Exam 1: Brainstem 1: Introduction and Medulla + CN nuclei origins for medulla and pons Flashcards
What is meant by the terms “modality” and “neuromodulation”?
Modality:
1) the method of application of a therapeutic agent or regimen.
2) a sensory entity, such as the sense of vision or taste.
Neuromodulation:
controlled stimulation of the peripheral or central nervous system with electricity.
In broad terms, how are motion and balance regulated by the CNS?
What about the autonomic nervous system?
motion and balance are regulated by the CNS:
I am not sure what she expected us to answer for this slide? If you know you want to shoot me a message so I can update this? Thanks!
motion and balance are regulated by the ANS:
I am not sure what she expected us to answer for this slide? If you know you want to shoot me a message so I can update this? Thanks!
MOTOR Basic Circuitry: There are ___ Neuron Pathways
And where is each motor neuron located and their pathways?
MOTOR Basic Circuitry: 2 Neuron Pathways
N1:
The upper motor neuron (UMN) is located in the precentral gyrus (motor cortex) and runs to the lower motor neuron
N2:
The lower motor neuron (LMN) is in the contralateral spinal cord and runs to the skeletal muscle

The upper motor neuron (UMN) pathway decussates to the contralateral side in the _____ _____, then travels through the _____ _____ tracts until reaching the lower motor neurons (LMN).
The upper motor neuron (UMN) pathway decussates to the contralateral side in the pyamidal descussation, then travels through the lateral corticospinal tracts until reaching the lower motor neurons.

2 Feedback Loops Involved in Modulation of the Motor System:
1) Cortex → ___ → ___ → ___ → Cortex
2) Cortex → ___ → ___ → Cortex
2 Feedback Loops Involved in Modulation of the Motor System:
1) Cortex → Pons → Cerebellum → Thalamus → Cortex
2) Cortex → Basal Ganglia → Thalamus → Cortex

SENSORY Basic Circuitry: There are ___ Neuron Pathways
And where is each sensory neuron located and their pathways?
SENSORY Basic Circuitry: 3 Neuron Pathways
1ºsensory neuron
is the peripheral ganglion
2__º sensory neuron
is in the spinal cord, where the axons then move contralaterally before exiting the spinal cord
3º sensory neuron
is in the thalamus

Integration and Relay of Sensory Input is done through the _____
Integration and Relay of Sensory Input is done through the thalamus

Ipsilateral
same side
Contralateral
Opposite side
Cerebrum = _____ + _____
Cerebrum = Telencephalon + Diencephalon
Cerebral Hemisphere = _____ + _____ _____
Cerebral Hemisphere = Telencephalon + Lateral ventricles
Telencephalon = _____ _____ + _____ _____ + _____ _____
Telencephalon = Cerebral cortex + White matter + Basal nuclei
Brain =
Forebrain ( _____ and _____ )
+ Midbrain
+ Hindbrain ( _____, _____, and _____ _____ )
Brain =
Forebrain ( cerebrum and diencephalon )
+ Midbrain
+ Hindbrain ( cerebellum, pons, and medulla oblongata)
Brainstem = _____, _____, and _____ _____
Brainstem = Midbrain, pons, and medulla oblongata

Identify the stucture

Brainstem
*** The attached image is a good image to use to study all of the landmarks on the medial view of the brain ***

What are 3 functions of the brainstem?
The brainstem:
1) Conduit between spinal cord and brain
2) Reflex centers for breathing, cardiovascular, and consciousness
3) Location of cranial nerve nuclei (gray matter)*, reticular formation, nuclei for long tracts, and nuclei that connect to the cerebellum
*(most of, but not all)
The brainstem is:
a conduit between _____ _____ and _____ (therefore, contains _____ matter fibers of both _____ and _____ pathways.
the location of important _____
The brainstem is:
is a conduit between spinal cord and brain (therefore, contains white matter fibers of both afferent and efferent pathways
It is location of important decussations
The brainstem contains:
Reflex centers for_____, _____, and _____
and is evolutionarily the most _____ part of the human brain.
How is the cerebral cortex different?
The brainstem contains:
Reflex centers for breathing, cardiovascular, and consciousness
and is evolutionarily the most conservative part of the human brain.
[translation: human brainstem structure is still much like that of a lizard or a sheep.]
The human cerebral cortex is unique!
Identify the main components of the brainstem
Identify A
Identify B
Identify C

Identify the main components of the brainstem
A is reticular formation
B are cranial nerves
C are long tracts

Indentify the landmarks on the developing brainstem:
Identify A
Identify B

Indentify the landmarks on the developing brainstem:
A is Somatic motor nuclei
B is Somatic motor: GSE (hypoglossal nucleus)

Indentify the landmarks on the developing brainstem:
Identify A
Identify B
Identify C

Indentify the landmarks on the developing brainstem:
A is Visceral motor nuclei
B is Parasympathetic: GVE (dorsal motor nucleus of CN X)
C is Branchial motor: SVE (nucleus ambiguus)

Indentify the landmarks on the developing brainstem:
Identify A
Identify B

Indentify the landmarks on the developing brainstem:
A is Visceral sensory nuclei
B is Visceral sensory: SVA and GVA (nucleus solitarius)

Indentify the landmarks on the developing brainstem:
Identify A
Identify B
Identify C

Indentify the landmarks on the developing brainstem:
A is Somatic sensory nuclei
B is Special somatic sensory: SSA (vestibular nuclei)
C is General somatic sensory: GSA (spinal trigeminal nucleus)

Identify the landmark on the devoloping brainstem:
Identify A

Identify the landmark on the devoloping brainstem:
A is Sulcus limitans

Identify the landmark on the devoloping brainstem:
Identify A

Identify the landmark on the devoloping brainstem:
A is an Inferior olivary nuclei
***They are a landmark that shows you are in the medulla!***
The inferior olivary nucleus consists of a gray folded lamina arranged in the form of an incomplete capsule, opening medially by an aperture called the hilum.

Paired sets of nuclei:
CN nuclei ( ___ through ___)
_____ formation
Nuclei associated with _____ tracts
Nuclei associated with _____ circuitry
Paired sets of nuclei:
CN nuclei ( III through XII )
Reticular formation
Nuclei associated with long tracts
Nuclei associated with cerebellar circuitry

Which Cranial Nerves have nuclei located between several regions of the brainstem?
VII (Facial)
VIII (Vestibulocochlear)

Be able to identify the nuclei where the Cranial Nerves originates, and their positions (related to each other and the landmarks on the brainstem).
*This slide is just for self study, as an overview. Their are also individual cards made for each of the 19 main nuclei shown on the left image attached, included later in this deck of cards.

Be able to identify the nuclei where the Cranial Nerves originate and their positions (related to each other and the landmarks on the brainstem).
*This slide is just for self study, as an overview. Their are also individual cards made for each of the 19 main nuclei shown on the left image included in this deck of cards.

Identify the nucleus
Which Cranial Nerves originate at this nucleus?

Edinger-Westphal nucleus
(GVE: CN III)
Identify the nucleus
Which Cranial Nerves originate at this nucleus?

Oculomotor nucleus
(GSE: CN III)
Identify the nucleus
Which Cranial Nerves originate at this nucleus?

Trochlear nucleus
(GSE: CN IV)
Identify the nucleus
Which Cranial Nerves originate at this nucleus?

Trigeminal motor nucleus
(GSE: CN V)
Identify the nucleus
Which Cranial Nerves originate at this nucleus?

Superior salivatory nucleus
(GVE: CN VII)
Identify the nucleus
Which Cranial Nerves originate at this nucleus?

Facial nucleus
(SVE: CN VII)
Identify the nucleus
Which Cranial Nerves originate at this nucleus?

Abducens nucleus
(GSE: CN VI)
Identify the nucleus
Which Cranial Nerves originate at this nucleus?

Inferior salivatory nucleus
(GVE: CN IX)
Identify the nucleus
Which Cranial Nerves originate at this nucleus?

Nucleus ambiguus
(SVE: CN IX, X)
Identify the nucleus
Which Cranial Nerves originate at this nucleus?

Hypoglossal nucleus
(GSE: CN XII)
Identify the nucleus
Which Cranial Nerves originate at this nucleus?

Dorsal motor nucleus of CN X
(GVE: CN X)
Identify the nucleus
Which Cranial Nerves originate at this nucleus?

Spinal accessory nucleus
(SVE: CN XI)
Identify the nucleus
Which Cranial Nerves originate at this nucleus?

Trigeminal nuclei
(GSA: CN V, VII, IX, X)
&
Mesencephalic nucleus of CN V
Identify the nucleus
Which Cranial Nerves originate at this nucleus?

Chief sensory nucleus of CN V
(GSA: CN V)
Identify the nucleus
Which Cranial Nerves originate at this nucleus?

Spinal trigeminal nucleus
(GSA: CN V, VII, IX, X)
Identify the nucleus
Which Cranial Nerves originate at this nucleus?

Vestibular nuclei
(SSA: CN VIII)
Identify the nucleus
Which Cranial Nerves originate at this nucleus?

Dorsal and ventral cochlear nuclei
(SSA: CN VIII)
Identify the nucleus
Which Cranial Nerves originate at this nucleus?

nucleus solitarius, rostral portion
(SVA: CN VII, IX, X)
Identify the nucleus
Which Cranial Nerves originate at this nucleus?

nucleus solitarius, caudal portion
(GVA: CN IX, X)
What are the efferent cranial nerves nuclei that are located in the medulla?
Hypoglossal (XII)
Dorsal motor of vagus (X)
*Inferior salivitory (IX)
**Nucleus ambiguus (IX, X)
*parasympathetics to ottic ganglion; medial to N. ambiguous so difficult to see in cross sections)
**1 nucleus (Nucleus ambiguus) shares neurons! They arelower motor neurons, upper motor neurons usually come from the cerebral cortex)
What are the afferent cranial nerves nuclei that are located in the medulla?
*Solitary (VII, IX, X)
Vestibular (VIII, n=4**)
Cochlear (VIII, ventral and dorsal)
Trigeminal (spinal)
*The solitary nucleus has a rostral portion (gustatory) which has taste sensations in CN VII, IX, and X. It also has a caudal portion which has inputs for control of cardiorespiratory and digestive functions
**Vestibular nucleus is a complex of 4 nuclei
Other important nuclei in the medulla:
_____ formation nuclei
_____ tract nuclei
_____ pathways
Other important nuclei in the medulla:
Reticular formation nuclei
Long tract nuclei
Cerebellar pathways
Long tract nuclei in the medulla:
Nucleus _____: receives 1st-order somatosensory input from _____ gracilis in dorsal column of spinal cord)
Nucleus _____: receives 1st-order somatosensory input from _____ cuneatus in dorsal column of spinal cord)
Long tract nuclei in the medulla:
Nucleus gracilis: receives 1st-order somatosensory input from fasiculus gracilis in dorsal column of spinal cord)
Nucleus cuneatus: receives 1st-order somatosensory input from fasiculus cuneatus in dorsal column of spinal cord)
Cerebellar pathways in the medulla:
_____ _____ nucleus
_____ _____ nucleus
Cerebellar pathways in the medulla:
Accessory cuneate nucleus
Inferior olivary nucleus
Identify which cranial nerve exits at this location of the medulla

Roots of trigeminal nerve (CN V)
Identify which cranial nerve exits at this location of the medulla

Abducent nerve (CN VI)
Identify which cranial nerve exits at this location of the medulla

Motor root of facial nerve (CN VII)
Identify which cranial nerve exits at this location of the medulla

Sensory root of facial nerve (CN VII)
Identify which cranial nerve exits at this location of the medulla

Vestibulocochlear nerve (CN VIII)
Identify which cranial nerve exits at this location of the medulla

Glossopharyngeal nerve (CN IX)
Identify which cranial nerve exits at this location of the medulla

Roots of vagus nerve (CN X)
Identify which cranial nerve exits at this location of the medulla

Hypoglossal nerve (CN XII)
Identify which cranial nerve exits at this location of the medulla

Accessory nerve (CN XI)
Identify which cranial nerve exits at this location of the medulla

Cranial roots of accessory nerve (CN XI)
Identify which cranial nerve exits at this location of the medulla

Spinal roots of accessory nerve (CN XI)
Caudal (“Closed”) Medulla:
Level of _____ Decussation (roughly 90% of _____ corticospinal tract fibers)
Nucleus g____ and nucleus c____
Spinal nucleus of trigeminal nerve (_____ and _____ of CN V)
Level of Medial _____ _____ (sensory pathways to _____ from nucleus gracilis/cuneatus)
Accessory cuneate nucleus (input from _____ _____ and _____ _____ organs)
Caudal (“Closed”) Medulla:
Level of Pyramidal Decussation (roughly 90% of lateral corticospinal tract fibers)
Nucleus gracilis and nucleus cuneatus
Spinal nucleus of trigeminal nerve (pain and temperature of CN V)
Level of Medial Lemniscus Decussation (sensory pathways to thalamus from nucleus gracilis/cuneatus)
Accessory cuneate nucleus (input from muscles spindles and Golgi tendon organs)

Rostral “Open” Medulla:
Cranial nerve nuclei (in addition to _____ of CN V)
_____ tracts (descending fibers) and _____ _____ _____ (MLF; descending and ascending fibers) (both associated with _____ _____ based on visual inputs)
_____ olivary nuclei (inputs from _____ and _____ nucleus of midbrain, outputs to _____; coordination of _____ input to allow for _____ _____)
Rostral “Open” Medulla:
Cranial nerve nuclei (in addition to spinal nucleus of CN V)
Tectospinal tracts (descending fibers) and medial longitudinal fasiculus (MLF; descending and ascending fibers) (both associated with head orientation based on visual inputs)
Inferior olivary nuclei (inputs from spine and red nucleus of midbrain, outputs to cerebellum; coordination of sensory input to allow for smooth movements)

The level of the Pyramidal Decussation is found in the _____ (“_____”) Medulla, and is roughly 90% of _____ _____ tract fibers
The level of the Pyramidal Decussation is found in the Caudal (“Closed”) Medulla, and is roughly 90% of lateral corticospinal tract fibers

The Nucleus gracilis and nucleus cuneatus are found in the _____(“_____”) Medulla
The Nucleus gracilis and nucleus cuneatus are found in the Caudal (“Closed”) Medulla

Spinal nucleus of trigeminal nerve (_____ and _____ of CN V) is found in the _____ (“_____”) Medulla
Spinal nucleus of trigeminal nerve (pain and temperature of CN V) is found in the Caudal (“Closed”) Medulla

The level of the Medial Lemniscus Decussation (sensory pathways to _____ from nucleus _____/_____) is found in the _____ (“_____”) Medulla
The level of the Medial Lemniscus Decussation (sensory pathways to thalamus from nucleus gracilis/cuneatus) is found in the Caudal (“Closed”) Medulla

The accessory cuneate nucleus (input from _____ _____ and _____ _____ organs) is found in the _____ (“_____”) Medulla
The accessory cuneate nucleus (input from muscles spindles and Golgi tendon organs) is found in the Caudal (“Closed”) Medulla

Cranial nerve nuclei (in addition to _____ nucleus of CN V) are found in the _____ (“_____”) Medulla
Cranial nerve nuclei (in addition to spinal nucleus of CN V) are found in the Rostral (“Open”) Medulla

Tectospinal tracts (_____ fibers) and medial longitudinal fasiculus (MLF; _____ and _____ fibers) are found in the _____ (“_____”) Medulla
*Both associated with _____ _____ based on visual inputs
Tectospinal tracts (descending fibers) and medial longitudinal fasiculus (MLF; descending and ascending fibers) are found in the Rostral (“Open”) Medulla
*Both associated with head orientation based on visual inputs

Inferior olivary nuclei (inputs from _____ and _____ nucleus of midbrain, outputs to _____; coordination of sensory input to allow for _____ _____) are found in the _____ (“_____”) Medulla
Inferior olivary nuclei (inputs from spine and red nucleus of midbrain, outputs to cerebellum; coordination of sensory input to allow for smooth movements) are found in the Rostral (“Open”) Medulla
