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Neuro Exam 2 > Brainstem/Cerebellum > Flashcards

Brainstem/Cerebellum Flashcards

1
Q
  • Locate the hypoglossal nucleus and the hypoglossal nerve exiting the brainstem
  • Point out the reticular formation
A
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2
Q

What is the reticular formation?

A

Diffuse nerve network throughout the entire brainstem that connects all the surrounding structures

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3
Q

What are the cranial nerves in the medulla?

A

CN IX, X, XI, and XII (9-12)

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4
Q

Name the labeled structures

A
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5
Q

What CN(s) come out the dorsal surface of the brainstem?

A

Only CN IV (trochlear)

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6
Q

What functional fibers are in CN XI?

-what does CN XI innervate?

A

GSE

  • for this course consider CN XI (accessory) to contain GSE (as if it’s innervating muscles from somite, not branchial arch, derivatives)
  • CN XI innervates trapezius and SCn
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7
Q

Point out the pyramidal decussation and medullary pyramids

A
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8
Q

Point out the place where the dorsal medial pathway fibers decussate and travel

A
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9
Q

Where does the hypoglossal nerve exit the brain?

A

Exits most medially out of the medulla. Exits out on the preolivary sulcus between the olive and the pyramids

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10
Q

How does the hypoglossal nerve leave the skull?

A

Out the hypoglossal foramen to provide motor innervation (GSE) to the tongue

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11
Q

Locate the spinal accessory nucleus in the image

A
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12
Q

Which number if the hypoglossal nuclei?

A

11

  • most medial (b/c motor) in the medulla oblongata
  • contains GSE fibers
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13
Q

Which number is the accessory nucleus?

A

20

-very medial (second most medial) in the superior spinal cord, GSE fibers

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14
Q

Point out the

(a) Nucleus that provides the SVE fibers to the vagus nerve
(b) Exit of CN X

A

(a) Nucleus ambiguus provides the parasympathetics to the vagus nerve
(b) CN X exits out the inferior olivary sulcus (right below the inferior olive)

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15
Q

Locate the nucleus that provides parasympathetics to the vagus nerve

A

= Dorsal motor nucleus of the vagus

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16
Q

Differentiate the location of the 4 pathways/nuclei that provide fibers to the vagus nerve

A
  • yellow = nucleus ambiguus, provides the SVE fibers to muscles derived from the VI and VIth branchial arch
  • darker blue = dorsal vagal motor nucleus, provides the GVE (parasympathetic) fibers for motor to the gut
  • teal (most lateral) = spinal trigeminal nucleus (GSA fibers)
  • purple/green = solitary nucleus (GVA and SVA)
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17
Q

Label the blue arrows and red line

A
  • red line = sulca limitans, separates the motor and sensory components of the brainstem
  • see CN IX exiting
  • inferior salivatory nucleus provides the parasympathetics (GVE) to CN IX
  • spinal trigeminal nucleus provides the somatic sensory (GSA) to both CN X and IX
  • nucleus solitarious provides the visceral sensory (GVA) to both CN X and IX
  • nucleus ambiguus provides the somatic sensory (GSA) to both CN X and IX
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18
Q

What is the main structure of the posterior fossa?

A

Cerebellum, takes up mostly all the psace in the posterior fossa => if anything takes up space it can cause herniation

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19
Q

What structure forms the roof of the 4th ventricle

A

Cerebellum

-then the lateral walls of the 4th ventricles are the peduncles running and out of the cerebellum

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20
Q

Which cerebral peduncle(s) are the main outflow tract of the cerebellum?

A

Superior cerebellar peduncles = main outflow tract for efferent fibers leaving the cerebellum

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21
Q

Which cerebral peduncle(s) are the main inflow tract of the cerebellum?

A

Middle and inferior cerebellar peduncles act as the inflow tracts for the afferent fibers going into the cerebellum

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22
Q

What is the clinical significance of the cerebellar tonsils?

A

Tonsils = lowest (most inferior/caudal) part of the cerebellum

=> any mass-consuming lesion in the posterior fossa (ex: hemorrhage, tumor, increased pressure) can cause herniation of the cerebellar tonsils thru the foramen magnum

23
Q

Define a brainstem nucleus

A

Nucleus = gray matter- collection of neurons in a specific anatomical space

24
Q

Which part of the cerebllum controls distal limb coordination?

A

Intermediate hemisphere

25
Q

Which part of the cerebellum controls gait and balance?

A

Vermis and floculonodular lobe in the middle

26
Q

Which part of the cerebllum controls the VOR reflex?

A

Vermis and floculonodular lobe in the middle

27
Q

Name the main nuclei of the cerebellum

A

Dentate, fastigial, globose, and emboliform

-then interposed nuclei = emboliform + globose

28
Q

What are purkinje cells?

A

GABAergic neurons in the cerebellum

29
Q

Define dysmetria

A

Type of ataxia associated w/ lack of coordination of movement typified by under or overshoot of the intended position

30
Q

Define hypometria

A

= undershooting

ex: trying to do finger to nose but undershoot the distance

31
Q

Define hypermetria

A

= pass-pointing

  • overshooting
    ex: when doing finger to nose and pt overshoots
  • type of dysmetria which is a type of ataxia
32
Q

Define dyssynergia

A

= aspect of ataxia characterizted by uncoordinated and aburpt movement

-decomposition of mov’t

33
Q

Define dysdiadochokinesia

A

Feature of cerebral ataxia

= inability to perform rapid, alternating movements

ex: disorganized mov’t when asked to move palms up and down

34
Q

Define titubation

A

Postural sway in the AP direction

35
Q

Define a positive Babinski sign

A

When you stroke the sole of the foot and the big toe goes up

-sign of possible pathology if the big toe goes up when the sole of the foot is stroked

36
Q

Define asthenia

A

Weakness only during movement (not seen at rest)

-can be a result of cerebellar dysfunction

37
Q

Define rebound as a symptom of cerebellar dysfunction

A

-upward displacement of outstretched arm when tapped

38
Q

Describe the cerebellum’s role in cognition?

A

Learning new motor tasks and some perception

39
Q

What is multiple system atrophy? Name one way in which it can present

A

Multiple system atrophy type C (MSA-C) is a neurodegenerative disease which can present as sporadic ataxia

40
Q

What is Friedreich’s ataxia

A

Autosomal recessive inherited form of ataxia

-due to trinucleotide repeat

41
Q

What is SCAs?

A

A group of autosomally dominant inherited ataxias

SCA = spinocerebellar ataxias

42
Q

What are the three most common forms of SCA?

A

SCA 2,3, and 6 are the most common, make up about 50% of the diagnoses

-over 30 described clinical SCA syndromes

43
Q

What is the cause of SCAs?

A

Spinocerebellar ataxias = genetic, auto dom

-trinucleotide repeat expansion

44
Q

Which side is rostral vs. caudal?

Distinguish the 4 parts (thalamus, midbrain, pons, medulla)

Point out all the cranial nerves in the image

A
45
Q

Name each of the colored columns

A

Motor columns shown on the left:

  • Most medial = red = somatic motor column (GSE)
  • middle = GVE = parasympathetic column
  • most lateral of the motor columns (still medial to all the sensory) = SVE = branchial motor column

Sensory columns shown on the right:

  • most medial (still lateral to all motor) = SVA and GVA = Visceral sensory column
  • Middle/lateral: GSA = general somatic sensory column
  • Middle/lateral = SSA = special somatic sensory column
46
Q

Name the location of the nucleus of CN VIII

A

Vestibular and cochlear nuclei- mainly in the medulla, little bit extending upwards into the pons

-situated laterally b/c they’re purely sensory (SSA)

47
Q

What are the 3 sets of arrows pointing to?

A
  • pink arrows = Vestibular nuclei
  • blue arrows = cochlear nuclei
  • other blue arrows = CN VIII
48
Q

What is the function of the medial geniculate body of the thalamus?

A

Relay station btwn the inferior colliculus (of the midbrain tectum) and the auditory cortex (in the transverse temporal gyrus)

-fxn in hearing

49
Q

What forms a unique wine glass appearance on cross section?

A

Lateral lemniscus

-where the auditory fibers run up to get to the inferior calliculus in the auditory pathway

50
Q

Name the arrowed structures

A
51
Q

Name the circled structure

A

Spinal trigeminal tract and nucleus

-

52
Q

Name the arrowed structures

A
53
Q

Which nucleus mediates the jaw jerk reflex?

A

Mesencephalic nucleus which contains the GVA fibers of CN V (trigeminal) for proprioception

Neuro Exam 2 (4 decks)

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