Neuro Final Flashcards
To which layer(s) of the lateral geniculate nucleus does visual information from the contralateral and ipsilateral eye project?
Contralateral eye: Layers 1, 4, and 6.
Ipsilateral eye: Layers 2, 3, and 5.
L8b #43
A parietal lobe lesion will affect the ________ optic radiations, causing _________ quadrantanopia.
superior optic radiations
inferior quadrantanopia
L8b #52
A temporal lobe lesion will affect the ________ optic radiations, causing _______ quadrantanopia.
inferior optic radiations
superior quadrantanopia
L8b #52
- ) Which type(s) of tract(s) are found in the ventral/anterior brainstem?
- ) Consequence of injury?
1.) Descending motor tracts (ONLY found in ventral/anterior brainstem).
2.) Paralysis only – No sensory loss.
L5a #5
- ) What two general things are found within the tegmentum?
2. ) Where is tegmentum?
1.) (i) Ascending/sensory tracts and (ii) CN nuclei
2.) Deep to basal portion/basis —> In the midbrain, it lies between basis and tectum (only exists in the midbrain). Tectum is most dorsal part of the midbrain.
L5a #5
- ) What is the laterality of (a) motor and (b) sensory cranial nerve nuclei within the brainstem (i.e. lateral or medial)?
- ) What limits them (i.e. medial or lateral to what landmark)?
1.) (a) Motor = Medial (b) Sensory = Lateral
2.) Sulcus limitans
L5a #7
Decussation of the corticospinal tract (aka _______ ) occurs where in the brainstem?
aka Pyramidal decussation – Occurs in the ventral lower (caudal) medulla.
L5a #12
Where does the sensory decussation occur in the brainstem?
Within the internal arcuate fibers of the mid-medulla.
L5a #13
- ) Horner’s Syndrome is always _________ (laterality)?
2. ) Caused by damage to what/where?
1.) Ipsilateral
2.) Hypothalamospinal tract in the lateral medulla.
L5a #22
Give the blood supply for:
- ) Upper pons
- ) Lower pons
- ) Lateral medulla
- ) Medial medulla
1.) Superior cerebellar artery (L5b #38)
2.) AICA
3.) PICA
4.) Anterior spinal artery
L5b #24
Which three arteries supply the open medulla?
Anterior spinal, vertebral (medullary branches), PICA
L5b #24
- ) Occlusion of the Anterior spinal artery will cause damage to which three structures in the medulla?
- ) Clinical symptoms (3)?
- ) What is the clinical name for this problem?
1.) CN XII, pyramid, medial lemniscus
2.) Ipsilateral tongue paralysis (deviates to side of lesion), contralateral bodily paralysis (pyramid), contralateral loss of vibration, two-pt discrimination, and conscious proprioception (medial lemniscus).
3.) Medial medullary syndrome
L5a #25
- ) What is Wallenberg syndrome?
- ) Clinical symptoms (6)?
- ) How is this different from AICA syndrome?
1.) Lateral medullary/PICA syndrome
2.) (1) contralateral loss of pain and temperature sensation from the body (Spinothalamic tract/anterolateral system), (2) ipsilateral loss of pain and temperature sensation from the face (spinal trigeminal tract and nucleus), (3) some vertigo, vomiting, nausea, and nystagmus (vestibular nuclei), (4) loss of taste from the ipsilateral half of the tongue (solitary tract and nucleus), (5) hoarseness and dysphagia (nucleus ambiguus, i.e. roots of cranial nerves IX and X).
(6) Patients with the lateral medullary syndrome may also have the Horner syndrome owing to injury to hypothalamospinal fibers descending through the lateral areas of the medulla.
3.) Same, except AICA syndrome involves MOTOR CN VII NUCLEUS (L5a #43)
L5b #26, p.156 Haines, p.124 Atlas
Describe the location where the trigeminal nerve exits the brainstem
Externally at the junction between the middle cerebellar peduncle and basis of the pons
L5b #27
- ) Where do the fibers for the auditory pathway cross (structure and location)?
- ) What other structure associated with the auditory pathway is in this location?
1.) Trapezoid body in the DORSAL tegmentum of the lower pons.
-They form the lateral lemniscus
2.) Superior olivary nucleus (L5a #32)
L5b #30
If there is a tumor in the region of the facial colliculus, which extra-ocular muscle is affected (and via which CN)?
Lateral rectus (via Abducens nerve, CN VI) L5b #31
- ) Where is the only other place in the CNS that has pseudo-unipolar neurons just like the DRG?
- ) What reflex is mediated here?
1.) Mesencephalic nucleus (of CN V) in the midbrain.
2.) Jaw-jerk reflex
L5b #35
- ) Where does the trigeminal lemniscus lie?
- ) What does it carry and to where?
- ) Where are its 1st, 2nd, and 3rd order neurons?
1.) Lateral to the medial lemniscus in the UPPER PONS
2.) Carries pain and temperature from the CONTRALATERAL side of the face to the VPM nucleus of the thalamus.
3.)
1st: Peripheral ganglia associated with CNs V, VII, IX, and X.
2nd: Ipsilateral spinal trigeminal nucleus
3rd: Contralateral VPM nucleus of thalamus
L5b #37, p.164 BRS
- ) What is another name for abnormal flexion posturing?
2. ) Cause?
1.) Decorticate rigidity
flexOR = decORticate
2.) Injury superior to the level of the red nucleus (i.e. above the midbrain). Flexion of upper limbs is mediated by surviving rubrospinal tract (facilitates flexor muscle tone).
Lower limbs are extended
L5b #62-63
- ) What is another name for abnormal extension posturing?
2. ) Cause?
1.) Decerebrate rigidity
2.) Injury inferior to the level of the red nucleus in the midbrain (i.e. below the midbrain). Extension is due to unopposed action of the vestibulospinal tract.
Since rubrospinal tract is also cut, flexion of upper limbs is also lost
Mnemonic —> dEcErEbratE (lots of E’s) = ExtEnsion (more E’s than flExion).
L5b #62-63
- ) What is the EEG pattern called during sleep?
2. ) What is the characteristic amplitude and frequency?
1.) Synchronus pattern
2.) High amplitude, low frequency
L5a sleep #10
- ) What is the EEG pattern called during awakened state?
2. ) What is the characteristic amplitude and frequency?
1.) Desynchronus pattern
2.) Low amplitude, high frequency
L5a sleep #9
- ) Describe the neurotransmitter-mediated induction of sleep
- ) Awakened state?
1.) ACh released by cholinergic fibers from the midbrain that supply thalamic nuclei is reduced during sleep. This desensitizes thalamic nuclei.
GABA (an inhibitory NT) is released from the reticular nucleus inhibits the thalamic nuclei = Sensory thalamus inhibited = Sleep = EEG synchronous.
2.) In awakened state, ACh system is active and reticular nucleus is inhibited. Thus, the sensory thalamus is facilitated and the thalamocortical neurons are active = EEG de-synchronous.
L5a sleep #12-14
During sleep, _______ level is reduced, _______ neurons are not sensitized, and _______ nuclei inhibit the ________ neurons.
__________ ________ are in slow rhythm.
-ACh level is reduced
-Thalamic neurons are not sensitized
-Reticular nuclei inhibit thalamic neurons
-Thalamocortical neurons are in slow rhythm
L5a sleep #13-14