Brainstem Pathways Flashcards
1
Q
This is the receptor for pain and temperature senses
A
Free nerve endings
2
Q
This is the receptor for light touch and pressure senses
A
Free nerve endings
3
Q
What is the function of Medial lemniscus tract?
A
Conscious perception of proprioception, vibratory and tactile information
4
Q
The function of this ascending brainstem tract is conscious perception of proprioception, vibratory, and tactile information
A
Medial Lemniscus
5
Q
Ascending brainstem tract that is somatotopically organized
A
Medial Lemniscus
6
Q
Medial Lemniscus is somatotopically organized, and within the medullary segment the body is in this position
A
Upright
7
Q
Medial Lemniscus is somatotopically organized, and within the pontine portion the body is in this position
A
Lying down
Arms medial, legs lateral
8
Q
Medial Lemniscus is somatotopically organized, and within the midbrain portion the body is in this position
A
Upside down
Arms ventral, legs dorsal
9
Q
Medial Lemniscus is somatotopically organized, and within this portion the body is ‘upright’
A
Medullary segment
10
Q
Medial Lemniscus is somatotopically organized, and within this portion the body is ‘lying down’, with arms medial and legs lateral
A
Pontine portion
11
Q
Medial Lemniscus is somatotopically organized, and within this portion the body is ‘upside down’, arms ventral and legs dorsal
A
Midbrain portion
12
Q
Lesions to this tract result in contralateral hypesthesia limited to the body
A
Medial Lemniscus
13
Q
Lesion within the medial lemniscus results in this
A
Hypesthesia
Contralateral deficit limited to the body
14
Q
Ascending brainstem tract that is involved with the conscious perception of pain, temperature and crude touch
A
Anterolateral system
15
Q
What are the three separate tracts that provide input to the Anterolateral system, an ascending brainstem tract?
A
Spinothalamic
Spinoreticular
Spinomesencephalic
16
Q
What is the function of the Anterolateral system?
A
Conscious perception of pain, temperature and crude touch
17
Q
Where does the Anterolateral system tract cross?
A
At the level of the spinal cord
18
Q
What is the result of lesions to the Anterolateral system?
A
Hypalgesia (limited to the body)
Within the spinal lemniscus, results in contralesional deficit
19
Q
What is hypesthesia?
A
Diminished/absent sensation of proprioception, vibration, tactile info
20
Q
What is Hypalgesia?
A
Diminished/absent perception of pain and temperature
21
Q
Lesion to this ascending brainstem pathway results in hypalgesia limited to the body
Contralateral deficit
A
Anterolateral system
22
Q
Ascending brainstem pathway that receives input from three separate tracts (spinothalamic, spinoreticular, spinomesencephalic)
A
Anterolateral system
23
Q
Ascending brainstem pathway involved in bringing pain and temperature info from the face
A
Trigeminal lemniscus
24
Q
What is the function of the Trigeminal lemniscus?
A
Bringing pain and temperature information from the face
25
What is the output of the trigeminal lemniscus?
VPN of thalamus
26
Basic pathway of the trigeminal lemniscus that descends after entering into the pons and innervates the spinal trigeminal complex
Spinal trigeminal tract
27
Portion of the trigeminal pathway with 2nd order fibers crossing the midline and ascending to the VPN of the thalamus
Trigeminal lemniscus
28
Portion of the trigeminal pathway that brings in unconscious proprioception info from the face, including from muscles of mastication
Mesencephalic nucleus
29
Lesions of the spinal trigeminal tract cause this
Ipsilesional deficit in pain and temperature
30
Lesions of the trigeminal lemniscus cause this
Contralateral deficits in pain and temperature
31
Do lesions to the spinal trigeminal tract cause ipsilesional or contralesional deficits in pain and temperature?
Ipsilesional
32
Do lesions to the trigeminal lemniscus cause ipsilateral or contralateral deficits in pain and temperature?
Contralesional
33
Lesions to this tract cause ipsilesional deficit in pain and temperature
Spinal trigeminal tract
34
Lesions to this tract cause contralesional deficit in pain and temperature of the face
Trigeminal lemniscus
35
What is the function of the lateral lemniscus?
Audition
36
Audition is the function of this ascending brainstem pathway
Lateral lemniscus
37
CNVIII provides input to this ascending brainstem pathway
Lateral lemniscus
38
What is the input for the lateral lemniscus tract?
CNVIII
39
What is the output for the Lateral lemniscus tract?
Primary auditory cortex
(via the inferior colliculus and medial geniculate nucleus)
40
The primary auditory cortex is the output for this ascending brainstem pathway (via the inferior colliculus and medial geniculate nucleus)
Lateral lemniscus
41
The primary auditory cortex is the output for Lateral lemniscus tract, via these two structrues
Inferior colliculus
Medial geniculate nucleus
42
What are the three distinct pathways of the lateral lemniscus?
Intermediate acoustic stria
Trapezoid body
Dorsal acoustic stria
43
Intermediate acoustic stria, Trapezoid body and Dorsal acoustic stria are the three distinct pathways of this ascending brainstem tract
Lateral lemniscus
44
This is the primary pathway of the Lateral Lemniscus
Intermediate acoustic stria
45
Intermediate acoustic stria pathway is largely contralateral to this structure
Cochlea
46
Lesions of the cochlea or the nuclei result in this
Unilateral hearing deficits
47
Lesions in the lateral lemniscus (except the cochlea or nuclei) result in this
Deficits in higher-order auditory features such as source localization
48
Unilateral damage in the lateral lemniscus affects the contralateral ear slightly more if it occurs above this structure
Pons
49
Does unilateral damage in the lateral lemniscus affects the ipsilateral or contralateral ear slightly more if it occurs above the pons?
Contralateral
50
Does unilateral damage in the lateral lemniscus affects the ipsilateral or contralateral ear slightly more if it occurs below the pons?
Ipsilateral
51
Damage to one side of this ascending brainstem pathway will result in bilateral listening deficits
Lateral lemniscus
52
What is the function of the corticobulbar pathway?
Voluntary movement of the face
53
The function of this descending brainstem pathway is voluntary movement of the face
Corticobulbar
54
Corticobulbar fibers innervate the motor nuclei of these 5 cranial nerves
V, VII, IX, X, XII
55
Corticobulbar fiber connections to CNV, VII, IX, X, and XII are mainly contralateral, however these 4 CNs have some bilateral input
V, VII, IX, X
56
Cranial nerve that receives bilateral innervation from both contralateral primary motor cortex and bilateral cingulate motor regions
CNVII
This leads to the presence of a central VII pattern of weakness or a Bell's Palsy pattern
57
Primary motor cortex and cingulate motor areas provide input for this descending brainstem pathway
Corticobulbar
58
What is the input for the corticobulbar pathway?
Primary motor cortex and Cingulate motor areas
59
Does a UMN or LMN lesion of CNVII cause weakness of inferior facial muscles?
Upper motor neuron
60
Does a UMN or LMN lesion of CN VII cause weakness of superior and inferior facial muscles?
Lower motor neuron
61
UMN lesion to CN VII causes this
Weakness of inferior facial muscles
62
LMN lesion to CN VII causes this
Weakness of superior and inferior facial muscles
63
Bell's palsy involves a lower motor neuron lesion to this nerve
CN VII
64
Does Bell's palsy involve a LMN or UMN lesion to CN VII?
Lower motor neuron lesion
65
The function of this descending brainstem pathway is to convey information from cerebral cortex to cerebellum about intended motor actions
Corticopontine-Pontocerebellar tracts
66
What is the function of the Corticopontine-Pontocerebellar tracts?
Convey info from cerebral cortex to cerebellum about intended motor actions
67
Frontal and parietal cortices are input for this descending brainstem tract
Corticopontine-Pontocerebellar tracts
68
What is the input for the Corticopontine-Pontocerebellar tracts?
Frontal and parietal cortices
69
The cerebellum receives information from the Pontocerebellar tract via this structure
Middle cerebellar peduncle
70
The cerebellum receives information from the vestibular nuclei via this structure
Inferior cerebellar peduncle
71
Signs of damage involving this structure include ataxia, disruptions in motor planning, decomposition of movement, balance difficulties, language difficulties, and dysmetria
Cerebellum
72
The point-to-point reaching movements test is used to assess the function of this structure
Cerebellum
73
Brainstem pathway that functions in voluntary movement, especially flexion in upper extremities
Rubrospinal
74
What is the function of the rubrospinal tract?
Mediation of voluntary movement, especially flexion in upper extremities
75
Lesions in this pathway result in decorticate/flexor posture
Rubrospinal
76
Lesions in the Rubrospinal pathway result in this posture
Decorticate/flexor posture
77
In non-human primates, this pathway can take on much of the role of the corticospinal tract
Rubrospinal
78
Brainstem pathway that functions in descending motor control involved in posture and locomotion
Reticulospinal
79
What is the function of the Reticulospinal pathway?
Descending motor control involved in posture and locomotion
80
Lesions in this pathway result in decerebrate/extensor rigidity
Reticulospinal
81
Lesions in the reticulospinal pathway result in this posture
Decerebrate/extensor rigidity
82
Lesions in this pathway result in deficits in orienting response
Tectospinal
83
Brainstem pathway that is a bundle of ascending and descending fibers connecting CN’s associated with eye movements (III, IV, and VI), gaze centers in the frontal cortex (Frontal Eye Fields) and vestibular system to coordinated eye and head movements
Medial longitudinal fasciculus
84
Lesions in this brainstem pathway results in internuclear opthalmoplegia
Medial longitudinal fasciculus
85
Lesions in the Medial longitudinal fasciculus result in this
Internuclear opthalmoplegia
(commonly a product of demyelination as a result of MS)
86
Respiratory areas within these two structures control the respiration rate based on feedback from both mechanoreceptors and chemoreceptors which monitor lung inflation, and carbon dioxide levels (respectively)
Medulla and pons
87
The central pattern generator of respiration consists of these 3 structures
Dorsolateral pons
Nucleus of the solitary tract (NTS)
Ventrolateral medulla
88
Component of the central pattern generator that relays information from peripheral chemoreceptors and mechanoreceptors
Nucleus of the solitary tract (NTS)
89
Component of the central pattern generator that controls activity of inspiratory or expiratory motor neurons (ventral respiratory column)
Ventrolateral medulla
90
Does the dorsal or ventral respiratory group control the basic rhythm of breathing?
Dorsal
91
Does the dorsal or ventral respiratory group cycle the respiratory system to engage in active expiration
Ventral
92
The apneustic center is located in this structure
Within the lower pons
93
This center sends signals to the inspiratory center within the dorsal respiratory group to prolong inhalations
Apneustic center
94
This pattern of breathing involves long inspirations (30s+) followed by short, insufficient expirations
Seen when there is brainstem damage
Apneustic breathing pattern
95
What is the apneustic breathing pattern?
Long inspirations 30s+ followed by short, insufficient expirations
96
The apneustic center sends signals to this, to prolong inhalations
Inspiratory center within the dorsal respiratory group
97
The apneustic center sends signals that prolong this
Inhalations
98
Apneustic breathing pattern (long inspirations, short expirations) is seen when there is brainstem damage that has separated these two centers
Pneumotaxic center from the apneustic center
99
The pneumotaxic center is located in this structure
Within the upper pons
100
Is the apneustic center within the upper or lower pons?
Lower
101
Is the pneumotaxic center within the upper or lower pons?
Upper
102
This center switches off inspiration activity
Pneumotaxic center
103
This is antagonist to the apneustic breathing center
Pneumotaxic center
104
The main function of this center is to control lung inflation and respiratory rate by cycling into expiration
Pneumotaxic center
105
Direct damage to this structure results in an increased depth of respiration and decrease in respiratory rate
Pneumotaxic center
106
Does the apneustic or pneumotaxic center prolong inhalations?
Apneustic
107
Does the apneustic or pneumotaxic center switch off inspiration activity?
Pneumotaxic
108
Reflex that is initiated by increasing lung inhalation rate and/or volume
Mechanooreceptors detect lung stretch, and inhibit further inspiration to prevent over-inflation of the lungs
Hering-Breur Reflex
109
What is the Hering-Breur Reflex?
Is initiated by increasing lung inflation rate and/or volume
Inhibits further inspiration to prevent over-inflation of the lungs
110
The reticular formation is involved in cardiovascular control and provides output to this nerve
CNX
111
The reticular formation regulates sleep and consciousness via activating connections to this structure that are used to maintain levels of alertness and sleep
Thalamus
112
This pathway is the origin of the descending analgesic pathways back down to the spinal cord to "close the gate" on ascending pain information
Reticular spinal pathway
113
At the level of the brainstem, this structure can function as a filter blocking repetitive, meaningless or distracting stimuli from cortical processing
Reticular formation
114
The superior and inferior colliculus are found on the dorsal surface of this structure
Midbrain
115
Cerebral peduncles and interpeduncular fossa are on the ventral surface of this
Midbrain
116
4th ventricle is on the dorsal surface of this
Pons
117
Structure with a shallow basilar sulcus
(contrast to deeper interpeduncular fossa in midbrain or anterior median fissure in medulla)
Pons
118
Shallow basilar sulcus is found on this structure
Pons
119
Deeper interpeduncular fossa is found on this structure
Midbrain
120
Anterior median fissure is found on the ventral surface of this structure
Medulla
121
The anterior median fissure is found on the ventral or dorsal surface of the medulla?
Ventral
122
Pyramids and olives are found on the ventral surface of this
Medulla
123
Pyramids and olives are found on the ventral or dorsal surface of the medulla?
Ventral
124
Nucleus gracilis and cuneatus are found on the dorsal surface of this
Medulla
125
Nucleus gracilis and cuneatus are found on the ventral or dorsal surface of the medulla?
Dorsal
126
Does the 4th ventricle (on the dorsal surface of the pons) narrow rostrally or caudally?
Rostrally
127
Does the anterior median fissure on the medulla narrow rostrally or caudally?
Caudally
(blends into spinal cord)
128
This structure becomes shallower as the medulla blends caudally into the spinal cord
Anterior median fissure
129
What is the somatotopic organization of the dorsal columns?
Arms lateral, legs medial
(caudal body parts (sacral and lumbar) are represented medially; rostral segments (upper thoracic and cervical) represented laterally)
130
What is the somatotopic organization of the medial lemniscus within the medullary segment?
Arms dorsal, legs ventral
131
What is the somatotopic organization of the medial lemniscus within the pontine portion?
Arms medial, legs lateral
132
What is the somatotopic organization of the medial lemniscus within the midbrain portion?
Arms ventral, legs dorsal
133
Does lesion of the dorsal column result in ipsilesional or contralesional hypesthesia?
Ipsilesional
134
Does lesion of the 2nd order medial lemniscus result in ipsilesional or contralesional hypesthesia?
Contralesional
135
The change of first order to second order neurons of this ascending pathway leads to change in name and tract
Dorsal columns to Medial Lemniscus
136
The change from spinal cord to brainstem of this ascending pathway results in name change only
Spinothalamic to Spinal Lemniscus
137
1st order neurons of the trigeminal lemniscus enter the brainstem at the level of this structure
Pons
138
1st order neurons from the CNV ganglion descend after entering the pons, forming this tract
Spinal trigeminal tract
139
1st order neurons from the CNV ganglion descend after entering the pons, forming the spinal trigeminal tract, and synapsing here
In the spinal trigeminal complex
140
Term describing deficits in pain and temperature sensation
Hypalgesia
141
Lesions within the upper corticospinal tract result in this
Spastic paresis (UMN disease)
Contralesional deficit
142
Lesions within the lateral corticospinal tract result in this
Ipsilateral deficit in movements
143
Lesions within the lower motor neuron of the corticospinal tract result in this
Ipsilateral flaccid paralysis
144
Lesions to the Corticopontine-Pontocerebellar tracts result in this
Cerebellar signs
145
Lesions in this tract can result in ataxia and postural instability
Vestibulospinal
146
Neurons in this location can exert voluntary control of respiration
Motor cortex or the cerebrum
147
Central chemoreceptors are used to detect this
Hypercapnia
148
These are used to detect hypercapnia
Central chemoreceptors
149
Central chemoreceptors detect hypercapnia and are located here
Ventrolateral surface of medulla
150
This tract relays optic and vestibular information to the cerebellum for motor coordination
Reticulospinal
151
This tract connects the CPGs used in breathing and swallowing to lower motor units
Reticulospinal
152
paralysis of one limb (usually lower)
monoplegia
153
paralysis of both limbs on one side
Hemiplegia
154
paralysis of both lower limbs
Paraplegia
155
paralysis of all four limbs
Quadriplegia
156
impaired ability to perceive pain and temperature
Hypalgesia
157
impaired ability to perceive proprioception, vibratory, and tactile stimuli
Hypesthesia
158
increased muscle tone due to upper motor neuron lesion
Spastic paralysis/paresis
159
decreased muscle tone due to lower motor neuron lesion
Flaccid paralysis/paresis
160
Term that describes eyes look towards the side of weakness
Wrong way eyes
161
drooping eyelid due to paralysis of levator palpebrae superioris muscle (damage to CNIII, somatic motor)
Ptosis, voluntary
162
drooping eyelid due to paralysis of the sympathetic innervation of superior tarsal muscle (damage to spinal cord, sympathetic chain or brainstem, visceral motor)
Ptosis, involuntary
163
no medial movement of eye, stays in ‘down and out’ position (damage to CNIII)
Lateral strabismus
164
no lateral movement of eye, stays in medial position (damage to CNVI)
Medial strabismus
165
Lateral strabismus occurs due to damage of this nerve
CN III
166
Medial strabismus occurs due to damage of this nerve
CN VI
167
Diplopia with near vision is due to damage to this nerve
CN III
168
Diplopia with far vision is due to damage to this nerve
CN VI
169
Contricted pupil
Loss of sympathetic
Miosis
170
Dilated pupil
Lesion of Edwest or CN III - parasympathetic
Mydriasis
171
Is Miosis or Mydriasis due to loss of sympathetic?
Miosis (contricted pupil)
172
Is Miosis or Mydriasis due to loss of parasympathetic?
Mydriasis (dilated pupil)
(lesion of Edwest or CN III)
173
Retraction of eye within orbit due to loss of sympathetic
Enophthalmos
174
Enophthalmos is retraction of eye within orbit due to loss of this
Sympathetics
175
Dysphagia is due to damage or any of these 3 structures
Nucleus ambiguous
CN IX or CN X
176
Dysphonia is due to damage of either of these
Nucleus ambiguous or CN X
177
Lack of sweating on face due to loss of sympathetics
Anhidrosis
178
Crossed signs is weakness on one side of face and opposite side of body, and indicates involvement of this
Brainstem
179
Cranial nerve abnormalities could indicate involvement of this
Brainstem
180
These are symptoms of damage to this structure:
Third nerve palsy
Pupil dilation
Ataxia
Flexor posturing
Impaired consciousness
Midbrain
181
These are symptoms of damage to this structure:
Vertigo
Ataxia
Nystagmus
Nausea/vomiting
Respiratory tract
Autonomic instability
Hiccups
Medulla
182
These are symptoms of damage to this structure:
Bilateral babinski
Generalized weakness
Perioral numbness
Facial tingling
Bilateral upper or lower visual loss or blurring
Irregular breathing
Ocular bobbing
Shivering
Palatal myoclonus
Abducens palsy
Horizontal gaze palsy
Bilateral small but responsive pupils
Extensor posturing
Impaired consciousness
Pons
183
Lesion known as a “crossed” or “alternating” hemiplegia, as the body is affected on the opposite side of the lesion, but there are also cranial nerve deficits on the same side of the lesion
Medial medullary syndrome
184
Classical lesion involving:
Contralateral hemiplegia or hemiparesis
Contralateral hypesthesia
Ipsilesional tongue deviation
Medial medullary syndrome
185
Contralateral hemiplegia or hemiparesis is seen in Medial medullary syndrome due to damage of this tract
Corticospinal
186
Contralateral hypesthesia is seen in Medial medullary syndrome due to damage of this tract
Medial lemniscus
187
In Medial medullary syndrome, the tongue deviates toward the side of the lesion due to damage to this
Ipsilesional hypoglossal nerve
188
Classical lesion involving:
Contralesional hypalgesia of the body
Ipsilesional hypalgesia of the face
Dysphagia and dysphonia
Ipsilesional Horner’s syndrome
Ipsilesional ataxia
Vertigo
Lateral medullary syndrome (Wallenberg's)
189
Contralesional hypalgesia of the body is seen in Lateral medullary syndrome (Wallenberg’s) due to damage to this tract
Spinal lemniscus
190
Ipsilesional hypalgesia of the face is seen in Lateral medullary syndrome (Wallenberg’s) due to damage to this tract
Trigeminospinal tract
191
Dysphagia and dysphonia are seen in Lateral medullary syndrome (Wallenberg’s) due to damage to this
Nucleus ambiguous
192
Ipsilesional ataxia is seen in Lateral medullary syndrome (Wallenberg’s) due to infarction of this structure
Inferior cerebellar peduncle
193
Vertigo is seen in Lateral medullary syndrome (Wallenberg’s) due to infarction of this structure
Vestibular nuclei
194
In Lateral medullary syndrome (Wallenberg’s), does damage to the spinal lemniscus result in ipsilesional or contralesional hypalgesia of the body?
Contralesional
195
In Lateral medullary syndrome (Wallenberg’s), does damage to the trigeminospinal tract result in ipsilesional or contralesional hypalgesia of the face?
Ipsilesional
196
As territory affected by classical lesion moves dorsally, contralateral deficits in proprioception are due to this tract
Medial lemniscus
197
As territory affected by classical lesion moves dorsally, ipsilesional face weakness is due to this
Facial nucleus
198
As territory affected by classical lesion moves dorsally, ipsilesional horizontal gaze palsy is due to this
Abducens nucleus
199
Classical lesion involving:
Contralateral hemiplegia or hemiparesis (face and body)
Ipsilesional CN III palsy
Weber's syndrome
200
Contralateral hemiplegia or hemiparesis (face and body) is seen in Weber's syndrome due to damage of these two fibers in the cerebral peduncle
Corticospinal and Corticobulbar
201
Ipsilesional CN III palsy involves lateral strabismus, ptosis and mydriasis, and is seen in this classical lesion
Weber's syndrome
