Neuro 12 Brainstem 1

Front 1

the two pairs of bumps on the dorsal midbrain are?

Back 1

superior and inferior colliculi

Front 2

what structures lie dorsal to the pons?

Back 2

4th ventricle, cerebellum

Front 3

what are the bumps on the floor of the 4th ventricle?

Back 3

facial colliculi (abducens nuclei and fibers of CN VII)

Front 4

which cranial nerves do not emerge from the brainstem?

Back 4

CN I and II

Front 5

where do the optic nerves enter the brain?

Back 5

wrap around midbrain to enter LGN of the thalamus

Front 6

which CN's exit the brainstem dorsally?

Back 6

only CN IV (dorsal midbrain)

Front 7

origin of CN III?

structures around it?

Back 7

ventral midbrain interpeduncular fossa

passes btwn PCA and Sup Cerebellar A.

Front 8

which nerve protrudes from the ventral surface of the pons?

Back 8

CN V

Front 9

which nerves exit at the pontomedullary jctn?

Back 9

CN VI, VII, VIII, IX

Front 10

what's the region where CN VII, VIII and IX exit the brainstem called?

Back 10

cerebellopontine angle

Front 11

only nerve to exit brainstem anterior to inf olive?

Back 11

CN XII

Front 12

foramen for optic nerve

Back 12

optic canal

Front 13

nerves that traverse sup orbital fissure?

Back 13

CN III, IV, V1, VI

Front 14

foramina for branches of trigem?

Back 14

V1 = sup orbital fissure
V2 = foramen rotundum
V3 = foramen ovale

Front 15

how does facial nerve leave the skull?

Back 15

int auditory meatus -> stylomastoid foramen

Front 16

how do CN IX, X, and XI leave the skull?

Back 16

jugular foramen

Front 17

in general, motor CN nuclei are located more _____, sensory CN nuclei are located more _____.

Back 17

ventrally, dorsally

Front 18

furthest medial motor column of cranial nerve nuclei (GSE) includes which nuclei?

functions?

Back 18

oculomotor (sup colliculus), trochlear (inf colliculus), abducens, hypoglossal

extraocular muscles, intrinsic tongue muslces

Front 19

what CN nuclei are part of the parasympathetic GVE column?

functions?

Back 19

Edinger-Westphal (III), Sup salivatory (VII), Inf salivatory (IX), Dorsal motor nucleus of CN X

PNS of head and thoracoabdominal viscera above splenic flexure

Front 20

what CN nuclei are part of the SVE column?

functions?

Back 20

Trigem motor nucleus, Facial nucleus, Nucleus ambiguus (IX, X), Spinal acc. nucleus

mm. mastication, facial expression, middle ear, pharynx/larynx, SCM, upper traps

Front 21

what CN nuclei are in the visceral sensory column?

functions?

Back 21

nucleus solitarius

gustatory (rostral, VII, IX, X) = taste
cardiorespiratory (caudal, IX, X) = receives inputs for regulation of cardiac, resp, and GI fxn

Front 22

what nuclei are in the general somatic sensory column?

functions?

Back 22

Trigeminal nuclei (V, VII, IX, X)

general sensation for face, sinuses and meninges

Front 23

what nuclei are in the special somatic sensory column?

functions?

Back 23

cochlear, vestibular (VIII)

hearing, balance/orientation

Front 24

which muscles of the head/neck are derived from the occipital somites?

Back 24

extraocular and intrinsic tongue mm.
(somatic motor CN nuclei)

Front 25

which muscles of head/neck are derived from branchial arches?

Back 25

muscles of mastication, facial expression, middle ear, pharynx/larynx, SCM, upper traps

Front 26

which nuclei in the brainstem receive input from multiple nerves?

Back 26

solitarius, ambiguus, trigeminal

Front 27

which CN have both motor and sensory fxn?

Back 27

V, VII, IX, X

Front 28

Foster-Kennedy syndrome?

Back 28

meningiomas in olfactory sulcus region cause anosmia + I/L optic atrophy + C/L papilledema

Front 29

action of trochlear nerve?

Back 29

pull top of the eye medially and downward

Front 30

CN III carries parasympathetics to what structures?

Back 30

pupillary constrictor and ciliary muscle of the lens

Front 31

PNS ganglion associated with CN III?

location?

Back 31

ciliary

orbit

Front 32

innervation of dura mater?

Back 32

supratentorial = CN V
infratentorial = CN X & upper cerv

Front 33

innervation of nasal sinuses?

Back 33

CN V

Front 34

general sensation of tongue?

Back 34

ant 2/3 = CN V
post 1/3 = CN IX

Front 35

sensation for the face/head/neck goes through what thalamic nuclei?

Back 35

VPM

Front 36

what are the nuclei of the trigeminal nuclear complex and their functions?

Back 36

mesencephalic trigem nucleus (proprioception)

chief trigem sensory nucleus (fine touch, dental pressure)

spinal trigem nucleus (crude touch, pain, temp)

Front 37

the spinal trigeminal nucleus is analogous to what spinal sensory system?

Back 37

anterolateral system
(crude touch, pain, temp)

Front 38

fibers from which trigem nuclei ascend to the CL VPM?

what are these fiber tracts called?

Back 38

chief sensory nucleus
(trigeminal lemniscus)

spinal trigeminal nucleus
(trigemino-thalamic tract)

Front 39

in the spinal trigeminal tract and nucleus, which cutaneous areas are represented most rostrally in the tract? which division of CN V is represented most dorsally?

Back 39

rostral to caudal = perioral areas > eyes, cheeks > chin, ears, scalp

dorsal to ventral = mandibular > maxillary > ophthalmic

Front 40

the mesencephalic trigeminal tract runs lateral to what structure in the midbrain?

Back 40

periaqueductal gray matter

Front 41

where does the branchial motor root of CN V exit the skull?

muscles innervated by it?

Back 41

runs inferomedial to trigem ganglion then joins V3 to exit via foramen ovale

masseter, temporalis, medial/lateral pterygoids, tensor tympani, tensor veli palatini, mylohyoid, ant belly digastric

Front 42

multiple sclerosis is sometimes assoc'd with what nerve disorder?

Back 42

trigem neuralgia

Front 43

DOC for trigem neuralgia?

Back 43

carbamazepine or baclofen

Front 44

lesions of trigem nuclei in brainstem cause ____ loss of facial sensation

Back 44

ipselateral

Front 45

what nerve regulates PNS for lacrimation and salivation as well as taste and general sensation to a small area around the ear?

Back 45

nervus intermedius (CN VII)

Front 46

the bodies of primary sensory neurons for taste to the ant 2/3 of the tongue lie in what ganglion?

with which nerves do the fibers travel?

where do they synapse in the brainstem?

Back 46

geniculate ganglion (CN VII)

lingual nerve (V3) and chorda tympani (VII)

gustatory nucleus (nuc solitarius)

Front 47

what goes through foramen lacerum?

Back 47

int carotid a., a. of pterygoid canal, n. of pterygoid canal

Front 48

what comes from sup salivatory nucleus and where does it go?

Back 48

PNS nerves of the facial nerve
At genu, it splits into greater petrosal (which goes to sphenopalatine ganglion to lacrimal gland and nasal mucosa) and chorda tympani (which exits at petrotympanic fissure, joins lingual nerve to submandibular ganglion to submandibular and submaxillary glands)

Front 49

what type of neuron injury spares the muscle innervation to the forehead?

Back 49

U/L UMN lesion of CN VII

Front 50

innervation of corneal reflex?

innervation of threat blink reflex?

Back 50

afferent = CN V1 to chief sensory and spinal trigem nucleus; efferent = CN VII to orbicularis oculi mm.

afferent = CN II, efferent = CN VII

Front 51

innervation of jaw jerk reflex?

when is it seen?

Back 51

sensory neurons in mesencephalic trigem nucleus send axons to pons to synapse in motor trigem nucleus

BL UMN lesions (e.g. ALS) or diffuse white matter disease

Front 52

the bony labyrinth is filled with ___, while the membranous labyrinth is filled with ____.

Back 52

perilymph
endolymph

Front 53

fibers from ____ pass through the trapezoid body, skip the sup olivary nucleus to travel through the ____ to the inferior colliculus

Back 53

dorsal cochlear nuclei
lateral lemniscus

Front 54

what area is specialized to localize sounds horizontally in space?

Back 54

superior olivary nuclear complex of the pons

Front 55

the ____ is traversed at right angles by the medial lemniscus

Back 55

trapezoid body

Front 56

which vestibular nuclei are important in maintaining balance and extensor tone throughout the length of the SC?

Back 56

lateral

Front 57

which vestibular nuclei are important in controlling head/neck position?

Back 57

medial and inferior

Front 58

which vestibular nucleus has a checkerboard appearance on myelin stained section?

Back 58

inferior

Front 59

purpose of MLF?

Back 59

connect oculomotor, trochlear, abducens nuclei to each other and to medial and superior vestibular nuclei

Front 60

which hearing test evaluates conductive hearing loss?

Back 60

Rinne
(normal = air > bone; conductive hearing loss = bone > air)

Front 61

which hearing test evaluates sensorineural hearing loss?

Back 61

Weber
(normal = tone equal on both sides; sensorineural loss = tone louder on unaffected side)

Front 62

TxOC for pt c/o recurrent vertigo w/ fluctuating and/or step-wise progressive hearing loss?

Back 62

salt restriction and diuretics (Meniere's dz)

Front 63

muscles innervated by CN IX?

Back 63

stylopharyngeus

Front 64

Talk to daddy about the inferior salivatory nucleus. I'm interested.

Back 64

PNS fibers run with CN IX to lesser petrosal n., synapse in otic ganglion to the parotid gland

Front 65

what special sensory functions does CN IX mediate?

Back 65

taste post 1/3 tongue
chemo-/baroreceptors of carotid body

Front 66

what nerve controls almost all the pharyngeal and laryngeal muscles?

Back 66

branchial motor component of CN X

Front 67

where are postganglionic PNS neurons innervated by CN X located?

Back 67

terminal ganglia within or near effector organs

Front 68

innervation of cricothyroid m.?

Back 68

sup laryngeal n. (all other intrinsic laryngeal mm. = recurrent laryngeal n)

Front 69

somatosensory areas of CN X?

special sensory?

Back 69

pharynx, larynx, infratentorial meninges, ext auditory meatus

taste from epiglottis and post pharynx

Front 70

manifestation of LMN lesion of CN XI?

Back 70

IL shoulder shrug or arm elevation weakness

weakness turning head AWAY from lesion

Front 71

weakness of head turning in UMN lesion of CN XI?

Back 71

weak turning AWAY from lesion
(same as LMN lesion)

Front 72

CN XII innervates what muscles?

Back 72

intrinsic and extrinsic tongue mm EXCEPT palatoglossus (CN X)

Front 73

dx: weak shoulder shrug, weak head turning, dysphagia for solids & liquids, hoarseness, fluctuant BP, fleshy vascular mass in middle ear

Back 73

glomus tumor compressing CN IX, X, XI

Front 74

appearance of soft palate/uvula with UL lesions of CN X or nuc ambiguus?

Back 74

uvula deviates toward normal side, soft palate hangs low on affected side

Front 75

dx: uncontrollable bouts of laughter or crying w/o associated emotions

Back 75

pseudobulbar affect
(UMN-like disorder of CN VII, IX, X, XII leads to abnml reflex activation of laugh/cry circuits in brainstem)

Front 76

dx: episodes of inappropriate laughter (2)

Back 76

gelastic epilepsy (hypothalamic hamartoma)
temporal lobe seizures