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Neuro
Kaplan5a - The Brain Stem (structures)
20
Accounting
Pre-School
04/14/2013

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Term
As far as midbrain, pons, and medulla, which CNs come from where? Where do they exit the brain stem?
Definition
-Midbrain; 3, 4
-Pons; 5, 6, 7, 8
-Medulla; 9, 10, 12

-1, 2, & 11 are outside of the brain stem
-Broken into 4.4.4 (but with missing ones)

-The purely motor ones (3, 4, 6, 12) exit medially, while the mixed ones (5, 7, 9, 10) exit laterally
-The trochlear nerve is the only one arising dorsally

-See *373
Term
What is Parinaud syndrome?
Definition
-Usually from a pineal tumor that compresses the adjacent superior colliculi and *pretectal areas (gaze and light reflex)
-Get upward gaze paralysis and noncommunicating hydrocephalus
Term
In CNV lesion, which was will the jaw protrude?
Definition
-Towards lesion (from lat. pterygoid)
Term
Find the three major tracts in the following sections;

http://www.dartmouth.edu/~rswenson/Atlas/BrainStem/

Q & O (upper and lower midbrain)
M & K (upper and lower medulla)
H & D (upper and lower pons)

-Find also; Edinger Westfall nucleus, inferior and superior colliculi,...
-*Abducens nuc. & facial nerve & nuc. relation*, spinal tract and nucleus of V, superior olivary nucleus,...
-Hypoglossal nuc. and n., dorsal motor nuc. of X, solitary n., vestibular nuc, inf. cerebellar peduncle, inferior olivary nuc., nuc gracilis and cuneatus, spinal tract and nucleus of V
Definition
Term
In general, where do we find the nucleus and tract for CNV?
Definition
-Both start all the way down in the cervical spinal cord; basically the dorsal horn for the nuc. and the tract lat. to it
-They end where the nerve exits out of the pons

-Puts them basically lateral in the brain stem
Term
What is the solitary nucleus? Where is it?
Definition
-Receives all general and special *visceral afferent from 7, 9, and 10
-Lat. to the motor nuc. for X (which is lat. to the XII nuc.)
Term
What is the nucleus ambiguus?
Definition
-Basically gives the **somatic motor for X (soft palate, larynx, pharynx, upper esophagus)
Term
What is the dorsal motor nucleus of CNX? Where?
Definition
-It carries the **visceral motor for X (major **PANS)
-Located just lateral to the hypoglossal nucleus (right in front of the fourth ventricle)
Term
Give the excepts surrounding the vagus?
Definition
-All palate except; tensor palatini (V)
-All pharynx except; stylopharygeus (IX; only muscle)
-Gets palatoglossus; all other tongue are XII
Term
What is the internal genu of the facial nerve?
Definition
-The curve it makes as it wraps around the abducens nucleus
Term
Where was the sup. olivary nucleus? What was it for?
Definition
-Just ventral to the facial nucleus
-First to get *auditory from cochlear nuclei which is newly **binaural
Term
Where do we find the cochlear nuclei?
Definition
-Pontomedulary junction, lat. to vestibular in a curved shape around the inf. cerebellar peduncle (check J)
Term
What input do the sup. and inf. colliculi handle?
Definition
-Sup. is visual
-Inf. is auditory

(eyes over ears)
Term
Where do the defending hypothalamic fibers course? What can we expect in a lesion?
Definition
-With the spinothalamic tract
-Ipsi. Horners syndrome, opten with contra. loss of pain and temp.
Term
What does the lateral lemniscus do? Where is it found?
Definition
-Carries auditory fibers from sup. olivary n. to inf. colliculus
-It is found running through the pons primarily (lat. side)
Term
What are the nuclei for V and locations?
Definition
Motor;
1. Motor nucleus; Pons (next to exit of V)

Sensory;
2. Main sensory nucleus; Pons (lat. to motor), **touch**
3. Spinal trigeminal nucleus; Spinal cord to pons (below/continuation of main sensory nuc., basically dorsal horn), **pain and temp**
4. Mesencephalic nucleus; Midbrain (above main sensory), **proprioception**-->**jaw jerk reflex (monosynaptic)
Term
What gets the external surface of the tympanic membrane?
Definition
-V3 mostly
-Also ant. side of skin of external auditory meatus
Term
Where does all the V sensory info end up in the thalamus? What else does it receive?
Definition
-The touch, pain, and temp all go to the **VPM nucleus
-Also gets taste from 7 and 9

-So, overall; skin-->sensory nuc. of V-->VPM-->postcentral gyrus

-Note that the pain and temp. must travel down a bit (see 381); can help localize lesion
Term
What are the upper motor neurons for cranial nerves? What is special about the innervation?
Definition
-Innervated by **corticobulbar fibers

-Differ from corticospinal fibers in that they innervate the cranial motor nuclei **bilaterally
-Exception are ***lower facial expression muscles, and often some **tongue muscles; only contra. innervation
Term
So what will lesion of facial corticobulbar fibers produce?
Definition
-Contralateral paralysis of lower face only (droopy mouth) without paralysis of the eyelid, etc.

Basically;
-Whole face (Bell's palsy); facial nerve
-Lower face only; corticobulbar fibers (cortex, etc.)
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