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Neuroscience > Brainstem > Flashcards

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
Q

lateral medullary syndrome

A

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

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26
Q

decorticate

A

above red nucleus, above medulla

- flexed UE and extended LE rigidity

27
Q

decerebrate

A

below red nucleus and midbrain, above nuclei

- extended UE and LE rigidity

28
Q

Lateral medullary syndrome: spinothalamic tract

A

above decussation

- contralateral loss of pain and temp

29
Q

Lateral medullary syndrome: trigeminal nucleus

A

ipsilateral pain and temp to face

30
Q

Lateral medullary syndrome: nucleus ambiguous

A

swallowing problems

- CN 9,10,11

31
Q

Lateral medullary syndrome: inferior cerebellar peduncle

A

input pathway of cerebellum disrupted(atoxic movements)

32
Q

Signs of brainstem dysfunction

A

the 4 D’s:

  • Dysphagia
  • Dysarthria
  • Diplopia
  • Dysmetria
33
Q

Dysphagia

A 
trouble swallowing(choking especially on liquids)
- glossopharyngeal, vagus
34
Q

Dysarthria

A 
speech problems(CN 7 and 12)
- dysfunction of muscles(caused by tumor, CVA)(drunk, medication)
35
Q

Diplopia

A

eyes don’t track together

- affect corticobulbar tract or CN 3,4,6

36
Q

Dysmetria

A

inability to accurately move an intended distance

  • typically affects the cerebellum(disrupts pathways to cerebellum)
  • Lateral medullary syndrome
37
Q

tracts that synapse in the pons

A

corticopontine tract

some corticobrainstem tracts

38
Q

pontine nuclei

A

where the corticopontine tract terminates

39
Q

transverse fibers of the pons

A

pontocerebellar fibers bundled

- signals from cortex to cerebellum to inform about plan(through middle cerebellar peduncle)

40
Q

tegmentum on pons

A

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
Q

substantia nigra in midbrain

A

between tegmentum and crus cerebri

  • produces dopamine and stores it
  • Parkinson’s = degeneration of substantia nigra, therefore decrease in dopamine
42
Q

tegmentum of midbrain

A

contains:

1) red nucleus
2) CN nuclei 3 & 4
3) medial lemniscus
4) medial longitudinal fasciculus

43
Q

tectum of midbrain

A

superior colliculus

- tectospinal tract(visual-grasp reflex)

44
Q

red nucleus

A

origin of rubrospinal tract

  • helps update motorplans with cerebellum and motor planning
  • flexor of UE, but not hand
45
Q

CN 3 nuclei

A

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
Q

peripheral visual information

A

temporal field

  • crosses at optic chiasm (contralateral)
  • processed on opposite temporal lobe
47
Q

nasal visual information

A

stays ipsilateral

48
Q

pathways of visual information

A

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
Q

right homonymous hemianopsia

A

lesion at the L optic tract

- lose right part of visual field for both eyes

50
Q

superior cerebellar peduncle

A

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
Q

parietal lobe

A

processes spatial information(where it is)

- dorsal stream

52
Q

temporal lobe

A

what it is you are seeing(ventral stream)

53
Q

lesion affecting corticospinal tract

A

motor impairment(contralateral)

  • hemiparesis
  • hemiplesia
54
Q

lesion affecting corticopontine tract

A

some cerebellar signs

55
Q

lesion affecting the corticobulbar tract

A

lack of motor in lower face(contralateral)

- tongue weakness contralateral

56
Q

lesion at CN 3

A

no pupil retractions

- eye almost closed

57
Q

reticular formation

A

1) integrates sensory and cortical information
2) regulates somatic motor activity, autonomic function, and consciousness
3) modulates nociceptive/pain information

58
Q

major reticular nuclei

A

1) ventral tegmental area
2) pedunculopontine nucleus
3) raphe nuclei
4) locus coeruleus and medial reticular area

59
Q

ventral tegmental area

A

produces dopamine

  • part of the reticular formation
  • substantia nigra also produces dopamine
60
Q

pedunculopontine nucleus

A

produces ACh

  • located in the caudal midbrain
  • influences movement
61
Q

raphe nuclei

A

produces serotonin

- located along the midline of the brainstem

62
Q

locus cereleus and medial reticular zone

A

produces norepinephrine

- in reticular formation

63
Q

what function will be disrupted by a lesion in the anterior medulla?

A

tongue control

- lesion would effect CN 12

Neuroscience (14 decks)

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