Exam IV- BrainStem Flashcards

1
Q

What is the name for the more ventral portion of the brainstem?

A

The basilar region

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2
Q

What is the more posterior/dorsal region of the brainstem?

A

The tegmentum

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3
Q

What is posterior to the cerebral aqueduct in the midbrain?

A

The tectum

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4
Q

Where is the reticular formation in the brainstem?

A

The tegmentum area (dorsal portion of midbrain, pons, & medulla)

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5
Q

Where will I find Ascending pathways in the brainstem?

A

The tegmentum, makes sense because sensory is always dorsal

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6
Q

Where will I find Descending pathways in the brainstem?

A

The basilar region, makes sense because motor is always ventral

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7
Q

Where do the spinalThalamic ascending pathways cross?

A

The spinal cord, by the time we get to the brainstem they are crossed.

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8
Q

Where does the DC-ML ascending pathway cross?

A

The medulla

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9
Q

What does DC-ML stand for? What is its function?

A

Dorsal Column-Medial Lemniscal, fine touch and conscious proproception from the body

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10
Q

What is the function of the Trigeminal Lemniscal pathway?

A

Fine touch and conscious proprioception from the face

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11
Q

What is the function of the SpinoThalamic Pathway?

A

Pain and temperature from the body

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12
Q

What is the function of the Trigeminal Thalamic pathway?

A

Pain and temperature from the face

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13
Q

For the ascending pathways, what is the result of a lesion BELOW the decussation?

A

An IPSIlateral deficit

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14
Q

For the ascending pathways, what is the result of a lesion ABOVE the decussation?

A

CONTRAlateral deficit

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15
Q

For the ascending pathways what is the result of a lesion AT the decussation?

A

BIlateral deficit

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16
Q

What is the main function of the rostral portion of the Reticular Formation? What is the fancy science name of this portion?

A

Alertness, like the alarm clock!…PontoMesencaphalic

17
Q

What is the main function of the caudal portion of the Reticular Formation? Whats the fancy scientific name for this portion?

A

Vital Functions….PontoMedullary

18
Q

What is the name of the system that regulates alertness, sleep/wake, consciousness in the rostral reticular formation?

A

(ARAS) Ascending Reticular Activating System

19
Q

What is a classic result of a lesion to the Rostral Reticular Formation?

A

A coma

20
Q

What are the 5 N.T.s associated with the Rostral Reticular Formation? What is a main fxn of each?

A
  1. Ach(alertness,memory) 2.NorEpi(alertness,mood) 3.Dopamine(movement,initiative,memory) 4.Seratonin(mood) 5. Histamine(alertness)
21
Q

What are the four main inputs to the Rostral Reticular Formation? Think of reasons you can’t sleep :)

A

1.Fronto-Parietal Assoc. Cortices (Thinking too much in bed)2. Limbic&Cingulate Cortices 3.Thalamus 4. SpinoReticular Tract(part of Spinothalamic System CANT SLEEP W PAIN/Temperature)

22
Q

What are the 6 main functions of the Caudal Reticular formation?

A
  1. Respiration 2. Heart Rate 3. Blood Pressure Regulation 4. Descending Motor Control 5. C.N. Reflexes 6. LOTS of Involuntary movements (coughing, hiccups…)
23
Q

What are the 6 brainstem lesions we discussed?

A

1.INFERIOR Alternating Hemi-Ple-Gia 2.Wallenberg’s Syndrome 3.Acoustic Neuroma 4. MIDDLE Alternating Hemi-Ple-Gia 5. Trigeminal Alternating Hemi-Ple-Gia 6. SUPERIOR Alternating Hemi-Pel-Gia (Weber’s)

24
Q

Where is the source of Inferior Alternating Hemiplegia? What blood supply problem?

A

Source: AnterioMedial Medulla Blood: Anterior Spinal Artery

25
Q

What are the three main structures affected with Inferior Alternating Hemiplegia?

A
  1. Hypoglossal Nuc/Nerve 2. Pyramid 3. Medial Lemniscus
26
Q

What are 2 symptoms of Inferior Alternating Hemiplegia?

A
  1. IpsiLateral paralysis of tongue (towards side of lesion) 2.UMN=ContraLat sensory/motor loss (ABOVE DECUSS=CONTRA)
27
Q

Where is the source of Wallenberg’s Syndrome? What artery is the problem?

A

Where: Lateral Lesion of medulla Blood: PICA

28
Q

What are 3 main symptoms of Wallenberg’s syndrome?

A
  1. Loss of pain and temperature 2. Difficulty swallowing 3. DIZZINESS!! main one!!!
29
Q

Where is the source of an Acoustic Neuroma (Schwannoma)?

A

The cerebellaponitne angle (remember the picture!?). NO blood problem because its a tumor

30
Q

What are the CNs involved with Acoustic Neuroma? Since you know the CNs what are the symptoms?

A

7: Bell’s, HyperAccusis 8:Tinnitus, Nystagmus and if its big enough 5. Alternating Hemianesthesia

31
Q

Where is the source of a Middle (Abducens) Alternating HemiPlegia? What is the blood supply problem?

A

The Caudal Pons, branches of the Basilar Artery

32
Q

What are the 4 structures affected in the Middle(Abducens) Alternating HemiPelgia?

A
  1. VI (ABDUCENS) 2. VII 3.CorticoSpinal Tract 4. Medial Lemniscus
33
Q

What are the 4 main symptoms of MiddleA.H.? Think structures affected!

A
  1. IPSIlat adduction of eye (c/o VI being out) 2. Positive Babinski sign (c/o Cort.Spin.Tract) 3. Bell’s (VII) 4. CONTRA lat sensory loss (ML )
34
Q

Where is the problem with a Trigeminal Alternating Hemiplegia? Blood Supply?

A

Where: the Mid Pons BLOOD: Basilar Art

35
Q

How many structures are affected my Trigemninal AH? What are the 3 MAIN structures and what are some symptoms?

A

There are 7 freaking structures affected…..#1) V: Ipsilat BITE DOWN, SENSATION (all freaking over) #2)Ascending and #3)Descending Tracts: Body sensation and Motor

36
Q

Where is the problem with Weber’s Syndrome? (SUP A.H.) Blood Supply?

A

Where: The Midbrain BLOOD: Basilar Art., Post Cerebral Art

37
Q

What are the 3 structures involved in Superior AH/Weber’s? What are the LMN lesion signs? What are the UMN lesion signs?

A

III, CorticoSpinal, CorticoBulbar….LMN: Ptosis, Pupil Dilation, External Strabismus, Inability to move the eye in any of the III motor directions……UMN: pos babinski, CONTRAlat paralysis CONTRA lower face

38
Q

Which part of the face receives BILATERAL input from UMNs?

A

The UPPER part of the face

39
Q

Which part of the face receives CONTRALATERAL input from UMNs?

A

The LOWER part of the face