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Emma H&N > Medulla HY > Flashcards

Medulla HY Flashcards

1
Q

characteristics of brainstem lesions

A

1) lesions of long tracts = contralateral deficit in body
2) Cranial Nerve signs reveal level of lesion in brainstem
3) Cranial nerve signs observed ipsilaterally

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2
Q

supply of blood to midbrain

A

posterior cerebral artery

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3
Q

supply of blood to pons

A

basilar artery

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4
Q

supply of blood to medulla

A

vertebral artery

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5
Q

cranial nerves originating from medulla

A

IX, X, XI, XII

9-12

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6
Q

cranial nerve motor nuclei of medulla – think of like _________

A

cranial nerve motor nuclei of medulla – think of like LMN

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7
Q

motor cranial nerve nuclei receive cortical input via _________ pathway

A

motor cranial nerve nuclei receive cortical input via CORTICOBULBAR pathway

(except eyes… TBD)

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8
Q

corticobulbar pathway receives ________ input

A

corticobulbar pathway receives BILATERAL input

except lower face… TBD

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9
Q

alar plate gives rise to _______

basal plate gives rise to _________

A

alar plate gives rise to SENSORY NEURONS

basal plate gives rise to MOTOR NEURONS

-separated by sulcus limitans

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10
Q

motor nuclei are ________ to sensory nuclei in brainstem

A

motor nuclei are MEDIAL to sensory nuclei in brainstem

motor - medial
sensory - lateral

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11
Q

medulla - columns of CN nuclei, from midline to lateral

A

MIDLINE
1) Somatic Motor - Hypoglossal Nuclei

2) Branchial Motor (pharyngeal) - Ambiguus Nuclei
3) Visceral Motor (Autonomic) - Dorsal Vagal Nuclei
4) Visceral Sensory - Solitarius Nuclei
5) Somatosensory - Spinal V nuclei
6) Special Senses - vestibular, cochlear nuclei

LATERAL

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12
Q

3 sections thru medulla

A

1) caudal medulla - motor crossing
2) caudal medulla - sensory crossing
3) rostral medulla

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13
Q

somatic motor column

A

Hypoglossal nucleus

  • innervates intrinsic/extrinsic muscles of tongue
  • most medial
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14
Q

hypoglossal lesion

A
  • paralysis of tongue ipsilaterally
  • fasciculations (LMN) ipsilaterally
  • upon protrusion, tongue deviates to side of lesion
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15
Q

branchial motor column

A

Nucleus Ambiguus

  • innervates larynx, pharynx, soft palate
  • CN IX, X
  • lateral?
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16
Q

nucleus ambiguus lesion

A
  • hoarseness
  • difficulty swallowing
  • ipsilateral droop of arch of soft palate
  • contralateral uvula deviation
17
Q

visceral motor column

A

Dorsal Motor Nucleus of X

  • preganglionic parasympathetics for thoracic and abdominal viscera
  • medial (but just lateral to hypoglossal)
18
Q

visceral sensory column

A

Nucleus Solitarius

  • receives taste/sensation from viscera
  • CN VII, IX, X
19
Q

somatic sensory column

A

Spinal Nucleus of V

  • pain/temperature from face
  • lesion = ipsilateral deficit
  • mostly CN V, but some VII, IX, X
20
Q

lateral medullary lesion

A

-most common medullary lesion

LOSS OF NUCLEI:

  • Solitarius: CN VII, IX, X
  • —-taste/sensation from viscera
  • Vestibular: CN VIII
  • —–hearing (??)
  • Spinal V: CN V (some VII, IX, X)
  • —-ipsilateral deficit of pain/temperature
  • Ambiguus: CN IX, X
  • —-ipsilateral droop of soft palate arch
  • —-contralateral uvula deviation

LOSS OF LONG TRACTS:

  • STT (spinothalamic tract)
  • —-contralateral deficit of pain/temperature
  • ICP
  • —–ipsilateral ataxia
  • Reticular formation
  • ——respiration, BP, HR

CN SIGNS
-X: parasympathetic to thoracic/abdominal viscera

21
Q

medial medullary lesion

A

-other main medullary lesion

TRACTS LOST:
Reticular Formation
-respiration, BP, HR
Medial Lemniscus
-dorsal column pathway
-position, vibration 
Corticospinal Tract
-fine, distal movement
CRANIAL NERVE SIGNS
CN XII: Hypoglossal
-ipsilateral tongue paralysis
-fasiculations 
-protrusion  causes ispsilateral tongue deviation
22
Q

reticular formation (location, function?)

A

medial

MEDULLA

  • respiration
  • BP
  • HR

PONS/MIDBRAIN (additionally)
-arousal/consciousness

23
Q

corticospinal tract (location?)

A

-always ventral

24
Q

medial lemniscus (location?)

A

Dorsal Column Pathway

  • medial
  • midline medulla: vertical
  • as it travels up, it becomes more horizontal, joins with spinothalamic pathway
25
Q

spinothalamic pathway (location?)

A

always lateral

Emma H&N (49 decks)

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