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brainstem and cerebellum Flashcards

1
Q

what are the general functions of the brainstem?

A

act as a conduit, cranial nerves and integrative

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2
Q

what is meant by the brainstem is a conduit?

A

it allows ascending and descending pathways to reach thalamus and cerebellum from spinal cord and relay nuclei

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3
Q

what is meant by the brainstem is integrative?

A

there is control of cardiovascular and respiratory functions and through the reticular foramen consciousness as well as complex motor patterns such as balance

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4
Q

what are the cranial nerves for?

A

supply the head, they are for sight, gustation, hearing, equilibrium - relay centres and cranial nerve nuclei

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5
Q

what is a collection of cell bodies or grey matter in the CNS/PNS?

A

CNS - nucleus

PNS - ganglion

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6
Q

what can aid the synapse function?

A

collection of cell bodies there as the information can travel from one place to another in a relay

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7
Q

where are the ascending and descending pathways found?

A

ventral to the reticular foramen which is found in the central aspect of the brainstem

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8
Q

what happens when there is an infarct of the blood vessels supplying the ventral aspect of the brainstem such as the pons?

A

locked in syndrome

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9
Q

what are the characteristics of locked in syndrome?

A

reticular foramen is intact, may still be able to move eyes as the cranial nerves emerge more superior and cannot move anything else but are conscious of everything that is happening

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10
Q

where do cranial nerves emerge from?

A

the brainstem

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11
Q

where does the brainstem sit in the brain and in relation to other structures?

A

it sits below the thalamus/diencephalon and is rostrally continous with the diencephalon. It is dorsally continuous with the cerebellum and caudally with the spinal cord at the level of the foramen magnum. It is ventrally continuous with the clivus of the occipital bone.

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12
Q

where is the midbrain?

A

it is just under the mamillary bodies, then the pons and then the medulla

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13
Q

where is CSF found?

A

channels of the ventricular system - runs in hemispheres and through the brainstem

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14
Q

what is between the pons and the cerebellum and what does it form?

A

the cerebral aqueduct - drains into the diamond shaped fourth ventricle

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15
Q

how many cranial nerves arise from the brainstem and how many are PNS?

A

10/12 are PNS and 10/12 from the brainstem - sensory and motor parts

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16
Q

how does the brain develop?

A

from primary and secondary ventricles - the spaces then form the ventricles

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17
Q

what is in the primary vesicles?

A

the prosencephalon (forebrain - cerebrum), mesencephalon (midbrain), rhomencephalon (hindbrain)

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18
Q

what does the prosencephalon form?

A

third (diencephalon) and lateral ventricles (telencephalon). The telencephalon forms the cerebral cortex, cerebral hemispheres, caudate nucleus, putamen and the amygdala and the diencephalon forms the thalamus, hypothalamus, retina and pineal gland, subthalamus and epithalamus

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19
Q

what does the mesencephalon form?

A

the cerebral aqueduct - midbrain

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20
Q

what does the rhombencephalon form?

A

the fourth ventricle and hindbrain - this is the metencephalon forming the pons and cerebellum and the myelencephalon forming the medulla

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21
Q

what are the secondary ventricles?

A

telencephalon and diencephalon, mesencephalon, metencephalon and myelencephalon

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22
Q

what is anterior to the central canal?

A

central grey matter

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23
Q

what is inferior to the pons?

A

pyramids

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24
Q

what is the PAG?

A

the periaqueduct grey - grey matter surrounding the aqueduct

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25
what can be identified at any level of the brainstem
tectum, tegmentum and basal
26
what is the tectum?
the roof. it's only significant portion is found in the most dorsal aspect of the brainstem (sup. and inf. colliculi) posterior to the ventricular system cavities
27
where is the tegmentum found?
anterior to the ventricular system cavities in the middle region of the brain stem and contains reticular information and cranial heads and some ascending and descending pathways
28
where is the basal?
ventral - descending motor pathways are contained here - pyramids and peduncles
29
what is the structure of the medulla?
it is the most inferior part of the brainstem and connects with pons through the pontomedullary junction. The ventral surface has tiny bumps on it and the dorsal is smoother
30
what is the rhomboid fossa?
when the cerebellum is removed there will be a rhomboid shaped space that is the floor of the fourth ventricle
31
what is at the bottom of the floor of the fourth ventricle and meets the top of the posterior median fissure of the posterior medulla?
the obex
32
what does the posterior median fissure of the medulla separate?
the two fasciculi gracilis that contain axons
33
what are lateral to the fasciculi gracilis?
the fasciculus cuneatus
34
what is on the superior parts of the fasciculi?
the tubercles for each fasciculus respectively - contain cell bodies
35
on the ventral medulla what is the order from inferior to superior of the emergence of cranial nerves 9-12?
inferior - XI XII X (lateral to XII) IX
36
what is lateral to the decussation of the pyramids?
the pyramids and then olives
37
what separates the pyramids from the olives and what is lateral to the olives?
the antero-lateral sulcus separates and the postero-lateral sulcus is lateral to olives
38
what is the fissure in the middle of the anterior aspect of the ventral medulla?
the anterior median fissure
39
what is the pyramidal tract?
they are posterior to the pyramids - axons containing descending pathways to control muscles of the body
40
what happens at decussation of the pyramids?
fibres from one side of the brain cross the midline of the body - travel on one side of ventral pons and medulla and then cross to the other side
41
where are CN 9 and 10 found?
lateral to the olives
42
what structure travels through the foramen magnum with the spinal cord?
the hypoglossal nerve
43
what type of fibres are in the fasciculus gracilis?
white matter tracts - synapse at the tubercles - carry information from the lower limbs through SC and medulla
44
what is in the fasciculus cuneatus?
information from the upper limb
45
how would you recognise a closed medulla?
the central canal with brain tissue behind and infront of - cut anywhere below the obex
46
what will be behind the medulla in an open medulla?
there is the fourth ventricle above the obex and therefore space not tissue
47
where does the hypoglossal nerve emerge from?
the anterolateral sulcus
48
where do the vagus and glossopharyngeal nerves arise from?
the posterolateral sulcus
49
what structures of the medulla are part of the dorsal column pathway?
the fascicles - sensory information from body to brain
50
what separates the pons from the midbrain?
the pontomesencephalic junction
51
what does the ventral pons connect?
the cerebrum, cerebellar hemispheres and brainstem
52
in what direction do fibres travel across the pons?
transverse
53
where does CNV, VI and VII emerge from?
V - trigeminal - motor and sensory - from middle of pons VI - midline of the pontomedullar junction VII - facial and VIII - laterally in cerebellopontine angle
54
what are peduncles, and where are they found?
the peduncles are inferior middle (large) and superior and are found in the dorsal pons that connect the brainstem to the cerebellum
55
what is the bump in the dorsal aspect of the pons?
facial colliculus - fibres of the facial nerve travel in such a way that they form a bump
56
what structures is on the caudal side of the pons?
the fourth ventricle and MCP
57
what is at the rostral end of the pons?
brain tissue and basal pons
58
what is the function of the basal pons?
contains all transverse pontine fibres that cross to reach either side of cerebellum - interrupt the descending fibres and they then merge in middle
59
why might injury to CNVI cause injury to CNVII?
the fibres of CNVII loop around the nucleus of CNVI to make colliculus
60
where does the basilar artery travel?
the basilar groove down the anterior midline of pons
61
what can be seen in the caudal pons?
the MCP dorso-lateral and the floor of fourth ventricle dorsally and groove for basilar artery - lower than rostral
62
what can be seen in rostral pons?
the cerebral aqueduct centrally and the groove for basilar artery
63
what do each of the cerebellar peduncles connect?
SCP - midbrain to cerebellum and is the roof of the fourth ventricle MCP - pons to cerebellum ICP - medulla to cerebellum
64
where is the midbrain found?
just below the mammillary bodies of the hypothalamus
65
what do cerebral peduncles do?
they are ventral and are white matter tracts connecting structures - midbrain to the cerebrum above and contain descending motor fibres
66
what is the course of the descending motor fibres?
the fibres descend, pass through the cerebral peduncles and ventral pons and are interrupted in pons due to transverse firbes, they then enter pyramids and travel on same side until decussation
67
where in the ventral midbrain does CNVIII emerge?
occulomotor nerve emerges in the intrapeduncular fossa between the two CP
68
where does CNIV emerge from?
dorsal view of the midbrain
69
what is the dorsal midbrain?
it is four bumps that are coliculli - superior and inferior
70
what are the roles of the coliculli?
superior - visual and inferior - auditory
71
where does the dorsal midbrain sit?
it sites just below the diencephalon but posteriorly is the pineal gland and the third ventricle which separates the two sides of the diencephalon
72
how do the coliculli and the diencephalon connect?
the brachium of the coliculli reach out laterally to the thalamus of diencephalon
73
where are white matter tracts found in midbrain?
basal
74
what is a feature of a cross section of midbrain?
the cerebral peduncle stick out laterally and intrapeduncular fossa in middle. The cerebral aqueduct is surrounded by inferior colliculi
75
what is seen in middle of cross section of midbrain?
two nuclei of CNIII - trochlear and fibres from the inferior colliculi travelling and cerebral aqueduct running through
76
ventrally what comes superiorly off the mammillary bodies?
the pituitary stalk
77
what surrounds the peduncles?
the optic tract leading centrally to chiasm
78
what is the Tec formed from?
colliculi
79
what is next to tec?
teg
80
what is the reticular formation for?
consciousness and sleep cycles
81
what is the reticular formation?
a complex, multisynaptic network of neurones in the tegmentum of the brainstem
82
what comprises the reticular formation?
reticular nuclei, vital autonomic centres and ascending reticular activating system
83
what is the reticular nuclei for?
gives rise to a descending motor pathway
84
what is the vital autonomic centre for?
respiratory and cardiovascular functions
85
what are the cells that give rise to the ascending reticular activating system for?
pass to cortex and involved in consciousness - damage = coma
86
what are the functions of the reticular formation?
pain modulation, sleep wake cycle and arousal
87
where is CNII found?
between the superior and posterior cerebellar arteries
88
where is CNVI found?
behind the anterior inferior cerebellar artery
89
where is CNIII in relation to SCA?
it loops underneath
90
where do the circumferential branches of the basilar artery supply?
lateral pons
91
what is the blood supply of the brainstem?
PCA, SCA, basilar and branches, AICA and PICA, vertebral arteries and branches
92
which cranial nerves arise from the brainstem?
CN 3,5,6,7,8,9,10, 11 and 12
93
where do cranial nerves 1 and 2 emerge from?
higher up than brainstem
94
what is the primary function of the cerebellum?
coordination of movement, maintenance of balance and posture
95
what are cerebellar peduncles for?
connecting the dorsal brainstem to cerebellum
96
what can be seen from the superior dorsal cerebellum?
the midbrain
97
what separates the anterior and posterior lobe of the cerebellum?
the primary fissure
98
what is between the two hemispheres of the cerebellum?
the vermis - middle portion
99
from an infero-ventral view of the cerebellum what is seen?
the medulla, vermis and tonsils - bumps on either side
100
what will need to be removed to see the peduncles?
the brainstem
101
what is the nodulus, floculus and together?
nodulus - most inferior part of vermis flocculus - either side of nodulus together - flocculonodular lobe
102
what is the anatomical structure of the cerebellum?
three lobes, two hemispheres with vermis in middle, and tonsils with direct relationship with medulla, flocculus on either side and nodules
103
where is the cerebellum found?
under the occipital lobes of the cerebral hemispheres
104
when looking at the inferior view what lobules of the cerebellum can be seen?
the inferior semilunar most posteriorly, the gracile lobule more medially and anteriorly and anterior most is the biventer lobule
105
when looking at the superior view what lobules of the cerebellum can be seen?
superior semilunar posterior most, posterior quadrangular and anterior and anterior quadrangular

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