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156 Cards in this Set
- Front
- Back
What does the Alar plate contain?
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Sensory nuclei
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What does the Basal plate contain?
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Motor nuclei (motor neurons and preganglionic parasympathetic neurons)
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Which plate is located in the dorsolateral location?
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Alar
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Which plate is located in the ventromedial location?
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Basal
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Border between motor and sensory nuclei
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Sulcus Limitans
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What lie away from the sulcus limitans?
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SOMATIC motor and sensory nuclei
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What lie adjacent to the sulcus limitans?
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VISCERAL motor and sensory nuclei
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How many sensory nuclei in the BS?
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six
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How many motor nuclei in the BS?
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11
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Sensory nuclei in the BS are what order neurons?
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Secondary
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Are there parasympathetics in the BS? Which nerves?
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YES: 3,7,9,10
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What nerve is associated with Edinger-Westphal nucleus?
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Occulomotor 3
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What nerve is associated with Superior salivatory and lacrimal nucleus?
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Facial 7
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What nerve is associated with Inferior salivatory nucleus?
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Glossopharyngeal 9
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What nerves are associated with nucleus ambiguous?
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Glossopharyngeal 9 and Vagus 10
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What nerves are associated with the general visceral portion of the solitary nucleus?
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9 and 10
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What nerves are associated with the gustatory portion of the solitary nucleus?
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7,9,10
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Is there sympathetic neurons in the BS?
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No, but there is innervation to the head from the superior cervical ganglion
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What nuclei of the vagus is involved in parasympathetics?
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Ambiguous and Dorsal motor
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What nuclei of the oculomotor is involved in parasympathetics?
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Edinger-Westphal
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What nuclei of the Facial is involved in parasympathetics?
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Superior salivatory
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What nuclei of the Glossopharyngeal is involved in parasympathetics?
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Inferior salivatory
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What cranial nerves are GSE?
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3,4,6 (eye muscles)
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What eye muscle does the Trochlear nerve innervate?
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Superior oblique
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What eye muscle does the abducens nerve innervate?
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Lateral rectus
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What muscles does the oculomotor nerve innervate?
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All of the eye muscles except lateral rectus and superior oblique
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Where is the LMN of 3 located?
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Just below cerebral aqueduct at the level of the superior colliculus in MB
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Where is the LMN (GSE) component of 4 located?
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Just below the cerebral aqueduct at the inferior colliculus level of the MB
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Where is the LMN (GSE) component of 6 located?
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Floor of the 4th ventricle at the pons beneath the facial colliculus
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What makes up the facial colliculus?
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Formed by Abducens nucleus and overlying facial motor nerve fibers
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What nerves travel between the posterior cerebral and superior cerebellar arteries?
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3 and 4
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What GSE nerves travel through the cavernous sinuses?
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3,4,6
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What is the only nerve to exit the DORSAL aspect of the brain stem?
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4
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Where do 3,4,6 leave the skull?
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Superior orbital fissure
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What is the laterality of the oculomotor innervation?
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ipsilateral as the nerve
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What is the laterality of the trochlear innervation?
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Contralateral to nucleus
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What is the laterality of the abducens innervation?
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Ipsilateral to nucleus
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What constitutes the efferent limb of the pupillary light reflex and accomodation reflex?
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Oculomotor GVE/Parasympathetic of Edinger-Westphal nucleus
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What ganglion do the preganglionic axons of the Edinger-Westphal nucleus synapse on?
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Cilary Ganglion
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What leaves the ciliary ganglion to innervate the ciliary muscle and pupillary constrictor?
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Postgagnlionic axons as short ciliary nerves
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What innervates the ciliary muscle and pupillary constrictor?
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GVE/Parasympathetic portion of Occulomotor from Edinger-Westphal nucleus
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Uncal herniation would cause problems to what first?
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Parasympathetics of the occulomotor (Pupil constriction) --> Tend to be on outside and lateral part of 3
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What symptoms would you see in an oculomotor lesion due to damage of the GSE fibers?
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Lateral or external strabismus, diplopia and ptosis
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What symptoms would you see in an occulomotor lesion due to damage of the GVE fibers?
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fixed and dilated pupil
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Laterality of LMN lesion of Oculomotor?
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ipsilateral to nerve and usually bilateral
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What is the eye unable to do due to a LMN lesion of the Trochlear?
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Cannot move down and in --> Diplopia when looking down
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Where would you see problems with reading and descending stairs?
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LMN lesion of trochlear
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Laterality of LMN lesion to trochlear?
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contralateral to nucleus, ipsilateral to nerve after its decussation
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What type of strabisumus would you see due to an abducens nerve lesion?
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medial or internal and diplopia
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Laterality of a LMN lesion of the abducens?
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Ipsilateral to nerve and nucleus
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Where may you see paralysis of lateral gaze?
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Lesion of the abducens nucleus involving the nucleus itself
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A UNILATERAL UMN lesion of the Corticobulbar tract would produce what?
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no noticeable deficits involving tghe eye muscles because each 3,4 and 6 nerve receives CBT input from the cerebral cortex of BOTH hemispheres in the BS
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What corrdinates activity of the eye muscles through connections with nuclei of 3,4,6 and vestibular nuclei?
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Medial Longitudinal Fasciculus (MLF)
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What is the afferent limb of the VOR?
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Vestibular nerve
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What are the efferent limbs of the VOR?
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3,4,6 nerves
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What may result from damage to the MLF and may be seen as the first deficit in MS?
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Internuclear opthalmoplegia
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What is an important source of info about gravity, rotation and accelaeration?
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Vestibular nerve
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What is used for maintaining posture and equilibrium and coordinating head and eye movements?
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Vestibular nerve (Vestibulospinal tract and MLF)
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Where does the vestibular nerve enter the BS?
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pons/medulla junction (cerebellopontine angle)
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Where are the 1st order or primary afferents of the vestibular nerve located?
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Bipolar neuron CB located in vestibular (Scarpa's) ganglion
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Where does the Vestibular or Scarpa's ganglion lie?
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within the internal auditory meatus
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Where are the second order CB of the vestibular nerve located?
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Vestibular nuclei in the floor of the 4th ventricle
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Where does the vestibulocerebellar tract travel?
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Inferior Cerebellar peduncle
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Where does the vestibulocerebellar tract terminate?
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Flocculonodular lobe
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What tract facilitates antigravity muscles (extensors) important in maintaining posture?
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Vestibulospinal
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Damage to what may cause dizziness, falling, abnormal eye movements, nausea and vomiting?
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Vestibular nerve or nuclei
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Acoustic neuroma in the cerebellopontine angle is the most common cause of damage to what?
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Vestibular nerve/nuclei
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Lateral gaze center
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Paramedian Pontine Reticular Formation (PPRF)
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Damage to the left MLF would present as what when asking the patient to look to the opposite side of the lesion (right)?
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Left eye (ipsilateral to lesion) cannot move past midline due to damaged III and Medial Rectus. --> Internuclear Ophthalmoplegia
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Where is the PPRF located?
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Near the abducens nuclei
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What does the PPRF coordinate?
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Medial and lateral rectus muscles via III and VI
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Damage to the Paramedian Pontine Reticular Formation would present as what?
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Paralysis of lateral gaze (medial strabismus of ipsilateral eye, cannot move contralateral eye medially past the midpoint even though the III on contralateral side is intact)
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Paralysis of the lateral gaze would be caused by what?
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Damage to abducens nuclei and PPRF
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Where is the center for vertical gaze located?
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Periaqueductal gray of MB at level of the superior colliculus
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What can be damaged by pressure from a pineal tumor?
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Center for vertical gaze
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Saccades
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Voluntary, conjugate eye movements (Frontal eye field = 8)
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Where is area 8?
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Caudal aspect of middle/superior frontal gyri
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If a seizure or stimulation to area 8, where do the eyes look?
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Away or opposite of lesion
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If a stroke or destruction in area 8, where do the eyes look?
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AT the lesion
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What area is the frontal eye field?
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8
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What area is the occipital eye field?
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18 and 19
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A lesion in areas 18 and 19 would cause what?
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visual agnosia (do not recognize what is seen) and disruption of reflexes such as fixation and accomodation/convergence
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Where does the cochlear nerve enter the BS?
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Pons/medulla junction (cerebellopontine angle) same as vestibular nerve but they enter as separate roots
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Where is the peripheral process of the primary afferent cochlear nerve?
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associated with receptors (hair cells) of the cochlea
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Where are the CB of the primary afferent cochlear nerve?
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Cochlear or spiral ganglion
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Where are the second order CB of the cochlear nerve?
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Dorsal and ventral cochlear nuclei
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Where will the cochlear nerve always synapse?
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Cochlear or spiral ganglion, dorsal or ventral cochlear nuclei, inferior colliculus, medial geniculate nucleus, Transverse Temporal Gyri
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Areas 41 and 42
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Transverse Temporal Gyri
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Damage to the cochlear nuclei or cochlear or spiral ganglion would cause what?
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Deafness in ipsilateral ear
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Damage to anything above the cochlear nuclei would cause what? (if lesion is unilateral)
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minimal hearing loss in contralateral ear
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What Nucleus contains 2nd CB which carry input from discrimitive touch and propriocetion of the head?
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Main trigeminal nucleus
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Which is more lateral in the pons, the tirgeminal main sensory nucleus or the Tigeminal Motor nucleus?
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Main sensory nucleus is more lateral
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Which tract is the Main trigeminal nucleus analagous to?
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DCML
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What nucleus carries pain and temperature information from the head?
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Spinal V
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What nucleus is coextensive with Lissauer's tract of the SC?
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Spinal V
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Where do the 3 CB of the TTT terminate?
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VPM of Thalamus
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Where do the TTT have their 1 CB?
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Trigeminal ganglion
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Specifically where do the neurons of the VPM terminate?
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Postcentral gyrus nearest the lateral fissure
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What is the only nucleus to have its first order neurons inside the CNS?
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Mesencephalic Trigeminal Nucleus (GSA)
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What nucleus carries proprioception from muscle spindles in muscles of mastication?
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Mesencephalic Trigeminal
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What is the afferent limb of the jaw jerk?
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Mesencephalic Trigeminal Nucleus
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What is the efferent limb of the jaw jerk reflex?
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SVE motor component of Trigeminal
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The SVE component of Trigeminal innervates muscles from which arch?
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1st
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Laterality of trigeminal motor nucleus?
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Ipsilateral
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Damage to the sensory components of Trigeminal nerve?
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Disturbed discriminative touch, proprioception, pain or temp, Trigeminal neuralgia (Tic Douloreux)
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Laterality of a sensory defecit to Trigeminal?
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Depends upon whether the lesion is above or below the decussation of the trigeminothalamic tract
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Damage to the LMN motor component of V?
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Ipsilateral paralysis of muscles of mastication, atrophy
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Unilateral UMN (CBT) lesion of motor component of Trigeminal?
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Usually little deficit, but may be SOME contralateral weakness
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Where are the first order CB of sensory components of VII located?
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Geniculate ganglion
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GSA of facial?
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Skin of external ear, wall of auditory tube and outer surface of tympanic membrane
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What contains the processes of the 1st order neurons of the GSA of the facial nerve?
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Nervus intermedius
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Where are the 2 CB found of the GSA of the facial?
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Spinal V!
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Where are the 3 CB of the sensory portions of the facial nerve located?
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VPM of thalamus
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What supplies taste to the anterior two thirds of the tongue?
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SVA of facial
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What portion of the solitary nucleus does the SVA of the facial synapse?
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Rostral
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What contains the 2 CB of the SVA portion of the facial?
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Solitary nucleus (rostral portion)
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Rostral part of the solitary nucleus AKA
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Gustatory nucleus
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Damage to the sensory portion of the facial?
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Loss of taste to anterior 2/3 of tongue, plus minimal loss of general sensation from ear, auditory tube and outer surface of tympanic membrane
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The SVE component of the facial innervates muscles from which arch?
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2nd
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What is located in the Facial motor nucleus?
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LMN
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Laterality of motor component of facial nerve?
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ipsilateral
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What serves as the efferent limb of the blink or corneal reflex?
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Motor component of facial nerve
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What nerve loops of the abducens nucleus/facial colliculus?
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Motor component of facial
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CBT (UMN) input to facial neurons innervating the face is ______ while those innervating the lower face is ______
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bilateral to upper face, but contralateral to lower face
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Unilateral UMN (CBT) lesion to facial motor nerve would cause what?
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Contralateral lower face paralysis (Upper face OK!)
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Unilateral LMN lesion to motor facial nerve?
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Ipsilateral upper AND lower face paralysis (Bell Palsy)
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Lesions within the pons produce deficits to which nerves?
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6 and 7
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Leision in the cerebellopontine angle produces defeicits in which nerves?
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7 and 8
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What nerve is associated with the superior salivatory nucleus and lacrimal nucleus?
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Facial (GVE) Parasympathetic component
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What provides general sensation to the skin of the external ear, internal surface of the tympanic membrane and the posterior 1/3 of the tongue and upper pharynx?
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GSA of 9
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Where do the 1 CB of GSA 9 synapse?
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Spinal V nucleus
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What forms the afferent limb of the gag reflex?
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GSA of 9
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What receives input of the carotid sinus (baroreceptors) and carotid bodies (chemoreceptors)?
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GVA of 9
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Where are the 1 CB of the SVA and GVA of 9 located?
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Inferior glossopharyngeal (petrosal) ganglion
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What portion of the solitary nucleus does the SVA of 9 synapse?
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rostral
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Where does the 1 order neuron of the SVA of 9 synapse?
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Rostral portion of Solitary nucleus
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What portion of the solitary nucleus does the GVA of 9 synapse?
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Caudal
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9 innervates the stylopharyngeus which is derived from which arch?
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3
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LMN of the SVE of 9 are located where?
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nucleus ambiguous
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Where are the 1 CB of the GVE (Parasympathetic) of 9 located?
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Inferior salivatory nucleus
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What serves as parasympathetic innervation to the parotid gland?
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GVE of 9
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2nd order CB of the GSA component of the Vagus are located where?
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Spinal V
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What part of the Vagus has little significance in the adult?
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SVA (rostral solitary nucleus)
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Where does the GVA of 10 have its 2 CB?
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Caudal portion of solitary nucleus
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Is there cortical projection of the GVA component of 10?
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NO
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The SVE motor component of 10 innervates muscles from which arch?
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4 and 6 (larynx and pharynx)
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Where are the LMN of the SVE of 10 lcoated?
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Nucleus ambiguus
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What is the efferent limb of the gag reflex?
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SVE of 10
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Unilateral LMN lesion of nucleus ambiguus
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9 and 10: absent gag reflex, ipsilateral paralysis, hoarseness and uvula deviates to NORMAL side (away from lesion)
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Bilateral LMN lesion of nucleus ambiguus
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fatal
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Unilateral UMN of Vagus
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no deficit
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The LMN of 11 are located where?
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Spinal accessory nucleus at C1-C5
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LMN lesions of 11
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shoulder drop, downward and lateral rotation of scapula, weakness in turning head to side contralateral to lesion
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UMN lesion of 11?
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transietn contralateral paresis or paralysis in trap and SCM
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LMN of the GSE hypoglossal?
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Hypoglossal nucleus
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LMN or UMN of 12?
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tongue deviates to side of lesion (weak side)
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