Midbrain lesions

Question 1

Vertical tract signs

Answer 1

Lateral Corticospinal, DCML , spinothalamic tracts with contralateral cerebellum
-only spot for ipsilateral is lower medulla for DCML and Corticospinal

Question 2

A lesion with the follow would?
Problems with motor CN 5,7,9,10,11,12
Muscle hypertonia, hyporeflexia, muscle flaccidity
Projections bilaterally except lower face and sometimes hypoglossal

Answer 2

Corticobrainstem tract

Question 3

What are the 5 D’s of brainstem dysfunction?

Answer 3

Dysphasia (generation of speech)
Dysarthria (slow/slurred speech)
Dilopia
lack of coordinated movement-under/overshooting)
Drop attacks

Question 4

Lesion causes:

Vertigo, nausea, vomiting, nystagmus, tilted head position, balance problems

Answer 4

CN VIII vestibular nuclei

Question 5

Lesion causes:

Problems with digestion and decrease ability to slow heart rate

Answer 5

CN X efferents from dorsal motor nucleus vagus

Question 6

Lesion causes:

Loss of taste from ipsilateral anterior tongue

Answer 6

CN X afferent to solitary nucleus

Question 7

Lesion causes:

Problems swallowing,speaking, loss of gag reflex, hoarseness

Answer 7

CN 9, 10, 12

Question 8

A lesion in the spinocerebellar: lateral cuneate nucleus and inferior Cerebellar peduncle would display:

Answer 8

Ataxia

Question 9

Lesion causes:

Loss of nociception and temperature information from ipsilateral face

Answer 9

Spinal tract and nucleus of trigeminal nerve

Question 10

Lesion causes:

Loss of nociception and temperature sensation from contralateral body

Answer 10

Spinothalamic tract

Question 11

Lesion Causes ipsilateral horner’s syndrome

Answer 11

Descending sympathetic tract

Question 12

Lesion causes:
Ipsilateral paralysis muscles of face, loss of efferent limb of corneal reflex, and stapedial reflex ( causes sounds to be louder due to loss of stapes bone movement damping)

Answer 12

CN 7 facial nucleus

Question 13

Lesion causes:

Lack of tears in the eye and decreased salivation

Answer 13

CN 7 salivatory nucleus

Question 14

Lesion in CN VIII cochlear nucleus

Answer 14

Unilateral deafness

Question 15

Lesion causes:

Dilation of pupil and unable to focus on near objects

Answer 15

CNIII

Oculomotor nerve parasympathetic nucleus

Question 16

Lesion causes:
Un able to move eye up, down, and in: drooping of upper eye lid. Eye abduction and depression by intact lateral Rectus and superior oblique; double vision

Answer 16

CN 3 oculomotor nucleus

Question 17

Lesion causes:

Contralateral loss of sensation from the face

Answer 17

Trigeminal lemniscus

Question 18

Lesion causes:

Contralateral loss of sensation from the body

Answer 18

Medial lemniscus

Question 19

Lesion causes:

Contralateral Cerebellar ataxia

Answer 19

Cerebellothalamic axons
Or
Motor tract: corticopontine tract

Question 20

Lesion causes:

Mild weakness of wrist and finger extensors, obscured by ataxia

Answer 20

Motor: red nucleus