Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
63 Cards in this Set
- Front
- Back
What structures are in the base of the rostral medulla?
|
Inferior olive, pyramids and most of the medial lemniscus
|
|
What structures are in the tegmentum of the rostral medulla?
|
Inferior cerebellar peduncle, reticular formation, STT
CN X, XII, Nucleus ambiguus, V spinal, Vestibular (8-12 and V spinal) |
|
What structures are in the base of the caudal pons?
|
pontine nuclei, pyramids
|
|
What structures are in the tegmentum of the caudal pons?
|
Tracts: medial lemniscus, STT, medial longitudinal fasciculus
Nuclei: Reticular formation, raphe nuclei CN: V, VI, VII |
|
What structures are in the base of the rostral pons?
|
pyramids, pontine nuclei
|
|
What structure are in the tegentum of the rostral pons?
|
Tracts: ML, STT, MLF
Nuclei: Raphe nuclei, reticuar formation, locus ceruleus CN: V Other: sup cerebellar peduncle |
|
What structures are in the base of the caudal midbrain?
|
Pyramids, substantia nigra
|
|
What structures are in the tegmentum of the caudal midbrain?
|
Tracts: ML, STT, MLF
Nuclei: Reticular formation, CN: VI Other: des superior cerebellar peduncle |
|
What structures are in the base of the rostral midbrain?
|
Substantia Nigra, Corticospinal fibers (pyramids), Ventral tegmental area
|
|
What structures are in the tegmentum of the rostral midbrain?
|
Tracts: MLF, STT, ML
Nuclei: Red, Reticular formation CN: III |
|
What nuclei make up the ambiguus nucleus and what is it's function?
|
9, 10, 11
Motor to larynx, pharynx and palate |
|
What CN nucleus caries sensation from the face?
|
Spinal of V
|
|
What CN allows for mastication?
|
V
|
|
What CN controls muscles of facial expression
|
VII
|
|
What portion of the brainstem does the corticospinal tract pass through?
|
base
|
|
What portion of the brainstem does the dorsal column system pass through?
|
Tegmentum
|
|
What nuclei is involved w/ corneal reflex?
|
Reticular formation
|
|
Where does MCP receive message from?
|
contralateral cerebral cortex
|
|
What cells do cerebral output synapse onto?
|
granule cells
|
|
What structures in the pons are served by the paramedian branch of the basilar art?
|
MLF, VI, ML, CSP
|
|
What structures in the pons are served by the long circumferential branch of basilar?
|
V, VII
|
|
What blood supply goes to the midbrain?
|
Choroidal arteries off post cerebral
|
|
What blood supply serves the medulla?
|
PICA
|
|
What is the medial longitudinal fasciculus?
|
Pathway that interconnects vestibular and eye muscle nuclei
|
|
Trace Medial longitudinal fasciculus pathway (use R turn)
|
Turn head to R --> R VIII --> R Vestibular nucleus --> L VI nucleus-->
1. L LR 2. R MR --> Eyes turn to left to compensate for head turn to right |
|
Activation of the R corticobulbar tract --> what response?
|
R - forehead
L- forehead L- lower neurons |
|
What do dominant hemisphere lesions present as?
|
Aphagia, R Visual field deficit (homonymous hemianopsia/quadrantanopsia), L Gaze preference, hemiparesis/sensory loss (face/arm>leg)
|
|
What do non-dominant hemispheric lesions present as?
|
L visual field defect
L hemiparesis/sensory loss R gaze preference L hemineglect |
|
What do ACA blocks present as?
|
Apathy, leg weakness>>arm/head, +/- aphagia
|
|
What do brainstem lesions present as?
|
Dysconjugate gaze/diplopia
Vertigo/tinnitus Dysarthria/dysphagia dec consciousness N/V Hiccups/Respirations |
|
Where does lethargy localize?
|
bicerebral hemispheres
|
|
Where does seizure localize?
|
cortex
|
|
Where does memory impairment localize?
|
Thalamus/medial temporal lobe
|
|
Where does dec consciousness localize?
|
pons (RAS)
|
|
Where does dysarthria/dysphagia localize?
|
weakness in XII or IX/X
|
|
A lesion to a CN will result in a defect in which side?
|
ipsilateral
|
|
What is syringomyelia?
|
cystic cavitation of SC (mostly cervical) asc/ w/ brain abnormalities, remote SC trauma or tumor w/i SC
|
|
What structures are compromised in syringomyelia?
|
Ant horns, ant white commissure and possibly lat columns
|
|
What is tabes dorsalis?
|
Sequelae of neurosyphilis where there is selective damage to dorsal column
|
|
How does tabes dorsalis present?
|
loss of proprioception, absent Achilles reflex
|
|
What occurs in vit B12 or HIV vacuolar myopathy?
|
Subacute degeneration of post and lat columns
|
|
How does vit B12 and HIV vacuolar myopathy present?
|
spastic paraparesis w/ sensory loss (--> sensory ataxia)
|
|
What structures are affected in an ant spinal art infarction?
|
ant 2/3 of cord - lateral column and STT
|
|
How does ant spinal art infarction present?
|
spastic paraparesis and loss of pain/temp w/ intact vibration and proprioception
|
|
What is HTVL-1?
|
Chronic progressive demyelinating inflammatory myelopathy
|
|
What structures are affected in HTVL-1?
|
corticospinal tract +/- minor sensory loss
|
|
What is Brown-Sequard syndrome
|
lateral hemisection of cord --> ipsilateral weakness and hyperreflexia
w/ contralateral sensory loss |
|
What is the Cushing's Response?
|
Triad of htn, bradycardia and irregular respiration...occurs when brainstem is compressed
|
|
What are the 4 types of herniation?
|
Subfalcine
central uncal cerebellar |
|
What is the dx tool of choice to look for herniation?
|
CT w/o contrast
|
|
What is the immediate tx for herniation?
|
1. Elevate head 30o
2. Intubate and hyperventilate 3. Mannitol IV push 4. Dexamethasone IV 5. Hyperthermia 6. Hypertonic saline |
|
How does hyperventilation help w/ inc intracranial pressure?
|
dec pCO2 --> vasoconstriction --> dec blood flow to brain
|
|
What supplies blood to the the medial part of the medulla
|
Anterior spinal artery
|
|
What portion of the braistem does the STT run through?
|
tegmentum
|
|
What is decerebrate posturing and what is it due to?
|
Arm rigidly extended and internally rotated, wrist flexed and leg extended
- extensive brainstem damage |
|
What is decorticate posturing and what is it due to?
|
Arm flexed and adducted over chest, leg extended
- extensive damage to cortex |
|
What are the signs of upper motor neuron damage?
|
diffuse hyperreflexia, clonus, Hoffmann and Babinski sign
|
|
Where is muscle atrophy seen?
|
lower motor neuron dz
|
|
What portion of the SC do spinothalamic tract run?
|
Anterior lateral
|
|
What portion of the SC do corticospinal tracts run?
|
lateral column
|
|
Where is Wernicke's area located?
|
Upper temporal lobe
|
|
Where is Broca's area located?
|
Parietal in precentral gyrus
|
|
What are the signs of lateral medullary syndrome and what artery is involved?
|
Horner's syndrome - loss of symp tone and loss of pain/temmp on ipsilateral side of face
- PICA |