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