Neuro Lab Flashcards
lesions affecting the _____ nucleus or nerve present with lateral strabismus, diplopia, and pupillary dilation
oculomotor (uncal herniation)
function of abducens nuclei
lateral rectus nucleus of ipsilateral eye
region within the reticular formation at the rostral end of the medial longitudinal fasciculus in the midbrain involved in coordinating conjugate vertical eye movements
interstitial nucleus aka vertical gaze center aka nucleus of cajal
root that mediates dorsiflexion at the ankle
L5
what carries sensation from head and neck
trigem
crossing fibers of auditory
trapezoid body
function of spinal nucleus and tract of V
protopathic sensory from face, then epicritic
protopathic sense
pain, temperature
tract in the genu of the internal capsule
corticobulbar (motor)
axons in lateral lemniscus
from both ears
where will you find contralateral cerebellar signs
superior cerebellar peduncle, red nucleus
artery that supplies basal ganglia, post limb internal capsule, visual radiations, thalamus, amygdala
lenticulostriate
artery that supplies dorsal 1/3 of spinal cord
posterior spinal (2)
function of chief sensory nucleus of V
epicritic sensation for head and neck, same side
two tracts in the anterior limb of the interal capsule
frontopontine, thalamocortical
at the caudal midbrain level, the medial lemniscus carries ____ signal for the entire (ipsi/contra) lateral side of the body
epicritic sensory signals, contralateral, including the head
spinal nucleus of CN 5 in the medulla receives what type of info
protopathic from face
to where do projections from the inferior olive go
cross over, serve as source of climbing fibers in cerebellum
blood supply to inferior cerebellar peduncle
PICA
damage to the cranial nucleus or nerve itself causes (ipsi/contra) lateral symptoms
ipsilateral
signs of tumor
unilateral, progressive, increased intracranial pressure
type of stroke that causes: bilateral blindness (occ lobes), memory loss (temp lobes), somatosensory loss (thalamus)
top of the basilar
what carries protopathic
anterolateral
made in locus ceruleus
norepi
stroke to anterior spinal artery, medulla branch
contralateral sensory loss and paresis, ipsilateral tongue paralysis
pathology of solitary nuc and is it ipsi or contra
ipsilateral loss of taste
localizer for anterograde amnesia
parahippocampal gyri
stroke to anterior cerebral
contralateral paralysis and sensory loss in leg and foot, sometimes apraxia
dilation of pupil localizes to what area of the brain
midbrain
signs of AICA stroke
facial paralysis, deafness, CN 7 and 8 problems
SCA stroke symptoms
ataxia, tremor, protopathic loss to face, Horner’s
pathology of medial longitudinal fasciculus
internuclear opthalmoplegia: contralateral eye cannot adduct for conjugate gaze shift but can adduct during convergence
efferent portion of gag reflex (which CN)
X vagus
a pinealoma will press down on the ____ ____ and the first diagnostic symptom is:
posterior commissure; paralysis of upward eye movements
stroke to post cerebral, bilateral
top of basilar occlusion, bilateral blindness, memory loss, somatosensory loss, coma, death
CN _ =afferent limb of pupillary light reflex
2
symptoms of vermis and flocculus lesions
ataxia, broad based gait, nystagmus, hypotonia
afferent portion of gag reflex (which CN)
IX glossopharyngeal
can’t speak but understand fine
broca’s (inf frontal gyrus)
rostral endpoint of midbrain
posterior commissure
function of pineal body
makes melatonin
tract that connects the abducens nuclei in pons to the trochlear and oculomotor nuclei in the midbrain, crosses
medial longitudinal fasciculus
artery that supplies occipital lobe, medial temporal, portion of parietal, midbrain, crus cerebri, posterior thalamus, angular gyrus
posterior cerebral artery
cranial nerves evident on surface of basilar pons
8, 7, 6, 5
root that mediates inversion of foot
L4
superior colliculi are part of the ___ system
visual
epicritic sense
vibration, tactile form (2 point discrimination), position sense, simple touch
function of dorsolateral fasiculus
protopathic enters here, goes up a few, then crosses over through anterior white commissure to the anterolateral system
stroke to post communicating arteries
contralateral paresis, coma, death
artery that supplies ventral 2/3 spinal cord
anterior spinal
cranial nerve in middle pons
V-motor nucleus, principal sensory nucleus
roots that mediate flexion at the elbow and the biceps reflex
C5 and C6
midbrain region that makes dopamine and where the neurons project
substantia nigra, striatum
where is the spinal nucleus of V and what sensory info is there
medulla and caudal pons, protopathic
root that mediates hip abductors and dorsiflexion of food
L5
six UMN signs
spastic paralysis, hyperreflexia, Babinski, hypertonia, CN7 contralateral lower face droop, CN12 tongue deviates to contralateral side
seven LMN signs
flaccid paralysis, hyporeflexia, decreased muscle tone, muscle atrophy, muscle fasciculations, CN7 entire half face paralysis, CN12 lick the lesion
three outputs of vestibular nuclei
cranial nerve nuclei that move the eyes (3, 4, 6), to spinal cord via vestibulospinal tracts (posture), to cerebellum via inferior cerebellar peduncle (balance, reflexive eye movements)
lesions to which CN cause deafness in ipsilateral ear, nystagmus, vertigo, and balance problems
VIII
what CN does protrusion of tongue test
XII
how does the rostral pons connect to the cerebellum
sup cerebellar peduncles
roots that mediate extension of knee and adductors of hip
L2 and L3
the auditory portion of CN 8 synapses where
on cochlear nuclei
root that mediates leg extension at the knee and the patellar tendon reflex
L4
root that mediates the elbow extension and the triceps reflex
C7
how to differentiate between vestibular nystagmus and cerebellar nystagmus
cerebellar-intention, gaze induced
vestibular-not induced
a brainstem lesion most rostral symptom will be (ipsi/contra) lateral and the more caudal symptoms will be (ipsi/contra) lateral
most rostral: same side
caudal symptoms: opposite
function of vestibular nuclei
receive sensory info about head movement via CN 8.
pregnant and carpal tunnel
could be preeclampsia, swelling causing nerve problems
what carries the epicritic sense
doral columns, lemniscal
symptoms of vermis or flocculus damage
nystagmus
horizontal gaze center
caudal pons, abducens nuclei and paramedian pontine reticular formation
motor pathway: cortex > ______ > ______> descend contralerally
internal capsule > caudal medulla (pyramidal decussation)
what causes papilledema
increased intracranial pressure
artery that supplies lateral surface of frontal, temporal, parietal lobes, Wernicke’s
middle cerebral
pretectal area controls
total amount of light entering the eye
the brachium of the inf colliculus ends in the ____ _____ _____ of the thalamus
medial geniculate nucleus of the thalamus
stroke to anterior choroidal
with hemorrhage: may cause paralysis, sensory deficits, visual field deficit (internal capsule)
entire side of face drooping including forehead localizes lesion to where
pons–lower motor lesion of facial VII-same side, facial nucleus or nerve
damage to corticobulbar paths which control the CN nuceli may cause (ipsi/contral) lateral symptoms
contralateral
PICA stroke symptoms
lateral medullary, vertigo, hoarseness
dysmetria
past pointing
when uvula deviates to the left, there is a (R/L) problem with which cranial nerve
vagus
roots that mediate hip flexion
L1, L2
function of medial longitudinal fasciculus
coordinates head and eye movement
symptoms of increased intracranial pressure
nausea, vomiting, stupor, headache, seizures, coma, death
this syndrome results from occlusion of branches of the anterior spinal artery
medial medullary syndrome
if the lesion is in forebrain, all sensory and motor symptoms are on which side of the body
contralateral
________ nucleus contains preganglionic parasympathetic neurons that project to the ciliary ganglion, responsible for:
Edinger-Westphal; pupillary constriction and thickening of the lens (accommodation with convergence of the pupils to focus on near objects)
the medial longitudinal fasciculus connects what three structures and three cranial nerve nuceli
superior colliculus, vestibular nuceli, CN 3/4/6, cervical spinal cord
cranial nerve nucleus at junction of medulla-pons
VIII (vestibulocochlear)
root that mediates plantar flexion at the ankle and the Achilles tendon reflex
S1
Romberg sign
loss of balance when eyes are closed
if lesion is in spinal cord, on will you observe symptoms
same side except protopathic will be contralateral
can speak but can’t understand
wernicke’s (angular and supramarginal gyri)
stroke to lenticulostriate
involuntary movements (basal ganglia), paralysis, sensory deficits over half of body, homonymous visual field defects (internal capsule)
superior olive involved in what?
audition
root that mediates flexion of knee, eversion of foot, plantar flexion of foot
S1
stroke to middle cerebral
contralateral paralysis and sensory loss, apraxia, aphasia, partial blindness
pathology of facial nucleus
paralysis of facial muscles ipsilateral, mouth droops, can’t close eye, can lead to drying out of cornea
trapezoid body
cross over point for auditory info, contains medial lemniscus
what carries propioceptive
spinocerebellar
root that mediates flexion of upper limb digits
C8
symptoms of lateral cerebellar lesions
intention tremor, dysmetria, dysdiadochokinesia
stroke to ant spinal art, spinal cord branch
paralysis, loss of protopathic below occlusion
pathology of TST causes
nausea, dizziness, imbalance, nystagmus
root that mediates abduction and adduction of upper limb digits
T1
stroke to ant inf cerebellar
ipsilateral cerebellar signs, facial paralysis, ipsilateral hearing loss, loss of protopathic over ipsilateral face
inf cerebellar peduncles receives connections from:
spinocerebellar tracts, inferior olive (contra), vestibular nuclei
stroke to post inf cerebellar
Wallenburg’s: vertigo, loss of balance, ipsilateral cerebellar signs, loss of facial pain sensation, hoarseness
two cranial nerve nuceli in tegmentum of midbrain
III and IV
MLF receives connections from:
vestibular nuclei, CN VI
symptoms of medial medullary syndrome
contralateral hemiplegia of limbs, contralateral loss of epicritic (medial lemniscus), deviation of tongue to ipsilateral when protruded
dysarthria
motor inability to speak
why do you see hyporeflexes after a trauma and then hyperreflexia in a follow up?
shock first, then UMN damage presents
CN _=efferent limb of pupillary light reflex
3
cranial nerves that localize to the medulla
XII, XI, X, IX, VIII
function of nucleus ambiguus
movement of larynx and pharynx
stroke to post cerebral, unilateral
blindness in the contralateral visual field, alexia
inferior colliculi are part of the ___ system
auditory
function of motor nucleus of V
muscles of mastication, same side
medial lemniscus (auditory/somatosensory), and is a component of what system
somatosensory, dorsal column system
for which CN is internal strabismus a sign, and which side
abducens 6 (same side lesion and symptom)
diagnostic symptoms of a pinealoma
paralysis of upward eye movements, pupillary light reflex blocked (pretectal area), non-communicating hydrocephalus (tectum and obstruct cerebral aqueduct)
damage to Edinger-Westphal nucleus causes
severely disrupted eye movements, eye is fixed and deviated laterally and down and there is ptosis (lid droops), dilated pupil (mydriasis) and unresponsive to light shined in other eye
function of facial nucleus
motor for facial muscles, innervates stapedius, auricularis, and stylohyoid muscles
head to toe deficit of motor, sensory, and vision indicates lesion to what structure
posterior limb of internal capsule
MLF sends connections to:
CN III nuclei, IV, VI, cervical cord
lateral lemniscus: (auditory/somatosensory)
auditory
pathology of abducens nuclei
diplopia
function of reticular formation
coordinates reflexes from cranial nerves (ex. swallowing X)
two cranial nerves in solitary nuc
9 and 10
dysdiadochokinesia (inability to make rapid alternating movements) is a symptom of what kind of damage
hemispheric, cerebellar
stroke to which artery causes bilateral blindness
basal artery (tip occlusion)
stroke to basilar branches
paralysis and loss of sensation in face, body, and limbs; can also affect eye movements and cause diplopia
how does the caudal pons connect to the cerebellum
inf, middle, and sup cerebellar peduncles
symptoms of vestibular nuclei pathology
nystagmus, loss of balance, vertigo
function of TST
head movements during visual and auditory tracking
a stroke to which artery causes blindness in ipsilateral eye
internal carotid artery (branch to opthalamic)
what causes a roaring sound
if nerve (VII) to stapedius muscle is damaged (because usually stapedius dampens sound)
symptoms of lateral medullary syndrome
contralateral loss of protopathic over the body (anterolateral), ipsilateral loss of protopathic over face (spinal trigem tract), dysphagia, soft palate paralysis, hoarseness, diminished gag reflex (all nucleus ambiguus), ipsilateral Horner’s (HRST), nausea and diplopia (vestibular nuclei), ataxia to ipsilateral side
stroke to sup cerebellar
ipsilateral cerebellar signs, contralateral protopathic loss, Horner’s
large cholinergic nucleus that projects directly to cerebral cortex
basal nucelus of Meynert
“shade pulled down over eye” suggestive of disease in which artery
ICA proximal to opthalamic branch
cranial nerve lesions that localize to the pons
5,6,7
root that mediates arm abduction at the shoulder
C5
artery that supplies post limb of internal capsule, hippocampus (but not basal ganglia)
ant choroidal
two tracts in the posterior limb of the internal capsule
corticospinal (motor descending), thalamocortical (sensory ascending)
what CN does shrugging shoulders test
XI
the principal/chief sensory nucleus of CN 5 in the pons processes what type of info
epicritic from face
this syndrome results from occlusion of the PICA or PICA branches
lateral medullary syndrome aka Wallenberg
where is the CN VIII found in the medulla
rostral only
connections to TST come from
deep layers of cuperior colliculus
how does the middle pons connect to the cerebellum
middle and sup cerebellar peduncles
two arteries that supply the pons
AICA and perforating branches of the basilar
made in raphe nucleus
serotonin