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Neuroscience I Test 3 > Brainstem Morphology > Flashcards

Brainstem Morphology Flashcards

1
Q

mesencephalon

A

roof: tectum
ventricular cavity: cerebral aqueduct
basilar portion: crura cerebri

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2
Q

tegmentum

A

consistently located b/w the ventricular system and the basilar portion of the midbrain, pons, and medulla

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3
Q

metencephalon

A

roof: cerebellum
ventricular cavity: 4th ventricle
basilar portion: pons

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4
Q

myelencephalon

A

roof: posterior columns
ventricular cavity: central canal
basilar portion: pyramids

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5
Q

blood supply to the brainstem

A
  • branches from the circle of Willis, vertebral As, and basilar As
  • highly vascularized and vulnerable to thrombosis and emboli
  • penetrating As have a wedge shaped pattern of distribution–thrombosis of one of the As would result in a wedge shaped region of infarction
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6
Q

spinal lemniscus

A
  • sensory
  • conveys pain and temp info from the opposite 1/2 of the body
  • either lateral or posterolateral to ML
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7
Q

medial lemniscus

A
  • sensory
  • conveys prop, 2 pt, and vibratory sensations from opposite 1/2 of body
  • at level of upper pons and midbrain, the ML also contains fibers that convey taste info from ipsilateral 1/2 of the tongue and pharynx
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8
Q

trigeminal lemniscus

A
  • conveys pain, temp, and crude tactile sensations from the opposite 1/2 of face
  • located b/w ML and SL
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9
Q

lateral lemniscus

A
  • conveys bilateral auditory info, but predominantly info from opposite ear
  • located in lateral aspect of brain
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10
Q

medial longitudinal fasciculus

A
  • conveys vestibular influences to the CN 3, 4, 6
  • contains fibers for oculomotor N
  • located next to midline and anterior to central gray
  • in medulla and lower pons, located in dorsal tip of ML
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11
Q

internuclear ophthalmoplegia

A
  • lesion of medial longitudinal fasciculus
  • have an abnormal response to horizontal gaze in direction opposite the side of the lesion
  • horizontal gaze contralateral to MLF lesion is abnormal
    • named according to side of Oculomotor impairment
    • ex: if horizontal to R is normal and disconjugate to left, so R eye does not adduct, then there is right INO due to lesion of R MLF
    • ex: if horizontal to L is normal and disconjugate to left (L eye does not adduct), then there is a left INO with lesion of L MLF

-bilateral in young pts with MS or unilateral in order pts with vascular dz

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12
Q

unilateral lesion of medial longitudinal fasciculus

A

-impairment or loss of adduction (MR) of ipsilateral eye and nystagmus of abducting eye

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13
Q

corticospinal tract

A
  • conveys descending motor info from motor cortex

- unilateral lesion: contralateral spastic hemiplegia

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14
Q

corticobulbar tract

A
  • brainstem CN motor nuclei and innervated by corticobulbar fibers
  • most decussate in lower pons b/w trigeminal and abducens N
  • unilateral lesion of CBF result in denervation of brainstem motor nuclei below level of lesion
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15
Q

unilateral lesion of CBF above level of decussation

A

contralateral paralysis or paresis of mimetic Ms of lower 1/2 of face–supranuclear facial palsy
-as well as other cranial palsies due to denervation of abducens nucleus, hypoglossal nucleus, and nucleus ambiguus

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16
Q

lesions of CBF below the decussation

A

ipsilateral cranial nerve palsies

17
Q

supra nuclear facial palsy

A
  • upper quadrant of face is unaffected by unilateral lesion of CBF
  • unilateral lesion of CBF to the facial nucleus results in paralysis of contralateral lower quadrant of face
18
Q

cranial N by level

A
  • telencephalon: I
  • diencephalon: 2
  • mesencephalon/midbrain: 3, 4
  • metencephalon/pons: 5
  • pontomedullary sulcus: 6, 7, 8
  • myelencephalon/medulla oblongata: 9-12
19
Q

lesion at the level of the diencephalon

A

optic N, chiasm, tract

-visual field blindness

20
Q

lesion of midbrain

A
  • oculomotor N–external strabismus, pupillary dilation, complete ptosis
  • trochlear N–can’t adduct and depress eye
21
Q

lesion of pons

A

trigeminal N–ipsilateral loss of sensations from 1/2 of face, paralysis and atrophy of ipsilateral Ms of mastication
-when pt opens his mouth wide, chin deviates toward side of lesion

22
Q

lesion of pontomedullary sulcus

A
  • abducens N–ipsilateral paralysis of lateral gaze and internal strabismus
  • facial N–ipsilateral Bell’s palsy, loss of taste sensations from the anterior 2/3 of tongue, hyperacusis
  • vestibulocochlear N–ipsilateral deafness, problems with equilibrium and posture, and nystagmus
23
Q

lesion at level of medulla

A
  • glossopharyngeal N–dec sensation from palate and pharynx and loss of taste from posterior 1/3 of tongue
  • vagus N–dysphagia, dysarthria, hoarseness, paralysis or paresis of Ms of palate
    • uvula may deviate to side opposite the lesion
  • spinal accessory N–pt can’t turn head away from affected side or shrug shoulders
  • hypoglossal N–atrophy of ipsilateral intrinsic Ms of tongue, dysarthria, dysphagia, protruded tongue deviates towards side of lesion
24
Q

lesion of nucleus ambiguus

A
  • deviation of uvula away from affected lesion

- dysarthria, dysphagia, hoarseness

25
Q

what determines the level and side of lesion?

A

the highest affected cranial N

26
Q

anterior white commissure lesion

A
  • syringomyelia

- bilateral loss of pain and temp–yoke like

27
Q

descending nucleus and tract of V lesion

A

-unilateral hemianalgesia and thermal hemianalgesia of face

28
Q

inferior olivary nucleus

A
  • receives CTF

- projects to cerebellum

29
Q

spinal lemniscus lesion

A

-contralateral hemianalgesia of body

30
Q

medial lemniscus lesion

A

contralateral loss of prop and 2 pt tactile from body

31
Q

medial longitudinal fasciculus

A

internuclear ophthalmoplegia

32
Q

corticospinal tract lesion

A

contralateral spastic hemiplegia

33
Q

pulvinar

A

tectal visual pathway

34
Q

substantia nigra

A
  • Parkinson’s dz
  • afferents from striatum
  • efferents to thalamic motor nuclei
35
Q

mammillary body

A

-Korsakoff’s Syndrome

36
Q

optic radiations lesion

A

contralateral homonymous hemianopsia

37
Q

PLIC lesion

A

contralateral spastic hemiplegia

38
Q

genu of internal capsule lesion

A

supra nuclear facial palsy

Neuroscience I Test 3 (20 decks)

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