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Neuroscience > LESSON 11_BRAINSTEM > Flashcards

LESSON 11_BRAINSTEM Flashcards

1
Q

Brainstem comprises of (top to bottom):
* ____
* ____
* ____

____ - demarcates the separation between the medulla and SC at the ____

A

Brainstem comprises of (top to bottom):
* midbrain
* pons
* medulla

Foramen magnum - demarcates the separation between the medulla and SC at the cervicomedullary junction

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2
Q

Boundaries of the Brainstem

  • rostral: ____
  • caudally: ____ at the level of the ____ and ____
A
  • rostral: midbrain-diencephalic junction
  • caudally: cervicomedullary junction at the level of the foramen magnum and pyramidal decussation
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3
Q

functions of the brainstem

A
  • acts as a conduit for ascending and descending tracts to the high centers in the forebrain
  • contains reflex centers associated with cardiovascular and respiratory functions and consciousness
  • contains nuclei of CN III-XII
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4
Q

attached to the dorsal surface of the pons and upper medulla

A

cerebellum

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5
Q

only in the midbrain; has the superior and inferior colliculi

A

tectum (roof)

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6
Q

tegmentum (covering)
* at the midbrain, is ventral to the ____
* at the pons and medulla, is ventral to the ____

makes up the main bulk of ____ and ____

A

tegmentum (covering)
* at the midbrain, is ventral to the cerebral aqueduct
* at the pons and medulla, is ventral to the 4th ventricle

makes up the main bulk of brainstem nuclei and reticular formation

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7
Q

The ____ is most ventral portion of the brainstem with a large collection of fibers making up the ____ and ____ tracts.

A

basis

corticospinal; corticobulbar

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8
Q

Surface Anatomy

Ventral Surface of the Brainstem
* ____
* ____ - where the ____ exits ventrally

Dorsal Surface of the Brainstem
* ____ - superior and inferior colliculi

A

Ventral Surface of the Brainstem
* cerebral peduncles
* interpeduncular fossa - where the oculomotor nerve exits ventrally

Dorsal Surface of the Brainstem
* tectum - superior and inferior colliculi

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9
Q

Surface Anatomy

Pons
* ventral surface - ____; ____
* limited dorsally by the ____
* dorsolaterally, attached to the ____ by the ____

A

Pons
* ventral surface - transverse fibers; convex
* limited dorsally by the 4th ventricle
* dorsolaterally, attached to the cerebellum by the superior, middle, and inferior cerebellar peduncles

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10
Q

Surface Anatomy

Medulla
* ventral surface - ____ and ____ (____) located lateral to the ____
* dorsal surface (____ medulla) - ____

A

Medulla
* ventral surface - pyramids and olives (inferior olivary nuclei) located lateral to the pyramids
* dorsal surface (caudal medulla) - posterior columns tracts and their nuclei

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11
Q

forms the floor of the 4th ventricle

A

pons (rostral) to rostral medulla (caudal)

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12
Q

bumps on the floor of the 4th ventricle; found in the pons

A

facial colliculi

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13
Q

The ____ and ____ are formed by the CN XII nucleus and the dorsal motor nucleus of CN X (medulla).

A

The hypoglossal trigone and vagal trigone are formed by the CN XII nucleus and the dorsal motor nucleus of CN X (medulla).

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14
Q

joins the 4th ventricle superiorly; runs through the midbrain

A

cerebral aqueduct of Sylvius

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15
Q

where the 4th ventricle drains into caudally

A

two lateral foramina of Luschka and one medial foramen of Magendie

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16
Q

The sensory and motor nuclei are demarcated by the ____, which is still along the ____ wall of the 4th ventricle.
* motor nuclei located ____
* sensory nuclei located ____

A

The sensory and motor nuclei are demarcated by the sulcus limitans, which is still along the lateral wall of the 4th ventricle.
* motor nuclei located ventromedially
* sensory nuclei located dorsolaterally

motor nuclei, ventromedially

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17
Q

The tectum is located ____ to the cerebral aqueduct.

A

dorsal

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18
Q

Name, Sensory/Motor, Function, Emerge from, Exit Foramen

CN I

A
  • olfactory nerve
  • sensory
  • olfaction
  • cerebrum (ventral surface of frontal lobes)
  • cribriform plate
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19
Q

Name, Sensory/Motor, Function, Emerge from, Exit Foramen

CN II

A
  • optic nerve
  • sensory
  • vision
  • cerebrum
  • optic canal
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20
Q

Name, Sensory/Motor, Function, Emerge from, Exit Foramen

CN III

A
  • oculomotor nerve
  • motor
  • eye movement, pupil constriction
  • midbrain - ventral near midline; exit at interpeduncular fossa between PCA and SCA
  • superior orbital fissure
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21
Q

Name, Sensory/Motor, Function, Emerge from, Exit Foramen

CN IV

A
  • trochlear
  • motor
  • eye movements
  • midbrain (dorsal)
  • superior orbital fissure
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22
Q

only cranial nerve that exits dorsally; immediately decussates once it exits

A

trochlear nerve

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23
Q

Name, Sensory/Motor, Function, Emerge from, Exit Foramen

CN V

A
  • trigeminal nerve
  • both
  • facial sensation and muscles of mastication
  • pons (ventrolateral)
  • V1 from superior orbital fissure, V2 from foramen rotundum, V3 from foramen ovale

V1 (opthalmic), V2 (maxillary), V3 (mandibular)

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24
Q

Name, Sensory/Motor, Function, Emerge from, Exit Foramen

CN VI

A
  • abducens nerve
  • motor
  • eye movements
  • pons (pontomedullary junction; ventrally near midline)
  • superior orbital fissure
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25
Q

Name, Sensory/Motor, Function, Emerge from, Exit Foramen

CN VII

A
  • facial nerve
  • both
  • muscles of facial expression; taste, lacrimation, and salivation
  • pons (ventrolateral; cerebellopontine angle [CPA])
  • auditory canal (stylomastoid foramen)
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26
Q

Name, Sensory/Motor, Function, Emerge from, Exit Foramen

CN VIII

A
  • vestibulocochlear/auditory nerve
  • sensory
  • hearing; equilibrium sense
  • pons (ventrolateral; CPA)
  • auditory canal
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27
Q

Name, Sensory/Motor, Function, Emerge from, Exit Foramen

CN IX

A
  • glossopharyngeal nerve
  • both
  • pharyngeal muscles; carotid body reflexes; salivation
  • medulla - ventrolateral (CPA)
  • jugular foramen
28
Q

Name, Sensory/Motor, Function, Emerge from, Exit Foramen

CN X

A
  • vagus nerve
  • both
  • parasympathetics to most organs; laryngeal muscles (voice); pharyngeal muscles (swallowing); aortic arch reflexes
  • medulla - ventrolateral
  • jugular foramen
29
Q

Name, Sensory/Motor, Function, Emerge from, Exit Foramen

CN XI

A
  • spinal accessory nerve
  • motor
  • head turning (trapezius and SCM muscles)
  • medulla
  • jugular foramen (enters skull via foramen magnum)
30
Q

Name, Sensory/Motor, Function, Emerge from, Exit Foramen

CN XII

A
  • hypoglossal nerve
  • motor
  • tongue movement
  • medulla (between pyramids and olives)
  • hypoglossal foramen (canal)
31
Q

Identify where the opening of the skull is located

Anterior cranial fossa
* perforations in cribriform plate -

Middle cranial fossa
* optic canal -
* superior orbital fissure -
* foramen rotundum -
* foramen ovale -
* foramen spinosum -
* foramen lacerum -

Posterior cranial fossa
* foramen magnum -
* hypoglossal canal -
* jugular foramen -
* internal acoustic meatus -

A

Anterior cranial fossa
* perforations in cribriform plate - ethmoid

Middle cranial fossa
* optic canal - lesser wing of the sphenoid
* superior orbital fissure - between lesser and greater wings of the sphenoid
* foramen rotundum - greater wing of the sphenoid
* foramen ovale - greater wing of the sphenoid
* foramen spinosum - greater wing of the sphenoid
* foramen lacerum - between petrous part of temporal and sphenoid

Posterior cranial fossa
* foramen magnum - occipital
* hypoglossal canal - occipital
* jugular foramen - between petrous part of temporal and condylar part of occipital
* internal acoustic meatus - petrous part of temporal

32
Q

tumor in this area will affect CN VII-XI

A

cerebellopontine angle (CPA)

33
Q

internal carotid artery exits through where?

A

carotid foramen

34
Q

shallow, diamond shaped depression on the dorsal surface of the pons and medulla that forms the floor of the 4th ventricle

A

rhomboid fossa

35
Q

Medullary Surface Landmarks

continuation of the posterior median sulcus of SC

protuberance of the CN XII nucleus

protuberance of the dorsal motor nucleus of the CN X … this lies ____ to the previous one

A

posterior median fissure

hypoglossal trigone

vagal trigone … lies lateral to the hypoglossal trigone

36
Q

Pontine Surface Landmarks

Subependymal bundle of CN VII … this winds around which nucleus?

between rostral and caudal parts of floor; fiber bundle coursing laterally … surface landmark of ____ from ____ to ____ and is for ____

A

facial colliculi … winds around the abducens nucleus

stria medullaris … surface landmark of arcuatocerebellar bundle from arcuate nucleus of medulla to cerebellum and is for respiration

37
Q

structures that form the roof of the 4th ventricle

A

velum, cerebellum, and choroid plexus of 4th ventricle

38
Q

runs between the superior cerebellar peduncles … this runs with what?

A

superior (anterior) medullary velum … runs with the inferior medullary velum

39
Q

Lateral Boundaries of the 4th Ventricle

connects the cerebellum and midbrain

connects cerebellum and medulla

surface markings of gracile and cuneate nuclei

lateral angles of the 4th ventricle

A

brachium conjunctivum (SCP)

restiform body (ICP)

gracile and cuneate tubercles

lateral recess

40
Q

connects the pons superiorly and SC inferiorly

Side Questions:
* ____-shaped; broad ____
* central canal of SC enters the lower half of the medulla to expand into the cavity of the ____

A

medulla oblongata

Side Questions:
* cone-shaped; broad superiorly
* central canal of SC enters the lower half of the medulla to expand into the cavity of the 4th ventricle

41
Q

corresponds to the level spinal cord; contains pyramidal decussation

A

cervicomedullary junction

42
Q

Ventral Surface of the Internal Brainstem

correspond to the anterior median fissure of the SC

swelling on either side of the median fissure
* bound laterally by the ____
* contains ____ to SC and ____ (for CN) in brainstem

posterolateral to the pyramids
* oval elevations produced by the underlying ____

A

anterior median fissure

pyramids
* bound laterally by the ventrolateral sulcus
* contains anterior and lateral corticospinal tracts to SC and corticobulbar tracts (for CN) in brainstem

olives
* oval elevations produced by the underlying inferior olivary nuclei

43
Q

Ventral Surface of the Internal Brainstem

emerges from the groove between the olives and pyramids

lies posterior to the olives
* connects the ____ and ____

emerges lateral to the olives

CNs ____ only at this level

A

rootlets of the hypoglossal nerve

restiform body (ICP)
* connects the cerebellum and medulla

roots of the glossopharyngeal, vagus, and spinal accessory nerves

CNs IX-XII only at this level

44
Q

Dorsal Surface of the Internal Brainstem

____ surface of ____ half of medulla forms lower part of floor of 4th ventricle

____ surface of ____ half of medulla is continuous with posterior aspect of SC and possesses a ____

On each side of ____, an elongated swelling the ____ is produced by the ____

Lateral to it is the ____ produced by the ____

A

Posterior surface of superior half of medulla forms lower part of floor of 4th ventricle

Posterior surface of inferior half of medulla is continuous with posterior aspect of SC and possesses a posterior median sulcus

On each side of posterior median sulcus, an elongated swelling the gracile tubercle is produced by the gracile nucleus

Lateral to it is the cuneate tubercle produced by the cuneate nucleus

45
Q

Level of Pyramidal Decussation

Superiorly, ____ occupy and form the ____

Inferiorly, about ____ of fibers decussate and continue down the ____ as ____
* Decussates at the ____
* ____ decussates on the other side and becomes the ____

Somatotopically organized
* ____ more lateral
* ____ more medial and decussates ____

____ leave as they descend to project to the CN nuclei

____ continue to ascend superiorly, posterior to the central gray matter

____ appear as posterior extensions of the central gray matter

____ becomes continuous with the inferior end of the nucleus of the spinal tract of trigeminal nerve (at the level of ____)

A

Superiorly, corticospinal fibers occupy and form the pyramid

Inferiorly, about 90% of fibers decussate and continue down the lateral funiculus as lateral corticospinal tract
* Decussates at the cervicomedullary junction
* 10% decussates on the other side and becomes the anterior corticospinal tract

Somatotopically organized
* LE more lateral
* neck and UE more medial and decussates first

Corticobulbar fibers leave as they descend to project to the CN nuclei

Fasciculus gracilis and cuneatus continue to ascend superiorly, posterior to the central gray matter

Nucleus gracilis and cuneatus appear as posterior extensions of the central gray matter

Substantia gelatinosa becomes continuous with the inferior end of the nucleus of the spinal tract of trigeminal nerve (at the level of C3)

46
Q

Level of Lemniscal Decussation

Level of ____

At the ____ half of medulla, above the ____

Crossing of second order neuron of the ____

Decussation of lemnisci occurs anterior to the ____, posterior to the ____

Axons of neurons in the dorsal column lemnisci (____ and ____) travel ventromedially as ____ and cross to the opposite side (sensory decussation) to form the ____

____ first travel anteriorly and laterally around the ____ then curve medially toward the midline where they decussate (tracts = ____, nucleus = ____)

A

Level of sensory decussation

At the inferior half of medulla, above the pyramidal decussation

Crossing of second order neuron of the DCML

Decussation of lemnisci occurs anterior to the central gray matter, posterior to the pyramids

Axons of neurons in the dorsal column lemnisci (nucleus gracilis and nucleus cuneatus) travel ventromedially as internal arcuate fibers and cross to the opposite side (sensory decussation) to form the medial lemniscus

Internal arcuate fibers first travel anteriorly and laterally around the central gray matter then curve medially toward the midline where they decussate (tracts = outer, nucleus = central)

47
Q

Level of Lemniscal Decussation

has a dorsolateral position in the medulla; lies lateral to the internal arcuate fibers

Side Questions:
* ____ lies lateral to this
* continuous caudally with the ____ and rostrally with the ____ in the pons
* extend throughout the medulla to the level of ____ of SC
* responsible for ____ of the ____

A

spinal trigeminal nucleus

Side Questions:
* spinal tract of trigeminal nerve lies lateral to this
* continuous caudally with the substantia gelatinosa and rostrally with the main sensory nucleus of the trigeminal nerve in the pons
* extend throughout the medulla to the level of C3 of SC
* responsible for exteroreceptive sensations (pain, light touch, and temperature) of the ipsilateral side of the face

48
Q

Level of Lemniscal Decussation

tracts that lie lateral to the lemnisci decussation

tracts at the anterolateral region

A
  • lateral spinothalamic tract
  • anterior spinothalamic tract
  • spinotectal tract = spinal lemniscus
    ~~
  • spinocerebellar tract
  • vestibulospinal tract
  • rubrospinal tract
49
Q

lies posterolateral to the pyramids and anterior to the ICP

Side Questions
* these are oval elevations of what?
* forms the inferior part of the floor of what?

A

olives

Side Questions
* inferior olivary nuclei
* 4th ventricle

50
Q

stuff at the level of the olives

A
  • nuclei of CN VIII-XII
  • spinal trigeminal nucleus
  • spinal trigeminal tract
51
Q

gray matter shaped like a crumpled paper bag with the mouth directed medially

Side Questions
* responsible for the ____
* nuclei: ____ (principal nucleus); ____ and ____
* cells of the principal nucleus send fibers across the midline to enter the cerebellum through the ____
* afferent fibers: ____, ____, and ____
* associated with ____

A

olivary nuclear complex

Side Questions
* responsible for the olives
* nuclei: inferior olivary nucleus (principal nucleus); medial accessory olivary nucleus and dorsal accessory olivary nucleus
* cells of the principal nucleus send fibers across the midline to enter the cerebellum through the ICP
* afferent fibers: spino-olivary tracts, cerebellum, and cerebral cortex
* associated with voluntary muscle movement

52
Q

parts of the vestibular nuclear complex … seen at the level of the olives: ____ and ____

cochlear nuclei:
* ____ → anterolateral aspect of the inferior cerebellar peduncle
* ____ → posterior aspect of peduncle lateral to the floor of the 4th ventricle

A
  • medial vestibular nucleus
  • inferior vestibular nucleus
  • lateral vestibular nucleus
  • superior vestibular nucleus

seen at the level of the olives: medial and inferior

Cochlear Nuclei
* Anterior cochlear nucleus → anterolateral aspect of the inferior cerebellar peduncle
* Posterior cochlear nucleus → posterior aspect of peduncle lateral to the floor of the 4th ventricle

53
Q

special visceral efferent (SVE) fibers of CN IX and X

A

nucleus ambiguus

54
Q

Nucleus Ambiguus

  • ____ (IX); ____ for swallowing and ____ (X)
  • ____ motor neurons
  • Deep within the ____
  • Emerging fibers join the ____, ____ and ____
A
  • stylopharyngeus (IX); pharyngeal muscles for swallowing and laryngeal muscles (X)
  • Large motor neurons
  • Deep within the reticular formation
  • Emerging fibers join the glossopharyngeal, vagus and cranial part of accessory nerve
55
Q

on the anterior surface of the pyramids; responsible for the control of breathing

Side Question:
* receives afferents from cerebral cortex and send efferents to the cerebellum through ____

A

arcuate nucleus

Side Question:
* receives afferents from cerebral cortex and send efferents to the cerebellum through anterior external arcuate fibers

56
Q

The pyramids contain ____ and some ____ fibers.

Anterior of the medulla is separated by the ____.

A

The pyramids contain corticospinal and some corticonuclear fibers.

Anterior of the medulla is separated by the anterior median fissure.

57
Q

Fibers emerge from the decussation of the lemnisci and send afferents to the thalamus; flattened tract on each side of the midline posterior to the pyramid

A

medial lemniscus

58
Q

found in the posterolateral corner, lateral to the 4th ventricle

A

ICP

59
Q

small tract on each side of midline posterior to medial lemniscus and anterior to the hypoglossal nucleus

A

medial longitudinal fasciculus (MLF)

60
Q

Medial Longitudinal Fasciculus (MLF)

  • Pathway that connects the nuclei involved in eye movements (CN ____, ____ and ____) to each other and to the ____ for horizontal and conjugate eye movement
  • Highly myelinated tract near midline on each side, just below ____ and ____ nuclei in the midbrain and just under the floor of the 4th ventricle in the midline of the pons
  • ____ ascend in MLF to oculomotor, trochlear, and abducens nuclei mediating ____
  • “____” = eyes dont move
A
  • Pathway that connects the nuclei involved in eye movements (CN III, IV and VI) to each other and to the vestibular nuclei for horizontal and conjugate eye movement
  • Highly myelinated tract near midline on each side, just below oculomotor and trochlear nuclei in the midbrain and just under the floor of the 4th ventricle in the midline of the pons
  • Medial vestibular nucleus fibers ascend in MLF to oculomotor, trochlear, and abducens nuclei mediating vestibulo-ocular reflex
  • “Doll’s Eyes” = eyes dont move
61
Q

on the anteromedial aspect of the ICP

near the surface; between inferior olivary nucleus and nucleus of spinal tract of trigeminal nucleus

deeply placed ____ (consists of ____, ____, and ____)

diffuse mixture of nerve fibers and cells deeply placed posterior to the olivary nucleus

A

spinal tract and nucleus of the trigeminal nerve

anterior spinocerebellar tract

deeply placed spinal lemniscus (consists of anterior spinothalamic tract, lateral spinothalamic tract, and spinotectal tract)

reticular formation

62
Q

runs forward and laterally and emerges between the olives and ICPs at the level just inferior to the pons

runs anteriorly and laterally; emerges between the pyramids and the olives

A

glossopharyngeal, vagus, and cranial part of accessory nerves

hypoglossal nerve

63
Q

found at the level just inferior to the pons instead of the inferior vestibular nucleus

A

lateral vestibular nucleus

64
Q

At the level just below the pons, the ____ are visible on the anterior and posterior surface of the ICP.

A

cochlear nuclei

65
Q

at the dorsolateral border of the medulla; carries mainly inputs to cerebellum from SC … forms a distinct bundle at the ____

A

inferior cerebellar peduncles

forms a distinct bundle at the midolivary level

66
Q
A

Neuroscience (3 decks)

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