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NEURO FINAL > Lecture 11- clinical syndromes of the brainstem > Flashcards

Lecture 11- clinical syndromes of the brainstem Flashcards

1
Q

the basilar has ____ axons from cerebral cortex, corticospinal , corticobrainstem , corticopontine , and corticoreticular tracts

A

descending

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2
Q

the basilar has motor nuclei from what 3 things

A

substantia nigra , pons and inferior olive

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3
Q

where are Pontocerebellar axons found

A

basilar

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4
Q

the tegmentum is also called what

A

reticular formation

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5
Q

the tegmentum contains ___ nuclei and ___ sensory tracts

A

sensory
ascending

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6
Q

what CN nuclei is located near the tegmentum

A

CN V (trigemenal)

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7
Q

what does the medial longitudinal fasciclus do

A

coordinated head and eye movements

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8
Q

the medial longitudinal fascicular is near what division of the longitudinal brainstem

A

tegmentum

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9
Q

the tectum divison is located in the ____ only

A

midbrain

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10
Q

which part of the longitudinal divison of the brainstem have structures for reflexive movements of intrinsic/ extrinsic eye muscles and head

A

tectum

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11
Q

what are the 3 things of the tectum that are structures for reflexive movements of intrinsic/ extrinsic eye muscles and head

A

pretectum
inferior and superior colliculi

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12
Q

the basis pedunculi includes what 2 things

A

cerebral peduncles and substantia nigra nucleus

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13
Q

cerebral peduncles are ___ tracts from the cortex

A

motor

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14
Q

substantia nigra nucleus is part of the ___ ____ circuits

A

basal ganglia

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15
Q

the midbrain tegmentum has ascending ___ tracts

A

sensory

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16
Q

the midbrain tegmetum contains the ___ cerebellar peduncle

A

superior

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17
Q

what division of the midbrain contains the red nucleus

A

midbrain tegmentum

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18
Q

what division of the midbrain contains the pedunculopontine nucleus

A

midbrain tegmentum

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19
Q

what nuclei of CN are located in the midbrain tegmentum

A

3 and 4

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20
Q

the midbrain tegmentum contain the ___ longitudinal fasciculus

A

medial

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21
Q

what part of the midbrain division is the periaqueductal gray located

A

midbrain tegmentum

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22
Q

the tectum division of the midbrain contains the ___ area

A

pretectal

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23
Q

in the midbrain division of the tectum it contains which 2 colliculi

A

inferior and superior

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24
Q

the superior cerebella peduncle is mostly ___ info from the ____

A

sensory
cerebellum

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25
Q

the red nucleus is ___ matter and is part of the cognitive/motor circuit

A

gray

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26
Q

what is the function of the periaqueductal gray

A

nociceptive inhibition , coordinates reaction to pain , threats and emotions

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27
Q

which colliculi relays info from cochlear n to superior colliculi and thalamus

A

inferior

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28
Q

what does the superior colliculi do

A

motor and sensory information to orient head/eyes to external stimuli

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29
Q

the pons forms the __ wall of the __ ventricle

A

anterior
4th

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30
Q

what forms the posterior wall of the 4th ventricle

A

cerebellum

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31
Q

T/F: most vertical tracts go thru pons without synapsing

A

T

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32
Q

most vertical tracts go thru the pons witout synapsing however what are the two exceptions

A

corticopontine tract and corticobrainstem tracts

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33
Q

where does the corticopontine tract synapse on

A

the pontine nuclei

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34
Q

after the corticopontine tract synpase on the pontine nuceli what happens to the pontocerebellar fibers

A

they cross and enter middle cerebellar peduncle to synapse in contralteral cerebellar hemisphere

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35
Q

where does the corticobrainstem tract synapse

A

with neurons of trigeminal mtor nucleus and facial nucleus

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36
Q

in the basilar of the pons there is ___ tracts , ___ nuclei , and ___ axons

A

descending
pontine
pontocerebellar

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37
Q

what are the three descending tracts of the basilar

A

corticospinal , corticobrainstem and corticopontine axons

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38
Q

the tegmentum of the pons includes what 6 things

A

sensory tracts
reticular formation
autonomic pathways
medial longitudinal fasciculi
CN 5,6,7,8

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39
Q

what ventricle is on the posterior surface of the upper medulla and narrows in lower to form central canal of SC

A

4th

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40
Q

what CN exits between pyramid and inferior olive on the medulla

A

CN XII (hypoglossal)

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41
Q

CN IX , X from ___ groove . ___ to olive

A

lateral 2x

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42
Q

in the upper medulla most CN nuclei is in the ___ part from ___ to ____

A

dorsal
medial to lateral

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43
Q

which CN nuclei is in the dorsal part from the medial to lateral in the upper medula

A

CN XII, X (dorsal motor), solitary nucleus ( afferents from VII and IX) , autonomic afferents from IX, X , vestibular nuclei VII

44
Q

which nucleus are more lateral on the upper medulla

A

spinal trigeminal nucleus and nucleus ambigus

45
Q

spinal trigminal nucleus is for what

A

pain
and temp

46
Q

the nucleus ambiguus is motor for what

A

swallowing and vocalization muscles

47
Q

where is the nuclei of CN VIII of the upper medulla at

A

medullopontine junction

48
Q

the inferior olivary nuclei of the upper medulla receive infro from many cortical and sc motor areas and then project where and thru what

A

to contralateral cerebellum thru olivocerebellar tract

49
Q

which four tracts go from the medulla to cerebellum via inferior cerebellar peduncle

A

spinocerebellar, olivocerebellar , vestibulocerebellar , reticulocerebellar

50
Q

which tract is the only tract to enter medulla from cerebellum

A

cerebellovestibular

51
Q

which tract crosses at the inferior border of medulla

A

lateral corticospinal tract

52
Q

in the inferior medulla the ___ tracts travel posteriorly

A

sensory

53
Q

whcih CN are in the mid brain

A

CN III , IV

54
Q

which CN is in the PONS

A

trigeminal V,
abducencs VI ,
facial VII ,
vestibulocochlear VIII

55
Q

what are the 2 arteries that come off the vertebral artery

A

anterior spinal artery
posterior inferior cerebellar artery

56
Q

what anterior inferior cerebellar artery and superior cerebellar artery come off which artery

A

basilar

57
Q

what are the 3 artieres that provide brainstem blood supply

A

vertebral artery
basilar artery
posterior cerebral artery

58
Q

the anterior spinal artery and PICA is in what part of the brainstem

A

medulla

59
Q

the basilar artery and AICA are in what part of the brainstem

A

pons

60
Q

the posterior cerebral artery and midbrain branches of basilar artery is in what part of the brainstem

A

midbrain

61
Q

what conveys signals from/to cortex and spinal cord ( vertical trats)

A

brainstem

62
Q

the dorsal column/medial lemniscus , spinothalamic , spinocerebellar , and trigeminal lemniscus are sensory or motor tracts?

A

sensory tracts

63
Q

what are the four examples of the motor tracts

A

corticospinal , corticobulbar , corticopontine , and corticoreticular

64
Q

the rubrospinal tracts , vestibulospinal tract , reticulospinal tract and tectospinal tracts are examples of what kind of tracts

A

brainstem tract

65
Q

the brainstem modulates consciousness thru what 2 things

A

reticular formation and reticular activation system

66
Q

the brain stem also regulated vital signs like what

A

HR
BP
breathing pattern

67
Q

what are the 4 cardinal signs of brainstem dysfunctions after a lesion of the brainstem

A

dysphagia , dysarthria , diplopia , dysmetria

68
Q

damage to the brainstem could cause what to the vitals

A

heart to stop beating
BP to increase
breathing to cease

69
Q

lesions of the brainstem can causes what 4 things

A

cardial signs of brainstem dysfunction
disorders of vital function
disorders of consciousness
motor and sensor loss

70
Q

if there is damage to the reticular formation and/or reticular activatiing system what can happen

A

disorders of consciousness

71
Q

people in vegetative and minimally conscious states have loss of tissue in what 3 places

A

subcortical
thalamic
brainstem

72
Q

what type of lesions may cause a mix of ipsilaterla and contralateral signs

A

brainstem

73
Q

single cranial nerve or cranial nerve nuclei lesions likely result in ____ signs

A

ipsilaterla

74
Q

lesions of lateral corticospinal and dorsal column tracts in the brainstem usually causes ___ signs bc these tracts cross the ___ of the ____ medulla

A

contralateral
midline
inferior

75
Q

what is blocked for a anteriomedial midbrain syndrome ( weber’s)

A

blockage of PCA or basilar artery

76
Q

what are the primary structure affected by anteromedial midbrain syndrome

A

corticospinal tract
oculomtor nerve nucleus
red nucleus

77
Q

what are the clinical manifestations of the corticospinal tract if it is damaged in Webers syndrome

A

contralateral hemiparesis bc where it crosses is below the midbrain

78
Q

what is the clinical manifestations of the oculomtor nerve nucleus if damaged with anteromedial midbrain syndrome (weber’s)

A

ispi decreased eye movement
ipsi paralysis of eyelid
ipsi dilated pupil

79
Q

what are clinical manifestations if red nucleus is affected in anteromedial midbrain syndrome (Weber’s)

A

axtaia
emotional thing
lability (crying and laughing at inappropriate times)

80
Q

what syndrome is due to occulusion of anterior inferior cerebellar artery

A

lateral inferior pontine syndrome

81
Q

what are the seven primary structures affected with lateral inferior pontine syndrome

A

cochlear nuclei ,
vestibular nuclei
imparied sympathics
trigeminal nuclei
salvatory nuclei
spinothalamic tract
facial nuclei

82
Q

what structure is affected with the lateral inferior pontine syndrome if someone has ipsilateral hearing loss and ipsilateral horners syndrome

A

cochlear nuclei an imparied sympathics

83
Q

what structure is affected with the lateral inferior pontine syndrome if someone has dysequilibrium , nausea and vomiting

A

vestibular nuclei

84
Q

what structure is affected with the lateral inferior pontine syndrome if somen has ipsilateral facial pain and temperature sensory loss and decreased tears and salivation

A

trigeminal nuclei and salvatory nuclei

85
Q

what structure is affected with the lateral inferior pontine syndrome if someon has contralateral pain and temperature sensation to body

A

spinothalamic tract

86
Q

what structure is affected with the lateral inferior pontine syndrome if somen has ipsilateral weakness of facial expression

A

facial n

87
Q

damage to which CN causes Bells palsy

A

CN VII

88
Q

how will bells palsy facial weakness differe from facial weakness after cortical stroke

A

facial nerves is the whole face for bells palsy and cortical stroke is just lower half of face

89
Q

describe someone with horners syndrome

A

pupil is contricted and droppy eye with dry skin

90
Q

what syndome is likely due to basilar artery thrombosis or stenosis impacting ventral pons bilaterally

A

locked in syndrome

91
Q

what are the primary structures involved with locked in syndrome

A

B corticospainal tracts
B corticobulbar tracts
B abducens nerve nuclei

92
Q

what is the clinical manifestations if B corticospinal tracts are affected in locked in syndrome

A

paralysis below head

93
Q

what is the clinical manifestations if B corticobulbar tracts are affected in locked in syndrome

A

paralysis to facial muscles , talking and chewing

94
Q

what is the clinical manifestations if B abducens nerve nuclei are affected in locked in syndrome

A

cant move eyes to side

95
Q

what is spared in locked in syndrome

A

reticular activating system/reticular formation
vertical gaze centers from midbrain
(CN 1-4)

96
Q

what causes the medial medullary syndrome

A

due to blockage of anterior spinal artery

97
Q

what are the primary structures affected in medial medullary syndrome

A

hypoglossal nuclei
DCML
CST

98
Q

what is the clinical manifestations if the hypoglossal nuclei is affected in medial medullary syndrome

A

ispilateral tongue protrusion

99
Q

what is the clinical manifestations if the DCML is affected in medial medullary syndrome

A

contralateral loss of vibration , prop, and light tough

100
Q

what is the clinical manifestations if the CST is affected in medial medullary syndrome

A

contralateral hemiparesis

101
Q

what is the most common brainstem stroke

A

lateral medullary syndrome (wallenbergs)

102
Q

what are the primary structures affected in lateral medullary syndrome (9)

A

solitary nucleus
vestibualr nucleus
vagus nerve nuclus
trigeminal nerve
inferior cerebellar peduncle
salivatory nucleus
spinothalamic tract
descending sympathetic tract
nucleus ambiguus (CN IX, X , XII)

103
Q

If soliatry nucleus m vestibular nucleus and vagus nerve nucleus is involved with lateral medullary syndrome (wallenberg’s) what would be the clinical manifestations

A

increase HR
equillbrium prob
increase HR

104
Q

If trigeminal nerve , inferior cerebellar peduncle and salivatory nucleus is involved with lateral medullary syndrome (wallenberg’s) what would be the clinical manifestations

A

t: fascial sensation
I: issuses with cerebellum , ipsilateral ataxia
S: decrease salvation and tear gland

105
Q

If spinothalamic tract , descending sympathetic tract and nucleus ambiguus is involved with lateral medullary syndrome (wallenberg’s) what would be the clinical manifestations

A

ST: decrease pain and temp contralaterally
D: ipsilateral horners syndrome
N: decrease gag reflex

106
Q

what is the 2nd most common brainstem stroke

A

lateral inferior pontine syndrome

107
Q
A

NEURO FINAL (10 decks)

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