The Brain Stem Flashcards

1
Q

group of cell bodies in the PNS

A

ganglion

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2
Q

groups of cell bodies in the CNS

A

nuclei

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3
Q

group of cell bodies on the surface of the brain

A

cortex

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4
Q

bundle of myelinated axons in the CNS connecting CNS structures

A

tract, fasiculus, column, pedundle, capsule, lemniscus

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5
Q

what are the 3 primary functions of the brainstem

A

Conduit: ascending (sensory) and descending (motor and autonomic) tracts
Cranial nerve ganglia and nuclei: sensory and motor for head, neck, viscera and hearing, equilibrium and taste
Reticular formation

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6
Q

what does reticular formation help in the regulation of

A

sleep, arousal, pain, perception, visceral activities, cardiovascular and pulmonary function

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7
Q

ALS

A

pain, crude touch, temperature

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8
Q

DCML

A

proprioception, vibration, discriminative touch

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9
Q

spinocerebellar tract

A

unconscious proprioception and coordination to cerebellum

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10
Q

what the primary descending tract

A

corticospinal tract (pyramidal tract)

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11
Q

where does the corticospinal tract go to

A

lower motor neurons in lamina 9 of the ventral horn of spinal cord

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12
Q

what descending tracts originate in the brainstem, are motor, but do not pass through the pyramids

A

extrapyramidal descending tracts

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13
Q

examples of extrapyramidal tracts

A

tectospinal, rubrospinal, reticulospinal, vestibulospinal, ceruleospinal and raphespinal tracts

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14
Q

connects CN 3, 4, and 6 with vestibular nuclei

A

medial longitudinal fasciculus

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15
Q

connects cortex to the brainstem

A

corticobulbar (corticobrainstem) tracts

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16
Q

bulb

A

brainstem

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17
Q

what two tracts cross in the brainstem

A

DCML (ascending) and corticospinal (descending) tracts

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18
Q

where is the crossing point in the brainstem

A

pyramids

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19
Q

what two CN are associated with midbrain

A

3 and 4

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20
Q

what 4 CN are associated with pons

A

5-8

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21
Q

what 3 CN are associated with medulla

A

9, 10, 12

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22
Q

where is CN 11 nuclei located

A

cervical spinal cord

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23
Q

netlike

A

reticulum

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24
Q

a neural network of reticular nuclei and axons extending t/o brainstem

A

reticular formation

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25
Q

where does reticular formation send information to (4 major regions of the brain)

A

thalamus, spinal cord, brain stem nuclei, cerebellum

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26
Q

what is the main function of the reticular formation

A

regulates the excitability of cortical neurons through many convergent and divergent synapses

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27
Q

what does the reticular formation process and regulate

A
  • process sensory info
  • regulate motor function
  • regulate autonomic function
  • regulate sleep/wake cycles and state of consciousness via Reticular Activating system
  • regulate emotional behavior
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28
Q

ventral tegmental areas produces what

A

dopamine

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29
Q

pedunculopontine nucleus produces what

A

acetylcholine

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30
Q

raphe nucleis produces what

A

serotonin

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31
Q

locus coeruleus produces what

A

norepinephrine and epinephrine

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32
Q

motivation, decision making, reward seeking, drug addiction, schizophrenia

A

dopamine

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33
Q

influences movement through connections with basal ganglia and emotional system

A

acetycholine

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34
Q

in midline of medulla, pons and midbrain and is associated with mood, pain regulation and sleep

A

serotonin

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35
Q

under floor of 4th ventricle associated with direction of attention and regulation of autonomic functions

A

norepinephrine and epinephrine

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36
Q

what is the anterior division of brainstem and what is primarily there

A

basilar section, primary motor (descending tracts)

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37
Q

what is the posterior division of the brainstem

A

tegmentum

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38
Q

what is in the tegmentum

A

reticular formation, sensory nuclei an tracts, CN nuclei and medial longitudinal fasciculus

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39
Q

most inferior part of brainstem and continuous with spinal cord

A

medulla

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40
Q

location where most of the descending corticospinal tracts decussate

A

pyramids

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41
Q

where does the DCML synapse on

A

nucleus gracilis and nucleus cuteatus

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42
Q

what does DCML decussate to

A

medial lemniscus

43
Q

what nuclei are found in medulla

A

spinal tract and nucleus trigeminal N
hypoglossal nucleus
MLF connecting CN 3, 4, 6 and vestibular nuclei
motor nucleus CN 10
solitary nucleus
nucleus ambiguus motor to CN 9 and 10
cochlear and vestibular nuclei CN 8
inferior olivary nucleus

44
Q

nociception and temperature to the face

A

spinal tract and nucleus of trigeminal N

45
Q

CN motor to the tongue

A

hypoglossal nucleus

46
Q

coordination of eye movement with head movement

A

MLF connecting CN 3, 4, 6 and vestibular nuclei

47
Q

gag and swallowing reflex, parasympathetic regulation

A

motor nucleus CN 10

48
Q

visceral and taste from CN 7, 9, 10

A

solitary nucleus

49
Q

motor to CN 9 and 10, vocal cords, pharynx, and swallowing

A

nucleus ambiguus

50
Q

auditory, head position, VOR

A

cochlear and vestibular nuclei CN 8

51
Q

motor information to cerebellum

A

inferior olivary nucleus

52
Q

what are the function of medulla

A

coordinate cardiovascular control
breathing control
head movement
swallowing
tongue movement
SCM and upper trap function
gag reflex

53
Q

continuous with medulla

A

pons

54
Q

posterior pons borders what

A

4th ventricle

55
Q

what does the anterior pons containg

A

descending motor tracts

56
Q

what does posterior pons contain

A

ascending sensory tracts, MFL, reticular formation and autonomic pathways

57
Q

what tracts synapse in the pons

A

corticopontine and corticobulbar tracts

58
Q

what are the functions of pons

A
  • process sensory info from face via CN 5
  • control lateral eye movement via CN 6
  • control facial and chewing muscles via CN 5 and 7
  • process motor info from cerebrum and passes it to cerebellum
  • conveys info about sound, head movements and head position via CN 8
59
Q

uppermost part of brainstem

A

midbrain

60
Q

what does the midbrain connect

A

diencephalon and pons

61
Q

what connects midbrain to cerebellum and is the only way info can lead cerebellum

A

superior cerebellar peduncle

62
Q

is within the midbrain and receives info from cerebral cortex and projects it to the spinal cord and cerebellum via rubospinal tract

A

red nucleus

63
Q

part of CN 3 and constricts pupil and adjusts short of lens in eye

A

edinger-wesphal nucleus

64
Q

pain suppression and coordination of fight or flight response

A

periaqueductal gray (PAG)

65
Q

what are the two posterior collections of cell bodies that are important relay areas in the midbrain

A

superior and inferior colliculi

66
Q

superior colliculi function

A

orients head/eyes toward external stimuli/movement

67
Q

inferior colliculi function

A

relays auditory information to thalamus

68
Q

involved in pupillary and accommodation reflexes of the eye

A

pretectal area

69
Q

what are the functions of the midbrain

A
  • eye movement, pupillary reflexes, shape of lens in eye
  • coordination of somatic and autonomic response to nociception
  • transmis efferent information from cerebellum to cerebral cortex
  • regulation of muscle tone and distal UE extension
  • relay of visual and auditory info to cortex
70
Q

branches of the vertebral supply what

A

medulla

71
Q

branches from basilar supply

A

pons and cerebellum

72
Q

what artery supplies midbrain

A

posterior cerebral A

73
Q

4 midline structures that begin with M

A
  • Motor nuclei that move eyes (CN 3, 4, 6) and tongue (CN 12)
  • Motor tract - corticospinal tract
  • MLF - coordinates eyes with heat
  • Medial lemniscus - DCML info to thalamus
74
Q

4 lateral structures that begin with S

A
  • Sympathetic tract that raises eyelids and pupillary dialator muscles
  • Spinothalamic tract to thalamus
  • Sensory tract of trigeminal N
  • Spinocerebellar tract
75
Q

4 CN in medulla

A

8, 9, 10, 12

76
Q

4 CN in pons

A

5, 6, 7, 8

77
Q

CN motor nuclei that innervate muscles divide equally into the number 12

A

3, 4, 6, 12

78
Q

medial brainstem lesion affects

A
  • 4 Ms
  • motor nuclei depending on where the brainstem lesion is located
79
Q

lateral brainstem lesion affects

A
  • 4 Ss
  • if in pons, affects CN 5, 6, 7, 8
  • if in medulla, affects CN 8, 9, 10
80
Q

cause a mix of ipsilateral and contralateral sx and interfere with vital functions and consciousness

A

brainstem lesions

81
Q

do CN supply ipsilateral or contralateral face and neck

A

ipsilateral

82
Q

do ascending and descending tracts supply ipsilateral or contralateral body

A

contralateral

83
Q

what does a lesion in the lower medulla produce

A
  • contralateral hemiplegia
  • contralateral loss of proprioception, pressure, vibration, 2 point discrimination
  • contralateral pain, temp, touch
  • ipsilateral face, head, and neck paresis and paralysis
  • may cause heart to stop beating, BP to fluctuate, and/or cessation of breathing
84
Q

occurs with reticular formation or cortical lesions in hypothalamus, thalamus or cortex

A

disorders of consciousness

85
Q

what can disorders of consciousness lead to

A

vegetative or minimally conscious state and locked in syndrome

86
Q

brainstem tumors lead to increased what

A

intracranial pressure

87
Q

sx/outcomes of brainstem lesions

A

HA, N and V, CN disorders, hydrocephalus

88
Q

example of brainstem tumor that wraps around CN 8 that can cause tinnitus and deadness

A

acoustic neuroma

89
Q

brainstem ischemia leads to abrupt onset of

A

dizziness, visual disorders, weakness, incoordination, somatosensory disorders

90
Q

most common brainstem stroke and leads to blockage of PICA

A

lateral medullary/Wallenberg’s syndrome

91
Q

second most common brainstem stroke that leads to blockage of AICA

A

lateral inferior pons

92
Q

blockage of anterior spinal, vertebral, or basilar artery

A

medial medullary syndrome

93
Q

occurs most often due to blockage of basilar A and affects medial structures

A

midbrain stroke

94
Q

how to test for brainstem ischemia/stroke

A

VBI testing - neck ext/SB/rot

95
Q

what are the 4 Ds of brainstem dysfunction

A

dysarthria, dysphagia, diplopia, dysmetria

96
Q

difficulty swallowing - CN 5, 7, 9, 10, 12

A

dysphagia

97
Q

double vision - CN 3

A

diploplia

98
Q

difficulty speaking due to poor control of speech muscles

A

CN 5, 7, 10, 12

99
Q

difficulty controlling distance of movements - cerebella

A

dysmetria

100
Q

which CN are part of CNS

A

olfactory and CNS

101
Q

sensory CN cell bodies in _____ outside the brainstem

A

ganglia

102
Q

motor CN cell bodies in _____ inside the brainstem

A

nuclei

103
Q

which CNs are myelinated by olgiodendrocytes

A

olfactory and optic