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Neuro Block 2 > Brainstem part I: The Midbrain > Flashcards

Brainstem part I: The Midbrain Flashcards

1
Q

the midbrain has all these 9 structures..

A
  1. CN III and CN IV
  2. Substantia nigra
  3. Red nucleus
  4. Crus cerebri
  5. Cerebral aqueduct
  6. Superior and inferior colliculi
  7. Lemnicuses (spinal, trigeminal, medial)
  8. Peri-aqueductal grey matter
  9. Reticular formation
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2
Q

What is another name fro crus cerebri?

what do you get if you damage CN III?

where do we find the substantia nigra? it is involved in what disease?

what are the superior adn inferior colliculi involved in?

what is a lemniscus?

what is the peri-aqueductal grey matter?

where do we find the reticular formation?

A

cerebral peduncle

horner’s

in the midbrain - parkinson’s

in reflexes

they are sending ascending information

grey area surrounding the aqueduct that is involved in pain suppression pathway

in the tegmentum, behind the pons

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3
Q

what does a sudden onset tell you?

A

it is vascular?

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4
Q

identify all the structures found here

A
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5
Q

at what level is this picture?

A

at the level of the superior colliculi

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6
Q

identify the structures

A
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7
Q

at what age do we start considering hypertension for lesions?

A

40

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8
Q

what level of the brainstem is this?

A

Rostral Midbrain

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9
Q

How do you know a section is rostral midbrain?

A
  • Mammillary Bodies (MB)
  • Thalamic Nuclei Medial Geniculate N. (MGN)
  • Lateral Geniculate N. (LGN)
  • Red Nucleus (RN)
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10
Q

identify the structures

A
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11
Q

at what level is this picture?

A

rostral midbrain

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12
Q

what cranial nerve is the only 1 that comes out the back through the back?

A

trochlear

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13
Q

identify the structures

A
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14
Q

where does the left trochlear nerve come from?

where does the right trochlear nerve come from?

A

right trochlear nucleus

left trochlear nucleus

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15
Q

what is the Spinal lemniscus?

A

it is made up of the lateral and anterior spinothalamic tracts, and spinotectal tract.

Ex: As these ascending sensory tracts leave the spinal

cord, they come together to form the spinal lemniscus.

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16
Q

what is the Medial lemniscus?

A

Dorsal column/medial lemniscus fiber tract is called the medial lemniscus when it passes through the brainstem.

17
Q

what is the Trigeminal lemniscus?

A

The name for the ascending axons of the trigeminal nerve (going to thalamus).

18
Q

what does the MLF do?

A

it allows conjugate gaze or allows for both eyes to look at the same place at the same time

19
Q

what is the center red ring?

A

the periaqueductal grey matter

20
Q

what structure do each of the circles make up?

A
21
Q

what do we find in the peduncles?

A

corticospinal and corticonuclear nerve fibers

22
Q

What do we find in the peduncle?

A

the corticospinal and corticobulbar tracts

23
Q

what type of motor neuron is the corticobulbar tract?

what type of motor neuron is the corticospinal tract?

A

corticobulbar = UMN control of cranial nerves

corticospinal = UMN control of spinal nerves.

24
Q

what is the difference between Corticobulbar and Corticospinal?

A

Coritocobulbar Tract innervates most Cranial Nerve’s bilaterally.

25
Q

A corticobulbar tract damage will result in what symptoms?

A
  • Contralateral lower face paralysis
  • Contralateral tongue weakness (tongue will deviate away from a CBT lesion).
  • Contralateral palate (uvula will deviate towards a CBT lesion).
26
Q

What originates in the Red Nucleus?

what is the crus cerebri?

A
  • the Rubrospinal tract
  • region of the midbrain through which the corticospinal and corticonuclear (corticobulbar) fibers pass
27
Q

What is the Red nucleus

afferents to the Red Nucleus are: ipsilateral or contralateral?

from where does the red nucleus receive its innervation?

how do axons here synapse?

A
  • Pathway by which cerebellum influences coordination of skilled motor movements.
  • Cerebellar afferents to red nucleus are contralateral; rubrospinal tract crosses back (ie. circuit stays ipsilateral).
  • from the cerebellum
  • Axons synapse mostly on interneurons in gray matter of spinal cord; interneurons then synapse on alpha and gamma motor neurons.
28
Q

identify the parts

A
29
Q

what cranial nerves does the MLF connect?

for what?

A

Connects CN’s III, IV and VI for conjugate eye movements

30
Q

Brainstem lesions usually result in what?

A

ipsilateral cranial nerve dysfunction, contralateral body dysfunction.

31
Q

What are 2 names for Weber’s Syndrome?

A

Medial Midbrain Syndrome

Superior Alternating Syndrome

32
Q

what are the symptoms of Weber’s syndrome?

A
  1. CN III axons: Ipsilateral ptosis, mydriasis, eye down and out.
  2. Corticospinal: Contralateral arm and leg weakness, Babinski, etc.
  3. Corticobulbar: Contralateral lower face, tongue, and palate (see earlier slide).
33
Q

Benedikt’s Syndrome, what is the artery damaged here?

what is another name for it?

A

branch of the posterior cerebral artery (Paramedian)

Paramedian Midbrain Syndrome

34
Q

What are the symptoms in Benedikts?

A
  1. Oculomotor deficits:
    * Ipsilateral oculomotor nerve paralysis.
    * Eye abduction and depression.
    * Severe ptosis.
    * Fixed, dilated pupil (internal opthalmoplegia).
  2. Cerebellar ataxia (damage to red nucleus).
  3. Contralateral extrapyramidal motor symptoms (red nucleus)
  4. Contralateral loss of proprioception, discriminative touch, and vibration.
35
Q

Parinaud’s syndrome usually results from what?

A

a pineal gland tumor

36
Q

what are the symptoms of Parinaud’s Syndrome?

A
  1. Paralysis of upward and downward gaze pupillary disturbances, absence of convergence.
  2. Non-communicating hydrocephalus due to compression of the aqueduct.
37
Q

What can cause midbrain lesions?

A
  1. Occlusion of different branches of posterior
  2. Cerebral artery.
  3. Aneurysms in the circle of Willis.
  4. Tumors of the pineal gland.
  5. Hydrocephalus.
  6. Other tumors.
  7. Supratentorial mass lesions.
38
Q

What is A?

What is B?

What is C?

A

Parinaud’s

Benedikt’s

Weber’s

39
Q

things that can cause Weber’s (4)

A
  1. occlusion of paramedia branch
  2. tumor (any supratentorial mass)
  3. cyst
  4. subarachnoid hemmorrhage

Neuro Block 2 (7 decks)

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