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Control and Movement Term 1 > Practical neuroanatomy 2: Brainstem, cranial nerves and cerebellum > Flashcards

Practical neuroanatomy 2: Brainstem, cranial nerves and cerebellum Flashcards

1
Q

What is the name of the ridge that is visible on either side of the ventral midline of the medulla?

A

Pyramid (corticospinal tract). Consists of descending fibres originating from ipsilateral cerebral cortex. Fibres cross over at the decussation.

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2
Q

Where on the dorsal aspect of the brainstem would you find the gracile and cuneate tubercles?

A

Rostral medulla.

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3
Q

Where on the dorsal aspect of the brainstem would you find the gracile and cuneate fascicles?

A

Caudal - mid medulla.

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4
Q

Where on the dorsal aspect of the brainstem would you find the inferior cerebellar peduncle?

A

Caudolateral pons.

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5
Q

Where on the dorsal aspect of the brainstem would you find the middle cerebellar peduncle?

A

Most lateral structure of the pons.

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6
Q

Where on the dorsal aspect of the brainstem would you find the superior cerebellar peduncle?

A

Most medial peduncle, rostral to others. Rostromedial pons.

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7
Q

Where on the dorsal aspect of the brainstem would you find the inferior colliculli?

A

Caudal midbrain

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8
Q

Where on the dorsal aspect of the brainstem would you find the superior colliculli?

A

Rostral midbrain

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9
Q

What are peduncles?

A

White matter bundles that connect the brainstem to the cerebellum/cerebrum.

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10
Q

What type of fibres are carried in the gracile and cuneate fascicles?

A

First order sensory neurones, continuing rostrally from the spinal cord to termination in nuclei gracilis and cuneatus.

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11
Q

What is the function of the inferior colliculli?

A

Constitutes part of the ascending acoustic (auditory) projection. Ascending auditory fibres terminate here.

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12
Q

What is the function of the superior colliculli?

A

Part of the visual system. Afferents originate from the visual cortex of occipital lobe and frontal eye field of frotal lobe. These fibres are concerned with controlling eye movements (saccidic, smooth pursuit), also involved in the accomodation reflex.

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13
Q

What are ‘smooth pursuit’ eye movements?

A

Slow tracking movements of the eyes designed to keep a moving stimulus on the fovea. Such movements are under voluntary control.

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14
Q

What are saccadic eye movements?

A

Rapid, ballistic movements of the eyes that abruptly change the point of fixation. They range in amplitude from the small movements made while reading, for example, to the much larger movements made while gazing around a room. May be voluntary or involuntary.

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15
Q

In which regions of the brainstem is the central canal expanded to form the fourth ventricle?

A

Caudal pons and rostral medulla on the dorsal aspect.

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16
Q

What structure sits on the roof of the fourth ventricle?

A

The ventral cerebellum.

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17
Q

What are the distinguishing features of the ventral surface of the medulla oblongata?

A

Pyramids (medial - with decussation) and olives (rostrolateral).

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18
Q

What are the distinguishing features of the ventral surface of the pons?

A

Ventrolateral surface of middle cerebellar peduncle (i.e. the big bulge).

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19
Q

To which side of the brainstem do all but one of the cranial nerves attach?

A

The ventral side.

20
Q

Which cranial nerves attach to the midbrain?

A

III (3) Oculomotor

IV (4) Trochlear

21
Q

Which cranial nerves attach to the pons?

A

V (5) Trigeminal

VI (6) Abducens

VII (7) Facial

22
Q

Which cranial nerves attach to the medulla oblongata?

A

VIII (8) Vestibulocochlear

IX (9) Glossopharyngeal

X (10) Vagus

XI (11) Axillary

XII (12) Hypoglossal

23
Q

What name is given to the angle between the medulla, pons and cerebellum?

A

Cerebellopontine angle

24
Q

Which cranial nerves are likely to be compressed by an acoustic neuroma (tumour of Vestibulocochlear nerve)? What might the symptoms be?

A

V-VII (5-7) (trigeminal, facial, vestibulocochlear).

Dizziness, deafness, cerebellar ataxia.

25
Q

How would you test olfactory (CNI) nerve function?

A

Ask them if they have noticed a change in olfactory perception. Test smell in each nostril separately (closing the other).

26
Q

How would you test optic (CNII) nerve function?

A

Test visual acuity, visual fields, colour perception and pupillary light reflex. Perform fundoscopy.

27
Q

How do you test function of the oculomotor (CNIII) nerve?

A

Inspect for ptosis, nystagmus and eye position (PERRLA). Test eye movement in H pattern. Accommodation reflex - finger to nose.

28
Q

How would you test the function of the trochlear (CNIV) nerve?

A

As you would the oculomotor.

29
Q

How would you test the function of the trigeminal (CNV) nerve?

A

Sensory part - light touch tested in each of 3 divisions of the nerve with point stimulus. Test corneal reflex.

Motor part - palpate temporalis and masseter when jaw is clenched. Test pteregoids.

30
Q

How would you test the function of the abducens (CNVI) nerve?

A

?As you would the oculomotor.

31
Q

How would you test the function of the facial (CNVII) nerve?

A

Sensory - test for taste

Motor - ask patient to raise eyebrows, frown, open eyes against resistance, show upper and lower teeth, smile and puff out both cheeks.

32
Q

How would you test the function of the Vestibulocochlear (CNVIII) nerve?

A

Hearing test - not routinely tested.

33
Q

How would you test the function of the glossopharyngeal (CNIX) nerve?

A

Either test the gag reflex or touch the arches of the palate.

34
Q

How would you test the function of the vagus (CNX) nerve?

A

Ask patient to say ‘ah’ while tongue is depressed. the uvula will deviate away from the affected side.

35
Q

How would you test the function of the accessory (CNXI) nerve?

A

Shrug shoulders, turn head from side to side.

36
Q

How would you test the function of the hypoglossal (CNXI) nerve?

A

Stick out tongue, move from one side to the other. Inspect for tongue atrophy, fasciculations and asymmetry in movement. Tongue may deviate to affected side.

37
Q

Which cranial nerve is involved in the pupillary light reflex?

A

Optic (CNII)

To test shine light obliquely into each eye.

38
Q

Which cranial nerve is involved in the corneal reflex?

A

Facial (CNVII)

Touch cornea - elicit involuntary blink.

39
Q

Which cranial nerves are involved in the gag reflex?

A

Glossopharyngeal CNXI (9) and Vagus CNX (10)

40
Q

To which region of the brainstem does the inferior cerebellar peduncle connect?

A

Medulla oblongata

41
Q

To which part of the brainstem does the middle cerebellar peduncle connect?

A

Pons

42
Q

To which part of the brainstem does the superior cerebellar peduncle connect?

A

Midbrain

43
Q

Which arteries supply the cerebellum?

A

Posterior inferior cerebellar

Anterior inferior cerebellar

Superior cerebellar

44
Q

What are the major functions of the cerebellum?

A

Voluntary movement

Coordination

Speech

Balance Posture

Eye movements

45
Q

What is past-pointing (dysmetria)?

A

A patient attempting to reach a fixed point with a finger will overshoot it.

46
Q

What is an intention tremor?

A

Coarse, low frequency tremor seen during goal-directed movements.

47
Q

What is dysdiadochokinesis?

A

Impaired ability to perform rapid, alternating movements e.g. ‘palm test’

Control and Movement Term 1 (23 decks)

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