Neuro 3 - Brainstem and Cranial Nerves

Question 1

What is the brainstem?

Answer 1

1. Part of CNS
2. Exclusive of cerebellum
3. Lies between cerebrum and spinal cord

Question 2

What are the 3 major divisions of the brainstem?

Answer 2

1. Medulla oblongata
2. Pons
3. Midbrain

Question 3

Name the posterior features of the brainstem. (assuming we’ve cut through the cerebellum)

Answer 3

1. Pineal gland (not bilateral)
2. 2x superior colliculi
3. 2x inferior colliculi
4. CN 4 (Trochlear N)

Question 4

What is the pineal gland for?

Answer 4

Vital for circadian rhythms - melatonin release

Question 5

What forms the floor of the 4th ventricle?

Answer 5

The pons

Question 6

What is cranial nerve number 1?

Answer 6

Olfactory N

Question 7

Where does cranial nerve 1 synapse?

Answer 7

Olfactory bulb

Question 8

What is cranial nerve number 2?

Answer 8

Optic Nerve

Question 9

Where does CN 2 synapse?

Answer 9

Optic chiasm

Question 10

From where does the trochlear N emerge?

Answer 10

Dorsal aspect of the brainstem

Question 11

What lies behind the pituitary stalk?

Answer 11

Mammillary body (part of diencephalon)

They turn dark if alcohol abuse - due to neovascularisation

Question 12

Which 2 nerves emerge at the midbrain level?

Answer 12

1. Oculomotor n

2. Trochlear N

Question 13

What do the cerebral peduncles do?

Answer 13

Functional and structural use.

Hold cerebral cortex onto brainstem

Question 14

Which nerve emerges at the level of the pons?

Answer 14

Trigeminal N

Question 15

Muscles of mastication are supplied by which nerve?

Answer 15

The trigeminal

Question 16

At the ponto-medullary junction, what nerves are present?

Answer 16

CN 6, 7, 8 (medial to lateral)

Question 17

What eye movement muscle does the abducens nerve supple?

Answer 17

The lateral rectus muscle

Question 18

What is the facial nerve used for?

Answer 18

Muscles of facial expression

Question 19

What is CN 6?

Answer 19

Abducens

Question 20

What is CN 7?

Answer 20

Facial

Question 21

What is CN 8?

Answer 21

Vestibulocochlear

Question 22

Which nerves emerge from the lateral part of the medulla?

Answer 22

CN 9, 10, 11

Question 23

What is CN 11, and what does it supply?

Answer 23

Accessory n, supplies shoulder muscles (e.g. trapezius and SCM)

Question 24

CN 9?

Answer 24

Glossopharyngeal

Question 25

CN 10?

Answer 25

Vagus

Question 26

CN 12?

Answer 26

Hypoglossal, innervates tongue

Question 27

What is the significance of the pyramidal decussation?

Answer 27

Where 90-95% of the motor fibres cross over. Anatomical basis for contralateral motor control

Question 28

GSA?

Answer 28

General Somatic Afferent. | Sensory information from skin and mucous membranes

Question 29

GVA?

Answer 29

General Visceral Afferent. | Sensory information from GIT, heart, vessels and lungs

Question 30

GSE?

Answer 30

General somatic efferent. | In head = muscles for eye and Tongue movements

Question 31

GVE?

Answer 31

General visceral efferent. Preganglionic parasympathetic (eg vagus n)

Question 32

What are the Special somatic afferent nerves?

Answer 32

Optic and Vestibulocochlear

Question 33

What are the special visceral afferent nerves?

Answer 33

Olfactory N, facial N, glossopharyngeal N Smell and taste. (Glossopharyngeal posteriorly)

Question 34

What are the special somatic efferent nerves?

Answer 34

Muscles involved in chewing, facial expression, swallowing, vocal sound and turning head

Question 35

What is the dorsal root ganglion made up of?

Answer 35

Neural crest cells

Question 36

In the brainstem, are motor neurones located medially or laterally?

Answer 36

Medially

Question 37

What is the most medial cell column in the brainstem?

Answer 37

GSE

Question 38

What GSE nerves are in the midbrain?

Answer 38

Oculomotor and Trochlear

Question 39

Where does the abducens nerve arise from?

Answer 39

The ponto-medullary junction

Question 40

Where is the abducens N nucleus located?

Answer 40

Within the pons

Question 41

Which is the GSE N in the pons?

Answer 41

Abducens

Question 42

Which 3 nuclei control eye movement?

Answer 42

Oculomotor, Trochlear and Abducens

Question 43

Which GSE nucleus is in the medulla?

Answer 43

Hypoglossal

Question 44

What are the GSE Nerves?

Answer 44

Oculomotor, abducens, trochlear, hypoglossal

Question 45

Which cell column is just lateral to GSE?

Answer 45

SVE

Question 46

Are there any SVE cells located in the midbrain?

Answer 46

NO

Question 47

Which SVE nuclei are located in the pons?

Answer 47

Trigeminal, facial nerve

Question 48

Which nerve supplies the muscles for mastication?

Answer 48

Trigeminal

Question 49

What is the nucleus ambiguous used for?

Answer 49

Laryngeal movements

Question 50

Name the SVE nucleus in the medulla

Answer 50

Nucleus ambiguous

Question 51

Where does the accessory nerve have its nucleus?

Answer 51

In the crevice-spinal cord

Question 52

Name the SVE nuclei.

Answer 52

Trigeminal, facial, nucleus ambiguous, accessory n

Question 53

Which is the most lateral motor nerve cell column of the brainstem?

Answer 53

GVE (parasympathetic)

Question 54

Name any GVE nuclei in the midbrain

Answer 54

Edinger-Westphal

Question 55

What nerve provides PNS innervation to the eye?

Answer 55

Edinger westphal

Question 56

What GVE nuclei are a the border between the pons and the medulla?

Answer 56

Salivatory nuclei

Question 57

Edinger Westphal fibres follow which nerve fibres?

Answer 57

Oculomotor

Question 58

Which GVE nuclei is present in the medulla?

Answer 58

Vagus

Question 59

What are the GVE nuclei?

Answer 59

Edinger Westphal, salivary, vagus

Question 60

What is the most medial sensory cell column?

Answer 60

GVA/SVA

Question 61

Name the nuclei present in the GVA/SVA column

Answer 61

Solitarius

Question 62

What is the nucleus solitarius used for?

Answer 62

Connects nerves responsible for taste

Question 63

What part of the brainstem is the nucleus solitarius present?

Answer 63

Medulla

Question 64

What is the medial sensory cell column?

Answer 64

GSA

Question 65

What is found in the GSA column?

Answer 65

Trigeminal, present in midbrain, pons, medulla and CVS

Question 66

What is the most lateral nuclei?

Answer 66

Vestibulocochlear.

Question 67

What is the most lateral cell column?

Answer 67

SSA

Question 68

What level of the brainstem is the vestibulocochlear nuclei present?

Answer 68

Pons & medulla

Question 69

Midbrain has what distinct feature on MRI?

Answer 69

Mickey Mouse ears

Question 70

Substantia nigra is present in the midbrain. It is almost absent in someone with?

Answer 70

Parkinsons

Question 71

What are MRI features in the midbrain?

Answer 71

Inferior colliculus, cerebral aqueduct, substantia nigra, cerebral peduncle

Question 72

What features on MRI are present on the level of the pons?

Answer 72

4th ventricle, middle cerebellar peduncle, transverse fibres

Question 73

Where is the inferior olivary nucleus?

Answer 73

Medulla

Question 74

Pyramids are in?

Answer 74

Medulla

Question 75

Where is the pyramidal decussation?

Answer 75

Lower medulla

Question 76

What are the 2 causes of lateral medullary syndrome?

Answer 76

Thrombosis of vertebral artery | Thrombosis of Posterior Inferior Cerebellar Artery (PICA)

Question 77

What are the symptoms of lateral medullary syndrome?

Answer 77

1. Vertigo 2. Ipsilateral loss of thermal sense/pain in face 3. Contralateral loss of thermal sense/pain in trunk and limbs 4. Ipsilateral cerebellar ataxia 5. Horners syndrome (lack of sweating) 6. Hoarseness / difficulty of swallowing

Question 78

What information does the inferior cerebellar peduncle carry?

Answer 78

Information about the bodies position in space

Question 79

What problems occur in lateral medullary syndrome

Answer 79

1. Vestibulocochlear nucleus 2. Nucleus ambiguus 3. Inferior cerebellar peduncle 4. Spinal nucleus 5. Spinothalamic tract 6. Sympathetic tract