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Brainstem Flashcards

1
Q

Main functions of the brainstem

A

1) conduit
- for tracts and connections between periphery and cortex
2) cranial nerves
- 3 to 12
3) reticular formation
- visceral function(respiratory, cardiac)

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2
Q

brainstem

A

midbrain(mesencephalon)
pons
medulla
- postural control, respiration, origins of descending analgesics, decussations, CN’s(3-12), lots of pathways

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3
Q

reticular formation

A

reticular activating system

  • keeps you alert and awake
  • works better in vertical position(standing and sitting)
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4
Q

locus ceruleus

A

lateral zone of reticular formation

  • releases norepinephrine
  • descending pain control
  • aids in awakefulness, attention, and REM sleep
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5
Q

medial zone of reticular formation

A

location of vital functions

  • respiratory, cardiac, swallowing
  • reticulospinal pathways
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6
Q

midline zone of reticular formation

A

raphe nucleus

- releases serotonin

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7
Q

Dopamine

A

from substantia nigra in midbrain

  • “feel good” neurotransmitter(lack of = depression)
  • regulate sleep/wake cycles(attentiveness)
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8
Q

Acetylcholine

A

from pedunculopontine nucleus to cortex, limbic, cerebellum

- arousal and feelings of reward

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9
Q

Serotonin

A

from Raphe nucleus to dorsal horn and to cortex

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10
Q

Decussation of medial lemniscus

A

internal arcuate fibers crossing

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11
Q

inferior olive nucleus

A

upper part of medulla

  • receives input from all over CNS
  • helps cerebellum with error detection
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12
Q

CN 12

A

hypoglossal

- located between the corticospinal tract and inferior olivary nucleus

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13
Q

Inferior cerebellar peduncle

A

Primary INPUT pathway to the cerebellum(afferents)

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14
Q

Afferent pathways into inferior cerebellar peduncles

A

1) vestibulocerebellar
2) olivocerebellar
3) dorsal spinocerebellar = unconscious proprioception(LE and lower trunk)
4) ventral spinocerebellar
5) Cuneocerebellar = unconscious proprioception(UE and upper trunk)
6) reticulocerebellar = reticular activating system(rejecting info from cerebellum)

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15
Q

nuclei in the medulla

A

1) vestibular nuclei(4)
2) nucleus ambiguus
3) spinal nucleus and tract of CN 5

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16
Q

nucleus ambiguus

A

supplies the soft palate, pharynx, larynx, and upper esophagus
- projections via 9,10,11

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17
Q

spinal nucleus and tract of CN 5

A
  • pain and temp(face)

- crude touch –> C3, maybe ipsilateral

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18
Q

medial medullary syndrome

A

infarction of medullary branch of vertebral artery

- affects medial lemniscus, corticospinal tract, and CN 12

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19
Q

medial medullary syndrome: corticospinal tract

A

above decussation

  • contralateral hemiplesia
  • UMN’s signs and symptoms(hypertonicity, spastic paralysis)
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20
Q

medial medullary syndrome: CN 12

A

ipsilateral affect of 12

- tongue deviates to side affected

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21
Q

medial medullary syndrome: medial lemniscus

A

above decussation

- contralateral loss of discriminative touch, conscious proprioception, vibration

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22
Q

blood supply to medulla

A

from the 3 branches of the vertebral artery

  • anterior and posterior spinal arteries
  • posterior inferior cerebellar artery
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23
Q

blood supply to pons

A

basilar artery and 2 branches

  • anterior inferior cerebellar
  • superior cerebellar
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24
Q

primary blood supply to midbrain

A

posterior cerebral artery

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25
lateral medullary syndrome
Wallenberg's - infarction of the posterior inferior cerebellar artery Affected: - spinothalamic, trigeminal nucleus, ventral spinocerebellar tract, CN 9, olivocerebellar tract, nucleus amiguous(9,10,11), inferior cerebellar peduncle - motor pathways are fine, but smooth motor is disrupted
26
decorticate
above red nucleus, above medulla | - flexed UE and extended LE rigidity
27
decerebrate
below red nucleus and midbrain, above nuclei | - extended UE and LE rigidity
28
Lateral medullary syndrome: spinothalamic tract
above decussation | - contralateral loss of pain and temp
29
Lateral medullary syndrome: trigeminal nucleus
ipsilateral pain and temp to face
30
Lateral medullary syndrome: nucleus ambiguous
swallowing problems | - CN 9,10,11
31
Lateral medullary syndrome: inferior cerebellar peduncle
input pathway of cerebellum disrupted(atoxic movements)
32
Signs of brainstem dysfunction
the 4 D's: - Dysphagia - Dysarthria - Diplopia - Dysmetria
33
Dysphagia
``` trouble swallowing(choking especially on liquids) - glossopharyngeal, vagus ```
34
Dysarthria
``` speech problems(CN 7 and 12) - dysfunction of muscles(caused by tumor, CVA)(drunk, medication) ```
35
Diplopia
eyes don't track together | - affect corticobulbar tract or CN 3,4,6
36
Dysmetria
inability to accurately move an intended distance - typically affects the cerebellum(disrupts pathways to cerebellum) - Lateral medullary syndrome
37
tracts that synapse in the pons
corticopontine tract | some corticobrainstem tracts
38
pontine nuclei
where the corticopontine tract terminates
39
transverse fibers of the pons
pontocerebellar fibers bundled | - signals from cortex to cerebellum to inform about plan(through middle cerebellar peduncle)
40
tegmentum on pons
anterior/inferior part of the pons - reticular formation - pontinereticular pathway - nuclei for CN 5(sensation of the face and muscles of mastication) - 6 (lateral movement of the eye) - 7 ( facial and chewing muscles)
41
substantia nigra in midbrain
between tegmentum and crus cerebri - produces dopamine and stores it - Parkinson's = degeneration of substantia nigra, therefore decrease in dopamine
42
tegmentum of midbrain
contains: 1) red nucleus 2) CN nuclei 3 & 4 3) medial lemniscus 4) medial longitudinal fasciculus
43
tectum of midbrain
superior colliculus | - tectospinal tract(visual-grasp reflex)
44
red nucleus
origin of rubrospinal tract - helps update motorplans with cerebellum and motor planning - flexor of UE, but not hand
45
CN 3 nuclei
occulomotor - movement of the eye except lateral and inferior-medial - pupil constriction, levator palpibrae - can be compressed into tentorium by increased cranial pressure(presents with fixed dilated pupils)
46
peripheral visual information
temporal field - crosses at optic chiasm (contralateral) - processed on opposite temporal lobe
47
nasal visual information
stays ipsilateral
48
pathways of visual information
Unconscious = optic nerve-->optic chiasm--> optic tract-->superior colliculus(relay area) Conscious = optic nerve-->optic chiasm-->optic tract-->lateral geniculate nucleus-->primary visual cortex
49
right homonymous hemianopsia
lesion at the L optic tract | - lose right part of visual field for both eyes
50
superior cerebellar peduncle
primary OUTPUT pathway of cerebellum - detects errors in motor plan and updates motor cortex - R side of cerebellum updates L side of cortex - L side of cerebellum updates R side of cortex - cerebellum controls ipsilateral part of body - everything out of the cerebellum leaves through the superior cerebellar peduncle
51
parietal lobe
processes spatial information(where it is) | - dorsal stream
52
temporal lobe
what it is you are seeing(ventral stream)
53
lesion affecting corticospinal tract
motor impairment(contralateral) - hemiparesis - hemiplesia
54
lesion affecting corticopontine tract
some cerebellar signs
55
lesion affecting the corticobulbar tract
lack of motor in lower face(contralateral) | - tongue weakness contralateral
56
lesion at CN 3
no pupil retractions | - eye almost closed
57
reticular formation
1) integrates sensory and cortical information 2) regulates somatic motor activity, autonomic function, and consciousness 3) modulates nociceptive/pain information
58
major reticular nuclei
1) ventral tegmental area 2) pedunculopontine nucleus 3) raphe nuclei 4) locus coeruleus and medial reticular area
59
ventral tegmental area
produces dopamine - part of the reticular formation - substantia nigra also produces dopamine
60
pedunculopontine nucleus
produces ACh - located in the caudal midbrain - influences movement
61
raphe nuclei
produces serotonin | - located along the midline of the brainstem
62
locus cereleus and medial reticular zone
produces norepinephrine | - in reticular formation
63
what function will be disrupted by a lesion in the anterior medulla?
tongue control | - lesion would effect CN 12

Neuroscience (14 decks)

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