Lecture 3 - Brainstem Anatomy Flashcards

1
Q

The three functions of the brainstem are:

  1. It is a _______ for the travel of information between brain and spinal cord
  2. ________ _______ originate from here
  3. ________ _______: complex motor patterns and cardiorespiratory control (involves reticular formation)
A
  1. conduit
  2. cranial nerves
  3. integrative functions
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2
Q

3 main subdivisions of brainstem (inferior to superior)

  • all notecards will proceed from inferior to superior
A
  • medulla
  • pons
  • midbrain
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3
Q

When thinking of the brainstem, it is best to separate each of the 3 main subdivisions into ____ and ____ halves.

A
  • rostral

- caudal

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4
Q

Medulla Anatomy:

The portion of the medulla that is closed and forms a continuous central canal with the spinal cord is the _____ end. The portion of the medulla that is open and connects the central canal to the 4th ventricle anterior to the cerebellum is the ______ end.

A
  • caudal

- rostral

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5
Q

Medulla Anatomy:

The apex of the 4th ventricle where it narrows into the central canal of the medulla is called the _____.

A

obex

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6
Q

Medulla Anatomy:

At the junction of the brainstem and spinal cord, the anterior median fissure is interrupted by an area containing the corticospinal tract called the _____ ______.

A

pyramidal decussation

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7
Q

3 nuclei of the medulla

A
  • nucleus cuneatus
  • nucleus gracillis
  • olivary nucleus
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8
Q

Medulla Anatomy:

At the anterolateral or preolivary sulcus, the rootlets of the _______ nerve exit the medulla. At the postolivary sulcus, lateral to the olive, rootlets of the ______ and ______ nerves emerge. The regions these nerves emerge from small swellings called ________.

A
  • hypoglossal (CN XII)
  • glossopharyngeal (CN IX)
  • vagus (CN X)
  • trigones
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9
Q

Medulla Anatomy:

The embryonic dividing line between ______ (medial) and ______ (lateral) fibers is known as the ______ ______.

A
  • motor
  • sensory
  • sulcus limitans
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10
Q

Medulla Anatomy:

The ______ ______ is where the facial nerve loops over the abducens nerve to exit the brainstem.

A

facial colliculus

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11
Q

One of the main functions of the pons is to act as a conduit between the ______ and _____ with its “cross fibers.”

A
  • cerebrum
  • cerebellum
  • cerebropontocerebellar pathway
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12
Q

Pons Anatomy:

The large bulges on the posterior surface of the pons used for communication with the cerebellum are called the _______ _______ _______ (MCP).

A

middle cerebellar peduncles

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13
Q

Pons Anatomy:

Entering at the midpontine level through the middle cerebellar peduncle (MCP) is the ________ nerve. Near the midline of the pontomedullary junction, the _____ nerve exits the brainstem.

A
  • trigeminal nerve (CN V)

- abducens nerve (CN VI)

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14
Q

Pons Anatomy:

Lateral to the abducens (CN VI) at the pontomedullary junction, the _____ nerve exits in 2 parts: a medial ______ and lateral ______ portion.

A
  • facial nerve (CN VII)
  • motor
  • sensory
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15
Q

Pons Anatomy:

Lateral of both CN VI and CN VII at the pontomedullary junction, the ______ nerve exits the brainstem. It 2 divisions: the medial _______, and lateral ________.

A
  • vestibulocochlear (CN VIII)
  • vestibular
  • cochlear
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16
Q

Pons Anatomy:

A cerebellar output junction that forms the roof of the 4th ventricle and enters the brainstem at the junction of the midbrain and pons is the ______ ______ _______.

A

superior cerebellar peduncle

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17
Q

Pons Anatomy:

Band of fibers that covers the superior cerebellar peduncle in the rostral pons that is part of the ascending auditory pathway is the _______ ________.

A

lateral lemniscus

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18
Q

Midbrain Anatomy:

The channel in the midbrain that connects the 3rd and 4th ventricles is the _____ ______. It is a remnant of the embryonic _________, and drains _____.

A
  • cerebral aqueduct
  • mesencephalon
  • CSF
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19
Q

Midbrain Anatomy:

The gray matter mass in the roof of the ROSTRAL midbrain that has eye-related functions is the _____ ___. The gray matter mass in the roof of the CAUDAL midbrain that has auditory functions is the _____ _____.

A
  • superior colliculus

- inferior colliculus

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20
Q

Midbrain Anatomy:

Large bundles of WHITE matter at the base of the midbrain that contain tightly packed fibers from the cerebral cortex on their way to the brainstem and spinal cord are ______ ______.

A

cerebral peduncles

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21
Q

Midbrain Anatomy:

In the rostral midbrain, the nerve that controls extrocular muscles and preganglionic parasympathetic neurons for ciliary muscles is the ________ nerve.

A

oculomotor nerve (CN III)

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22
Q

Midbrain Anatomy:

In the caudal midbrain, the nerve that exits below the inferior colliculus and controls the superior oblique muscles is the ______ nerve.

A

trochlear nerve (CN IV)

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23
Q

Midbrain Anatomy:

The inferior colliculus has a projection towards the thalamus for the auditory pathway called the _____ ______.

A

inferior brachium

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24
Q

3 areas of all parts of the brainstem:

  • tissue anterior to ventricles is the ________
  • tissue posterior to ventricles is the _______ (“roof”)
  • “_______”
A
  • tegmentum
  • tectum
  • “stuff added onto anterior surface”
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25
Q

3 main fiber tracts in brainstem:

  • anterior: ____________ tract
  • anterolateral: ___________ tract
  • central/anterior/variable: ____________ __________
A
  • corticospinal
  • spinothalamic
  • medial lemniscus
26
Q

The CAUDAL medulla extends from the caudal edge of the _______ _______ to the _______.

A
  • pyramidal decussation

- obex

27
Q

The ROSTRAL medulla extends from the caudal portion of the ______ to the lateral recess of the _____ ______.

A
  • obex

- 4th ventricle

28
Q

Caudal Medulla summary (4 parts):

A
  • central canal
  • gracillis and cuneate tracts
  • internal arcuate fibers form medial lemniscus
  • pyramidal decussation
29
Q

Rostral Medulla summary (5 parts):

A
  • 4th ventricle
  • inferior olivary nucleus
  • CN XII (hypoglossal)
  • internal arcuate fibers form IO (inferior olivary nucleus) to ICP (inferior cerebellar peduncle)
  • pyramids
30
Q

The CAUDAL pons extends from the rostral wall of the lateral recess of the ______ _______ to the rostral edge of the ______ ______ _______ (attachment to cerebellum).

A
  • 4th ventricle

- middle cerebellar peduncle

31
Q

The ROSTRAL pons extends from the top of the _____ ______ _______ to the _______ ________.

A
  • middle cerebellar peduncle

- cerebral aqueduct

32
Q

Summary: the rostral pons contains the ______ ______ _______, while the caudal pons contains the ______ _____ ______ and ______ ______ _______.

A
  • superior cerebellar peduncle
  • middle cerebellar peduncle
  • inferior cerebellar peduncle
33
Q

The CAUDAL midbrain contains the _______ _______. The ROSTRAL midbrain contains the ______ _______.

A
  • inferior colliculi

- superior colliculi

34
Q

caudal midbrain summary (3 things):

A
  • inferior colliculi
  • CN IV (trochlear)
  • decussation of SCP (superior cerebellar peduncle)
35
Q

rostral midbrain summary (4 things):

A
  • superior colliculi
  • CN III (oculomotor)
  • red nucleus (???)
  • substantia nigra
36
Q

The blood supplying the brainstem is part of the ______-______ system. Anterior and medial portions of the brainstem are also supplied by ______ branches.

A
  • vertebral-basilar

- perforating

37
Q

Exterior arteries wrapping around and supplying the lateral brainstem and cerebellum are _______ arteries.

A

circumferential

  • includes SCA, AICA, PICA
38
Q

Medial and lateral portions of the brainstem are often _______ affected in strokes (one side suffers more).

A

preferentially

39
Q

Look at the picture on slide #42 for regional blood supply.

A

Just do it.

40
Q

List the 12 cranial nerves in order.

A
  • CN I = olfactory
  • CN II = optic
  • CN III = oculomotor
  • CN IV = trochlear
  • CN V = trigeminal
  • CN VI = abducens
  • CN VII = facial
  • CN VIII = vestibulocochlear
  • CN IX = glossopharyngeal
  • CN X = vagus
  • CN XI = accessory
  • CN XII = hypoglossal
41
Q

Which cranial nerve is somatic afferent for skin, muscles and joints of the head?

A

trigeminal (CN V)

42
Q

Which cranial nerve is visceral afferent for the cranial, thoracic, and abdominal viscera?

A

vagus (CN X)

43
Q

Which 2 cranial nerves are visceral afferent for taste buds?

A
  • facial (CN VII)

- glossopharyngeal (CN IX)

44
Q

Which cranial nerve is special afferent for the inner ear?

A
  • vestibulocochlear (CN VIII)
45
Q

Which 3 cranial nerves are somatic efferent for the extraocular muscles?

A
  • oculomotor (CN III)
  • trochlear (CN IV)
  • abducens (CN VI)
46
Q

Which cranial nerve is somatic efferent for the tongue muscles?

A

facial (CN VII)

47
Q

Which cranial nerve is visceral efferent for the parasympathetic ganglia for cranial, thoracic, and abdominal viscera?

A

vagus (CN X)

48
Q

Which cranial nerve is brachial efferent for the jaw muscles?

A

trigeminal (CN V)

49
Q

Which cranial nerve is brachial efferent for the facial muscles?

A

facial (CN VII)

50
Q

Which cranial nerve is brachial efferent for the laryngeal and pharyngeal muscles?

A

vagus (CN X)

51
Q

Which 2 cranial nerves are brachial efferent for the middle ear muscles?

A
  • trigeminal (CN V)

- facial (CN VII)

52
Q

Which cranial nerve is brachial efferent for the SCM and trapezius muscles?

A

accessory (CN XI)

53
Q

An axon that receives input for pain, temperature, or mechanical signals is _______ ______. It enters the spinal cord via the ______ root.

A
  • somatic sensory

- dorsal

54
Q

An axon that receives input from the GI tract or blood vessels is ______ _______. It enters the spinal cord via the ______ root.

A
  • visceral sensory

- dorsal

55
Q

A preganglionic autonomic axon is ______ ______. Enters the spinal cord via the _____ root.

A
  • visceral motor

- ventral

56
Q

An axon that innervates skeletal muscle is _____ _____. Enters the spinal cord via the _____ root.

A
  • somatic motor

- ventral

57
Q

Vision, smell, hearing, and equilibrium signals are received by _____ ______ neurons.

A

special sensory

58
Q

Nerves supplying muscles derived embryologically from the pharyngeal arches are called ______ ______ neurons.

A

branchial motor

59
Q

From most lateral to most medial in the brainstem, list the arrangement of the 6 neuron types:

A
  • special sensory
  • SA
  • VA
  • VE
  • branchial efferent
  • SE
  • S = somatic; V = visceral; A = afferent/sensory; E = efferent/motor
60
Q

Which 4 cranial nerves are exclusively somatic efferent (motor)?

A
  • oculomotor (CN III)
  • trochlear (CN IV)
  • abducens (CN VI)
  • hypoglossal (CN XII)
61
Q

Which 3 cranial nerves are exclusively special sensory?

A
  • olfactory (CN I)
  • optic (CN II)
  • vestibulocochlear (CN VIII)
62
Q

Which 5 cranial nerves have mixed fibers, and are also “branchiomeric?”

A
  • trigeminal (CN V)
  • facial (CN VII)
  • glossopharyngeal (CN IX)
  • vagus (CN X)
  • accessory (CN XI)