Term
| Where do the rootlets of the Hypoglossal nerve emerge from in the brainstem? |
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Definition
| In the anterolateral sulcus, or Pre-Olivary Sulcus |
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Term
| The Spinal Tract of the Trigeminal Nerve is equivalent to which structure in the spinal cord? |
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Definition
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Term
| What structures does the Tegmentum contain? |
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Definition
| Reticular Formation, Cranial Nerve Nuclei and Tracts, Pathways ascending from the spinal cord, and some descending pathways. |
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Term
| What is the pathway of the Corticospinal Tract in the brainstem? |
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Definition
| Located in the most ventral aspect of the brainstem, they traverse the cerebral peduncle, basal pons, and medullary pyramid. |
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Term
| What is the position of the Spinothalamic Tract in the brainstem? |
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Definition
| It maintains an anterolateral position similar to its position in the spinal cord. |
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Term
| What happens to the Posterior Column tract in the brainstem? |
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Definition
| As they enter into the medulla, they synapse on the Posterior Column Nuclei (Nucleus Gracilis and Nucleus Cuneatus) and move towards the Medial Lemniscus to reach the Thalamus. |
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Term
| What replaces Fasciculus Gracilis and Fasciculus Cuneatus in the brainstem? |
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Definition
| They are replaced by Posterior Column Nuclei (Nucleus Gracilis and Nucleus Cuneatus). |
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Term
| What are the internal arcuate fibers? |
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Definition
| These are the fibers that transmit information from the Posterior Nuclei toward the Medial Lemniscus. |
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Term
| What is the Lateral Cuneate Nucleus? |
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Definition
| This is the upper extremity of Clarke's nucleus, and the axons of these cells join the posterior spinocerebellar tract in the inferior cerebellar peduncle at a slightly more rostral level. |
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Term
| What is the area that most of the internal arcuate fibers travel in? |
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Definition
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Term
| Lissauer's Tract and the Posterior Horn are replaced by what in the caudal medulla? |
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Definition
| Spinal Tract and Spinal Nucleus of the Trigeminal Nerve |
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Term
| What makes up the swelling of the olive in the brainstem? |
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Definition
| Inferior Olivary Complex. This is a relay nucleus for information heading towards the cerebellum. |
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Term
| What is the function of the Medial Longitudinal Fasciculus? |
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Definition
| It is involved in coordinating head and eye movements. |
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Term
| What makes up the bulk of the middle cerebellar peduncle? |
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Definition
| Fibers arising in the pontine nuclei that cross the midline and enter into the cerebellum. |
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Term
| How does the orientation of the MLF change as one moves rostrally in the brainstem? |
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Definition
| Initially it has an anterior to posterior orientation in the rostral medulla that changes to lateral in the pons. |
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Term
| What sensory system is associated with the inferior colliculi? |
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Definition
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Term
| Where is the periaqueductal grey and what is its purpose? |
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Definition
| It is located medial to the inferior colliculi and is a pale region that encircles the cerebral aqueduct. It is responsible for descending pain-control systems. |
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Term
| What tracts go through the cerebral peduncle? |
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Definition
| Corticospinal and Corticopontine fibers |
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Term
| What are the key structures in the ventral Medulla? |
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Definition
Pyramids
CN XII
Pyramidal Decussation
Olive
CN XI, X, IX
Pontomedullary Junction
CN VI, VII, VIII |
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Term
| What are the key structures in the ventral Pons? |
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Definition
Basilar Pons
Pontocerebellar Fibers
Middle Cerebellar Peduncle
CN V |
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Term
| What are the key structures in the ventral Midbrain? |
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Definition
Cerebral Peduncle
Interpeduncular Fossa
CN IV, III |
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Term
| What are the key structures in the dorsal Medulla? |
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Definition
Fasciculus Gracilis
Fasciculus Cuneatus
Gracile Tubercle
Obex
Stria Medullaris
Tuber Cinereum |
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Term
| What are the three synapses that separate the cortex and the periphery in the PCML system? |
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Definition
1. Posterior Column Nuclei
2. VPL/VPM of the Thalamus
3. Post-Central Gyrus of Cortex |
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Term
| In the event of a unilateral medullary lesion above the pyramidal decussation do the deficits present ipsilaterally or contralaterally? |
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Definition
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Term
| What regulates the relay of incoming information through the PCN? |
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Definition
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Term
| What is feed-forward inhibition with regard to the PCML system? |
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Definition
| It allows one input from the posterior column to inhibit others by activating inhibitory interneurons directly. |
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Term
| What is cruical for two-point discrimination in the PCML system? |
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Definition
| Lateral Inhibition caused from Recurrent (Feedback) |
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Term
| What are the 5 branches of the Internal Carotid Artery? |
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Definition
1. Anterior Cerebral
2. Middle Cerebral
3. Anterior Choroidal
4. Posterior Communicating
5. Ophthalmic |
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Term
| What are the major areas that are supplied by the ACA, MCA, and PCA? |
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Definition
- Median surface of cerebral hemispheres
- Lateral surface of the frontal, parietal, and temporal lobes
- Lower temporal gyri and all of the occipital lobe
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Term
| Venous blood from superficial and deep veins enters the ________ and eventually drains into the ___________. |
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Definition
dural sinuses
internal jugular vein |
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Term
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Definition
| Unplesant sensory and emotional experience associated with actual or potential tissue damage. |
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Term
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Definition
| Complex series of electrochemical events which occur between the site of tissue damage and the perception of pain. |
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Term
| What are the core components of Nociception? |
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Definition
Transduction
Transmission
Modulation
Perception |
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Term
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Definition
| Primary afferent fiber concerned with nociception, as well as the free nerve endings or "receptors" of primary afferents. |
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Term
| What is the difference between Nociceptive afferents (C-fibers Adelta fibers) and non-nociceptive afferents? |
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Definition
| Nociceptive afferents are either not or very lightly myelinated with a higher threshold and lower sensitivity compared to non-nociceptive afferents. |
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Term
What are the fast responders in nociception?
What are the slow responders? |
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Definition
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Term
| Where do primary afferents of nociceptors terminate? |
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Definition
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Term
| What are Wide Dynamic Range cells? |
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Definition
| Cells founds in Lamina 5 in the dorsal horn. They are responsible for windup and central sensitization. |
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Term
| What can block central sensitization and wind up? |
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Definition
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Term
| What is the role of the Spinomesencephalic Tract? |
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Definition
| A crossed pathway that is involved in transmission of non-discriminative aspects of pain transmission and activation of autonomic reflexes to pain. Plays a role in stimulating descending inhibition. |
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Term
| Where does referred pain from the liver & gallbladder project to? |
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Definition
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Term
| Where does referred pain from the lung & diaphragm project to? |
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Definition
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Term
| Where does referred pain from the heart project to? |
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Definition
| left chest and down the left arm |
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Term
| Where does referred pain from the kidney project to? |
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Definition
| pelvic and lower back region |
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Term
| What are regions, that when stimulated, tend to relieve pain? |
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Definition
Periventricular gray matter lateral to hypothalamus
Periaqueductal grey matter in the midbrain
rostroventral medulla |
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Term
| What are the 4 basic domains of mental function? |
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Definition
1. Emotion
2. Perception
3. Cognition
4. Behavior |
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Term
| What are the typical assesments made during the Mental Status Exam? |
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Definition
Appearance
Behavior
Speech
Mood
Affect
Thought Process
Thought Content |
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Term
| What are the additional components of cranial nerves that spinal nerves do not have? |
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Definition
Special Somatic Afferents (SSA) - relate to auditory and vestibular senses
Special Viseral Afferents (SVA) - relate to taste sense
Special Visceral Efferents (SVE) - relate to the motor innervation of striated muscle derived from the branchial arches |
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Term
| Where is the relative location of motor and sensory nuclei in the brainstem? |
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Definition
Motor - Medial
Sensory - Lateral |
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Term
| What is the major somatosensory nerve in the head? |
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Definition
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Term
| What are the GSA cell bodies in the Trigeminal system? |
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Definition
Spinal Nucleus of V
Main Sensory Nucleus of V
Mesencephalic Nucleus of V |
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Term
| What are the SVE of the Trigeminal? |
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Definition
| They are lower motor neurons that are loacted in the motor nucleus of the trigeminal that innervate the muscles of mastication. |
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Term
| What are the 4 functional components of the Facial nerve? |
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Definition
SVE - from the facial motor nucleus - provide innervation to muscles of facial expression
GVE - from the superior salivatory nucleus - provides innervation to mucous glands
GSA - terminate in spinal nucleus of trigeminal - provides sensation to skin of the external ear
SVA - terminate in the rostral portion of the solitary nucleus - provides taste innervation to the anterior 2/3 of the tongue and soft palate. |
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Term
| With an upper motor facial nerve lesion, where do the symptoms present? |
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Definition
| Contralateral Lower face only. This is because the dual innervation of the upper portion of the face from both hemispheres of the cortex. |
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Term
What type of fibers does the hypoglossal nerve contain?
What is its nucleus and where is it located? |
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Definition
GSE - innervate the intrisic and extrinsic muscles of the tongue
Hypoglossal Nucleus - Located in the dorsomedial aspect of the rostral medulla |
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Term
What type of fibers does the spinal accesory nerve contain?
What is its nucleus and where is it located? |
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Definition
SVE - Spinal portion innervates the SCM and trapezius, while cranial portion innervates the larynx and pharynx
Spinal - Accesory Nucleus in the cervical spinal cord
Cranial - Nucleus Ambiguus in rostral medulla |
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Term
What are the 5 functional portions of the Vagus?
What do they innervate?
What nucleus are they associated with? |
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Definition
1. SVE - innervate muscles of the larynx and pharynx - nucleus ambiguus
2. GVE - innervate the smooth muscle and glands of the pharynx and larynx and thoracic and abdominal viscera - dorsal motor nucleus of X
3. GVA - sensory information from larynx and pharynx - solitary nucleus
4. SVA - taste information for the hard and soft palate - nucleus of the solitary tract
5. GSA - sensory innervation to the external portion of the acoustic meatus, external surface of tympanic membrane - spinal trigeminal nuclei
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Term
What are the 5 functional portions of CN IX?
What do they innervate?
What nuclei are they associated with? |
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Definition
1. SVE - innervate the stylopharyngeus muscle - nucleus ambiguus
2. GVE - supply preganglionic parasympathetic innervation to the otic ganglion, postganglionic fibers innervate the parotid gland - inferior salivatory nucleus
3. GVA - convey sensory information from the carotid body and carotid sinus - solitary nucleus
4. GSA - general sensation to posterior third of the tongue - spinal trigeminal nucleus
5. SVA - taste in posterior 1/3 of tongue - solitary nucleus |
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Term
| What are the functions of the Reticular Formation? |
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Definition
1. Regulation of Muscle Tone
2. Modulation of Pain
3. Regulation of Autonomic Function
4. Regulation of Arousal and Consciousness
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Term
| How does the Gamma Loop affect muscle tone? |
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Definition
1. Gamma motor neurons fire
2. Pull the muscle spindle
3. Activate the Ia fibers
4. Activate the alpha motor neurons to create contraction of limb |
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Term
| T/F: Voluntary motor contraction of muscles goes through the gamma motor neurons to reach the alpha motor neurons. |
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Definition
| False. During voluntary movement, gamma motor neurons are not used. |
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Term
|
Definition
| This is an observed increase in resting muscle tone. |
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Term
| What are the two regions that are simultaneously active and balance each other to regulate muscle tone? |
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Definition
Pontine and Rostral Medullary Reticular Formation - Excitatory - Driven from BELOW
Caudal Medullary Reticular Formation - Inhibitory - Driven from ABOVE |
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Term
| What is the pathology that is involved with Hypertonia with spinal cord lesions and stroke respectively? |
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Definition
Spinal Cord Lesion - Both inhibitory and excitatory neurons are disconnected from alpha motor neurons and thus muscle is under local spinal involuntary control.
Stroke - Usually affects that internal capsule so that Corticospinal fibers cannot excite the medullary reticular formation which is responsible for inhibition. |
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Term
| What is sleeping sickness? |
|
Definition
| Disease caused by the bite of the tsetse fly. |
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Term
| What are the levels of the ASIA system? |
|
Definition
ASIA A - loss of motor and sensation below the lesion
ASIA B - Motor loss but preserved sacral sensation below lesion
ASIA C - Motor strength less than 3/5 with preserved sensation
ASIA D - Motor strength greater than 3/5 with preserved sensation
ASIA E - Normal |
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|
Term
| What are characteristics of a Central Cord Syndrome? |
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Definition
1. Occurs in the cervical levels as a result of traumatic hyper extension injuries of the spinal cord.
2. Defined as injuries where the hands are more severly compromised than the legs.
3. Younger patients have a much better chance at recovery |
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Term
| What are the characteristics of a Brown-Sequard Syndrome? |
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Definition
1. Injury to a hemisection, usually from a knife wound
2. Ipsilateral loss of voluntary motor control, proprioception and touch.
3. Contralateral loss of pain and temperature |
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|
Term
| What are the characteristics of the Cauda Equina Syndrome? |
|
Definition
1. Loss of sacral sensation
2. bladder and bowel dysfunction
3. urinary incontinence
4. seen with acute lumbar disc herniations |
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