The brainstem Flashcards

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1
Q

What are the embryological names for forebrain, midbrain and hindbrain?

A

Forebrain: prosencephalon
Midbrain: mesencephalon
Hindbrain: rhombencephalon

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2
Q

Main role of the midbrain?

A

Maintaining conciousness, processing visual and auditory data

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3
Q

Main role of the pons?

A

Relays sensory information to cerebellum and thalamus

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4
Q

Main role of the medulla?

A

Relays information to the thalamus

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5
Q

3 general functions of the brainstem?

A

Conduit: long tracts to/from spinal cord pass through brainstem
Cranial nerves: sensory input and motor output, as well as parasympathetic motor output
Sensorimotor integration: connects to cerebellum

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6
Q

3 things that brainstem mediates

A

Autonomic control of respiratory and cardiovascular reflexes
Somatic/ autonomic modulation via descending pathways
Diffuse neuromodulatory systems regulate conscious states

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7
Q

What is found in dorsal part of brainstem?

A

Cranial nerve nuclei and sensory reflex centres

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8
Q

What is found in middle part of brainstem?

A

Ascending motor pathways and reticular formation

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9
Q

What is found in ventral part of brainstem?

A

Descending motor pathways

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10
Q

Describe organisation of cranial nerve nuclei in the dorsal brainstem?

A

Motor nuclei- medial
Mixed nuclei- more lateral
Sensory nuclei- sensory

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11
Q

What does tectum and tegmentum (of midbrain) mean?

A
Tectum= roof
Tegmentum= body
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12
Q

Where do the corticospinal and corticobulbar tracts pass?

A

Through cerebral peduncle of the midbrain

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13
Q

What are the white parts of the internal pons?

A

Remnants of corticospinal tract

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14
Q

What can be found in open medulla?

A

Cranial nerves, inferior cerebral peduncle, nuclear groups that project to cerebellum

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15
Q

Where do cranial nerve afferents arise from?

A

Ganglia

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16
Q

Where are second order sensory neurons located?

A

Cranial nerve nuclei

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17
Q

Which cranial nerves are only sensory?

A

I, II, VIII

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18
Q

Which cranial nerves are only motor?

A

III, IV, VI, XI and XII

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19
Q

Which cranial nerves are mixed?

A

V, VII, IX and X

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20
Q

Describe 3 types of cranial nerve motor nuclei

A
  • Somatic motor nuclei project to skeletal muscle
  • Branchial motor nuclei project to muscles derived from branchial arches (craniofacial structures such as movement of jaw, expression etc)
  • Visceral motor nuclei: preganglionic parasympathetic fibres
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21
Q

At what level does spinal cord begin to become brainstem?

A

C2

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22
Q

Describe position of nuclei, midline to laterally, in the brainstem

A

Somatic motor (LMN)
Visceral motor (pre ganglionic parasympathetic)
Visceral sensory
Somatic sensory

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23
Q

Define cranial nerve nuclei

A

Columns of neurons associated with cranial nerves

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24
Q

What type of nerve is hypoglossal? What does it innervate?

A

Somatic motor

Internal and external tongue muscles

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25
Q

What type of nerve is spinal accesory? Where does it arise from?

A

Branchial motor

Arises from branchial motor neurons in spinal cord

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26
Q

What does spinal accesory nerve innervate?

A

Trapezius and sternocleidomastoid

27
Q

Where does spinal accesory nerve enter/ exit the skull?

A

Enters through foramen magnum

Exits through jugular foramen

28
Q

What type of nerve is vagus? Where does it arise from?

A

Mixed nerve

Arises from nucleus ambiguus

29
Q

What type of nerve is glossopharyngeal?

A

Mixed (although mainly has sensory functions)

30
Q

Functions of glossopharyngeal nerve

A

Parasympathetic secretomotor to parotid
special sensory- detects taste at back of mouth
touch fibres from back of mouth

31
Q

What happens if there is damage to vagus?

A

Loss of voice on affected side

32
Q

What happens if there is damage to glossopharyngeal?

A

Loss of gag reflex on affected side

33
Q

What type of nerve is vestibulocochlear? What information does it convey?

A

Sensory

Special sense of hearing, perception of self motion, head position and spatial orientation

34
Q

What type of nerve is facial?

A

Mixed

35
Q

5 somatic branches of facial nerve

A

Temporal, zygomatic, buccal, mandibular, cervical

36
Q

What does facial nerve parasympathetic output control?

A

Nasal secretion and lacrimation

37
Q

Sensory input from facial nerve? Describe course of sensory fibres?

A

Taste afferents from anterior 2/3 of the tongue

Travel from chorda tympani via geniculate ganglion to rostral nucleus of solitary tract

38
Q

What type of nerve is trigeminal?

A

Mixed nerve

39
Q

Motor output of trigeminal nerve?

A

V3: motor to muscles of mastication

40
Q

What does the medial longitudinal fasciculus connect?

A

The cranial nerve nuclei controlled eye movement and vestibular nuclei

41
Q

Which cranial nerves innervate extraocular eye muscles?

A

III, IV and VI

42
Q

What does damage to the medial longitunal fasciculus cause? Why?

A

Internuclear pohthalmoplegia
Normally when looking left VI nucleus fres to contract left lateral recus. The righ lateral rectus also contracts due to connection to contralateral oculomotor nucleus.
Both eyes should look in same direction, but if there is damage to MLF this doesn
t work

43
Q

What usually causes unilateral internuclear ophthalmoplegia?

A

A stroke

44
Q

What usually causes bilateral internuclear ophthalmoplegia?

A

MS

45
Q

What is the role of signals from vestibular nuclei?

A

Keep the eyes balanced in space, despite head movements

46
Q

What does the MLF become in the spinal cord?

A

Medial vestibulospinal tract

47
Q

Role of medial vestibulospinal tract?

A

Acts on motor neurons in neck to coordinate reflexes

48
Q

What cranial nerves coordinate pupillary light relfex?

A

CNII in and III out

49
Q

What is the reticular formation?

A

Forms a core of interconnecting neurons
Key centre for regulating conciousness
Integrates and modulates inputs

50
Q

What does reticular formation have output to?

A

hypothalamus, cortex, limbic system and descending projections

51
Q

What part of brainstem produces noradrenaline?

A

Locus coeruleus

52
Q

What part of brainstem produces serotonin

A

Raphe nuclei

53
Q

What part of brainstem produces dopamine?

A

Substantia nigra and ventral tegmental area

54
Q

What part of the brainstem produces acetyl choline?

A

Pedunculopontine nucleus

55
Q

What is the function of dopamine made in substantia nigra?

A

Control of movement

56
Q

Low levels of dopamine from SN=

A

parkinsons

57
Q

What is function of dopamine made in ventral tegmental area?

A

organising behaviour, focusing and attention, reward and motivation

58
Q

Disturbance of dopamine levels from VTA=

A

Schizophrenia and addiction

59
Q

Functions of noradrenaline?

A

activates motor system so reflees are faster, inhibits pain,

60
Q

Functions of serotonin?

A

Rostrally: inhibit basal forebrain GABA cells to produce arousal
Caudally: modulates pain perception

61
Q

Results of deficits in serotonin?

A

OCD, depression, anxiety, aggresion

62
Q

How would you define a monoamine and cholinergic brainstem centre

A

Nuclei containing specific neurotransmitters which modulate variety

63
Q

What controls noradrenaline release?

A

Sympathetic nervous system control centre activated by the hypothalamus
Descending fibres carried in reticulospinal tract activate preganglioninc sympathetics