TBL Flashcards

1
Q

Rostral midbrain

A
Nuclei:
•     Oculomotor nuclei (CN III) 
•     Red Nucleus 
•     Mesencephalic Trigeminal Nucleus
Tracts: 
•	Spinothalamic tract 
•	Medial lemniscus
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2
Q

Caudal midbrain

A
Nuclei: 
•	Trochlear nuclei (CN IV)
•	Mesencephalic Trigeminal Nucleus
Tracts: 
•	Spinothalamic tract 
•	Medial lemniscus
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3
Q

Pontomesencephalic junction

A

Nuclei: pontine nuclei
Tracts:
• Anterolateral system
• Corticospinal tract

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4
Q

Rostral pons

A
Nuclei: 
•	Chief sensory nucleus of Trigeminal n. (CN V)
•	Motor nucleus of Trigeminal n. (CN V) 
•	Pontine nuclei
Tracts: 
•	Spinothalamic tract 
•	Medial lemniscus
•	Corticospinal tract
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5
Q

Caudal pons

A
Nuclei: 
•	Pontine nuclei
•	Facial nuclei (CN VII)
•	Abducens nuclei (CN VI)
•	Vestibular nuclei
•	Cochlear nuclei
•	Spinal trigeminal nucleus (CN V)
Tracts:
•	Spinothalamic tract 
•	Medial lemniscus
•	Corticospinal tract
•	Spinal trigeminal tract
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6
Q

Rostral medulla

A
Nuclei: 
•	Inferior olivary nucleus 
•	Hypoglossal nuclei (CN XII) 
•	Nucleus ambiguous (CN IX, X) 
•	Dorsal motor nucleus X 
•	Nucleus solitarius (CN IX, X)
•	Spinal trigeminal nucleus (CN V)
•	Vestibular nuclei 
Tracts: 
•	Spinothalamic tract 
•	Medial lemniscus
•	Pyramidal/corticospinal tract
•	Spinal trigeminal tract
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7
Q

Caudal medulla

A
Nuclei: 
•	Gracilis and Cuneatus
•	Central Canal: hypoglossal nucleus, dorsal motor nucleus of X and solitary nucleus
•	Spinal trigeminal nucleus (CN V)
Tracts:
•	Spinothalamic tract 
•	Pyramidal/corticospinal tract
•	Medial lemniscus 
•	Spinal trigeminal tract
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8
Q

Cervicomedullary junction

A

Nuclei: Gracilis and Cuneatus
Tracts: Anterolateral system

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9
Q

Cervical spinal cord

A
Nuclei:
•	Gracilis and Cuneatus 
•	Accessory spinal nucleus (CN XI)
Tracts:  
•	Anterolateral system 
•	Lateral corticospinal tract
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10
Q

Vascular territories of PCA

A
  • Midbrain
  • Most of thalamus
  • Medial occipital lobes
  • Inferior medial temporal lobes
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11
Q

Vascular territories of superior cerebellar a.

A
  • Superior cerebellum

- Part of rostral laterodorsal pons

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12
Q

Dorsal

A

Posterior

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13
Q

Ventral

A

Anterior

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14
Q

Caudal

A

Towards feet

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15
Q

Rostral

A

Towards head

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16
Q

Vascular territories of AICA

A
  • Lateral caudal pons

- Small part of cerebellum

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17
Q

Vascular territories of PICA

A
  • Lateral medulla

- Inferior cerebellum

18
Q

Vascular territories of basilar a. (paramedian and circumferential branches)

A
  • Medial pons (paramedian)

- Lateral pons (circumferential)

19
Q

Vascular territories of vertebral aa.

A

-Medulla

20
Q

Vascular territories of anterior spinal aa.

A

-Medial medulla

21
Q

Blood supply to midbrain

A
  • PCA

- Basilar a. (top paramedian and penetrating branches)

22
Q

Blood supply to rostral pons

A
  • Basilar a (circumferential and paramedian branches)

- Superior cerebellar a

23
Q

Blood supply to caudal pons

A
  • Basilar a (paramedian and circumferential branches)

- AICA

24
Q

Blood supply to medial medulla

A

-Paramedian branches of vertebral and spinal arteries

25
Q

Blood supply to lateral medulla

A

-Vertebral arteries and posterior inferior cerebellar a.

26
Q

Clinical signs and associated neural structures of midbrain

A
  • Corticospinal tract (CN III palsy, pupil dilation, flexor posturing)
  • Cerebellum or cerebellar pathways (ataxia)
  • Pontomesencephalic reticular formation or bilateral thalami (impaired consciousness)
27
Q

Clinical signs and associated neural structures of pontine

A
  • Corticospinal tract (generalized weakness, bilateral Babinski’s sign, extensor posturing)
  • Lack of blood flow from basilar a. to PCAs (bilateral upper/lower visual loss or blurring)
  • Long somatosensory pathways or trigeminal system (perioral numbness, facial tingling)
  • Respiration center of pons (irregular respiration)
  • Supranuclear or infranuclear eye movement pathways (ocular bobbing)
  • Central tegmental tract (shivering, palatal myoclonus)
  • Abducens nucleus (abducens palsy/horizontal gaze palsy)
  • Disruption of descending sympathetic fibers (bilateral small but reactive pupils)
  • Pontomesencephalic reticular formation or bilateral thalami (impaired consciousness)
28
Q

Clinical signs and associated neural structures of medulla

A
  • Vestibular nuclei, cerebellum, or inner ear (vertigo, N/V)
  • Cerebellum or cerebellar pathways (ataxia)
  • Vestibular nucleus (nystagmus)
  • Corticospinal tract (respiratory arrest, autonomic instability)
  • Occlusion of PICA or one of the branches of vertebral (hiccups)
29
Q

Medial medullary syndrome clinical features, affected neural structures, and blood supply

A

Clinical features and affected neural structures:
-contralateral arm or leg weakness (pyramidal tract)
-contralateral decreased position and vibration sense (ML)
-ipsilateral tongue weakness (hypoglossal nucleus)
Blood supply: paramedian branches of vertebral and anterior spinal aa.

30
Q

Lateral medullary syndrome clinical features, affected neural structures, and blood supply (Wallenberg’s)

A

Clinical features and affected neural structures:
-Ipsilateral ataxia, vertigo, nystagmus, nausea (inferior cerebellar peduncle, vestibular nuclei)
-Ipsilateral facial decreased pain and temp sense (trigeminal nucleus and tract)
-Contralateral body decreased pain and temp sense (spinothalamic tract)
-Ipsilateral Horner’s (descending sympathetics)
-Hoarseness, dysphagia (nucleus ambiguus)
-Ipsilateral decreased taste (nucleus solitarius)
Blood supply: vertebral

31
Q

Infarct of medial pontine basis (dysarthria hemiparesis and ataxic hemiparesis) clinical features, affected neural structures, and blood supply

A

Clinical features and affected neural structures:
-contralateral face, arm, and leg weakness; dysarthria (corticospinal/bulbar tracts)
-contralateral ataxia (sometimes ipsilateral) (pontine nuclei and pontocerebellar fibers)
Blood supply: paramedian branches of basilar a., ventral territory

32
Q

AICA syndrome clinical features, affected neural structures, and blood supply

A

Clinical features and affected neural structures:
-ipsilateral ataxia (middle cerebral peduncle)
-vertigo, nystagmus (vestibular nuclei)
-ipsilateral facial decreased pain and temp sense (trigeminal nucleus and tract)
-contralateral body decreased pain and temp sense (spinothalamic tract)
-ipsilateral Horner’s (descending sympathetics)
Blood supply: AICA

33
Q

Infarct of midrbain basis (Weber’s) clinical features, affected neural structures, and blood supply

A

Clinical features and affected neural structures:
-ipsilateral CN III palsy (oculomotor fascicles)
-contralateral hemiparesis (cerebral peduncle)
Blood supply: branches of PCA and top of basilar

34
Q

Infarct of midbrain tegmentum (Claude’s) clinical features, affected neural structures, and blood supply

A

Clinical features and affected neural structures:
-ipsilateral CN III palsy (oculomotor fascicles)
-contralateral ataxia (red nucleus, superiro cerebellar peduncle fibers)
Blood supply: branches of PCA and top of basilar a.

35
Q

GSE

A

Oculomotor nucleus
Trochlear nucleus
Abducens nucleus
Hypoglossal nucleus

36
Q

SVE

A

Motor nucleus of V
Facial motor nucleus
Nucleus ambiguus (IX, X)
Spinal accessory nucleus

37
Q

GVE

A

Edinger-Westphal (III)
Superior salivatory nucleus (VII)
Inferior salivatory nucleus (IX)
dorsal motor nucleus of X

38
Q

SVA

A

Rostral nucleus solitarius (gustatory) (VII, IX, X)

39
Q

GVA

A

Caudal nucleus solitarius (cardiorespiratory) (IX, X)

40
Q

GSA

A

Chief sensory nucleus
Mesencephalic nucleus
Spinal trigeminal nucleus (V, VII, IX, X)

41
Q

SSA

A

Cochlear and vestibular nuclei (VIII)