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Neuro Test 2 > Lecture 11 > Flashcards

Lecture 11 Flashcards

1
Q

What are the 3 longitudinal divisions of the brainstem?

A

Basilar - front

Tegmentum - middle

Tectum - back

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2
Q

The tectum is only found in the….

A

Midbrain

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3
Q

What does the tectum consist of?

A

Superior + inferior colliculus and pretectum

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4
Q

What is inside of the tegmentum

A

Reticular Formation

CN V nuclei

medial longitudinal fasciculus (coordinates head and eye mvmt)

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5
Q

What is inside of the basilar division?

A

descending axons from cerebral cortex, corticospinal, corticobrainstem, corticopontine, and corticoreticular tracts

Motor nuclei from substantia nigra, pons, and inferior olive

Basically a bunch of motor stuff (all tracts that start with cortico-)

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6
Q

What is in the basis pedunculi?

A

Cerebral peduncles

substantia niagra nucleus

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7
Q

What does the superior colliculus do?

A

motor and sensory info to orient head and eyes

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8
Q

What does the inferior colliculus do?

A

relays info from cochlear nerve to superior colliculus and thalamus

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9
Q

The pretectal area of the midbrain does what?

A

mediates eye reflexes

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10
Q

What kind of matter is the red nucleus made out of?

A

Gray matter

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11
Q

What cranial nerve nuclei are found in the midbrain tegmentum

A

3 and 4

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12
Q

What 2 tracts synapse in the pons? Most of the tracts do not

A

corticopontine tract- Synapse on pontine nuclei -> pontocerebellar fibers -> middle cerebellar peduncle -> synapse in contralateral cerebellar hemisphere

corticobrainstem tract - synapses with trigeminal motor nucleus and facial nucleus

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13
Q
A
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14
Q

What kind of fibers are in the superior cerebellar peduncle?

A

Sensory fibers

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15
Q

What can you find in the basilar portion of the pons?

A

Descending tracts- corticospinal, corticobrainstem, corticopontine

Pontine nuclei

Pontocerebellar axons

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16
Q

What can be found in the tegmentum of the Pons?

A

Sensory Tracts

Reticular Formation

Autonomic pathways

CN 5,6,7,8 nuclei

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17
Q

What cranial nerve nuclei exits between the pyramid and inferior olive?

A

CN 12

18
Q

What is the nucleus ambiguus for?

A

Motor output to swallowing/vocalization muscles

(Which would be CN 9, 10, 12)

19
Q

What is the only tract that enters the medulla from the cerebellum

(The rest enter medulla -> inferior cerebellar peduncle -> cerebellum)

A

Cerebellovestibular tract

20
Q

The DCML crosses in the inferior medulla ________ to the crossing of the corticospinal tract

A

Posterior

21
Q

The anterior inferior cerebellar artery supplies the _____ whereas the Posterior inferior cerebellar artery supplies the _______

A

Pons

Medulla

22
Q

What are the 4 brain stem tracts?

A

Rubrospinal Vestibulospinal Reticulospinal Tectospinal

23
Q

What are the general brain stem functions

A

Modulates conciousness

Regulates vital signs

Conveys signal from cortex to spinal cord

24
Q

What are the 4 cardinal signs of brain stem dysfunction? 4 Ds

A

Dysphagia, Dysarthria, diplopia, dysmetria

25
Q

Damage to brain stem could cause….

A

Heart to stop beating

BP to fluctuate

Breathing to stop

26
Q

Disorders of conciousness are due to damage of_______

A

Reticular activating formation/ reticular formation

People in vegetative or minimally concious states have loss of tissue in subcoritcal/thalamic/brainstem regions

27
Q

Anteriormedial midbrain syndrome (webers) is caused by….

A

Blockage of PCA or Basilar artery

28
Q

What are the primary structures affected by Anteromedial midbrain syndrome (webers)

A

Corticospinal tract- contralateral motor paralysis

Occulomotor nerve nucleus- Ipsilateral loss of eye movements. Paralysis of eyelid, dilated pupil

Red Nucleus- loss of motor coordination, ataxia, CONTRALATERAL, inappropriate laughing and crying. Lability

29
Q

What does CN3 palsy look like?

A

Eye deviated down and out

30
Q

Lateral inferior pontine syndrome is due to occlusion of the….

A

Anterior inferior cerebellar artery

31
Q

What are the clinical manifestations of lateral inferior pontine syndrome

What artery?

A

Cochlear nucleus- ipsilateral hearing loss

Vestibular nucleus affected- dysequilibrium, nausea, vomiting

Impaired descending sympathetic- ipsilateral Horner’s syndrome

Trigeminal nerve- ipsilateral pain and temp loss of face

Salivatory nucleus- decreased tears and salivation

Spinothalamic tract- contralateral pain and temperature sensation to body

Facial nerve- ipsilateral loss of facial muscles

Remember, Trigeminal, Facial, And Vestibulocochlear nerve are all on the pons and the pons is supplied blood by AICA

32
Q

Damage to what nerve causes Bell’s palsy

How will Bell’s palsy differ from a facial weakness after stroke

A

Facial nerve

Stroke is usually only lower facial weakness

(Upperface muscle preserved due to dual innervation of the upper face)

33
Q

What is Horner’s syndrome?

A

Miosis- pupil constricted

Ptosis- drooping eye lid

Anhidrosis- drying of skin in the area

Damage to sympathetic nerves

34
Q

Locked in syndrome is due to damage of the….

A

Basiliar artery impacting the ventral pons bilaterally

35
Q

What are the primary structures involved in locked in syndrome-

A

B corticospinal tracts- paralysis below the head

B corticobulbar tracts- paralysis of facial muscles

B abducens tracts- unable to move eyes to side

Note: most of the time cranial nerve 3 is preserved but sometimes its impacted

36
Q

What are spared in locked-in syndrome?

A

Reticular activating formation/ reticular formation

Vertical gaze centers are spared.

37
Q

Middle medullary syndrome is caused by a blockage in the ….

A

Anterior spinal artery

38
Q

What is the 2nd most common place to have a stroke in the brainstem?

A

AICA

39
Q

What are the primary structures affected by medial medullary syndrome

A

hypoglossal nerve- ipsilateral tongue protrusion

DCML- contralateral loss of DCML senses

Lateral corticospinal- contralateral hemiparesis

Remember the hypoglossal nerve comes off of the medial medulla!

40
Q

What is the most common brainstem stroke, and what artery causes it?

A

Lateral medullary syndrome (wallenberg)

Due to blockage of PICA

41
Q

What structures are affected due to Wallenberg syndrome (lateral medullary syndrome)

A

Vagus nerve/Solitary nucleus- elevated HR

Vestibular nucleus- balance

Vagus nerve nucleus- altered vitals

Trigeminal Nerve

Inferior cerebellar peduncle - ataxia/coordination ipsilateral

Salivatory nucleus - unable to salivate or make tears

Spinothalamic tract- contralateral

Descending sympathetic- ipsilateral Horner syndrome

Nucleus ambiguus (9 10) and 12 cranial nerve. Tongue/ larynx/pharynx affected. Lack of gag reflex

42
Q

The reticular formation is in the _______ of the pons

A

tegmentum

Neuro Test 2 (19 decks)

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