- reticulospinal

autonomic (descending) tracts:
- lateral and medial corticospinal
- vestibulospinal
- rubrospinal
- reticulospinal

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3
Q

what does the DCML do?

A

light touch, conscious proprioception

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4
Q

what does the spinothalamic tract do?

A

crude touch, temp, fast nociception

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5
Q

what is the connection w/ the cerebellum?

A

peduncles

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6
Q

what are the major centers and nuclei?

A

autonomic function

reticular function

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7
Q

what are the longitudinal sections of the brainstem?

A

most ventral-basilar part (basis pedunculi)

middle-tegmentum

most dorsal-tectum

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8
Q

basis pedunculi

A

most ventral longitudinal section of the brainstem

lots of motor structures including motor nuclei and axons from cortex

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9
Q

tegmentum

A

middle longitudinal section of the brainstem

contains a lot of sensory nuclei and some ascending tracts

reticular formation, sensory nucleus, and medial longitudinal fasciculus (MLF)

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10
Q

tectum

A

most dorsal longitudinal section of the brainstem

midbrain only

involved in control of eye and head movement

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11
Q

rule of 4 in the brainstem

A

4 structures in the midline begin with M

4 structures in the side begin with S

4 CNs in medulla, 4 in pons, 4 above pons (2 in midbrain)

4 motor nuclei in midline that divide equally into 12 (except 1 and 2)
- CN 3, 4, 6, 12
- CN 5, 6, 7, 9, 10, 11 in lateral brainstem

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12
Q

rule of 4: medial and lateral organization of the BS

A

4 Ms:
- motor tracts
- MLF
- medial lemniscus
- motor nuclei
–> CN 3, 4 in midbrain
–> CN 6 in pons
–> CN 12 in medulla

4 Ss:
- sympathetic tract (hypothalamospinal and hypothalmobulbar tracts)
- spinothalamic tract
- spinocerebellar tract
- sensory nuclei
–> CNS: midbrain, pons, medulla (Trigeminal tract)
–> CN 7 in pons
–> CN 8 in pons and medulla
–> CN 9, 10 in medulla

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13
Q

rule of 4: CNs

A

1-4 above pons
5-8 in pons
rest in medulla w/exception of 8 and 11
- 8 starts in pons, ends in medulla
- 11 in SC

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14
Q

connection w/cerebellum

A

cerebellar function dependent on connection w/BS

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15
Q

what are the 4 parts of the midbrain?

A

basis pedunculi

tegmentum

tectum

medial longitudinal fasciculus

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16
Q

basis pedunculi

A

anterior structure of the midbrain

cerebral peduncles

SN

also part of basal ganglia

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17
Q

tegmentum

A

largest portion of midbrain

sensory tracts
-retiular formation: midbrain to medulla
- autonomic pathways (hypothalamospinal tract (sympathetic))
- MLF (coordination of eye and head movements)
- CN 5-8 nuclei

oculomotor complex

CN 4 nuclei - trochlear

PPN

red nucleus

PAG

trigeminal lemniscus

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18
Q

what is in the oculomotor complex?

A

CN 3 nuclei
Edinger-Westphal nuclei (parasympathetic s of CN 3)
- innervates ciliary muscles of eye that adjust thickness of lens and constrict pupil

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19
Q

what is the role of CN 4 (trochlear)

A

eye adduction

superior oblique muscle

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20
Q

what does the PPN do?

A

modulates reticulospinal activation

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21
Q

what does the red nucleus do?

A

controls upper extremity flexors

descending tract (rubrospinal)

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22
Q

what is the role of the PAG?

A

pain modulation

one of the key areas of the brain that can spread ascending pain signal

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23
Q

what is the role of the trigeminal lemniscus?

A

info from face about light touch and conscious proprioception

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24
Q

midbrain tectum

A

pretectal areas - part of visual system

superior an inferior colliculus - head and eye movements

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25
Q

what is the role of pretectal areas

A

visual system

eye reflexes

located right in front of sup/info colliculus

26
Q

what is the role of the superior and inferior colliculus?

A

superior: reflexive eye and head movements in response to tactile info

inferior: auditory info contributing to visual attention

27
Q

MLF

A

located near midline bilaterally

ascending and descending fibers

coordinate eye movement
- connects CN 3, 4, 6
- integrates eye movement w/head movement (CN 8)

28
Q

what does damage to the MLF result in?

A

gaze palsy-can’t move eyeballs

29
Q

pons

A

major motor processing center

higher level respiratory control

most descending tracts pass through anterior pons (basilar part)

tegmentum (post, bordering 4th ventricle)

30
Q

most descending tracts pass through the basilar part of the pons. what are the 2 exceptions to this?

A

corticopontine tract: cortex to pons

corticobulbar tract: cortex to CN nuclei innervating face, head, and neck muscles
- facial expressions, muscles of mastication, pharynx, larynx, and tongue

31
Q

medulla

A

vasoconstricts/dilated, coughing, swallowing

needed for survival functions

ventrally located

pyramids: rubrospinal and lateral corticospinal go through pons here

olive: lateral to pyramids

posteriorly is inferior peduncle connecting medulla and 4th ventricle

32
Q

pontomedullary junction

A

connection b/w pons and medulla

cochlear and vestibular nuclei

medial and lateral vestibulospinal tracts

pontomedullary reticular formation

33
Q

what do the cochlear and vestibular nuclei do?

A

auditory and vestibular inputs to CN 8

output to medial and lateral vestibulospinal tracts

34
Q

what do the medial and lateral vestibulospinal tracts do?

A

postural muscles activity

head and eye movements-MLF

35
Q

what does the pontomedullary reticular formation do?

A

coughing, hiccuping, sneezing, yawning, shivering, gagging, vomitting, swallowing, laughing, crying

36
Q

what does the superior olive contribute to?

A

locating sounds

37
Q

what is in the rostral medulla?

A

nucleus ambiguus

hypoglossal nucleus (CN 12)

solitary nucleus

inferior olivary nucleus

38
Q

what is the nucleus ambiguus and what does it do?

A

motor efferent

controls muscles in pharynx and larynx via CN 9 and 10

shared motor nuclei for CN 9 and 10

damage=difficulty swallowing, dysphonia, and instability of HR

CN 9-soft pallette and pharynx

CN 10-vagus-slows HR (cardiac parasympathetic activity)

39
Q

what is the solitary nucleus and what does it do?

A

visceral sensory nucleus

visceral and taste efferents (CN 7)

cardiorespiratory centers (inputs from baroreceptors in carotid body and aortic arch -CN 9 and 10)

lesion=loss of taste and instability of BP

40
Q

what is the inferior olivary nucleus and what does it do?

A

irregularly shaped nucleus

perception of time and control of movement (olivocerebellar tracts)

afferent from motor and sensory corticies

efferent connection going out of cerebellum

timing of movement

41
Q

what is in the caudal medulla?

A

pyramids (corticospinal tract axons)
- lateral corticospinal is most important voluntary movement tract

spinothalamic tracts

DCML

CN 5

MLF

42
Q

what are the pathways to the medulla?

A

cerebrovestibular tract

43
Q

what are the pathways from the medulla?

A

spinocerebellar tract

olivocerebellar tract

vestibulocerebellar tract

reticulocerebellar tract

44
Q

what is in the reticular formation?

A

4 reticular nuclei
-VTA
- PPN
- raphe nuclei
- locus coeruleus and medial reticular zone (MRZ)

ascending/descending projections
- reticulospinal tracts (2)
- raphespinal tract
- ceruleospinal tract

45
Q

what are the functions of the reticular formation?

A

integrates sensory and cortical info

regulates motor activity, autonomic function, and consciousness

modulates nociceptive info-always ascending info

46
Q

what is the ventral tegmental area (VTA), where is it located, and what does it do?

A

midbrain

dopamine released (SN in midbrain also released dopamine)

motivation, decision-making, pleasure/reward

47
Q

where is most dopamine released into the CNS from?

A

midbrain (SN and VTA)

48
Q

what is the PPN, where is it located, and what does it do?

A

caudal midbrain

releases ACh (excitatory/inhibitory), GABA (inhibitory), and glutamate (excitatory)

motor control
- GP, STN influence reticulospinal tract neurons
- reticulospinal tract-posture and gross limb movement
- limbic system

lesion=issues w/initiation of movement

49
Q

what is the raphe nuclei, where is it located, and what does it do?

A

midbrain, pons, and medulla

releases serotonin

pontine raphe nuclei project mainly to cerebrum and modulate activity throughout cerebral cortex
- arousal and mood

medulary raphe nuclei are involved in pain modulation and provides serotonin to dorsal horn of SC inhibiting nociceptive info
- sensory and autonomic activity
- decreases pain-one of the fastest routes to decrease pain

50
Q

what is the locus coeruleus (LC) and medial reticular zone (MRZ), where are they located, what do they release, and what do they do?

A

pons

LC and MRZ: NE
MRZ: E

arousal, attention, autonomic regulation

LC: direct attention to food and enemies; inhibits spinothalamic neuron to modulate pain signals

nonspecific excitation of motor and interneurons in SC

MRZ: psychological responses to stress and panic- (related to sympathetic response)

51
Q

what are the 4 descending tracts of the reticular formation?

A

medial reticulospinal tract

lateral reticulospinal tract

raphespinal tract

ceruleospinal tract

52
Q

what does the medial reticulospinal tract do?

A

postural control

pons

53
Q

what does the lateral reticulospinal tract do?

A

gross limb movement

medulla

54
Q

what does the raphespinal tract do?

A

pain modulation (dorsal horn)

cardiac influence (lateral horn)

nonspecific activation of interneurons and motor neurons in SC (ventral horn)

55
Q

does the ceruleospinal tract do?

A

enhances activity of motor neuron pool and interneuron pool throughout SC

do same as ventral raphespinal w/different mechanism

56
Q

what structures are involved in the regulation of consciousness?

A

reticular formation

ascending reticular activating system (ARAS)

cerebral consciousness system

57
Q

what is the ARAS?

A

formation and cerebral consciousness system

actively induces sleep

58
Q

what are the structures of the cerebral consciousness system?

A

basal forebrain

thalamus

cerebral cortex

59
Q

what would a lesion in the structures that regulate consciousness result in?

A

difficulty controlling consciousness and wakefulness

60
Q

what is the blood supply of the midbrain?

A

posterior cerebral artery (branch of basilar artery)

61
Q

what is the blood supply of the pons?

A

anterior inferior cerebellar artery (AICA)

superior cerebellar artery

62
Q

what is the blood supply of the medulla?

A

basilar artery (paramedian and circumferential branches)

posterior inferior cerebellar artery (PICA)

anterior spinal artery

posterior spinal artery

DPT 503 (22 decks)

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