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297 Cards in this Set

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What does a lesion in the basal ganglia affect?
Movement--often causes involuntary movements
What areas does the basal ganglia refer to?
Caudate nucleus
Putamen
Globus pallidus
Subthalamic nucleus
Substantia nigra
What disease affects the caudate nucleus?
Huntington's Disease
What disease affects the putamen?
Wilson's/Dystonia
What disease affects the globus pallidus?
Carbon monoxide poisoning
What disease affects the subthalamic nucleus?
Hemiballismus
What disease affects the substantia nigra?
Parkinson's disease
What makes up the Striatum?
The putamen and the caudate
What does the putamen control?
Motor
What does the caudate control?
Cognitive/behavioral control
Eye movements
What does the lentiform nucleus relate to?
Putamen and Globus pallidus
What does the corpus striatum relate to?
Caudate, Putamen, globus pallidus
What is the nucleus accumbens involved in?
Addiction/Reward
What happens to the brain in Huntington's Disease?
It shrinks
What is the problem in Wilson's disease?
Copper toxicity--chews up putamen
What does a patient with Wilson's disease look like?
Fixed posture--dystonia
What is happens to the brain in Wilson's Disease?
Cu2+ chews up the putamen
What are the symptoms of CO poisoning?
Light headed
Nausea
What is affected in Parkinson's Disease?
The substantia nigra pars compacta
An abcess in the left subthalamic nucleus would produce what?
Hemiballismus on the right side
Does hyperkinesia have an increase or decrease in GPI?
Decrease in GPI
Does Parkinson's, hypokinesia, have an increase or decrease in GPI?
Increase in GPI--decrease in motor cortex activity
Is an increase in GPI excitatory or inhibitory?
Inhibitory
Is a decrease in GPI excitatory or inhibitory?
Excitatory
What is the output center of the basal ganglia?
The GPI
What are examples of hyperkinetic movements?
Chorea, Ballismus, Dystonia
What are the main clinical features of Parkinson's disease?
Resting tremor--usually one side
Bradykinesia
Rigidity
Postural instability
Reduced facial expression
Microphagia (sm hand writing)
What is deficient in Parkinson's disease?
Dopamine
Where is the loss of dopamine producing cells occuring?
Substantia nigra
What do the neurons that are not affected by the loss of dopamine contain?
Lewey bodies
Will a substantia nigra affected by Parkinson's disease stain darker black or lighter black?
Lighter black beacuse it has lost dopamine
What is pathognomic for PD?
Lewey bodies in the cytoplasm
Does dopamine deficiency lead to overactive or underactive GPI?
Overactive GPI
What is dopamine made from?
Tyrosine
What is the rate limiting step in the formation of dopamine?
Tyrosine to Dopa using TYROSINE HYDROXYLASE
What enzyme converts L-Dopa to Dopamine?
Aromatic amino acid decarboxylase (AAADC)
What is the "Nectar of the Gods" drug used for PD?
Sinemet
What does Sinemet include?
Carbidopa and levodopa
What is carbidopa?
An AAADC inhibitor
Why is an AAADC inhibitor used in treatment for PD if it is needed to make dopamine?
AAADC needs to be inhibited in the periphary--if not, all the L-dopa will be converted to dopamine in the blood and none will get to the brain
What dosage is Sinemet typically given in?
25/100 or 50/200

Top number is the dose of carbidopa and the bottom number is the dose of levodopa
How is dopamine broken down?
By MAO-B and COMT
What is dopamine broken down into?
DOPAC and HVA
What are drugs used to increase dopamine activity?
Sinement
Dopamine agonists
COMT and MAO-B inhibitors
Anticholingeric agents
Besides drugs, what are other treatment options for PD?
Surgery--thalamotomy
Bilateral GPI or STN brain stimulation
What are the two main goals of drugs in PD?
Either to increase Dopamine or to decrease Ach
Why is Sinemet considered to be "a rose that has thorns?"
Because the medicine works really well for PD symptoms but will eventually lead to Chorea
What is chorea?
Random, uncontrollable, involuntary movements
As PD progresses, what other clinical problems may develop?
Depression
Dementia
Psychosis
Chorea
What is dystonia?
Stereotyped, same movement--can be twisting, writhing, or jerking, but can also be fixed abnormal postures
What is dyskinesia?
Random involuntary movement
What is the extreme form of chorea?
Ballismus
What area of the brain does dystonia affect?
Putamen
Is dystonia a hyperkinetic or hypokinetic movement disorder?
Hyperkinetic--decreased GPI
What is a focal dystonia?
Typically begin in adulthood and involves only one part of the body--Usually idiopathic
What is cervical dystonia?
Torticollis--stiff or jerky movements of the neck
What is blepharospasm?
Uncontrolled blinking
What is oromandibular dystonia?
Jaw hangs--if you put a cigarette in the mouth it will fix it
What is spasmodic dysphonia?
Vocal cord dystonia--either whispering or a cracking voice
What treatment often helps focal dystonias?
Botulinum Toxin
What is generalized dystonia?
Affects the entire body and is often debilitating
What is the typical age of onset of generalized dystonia?
Usually in childhood and caused by genetic disorders (DYT1 gene mutations of the tosin protein)
How is generalized dystonia typically treated?
Drugs and Surgery (Bilateral GPI lesioning or bilateral GPI stimulation)
What is hemiballismus?
Large amplitude, throwing, ballistic movements
What does hemiballismus typically result from?
A lesion in the subthalamic nucleus
What is the classic basal ganglia disorder that causes chorea?
Huntington's Disease
What is chorea?
Brief involuntary movements that flit from one part of the body to another
How is HD transmitted?
Autosomal dominant--each child has a 50% chance of inherting the disease
What is the clinical presentation of HD?
Motor disorder, emotional disorders, and cognitive disturbance
What is the typical age of onset of HD?
39 years--ranges from 2-70 years--juvenile onset HD is usually paternally inherited
What is the mutation in HD?
A mutation in the coding region of the IT 15 gene on chromosome #4--a trinucleotide repeat (CAG)
What is anticipation?
Greater disease severity in successive generations
What is tardive dyskinesia?
Persistent abnormal involuntary movements caused by drugs that block dopamine receptors (neuroepileptics)
What is akathesia?
Nervous, anxious--side effect of dopamine blockers
What does classic tardive dyskinesia usually include?
Abnormal movements of the mouth and tongue
What are tics?
Intermittent stereotyped movements and sounds--motor and vocal tics
What causes Tourette's syndrome?
Supersensitive dopamine receptors in the striatum
What is one thing you should NOT do to a patient with tics?
Ask them about their old tics--they will start doing them again
Does having a tic harm the brain?
No
When your head turns to the left, what way do your eyes turn?
To the right
What is nystagmus?
Bilateral slow eye movement to the affected side and a fast saccadic eye movement the other way
How is nystagmus named?
For the direction of the fast eye movement
In nystagmus, what is the compensatory movement?
The slow eye movement to the affected side
Where are cranial nerves 1 and 2 located?
In the telencephalon
Where are cranial nerves 3 and 4 located?
In the midbrain
Where are cranial nerves 5, 6, 7, and 8 located?
In the pons
Where are cranial nerves 9, 10, and 12 located?
In the medulla
What is the kinocilium?
Tallest hair cell
Where are the cell bodies for the vestibular portion of CN #8?
Scarpa's ganlglia
What does bending the stereocilia towards the kinocilium cause?
Increased number of open-tip links
Depolarization b/c K+ increases
Increased transmitter release at the basolateral membrane
What does bending the stereocilia away from the kinocilium cause?
Decreased number of open tip links
Hyperpolarization
Decreased transmitter release
Decreased afferent nerve firing
What is the perilymph?
Fluid low in K+ and high in Na+ that is contained in the bony labyrinth
What is endolymph?
Fluid high in K+ and low in Na+ that is contained in a closed tube--the membranous labyrinth-- and doesn't communicate with any other space
What secretes the endolymph?
The stria vascularis
What does over production of endolymph cause?
Meniere's Syndrome--high fluid pressure within membranous labyrinth
What is the voltage of the endolymph?
80 mV
What is the voltage of the perilymph?
0 mV
What kind of gradient does K+ move in response to the motion of steroecilia?
An electrical gradient
What is the vestibular labyrinth system composed of?
Macula and Ampulla
What does the macula detect?
Linear acceleration--detect static displacement of hair bundles due to gravity
What type of linear movements does the macula detect?
Forward-backward, left-right, and up-down
What does the X axis detect?
Forward-backward---flex-extend the head
What does the Y axis detect?
Left-right----left side or right side
What does the Z axis detect?
Up-down----hypo-hyper gravity (elevator)
What is another name for macula?
Otolith organs
What stimulates the otolith organs?
Linear acceleration (dynamic signal) and/or gravity, steady head tilt (static head tilt)
How are hair cells oriented?
Back to back against the striola ridge
What is the purpose of the back to back orientation of hair cells?
So that movement of the otholithic membrane in any direction will stimulate some hair cells and inhibit others
Are hair cells polarized away from or towards the striola in the saccule?
Away from the stiola
Are hair cells polarized away from or towards the striola in the maccule?
Towards the striola
Macula in the saccule detect lineear changes in what direction?
Vertical plane--up and down
Macula in the utricle detect linear changes in what direction?
Horizontal plane--forward and backward as well as side to side
What do the semicircular canals detect?
Angular acceleration or deceleration
What planes do the semiciruclar canals detect acceleration in?
Horizontal, vertical, and lateral
At resting position, how do the semicircular canals sit?
Angled
Flexing the head 30 degrees forward puts the lateral canal in what position?
Horizontal
Extending the head backward 60 degrees or lifting a patient's head up 30 degrees puts the lateral canal in what position?
Vertical
How many ampulla does each semicircular canal have?
1 ampulla per semicircular canal
As the head moves clockwise, what way does the endolymph go?
Counterclockwise
When is each semicircular canal maximally stimulated?
When the plane of its circumference is at right angles to the axis of rotation
In the horizontal ampulla, how are the cilia oriented in reltaion to the utricle?
Toward the utricle
In the anterior and posterior ampulla, how are the cilia oriented in respect to the utricle?
Away from the utricle
What is the preferred direction of mechanical stimulation of hair cells in the semicircular canals and the otoliths?
Shortest steroecilia towards the kinocilium for afferent nerve excitation
What will head movement to the left stimulate?
Stimulate afferent firing from the left horizontal canal and inhibit firing from the right horizontal canal because they are in the same plane
What effect will head movement to the left have on the anterior and posterior semicircular canals?
Have no effect because they are not in the plane of rotation
The six semicircular canals promote coordination of what during head movement?
The coordination of the 12 extra ocular eye movements
If you turn your head to the left, which way do your eyes go?
To the right
What is the head turning/eye turning reflex called?
Vestibular Ocular Reflex
Is the VOR short or fast?
Very fast--Stimulus to onset of eye movement is 12 milliseconds
If you put cold water in an ear, what way is the nystagmus and why?
The nystagmus is to the opposite side because endolymph goes towards the ear that is stimulated causing hyperpolarization of the hair cells--therefore slow eye movement goes to the lower firing rate first
If you put hot water in an ear, what way is the nystagmus and why?
The nystagmus is to the same side because endolymph moves away from the ear that is stimulated causing depolarization of the hair cells--therefore the eyes move to the lower firing side first
When doing the Barany chair experiment in the dark, what direction is the nystagmus?
Nystagmus is in the direction of the chair rotation
When doing the Barany chair experiment in the dark, what happens in 30 sec after starting the experiment?
The nystagmus will stop because head, semicircular canals, and endlymph are all moving at the same velocity
What happens when doing the Barany chair experiment with the lights on?
The patient can see the envirnoment so you get optokinetic nystagmus
What is optokinetic nystagmus?
Allows the eyes to stay focused on an object while chair is still moving---focusing on consecutive telephone poles while riding in a car
What happens in the Barany chair experiment if the the lights are on and you come to a sudden stop?
You get postrotatory nystagmus because the endolymph keeps going
In the Barany chair experiment, in what direction is the postrotatory nystagmus going to be in?
In the direction the chair was turning
What is benign positional vertigo?
When the otoconia become displaced from the utricle macula and become dislodged in the cupula of the posterior canal
What does benign positional vertigo result in?
Brief episodes of vertigo that coincide with changes in body position
What is labyrinth disease?
Seasickness or space sickness
What are the symptoms of labyrinth disease?
Vertigo
Nausea
Oscillopsia
Anxiety
What are the signs of labyrinth disease?
Nystagmus
Falling or postural deviation
Sweating
Pallor
Vomiting
Hypotension
What is acute perpheral vestibulopathy?
A spontaneous attack of vertigo of unapparent cause--maybe infection
What are the symptoms of acute peripheral vestibulopathy?
Vertigo
Nausea
Vomiting of acute onset
Does the corticospinal tract contain upper or lower motor neurons?
Upper motor neurons
What are the two descending motor pathways?
Lateral motor systems and medial motor systems
Where do the lateral motor systems travel in the spinal cord?
In the lateral columns of the spinal cord--white matter
What do the lateral motor systems control?
They control movements of extremities--arms, legs, geet, hands
What are the two tracts in the lateral motor system?
Lateral corticospinal tract and rubrospinal tract
Where is the rubrospinal tract located?
In the red nucleus
What does the rubrospinal tract control?
Flexor tone in the upper extremities
Where do the medial motor pathways synapse?
On medial ventral horn motor neurons and interneurons
What do the medial motor pathways control?
Movements of the trunk (axial and gurdle movements)
Do the medial motor pathways influence musculature bilaterally or unilaterally?
Bilaterally
What are the four tracts in the medial motor system?
Anterior corticospinal tract
Vestibulospinal tracts
Resticulospinal tracts
Tectospinal tract
What does the anterior corticospinal tract control?
Bilateral control of axial and girdle muscles
Does the anterior corticospinal tract cross the midline?
No
What are the two Vestibulospinal tracts?
Lateral VST
Medial VST
What does the lateral VST control?
Controls extensor tone--runs the length of the spinal cord
What does the medial VST control?
Controls the head and neck--ends at the cervical cord level
What does the reticulospinal tract control?
Automatic posture and gait movements
How many reticulospinal tracts are there?
Two--lateral and medial RST
What does the tectospinal tract control?
Coordination of head and eye movements--ends in the spinal cord
In the corticospinal tract, what does the upper motor neuron "squeeze" between?
The putamen and caudate
Where do the upper motor neurons of the corticospinal lateral tract decussate?
Medulla-spinal cord juncture
How many of the neurons in the lateral corticospinal tract cross over?
90%
The 10% of neurons that don't cross over become what?
The medial motor system
As the corticospinal tract is descending, what does is pass through in the midbrain?
The cerebral peduncles
What is an example of trauma to the spinal cord?
Brown-Sequard syndrome
What are the symptoms of Brown-Sequard Syndrome?
Ipsilateral loss of motor and touch and pressure
Contralateral loss of pain and temperature
What happens in an anterior spinal artery infarct?
Knocks out the anterolateral pathways (pain and temp) bilaterally below the lesion and lower motor neuron signs--dorsal columns spared
What happens in a dorsal spinal artery occlusion?
Lose proprioception because the dorsal columns are gone
What happens to the spinal cord in a vitamin b12 deficiency?
Degeneration of myelin--B12 is required for myelin production
What are the symptoms in B12 deficiency?
Tingling and numbness of hands and feet
What area of the brain is affected more by the demyelination?
Dorsal columns
What can occur with degeneration of the cerebral white matter?
Dementia
What is infectious myelitis?
Inflammation of the spinal cord
What causes infectious myelitis?
HIV, Lyme disease, tertiary syphilis, and poliomyelitis
What is inflammatory myelitis?
Autoimmune inflammatory disorder affecting central nervous system myelin--Multiple sclerosis
What does degenerative/developmental problems in the spinal cord affect?
Upper motor neurons, lower motor neurons, or both
Where are cranial nerves 1 and 2 located?
Telencephalon
Where are cranial nerves 3 and 4 located?
Midbrain
Where are cranial nerves 5, 6, 7, and 8 located?
In the pons
Where are cranial nerves 9, 10, and 12 located?
In the medulla
What are the three parts of the brainstem?
Midbrain
Pons
Medulla
What is the most rostral portion of the brainstem?
Midbrain
What is the most caudal portion of the brainstem?
Medulla
What is the "roof" seen in the midbrain?
Tectum
What does the tectum contain?
Superior and inferior colliculi
What is the middle portion of the midbrain called?
Tegmentum
What does the tegmentum contain the bulk of?
The main bulk of the brain stem nuceli and the reticular formation
What is the most ventral part of the brain stem?
The base
What does the base contain?
Large collection of fibers and tracts--corticospinal, corticobulbar, and corticopontine tract
What are the three cranial nerves NOT associated with the brain stem?
1 and 2--Forebrain
11-cervical spinal cord
What are the sensory only cranial nerves?
1, 2, and 8
What are the motor only cranial nerves?
3, 4, 6, 11, and 12
What are the motor and sensory cranial nerves?
5, 7, 9, and 10
Where is the preganglionic cell body for CN3?
Edinger-Westphal nucleus in the midbrain
Where is the preganglionic cell body for CN7?
Superior salivatory nucleus in the pons
Where is the preganglionic cell body for CN9?
Inferior salivatory nucleus in the medulla
Where is the preganglionic cell body for CN10?
Dorsal motor nucleus in the medulla
Where are the postganglionic cell bodies for CN3?
In the ciliary ganglion
Where do the axons project after leaving the ciliary ganglion?
To the eye ciliary muscle and constrictor (spinchter) muscle of the iris
Where are the postganglionic cell bodies for CN7?
In the sphenopalatine ganglion and the submandibular ganglion
Where do the axons project after leaving the sphenopalatine ganglion?
To the lacrimal glands and nasal mucosa
Where do the axons project after leaving the submandibular ganglion?
To the submandibular and submaxillary salivary glands
Where are the postganglionic cell bodies located for CN9?
In the otic ganglion
Where do the axons project after leaving the otic ganglion?
To the parotid gland
Where are the postganglionic cell bodies located for CN10?
In various terminal ganglion
Where do the axons of Vagus project after leaving the various terminal ganglion?
To the effector organs--lungs, heart, and GI tract
What does the sympathetic nervous system innervate?
The eye, face, and scalp
Does the descending tract from the hypothalamus cross the midline as is descends through the brain stem and spinal cord?
No--it DOES NOT cross the midline
Where are all the SNS preganglionic cell bodies located?
In the IML cell column of the spinal cord (T1-L3)
Where are the preganglionic cell bodies that are innervating the head found?
T1-T2
Where are the postganglionic cell bodies that are innervating the head found?
In the superior cervical ganglion
A lesion of the sympathetic pathway to the head will cause what?
Ipsilateral Horner's Syndrome
What are the classic signs of Horner's Syndrome?
Miosis--constriction
Ptosis--drooping upper eyelid
Anhidrosis--lack of sweating on the face and neck
If you lesion the descending tract from the hypothalamus and the ascending ALS pathway, what will the symptoms be?
IPSILATERAL miosis, ptosis, and anhidrosis and CONTRALATERAL pain and temperature loss
What are signs of an upper motor neuron lesion?
Weakness
No atrophy
No fasiculation
Increased reflexes
Increased tone
What are signs of a lower motor neuron lesion?
Weakness
Atrophy
Fasiculation
Decreased reflexes
Decreased tone
What are the five main neural tracts?
Medial Lemniscus
Anterolateral System
Coricospinal tract
Descending Hypothalamic SNS Fibers
What is the 5th main neural tract?
Medial longitudinal fasciculus (MLF)
What does the MLF pathway connect?
Interconnects the centers for horizontal gaze, vestibular nuclei, and the nerve nuclei for CN 3, 4, and 6--Keeps eye movements and eye balls yoked together
What do brain stem lesions of the MLF produce?
Internuclear Opthalmoplegia (INO) and disrupt the vestibular occular reflex
If there is a lesion in the left internuclear neuron, what is the result?
The eye can't look to the right because the medial rectus is not getting the message
What are causes of lesions that affect the MLF?
MS
Pontine infarcts
Neoplasms
Where do upper motor neurons of the corticobulbar tract originate and where do they terminate?
They orginate in the motor cortex and terminate on MOTOR cranial nerve nuclei in the pons and medulla
What cranial nerves does the corticobulbar tract innervate?
All nuclei that cause skeletal muscle to contract--CN 5, 7, 10, 11, and 12
Is corticobulbar innervation of the lower motor neurons unilaterally or bilaterally?
Mainly bilaterally
What is the one exception in the corticobulbar tract that does not receive bilateral innervation?
CN 7--facial nerve LMN to the lower face receives only contralateral UMN innervation
A facial nerve lesion in the lower motor neuron will have what type of paralysis?
Ipsilateral total face paralysis--involves the forehead
A facial nerve lesion in the upper motor neuron will have what type of paralysis?
"Central 7"--will cause only lower face paralysis contralateral to the lesion--can still wrinkle forehead
Will a lower motor neuron in the facial nerve cause ipsilateral or contralateral loss?
Ipsilateral loss of total face
Will an upper motor neuron in the facial nerve cause ipsilateral or contralateral loss?
Contralateral loss of 1/4 of the face (lower portion of face--forhead spared)
Where are cell bodies of cranial nerves that do motor located?
Medial--near the midline
Where are cell bodies of cranial nerves that do sensory located?
Lateral
Where are the cell bodies of cranial nerves that do motor and sensory functions founds?
Near the sulcus limitans
What does the sulcus limitans separate?
The motor from the sensory areas in the brain stem
What are motor neurons that have both motor and sensory function called?
Branchiomeric skeletal motor--5, 7, 9, and 10
What are the five key brainstem sections?
The spinomeduallary junction
Caudal medulla
Rostral medulla
Caudal pons
Rostral midbrain
What does the spinomedullary junction contain?
The pyramidal tract decussation
What does the caudal medulla contain?
The dorsal column nuclei--internal arcute fibers
What does the rostral medulla contain?
The inferior olivary nucleus and CN 12 nucleus and facial colliculus
What is the caudal pons?
The level of genu of the facial nerve
What is the rostral midbrain the level of?
Level of the superior colliculus and CN3
What do the middle cerebellar peduncles connect?
Nuclei in the pons base to the cerebellum
What are the three main fiber tracts in the pons?
Corticospinal tract
Corticopontine
Corticonuclear (bulbar)
Bell's palsy will have ipsilateral or contralateral face weakness?
Ipsilateral loss of the whole side of the face
Lesions of lower motor neurons to the face give ipsilateral or contralateral loss?
Ipsilateral--loss of forehead
Lesions of upper motor neurons to the face give ipsilateral or contralateral loss?
Contralateral--spares forehead
What does a lesion of the abducens nerve cause?
Diploplia
What does a lesion of the abducens nucleus cause?
Ipsilateral lateral gaze palsy
What does a lesion of the abducens nucleus and ipsilateral MLF cause?
Ipsilateral lateral gaze palsy and INO
What nucleus is the proprioception for CN5 found in?
Mesencephalic Trigeminal Nucleus
What nucleus is fine touch for CN 5 found in?
Major trigeminal nucleus
What nucleus is pain and temperature for CN 5 found in?
Spinal trigeminal nucleus
What muscle does cranial nerve 4 control?
Superior oblique
What will a lesion to cranial nerve 4 cause?
Diploplia
Weakness while looking down with the abducted eye
What does a lesion of CN 3 cause?
Loss of near vision response
Ptosis
Dilated pupils
Loss of pupillary light reflex
What eye movements does the pons control?
Horizontal eye movement
What is the information super highway of eye movements?
Medial longitudinal fasciculus (MLF)
What does a lesion of the PPRF or the abducens nucleus cause?
Ipsilateral horizontal gaze palsy
What eye movements does the midbrain control?
Vertical and vergence eye movements
Vertical eye movements are initiated where in the midbrain?
The rostral midbrain and reticular fomration and pretectal area
Vergence eye movements are initiated where in the midbrain?
Midbrain reticular formation
What stimulates the PPRF and generates conjugate eye movements to the contralateral side?
Frontal eye fields
What stimulates smooth pursuit eye movements in the ipsilateral direction?
Parieto-occipitotemporal cortex
What eye movement allows us to rapidly redirect our line of sight......to bring objects of interest onto the fovea?
Saccadic eye movements
What eye movements allows us to hold the image on the fovea of the retina?
Smooth pursuit eye movements
What are the only type of eye movements which cause the eye to move in opposite directions?
Vergence--they are disconjugate
What is the near reflex?
Convergence
Accomodation
Constriction
What two systems operate together to hold images stable on the retina?
Vestibular and optokinetic
What does the SCA supply?
Superior cerebellum and rostral pons
What does the aICA supply?
Caudal pons and a small portion of the cerebellum
What does the pICA supply?
The medulla and inferior cerebellum
What arteries is the midbrain supplied by?
The posterior cerebral artery and top of the basilar artery
What arteries is the pons supplied by?
Basilar artery
What arteries is the medial medulla supplied by?
Basilar artery
What arteries is the lateral medulla supplied by?
Vertebral artery and PICA
What will lesions in the brain stem to any of the long tracts result it?
Body contralateral deficit
Lesions in the brain stem long tracts result in contralateral defcicts except for what?
Descending hypothalmic fibers
Cerebellar Peduncle damage
Damage to cranial nerves and nuclei

**All result in ipsilateral deficits**
What kind of posturing is seen in a lesion of the midbrain?
Decorticate posturing--lesion above the Red nucleus
What kind of posturing is seen in a lesion of the pons?
Decerebrate posturing
What is the major input center in the cerebellum?
Middle cerebellar peduncle
What are the input fibers of the middle cerebellar peduncle called?
Mossy fibers
What is the major output center of the cerebellum?
Superior cerebellar peduncle
Does the cerebelllum regulate output directly or indirectly?
Indirectly
What do lesions of the cerebellum produce?
Ataxia
What separates the two lobes of the cerebellum?
Vermis
What connects the cerebellum to the pons and medulla?
Cerebellar peduncles
What divides the cerebellum into an anterior and posterior lobe?
The primary fissure
What divides the posterior lobe from the flocculonodular lobe?
The posterolateral fissure
What part of the cerebellum does complex motor planning?
Cerebrocerebellum
What are the two parts of the spinocerebellum?
Paramedian
Vermis
What influences the lateral motor tracts?
Paramedian
What influences the medial motor tracts?
Vermis
What is responsible for balance, posture, and VOR?
Vestibulocerebellum--Flocculondoular lobe