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67 Cards in this Set
- Front
- Back
- 3rd side (hint)
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Where is the most rostral section of the brainstem
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It begins with the midbrain (mesencephalon) just below the diencephalon
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Where is the middle section of the brainstem
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It is the pons, and is usually overlain by the cerebellum
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What is the most caudal section of the brainstem
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Medulla, and it is caudal to the pons but right next to the spinal cord
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What is tectum
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Tectum is the roof of the brain, it is composed of the superior and inferior colliculi and lie dorsal to the cerebral aqueduct
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What is the tegmentum
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Is the covering and it lies ventral to the aqueduct and ventral to the 4th ventricle and the pons
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What is the significance of the tegmentum
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It is where the bulk of brainstem nuclei lie, and also the location of the reticular formation
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What is the basis
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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
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Where are the cell bodies of CN nuclei
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Brainstem
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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?
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CN2, CN7, and CN5 respectively
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How many CN originate or terminate in brain stem
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9/12
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Which ones do not associate with brain stem
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CN1, CN2(both associated with the forebrain), and CN11 (is associated with the spinal cord)
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None
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What are the 2 CN that are associated with the midbrain
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CN3 and 4
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What are the 4 CN associated with the PONS
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CN5,6,7,8
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What are the 3 CN associated with medulla
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Cn9,10,12
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What areas run the genitalia
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S2-S4, these are preganglionic sacral
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How are the CN divided
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Based on their function they are divided into 3 type, sensory, motor and mixed
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What CN are sensory
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1,2,8
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What CN are motor
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3,4,6,12
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What CN are both
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5,7,9,10
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What is the function of 3, 4, and 6
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and what holds them together
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What are the function of 9 and 10
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They are motor for viscera and sensory for the BP
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What CN are associated with PNS
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3,7,9,10
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Where are the preganglionic cell bodies foe these located
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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
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Where are the postganglionic neurons for PNS nuclei
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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
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None
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The post ganglionic cell bodies to 3 located
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CN3 in ciliary ganglion and innervate the ciliary muscle of the eyes to and constrictor (sphincter muscles)
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The post ganglionic cell bodies to 7 located
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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)
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The post ganglionic cell bodies to 9 located
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In the otic ganglia and the axons project to the parotid gland
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The post ganglionic cell bodies to 10 located
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Various terminal ganglia and the axons project to effector organs like heart, lungs, GI tract
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What are the ALS pathway
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These do pain, temp, itch and they crossover right away in the spinal cord (pain can’t wait) and they cause contralateral problems
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Which NS innervates the eye, face, and the scalp
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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
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Where are the preganglionic cell bodies for SNS located
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In the IML of spinal cord also called the rexed lamina (T1-L3)
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Where are the preganglionic SNS cell bodies innervating the head are found
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T1-T2
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Where are the postganglionic cell bodies for SNS lie
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SCG (superior cervical ganglia)
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What happens if there is a lesion in the SCG or other part of SNS
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Horner’s this is ipsilateral because they don’t cross the midline
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What are the classic signs of Horner’s
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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)
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What happens If there is a lesion in the right midbrain
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Right Horner’s
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Medullar problem
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Tongue effected and contralateral loss of pain, itch, and temp
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How does the lesion in UMN present
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Weakness, ↑reflexes, ↑tone, and ↓ fasciculations and atrophy
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How does the lesion un LMN present
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Weakness, atrophy and fasciculations, ↓reflexes and tone
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How many neural tracts are there and in what orientation
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There are 5 neural tracts and they can be ascending and descending
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What are the names of these tracts
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Medial lemniscus, ALS, corticospinal tract, descending hypothalamic , and MLF
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What is the function of the medial lemniscus
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It is sensory, and ascending
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ALS
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Sensory and it is the spinothalamic tract and it is ascending and it does the pain
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What is corticospinal tract
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Motor, and it is descending
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What are hypothalamic SNS fibers
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These are descending and they do the ANS, and they are motor
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What is the function of the these 4 tracts excluding MLF
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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
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What is MLF
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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
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What happens if there is a brainstem lesion in the MLF
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It results in INO, internuclear opthalmoplegia, which is the paralysis of the eye and it disrupts the VOR
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What of the lesion is on the Left side
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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
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What are some of the common causes of lesions in the MLF areas
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MS plaques and infarct in the pontine area or neoplasms involving the MLF
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What are the names of the tracts that the UMN travel on
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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
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What are the motor CN and what are the innervated by
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CN12 (tongue), CN11 (sternocleidomastoid and trap), CN10 (palate, pharynx and larynx), CN7 (muscles of facial expression) and CN5 (muscles of mastication)
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What is the mode of corticobulbar innervations of the CN motor nuclei
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Bilateral
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Are there any exceptions to bilateral innervation of the UMN to LMN
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Yes, CN7, facial nerve LMN to the lower face only receives contralateral UMN innervations
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None
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What is bell’s palsy
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It is the facial LMN lesion → to ipsilateral full (upper and lower face) paralysis
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What happens with the corticobulbar lesion
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It is an UMN lesion and it causes lower face palsy contralateral to the lesion
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So as far as Cn7 is concerned do the UMN or LMN have the bilateral lesion
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The UMN have bilateral innervations and the LMN has the just contralateral lesion
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In what orientation are the cell bodies of the of CN with motor function located
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They are located medial and anterior i.e. ventral and these are 3,4,6 (eye),12 (tongue)
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In what orientation are the cell bodies of the of CN with sensory function located
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These are located more laterally and their nerve fibers exit the brainstem more laterally
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In what orientation are the cell bodies of the of CN with mixed function located
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These are located near the sulcus limitans and their nerve fibers leave the brainstem between motor and sensory nerve fibers
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What Cranial nerves do hearing and balance
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8
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What CN do somatic sensory
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5,7,9,10
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What CN do viscerosensory and taste
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7,9,10
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What CN do autonomic
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3,7,9,10
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What CN do branchiomeric skeletal muscles
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5,7,9,10,11 and their cell bodies are located near sulcus limitans
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What CN do somatic skeletal motor
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3,4,6,12
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Look at pictures on pages 89,90,91
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