Brainstem: Internal Structure and Vascular supply

Question 1

What are the three longitudinal sections of the brainstem called and where are they located?

Answer 1

1. Basilar (ventral)
2. Tegmentum (dorsal)
3. Tectum (part of midbrain)

Question 2

What is housed in the basilar longitudinal sections?

Answer 2

motor tracts, motor nuclei, pontocerebellar axons

Question 3

What is housed in the tegmentum?

Answer 3

reticular formation, sensory nuclei, sensory tracts, cranial nerve nuclei, medial longitudinal fasciculus

Question 4

What is housed in the tectum?

Answer 4

Pretectal area, superior and inferior colliculi, tectospinal tract

Question 5

A patient has received injury to the anterior pons? Will pain and temperature likely be affected? Why?

Answer 5

No, because spinothalmic runs posteriorly in the tegmentum so they will be spared.

Question 6

A patient is suffering from hydrocephalus with a significant increase in ICP in the fourth ventricle. Will fine motor of the UEs be effected?

Answer 6

No, because the corticiospinal tracts run anteriorly in the basilar section, sparing them from the damage caused in the tegmentum.

Question 7

What are the functional divisions of the tegmentum and what do they control?

Answer 7

Rostral: maintain alert, conscious state

Caudal: Motor, reflex and autonomic functions

Question 8

You are carrying a glass vase and step on a nail. What keeps you from dropping the vase by suppressing the pain until the vase is sat down?

Answer 8

Tegmentum- caudal division

Question 9

What are the reticular nuclei?

Answer 9

1. Ventral Tegmental area
2. Pedunculopontine nucleus (PPN)
3. Raphe nuclei
4. Locus coeruleus and medial reticular area

Question 10

What neurotransmitter is secreted in the ventral tegmental area and what is its role?

Answer 10

Dopamine- motivation and decision making; reward seeking behavior

Question 11

What neurotransmitter is secreted in the Pedunculopontinue Nucleus and what is its role?

Answer 11

Acetylcholine- movement, arousal, attention

Question 12

What neurotransmitter is secreted in the Raphe Nuclei and what is its role?

Answer 12

Serotonin- controls how much pain we will become aware

Question 13

What neurotransmitter is secreted in the Locus coeruleus and what is its role?

Answer 13

Norepinephrine- direct attention and suppress pain info

Question 14

What neurotransmitter is secreted in the Medial Reticular Zone and what is its role?

Answer 14

Norepinephrine- regulates autonomic functions; arousal

Question 15

Define.

Patient is unarousable; may have altered respiration; no response to pain; reduce basic reflexes such as coughing and swallowing

Answer 15

Coma

Question 16

Define.

Sleeping more than awake, drowsy, confused when awake

Answer 16

Obtunded

Question 17

Define.

severely altered consciousness, can do one of the following: simple command, gesture, yes/no, intelligible speech, a movement

Answer 17

Minimally Conscious State (MCS)

Question 18

Define.

Complete LOC, without alteration of vital function; eye opening, regular sleep-wake, normal respiration

Answer 18

Vegetative state

Question 19

Define.

Arousable only by strong stimuli, able to function when awake but hard to keep awake

Answer 19

Stupor