Brainstem: Structure & Func on 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 connec on is important • Small lesions = big problems • Loca on, loca on, loca on!
Ques on 1
Cranial nerves exit from the following loca ons EXCEPT • a.) vagus nerve from posterior lateral sulcus • b.) facial nerve from cerebello-pon ne 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-sec ons: Clinical Correlates
Medulla Ques on 2
All of the following loca ons given are correct EXCEPT: • a.) motor nucleus of trigeminal - pon ne tegmentum • b.) superior salivatory nucleus of VII - pon ne tegmentum • c.) superior ves bular nucleus of VIII - pon ne tegmentum • d.) motor nucleus of hypoglossal - dorsal medulla • e.) motor nucleus of VI - mesencephalic tegmentum
MLF Pathway
• Func on: Connects oculomotor nuclei to integrate eye movements • Nerves: CN III and VI • Lesion causes Internuclear Opthalmoplegia • Abnormal adduc on of IPSILATERAL eye, usually with nystagmus • Where is the lesion here? Ques on 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 pon ne tegmentum • c.) axons of the nucleus located in the dorsal medulla • d.) axons of the superior cervical ganglion • e.) axons of the ciliary gangilion
Ques on 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
Cor cobulbar Tract Cor cobulbar Tract Cor cobulbar Tract
• Pathway: Primary motor cor ces - internal capsule - crus cerebri – X- CN nuclei in dorsal pons • Nerves: Brainstem LMN • Func on: Regula on of brainstem ac vity
Bell’s Palsy
• It looks far worse than it is • Central vs. peripheral lesion • CN VII • Principal of contralateral and ipsilateral MOTOR input
Ques on 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 (pon ne 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