Brainstem: Structure & Func On
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Brainstem: Structure & Func1on Adrian Poniatowski StudyAid Neuroanatomy Seminar November 26, 2017 A pleasure to meet you... • Name: Adrian Poniatowski • Hometown: New York City • Job: Professional Baller, Future Doctor • Hobbies: Winning @ Life Brainstem = Manha<an • Connects everything • Every connecon is important • Small lesions = big problems • Locaon, locaon, locaon! Ques1on 1 Cranial nerves exit from the following locaons EXCEPT • a.) vagus nerve from posterior lateral sulcus • b.) facial nerve from cerebello-ponne angle • c.) abducens nerve from anterior lateral sulcus • d.) trochlear nerve lateral to the frenulum of the superior medullary velum • e.) oculomotor nerve from interpeduncular fossa 3 Midbrain Pons Cross-secons: Clinical Correlates Medulla Ques1on 2 All of the following locaons given are correct EXCEPT: • a.) motor nucleus of trigeminal - ponne tegmentum • b.) superior salivatory nucleus of VII - ponne tegmentum • c.) superior vesMbular nucleus of VIII - ponne tegmentum • d.) motor nucleus of hypoglossal - dorsal medulla • e.) motor nucleus of VI - mesencephalic tegmentum MLF Pathway • FuncMon: Connects oculomotor nuclei to integrate eye movements • Nerves: CN III and VI • Lesion causes Internuclear Opthalmoplegia • Abnormal adducMon of IPSILATERAL eye, usually with nystagmus • Where is the lesion here? Ques1on 3 Muscles of the eyeball are innervated by all of the following EXCEPT: • a.) axons of the nucleus located in the mesencephalic tegmentum • b.) axons of the nucleus located in the ponne tegmentum • c.) axons of the nucleus located in the dorsal medulla • d.) axons of the superior cervical ganglion • e.) axons of the ciliary gangilion Ques1on 4 • Which of the following is NOT located in rhomboid fossa? • a.) medial eminence • b.) cuneate tubercle • c.) facial colliculus • d.) locus ceruleus • e.) hypoglossal triangle Cor1cobulbar Tract Cor1cobulbar Tract Cor1cobulbar Tract • Pathway: Primary motor corMces - internal capsule - crus cerebri – X- CN nuclei in dorsal pons • Nerves: Brainstem LMN • FuncMon: Regulaon of brainstem acMvity Bell’s Palsy • It looks far worse than it is • Central vs. peripheral lesion • CN VII • Principal of contralateral and ipsilateral MOTOR input Ques1on 5 Tracts which control voluntary movement of muscles of facial expression are characterized by all of the following EXCEPT: • a.) They arise from the postcentral gyrus • b.) they traverse genu of the internal capsule • c.) they traverse crus cerebri • d.) they reach contralateral motor nucleus • e.) they reach dorsal pons (ponne tegmentum) Solitary Tract • Pathways: Gustatory, Swallowing, Vagal Pathways • Nerves: inferior ganglion of CN X, geniculate ganglion of CN VII, and CN IX • Solitary nucleus originates in medulla .