Brainstem and CN Nerve Part 2 Flashcards
in general, where in the midbrain do you find the:
a) sensory tracts?
b) motor tracts?
c)
- CNs for motor?
- CNs for sensory?
sensory tracts: dorsal / posterior
motor tracts: anterior / ventral
CNs: motor in middle, sensory on outside
what is the blood supply to the medulla mainly from? [1]
- what are the 5 branches? [5]
- *medulla blood supply = verterbal arteries**
- anterior spinal artery
- posterior spinal artery
- posterior inferior cerebellar artery (PICA)
- anterir inferior cerebellar artery (AICA)
- basal artery
label where each bit of medulla gets blood from xx
which is main blood supply to pons? [1]
- branches? [3]
which is main blood supply to pons? [1]
basilar artery
- branches? [3]
paramedian branches
anterior iinferior cerebelllar artery
superior cerebellar artery
label the pons stuff
which 2 arteries provide main blood supply to midbrain? [2]
which 2 arteries provide main blood supply to midbrain? [2]
- *basilar artery
- superior cerebellar artery
- posterior cerebellar artery
choridal atery**
draw and explain the rule of 4 xx
Rule of 4:
which 4 midline structures do you get?
what are their deficits?
rule of 4:
what are the lateral structures you get?
what are their deficits?
rule of 4:
what the CN found in medulla?
what would be their deficit?
rule of 4:
what the CN found in pons?
what would be their deficit?
rule of 4:
what the CN found in above the pons?
what would be their deficit?
58 yr old patient with left sided loss of proprioception & right sided tongue deviation
- what CNS structures are affected? [3]
- explain symptoms with regards to structures affectedd? [2]
- where is the lesion? [1]
58 yr old patient with left sided loss of proprioception & right sided tongue deviation & left hemiparesis
- what CNS structures are affected? [3]
Corticospinal tract, right
medial leminicus right side, medial
CN 12 right side, medulla - explain symptoms with regards to structures affectedd? [2]
- *medial medullary syndrom right side caused by vert. artery medullary branch right side**
- where is the lesion? [1]
- *right side medulla**
right sided meiosis (small pupils), anhydorosis (inability to sweat normally) and ptosis (drooping of the upper eyelid)
right sided ataxia
ulula deviated to left
analgesia nad themoanalgesia to right side of face
- what CNS structures are affected? [4]
- explain symptoms with regards to structures affectedd? [2]
- where is the lesion? [1]
right sided meiosis (small pupils), anhydorosis (inability to sweat normally) and ptosis (drooping of the upper eyelid)
right sided ataxia
ulula deviated to left
analgesia nad themoanalgesia to right side of face
- what CNS structures are affected? [4]
symp tract, right side (Horners syndrome)
spinocerebellar tract, right side (causing ataxia)
CN 10, right side, medulla (uvula)
sensation from CN V - explain symptoms with regards to structures affectedd? [2]
- *lateral medullary syndrom right side**
- *PICA right side**
- where is the lesion? [1]
- *medulla**
70 yr old male with hypertension develops:
- left sided ipsilateral opthalmoplegia
- loss of pupillary light reflex in left eye
- paralysis of the right arm and leg
70 yr old male with hypertension develops:
- left sided ipsilateral opthalmoplegia: CN 3 left side (medial)
- loss of pupillary light reflex in left eye: CN 3 left side (medial)
- paralysis of the right arm and leg: Motor CST, left side (medial)
**midbrain, occulusion of branch of posterior cerebral artery
medial midbrain !!**
which structure seperates the cerebrum from the cerebellum?
falx cerebri
tentorium cerebelli
anterior cranial fossa
brainstem
corpus callosum
which structure seperates the cerebrum from the cerebellum?
falx cerebri
tentorium cerebelli
anterior cranial fossa
brainstem
corpus callosum
which structure seperates the cerebral hemispheres?
falx cerebri
tentorium cerebelli
anterior cranial fossa
brainstem
corpus callosum
which structure seperates the cerebral hemispheres?
falx cerebri
tentorium cerebelli
anterior cranial fossa
brainstem
corpus callosum
what can you get a raised intrcranial pressure from? [4]
what happpens when you get raised intracranial pressure? [1]
symptoms? ^ [3]
what can you get a raised intrcranial pressure from? [4]
- *- haemorrage
- tumour
- swelling of brain
- berry aneursym**
what happpens when you get raised intracranial pressure?
brains gets squashed under dura mater: creates brain hernations (e.g sub tentorium hernation)
symptoms? ^ [3]
headache, naseau, vom
what is the uncus? [1]
what happens if u get an temporal hernation?
- which structures of brain can herniate? [2]
- what happens to midbrain? [1]
- which CN compressed? [1]
- which artery occluded? [1]
what is the uncus? [1]
most inferior part of temporal lobe
what happens if u get an temporal herniation?
- *- uncus and hippocampus can herniate
- midbrain pushed to opposite side
- CN III compressed**
- PCA occluded
how do u check for raised intracranial pressure? [1]
how do u check for raised intracranial pressure? [1]
opthalmascope - look for optic nerve where it enters retina (eyes are outgrwoth of brain). optic nerve gets squashed at high pressure - causes papilledema / optic discs bulge out
which CN is affected?
CN VII
CN VIII
CN X
CN V
CN XII
which CN is affected?
CN VII: LMN lesion (she cant smile & forhead not wrinkling)
CN VIII
CN X
CN V
CN XII
which CN is affected?
CN VII
CN VIII
CN X
CN V
CN XII
which CN is affected?
CN VII
CN VIII
CN X
CN V
CN XII right side (same side as lesion)
which CN is affected?
CN VII
CN VIII
CN X
CN V
CN XI
which CN is affected?
CN VII
CN VIII
CN X left sided lesion
CN V
CN XII
which CN is affected? [1]
CN III - oculomotor
(levator palpebrae superior affected, lateral rectus also affected)
