Major Pathways of the brainstem and their relationship to lesions Flashcards

1
Q

Brain lesions make up ___-___% of strokes

A

5-15%

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2
Q

What are the general characteristics of a brainstem lesion? What affected CNs do these symptoms come from?

A

dysphagia and dysarthria (CN IX, X, and XII)
diploplia (CN III, IV, VI)
dysmetria (CN VIII)

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3
Q

definition: inability to judge distance that also includes balance and limb coordination

A

dysmetria

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4
Q

(true/false) receptive and expressive language deficits are often seen with brainstem lesions.

A

FALSE

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5
Q

With decorticate rigidity, the LEs are in ___ and the UEs are in ____.

A

EXT, FLX

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6
Q

With decorticate rigidity, the lesion is most likely at the _____ even though it is still functioning.

A

red nucleus (midbrain)

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7
Q

With decerebrate rigidity, the LEs are in ___ and the UEs are in ____.

A

EXT, EXT

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8
Q

Decerebrate rigidity is caused when a lesion travels below the ____.

A

red nucleus

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9
Q

Which is worse… decerebrate rigidity or decorticate rigidity?

A

decerebrate rigidity

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10
Q

(true/false) a patient can switch between decerebrate and decorticate postures.

A

TRUE

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11
Q

definition: lesion is in the base of the pons
- patient is tetraplegic but can still move and communicate with their eyes (ocular nerves are intact and patient does have cognition.

A

locked-in syndrome

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12
Q

What tract is affected when a patient has locked-in syndrome?

A

corticospinal tract

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13
Q

Lateral Medullary (Wallenberg) syndrome has lesions in the ___ and ___ arteries.

A

Vertebral and PICA arteries

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14
Q

(true/false) Motor and proprioception are not intact when lateral medullary (Wallenberg) Syndrome is present.

A

False, they are intact

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15
Q

What are the symptoms of lateral medullary (Wallenberg) syndrome? What causes these symptoms?

A
  • contralateral loss of pain and temperature (spinothalamic tract)
  • ipsilateral loss of pain and temperature in the face (CN V)
  • dysphagia and dysarthria (CN IX , X, and XII)
  • vestibular issues
  • ataxia (inferior cerebellar peduncle)
  • horner’s syndrome
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16
Q

Medial Medullary syndrome has lesions in the ___ and ___ arteries.

A

anterior spinal and vertebral arteries.

17
Q

What are the symptoms of medial medullary syndrome? What causes these symptoms?

A
  • contralateral hemiparesis (corticospinal tract)
  • contralateral impairment of proprioception and vibration (medial lemniscus)
  • ipsilateral motor problems of the tongue muscles (CN XII)
18
Q

Definition: disruption of the ANS pathway

A

horner’s syndrome

19
Q

What are the symptoms of Horner’s Syndrome?

A
  • ptosis
  • constricted pupils