Term
| What does the basilar run on? What are it's branches? |
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Definition
-The length of the pons
-AICA is it's lowest branch
-Labyrinthine is next (to the ear with CN8)
-Pontine
-Superior cerebellar
-Divides into the post. cerebral once it reaches midbrain |
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Term
What serves ant. medulla?
Lateral medulla? |
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Definition
-Ant. spinal artery
-PICA*** |
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Term
What serves medial pons?
Lat. pons? |
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Definition
-Pontine arteries
-AICA (caudal), superior cerebellar (rostral) |
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Term
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Definition
| -Posterior cerebral art. branches get the whole thing |
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Term
| Medial medullary syndrome? |
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Definition
-From occlusion of vertebral or **ant. spinal
-Pyramids-->Contra. spastic hemiparesis
-CN 12-->Tongue towards lesioned side
-Med. lemniscus-->Contra. pain and temp. |
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Term
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Definition
-Aka lateral medullary syndrome
-From loss of **PICA
-CN 5 (spinal), 8-10 (nuc. mostly)
-Spinothalamic tract & descending hypothalamus
-**Ipsi. palate droop & hoarseness (from **nuc. ambiguus)
-**Contra. pain & temp. in body + *ipsi. horners (long tract); together, these mean brain stem
-There are a few others such as ipsi. limb ataxia (inf. cerebellar ped., not weakness), ipsi. pain and temp from face (spinal 5), and nystagmus (away) & vertigo (vestibular n.), but those above are the most definitive for localization (10 + two long tracts)
-Notice the pain and temp are apposing |
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Term
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Definition
-From paramedian branches of basilar a. (pontine)
-Localized to caudal pon
-Corticospinal-->Contra. spastic hemiparesis
-Abducens nerve (exits ventrally)-->Medial strabismus
-May also have some facial n. and medial lemniscus involvement (ipsi. Bells + Horner's & contra. body p&t)
-Similar to medial medullary synd., but abducens localizes it (as well as CN7), rather than tongue involvement |
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Term
| Lateral pontine syndrome? |
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Definition
-From **AICA or *sup. cerebellar occlusion
Long tracts;
-Spinothalamic & descending hypothalmic
CN and Nuc.;
-**Facial & vestibulocochlear nn. (when caudal)
-Trigeminal (when rostral)
-Spinal V (always)
-Similar to lat. medullary, but now we get either ipsi. bells and *hearing, or ipsi. loss mastication & anesthesia
-Still get the contra loss of pain and temp. & ipsi. horners |
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Term
| Pontocerebellar angle syndrome? |
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Definition
-From **acoustic neuroma of CN8 (from vestibular n. Schwann cells)
-*No long tract involvement
-Commonly involves 7, then 5; loss of hearing, then Bell's, then anesthesia; all ipsi.
-Very similar to lateral pons, but outside brainstem b/c there are **no tracts involved (no body signs) |
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Term
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Definition
-Aka medial midbrain syndrome
-From **posterior cerebral a. occlusion**
-Corticospinal-->contra hemiparesis
-CN 3-->ipsi. down and out (+ eye PANS lost)
-Also catches the corticobulbar fibers (*contra. lower* face weakness) |
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Term
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Definition
-Aka dorsal midbrain syndrome
-From **pineal gland tumor
-Superior colliculi-->bilateral loss of **vertical conjugate gaze (can't look up)
-Often also will involve pretectal area (diminished *pupillary response) & aqueduct (*nc hydrocephalus) |
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Term
| What can we expect overall for cortex, brain stem, and spinal cord lesions? |
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Definition
-Cortex; all contra.
-Stem; ipsi. face, contra. body
-Spinal; Motor and touch ipsi., P&T contra.
-See 402 |
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Term
| What are the major components for the reticular formation? What are their special neurotransmitters and action? |
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Definition
1. Raphe nuclei-->serotonin (5-HT)-->mood and non REM sleep
2. Locus caeruleus-->NE-->arousal (REM sleep when shut off)
3. Periaqueductal gray-->opiod receptors-->descend to modulate pain in dorsal horn
-These are innervated by pain fibers from spinothalamic
-The reticular formation is a chemically significant portion of the brainstem and is involved in regulating things like respiration, cardiovascular responses, arousal, and sleep
-Not really important in lesions however |
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Term
| What disease is associated with the reticular formation? |
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Definition
-Alzheimers
-Raphe and locus coeruleus |
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Term
| Overall, what are the medially effected CNs and locations? |
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Definition
-3; midbrain
-6; pons (caudal)
-12; medulla
-See drawing on 401 |
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