Neu 8 - Brainstem In Cross Section Flashcards

1
Q

Which is the pathway of the dorsal column tract?

A

Decussates in the medulla, ascends Contralaterally in medial Lemniscus until VPL (Thalamus) to the sensory cortex.

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2
Q

Which is the pathway of the Spinothalamic tract?

A

Decussates at the anterior white commissure, travels Contralaterally in the brainstem until VPL to sensory cortex.

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3
Q

Which is the pathway of the lateral corticospinal tract?

A

The 1 grade motor cortex, descends ipsilaterally and decussates at caudal medulla (pyramidal decussation) descends Contralaterally and leaves spinal cord to the NMJ.

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4
Q

If the right vagus nerve or nuclei is damaged, then to which side will the uvula deviate?

A

Since the muscles of the left soft palate are working to raise the palate and the muscles on the right are not, the uvula will deviate to the left (opposite the side of the lesion).

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5
Q

A patient comes to your office and before you notice any other symptoms, you see that the patient’s uvula deviates to the right when she says “Ah”. What neurological areas might be damaged in order for this abnormality to be seen?

A

Right deviation of uvula means that the muscles of the right plate are raising the palate and the muscles of the left palate are not. -Left vagal nerve (CN X). -Left nucleus ambiguous. -Right corticobulbar tract. -Soft palate portion of right motor cortex.

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6
Q

If the right hypoglossal nerve or nuclei is damaged, then to which side will the tongue deviate when sticking out?

A

Since the tongue is “pushed” out, the muscles of the functional side (in this case the left side) will “push” the tongue to the non-functional side (in this case the right side) toward the side of the lesion.

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7
Q

If the portion of the right motor cortex (or right corticobulbar tract) that innervate the tongue is damaged, to which side will the tongue deviate?

A

Since tongue fiber from the right motor cortex travel to the left hypoglossal nucleus, the tongue will deviate to the left (away from the side of the lesion).

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8
Q

A patient come to your office and before you notice any other symptoms, you see that the patient’s tongue deviates to the left when he sticks out his tongue. What neurological areas might be damaged in order for this abnormality to be seen?

A

Left deviation of the tongue means that the muscles of the right tongue are pushing the tongue out unopposed by the muscles of the left tongue. -Left hypoglossal nerve (CN XII). -Left hypoglossal nucleus (anterior spinal artery-> vertebral artery). -Right corticobulbar tract. -Tongue portion of the right motor cortex.

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9
Q

How do the symptoms of a lesion to the cortical motor region of the face differ from a lesion of the facial nerve or nucleus?

A

1)Lesion in cortical motor face region - Paralysis of Contralateral side of lower face. 2)Lesion of facial nerve or nucleus - Paralysis ipsilateral side of entire face.

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10
Q

What mane is given to a collection of symptoms indicative of a lesion of the facial nerve or nucleus?

A

Bell’s palsy

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11
Q

What diseases might have Bell’s palsy as a complication?

A

Lyme disease, Herpes Zoster, AIDS, Sarcoidosis, Tumors, Diabetes

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12
Q

What artery supplies the medial Lemniscus and medullary pyramid of the medulla?

A

Anterior spinal artery.

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13
Q

Where does the corticospinal tract decussate in the brainstem?

A

Caudal medulla prior to medullary pyramids.

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14
Q

Where does the dorsal column-medial lemniscal pathway decussate?

A

Medulla than ascends as medial Lemniscus.

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15
Q

What artery supplies the following medullary structures: Spinothalamic tract, inferior cerebellar peduncle, nucleus ambiguus, and lateral Spinothalamic tract?

A

Posterior Inferior Cerebral Artery (PICA).

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16
Q

How can a stroke of the facial motor cortex be distinguished from Bell’s palsy?

A

In Bell’s palsy the patient is unable to winkle the forehead on affected side.

17
Q

A patient has leftward deviation of the tongue on protrusion and has a right sided spastic paralysis. Where is the lesion?

A

Left medulla at the level of the pyramid.

18
Q

What innervate the tongue for motor?

A

Cranial Nerve XII (Hypoglosso), and CN X.

19
Q

What innervate the tongue for taste?

A

Anterior 2/3: CN VII. Posterior 1/3: CN IX. Extreme posterior: CN X (solitary nucleus).

20
Q

What innervate the tongue for pain?

A

CN V3, CN IX and CN X.

21
Q

Which are the spinal tracts?

A

1)Dorsal column. 2)Spinothalamic tract. 3)Lateral corticospinal tract.

22
Q

Which is the function of the Dorsal column tract?

A

Pressure, vibration, touch and proprioception, there are two fasciculus gracile (lower body, legs) and cuneatus (upper body, arms).

23
Q

Which tracts are ascending?

A

Dorsal column and Lateral Spinothalamic tract, and anterior Spinothalamic tract.

24
Q

Which tracts are descending?

A

Lateral corticospinal tract and anterior corticospinal tract.