Brainstem lesions location, and Stroke+ foramina

Question 1

Let’s do foramina first,
the mnemonic you need to remember is?
And how do you use it?

Answer 1

1-Come
2-On
3-Sofia
4-Sofia
V1- Sofia
V2-Roll
V3-Over
6-Sofia
7- I am
8- in a mood
9-Jug
10-jug
11-jug
12-hey

Mini things you should always remember:
V3–> provides motor fibres to muscles of mastication
CN 2 AND 3—> pupillary reflex afferent and efferent.
Reflexes with same afferent and efferent:
Jaw Jerk–>V3 (3 alphabets)
Cough—> 10th nerve–> VAGUS (Guss Guss–> coughing)
Corneal reflex–> 1 and 7. (afferent is 1, efferent is 7–> corny people want sex)
Gag reflex—> 9, 10.

Question 2

Lateral and Medial Medullary Syndrome.

Answer 2

Lateral Medullary Syndrome—> Lemi piccup mi-self, eye am tipsy, can’t eat and the other side of my body is numb
Lemi (Lateral Medullary), piccup (PICA affected, hiccups), mi-self (mi= miosis of the ipsilateral eye) eye (ptosis of the ipsilateral eye), tipsy (vertigo due to vestibular nerve nucleus), can’t eat (very specific, doesn’t happen in any other stroke or lesion. Dysphagia, hoarseness, decreased gag reflex due to damage to nucleus ambiguus), can’t feel other side of my body (spinothalamic tract damage causes C/L loss of pain and temperature on body but loss of spinal trigerminal nucleus causes loss of pain and temperature on ipsilateral face)–> Imagine a person with ipsilateral face symptoms, but C/L body symptoms.

Medial Medullary–> Meredith MD can’t kick from C’L leg but licks tASAty ips-cream.
Meredith MD—> Medial Medullary
can’t kick from C/L leg–> C/L upper + lower limb affected.
licks ips-cream–> tongue deviated to ipsilateral side (hypoglossal nerve dysfunction)

Question 3

What is the most common stroke that occurs due to HTN?

Answer 3

HTN–> areas affected is internal capsule, striatum–> pure motor loss of C/L side of the body!

Question 4

ACA stroke causes?

Answer 4

ACA ACA–> koyi taangein daba raha hai.

ACA stroke causes—> loss of C/L sensory and motor lower limb. urinary incontinence.

Question 5

Which pathway is affected in schizophrenia, and which is affected in movement disorders?

Answer 5

Nigrostriatal–> affected in movement disorders, causes Extra Pyramidal Symptoms–> Negros have to be extra careful while parking.

Schizophrenia (MENTAL)—> ML pathway–> Mesolimbic.

Question 6

What substance is produced in the locus ceruleus of the brain?

Answer 6

Norepinephrine is produced in Locus ceruleus of Pons.

SHE SERIOUSLY NEEDS A PONY?
(Pons—locus ceruleus makes NE—> increased activity in anxiety because they speak like NENENENENENE, and decreased activity in depression because they speak like Ne…Ne….Ne..Ne

Question 7

Which part of brain produces serotonin?

Answer 7

Medusa’s Raphe are serene
(Serotinin is produced by Medulla–> specifically Raphe nucleus.)

Serotonin is decreased in—-> anxiety, depression, parkinson’s.

Question 8

Which part of brain produces Ach? And its production is affected in which of the diseases?

Answer 8

Basic Meynaar acha bana hua hai, kiyunkay parking ziaada hai but not good for altered hunting.

Nucleus Basalis of Meynart in the frontal lobe/forbrain–> produces Ach—> Increased in Parkinson’s, decreased in Huntington’s and alzheimer’s.

Question 9

Which part/nucleus of hypothalamus has decreased activity in Narcolepsy?

Answer 9

Hypocretin/Orexin and Histamine are produced is the posterior part of the hypothalamus—> Specifically the tuberomamillary nucleus.

Question 10

Which part of brain produces GABA? And this is altered in which diseases?

Answer 10

Baba cucumber nahyin khaatay anxiety mein, aur hunting kernay sey pehlay.

(GABA is produced by Nuclear Accumbens, and decreased production in anxiety and huntington’s.)

Question 11

What should be done after a Transient ischemic attack?

Answer 11

Simply start on statin therapy to lower cholesterol.

Question 12

Neonatal intraventricular hemorrhage is due to bleeding from ____________.

Answer 12

Originates in germinal matrix, a highly vascularized layer within the subventricular zone.

Question 13

Frontal eye field defect presents as what and in which artery’s stroke?

Answer 13

In frontal eye field defect is common in MCA stroke and in this–> Eyes look towards the lesion.

Question 14

PPRF when damaged—> the eyes will look ———>

Answer 14

The eyes will look at the RF side–> Matlab hemiplegia.

PPRF—> ROUGH SIDE–> hemiplegia

Question 15

Basal Ganglia are affected in which diseases?

Answer 15

Parkinsons affects–> substantia nigra (pars compacta)
Huntington’s—> striatum affected.
Hemiballism—> subthalamic nucleus affected due to a lacunar infarct. ( indirect pathway is affected so motion is INCREASED)
Wilson’s disease/ Keyser Fleisher rings–> Striatum and GP internus affected.