Lecom - Neuroanatomy 14: Brainstem Iii: Nuclei, Pathways, And Vascular Supply

Front 1

Functional components of the brainstem? (4)

Back 1

1) Cranial nerve nuclei 2) Long tracts 3) Cerebellar circuitry 4) Reticular formation and related structures.

Front 2

Anatomical components of the brainstem?

Back 2

Midbrain, pons, medulla oblongata.

Front 3

Structure dividing motor nuclei ventromedialy from sensory nuclei dorsolaterally?

Back 3

Sulcus Limitans

Front 4

Where is the sulcus limitans located?

Back 4

In the brainstem on the lateral wall of the 4th ventricle

Front 5

tectum

Back 5

"roof"; obvious only inthe midbrain and consists of the superior and inferior colliculi, which lie dorsal to the cerebral aqueduct

Front 6

Tegmentum

Back 6

"covering"; lies ventral to the cerebral aqueduct in the midbrain and ventral to the 4th ventricle in the pons and medulla

Front 7

Basis

Back 7

the most ventral portion of the brainstem, where the large collestions of fibers making up the corticospinal and corticobulbar tracts lie

Front 8

How do you distinguish sections with the superior colliculi from the sections of the inferior colliculi in the midbrain?

Back 8

Sections through the superior colliculi also inclue the oculomotor nuclei and the red nuclei while sections through the inferior colliculi include the trochlear nuclei and brachium nuclei

Front 9

What are the cerebral peduncles composed of?

Back 9

Substantia nigra + Basis pedunculi

Front 10

Major landmarks in the midbrain

Back 10

superior colliculus+oculomotor nuclei + red nuclei, inferior colliculus + trochlear nuclei + branchium conjunctivum, cerebral aqueduct, periaqueductal gray, midbrain reticular formation, medial lemnisus, anterolateral system, ad cerebral peduncles (substantia nigra + basis peduncles)

Front 11

The ventral pons consists of ___ which includes the corticospinal and corticobulbar tracts, as well as the pontine nuclei involved in cerebellar and corticospinal function.

Back 11

Basis Pontis

Front 12

What separates the pontine tegmentum from the cerebellum?

Back 12

The Fourth Ventricle.

Front 13

Pyramidal descussation

Back 13

transition between the medulla and spinal cord

Front 14

Where is the accessory spinal cord nucleus?

Back 14

Upper cervical spinal cord.

Front 15

The tegmentum of the midbrain lies ___ to the cerebral aqueduct.

Back 15

Ventral

Front 16

The tegmentum of the midbrain lies ___ to the 4th ventricle in the pons and medulla

Back 16

Ventral

Front 17

The corticospinal and corticobulbar tracts lie in the ____ of the midbrain.

Back 17

Basis

Front 18

Where do the superior and inferior colliculi lie in the midbrain?

Back 18

In the tectum

Front 19

The superior colliculi are more ___ than the inferior colliculi.

Back 19

rostral

Front 20

The oculomotor nuclei and red nuclei are contained in the _____

Back 20

Superior colliculi

Front 21

The trochlear nuclei and brainstem conjunctivum are contained in the ___

Back 21

Inferior colliculi

Front 22

The brainstem conjunctivum are aka ___

Back 22

Decussation of the superior cerebellar peduncles

Front 23

The cerebral peduncles are located in the midbrain. What do they consist of?

Back 23

Substantia nigra + basis pedunculi

Front 24

The medial geniculate nucleus is located ____ to the lateral geniculate nucleus in the rostral midbrain

Back 24

medial and dorsal

Front 25

The basis pedunculi is located ___ to the substantia nigra in the rostral midbrain

Back 25

ventral and lateral

Front 26

The red nucleus (parvocellular division) is located ___ to the cerebral aqueduct and ___ to the substantia nigra in the rostral midbrain

Back 26

ventral + lateral

dorsal + medial

Front 27

In the caudal midbrain, the mesencephalic trigeminal tract is located ___ to the periaqueductal gray matter and ___ to the fascicles of the trochlear nerve (CN 4)

Back 27

lateral, dorsal lateral

Front 28

A lesion in the caudal midbrain immediately dorsolateral to the periaqueductal gray matter will most likely affect...

Back 28

The inferior colliculi

Front 29

In the caudal midbrain, the trochlear nucleus is surrounded by the ___. This little complex" is located immediately ventral to the ___."

Back 29

Medial longitudinal fasciculus (MLF)

periaqueductal gray matter

Front 30

The ___ is located between the L and R superior cerebellar peduncle and decussation in the rostral midbrain.

Back 30

Median Raphe Nucleus

Front 31

Immediately caudal to the midbrain is the ___.

Back 31

Rostral pons

Front 32

The ventral pons consists of the ___ and ____.

Back 32

Basis pontis, pontine nuclei.

Front 33

The basis pontis contains the ____ and ____ tracts.

Back 33

corticospinal and corticobulbar

Front 34

The pontine nuclei are involved in ____ function

Back 34

cerebellar

Front 35

The ___ separates the pontine tegmentum from the cerebellum

Back 35

4th ventricle

Front 36

In the pontomesencephalic junction, the ____ and ___ are located immediately ventrolateral to the cerebral aqueduct.

Back 36

mesencephalic trigeminal nucleus/tract and the dorsal longitudinal fasciculus

Front 37

In the pontomesencephalic junction, the MLF is ____ to the reticular formation and ____ to the dorsal longitudinal fasciculus.

Back 37

dorsal

ventral

Front 38

A lesion on the dorsolateral surface of the pontomesencephalic junction will most likely impinge upon which of the following?

- dorsal longitudinal fasciculus

- trigeminal lemniscus

- lateral lemniscus and nucleus

- corticospinal fibers

Back 38

lateral lemniscus and nucleus

Front 39

A lesion that is midline immediately posterior to median raphe nucleus will most likely impinge upon which of the following?

- middle cerebellar peduncle

- pontine nuclei

- superior medullary velum

- reticular formation

Back 39

reticular formation

Front 40

The 4th ventricle begins in the ___.

Back 40

Pons (rostral-mid, specifically)

Front 41

In the rostral/mid pons, the MLF is located midline and ___ to the 4th ventricle.

Back 41

Ventral

Front 42

In the rostral/mid pons, a lesion of the pontine nuclei will be seen on a scan ___ to the middle cerebellar peduncle and ___ to the superior cerebellar peduncle.

Back 42

medial, ventral/anterior

Front 43

In the rostral/mid pons, the principal sensory trigeminal nucleus is seen medial to the ___ and ventrolateral to the ___

Back 43

middle cerebellar peduncle, superior cerebellar peduncle

Front 44

In the rostral/mid pons, the superior vestibular nucleus of CN 8 is ___ to the 4th ventricle and ___ to the principal sensory trigeminal nucleus

Back 44

lateral, dorsomedial

Front 45

In the rostral/mid pons, the trigeminal nerve fascicles are ___ to the middle cerebellar peduncles

Back 45

medial

Front 46

In the rostral/mid pons, the medial lemniscus is located ___ to the lateral lemniscus

Back 46

medial. Duh.

Front 47

In the caudal pons, the nodulus of cerebellum extends into the ____ on the posterior side.

Back 47

4th ventricle

Front 48

In the caudal pons, the knee or the genu of CN 7 can be found here...

Back 48

adjacent to midline on the floor of the 4th ventricle

Front 49

In the caudal pons, the ___ can be found immediately dorsolateral to the genu of CN 7

Back 49

Dorsal longitudinal fasciculus

Front 50

In the caudal pons, the ___ is found immediately anterior to the dorsal longitudinal fasciculus and lateral to the genu of CN 7

Back 50

Nucleus of CN 4 (abducens nucleus)

Front 51

The deep cerebellar nuclei include (from medial to lateral):

Back 51

Fastigial, Globose, Emboliform, Dentate

(fat girls eat donuts)

Front 52

In the caudal pons, the corticospinal and corticobulbar tracts are the most ___ structures compared with the others.

Back 52

ventral/anterior

Front 53

In the caudal pons, the CN 7 nucleus is found ___ to the genu of CN 7, ___ to the dorsal longitudinal fasciculus, and ___ to the abducens nucleus.

Back 53

ventrolateral, ventrolateral, ventrolateral

Front 54

In the caudal pons, the ___ cerebellar peduncle is located medial to the dentate nucleus, whereas the ___ and ___ cerebellar peduncles are localted lateral.

Back 54

superior

middle

inferior

Front 55

In the caudal pons, you can see the cerebellar peduncles from medial to lateral:

Back 55

superior, inferior, middle

Front 56

Where can the inferior olivary nucleus be seen?

Back 56

rostral medulla

Front 57

Where to the posterior columns and nuclei start appearing?

Back 57

caudal medulla

Front 58

Somatic Motor Nuclei (GSE)

Back 58

oculomotor, trochlear, abducens, hypoglossal; adjacent to midline

Front 59

Location oculomotor nuclei

Back 59

rostral midbrain

Front 60

Location trochlear nuclei

Back 60

caudal midbrain

Front 61

Medial Longitudinal Fasiculus

Back 61

interconnects occulomotor, trochlear, abducens, and vestibular nerve

Front 62

location hypoglossal nuclei

Back 62

form the hypoglossal trigones on the floor of the fourth ventricle

Front 63

Location trigeminal motor nucleus

Back 63

upper to mid pons, just ventral to the chief trigeminal sensory nucleus

Front 64

Parasympathetic nuclei and nerves

Back 64

Edinger-Westphal nucleus (III), Superior (VII) and Inferior (IX) Salivatory nuclei, and Dorsal motor nucleus of X

Front 65

Branchial motor nuclei

Back 65

trigeminal motor nucleus (CN V), spinal accessory nucleus (CN IX), facial nucleus (CN VII), nucleus ambiguous (CN IX, X)

Front 66

What is the trapezoid body?

Back 66

Where many cochlear nuclei decussate in the caudal pons.

Front 67

Where do all visceral afferents (special or general) travel to?

Back 67

Nucleus solitarius

Front 68

Where do Special Visceral Afferents (SVA) for taste go to?

Back 68

(VII, IX, and X) reach the rostral nucleus solitarius.

Front 69

Where do general visceral afferents (GVA) go to?

Back 69

They reach the caudal nucleus solitarius. (IX and X).

Front 70

The taste pathway continues rostrally via the ____ tract to synapse on the ___ nucleus of the thalamus.

Back 70

Central Tegmental tract. Ventral Posterior Nucleus. (VPM)

Front 71

In the rostral medulla, the nucleus solitarius gives rise to CN __, __, and __.

Back 71

CN VII, IX, X

Front 72

In the rostral medulla, the nucleus solitarius surrounds the ___.

Back 72

solitary tract of CN 7, 9, 10

Front 73

In the rostral medulla, the spinal trigeminal tract is located immediately medial to the ___ and carries fibers for CN ____

Back 73

inferior cerebellar peduncle

CN 5, 7, 9, 10

Front 74

In the rostral medulla, the spinal trigeminal tract is located immediately lateral to the ___

Back 74

Spinal trigeminal nucleus

Front 75

In the rostral medulla, the nucleus ambiguus is located ___ to the spinal trigeminal nucleus

Back 75

medial

Front 76

The nucleus ambiguus gives rise to tracts that form CN ___.

Back 76

9, 10 & 11

Front 77

In the rostral medulla, what is located adjacent to midline and posterior to the pyramid (corticospinal tract) and anterior to the solitary tract of CN 7, 9, and 10?

Back 77

Medial lemiscus

Front 78

In the rostral medulla, what nuclei are located posterior/dorsal to the nucleus solitarius?

Back 78

Medial and Inferior vestibular nuclei (CN 8)

Front 79

In the rostral medulla, the ___ nuclei are located immediately medial to the nucleus solitatius.

Back 79

dorsal motor nucleus of CN 10

Front 80

In the rostral medulla, what nucleus is located immediately medial to the dorsal motor nucleus of CN 10?

Back 80

Hypoglossal nucleus CN 12

Front 81

In the rostral medulla, the reticular formation is located medial to the ___ and lateral to the ___

Back 81

nucleus ambiguus

medial lemniscus

Front 82

What are the 3 parts to the inferior olivary nucleus?

Back 82

Dorsal accessory

Principal (teethlike looking part)

Medial accessory

Front 83

In the caudal medulla, the nucleus that is adjacent to midline in the posterior/dorsal portion is called the __ nucleus and the nucleus immediately lateral to it is called the ___ nucleus.

Back 83

Gracile nucleus, cuneate nucleus

Front 84

In the caudal medulla, the ___ nucleus/tract is immediately ventrolateral to the cuneate nucleus/tract.

Back 84

Spinal trigeminal nucleus/tract for CN 5, 7, 9, 10.

Front 85

In the caudal medulla, the nucleus solitarius, dorsal motor nucleus of vagus, and the hypoglossal nucleus are all surrounding the ___

Back 85

central canal

Front 86

T/F: In the caudal medulla, the reticular formation is located adjacent to midline and immediately medial to the nucleus ambiguus.

Back 86

F: In the caudal medulla, the reticular formation is located lateral to the medial lemniscus (which are adjacent to midline) and immediately medial to the nucleus ambiguus.

Front 87

In the caudal medulla, the ___ is/are the most anterior/ventral structure(s)

Back 87

Pyramid (corticospinal tract)

Front 88

In the caudal medulla, name 3 structures that are located immediately anterior/ventral to the central canal.

Back 88

medial vestibulospinal tract

tectospinal tract

medial lemniscus/sensory decussation

Front 89

In the caudal medulla, a lesion on the dorsolateral surface will most likely impede on which of the following structures?

- gracile fascicle

- cuneate fascicle

- rubrospinal tract

- arcuate nucleus

Back 89

cuneate fascicle

Front 90

Describe the location of the gracile nuclei and fascicle in the cervicomedullary junction.

Back 90

Adjacent to midline in the posterior aspect

Front 91

Describe the location of the cuneate nuclei and fascicle in the cervicomedullary junction.

Back 91

Immediately lateral to the gracile nuclei (which are adjacent to midline)

Front 92

Describe the location of the spinal trigeminal tract and nuclei in the cervicomedullary junction.

Back 92

Immediately lateral to the cuneate nuclei and posterior to the dorsal spinocerebellar tract and rubrospinal tract

Front 93

The spinal trigeminal nucleus has 3 portions seen in the cervicomedullar junction. Name them.

Back 93

Marginal zone

Substantia gelatinosa

Magnocellular nucleus

Front 94

The corticospinal tract crosses via the _____ in the _____ portion of the cervicomedullary junction.

Back 94

pyramidal decussation

anterior

Front 95

In the cervicomedullary junction, the dorsal and ventral spinocerebellar tracts are located ___

Back 95

laterally

Front 96

In the cervicomedullary junction, the ___ is located immediately medial to the spinocerebellar tracts

Back 96

anterolateral system

Front 97

In the cervicomedullary junction, the ____ is located immediately medial to the anterolateral system.

Back 97

Spinal Accessory nucleus (CN 11)

Front 98

The pyramidal decussation is located immediately anterior to the ___

Back 98

central gray matter

Front 99

A lesion in the anterior portion of the cervicomedullary junction will most likely impinge on which of the following?

- lateral vestibulospinal and reticulospinal tracts

- central gray matter

- rubrospinal tract

- cuneate fascicle

Back 99

lateral vestibulospinal and reticulospinal tracts

Front 100

In the cervical spinal cord, a midline lesion on the posterior aspect will most likely impinge upon...

- lissauer's tract

- anterior corticospinal tract

- rubrospinal tract

- gracile fasciculus

Back 100

gracile fasciculus

Front 101

In the cervical spinal cord, a lesion on the anterolateral aspect will most likely impinge upon...

- gracile fasciculus

- cuneate fasciculus

- rubrospinal tract

- substantia gelatinosa

Back 101

rubrospinal tract

Front 102

In the cervical spinal cord, a large lesion of the central canal area will most likely SPARE which of these?

- dorsal spinocerebellar tract

- lateral corticospinal tract

- spinal accessory nucleus

- tectospinal tract

Back 102

dorsal spinocerebellar tract

Front 103

In the cervical spinal cord, the anterior corticospinal tract is located...

Back 103

adjacent to midline, anteriorly

Front 104

In the cervical spinal cord, what is located immediately lateral to the anterior corticospinal tract?

Back 104

Medial vestibulospinal tract

Tectospinal tract

Front 105

In the cervical spinal cord, where are the anterior corticospinal tract, medial vestibulospinal tract, and tectospinal tract located in relationship to the ventral horns?

Back 105

Medial

Front 106

In the cervical spinal cord, if someone wanked upon an area of the posterior aspect immediately medial to the dorsal root of the spinal nerve, what structure did he most likely wank upon?

Back 106

Cuneate fasciculus

Front 107

Name the somatic motor nuclei (GSE).

Back 107

oculomotor

trochlear

abducens

Front 108

Where is the oculomotor nucleus located?

Back 108

rostral midbrain, ventral to the periaqueductal gray area

Front 109

Where is the trochlear nucleus located?

Back 109

caudal midbrain, ventral to the periaqueductal gray area

Front 110

What forms the ventral border of the oculomotor and trochlear nuclei, interconnecting them with the abducens and vestibular nuclei?

Back 110

MLF

Front 111

The hypoglossal trigones are located...

Back 111

on the floor of the 4th ventricle in the medulla

Front 112

In the 4th ventricle, name the 3 nuclei from medial to lateral

Back 112

hypoglossal

dorsal motor 10

solitary

Front 113

The branchial motor nuclei include the trigeminal motor nucleus, facial nucleus, nucleus ambiguus, and spinal accessory nucleus. These generally lie ___ to the somatic motor nuclei and eventually end up in the ___

Back 113

lateral

tegmentum

Front 114

The spinal accessory nucleus is located...

Back 114

in the upper 5 cervical segments

Front 115

The trigeminal nuclear complex consists of _____ and runs from the ___ to the _____.

Back 115

mesecephalic, chief sensory, and spinal trigeminal nuclei

midbrain

upper cervical spinal cord

Front 116

The mesencephalic trigeminal nucleus and tract run along the ___ edge of the periaqueductal gray matter and subserve ____.

Back 116

lateral

proprioception

Front 117

The chief trigeminal sensory nucleus is located _____ and is _____ to the trigeminal motor nucleus.

Back 117

in the upper/mid pons

dorsolateral

Front 118

The spinal trigeminal nucleus and spinal trigeminal tract run the length of the ___ and ___

Back 118

lateral pons

medulla

Front 119

The spinal trigeminal nucleus is the ___ extension of the ____ of the spinal cord.

Back 119

rostral

dorsal horn

Front 120

The spinal trigeminal nucleus conveys ____ from the ____

Back 120

pain and temperature sensation

face

Front 121

The chief trigeminal nuclei convey ___ from the ___.

Back 121

fine discriminative touch

face

Front 122

The dorsal and ventral cochlear nuclei wrap around the lateral aspect of the ___ at the pontomedullary junction

Back 122

inferior cerebellar peduncle

Front 123

T/F: the hearing pathways decussate at multiple levels, not at a single level.

Back 123

TRUE

Front 124

The vestibular nuclei (superior, inferior, medial, lateral) are located on either side of the brainstem on the ___ in the ___

Back 124

lateral floor of 4th ventricle

pons and rostral medulla

Front 125

The ___ vestibular nucleus is the largest.

Back 125

Medial

Front 126

Where do fibers of the lateral vestibular nucleus go?

Back 126

They traverse the inferior vestibular nucleus and descend to the spinal cord

Front 127

All visceral afferents (special AND general) travel to the...

Back 127

nucleus solitarius

Front 128

The nucleus solitarius is located ___ to the dorsal motor nucleus of CN 10

Back 128

lateral

Front 129

The rostral nucleus solitarius is for ___ (what kind of afferent?) and CN ___ go to it.

Back 129

gustatory (taste)

7, 9, 10

Front 130

The caudal nucleus solitarius is for ___ (what kind of afferent?) and CN ___ go to it.

Back 130

cardiorespiratory and GI

9, 10

Front 131

The taste pathway goes rostrally via the _____ tract to the ____ of the thalamus, and then to the cortical taste area.

Back 131

central tegmental

VPM

Front 132

The corticospinal and corticobulbar tracts travel in the _____ of the cerebral peduncles in the midbrian?

Back 132

middle 1/3.

Front 133

The other portions of the cerebral peduncles carry predominantly what?

Back 133

Corticopontine fibers involved in cerebellar circuitry.

Front 134

Where to medial lemniscus fibers synapse in the thalamus?

Back 134

VPL (Ventro Posterior Lateral nucleus).

Front 135

Where does the sympathetic pathway run in the brainstem?

Back 135

Laterally. In close proximity to the Anterolateral system.

Front 136

What does damage here cause?

Back 136

Horner's syndrome.

Front 137

What is locked-in syndrome?

Back 137

Absent motor function, but maintain intact sensation and cognition (verticle eye movements and eye opening spared)

Front 138

What is locked-in syndrome usually caused by?

Back 138

Infarct of the ventral pons affected the bilateral corticospinal and corticobulbar tracts

Front 139

Why are vertical eye movements, but not horizontal movements, spared in locked-in syndrome?

Back 139

Vertical eyelid movements and eyelid elevation are controlled by a region in the tegmentum of the rostral midbrain; horizontal movements depend on pontine circuits

Front 140

Usually, locked in patients eventually succumb to...

Back 140

respiratory infection or complication of paralysis

Front 141

Ataxia

Back 141

uncoordinated wavering movement

Front 142

Does ataxia typically occur ipsilateral or contralateral to the side of the lesion? Why?

Back 142

Ipsilateral; cerebellar circuits tend to decussate twice before reaching lower motor neurons

Front 143

Superior cerebellar peduncle

Back 143

contained mainly cerebellar outputs; the decussation of the superior cerebellar peduncles occur at the midbrain at the level of the inferior colliculi

Front 144

Middle cerebellar peduncle

Back 144

largest of the cerebellar peduncles; receives massive inputs from pontine nuclei (which receive inputs from the corticopontine fibers of the cerebral peduncles)

Front 145

Inferior cerebellar peduncle

Back 145

Receives inputs from the spinal cord

Front 146

The red nucleus receives inputs from _________

Back 146

superior cerebellar peduncle

Front 147

Palatal myoclonus

Back 147

movement disturbance characterized by continuous, clicking, movements of the palate; caused by interruption of the circuit from the cerebellum to the brainstem and back to the cerebellum

Front 148

The central core of nuclei that runs the entire length of brainstem is...

Back 148

the reticular formation

Front 149

The reticular formation is continuous rostrally with certain ____ nuclei and caudally with the ___

Back 149

diencephalic

intermediate zone of the spinal cord

Front 150

What does the rostral reticular formation do?

Back 150

Maintain a conscious alert state in the forebrain

Front 151

What does the caudal reticular formation do?

Back 151

Helps carry out a variety of important motor, reflex, and autonomic functions.

Front 152

Which part of the brainstem is the reticular formation located?

Back 152

Throughout the whole brainstem; in the tegmentum

Front 153

The consciousness system is formed mainly by the ___

Back 153

medial and lateral frontoparietal association cortex (and also arousal circuits of rostral reticular formation)

Front 154

Where in the brain can a lesion cause a coma?

Back 154

rostral reticular formation and/or bilateral cerebral cortex or bilateral thalamus (especially the medial and intralaminar regions)

Front 155

Processes involved in the level of consciousness

Back 155

Alterness, Attention, Awareness

Front 156

Ascending reticular activating system (ARAS)

Back 156

areas in the rostral midbrain reticular formation and medial diencephalon; lesions in this area cause coma whereas stimulation can lead to arousal during deep anesthesia

Front 157

Where in the brain can a lesion cause coma?

Back 157

Coma is caused either by dysfunction of the upper brainstem reticular formation or by dysfunction of extensive bilateral regions of the cerebral cortex; bilateral lesions in the thalamus

Front 158

Location of cell bodies in reticular formation

Back 158

midbrain and rostal pons

Front 159

Main targets of reticular formation

Back 159

thalamic intralaminar nuclei, hypothalamus, basal forebrain

Front 160

Neurotransmitter receptors: Reticular Formation

Back 160

Unknown (glutamate?)

Front 161

Functions Reticular formation

Back 161

alertness

Front 162

Locations of cell bodies intralaminar nuclei

Back 162

thalamic intralaminar nuclei

Front 163

Main targets of intralaminar nuclei

Back 163

cortex, straitum

Front 164

Neuroreceptor receptors of intralaminar nuclei

Back 164

Glutamate?

Front 165

Functions of intralaminar nuclei

Back 165

Alertness

Front 166

Locations of cell bodies: midline thalamic nuclei

Back 166

micline thalamic nuclei

Front 167

Main Targets: midline thalamic nuclei

Back 167

cortex

Front 168

Neurotransmitter receptors: midline thalamic nuclei

Back 168

glutamate?

Front 169

Function: midline thalamic nuclei

Back 169

alertness

Front 170

Locations cell bodies: Norepinephrine

Back 170

Pons: locus ceruleus and lateral tegmental area of pons and medulla

Front 171

Main targets: norepinephrine

Back 171

entire CNS

Front 172

Neurotransmitter Receptors: Norepinephrine

Back 172

alpha1A-D, alpha2A-D, Beta1-3

Front 173

CNS functions of Norepinephrine

Back 173

attention, sleep-wake states, and mood

Front 174

ADD is often treated with medications that enhance ___ transmission.

Back 174

Noradrenergic.

Front 175

The Locus ceruleus and Lateral Tegmental have what kind of neurons?

Back 175

Noradrenergic.

Front 176

Narcolepsy

Back 176

A sleep disorder characterized by excessive daytime sleepiness; often responds to treatment with noradrenergic-enhancing medications

Front 177

Location cell bodies: Dopamine

Back 177

Ventral Midbrain: substanstia nigra pars compacts and ventral tegmental area

Front 178

Main targets: Dopamine

Back 178

Striatum, limbic cortex, amygdala, nucleus accumbens, prefrontal cortex

Front 179

Neurotransmitter receptors: Dopamine

Back 179

D1-5

Front 180

Functions: Dopamine

Back 180

Movements, initiative, working memory

Front 181

Three projection systems arising from substantia nigra and ventral tegmental area

Back 181

(1) mesostriatal (nigrostriatal) pathway (2) mesolimbic pathway (3) mesocortical pathway

Front 182

Mesostriatal pathway

Back 182

arises mainly from the substantia nigra pars compacta and projects to the caudate and putamen

Front 183

Dysfunctions of the mesostriatal pathway produces movement disorders such as?

Back 183

Parkinson's Disease.

Front 184

The mesolimbic pathway arises mainly from where? And projects to where?

Back 184

Ventral tegmental area and projected to the limbic structures. (Medial temporal cortex, amygdala, cingulate gyrus, and nucleus accumbens.)

Front 185

The mesolimbic pathway plays a major role in what?

Back 185

Reward circuitry and addiction.

Front 186

Overactivity of the mesolimbic pathway is thought to be important in the "positive" symptoms of what? Examples?

Back 186

Schizophrenia. Sucha s hallucinations, which often respond to dopaminergic antagonists.

Front 187

Mesocortical pathway arises mainly from where? And projects to where?

Back 187

From the ventral tegmental area and projects to the prefrontal cortex.

Front 188

The mesocortical pathway has what roles?

Back 188

proposed in frontal lobe functions such as working memory and attentional aspects of motor initiation.

Front 189

Damage to the mesocortical pathway may be important for some of the cognitive defects and hypokinesia seen in what disease?

Back 189

Parkinson's Disease.

Front 190

Damage to the mesocortical pathway may be important for some of the "negative" symptoms of what disease?

Back 190

Schizophrenia.

Front 191

Locations of cell bodies for serotonin

Back 191

midbrain, pons, and medulla: raphe nuclei; small amounts have been found in the area postrema and caudal nucleus ceruleus

Front 192

Main targets: Serotonin

Back 192

Entire CNS

Front 193

Neurotransmitter receptors: Serotonin

Back 193

5-HT1A-F, 5-HT2A-C, 5-HT3-7

Front 194

Functions: Serotonin

Back 194

Alertness, mood elevation, breathing control, temperature and pain modulation

Front 195

Diseases associated with serotonin

Back 195

depression, anxiety, OCD, aggressive behavior, an certain eating disorders; SIDS

Front 196

Sudden Infant Death Syndrome (SIDS) is associated with what?

Back 196

Defects in serotonin neurons, possibly causing impaired arousal in response to hypoventilation.

Front 197

Locations of cell bodies: Histamine

Back 197

Hypothalamus: tuberomammillary nucleus; midbrain; reticular formation

Front 198

Main targets: Histamine

Back 198

entire brain

Front 199

Neurotransmitter receptor: Histamine

Back 199

H1-3

Front 200

Functions Histamine

Back 200

Alterness

Front 201

Side effects of antihistamine medications

Back 201

drowsiness

Front 202

Locations of cell bodies: Orexin (hypocretin)

Back 202

Posterior lateral thalamus

Front 203

Main targets: Orexin

Back 203

Entire brain; cerebral cortex

Front 204

Neurotransmitter Receptor: Orexin

Back 204

OX1, OX2

Front 205

Functions: Orexin

Back 205

Alterness and food intake; orexins excite the brainstem and hypothalamic arousal systems and are crucial for the alert state

Front 206

Locations cell bodies: ACh

Back 206

(1) Basal forebrain: nucleus basilis, medial septal nucleus, and nucleus of diagonal band (2) Pontomesencephalic region: pedunculopontine nucleus and laterodorsal tegmental nucleus

Front 207

Main targets: ACh

Back 207

(1) Cerebral cortex including hippocampus (2) Thalamus, cerebrm, pons, medulla

Front 208

Neutrotransmitter Receptors: ACh

Back 208

Muscarinic, nicotinic subtypes

Front 209

CNS Functions of ACh

Back 209

Alertness, memory, learning

Front 210

Cholinergic projections to the hippocampal formation arise from _____ and _______

Back 210

medial septal nuclei and the nucleus of the diagonal band

Front 211

Hippocampal theta rhythm

Back 211

postulated to play a role in memory functions; rhythmic oscillation due to ACh

Front 212

Main cholinergic receptor in the CNS?

Back 212

Muscarinic.

Front 213

Pharmacological blockage of central cholinergic tranmission causes

Back 213

delirium and memory deficits

Front 214

Degeneration of cholinergic neurons in the basal forebrain may be responsible for the memory decline in which disease?

Back 214

Alzheimer's disease.

Front 215

Cholinergic inputs to the cortex mainly come from ___

Back 215

Basal forebrain (nucleus basalis of Meynert)

Front 216

Diffuse (Widespread) projection systems

Back 216

pathways which emanate from a single region to innervate many structures or even the entire nervous system

Front 217

Main excitatory neurotransmitter in the CNS

Back 217

glutamate

Front 218

Main inhibitory neutrotransmitter in the CNS

Back 218

GABA

Front 219

Lesions or blockades of some neurotransmitter systems, especially ACh and histamine will cause

Back 219

confusion and drowsiness; NOT COMA

Front 220

Location of Adenosine receptors

Back 220

thalamus and cortex

Front 221

Mechanism caffeine in relation to increased alertness

Back 221

blockade of adenosine receptors

Front 222

NonREM

Back 222

stages 1-4

Front 223

Sleep-promoting regions are postulated to be where?

Back 223

in the medullary reticular formation and nucleus soltarius

Front 224

galanin

Back 224

peptide that contributes to inhibitory pathway related to sleep

Front 225

Where are REM-on cells located

Back 225

pontine reticular formation

Front 226

Ventrolateral preoptic area (VPLO)

Back 226

promotes sleep during non-REM by inhibiting neurons involved in wakefulness; releases GABA and galanin

Front 227

Neurotransmitters which show progressive reduced firing during stages 1-4 of nonREM sleep and are silent during REM

Back 227

norepinephrine and serotonin

Front 228

Neuropeptide which is increased during REM sleep

Back 228

ACh

Front 229

PGO (ponto-geniculo-occipital) waves

Back 229

intermittent waves of activation passing from pons to thalamus to cortex thought to induce the visual imagery of dreams and assocaited with rapid eye movements

Front 230

glutamatergic REM-on cells

Back 230

located in the reticular formation; activate circuits involving inhibitory transmitter glycine in the medulla and spinal cord which inhibits lower motor neurons and accounts for decreased muscle tone during REM

Front 231

REM sleep behavioral disorder

Back 231

caused by lesions of glutamatergic REM-on cell pathway; abolishes the normal inhibition of motor activity during REM

Front 232

Levels of near orexin neurons and melanin during sleep and wake state

Back 232

higher during sleep and lower during wake

Front 233

The suprachiasmatic nucleus of the hypothalamus

Back 233

receives retinal inputs and is crucial for setting circadian rhythms and synchronizing them with the light-dark cycle

Front 234

What are the four classical clinical findings of narcolepsy?

Back 234

1) Excessive daytime sleepiness 2) Cataplexy (Sudden loss of muscle tone from the awake state, often in response to an emotional stimulus) 2) Hypnagogic or Hypnopompic dreamlike hallucinations 4) Sleep paralysis

Front 235

What is a coma?

Back 235

Unarousable unresponsiveness in which the patient lies with eyes closed for a minimum of 1 hour. Cerebral metabolism is typically reduced by at least 50%.

Front 236

What causes a coma?

Back 236

Impaired function of the cerebral cortex and diencephalic-upper brainstem arousal systems. Most commonly from trauma or anoxia.

Front 237

Brain death

Back 237

extreme, irreversible coma; no evidence of forebrain or brainstem function, including no brainstem reflexes; only spinal cord refexes may persist

Front 238

EEG in brain death

Back 238

electrocerebral inactivity or a flat pattern less than 2mV in amplitude

Front 239

Coma vs. brain death

Back 239

In a coma, many simple or even complex brainstem reflex activities are present

Front 240

EEG in coma

Back 240

usually abnormal (a common theme is that it is usually monotonous with little variability over time); but it can show many different patterns, including large-amplitude slow waves, burst-suppression, triphasic waves, spindle waves, or even alpha activity

Front 241

What is a vegetative state?

Back 241

When patients regain sleep-wake cycles and other primitive orienting responses and reflexes mediated by the brainstem and diencephalon, but remain unconscious; patients may open their eyes or turn heads toward audition

Front 242

Persistent vegetative state

Back 242

conditions lasting more than 1 month

Front 243

Appearance of visual tracking may be the earliest sign of emergence into what?

Back 243

A minimally conscious state

Front 244

What do akinetic mutism, abulia, and catatonia have in common?

Back 244

circuits involving frontal lobes, diencephalon, and ascending dopaminergic projections important to the initiation of motor and cognitive activity

Front 245

What is akinetic mutism?

Back 245

The patient appears fully awake and visually track the examiner, but do not respond to any commands. The primary deficit is in motor initiation rather than in consciousness. Can be seen as an extreme form of abulia.

Front 246

The primary deficit in akinetic mutism is ___

Back 246

motor intuition, not consciousness

Front 247

What is abulia?

Back 247

Often resulting from frontal lobe lesions, in which the patients usually sit passively but may occasionally respond to questions or commands after a long delay.

Front 248

What treatment can reverse abulia and akinetic mutism in some patients?

Back 248

Dopaminergic agonists.

Front 249

What is catatonia?

Back 249

An akinetic state that can occasionally be seen in advanced cases of schizophrenia. Frontal-lobe and dopaminergic dysfunction have been implicated.

Front 250

status epilepticus

Back 250

continuous seizure activity

Front 251

Cause: Transient loss of consciousness

Back 251

caused by cardiac or other medical conditions, not usually neurological

Front 252

Most common causes of bilateral cerebral dysfunction

Back 252

global anoxia, metabolic/toxic disorders, head trauma, bilateral infarcts

Front 253

Common causes of brainstem dysfunction causing coma

Back 253

extrinsic compression from cerebral of cerebellar mass lesions or by intrinsic lesions (infarct, hemorrhage)

Front 254

Tx coma before labs

Back 254

IV thiamine, dextrose, naloxone (flumazenil if benzodiazepine overdose is suspected)

Front 255

Who shouldn't get IV thiamine, dextrose, and naloxone when suspected of a coma?

Back 255

Infants. They shouldn't be given dextrose unless they're hypoglycemic.

Front 256

Appearance of pupils: toxic and metabolic disorders

Back 256

normal (usually)

Front 257

Appearance of pupils: midbrain lesion or transtentorial lesion

Back 257

unilateral or bilateral "blown" pupil

Front 258

Appearance of pupils: pontine lesion

Back 258

small, responsive to light bilaterally

Front 259

Appearance of pupils: opiate overdose

Back 259

pinpoint pupils bilaterally

Front 260

Respiration rhythms are controlled by what?

Back 260

The medulla; voluntary control in the forebrain

Front 261

pre-Botzinger complex

Back 261

located in the medulla; pacemaker for respiration

Front 262

Lower motor neurons involved in respiration

Back 262

Cervical spinal segments C3-C5 (phrenic) contract the diaphragm during inspiration, while thoracic levels control thoracic inspiratory and expiratory muscles

Front 263

Ataxix respiration

Back 263

ominous pattern of very irregular breathing that may lead to respiratory arrest

Front 264

Lesions in the rostral pons can lead to a peculiar breathing pattern called what?

Back 264

Apneustic respiration

Front 265

Apneustic respiration

Back 265

the patient has brief 2- to 3- second respiratory pauses at full inspiration

Front 266

Midbrain lesions may lead to what type of respiration?

Back 266

Central neurogenic hyperventilation

Front 267

Where are the presympathetic neurons that maintain normal BP found?

Back 267

Rostral ventrolateral medulla

Front 268

Crescendo-decrescendo breathing is most likely caused by lesions where?

Back 268

Bilateral lesions at or above the upper pons

Front 269

What causes Cheyne-Stokes respiration?

Back 269

In bilateral lesions at or above the level of the upper pons, or in mountain climbers sleeping at high altitudes, or in medical conditions such as cardiac failure.

Front 270

What is Cheyne-Stokes respiration?

Back 270

When breathing becomes progressively deeper and then shallower to the point of apnea.

Front 271

The nucleus solitarious is important in what?

Back 271

Circulatory regulation and respiration; received inputs from baroreceptors in the carotid body and aortic artch via cranial nerves IX and X

Front 272

Inputs from the nucleus soltarius to __________ may be important in mediating emotinal responses to altered cardiorespiratory function and have been postulated to play a role in triggering panic attacks

Back 272

limbic system

Front 273

What functions are heavilty dependent on circuits in the pontomedullary reticular formation?

Back 273

Coughing, hiccuping, sneezing, yawning, shivering, gagging, vomiting, swallowing, laughing and crying.

Front 274

What and where is the area postrema?

Back 274

Located on the lateral wall of the fourth ventricle in the medulla. It contains a chemotactic trigger zone where the blood-brain barrier is incomplete. Allows endogenous and exogenous to trigger nausea and vomitting.

Front 275

___ (neurotransmitter) release from stomach/SI cells also cause nausea/vomiting because this neurotransmitter stimulates afferents traveling with the vagus to reach the ___ in the brainstem.

Back 275

5-HT

nucleus solitarius

Front 276

sphincter control

Back 276

pontine micturation center and other regions of the reticular formation

Front 277

The periaqueductal gray matter functions with other regions in the brainstem to do what?

Back 277

modulate pain transmission.

Front 278

Where does blood to the posterior fossa come from?

Back 278

Vertebrobasilar system.

Front 279

What is the last cervical vertebra through which the vertebral arteries ascend before piercing the dura to enter the foramen magnum?

Back 279

C2

Front 280

The vertebral arteries enter the cranial cavity through the ________

Back 280

foramen magnum

Front 281

The paired vertebral arteries join to form a single _________ artery

Back 281

basilar

Front 282

The basilar artery splits at the _______ to form two _________

Back 282

pontomesencephalic junction; posterior cerebral arteries

Front 283

The PICA arises from the vertebral artery at the level of what?

Back 283

the medulla, and wraps around to supply the lateral medulla and inferior cerebellum.

Front 284

The AICA arises from the proximal basilar artery at the level of?

Back 284

The caudal pons and supplies the lateral caudal pons and a small region of the cerebellum.

Front 285

The SCA arises from the top of the basilar artery at the level of the rostral pons and supplies the what?

Back 285

Superior cerebellum as well as a small region of the rostral lateral dorsal pons.

Front 286

What cranial nerve passes between the SCA and the PCA?

Back 286

CN III Oculomotor.

Front 287

The PCA arises from the top of the basilar artery and supplies what?

Back 287

The midbrain, most of the thalamus, medial occipital lobes, and inferior-medial temporal lobes.

Front 288

Blood supply of medial medulla

Back 288

paramedian branches of the anterior spinal artery in more caudal regions and by paramedian branches of the vertebral arteries in more rostal regions

Front 289

The anterior spinal artery supplies what?

Back 289

The medial medulla caudally, by paramedian branches.

Front 290

Blood supply lateral medulla

Back 290

penetrating branches of the vertebral artery and the PICA

Front 291

Blood supply medial pons

Back 291

branches of the basilar artery

Front 292

Blood supply lateral pons

Back 292

circumferential branches of the basilar artery and AICA

Front 293

The inner ear is supplied by what?

Back 293

The internal auditory (labyrinthe) artery. From the AICA (occasionally will branch off of basilar artery)

Front 294

Blood supply rostral pons

Back 294

lateral pontine arteries (branches of basillar)

Front 295

Blood supply superior dorsolateral pons

Back 295

SCA

Front 296

Blood supply midbrain

Back 296

penetrating branches arising from the top of the basillary artery and from the proximal PCAs

Front 297

Blood supply thalamus

Back 297

top of the basilar artery and proximal PCA

Front 298

Arteries of Percheron

Back 298

anatomic variation in the brain vascularization in which a single arterial trunk arises from the posterior cerebral artery (PCA) to supply both sides of brain structures; the thalamus and midbrain

Front 299

Contralateral/one-sided/crossed sign symptoms are commonly more indicative of...

Back 299

brainstem involvement rather than cerebral

Front 300

Aphasia, hemineglect, hemianopia, and seizures indicate...

Back 300

hemispheric involvement rather than brainstem

Front 301

midbrain dysfunctions include...

Back 301

CN3 palsy, pupil dilation, ataxia, flexor posturing, impaired consciousness

Front 302

pons dysfunction....

Back 302

unilateral Babinski, weakness, perioral numbness, tingling face, bilateral upper or lower visual loss/blurring, irregular respirations, ocular bobbing, shivers, palatal myoclonus, abducens palsy, horizontal gaze palsy, small but reactive pupils

Front 303

medullary dysfunction...

Back 303

vertigo, ataxia, nystagmus, nausea, vomit, resp arrest, autonomic instability, hiccup

Front 304

How does atherosclerotic disease causing vertebral stenosis or basilar stenosis result in the brainstem?

Back 304

Waxing and waning signs that may be sensitive to changes in BP

Front 305

Why is vertebral or basilar thrombosis life threatening?

Back 305

potential widespread brainstem infarction

Front 306

When should tPA therapy be given?

Back 306

thrombosis events within 4.5 hours of onset

Front 307

After the window of tPA therapy, what should be given?

Back 307

antiplatelet agents like aspirin

Front 308

When is pontine hemorrhage most commonly seen?

Back 308

chronic HTN

Front 309

What part of the midbrain contains the cortico-spinal tract?

Back 309

basis

Front 310

Possible ischemic structures: Dizziness, vertigo, nausea

Back 310

vestibular nuclei, cerebellum, or inner ear

Front 311

Possible ischemic structures: diplopia, dysconjugate gaze

Back 311

Supranuclear or Infranuclear eye movement pathways.

Front 312

Possible ischemic structures: blurred vision or other visual disturbances

Back 312

eye movement pathways; long sensory or motor tracts.

Front 313

Possible ischemic structures: incoordination (ataxia)

Back 313

cerebellum or cerebellar pathways

Front 314

Possible ischemic structures: unsteady gait

Back 314

cerebellar pathways; long sensory or motor paths

Front 315

Possible ischemic structures: dysarthria, dysphagia

Back 315

corticobulbar pathways or brainstem cranial nerve nuclei

Front 316

Possible ischemic structures: numbness and tingling, particularly bilateral or perioral

Back 316

Long somatosensory pathways or trigeminal system

Front 317

Possible ischemic structures: hemiparesis, quadriparesis

Back 317

corticospinal tract

Front 318

Possible ischemic structures: somnolence

Back 318

pontomesencephalic reticular formation or bilateral thalami

Front 319

Possible ischemic structures: Occipital headache

Back 319

Posterior fossa meninges and vessels (CN X and cervical roots)

Front 320

Possible ischemic structures: frontal headache

Back 320

Supratentorial meninges and vessels (CN V; PCA is often CN V1)

Front 321

Possible ischemia structures: nonlocalized headache

Back 321

supra- and/or infratentorial meninges and vessels

Front 322

Crossed-signs and cranial nerve abnormalities are strongly suggestive of _____ involvement?

Back 322

Brain-stem.

Front 323

Aphasia, hemineglect, hemaniopia, and seizures are strongly suggestive of ____ involvement?

Back 323

Hemispheric.

Front 324

Signs of midbrain dysfunction

Back 324

third-nerve palsy, unilateral or bilateral pupil dilation, ataxia, flexor (decorticate) posturing, and impaired consciousness

Front 325

Signs of pontine dysfunction

Back 325

b/l Babinski's signs, generalized weakness, periorbital numbness, "salt and pepper" facial tingling, bilateral upper or lower visual loss or blurring (usually caused by impaird blood flow from the basilar artery to both PCAs), irregular respirations, ocular bobbing, shivering, palatal myoclonus (affecting central tegmental tract), abducens palsy or horizontal gaze palsy, b/l small but reactive pupils, extensor (decerebrae) posturing, and impaired consciousness

Front 326

Signs of medullary dysfunction

Back 326

vertigo, ataxia, nystagmus, nausea, vomiting, respiratory arrest, autonomic instability, and hiccups

Front 327

Lateral medullary syndrome is usually caused by?

Back 327

Vertebral thrombosis

Front 328

Medial basis pontis infarcts are usually caused by?

Back 328

Lacunar disease

Front 329

Structures found and anatomical clinical features caused by ischemia/stroke in the medial medulla

Back 329

Pyramidal tract (contralateral arm or leg weakness); medial lemniscus (contralateral decreased position and vibration sense), hypoglossal nucleus and exiting CN XII fasicles (Ipsilateral tongue weakness)

Front 330

Medial medullary syndrome is caused by occlusion of what?

Back 330

Paramedian branches of the anterior spinal or vertebral arteries.

Front 331

What are the feautures of wallenberg/ lateral medullary syndrome?

Back 331

Ipsilateral ataxia (inferior cerebellar peduncle), vertigo (vestibular nuclei), decreased pain and temperature sensation ipsilateral face (spinal trigeminal nucleus and tract) and of contralateral body ( spinothalmic tract). Horner's syndrome (descending sympathetic fibers).

Front 332

Presence of hoarseness or loss of taste sensation helps localize a syndrome to what brain region?

Back 332

Medulla. Hoarseness/Taste from the Nucleus ambiguus/Nucleus Solitarius.

Front 333

Ipsilateral hearing loss suggests ____ involvement rather than lateral medullary syndrome.

Back 333

AICA involvement.

Front 334

Dysarthria hemiparesis (pure motor hemiparesis): region and vascular supply

Back 334

medial pontine basis; paramedian branches of basilary artery, ventral territory

Front 335

Dysarthria hemiparesis (pure motor hemiparesis): affected structures and clinical features

Back 335

corticospinal and corticobulbar tracts (contralateral face, arm, and leg weaknss)

Front 336

Ataxic hemiparesis: region and vascular supply

Back 336

medial pontine basis; paramedian branches of basilary artery, ventral territory

Front 337

Ataxic hemiparesis: affected stuctures and clinical features

Back 337

corticospinal and corticobulbar tracts (contralateral face, arm, and leg weaknss)

Front 338

Foville's syndrome: region and vascular supply

Back 338

Medial pontine basis and tegmentum; paramedian branches of basilar artery, ventral and dorsal territories

Front 339

Foville's syndrome: affected structures and clinical features

Back 339

corticospinal and corticobulbar tracts (contralateral face, arm, and leg weaknss); facial colliculus (ipsilateral facial weakness, ipsilateral horizontal gaze palsy)

Front 340

Pontine wrong-way eyes: region and vascular supply

Back 340

Medial pontine basis and tegmentum; paramedian branches of basilar artery, ventral and dorsal territories

Front 341

Pontine wrong-way eyes: affected structures and clinical features

Back 341

corticospinal and corticobulbar tracts (contralateral face, arm, and leg weakness; dysarthria); abducens nucleus or paramedian pontine reticular formation (ipsilateral horizontal gaze palsy)

Front 342

Millard-Gubler syndrome: region and vascular supply

Back 342

Medial pontine basis and tegmentum; paramedian branches of basilar artery, ventral and dorsal territories

Front 343

Millard-Gubler syndrome: affected structures and clinical features

Back 343

corticospinal and corticobulbar tracts (contralateral face, arm, and leg weakness; dysarthria); facicles of facial nerve (ipsilateral facial weakness)

Front 344

AICA syndrome: region and vascular supply

Back 344

lateral caudal pons; AICA

Front 345

AICA syndrome: affected structures and clinical features

Back 345

middle cerebellar peduncle (ipsilateral ataxia); vestibular nuclei (vertigo, nystagmus); trigeminal nucleus and tract (ipsilateral facial decreased pain and temperature sense); spinothalamic tract (contralateral body decreased pain and temperature sense); Descending sympathetic fibers (ipsilateral Horner's)

Front 346

Ischemia to the labyrinthe artery causes what clinical features? Where is this artery located?

Back 346

ipsilateral hearing loss; lateral caudal pons

Front 347

SCA syndrome: region and vascular supply

Back 347

dorsolateral rostral pons; SCA

Front 348

SCA syndrome: affected structures and clinical features

Back 348

superior cerebellar peduncle and cerebellum (ipsilateral ataxia); other lateral tegmental structures (variable features)

Front 349

Weber's syndrome

Back 349

Occurs in the midbrain basis; branches of PCA and top of basilar artery; affects oculomotor nerve fasicles causing ipsilateral third nerve palsy and the cerebral peduncle causing contralateral hemiparesis

Front 350

Claude's syndrome

Back 350

Occurs in the midbrain tegmentum; branches of the PCA and top of basilar artery; affects oculomotor nerve fascicles causing ipsilateral third nerve palsy and red nucleus, superior cerebelllar peduncle fibers causing contralateral ataxia

Front 351

Benedikt's syndrome

Back 351

Occurs in the midbrain basis and tegmentum; branches of the PCA and top of basilar artery; affects oculomotor nerve fascicles (3rd nerve palsy), cerebral peduncle (contralateral ataxia), and red nucleus, substantia nigra, and superior cerebellar peduncle (contralateral ataxia, tremor, and involuntary movements)

Front 352

Cause: Top-of-the-basilar syndrome

Back 352

embolus that lodges the distal basilar artery

Front 353

Clinical features: Top-of-the-basilar syndrome

Back 353

visual disturbances resulting from infarcts of the visual cortex; memory disturbances from infarcts ofthe bilateral medial thalami or temporal; eye movements from oculomotor nuclei; somnolence, delirium, and vivid hallucinations

Front 354

Basilar scrape syndrome

Back 354

embolus that migrates up the basilar artery toward the top; it occludes various penetrator arteries in the pons

Front 355

What is Millard-Gubler syndrome?

Back 355

Occlusion of paramedian branches of basilar artery, ventral and dorsal territories. Affectiong the Corticospinal and corticobulbar tracts (in the pons), leading to contralateral face, arm, and leg weakness; dysarthria.

Front 356

Midbrain basis vascular syndrome is called?

Back 356

Weber's syndrome. Branches of PCA and top of basilar artery. Oculomotor nerve fascicles affected. Ipsilateral 3rd nerve palsy. Cerebral peduncle. Contralateral hemiparesis.

Front 357

Midbrain tegmentum vascular syndrome?

Back 357

Claude's syndrome. Branches of PCA and top of basilar artery. Oculomotor nerve fascicles and third-nerve palsy. Red nucleus/ superior cerebellar peduncle fibers. Contralateral ataxia.

Front 358

Midbrain basis and tegmentum vascular syndrome is called?

Back 358

Benedikt's syndrome. Branches of PCA and top of basilar artery. Oculomotor nerve fascicles, Cerebral peduncle, Red nucleus, substantia nigra, superior cerebellar peduncle fibers.

Front 359

Features of Benedikt's syndrome?

Back 359

Ipsilateral third-nerve palsy. Contralateral hemiparesis. Contralateral ataxia, tremor, involuntary movements.