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Neuroanatomy > brainstem 2 and 3 > Flashcards

brainstem 2 and 3 Flashcards

1
Q

medial medullary syndrome is caused by a lesion to

A

the anterior spinal artery

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2
Q

what structures are affected in a medial medullary syndrome?

A

pyramid, XII, ML

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3
Q

how would a pt. present with medial medullary syndrome?

A

contralateral hemiplegia to the body, ipsilateral tongue deviation, contralateral sensory loss in the body

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4
Q

what is lateral medullary syndrome also known as?

A

PICA and wallenberg syndrome

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5
Q

structures affected in a wallenberg syndrome

A

spinal trigeminal nucleus, lateral spinothalmic tract, vestibular nuclei, nucleus ambiguus, descending autonomic fibers, ICP

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6
Q

how would a pt. present with a lateral medullary lesion?

A

ipsilateral loss of pain and temperature from the face, contralateral loss of pain and temperature from the body, vertigo, dizziness, nausea, vomiting, nystagmus, dysphagia, dysarthria, ipsilateral horners syndrome, ipsilateral ataxic gait

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7
Q

what does dysarthria mean?

A

trouble articulating speech

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8
Q

what runs throught the MCP as it connects the pons to the cerebellum?

A

pontocerebellar fibers

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9
Q

what are the three levels that the pons is studied at?

A

caudal pons at the facial nucleus
mid pons at the level of the trigeminal nuclei
rostral pons at the locus ceruleus

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10
Q

what happens the the pupil if a pt. has horners syndrome?

A

gets smaller

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11
Q

what is the ‘locus’ coeruleus associated with? and where is it located?

A

located in the pons and is associated with response to physiological stress and panic

“muchas loca”

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12
Q

ventral pons/basilar pons has what 3 components?

A

descending cortical fibers, pontine fibers, pontocerebellar fibers

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13
Q

dorsal pons/pontine tegmentum has what 3 components?

A

ascending and descending tracts, reticular formation, cranial nerve nuclei

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14
Q

bbbb

A

e

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15
Q

what is the funcitoning component of CN VIII?

A

SSA only

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16
Q

N1 of auditory pathway is located in the

A

spiral ganglion

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17
Q

N2 of auditory pathway is located in the

A

dorsal cochlear nuclei

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18
Q

N3 of auditory pathway is located where?

A

in the trapezoid body

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19
Q

what does the trapezoid body carry to the contralateral superior olivary nuclei?

A

ventral cochlear nuclei

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20
Q

most of the fibers in the auditory cortex relay information to what

A

the MGB

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21
Q

after the auditory fibers leave the MGB what do they form?

A

auditory radiations of the internal capsule

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22
Q

after the auditory radiations leave the internal capsule what structure do they continue to?

A

primary auditory cortex

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23
Q

where is the primary auditory cortex located?

A

upper part of the superior temporal gyrus

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24
Q

what broadman area is heschl’s gyrus known as?

A

41

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25
Q

is hearing affected with a MCA syndrome?

A

no due to the bilateral representation of in the cerebral cortex

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26
Q

when would ipsilateral deafness occur with a lesion?

A

if in the organ of corti, cochlear nerve, cochlear nuclei

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27
Q

where would the lesion be a pt. presents with bilateral deafness

A

lateral lemniscus, medial geniculate body, auditory radiations

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28
Q

what causes menieres disease?

A

maybe a change in fluid in the tubes of the inner ear

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29
Q

what are the symptoms of menieres disease

A

loss of balance and hearing for mins to hrs, tinnitis, vertigo, aural fullness, nausea, vomiting, sweating,

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30
Q

where are the vestibular receptors located

A

the maculae

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31
Q

what type of equilibrium signals head position relative to trunk and where in there ear is this sensed?

A

static; the macula of the saccula and utricle

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32
Q

what kind of equilibrium signals head movement to maintain gaze on a selected target?
and where exactly in the ear is this loacted?

A

kinetic

located in the crista ampullaris of semicircular ducts

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33
Q

what is the kinetic equilibrium for according to the vestibular nuclei

A

signals head movement and provides information to maintain gaze on a selected target

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34
Q

N1 of the vestibular nuclei

A

scarpa’s ganglion/vestibular ganglion

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35
Q

where is scarpas ganglion located?

A

IAM = internal auditory meatus

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36
Q

N2 of the vestibular nerve

A

vestibular nuclei

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37
Q

vestibular nuclei can continue to what structures?

A

spinal cord, cerebellum, cranial nerves, DMNX

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38
Q

all __ of the vestibular nuclei connect to which lobe of the cerebellum?

A

4, flocculonodular lobe

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39
Q

lateral vestibular nuclei connect to which tract in the spinal cord

A

vestibulospinal tract

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40
Q

the medial vestibular nuclei connect to which tract in the spinal cord via which funiculus?

A

medial vestibulospinal tract via the MLF

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41
Q

which CN’s does the vestibular nuclei go to via the MLF for which overall function?

A

3,4,6 for head and eye movement

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42
Q

via the reticular formation where does the medial vestibular nucleus go to?

A

DMN X and the lateral horn of the spinal cord

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43
Q

over stimulation of DMN X will result in?

A

pallor, nausea, vomiting as in motion sickness

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44
Q

this nucleus is responsible for visceral function to the heart rate and vomiting?

A

DMNX

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45
Q

disturbance of the vestibular nerve will result in?

A

vertigo, nystagmus,

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46
Q

caloric test is a measure of what?

A

vestibular function

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47
Q

when putting cold water into the ear what direction should the eye go in a caloric test vs hot water?

A

cold: goes away

hot; goes towards

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48
Q

facial nerve functional compnents

A

SVE, GVE, SVA, GVA and GSA

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49
Q

motor root of CN VII SVE supplies what

A

mm. of facial expression, auricular muscles, post. belly of digastric, stylohyoid. stapedius

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50
Q

origin of motor nucleus of VII

A

in the caudal pons

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51
Q

CN VII nervus intermedius functional component

A

GVE, SVA, GVA

parasympathetic and sensory component of the facial CN

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52
Q

functions of the nervus intermedius

A

GVE: preganglionic parasympathetic
SVA: taste sensation to the post. 2/3 of tongue
GVA: sensations from glands innervated by facial nerve

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53
Q

geniculate sensory ganglion contains cell bodies for what?

A

SVA, GVA, GSA

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54
Q

where is the geniculate sensory ganglion located?

A

external genu of the facial nerve

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55
Q

superior salivatory nucleus functional compnent

A

GVE

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56
Q

superior salivatory nucleus origin of fiibers

A

parasympathetic fibers

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57
Q

the preganglionic fibers of superior salivatory nucleus synapse where

A

pterygopalatine ganglion and the submandibular ganglion

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58
Q

as the superior salvitory nucleus synapse onto the pterygopalatine ganglion they go throufh which nerve

A

the greater petrosal

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59
Q

as the superior salivatory nucleus synapse onto the submandibular ganglion they go through which nerve

A

chorda tympani

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60
Q

SVA and GVA fibers of CN VII synapse at which tract?

A

solitary

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61
Q

SVA and GVA fibers of which CNs synapse at the solitary nucleus?

A

7,9,10

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62
Q

a pt. may present with these symptoms if they have a lesion LMN to the CN VII

A

ipsilateral facial paralysis, decreases sensation of taste, dry eye, dry mouth, dry nose, and hyperacusis

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63
Q

what is hyperacusis

A

paralysis of the stapedius

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64
Q

extracranial causes of facial nerve lesion

A

cancer, damage during surgery

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65
Q

UMN lesion of the corticobulbar fibers will cause paralysis to what side of the face and portion?

A

contralateral ; lower portion only

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66
Q

which CN’s transmit general sensation from the posterior part of the auricle and external auditory meatus?

A

cn’s fibers within the geniculate ganglion of CN VII, superior ganglion of CN IX and superior ganglion of CN X

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67
Q

CN VI GSE fibers control what

A

lateal eye movement and conjugate gaze

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68
Q

what are the 2 neurons located in the nucleus of VI

A

motor and internuclear neurons

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69
Q

function of internuclear neurons that lead to the MLF?

A

sends fibers to the medial rectus of the eye on the other side through the MLF

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70
Q

abducent nerve lesion

A

lateral rectus paralyzed causing internal strabismus (squinting) and diplopia,

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71
Q

right MLF lesion will result in?

A

medial rectus of the left eye not working = internuclear ophthalmoplegia

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72
Q

the largest cranial nerve

A

trigeminal

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73
Q

CN V trigeminal functional compnents?

A

GSA, SVE

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74
Q

GSA of CN V supplies what?

A

sensations from the face and meninges

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75
Q

SVE of CN V supplies?

A

motor to the 8 muscles derived from the 1st branchial arch

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76
Q

which of the branches V1, V2 or V3 is mixed senosry and motor?

A

V3 = mandibular

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77
Q

which branch of CN V supplies cornea and conjunctiva?

A

V1

78
Q

which branch of CN V supplies sensory the anterior 2/3 of the tongue?

A

V3= mandibular

79
Q

which of the branches of CN V supplies motor to mm. of mastication?

A

V3

80
Q

Do all 3 branches of CN V supply sensory fibers to the cranial dura matter

A

yes

81
Q

how many nuclei does CN V have?

A

4

82
Q

how many of the nuclei of CN V are motor and sensory?

A

1 is motor while 3 is sensory

83
Q

wbat is the the main sensory nuclei of CN V?

A

cheif/principle nucleus

84
Q

what type of sensation does that principle nucleus recieve?

A

tactile discrimination and pressure sensation

85
Q

where in the pons is the princple nucleus located?

A

mid pon lateral to the motor nucleus

86
Q

name the 3 sensory GSA fibers of CN V

A

mesencephalic, principle, spinal

87
Q

mesencephalic nucleus recieves info for what?

A

proprioception from the face

88
Q

spinal nucleus of CN V recieves what kind of informaiton from the face

A

pain and temperature from face mouth, and internal nose

89
Q

the spinal trigeminal nucleus extends from what structures

A

c2 –> medulla –> mid pons

90
Q

mesencephalic nucleus is located where in the brainstem?

A

the midbrain in the gray matter lateral to the cerebral aquaduct

91
Q

where is the SVE portion of CN V located?

A

mid pons medial to the main sensory nucleus

92
Q

how is the SVE portion of CN V tested?

A

jaw jerk test

93
Q

CN V SVE innervates which muscles

A

mylohyoid, atnerior belly of digastric, tensor tympani, and tensor veli palantine muscles

94
Q

the ventral trigeminothalmic tract (VTTT) mediates what sensations from the face and oral cavity?

A

contrateral pain and temperature

95
Q

VTTT N1 is located where?

A

trigeminal ganglion

96
Q

what tract do the N1 axons of VTTT descend in

A

spinal trigeminal tract

97
Q

where are the N2 of the VTTT located?

A

spinal trigeminal nucleus

98
Q

where do the N2 axons of the VTTT terminate?

A

the contralteral VPM of the thalamus

99
Q

N3 of the VTTT are located where

A

the VPM of the thalamus

100
Q

what broadman areas are associated with the VTTT N3 axons?

A

312

101
Q

the dorsal trigeminothalmoc tract mediates what kind of sensation from the face?

A

ipsilateral tactile discrimination and pressure sensation from the face and oral cavity

102
Q

what is the source of input of the DTTT tract

A

meissners and pacinian corpuscles

103
Q

N1 of DTTT is located where and synapse where?

A

trigeminal ganglion –> principle sensory nucleus

104
Q

N2 of DTTT is located where?

A

principle sensory nucleus

105
Q

Do the N2 or the N1 of the DTTT decussate?

A

N2 fibers

106
Q

where are the N3 located of the DTTT

A

in the VPM of the thalamus

107
Q

at which broadman areas does the DTTT synapse at?

A

312

108
Q

what are both the DTTT and the VTTT referred to as?

A

trigeminal lemniscus

109
Q

fibers of what nucleus cross midline and ascend with the VTTT?

A

main sensory nucleus

110
Q

the afferent nerve resonsible for corneal blink reflex?

A

ophthalmic nerve

111
Q

the efferent limb nerve involved in the corneal blink reflex

A

facial

112
Q

which branch of CN V is responsible for sneezing reflex?

A

V1

113
Q

does tic douloureux happen more in women or men?

A

women

114
Q

VPL of the thalamus recieves information from what

A

the body

115
Q

VPM recieves information from where

A

the face

116
Q

blood supply to the pons from the basilar artery branches

A

AICA

pontine/paramedian , superior cerebellar arteries

117
Q

AICA is supplies what portion of the pons?

A

caudal popns

118
Q

what portion of the pons is supplied by the pontine/paramedian arteries?

A

medial caudal and mid pons

119
Q

what portion of the pons does the superior cerebellar arteries?

A

rostral pons

120
Q

medial inferior pontine syndrome?

A

injury to corticospinal tract –> contralateral spastic hemiplegia

injury to the medial lemniscus –> contralateral loss of proprioception

Abducens nerve injury –> ipsilateral rectus paralysis

121
Q

lateral inferior pontine syndrome?

A 
injury to the
 facial nucleus 
 cochlear nerve
 vestibular nerve
spinal nucleus
spinal lemniscus
ICP 
MCP
 descending sympathetic fibers
122
Q

MLF syndrome is seen in what neurological syndrome?

A

MS

123
Q

name the three parts of the midbrain?

A

tectum
tegmentum
crus cerebri

124
Q

tectum s formed by

A

2 superior and two inferior colliculi

125
Q

tegmentum contains what structures?

A
  • cranial nerve nuclei

* sylvius and periaqueductal gray matter and sensory patheways

126
Q

Crus cerebri also known as

A

basis pedunculi/cerebral peduncle

127
Q

front of the midbrain is called

A

crus cerebri

128
Q

what structure of the midbrain seperates the crus cerebri from hte tegmentum

A

substantia nigra

129
Q

what is located between the two crura cerebri?

A

interpenduncular fossa

130
Q

2 levels of the midbrain?

A

caudal and rostral

131
Q

what is located in the caudal midbrain?

A

inferior colliculi, trochlear nucleus, decussation of the SCP

132
Q

Rostral MB contains what?

A

superior colliculus, oculomotor nuclei, red nucleus

133
Q

where does the Lateral lemniscus end?

A

the inferior colliculus

134
Q

periaquaductal gray matter contain what

A

endorphin producing cells that supress paon

135
Q

what is the most slender CN?

A

trachlear

136
Q

where does the trochlear nerve exit

A

dorsally (only one that exits this way)

137
Q

what CN is located in central gray matter and dorsal to the MLF

A

trochlear

138
Q

what muscle does CN 4 innervate?

A

superior oblique

139
Q

job of SO muscle

A

moves eye down and lateral

140
Q

does CN 4 move the contralateral or ipsilateral eye?

A

contralateral

141
Q

decussation of SCP is where?

A

midbrain at the caudal portion

142
Q

where can the axons of the SCP synapse?

A

red nucleus or the thalamus

143
Q

what levels of the midbrain is the crus cerebri located?

A

both levels

144
Q

what level is the crus cerebri more pronounced?

A

rostral

145
Q

what are the medial and lateral parts of crus cerebri known as?

A

corticopontine fibers

146
Q

where do corticopontine fibers pelay on

A

pontine nuclei

147
Q

the axons the the transverse pontine fibers enter the cerebellum through what?

A

the MCP

148
Q

substantia nigra has __ parts

A

2

149
Q

the dorsal part of the substantia nigra is known as

A

substantia nigra compacta

150
Q

the substantia nigra compacta contain what?

A

melanin and substantia nigra reticularis

151
Q

what is the substantia nigra connected to?

A

the basal ganglia

152
Q

red nucleus is between what structures?

A

cerebral aqueduct and the substantia nigra

153
Q

where does the rubrospinal tract decussate?

A

ventral tegmental decussation

154
Q

red nucleus is located in what portion of the midbrain?

A

rostral

155
Q

red nucleus recieves afferents from where?

A

the motor cortex and cerebellum

156
Q

lesions to the red nucleus will result in what>

A

athetoid and writhing movements

157
Q

superior colliculi is connected to the lateral geniculate body via what

A

superior brachium

158
Q

the superior colliculus recieves afferent fibers from

A

optic nerve
visual cortex
spinal cortex
inferior colliculus

159
Q

the SCP projects to what structures

A

LGB –> primary visual cortex (BA 17)

160
Q

job of the SCP?

A

idenifies lines, shapes and colors

161
Q

what nucleus of the secondary visual cortex does the SCP project to?

A

pulvinar

162
Q

what are the BA of the secondary visual cortex?

A

18, 19

163
Q

what is the largest nucleus in the thalamus?

A

pulvinar

164
Q

pulvinar nucleus of the secondary visual cortex is responsible for what

A

visual association with things you have seen before

165
Q

SCP output to what structure of the spinal cord?

A

tectospinal tract

166
Q

how would a lesion to the superior colliculus present

A

loss of spinovisual reflexes

167
Q

where are the oculomotor nuclei located?

A

ventral part of the periaqueductal gray matter and dorsal to the MLF of the rostral midbrain

168
Q

name the two motot nucleu of the occulomotor nuclei

A

main motor GSE

parasympathetic nucleus = edinger westphal (GVE

169
Q

what are the muscles that the GSE portion of the occulomots supply

A

medial, superior, inferior rectus, inferior oblique and levator palpebrau superioris

170
Q

where does the edinger westphal synapse at

A

ciliary ganglion

171
Q

ciliary ganglion is responsible for

A

pupillary constriction

172
Q

CN III exits throught the interpeduncular fossa as it passes through which structures

A

PCA and the Superior cerebellar arteries

173
Q

CN III enters the orbit through which fissure

A

superior orbital fissure

174
Q

lesion of the CN III or nuclei will result in what ipsilaterally?

A 
eye will move down and outward
ptosis
mydriasis
loss of accommodation and convergene
verticle diplopia
175
Q

fibers of the optic tract enter wich nucleus>

A

pretectal

176
Q

where to the fibers of the pretectal nucleus run through>

A

the EW nucleus

177
Q

after the fibers of the pretectal nucleus synapse at E-W nucleus where do they go next

A

ciliary ganglion

178
Q

eyes converge through the contraction of what

A

bilateral contraction of the medial recti

179
Q

relaxation of what ligametns allow for the eye to accommodate

A

suspensory

180
Q

accommodation means that the lens becomes more what

A

convex

181
Q

argyl robertson pupil

A

small bilateral pupils that do not constrict which is found in late stage syphylis

182
Q

webers syndrome

A

damage to the PCA involving CNIII

Crus cerebri

183
Q

benedikts syndrome involves

A

lesion to the PCA involving:
red nucleus
medial lemniscus
CN III

184
Q

Rostral midbrain blood supply

A

PCA

185
Q

Caudal midbrain blood supply

A

PCA and superior cerebellar artery

186
Q

Rostral pons blood supply

A

superior cerebellar a

187
Q

mid pons blood supply

A

pontine/paramedian a.

188
Q

open medulla lateral blood supply

A

PICA

189
Q

medial open medulla blood supply

A

vertebral/ anterior spinal a

190
Q

caudal medulla blood supply

A

anterior and posterior spinal arteries

Neuroanatomy (11 decks)

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