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112 Cards in this Set

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telencephelon contains
cerebral hemispheres,basal ganglia: caudate nucleus, globus polidius,puteman, lateral ventricles, cerebral commissures and the internal capsule
Diencephelon contains
thalmus, epithalmus, hypothalmus, subthalmus, third ventrical and oculomoter nerve
Thalmus
is seperated from the hypothalmus by the hypothalamic sulcus..contains the Pulvinar, medial geniculate(auditory), lateral geniculate(visual), and massa intermedia
Hypothalmus
Optic chiasm, mamillary bodies, infundibulum
Epithalmus
Pineal body, Habenular trigome, Choriod plexus of third ventricle
Subthalmus
Subthalamic nucleus, Zona incerta
Mesencephelon
(MidBrain)
between the diencephelon and pons; contains the cerebral aquaduct. Ventral surface: cerebral peduncle, interpeduncular fossa (CN III). Dorsal surface: Superior colliculus, inferior colliculus, and Trochlear (CN IV)
Pons
Between midbrain and medulla. Ventral surface: Basilar pons, CN V,VI,VII,VIII, Dorsal surface: Locus ceruleus, facial colliculus,
sulcus limitans,
striae medullares
Medulla
Extends from C1 to the inferior pontine sulcus. Ventral surface: pyramids, olive, CN IX,X,XI,XII. Dorsal surface: Gracile tubercle, cuneate tubercle, rhomboid fossa.
Rhomboid fossa
On the dorsal surface of the Medulla includes: striae medullaris, vagal trigone, hypoglossal tricone, sulcus limitans, area postrema (vomiting center)
cerebellum
located in the posterior cranial fossa, forming the roof of the 4th ventricle, is seperated from the occipital lobe by the tentorium cerebelli. Contains: Two lateral hemispheress which are divided into anterior,posterior and floculonodual lobes; vermis, locculus and vermal nodes, tonsil, superior, middle, and inferior cerebellar peduncles.
striatum
combination of the caudate nucleus and the puteman
limbic lobe
is a C-shape structure that encircles the corpus collosum; contains: subcallosal area, cingulate gyrus, parahippocampal gyrus, hippocampal formation
basal ganglia
Part of the telencephelon; contains the caudate, putamen, globus pallidus, and amygdala.
corpus collosum
ant: genu, inf: rostrum, sup: body, post: splenium
Ascending Spinal Tracts
Six major tracts that convey sensory information from periphery to CNS, usually has 3 chain neuron unit with the first order always in the dorsal root ganglion. 1. Dorsal coulmn-medial lemniscus 2. Ventral spinothalamic tract 3.Lateral spinothalamic tract 4. Dorsal spiocerebellar tract 5. Ventral spinocerebellar tract 6. Cuneocerebellar tract
Gag reflex
A. Hypoglossal nucleus
B. Solitary nucleus
C. Nucleus ambiguous
D. CN IX
E. CN X
F. CN XII
What function does this pathway serve and what are the components?
Dorsal column-medial lemniscus
tactile discrimination, proprioception... first order neurons are in the Dorsal root ganglia, give rise to cuneate and gracile facicles. Second order bodies are in the caudal medulla in the cuneate and gracile nuclei, and go across the internal arcuate fibers (decasation) to form the medial lemniscus. The medial lemniscus ascends to the VPL. VPL to somatosensory cortex.
Name the four somatosensory functions for the vagus nerve:
1. GSA- (pain and touch) for ear external acoustic meatus, tympanic membrane, dura
2. SVA-(taste sensation) for epiglottis and pharynx
3. GVA-(sensory input from) the visceral organs of the abd/thorax, also baroreceptors for aortic arch
4. GVE-(information to) parasympathetic supply to the visceral organs,,,para, slows
5. SVE-(motor reflex) input from nuc. Ambiguous- relexes for cough, gag, vomit, allows for palatal bilateral rise. Also speech, swallow.
Ventral spinothalamic tract
Fine touch...First order neurons are in the dorsal root ganglia, project into the DREZ to second order neurons in the dorsal horn(cell body location). Second order neurons axons travel across the ventral white commissure and ascend inthe the contralateral VPL. Then from VPL to Post. limb of internal capsule and corona radiata to postecentral gyrus areas 3,1,2.
What are the four major nucleuses involved with the vagus nerve?
1. Dorsal motor vagal nucleus (GVE)
2. Solitary nucleus (SVA/GVA)
3. Spinal trigeminal (GSA)
4. Nucleus ambiguous (SVE)
Lateral spinothalamic tract
Pain and Temp...recieves input from nociceptors (A-delta and C fibers). First order neurons are found in dorsal root ganglia, axons go through the Lissauer tract to the second order neurons in the dorsal horn. Second order neurons give rise to axons that decussate at the ventral white commissure and ascend in the ventral half of the lateral funiculus. They project lateral to the reticular formation and terminate in the VPL. VPL(bodies) to the posterior limb of the internal capsule, to the somatosensory cortex areas 3,1,2
Name 2 syndromes associated with the vagus nerve that cause dysphagia and dysarthria?
1. Jugular foramen syndrome- causes ipsilateral paresis of pharyngeal/ laryngeal muscles.
2. Lateral medullary syndrome- dorsolateral vascular zone, lower motor neuron loss-palate raises on normal side.
dorsal spinocerebellar tract
fine coordination and postural control and lower extremity posture adjustments,, it is an uncrossed tract!!... FON-C8 to S3, project through DREZ into Clarkes nucleus. SON-From Clarkes nucleus through the lateral faniculus to inf. cere. peduncle. Terminate on ipsilateraly mossy fibers.
Name the somatosensory functions for the CN IX:
1. GSA-for ear and tympanic membrane, also post 1/3 of tongue and pharynx
2. GSE- for muscle
3. SVA- for taste
4. GVA- baroreceptors for carotids
Ventral spinocerebellar tract
Propreoceptive information, coordination and postural control for lower extremities... FON DRG of L1-S2, SON In the ventral horns of L1-S1, decussate on ventral white comissure, ascend lateral to lateral spinothalamic tract in Lat. Faniculus to the superior cerebellar peduncle to terminate on mossy fibers of contralateral side.
If a patient describes a stabbing pain in the base of the tongue or below the angle of the jaw, what might this describe as for a neurological syndrome?
Glossopharyngeal neuralgia
cuneocerebellar tract
Is the upper extremity equevelent to the dorsal spinocerebellar tract. FON- projects axons via the cuneat fascicle to the accessory cuneate nucleus. SON- are in the accessory cuneat nucleus of medulla, poject ipsilaterally to the inferior cerebellar peduncle.
Descending spinal tracts
1.Lateral corico spinal(pyramidal tract) 2.ventral corticospinal tract 3. Rubrospinal tract 4. Vestibulospinal tract 5. Descending autonomic tracts
Lateral corticospinal
Also known as the pyramidal tract, is the major tract responsible for volentary movement. Fibers flow from the precentral gyrus through the posterior limb of the internal capsule to the middle portion of the basis pedunculi to form the medullar pyramids. They then decussate in the caudal medulla where 90%decussate and travel down the dorsal portion of the lateral fasciculus to the synapse on cells in the ventral horn. 10% that do not decussate are the ventral corticospinal tract.
Dorsal Faniculis
what is this?
Dorsal Horn
What is this?
Lateral Funiculis
What is this
Ventral funiculis
What is this?
Ventral Horn
What is this?
Ventral Corticospinal tract
is a small uncrossed trat that decussates at the spinal cord level in the ventral whit commissure, controls the axial muscles.
Rubrospinal tract
Arises in the contralateral red nucleus of the midbrain, The rubrospinal tract is involved in large movements of proximal musculature of the limbs. It inhibits activity of extensors, and increases activity of flexors
Vestibulospinal tract
Arises from the giant cells of Deiters in the ipsilateral lateral vestibular nucleus. Plays a role in the control fo the extensor muscle tone.
Descending autonomic fibers
Project to the sympathetic T1-L3 and parasympathetic S2-S4 centers in the spinal cord
Ascending is red, descending are green.
1.Gracile fasicle
2.Cuneate fasicle
3.Dorsal Spinocerebellar
4.Ventral spinocerebellar
5.Anteriolateral or spinothalamic tract
6.Ventral corticospinal
7. medial tectospinal
8.vestibulospinal
9.Lateral tectospinal
10.Medial reticulospinal
11. Lateral reticulospinal
12. Lateral corticospinal
1. Identify the tracts
2. Which direction are they going?
Lateral Corticospinal tract
1. Cortex
2. Posterior branch internal capsul
3.Basis peduncle
4.Basilar pons
5.Pyramid
6. Pyramidal decussation
7. Lateral corticospinal tract
8. Lateral intermediate zone
9. Lateral motor nucleus

A. CORTEX
B. MIDBRAIN
C. PONS
D. ROSTRAL MEDULLA
E. CERVICOMEDULLARY DECUSSATION JUCT.
F. SPINAL CORD
NAME THE TRACT AND THE ASSOCIATED AREAS.
12. DRG
11. PRIMARY SENSORY NEURON
10. DREZ
9. DORSAL COLUMNS a. GRACILE. b. CUNEATE
8.INTERAL ARCUATE FIBERS
7. CUNEATE NUCLEUS
6.GRACILE NUCLEUS
5.MEDIAL LEMNISCUS
4.SECONDARY SENSORY NEURON
3.MEDIAL LEMNISCUS
2. VPL
1. CORTEX

A. CORTEX
B. MIDBRAIN
C. PONS
D. ROSTRAL MEDULLA
E. CAUDAL MEDULLA
F. CERVICAL SPINAL CORD
NAME THIS TRACT AND ITS ASSOCIATED STRUCTURES
12.DRG
11.PRIMARY SENSORY NEURON
10.DREZ
9.ANTERIOR COMMISURE (DECUSS)
8.ANTERIOLATERAL TRACT
7.LINSAUR TRACT
6.SECONDARY NEURON
5.SPINORETICULAR TRACT INPUT
4.SPINOMESENCEPHALIC TRACT INPUT
3.SPINOTHALAMIC TRACT
2.VPL
1.POST. CENTRAL GYRUS

A. CEREBRAL CORTEX
B. MIDBRAIN
C. PONS
D. ROSTAL MEDULLA
E. CAUDAL MEDULLA
F. SPINAL CORD
NAME THE TRACT, WHAT IT DOES AND ASSOCIATED STRUCTURES.
A. CERVICALMEDULLARY JUNCTION/ CAUDAL MEDULLA

1.GRACILE FASCICLE
2.GRACILE NUCLEUS
3.CUNEATE FASCICLE
4.SPINALTRIGEMINAL TRACT
5.SPINALTRIGEMINAL NUCLEUS
6.RUBROSPINAL TRACT
7.DORSAL SPINOCEREBELLAR TRACT
8.VENTRAL SPINOCEREBELLAR
9.ALS
10.PYRAMIDAL DECUSSATION
WHAT LEVEL IS THIS AND NAME THE ASSOCIATED STRUCTURES..
1.a.GRACILE NUCLEUS b. FASCICLE
2.DORSAL MOTOR VAGAL NUCLEUS
3.SOLITARY TRACT AND NUCLEUS
4.HYPOGLOSSAL NUCLEUS
5. INTERNAL ARCUATE FIBERS
6.NUCLEUS AMBIGUOUS
7.POSTOLIVARY SULCUS
8.PRINCIPLE OLIVARY NUCULEUS
9.PREOLIVARY SULCUS
10.MEDIAL LONG. FASCICULUS
11.TECTOBULBOSPINAL TRACT
12.MEDIAL LEMNISCUS
13.RAPHE
14.MEDIAL OLIVARY NUECLEUS
15.HYPOGLOSSAL NERVE FIBER
16.SPINOTHALAMIC TRACT
17.VENTRAL SPINOCEREBELLAR TRACT
18.DORSAL SPINOCEREBELLAR TRACT
19.a. SPINAL TRIGEMINAL NUCLEUS b. SPINAL TRIGEMINAL TRACT
20.a. CUNEATE NUECLEUS b. CUNEATE FASCICLE
21. RETICULAR FORMATION
22. PYRAMID
WHAT LEVEL IS THIS AND WHAT ARE THE ASSOCIATED STRUCTURES
1. Ant. Spinal artery
2. Post. Spinal artery
3. Vertebral artery
4. PICA
5. AICA
6. Vertebral artery + paramedian branches of caudal basilar artery
Name the arteriol supply to these zones.
A. Vertebral artery and PICA
1. Vestibular nuclei ( CN VIII)
2. Solitary nucleus and tract
3. ICP
4. Spinal trigeminal nucleus and tract (V)
5. Fascicles of vagus nerve (X)
6. Nucleus ambiguous (XI, X, XI)
7. Descending sympathetic fibers
8. Vagus nerve
9. Anteriolateral system
B. Vertebral artery
1. Primary olivary nucleus
C. Vertebral artery (paramedian branches) and ant. Spinal artery
1. Hypoglossal nucleus
2. Pyramid (corticospinal tract)
3. Medial lemniscus
4. Fascicles of hypoglossal nerve (XII)
Name the arterial supply to the vascular zones and the structures involved.
1. Paramedian branches of basilar
2. Long circumferential arteries and AICA
3. Short circumferential arteries of basilar
4. Long circumferential arteries and SCA
name the arterial supply for the shaded areas
With diplopia or disconjugate gaze, what pathways may be disturbed?
Supra and Infranuclear eye movement pathways.
What is dysarthria compared to dysphagia?

What pathways are compramised if these symptoms occur on a neural exam?
Dysphagia- difficulty swallowing
Dysarthria- difficulty speaking

Corticobulbar pathways or brainstem CN nuclei
What is a good indicator for a pontine dysfunction?
Bilat. Babinski sign
shivering
eye bobbing (fast down, slow to return)
What are some indicators for midbrain dysfunction?
Uni or bilateral pupil dialation, impaired conscousness, third nerve palsy
Rostral medulla
1. Medial vestibular nuclei
2. Inferior vestibular nuclei
3. Dorsal choclear nuclei
4. ICP
5. IX
6. Ventral spinocerebellar tract
7. Rubrospinal tract
8. ALS
9. Central tegmental tract
10. pyramid
11. Principle olivary nucleus
12. Raphe nuclei
13. Medial lemniscus
14. Reticular formation
15. Nucleus ambiguous
16. Spinal trigeminal tract
17. Spinal trigeminal nucleus
18. Solitary tract and nucleus
19. Tectospinal tract
20. MLF
What section is this, and name the labelled structures...
What are the steps involved with inervation of the parotid gland by IX? hint 7 steps
1. CN IX exits cranial cavity via jugular foramen
2. Tympanic branch of CN IX enters middle ear via tympanic canaliculus
3. Tympanic nerve forms tympanic plexus in middle ear
4. Lesser petrosal nerve arises and pentrates root of tympanic cavity to enter middle cranial fossa.
5. Leaves skull through foreman ovale
6. Preganglionic axons synapse on postganglionic neurons in the otic ganglion
7. Postganglionic axons distribute to the parotid gland with branches of auriculotemporal (V3)
What does the SVE from CN IX do? And what is their route?
Inervates the stylopharyngeus muscle, the cell bodies are located in nucleus ambiguous, fibers exit medulla via post olivary sulcus and go dorsal to olive and ventral to trigeminal tubercle
Medial medullary syndrome is caused by what vascularity obstruction and what are its symptoms? What structures are involved?
1. paramedian branches of vertebral and anterior spinal artery
2. contralateral extremity weakness, and decrease sense of position and vibration; CN XII ipsilateral tongue weakness
3. pyramidal tracts, medial lemniscus, hypoglossal nucleus
What is Wallenburg's syndrom? what are its symptoms, and what structures are effected?
Vertebral occlusion more than PICA (Lateral Medullary Syndrome)
1. Effects ICP’s vestibular nuclei, to cause ataxia, vomiting, nystagmous and vertigo
2. Effects Trigeminal nucleus and tract for decrease of pain and temp ipsilaterally on face; with ALS contralateral to body pain/temp
3. Descending hypothalamospinal Fibers to cause ipsilateral Horner’s syndrome (CN X)
4. Nucleus ambiguous for dysphagia, hoarsness
5. Solitary nucleus for ipsilateral taste loss
A. Anterior Spinal
B. Vertebral
C. Posterior Spinal
D. PICA

1. Nucleus ambiguous
2. STT
3. Spinal Trigeminal
4. Cuneate
5. Gracile
6. Hypoglossal nerve
7. Solitary nucleus
8. Vestibular
9. Dorasl motor Vagus
10. hypoglossal nucleus
11. Medial lemniscus
12. Pyramid
Identify the vascular supply and the labelled structures.
Pons1- Level of abducens and facial nerve
1. Genu of Facial nerve
2. Abducens nerve
3. Facial nerve
4. Facial nucleus
5. Spinal trigeminal tract
6. Spinal trigeminal nucleus
7. ALS
8. Central tegmental tract
9. Abducens nerve
10. Pontocerebellar fibers
11. Medial lemniscus
12. Trapzoid body (auditory info fibers)
13. Corticospinal & Corticobulbar tracts
14. Pontine Nuclei
15. Paramedian Reticular formation (horizontal cogn. Gaze)
16. Reticular formation
17. MCP
18. Tectospinal tract
19. MLF
Identify level and struct.
Pons2-level of abducens and facial nerve

1. Abducens nerve
2. Facial nerve Genu
3. Reticular formation
4. ICP
5. Superior Salivatory Nucleus
6. Central Tegmental Tract
7. MCP
8. Pontecerebellar fibers
9. MLF
10. Tectospinal tract
11. Medial lemniscus
12. Raphe (pain modulation)
13. Corticospinal tract
14. Pontine nucleus
15. Abducens nerve
16. Superior olivary nuc.
17. Lateral lemniscus
18. Facial nerve
19. Spinothalamic tract
20. Facial nucleus (SVE)
21. Spinal trigeminal
22. Solitary tract and nucleus (SVE)
23. Vestibular Nuclei
Identify the level and structure
Ponstri1- Pons at the level of the trigeminal nerve

1. Superior Medullary Vellum
2. 4th Ventricle
3. MLF
4. SCP
5. Locus Ceruleus
6. Ventral Spinocerebellar tract
7. Central tegmental tract
8. MCP
9. Pontine nucleus
10. Cortical spinal tract
11. Pontocerebellar fibers
12. Tectospinal tract
13. Raphe
14. Medial lemniscus
15. ALS
16. Lateral lemniscus
17. Trigeminal nerve
18. Trigeminal motor nucleus (SVE)
19. Pontine trigeminal nucleus (GSA) proprioception
20. Reticular formation
What level and what are the structures labelled
Ponstri2- Pons level of the trigeminal nerve

1. 4th ventricle
2. SCP
3. Trigeminal motor Nucleus
4. Central tegmental
5. MCP
6. Lateral lemniscus
7. Trigeminal nerve
8. ALS
9. Pontocerebellar fibers
10. Pontine nucleus
11. Corticobulbar and corticospinal tracts
12. Trapazoid body
13. Medial lemniscus
14. Reticular formation
15. Tectospinal
16. MLF
What level and what structures...
Audi1- Auditory tract

1. spiral nucleus
2. Cochlear nerve
3. Ventral cochlear nucleus
4. Dorsal cochlear nucleus
5. Decussation forming trapezoid body
6. Superior Olvary nucleus
7. Lateral lemniscus
8. Inferior coliculus
9. Subletial part of internal capsule
10. Primary auditory cortex
11. Medial Geniculate
Label the pathway
What are the somatosensory processes for CN VIII?
1. SSA- hearing from cochlea
a. Primary cell bodies in spiral ganglion in cochlea, end on ventral or dorsal cochlear nuclei
2. SSA- balance and equilibrium- utricle, saccule, & semicircular canal
a. Primary cell bodies in vestibular nucleus (U,S, SCC), terminate on vestibular nuclei., going to vestibulospinal tract and MLF to influence spinal motor neurons and extraocular muscles in coordination with cerebellum connection.
Nucleuses

1. Oculomotor nucleus
2. Trochlear nucleus
3. MLF
4. Abducens nucleus
5. Superior vestibular
6. Lateral vestibular
7. Medial vestibular
8. Inferior vestibular
9. Lateral vestibulospinal tract
10. Medial vestibulospinal tract
name these tracts
If examining the right eye, a corneal reflex test is done. If the right eye is stimulated and the response is the only the left eye blinks, then the left eye is stimulated and only the left eye blinks, then the lesion is where?
Facial nucleus
If examining the left eye for a corneal reflex, and neither eyes blink. Then on examination of the right eye, both eyes blink, then the lesion is where?
Pontine trigeminal nucleus
Ponsvasc1- vascular supply of the pons

A. AICA and circumfritial basilar arteries
B. Basilar Artery

1. MLF
2. Abducens nucleus
3. Vestibular nucleus
4. Facial nerve and nucleus
5. Spinal trigeminal tract and nucleus
6. MCP
7. Descending sympathetic fibers
8. ALS
9. Medial lemniscus
10. Corticospinal corticobulbar tract
11. Pontine nucleus
what are the vascular zones and their contents?
Medial inferior Pontine syndrome
- blockage of paramedian arteries of the basilar artery
1. Alternating hemiaplegia-
a. Flacid paralysis of contralateral body
b. Tongue points away (upper motor) from lesion, towards side of body effected
c. Ipsilateral paralysis of lateral rectus,, CN VI
d. Can be accompanied by horizontal gaze paralysis ( Abduc. And PPRF), nystagmous (MLF) and others
Medial superior Pontine syndrome-
- blockage of the paramedian basilar arteries
1. Contralateral hemiaplesia
2. loss of position and vibration
3. intranuclear opthaloplegia (MLF)
Millard-Gubler syndrome
-Occlusion of paramedian and short circumferential arteries of the medial and lateral zones (excluding tegmentum):
1. Same signs as Medial Inferior Pontine Syndrome + ipsilateral Bell’s palsy
Lateral Pontine Syndrome
-Occlusion of long circumferential arteries of basilar artery and/or AICA:
1. .Alternating hemiesthesia: loss of contralateral pain and temperature,
2. loss of ipsilateral cutaneous sensation of face.

a. facial nucleus and nerve- facial paralysis
b. trigeminal motor nucleus and nerve- paralysis of muscles of mastication
c. vestibular nucleus- nastagmus, vomiting, vertigo
d. abducens nucleus & PPRF- paralysis of conjugate gaze
e. cochlear nuc- deafness
f. MCP- ataxia
Midbrain-
1. Cerebral aquaduct
2. Periaquaductal grey matter
3. Inferior Colliculus
4. Lateral lemniscus
5. Raphe
6. ALS
7. Central tegmental tract
8. Medial lemniscus
9. Superior Cerebellar Peduncle Decussation
10. Substantia Nigra
11. Crus cerebri
12. Tectobulbospinal tract
13. corticopontine fibers
14. Corticobulbar fibers
15. Corticospinal fibers
16. corticopontine fibers
17. Trigeminal lemniscus
18. Reticular formation
19. MLF
20. Mesencephalic trigeminal nucleus
What level, what structures-
Midbrain2-

1. Commissure of Inferior colliculus
2. Inferior colliculus
3. Lateral lemniscus
4. Trochlear nucleus
5. MLF
6. Tectospinal tract
7. Trigeminothalamic tract
8. Rubrospinal tract
9. Basis Pedunculi
10. SCP and decussation
11. Pontocerebellar fibers
12. Interpeduncular nucleus
13. Pontine nuclei
14. Sbustantia nigra
15. median raphe nucleus
16. medial lemniscus
17. ALS
18. Central Tegmental tract
19. Dorsal Raphe nucleus
20. PAGM
21. Cerebral aquaduct
Level and structures...
Midbrain 3-

1. Cerebral Aquaduct
2. Oculomotor nucleus
3. MLF
4. Mesencephalic nucleus
5. Central tegmental tract
6. Medial lemniscus
7. Substancia nigra
8. Crus Cerebra
9. Oculomotor Nerve
10. Corticopontine
11. corticobulbar
12. corticospinal
13. Corticopontine
14. brachium of Inf. Colliculus
15. Spinothalamic tract
16. tectobulbospinal tract
17. Superior colliculus
18. PAGM
19. Red nucleus
structure and level
Edinger-Westphal nucleus-
(GVE) parasympathetic neurons project to ciliary ganglion; Postganglionic neurons in ciliary ganglion via short ciliary nerves that invervate the cilliary muscles and sphincter pupillae of iris, concerned with light reflex response
Name areas of the brain that are associated with voluntary eye movement-
1. frontal eye fields in the frontal cortex
2. superior colliculus
3. pretectal area
4. oculomotor
5. Trochlear
6. abducens nuclei
7. MLF
8. PPRF
Weber's syndrome (Midbrain basis)
alternaing hemiplegia-
contralateral hemiparesis, ipsilateral oculomotor palsey, and pupillary dialation
Benedict's syndrome (Midbrain basis and tegamentum)
alternating hemiaplesia-
coltralateral hemiparesis, ipsilateral oculomotor palsy, pupillary dialation, contralateral ataxia, involentary movements

Weber's with ataxia and involetary movements
Claude's syndrome (midbrain tegmental)
ipsilateral oculomotor palsey, pupillary dialation, contralateral ataxia, and involentary movements
Midbrain medial zone vascularity
Recieves small branches from basilar artery and PCA. Structures supplied are:
1.oculomotor,
2. Edinger-Westphal and trochlear nucleus
3. oculomotor nerve fibers
4. medial portions of substantia nigra and crus cerebri
Lateral midbrain zone of vascularity
Penetrating branches from quadrigeminal artery and branches from anterior chorid artery
Structures in zone:
1. medial lemniscus
2. lateral sub. nigra and crus cerbi
Dorsal midbrain vascular zone
Recieves branches from quadrigeminal & sperior cerebellar arteries
Structures include:
1. PAGM
2. Sup and inferior colliculus
3. ALS
4. brachium of inferior colliculus
Parinaud's syndrome
paralysis of upward gaze due to pineal gland tumor
Midbrain ext.

1. Superior brachium
2. Inferior brachium
3. inferior peduncle
4. troclear
5. medial geniculate
6. cerebral peduncle
7. Optic tract
8. lateral geniculate
stuctures at this level
Midbrain4
1. cerebral aquaduct
2. Edinger-Westvahl nucleus
3. Central tegmental tract
4. Medial geniculate
5. red nucleus
6. Corticopontine fibers
7. Corticospinal fibers
8. corticobulbar fibers
9. corticopontine fibers
10. Basis pedunculi
11. Interpeduncular fossa
12. Oculomotor nerve
13. Ventral tegmental area
14. substantia nigra
15. oculomotor nucleus
16. medial lemniscus
17. ALS
18. PAGM
19. Superior colliculus
level and structures
Midbrainvasc1
1. basilar artery
2. superior cerebellar artery
3. quadrageminal artery
4. superior cerebellar artery
5. Posterior Cerebral artery
name arteries and level
Midbrainvasc2
A. Superior Cerebellar artery and proximal Posterior Cerebral Artery
B. Proximal PCA
C. Paramedian branches of top of basilar artery

1. Reticular formation
2. ALS
3. Descending sympathetic fibers
4. Medial lemniscus
5. Red nucleus
6. Substantia nigra
7. Basis Peduculi
8. Oculomotor nucleus and nerve
vascular zones supply and structures
Horner's syndrom
Disruption of sympathetic inervation to the eye, head and neck
1. Anhydrosis
2. Miosis (dialated pupil)
3. ptosis
Somatorg1
A. Sulcus limitans

1. GSA
2. GVA
3. GVE
4. GSA
What is the organization of this and dividing line?
Somatorg 2

1. SVE
2. GVE
3. GSE
4. GVA and SVA
5. SSA
6. GSA
label the organization
extropia vs esotropia
x is out gaze with one eye
eso is in
Painful oculomotor palsy that involves the pupil should be a sign of?
Aneurysms in the Pcomm area
complete Oculomotor palsy that does not effect the pupil is a indicator of what?
Diabetes
Partial oculomotor palsy that spares the pupil is a sign of ?
partial compression due to aneurysm or tumor
give the two main causes for verticle diplopia-
Myasthenia gravis and
trochlear nerve palsy
Occlusions of PICA can cause?
VERTIGO!!! Supply vestibular nuclei
Lat, medial and inferior vestibular nuclei receives input from?
STATIC control from utricles and saccule
Head tilt or linear acceleration
Medial and Superior vestibular nuclei receive info from?
Kinetic semicircular canals due to endolymph lag of movement during angluar acceleration
Meniere's disease
recurrent vertigo, progressive hearing loss, tinnitis, full feeling in ear (incr. endolymph pressure)
Give 5 causes for true Vertigo-
1. benign paroxysmal positional vertigo
2. vestibular neuritis
3. Meniere's disease
4. central lesions to brainstem
5. central lessions to cerebellum
Edinger-westphal nucleus
1. bilateral projections to pupils
2.parasympathetic GVE
3 controls cilliary sphinctor of lens
All oculomotor muscles are innervated by what somatosensory type input?
Eye movement muscles are GSE, but pupillary dialtion is from the Edinger-Westphal nucleus and is GVE
What look should you have with oculomotor palsy?
down and out--- effect all muscles inverated by CN III
What are the three components of the accomodation response?
1.pupil
2. lens
3. convergence

Visual cortex to pertectal area to EW & Oculomotor nuclei
Marcus Gunn pupil
due to lesion of optic nerve, lesion of retina or eye.
direct response deminished, but consentual normal
contrast the difference in eye movement between a intranuclear opthalmopaligia to the 1 1/2 syndrom....
with intranuclear opthalmopaligia, the effected eye will not look in the direction opposite of the lesion (ADDuct, lesion of MLF),
With 1 1/2, the contralateral eye from the lesion will only look outward (abduct, lesion of both MLF and Abducens nucleus)
Two dopamine pathways involved in Parkinsin's
mesostriatum and mesocortical

substancia nigra to the stiatum and the cortex
Two dopamine pathways involved in Schizophrenia
mesolimbic and mesocortical

substancia nigra to the limbic and cortex
Norepinephrine is found where in the CNS and what is it responsible for?
Loci Cerillus- some control over awakeness/sleep and attention
Serotonin is found where in the CNS and what does it do?
Found in the Raphe nuclues
not sure, something about sever mental disorders
Histimine is found where in the CNS and what does it effect?
Found in the tubulomamillary body of the hypothalmus, it is excitatory for the thalmus,,,anti-histamine makes you sleepy