brainstem Flashcards
sympathetic NS cell bodies located in
spinal cord: thoracic + lumbar and synapse with sympathetic ganglia (outside spinal cord)
parasympathetic NS cell bodies located in
rostral medulla - dorsal motor nucleus (CN 10)
ptosis + anhidrosis (causes flushing) + miosis is called
Horner syndrome
related to sympathetic innervation of face
Horner syndrome can be caused by
pancoast tumor - compresses sympathetic trunk from thoracic spine to face
stroke of lateral medulla (PICA)
late stage syringomyelia
Brown–Sequard syndrome -cord hemisection
decussation of corticospinal tract
caudal medulla
decussation of dorsal column-medial lemniscus
medulla
decussation of spinothalamic tract
anterior white commissure of spinal cord
artery that supplies the inferior cerebellar peduncle + nucleus ambiguus + lateral spinothalamic tract in LATERAL medulla
PICA - posterior inferior cerebellar artery
artery that supplies the medullary pyramids and medial lemniscus in the MEDIAL medulla
ASA - anterior spinal artery
artery that supplies the medial longitudinal fasiculus (MLF) + corticospinal tract + medial lemniscus in MEDIAL pons
basilar artery + paramedian/median branches
artery that supplies the lateral spinothalamic tract in the LATERAL pons
AICA - anterior inferior cerebellar artery
decussation of corticospinal tract
medulla
decussation of spinothalamic tract
anterior white commissure of spinal cord (2-3 spinal levels above where it entered the spinal cord)
lesion of the medial longitudinal fasciculus (MLF) causes
ispilateral internuclear opthalmoplegia: deficit of eye tracking with lateral gaze
causes of MLF lesion (internuclear opthalmoplegia)
multiple sclerosis (
what causes:
ipsilateral medial rectus palsy with contralateral gaze (can’t adduct ipsilateral eye)
contralateral horizontal nystagmus with contralateral gaze
lesion of MLF: internuclear opthalmoplegia
causes of “locked-in syndrome”
basilar artery stroke - both sides of superior pons affected
rapid correction of hyponetremia causes central pontine myelinolysis (loss of myelin - increased MRI signal)
what syndrome is this:
preserved consciousness + blinking
quadriplegia
loss of voluntary facial, mouth, tongue movements
locked-in syndrome - basilar artery stroke (affects lower midbrain, pons, medulla - corticobulbar + corticospinal tracts)
what causes:
ipsilateral internuclear opathalmoplegia (most common)
paralysis of gaze to side of lesion (look away from lesion)
contralateral spastic hemiparesis
contralateral loss of vibration, fine touch, proprioception
medial pontine syndrome (paramedian br. of basilar artery)
ipsilateral internuclear opathalmoplegia (most common): ipsilateral MLF
paralysis of gaze to side of lesion (look away from lesion): PPRF (next to MLF)
contralateral spastic hemiparesis: corticospinal tract
contralateral loss of vibration, fine touch, proprioception: medial lemniscus tract
lesion of the medial longitudinal fasciculus (MLF) causes
ispilateral internuclear opthalmoplegia:
deficit of eye tracking with lateral gaze
no crosstalk between CN 6 + CN 3
causes of MLF lesion (internuclear opthalmoplegia)
multiple sclerosis (demyelination) (
what causes:
ipsilateral medial rectus palsy with gaze away from lesion (can’t adduct ipsilateral eye)
contralateral horizontal nystagmus with gaze away from lesion (CN 6 overfiring to stimulate CN 3)
normal convergence
lesion of MLF: internuclear opthalmoplegia
nucleus that provides: sensory from pharynx, trachea, esophagus taste sensation of very back of tongue baroreceptor + chemoreceptor info from carotid sinus/carotid body gut distention
nucleus solitarius (CN 10 nuclei) = Sensory
nucleus that provides:
motor to larynx, pharynx, + upper esophagus
speech + swallow
nucleus aMbiguus (CN 10 nuclei) = Motor
nucleus that provides:
parasympathetic innervation of upper GI, heart, lung
dorsal motor nucleus (CN 10 nuclei)
