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Neuro > Brainstem > Flashcards

Brainstem Flashcards

1
Q

Rhomboid Fossa

A
  • Floor of 4th ventricle = rhomboid fossa
    • Cerebral aquaduct at top apex
    • Cont w/ central canal at bottom or obey
    • Divided in half by median sulcus; further divided into medial & lateral on ea side by sulcus limitans
      • Medial = Motor
      • Lateral = Sensory
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2
Q

Reticular Formation

A
  • Makes up core of brainstem
  • 3 longitudinal zones
    • 1- Raphe Nuclei (most medial) - thin plate of neurons that release serotonin
    • 2- Medial Zone - source of most long ascending & descending projections; source of reticulospinal pathways for motor control
    • 3- Lateral Zone - CN reflexes and visceral functions; coordinate autonomic responses (get descending inputs- hypothalamus)

Ascending RAS

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3
Q

RAS

A
  • responsible for projecting to intralaminar nucleus (thalamus) —> cortex —> heightened arousal
  • Damage —> prolonged coma
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4
Q

Where do CN exit from?

A
  • Motor CN exits more medially and sensory CN exit more laterally
  • Midbrain - 3 & 4 (4 is only CN to exit on dorsal side)
  • Pons - 5, 6, 7, 8 (6 most medial b/c pure motor & vestibulocochlear most lat)
  • Medulla - 9, 10, 11, 12 (11 & 12 are pure motor; 11 comes from SC —> out brainstem)
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5
Q

Edinger Westphal Nucleus

A

CN III

  • controls pupil restriction to light
    • Retina —> superior colliculus —> pretectal nuclei —> bilaterally to EWN via posterior commissure —> ciliary ganglion —> sphincter pupillae
    • B/c bilateral input… light in 1 eye causes BOTH pupils to constrict
    • Damage
  • Controls accommodation
    • Parasympathetic inc lens curvature
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6
Q

Medial Longitudinal Fasciculus (MLF)

A

carries fibers b/n nuclei controlling eye movement

CN III

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7
Q

What are the 4 CN V nuclei?

A

1- Mesencephalic Nucleus

- Unipolar cell bodies (cell bodies in CNS)
- Jaw proprioception info
- Most rostral trigeminal nucleus

2- Trigeminal Motor Nucleus
- Bilateral monosynaptic connections from mesencephalic to jaw motor neurons

3- Chief Sensory Nucleus
- Gets touch info from face then crosses midline to join medial meniscus —> VPM thalamus

4- Spinal Trigeminal Nucleus

- Most caudal so fibers must travel down to synapse here (forms spinal tract); descend
- Then cross midline to join spinothalamic tract —> VPM thalamus
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8
Q

What are the 4 CN VII nuclei?

A

1- Motor Nucleus
- Axons course around abducens nucleus

2- Superior Salivatory Nucleus
- Cell bodies of all parasympathetic axons to salivation, nasal and lacrimal glands

3- Trigeminal Nuclei
- Afferents from skin of external ear go here

4- Nucleus Tractus Solaritus
- Afferents from ant 2/3 taste go here

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9
Q

What are the 6 CN VIII nuclei?

A
  • Vestibular Nuclei (Superior, Inferior, Lateral, Medial)
    • Extend most of the length of the pons and medulla
  • Dorsal Cochlear Nuclei & Ventral Cochlear Nuclei (DCN & VCN)
    • Rostral medulla; auditory afferents
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10
Q

What are the 4 CN IX nuclei?

A
  • Afferents from carotid sinus, pharynx mucous, posterior 1/3 taste all enter solitary tract —> nucleus solaritus (rostral)
  • External ear sensation —> trigeminal nuclei
  • Inferior salivatory nucleus - afferents to parotid gland (scattered collection of reticular formation cells in rostral medulla); parasympathetic
  • Nucleus Ambiguus - motor to stylopharyngeal; unclear area in medulla
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11
Q

What are the 4 CN X nuclei?

A

1- Dorsal Motor Nucleus of Vagus - gives rise to most parasympathetic output to thoracic/ab viscera (except heart parasympathetics come from nucleus ambiguous)

2- Motor to larynx & pharynx from Nucleus Ambiguous

3- Sensation from outer ear skin —> trigeminal (from CN 5,7, 9, 10)

4- Visceral afferents go to solitary nucleus via solitary tract

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12
Q

Spinal Accessory Nucleus

A

In SC - axons come from cervical SC then exit in brainstem

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13
Q

Wallenberg Syndrome

A

“Lateral Medullary Syndrome”

  • Occlusion of PICA - lateral and dorsal medulla
  • Damage to…spinothalamic tract, spinal trigeminal nucleus, inferior cerebellar peduncle, nucleus ambiguus & vestibular nuclei (PICA also supplies posterior cerebellum itself)
  • Signs/Symptoms…
    - Contralateral loss of pain & temp of body
    - Ipsilateral loss of pain & temp of face
    - Vertigo & nystagmus
    - Ipsilateral cerebellar signs (ataxia, DDK, etc)
    - Difficulty swallowing & dec gag reflex
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14
Q

Dejerine Syndrome

A

“Medial Medullary Syndorme”

  • Occlusion of Anterior Spinal Artery or paramedic branch of Vertebral Artery
  • Damage to…corticospinal tract, lemniscal tract, hypoglossal nucleus
  • Signs/Symptoms…
    - Contralateral loss of voluntary motor control
    - Contralateral loss of proprioception
    - Ipsilateral paralysis of tongue; tongue deviates toward lesion
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15
Q

Lateral Pontine Syndrome

A
  • Occlusion of AICA - lateral pons
  • Damage to… middle & inferior cerebellar peduncles, vestibular & cochlear nuclei; spinal trigeminal nucleus & tract; facial nerve & facial nerve nucleus; spinothalamic tract
  • Signs/Symptoms…
    • Vertigo, nystagmus, motion sickness
    • Ipsilateral deafness
    • Ipsilateral paralysis of face
    • Ipsilateral loss of lacrimation & reduced salivation
    • Ipsilateral loss of taste on ant 2/3 tongue
    • Ipsilateral cerebellar signs
    • Ipsilateral loss of pain & temp of face
    • Contralateral loss of pain & temp of body
    • Horner’s Syndrome
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16
Q

Locked-In Syndrome

A
  • Occlusion of Basilar - medial wedge of medulla, pons & lower midbrain
  • Damage to…corticospinal & cortiobulbar tracts, ocular CN nuclei
  • Signs/Symptoms…
    • Loss of horizontal eye movements (superior oblique fine)
    • Loss of voluntary facial, tongue and mouth movements

**RAS spared so conscious

17
Q

Horner’s Syndrome

A
  • Loss of descending control of sympathetic outflow
  • Signs/Symptoms…
    • Miosis - pupil constricted (unlike oculomotor damage —> dilated eye w/ pstosis_
    • Eyelid dropping (weak tarsal muscle) “pseudoptosis”
    • Red face (loss of vasoconstriction)
    • Impaired sweating on face
18
Q

Bell’s Palsy

A
  • Likely caused by viral infection of facial nerve
  • Signs/Symptoms
    • Facial paralysis including not being able to close eye —> dry cornea (not protected)
      • Full face b/c lower motor neuron problem
    • Dec lacrimation and salivation
    • Dec taste in anterior 2/3 tongue
19
Q

Oculomotor Palsy

A
  • Likely caused by aneurysm of posterior communicating artery compressing CN III
  • Signs/Symptoms…
    • Down & out eye
    • Ptosis - lose levator palp superioris
    • Mydriasis (pupil dilated) b/c loss of parasympathetics to pupillary sphincter

Neuro (31 decks)

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