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NeuroAnatomy & NeuroPathology Weeks 6-9 > NeuroAnatomy - Lecture Eight Objectives - Brainstem > Flashcards

NeuroAnatomy - Lecture Eight Objectives - Brainstem Flashcards

1
Q

which cranial nerves do not emerge from the brainstem?

A

CN I & CN II

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2
Q

which cranial nerves emerge from the midbrain of the brainstem?

A

CN III & CN IV

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3
Q

which cranial nerves emerge from the pons of the brainstem?

A

CN V - CN VIII

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4
Q

which cranial nerves emerge from the medulla of the brainstem?

A

CN IX - CN XII

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5
Q

which cranial nerves can be viewed in the anterior view?

A

all of them

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6
Q

which cranial nerves can be viewed in the posterior view?

A

CN IV is the only CN to emerge from posterior brainstem

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7
Q

what structures are found within the external midbrain?

A

CN III & CN IV , cerebral peduncles, superior/inferior colliculus

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8
Q

what structures are found within the internal midbrain?

A

cerebral aqueduct, periaqueductal gray area, CN III/CN IV nuclei, red nucleus, substantia nigra, descending motor tracts in peduncles

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9
Q

what structures are found within the pons?

A

CN V - CN VIII , motor tracts that descend into anterior pons, 4th ventricle

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10
Q

what structures are found within the medulla?

A

CN IX - CN XII , pyramids, pyramidal decussation

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11
Q

what are the three vertical columns of the brainstem listed from anterior - posterior?

A

basis, tegmentum, tectum

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12
Q

what structures are found within the tectum?

A

superior colliculus and inferior colliculus

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13
Q

what is the function of the superior colliculus?

A

visual reflexes; pupillary light, looking away/towards stimuli

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14
Q

what is the function of the inferior colliculus?

A

auditory reflexes

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15
Q

what structures are found within the tegmentum?

A

reticular formations & ascending/descending somatosensory tracts

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16
Q

what is the function of the ascending somatosensory tracts in the tegmentum?

A

proprioception, light touch, pain and temperature from the body and head

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17
Q

what are the four descending motor tracts originating from BRAINSTEM NUCLEI?

A

rubrospinal tract, tectospinal tract, reticulospinal tract, and vestibulospinal tract

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18
Q

where does the rubrospinal tract originate from?

A

red nucelus in midbrain

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19
Q

where does the tectospinal tract originate from?

A

tectum in midbrain

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20
Q

where does the reticulospinal tract originate from?

A

reticular nuclei in lower 2/3 of brainstem

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21
Q

where does the vestibulospinal tract originate from?

A

vestibular nuclei in lower brainsteam

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22
Q

what structures are found within the basis?

A

descending motor tracts that originate from cortex

23
Q

what are the three descending motor tracts originating from CORTEX?

A

corticospinal tract, corticobulbar tract, and corticopontine tract

24
Q

where does the corticospinal tract originate/descend to and does what function?

A

originates in the primary motor cortex, descends in basis of brainstem and continues down the spinal cord to supply muscles of the body

25
Q

where does the corticobulbar tract originate/descend to and does what function?

A

originates in the primary motor cortex, descends in basis of brainstem and connect to cranial nerves that supply muscles of the head

26
Q

where does the corticopontine tract originate/descend to and does what function?

A

descend from motor cortices, descends in basis of upper brainstem, terminates in pontine nuclei and connects to cerebellum

27
Q

what is reticular formation and where is it located?

A

a cluster of nuclei located in tegmentum throughout brainstem

28
Q

where is the rostral reticular formation?

A

upper pons/midbrain

29
Q

where is the caudal rectiular formation?

A

lower pons/medulla

30
Q

what does the reticular formation do?

A

regulates/modulates most CNS areas

31
Q

what is the function of CAUDAL reticular formation?

A
  1. modulate respiratory/cardiovascular nuclei of brainstem 2. modulate motor functions & complex physiological motor reflexes 3. modulate nociception pathways (inhibits)
32
Q

what is the function of ROSTRAL reticular formation?

A

modulate consciousness // alertness, attention, awareness. Damage to upper brainstem results in potential coma or impaired consciousness

33
Q

what are the characteristics of a coma?

A

unconscious, no meaningful response to stimuli, low GS scores, CNS cells alive but significantly reduces metabolism, generally not permanent and will progress/digress after 2-4 weeks

34
Q

what areas are affected relating to comas?

A

severely depressed function of cortex and sub-cortical regions as well as rostral reticular formation

35
Q

what reflexes are still intact during comas?

A

spinal cord and brainstem reflexes

36
Q

what are the characteristics of a vegetative state?

A

similar to coma, GS score SLIGHTLY higher than coma, displays some sub-cortical function (i.e. sleep-wake cycle and some arousal reflexes)

37
Q

what areas are affected relating to vegetative states?

A

severely depressed function of cortex and sub-cortical regions

38
Q

what reflexes are still intact during vegetative states?

A

spinal cord and brainstem reflexes as well as some arousal reflexes (open eyes / turn towards stimuli, random sounds or movements, etc)

39
Q

what are the characteristics of brain death?

A

no evidence of cortex, diencephalon, and brainstem function including absent brainstem reflexes

40
Q

what areas are affected relating to brain death?

A

absent function of cortex, sub-cortical arousal system and brainstem

41
Q

what reflexes are still intact during brain death?

A

spinal cord

42
Q

what artery supplies the medulla?

A

small branches of vertebral artery supplies most of medulla and PICA supplies lateral medulla

43
Q

what artery supplies the pons?

A

small branches of pontine arteries supply most of pons and AICA/branches from VA supplies small lateral region of lower pons

44
Q

what artery supplies the midbrain?

A

PCA

45
Q

what artery is involved in Weber’s Syndrome?

A

right or left PCA in midbrain

46
Q

what are the clinical findings of Weber’s Syndrome?

A

contralateral hemiplegia/paresis, ipsilateral CNIII palsy, Parkinsonian if substantia nigra is affected

47
Q

what artery is involved in Pure Motor Hemiparesis?

A

right or left pontine arteries of basilar artery along left or right anterior pons

48
Q

what are the clinical findings of Pure Motor Hemiparesis?

A

contralateral hemiplegia/paresis

49
Q

what artery is involved in Locked-In Syndrome?

A

basilar artery // “bilateral stroke of anterior pons”

50
Q

what are the clinical findings of Locked-In Syndrome?

A

quadriplegia with intact sensation/cognition, all motor function is impaired EXCEPT for CNIII and possibly CNIV

51
Q

how does a coma vs. locked-in syndrome compare?

A

locked-in syndrome mimics a coma but the patient is conscious and may be able to communicate via eye blinking and is aware of their environment

52
Q

what artery is involved in Wallenberg Syndrome?

A

vertebral artery, PICA, or small branches of PICA // unilateral stroke of lateral medulla

53
Q

what are the clinical findings of Wallenberg Syndrome?

A

loss of pain/temp to ipsilateral face (CNV) , contralateral body // vertigo/nausea/vomit/nystagmus (CNVIII) , hoarseness/dysphagia (CNIX/CNX), ataxia

NeuroAnatomy & NeuroPathology Weeks 6-9 (9 decks)

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