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67 Cards in this Set

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Where is the most rostral section of the brainstem
It begins with the midbrain (mesencephalon) just below the diencephalon
Where is the middle section of the brainstem
It is the pons, and is usually overlain by the cerebellum
What is the most caudal section of the brainstem
Medulla, and it is caudal to the pons but right next to the spinal cord
What is tectum
Tectum is the roof of the brain, it is composed of the superior and inferior colliculi and lie dorsal to the cerebral aqueduct
What is the tegmentum
Is the covering and it lies ventral to the aqueduct and ventral to the 4th ventricle and the pons
What is the significance of the tegmentum
It is where the bulk of brainstem nuclei lie, and also the location of the reticular formation
What is the basis
It is the most ventral part of the brainstem, it is only seen in the pons and midbrain and NOT in medulla, this is the location of the collection of fibers like corticospinal, corticobulbar, and corticopontine tracts
Where are the cell bodies of CN nuclei
Brainstem
If you being poke in the eye, which CN sees it? Which one shuts the eye lid? And if the poker touches the eye, which CN does that?
CN2, CN7, and CN5 respectively
How many CN originate or terminate in brain stem
9/12
Which ones do not associate with brain stem
CN1, CN2(both associated with the forebrain), and CN11 (is associated with the spinal cord)
None
What are the 2 CN that are associated with the midbrain
CN3 and 4
What are the 4 CN associated with the PONS
CN5,6,7,8
What are the 3 CN associated with medulla
Cn9,10,12
What areas run the genitalia
S2-S4, these are preganglionic sacral
How are the CN divided
Based on their function they are divided into 3 type, sensory, motor and mixed
What CN are sensory
1,2,8
What CN are motor
3,4,6,12
What CN are both
5,7,9,10
What is the function of 3, 4, and 6
and what holds them together
What are the function of 9 and 10
They are motor for viscera and sensory for the BP
What CN are associated with PNS
3,7,9,10
Where are the preganglionic cell bodies foe these located
These are located in the specific nuclei for CN3 it’s edinger westphal in midbrain, for CN7 it is the superior salivatory nucleus in pons, for CN9 it is the inferior salivatory nucleus in medulla, and for CN10 it the dorsal motor nucleus of 10 in medulla
Where are the postganglionic neurons for PNS nuclei
They are on the smooth muscles, viscera, glands and Cardiac muscles and provide autonomic tone to the head and thoracoabdominal viscera above the splenic flexure
None
The post ganglionic cell bodies to 3 located
CN3 in ciliary ganglion and innervate the ciliary muscle of the eyes to and constrictor (sphincter muscles)
The post ganglionic cell bodies to 7 located
These are more motor than sensory, are located in the sphenopalatine ganglion (axons project to the nasal mucosa and lacrimal glands→ cries and mucus secretion through the nose) and the submandibular ganglion (and the axons project to sumandibular and submaxillary glands = spits)
The post ganglionic cell bodies to 9 located
In the otic ganglia and the axons project to the parotid gland
The post ganglionic cell bodies to 10 located
Various terminal ganglia and the axons project to effector organs like heart, lungs, GI tract
What are the ALS pathway
These do pain, temp, itch and they crossover right away in the spinal cord (pain can’t wait) and they cause contralateral problems
Which NS innervates the eye, face, and the scalp
SNS and it is not located in the brainstem, and the descending tracts form the hypothalamus don’t cross the midline as they descend through the spinal cord to innervate the preganglionic SNS neurons
Where are the preganglionic cell bodies for SNS located
In the IML of spinal cord also called the rexed lamina (T1-L3)
Where are the preganglionic SNS cell bodies innervating the head are found
T1-T2
Where are the postganglionic cell bodies for SNS lie
SCG (superior cervical ganglia)
What happens if there is a lesion in the SCG or other part of SNS
Horner’s this is ipsilateral because they don’t cross the midline
What are the classic signs of Horner’s
Miosis (↓ pupil size, dilator muscles are not innervated), Ptosis ( drooping upper eye lid, smooth muscle not innervated) and Anhidrosis (↓ sweating on the face and the neck)
What happens If there is a lesion in the right midbrain
Right Horner’s
Medullar problem
Tongue effected and contralateral loss of pain, itch, and temp
How does the lesion in UMN present
Weakness, ↑reflexes, ↑tone, and ↓ fasciculations and atrophy
How does the lesion un LMN present
Weakness, atrophy and fasciculations, ↓reflexes and tone
How many neural tracts are there and in what orientation
There are 5 neural tracts and they can be ascending and descending
What are the names of these tracts
Medial lemniscus, ALS, corticospinal tract, descending hypothalamic , and MLF
What is the function of the medial lemniscus
It is sensory, and ascending
ALS
Sensory and it is the spinothalamic tract and it is ascending and it does the pain
What is corticospinal tract
Motor, and it is descending
What are hypothalamic SNS fibers
These are descending and they do the ANS, and they are motor
What is the function of the these 4 tracts excluding MLF
These descending fibers coarse with ascending fibers in the spinothalamic tract in the lateral part of the brainstem, and brain stem lesions can cause ipsilateral Horner’s and contralateral loss of pain and temp from the limbs and the body
What is MLF
This is located in the pons and the midbrain, they interconnect the centers of the horizontal gaze, vestibular nuclei, and CN3,4,6 (innervates the skeletal muscles of the eyes) and keep eye movements of both eye balls yoked together
What happens if there is a brainstem lesion in the MLF
It results in INO, internuclear opthalmoplegia, which is the paralysis of the eye and it disrupts the VOR
What of the lesion is on the Left side
The paralysis is going to be in the left eye, so both will be able to look left but the only the right eyes will be able to look right and the left eye will be stuck in forward gaze. This is a ipsilateral problem and the loss of innervations is to the medial rectus so the ipsi eye cannot adduct
What are some of the common causes of lesions in the MLF areas
MS plaques and infarct in the pontine area or neoplasms involving the MLF
What are the names of the tracts that the UMN travel on
The tracts are called corticobulbar or corticonuclear and they originate in the motor cortex and terminate on the motor CN nuclei in the pons and the medulla
What are the motor CN and what are the innervated by
CN12 (tongue), CN11 (sternocleidomastoid and trap), CN10 (palate, pharynx and larynx), CN7 (muscles of facial expression) and CN5 (muscles of mastication)
What is the mode of corticobulbar innervations of the CN motor nuclei
Bilateral
Are there any exceptions to bilateral innervation of the UMN to LMN
Yes, CN7, facial nerve LMN to the lower face only receives contralateral UMN innervations
None
What is bell’s palsy
It is the facial LMN lesion → to ipsilateral full (upper and lower face) paralysis
What happens with the corticobulbar lesion
It is an UMN lesion and it causes lower face palsy contralateral to the lesion
So as far as Cn7 is concerned do the UMN or LMN have the bilateral lesion
The UMN have bilateral innervations and the LMN has the just contralateral lesion
In what orientation are the cell bodies of the of CN with motor function located
They are located medial and anterior i.e. ventral and these are 3,4,6 (eye),12 (tongue)
In what orientation are the cell bodies of the of CN with sensory function located
These are located more laterally and their nerve fibers exit the brainstem more laterally
In what orientation are the cell bodies of the of CN with mixed function located
These are located near the sulcus limitans and their nerve fibers leave the brainstem between motor and sensory nerve fibers
What Cranial nerves do hearing and balance
8
What CN do somatic sensory
5,7,9,10
What CN do viscerosensory and taste
7,9,10
What CN do autonomic
3,7,9,10
What CN do branchiomeric skeletal muscles
5,7,9,10,11 and their cell bodies are located near sulcus limitans
What CN do somatic skeletal motor
3,4,6,12
Look at pictures on pages 89,90,91