Ch. 15: Brain Stem Flashcards
1
Q
4 D’s of Brainstem dysfunction
A
- Dysphagia (IX, X)
- Dysmetria (spinocerebellum)
- Dysarthria (V, VII, X, XII)
- Diplopia (III, IV, VI)
2
Q
Medulla
A
External
- Anterior: Pyramids
- CN Roots IX, X, XI, XII
- Dorsal: sensory tracts
Internal
- Ant: corticospinal tracts, medial lemniscus
- Post: spinothalamic tract, trigeminothalamic tract, reticular formation, autonomic control nuclei, CN nuclei IX, X, XII
3
Q
Pons
A
External
- ventral: bulge, CN Roots (V, VI, VII, VIII)
- Dorsal: cerebellar peduncles
Internal
- Basilar: corticospinal pontine nuclei, corticobrainstem tract
- Tegmentum: med lemniscus, spinothalamic tracts, trigeminothalamic tracts, autonomica control nuclei, CN nuclei (V, VI, VII, VIII)
4
Q
Midbrain
A
External
- ventral: cerebral peduncles, CN root III
- Dorsal: sup/inf colliculi, CN root IV
Internal
- basilar: cerebral peduncles, substantia nigra
- Tegmentum: red nucleus, pedunculopontine nucleus, occulomotor complex (III, IV), periaqueductal grey
- Tectum: sup/inf colliculi
5
Q
Brainstem Divisions
A
- Medulla, Pons, Midbrain
- Base, Tegmentum (sensory), Tectum (colliculi)
6
Q
Reticular formation
A
- cluster of cells down core of midbrain
- integrate sensory and cortical info
- regulate somatic motor, autonomic function and consciousness
- modify nociception info (level III)
- output: everywhere
7
Q
Reticular formation: role in sensation and cortical integration
A
- strong connection to basal ganglia
- help motor planning
- produce antidepressant NT (Serotonin)
- regulate mood
8
Q
Reticular formation: role in pain modulation
A
- level III pain control via connections to ventral horn
- (presynaptic inhibition from above, turned on by level IV)
9
Q
reticula formation: role in somatic, autonomic, and consciousness reg
A
- Motor: nonspecific activating tracts–>general excitability
- Autonom: part of pons/medulla involved in autonomic control
- consciousness: regulate consciousness and arousal and sleep wake cycles
10
Q
Reticular Formation output
A
- everywhere
- cortex, subcortex, b stem, s cord, cerebellum
11
Q
Cerebellum
A
- coordinate movement (gross/fine)
- motor planning with BG (direction, timing, rhythm, speed)
- cognitive function: mediate shift in attention
12
Q
Segmental S/Sx
A
- CN damage
- LMN S/Sx
- Ipsilateral
13
Q
Most 1-sided brainstem damage–>
A
- CN S/Sx ipsilateral (LMN)
- Contralat body (UMN)
14
Q
Disorders of Brainstem from:
A
- ischemia (stroke)
- compression (tumor/CSF)
- segmental damage=CN damage
15
Q
Vertical Tract Damage
A
- contralateral S/Sx (UMN)
- damage to DC/ML, Spinothalamic, corticospinal tracts
16
Q
One-sided brain stem damage–>
A
- Corticospinal tract: contralat paralysis limbs/trunk (UMN)
- ML: loss contralat sensatoin
- CN: ipsilateral (LMN)
17
Q
Disorders of Vital Function
A
- damage to cardiovascular and respiratory control centers in medulla
- one side damage to pons/medulla=ipsilateral S/Sx
Ex. Horner’s Syndrome
