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96 Cards in this Set

  • Front
  • Back
What part of the midbrain contains the cortico-spinal tract?
basis
The superior colliculi are found where?
tectum of rostral midbrain
The inferior colliculi are found where?
tectum of caudal midbrain
What lies between the pontine tegmentum and cerebellum?
4th ventricle
Accessory spinal nucleus is found where?
upper cervical spinal cord
Where is the trigeminal motor nucleus found?
ventral upper pons
Where is the facial nucleus found?
caudal pons
Superior and inferior salivatory nuclei are found where?
Pontine tegmentum
Which is more lateral in the medulla? Dorsal motor nucleus of CN X or Hypoglossal nuclei?
Dorsal motor nuclei of CN X is more lateral, Hypoglossal nuclei is more medial. Medial medullary infarcts affect tongue movement, Wallenburg syndrome usually doesn't
3 trigeminal sensory nuclei
Mesencephalic, Chief, Spinal trigeminal nuclei
Mesencephalic trigeminal nuclei send what sensory information?
facial proprioception
Chief trigeminal nuclei send what sensory information?
face vibration, fine touch
Spinal trigeminal nuclei send what sensory information?
face pain, crude touch, temperature
Auditory information is processed in which thalamic nuclei?
medial geniculate nuclei
Auditory information is processed in which colliculi?
inferior
4 vestibular nuclei
superior, inferior, medial, lateral
The MLF connects which vestibular nuclei to CN 3, 4 and 6?
medial and superior
Taste is sensed by which cranial nerve nuclei?
rostral nucleus solitarius (7, 9, 10)
Corticospinal fibers cross where?
cervicomedullary junction (pyramidal decussation)
Dorsal-lemniscal sensory fibers cross where?
internal arcuate fibers (above cervicomedullary junction)
Proprioception, vibration, fine touch sensory neurons for the legs will synapse on what nuclei?
nucleus gracilis (medial) in medulla
Proprioception, vibration, fine touch sensory neurons for the arms will synapse on what nuclei?
nuclei cuneatus (lateral) in medulla
Why can patients with locked-in syndrome move their eyes vertically?
locked-in syndrome is a lesion in the ventral pons affecting bilateral corticospinal/corticobulbar tracts so no movement can occur. but vertical eye and eyelid movement is controlled by the rostral midbrain which is superior to the lesion and can still function
Why does ataxia due to a cerebellar lesion occur ipsilaterally?
cerebellar tracts double cross
Superior cerebellar peduncles carry information where?
output form the cerebellum to the red nucleus and cortex
Middle and Inferior cerebellar peduncles carry information where?
input to the cerebellum from pons and spinal cord
Rostral reticular formation function
alertness, awareness, attention
Caudal reticular formation function
reflex and autonomic functions
The reticular formation is located in which part of the brainstem? (basis, tegmentum, tectum)
tegmentum all the way through
Lesions at which location in the brain can cause coma?
bilateral rostral reticular formation (pontomesencephalic), bilateral diffuse cortical lesions, bilateral thalami
Norepinephrine is made by what part of the CNS?
pons: locus ceruleus, pontine tegmentum
Dopamine is made by what part of the CNS?
substantia nigra of the midbrain
Serotonin is made by what part of the CNS?
raphe nuclei in midbrain
Histamine is made by what part of the CNS?
tubomamillary nucleus of hypothalamus
Orexin is made by what part of the CNS?
lateral hypothalamic nuclei
Acetylcholine is made by what part of the CNS?
basal forebrain (basalis, diagonal band, medial septal nucleus) and pedunculopontine nucleus
3 dopamine projection systems from the midbrain
mesostriatal (to thalamus), mesolimbic (to amygdala), mesocortical (to prefrontal cortex)
Parkinson's is a disorder caused by a lesion in which neurotransmitter pathway?
low dopamine
Overactivity of which dopamine pathway is implicated in Schizophrenia?
mesolimbic
Locus ceruleus makes which neurotransmitter?
norepinephrine
Midbrain raphe nuclei secrete which neurotransmitter?
serotonin
Norepinephrine from the locus ceruleus has what effect on alertness and attention?
increases alertness and awakeness. stimulated by ADD and narcolepsy medication
Caudal raphe nuclei send serotonin to what structures?
cerebellum, medulla, spinal cord
Defects in what neurotransmitter have been implicated in SIDS (sudden infant death syndrome)
serotonin defects caused by lesions of caudal raphe nuclei that control the medulla breathing centers
Peri-aqueductal gray matter is involved in what?
pain modulation (gate control theory)
Orexin function
stimulate awakeness; from lateral hypothalamus
What is paradoxical sleep?
REM sleep
Sleep promoting regions are found where in the brain?
medulla; transection at the pons = cats that don't sleep
Histamine function in the brain
stimulate awakeness; this is why anti-histamine drugs (anti-inflammatory, benadryl etc.) lead to drowsiness, they block histamines ability to keep you awake
VLPO function
the ventrolateral preoptic area promotes nonREM sleep by inhibiting activation from forebrain
VLPO has what effect on orexin?
inhibits it. orexin keeps you awake, VLPO wants you to sleep
VLPO inhibition of norepinephrine and serotonin leads to what type of sleep?
REM
During REM sleep, why is there high EEG activity?
during REM, VLPO inhibits norepinephrine/serotonin. low norepinephrine > more Ach active to thalamus = active EEG. but glycine from glutamatergic REM cells inhibits actual muscle movement in lower motor neurons
Narcolepsy is thought to be caused by a defect in which hormone?
orexin is responsible for stabilizing the awake state
Narcolepsy is thought to be caused by a defect in which hormone?
orexin is responsible for stabilizing the awake state
Visual tracking is characteristic of what state of alertness?
minimally conscious state
A patient in coma has damage possible in all parts of the brain, except ...
brainstem reflexes (caudal pons, medulla)
A patient in a vegetative state has damage possible in all parts of the brain, except ...
brainstem is fine, but midbrain and diencephalon have variable activity
A patient in a minimally conscious state has damage possible in all parts of the brain, except ...
reflexes in medulla/pons are fine, but variable damage all throughout
A patient in a catatonic state has damage possible in what part of the brain?
frontal lobe has variable function
What is akinetic mutism?
patient is awake, but fails to respond (catatonic state)
What is status epilepticus?
continuous seizure activity
What 3 drugs should be given immediately when patient falls into coma?
IV thiamine, dextrose, naloxone. coma can be caused by deficiency of these 3.
Opiate overdose leads to what type of pupils?
bilateral pinpoint (increased parasympathetics)
Blood oxygen sensation is monitored by which nuclei?
caudal nucleus solitarius (9, 10) from carotid sinus
What is Cheyne-Stokes breathing?
breathing gets progressively deeper, then shallower > apnea
Apneustic breathing can be caused by a lesion where?
rostral pons (Kolliker-Fuse complex)
Pacemaker for respiration?
pre-Botzinger complex
A lesion of the medulla can lead to what breathing problems?
anything, respiratory arrest, ataxic breathing
Why does emotional stress trigger heart attacks?
nucleus solitarius (afferents for cardio regulation) interacts with limbic system
Caudal reticular formation lesions can result in ...
sneezing, yawning, hiccuping, crying etc.
Nausea and vomiting is controlled by what area?
chemotactic trigger zone (area postrema) on wall of 4th ventricle
What neurotransmitter from the stomach can trigger vomiting?
serotonin 5-HT
Major branches off the basilar artery. Start with AICA
PICA (off vertebral), AICA, SCA, PCA
Circle of Willis arteries
PCA, Pcomm, internal carotid, ACA, Acomm
What is the function of the Circle of Willis?
anastomoses between vertebral/basilar artery and internal carotid
CN3 can be damaged by an aneurysm of which vessels?
SCerebellarA or PCerebralA
CN6 can be damaged by an aneurysm of which vessels?
AICA or labyrinth arteries (off AICA or basilar)
Where does the labyrinth artery supply?
inner ear
Ventral pons are supplied by which artery?
basilar
Where is the infarct in Wallenburg syndrome?
lateral medulla, blockage of of vertebral artery (sometimes PICA)
6 major things affected by lateral medullary (Wallenberg's) syndrome?
vestibular nuclei, nucleus ambiguus, nucleus solitarius, sympathetics, anterolateral system, spinal trigeminal tract
3 major things affected by medial medullary syndrome?
corticospinal tract, dorsal column (vibration, prop., fine touch) and hypoglossal nuclei
A blockage of the vertebral artery is causing infarction of the medial pontine basis. What symptoms should we expect?
A motor loss (face, arm, leg) due to corticospinal/corticobulbar tract loss. possible cerebellar damage
A patient has a blockage of the right SCA. What symptoms do we expect?
ipsilateral ataxia
After infarction, a patient is diagnosed with Foville's syndrome. Where was his blood clot most likely?
basilar artery
After infarction, a patient is diagnosed with Foville's syndrome. What symptoms will he have?
infarction of the pontine basis + tegmentum: ipsilateral face, arm, leg weakness
After infarction, a patient is diagnosed with Pontine wrong-way eyes. What structures are damaged?
clot in basilar artery, corticospinal/corticobulbar tract, abducens nuclei
After infarction, a patient is diagnosed with MIllard-Gubler syndrome. What structures are damaged?
clot in basilar artery, corticospinal/corticobulbar tract, facial nerve
A patient presents with left sided hemiparesis, left sided facial weakness and a lateral gaze deficit. What part of the brain is most likely infarcted? what is the diagnosis?
Pontine Wrong way eyes. right side pontine basis/tegmentum infarct due to basilar blockage
A patient has a blockage of left AICA. What symptoms do we expect?
left ataxia (cerebellum infarct), vertigo (vestibular nuclei infarct), ipsilateral decreased facial pain/temp/crude touch (spinal trigeminal nuclei infarct), anterolateral tract defect, Horner's syndrome (sympathetic damage)
A patient has a blockage of left AICA. What symptoms do we expect?
left ataxia (cerebellum infarct), vertigo (vestibular nuclei infarct), ipsilateral decreased facial pain/temp/crude touch (spinal trigeminal nuclei infarct), anterolateral tract defect, Horner's syndrome (sympathetic damage)
A patient is diagnosed with Weber's syndrome. What symptoms will they have? Where was their arterial blockage?
ipsilateral 3rd nerve palsy and contralateral hemiparesis; PCA (midbrain basis infarct)
A patient is diagnosed with Claude's syndrome. What symptoms will they have? Where was their arterial blockage?
ipsilateral 3rd nerve palsy and contralateral ataxia; PCA (midbrain tegmentum infarct)
A patient is diagnosed with Benedikt's syndrome. What symptoms will they have? Where was their arterial blockage?
ipsilateral 3rd nerve palsy and contralateral hemiparesis and ataxia; PCA (midbrain basis + tegmentum infarct)
A patient's right eye looks down and out, and they cannot move their left side. They also have left sided ataxia. What is the diagnosis?
Benedikt's syndrome: right midbrain basis + tegmentum infarct