Term
| Since the brainstem contains a compact arrangement of diverse structures, what will normally happen with a single lesion? |
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Definition
| It will damage several structures simultaneously. |
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Term
| What 3 things can a unilateral lesion of the brain stem cause? |
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Definition
1. Loss of function to 1 or more cranial nerves on the ipsilateral side of the body
2. Contralateral hemiplegia
3. Contralateral hemisensory loss |
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Term
| Why can a unilateral lesion of the brain stem cause contralateral hemiplegia? |
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Definition
| Because long descending motor pathways innervate contralateral extremities |
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Term
| Why can a unilateral lesion of the brain stem cause contralateral hemisensory loss? |
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Definition
| Because long ascending sensory pathways carry sensory information from contralateral extremities |
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Term
| What is another term for Lateral Medullary Syndrome? |
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Definition
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Term
| Has been attributed to occlusion of either the PICA (posterior inferior cerebellar artery) because this artery supplies the dorsolateral portion of the medulla, or the vertebral artery - from which the PICA arises- this artery is actually the more frequently occluded |
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Definition
| Lateral Medullary Syndrome (Wallenburg's Syndrome) |
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Term
| What artery supplies the dorsolateral portion of the medulla? |
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Definition
|
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Term
| From which artery does the PICA arise? |
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Definition
|
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Term
| Between the PICA and the vertebral artery, which one is more frequently occluded? |
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Definition
|
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Term
| What structures are usually involved in Wallenburg's Syndrome? |
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Definition
1. Spinal Trigeminal Tract & Nucleus
2. Anterolateral System Pathway
3. Nucleus Ambiguus
4. Descending Sympathetic Fibers - from hypothalamus to spinal cord - descending near the spinothalamic tract
5. Inferior Cerebellar Peduncle (part) |
|
|
Term
| Name 5 deficits seen with Wallenburg's Syndrome |
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Definition
1. Loss of pain and temp over ipsi. side of face and contra side of body
2. Hoarseness and difficulty swallowing
3. Ipsilateral Horner's Syndrome
4. Vertigo
5. Disturbances of equilibrium |
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Term
| Unusually results from interruption of descending autonomic pathways that course in the dorsolateral horn system (from hypothalamus). May also occur secondary to disruption of these fibers in the spinal cord and with lesions involving either preganglionic or postganglionic sympathetic fibers of the superior cervical ganglion. |
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Definition
|
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Term
| Name 5 characterizations of Horner's Syndrome. |
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Definition
1. Miosis
2. Partial Ptosis
3. Enophthalmos
4. Anhidrosis
5. Vasodilation |
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Term
|
Definition
| Constricted pupil (because dilator muscle is paralyzed) |
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Term
| Why will you see partial ptosis with Horner's Syndrome? |
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Definition
| Because smooth muscle fibers in the levator palpebrae superioris muscle are denervated |
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Term
| What does Enophthalmos mean? |
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Definition
| Eye appears to be sunken in socket |
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Term
| Absence of sweating on affected side of face. |
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Definition
|
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Term
| Causes redness of face on affected side |
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Definition
| Vasodilation during Horner's Syndrome |
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Term
| Generally caused by acoustic neuroma |
|
Definition
| Cerebellopontine Angle Syndrome |
|
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Term
| A slow growing tumor arising from Schwann cells in sheath of CN VIII |
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Definition
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Term
|
Definition
|
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Term
|
Definition
|
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Term
| Name 4 initial symptoms of 8th nerve damage seen in cerebellopontine angle syndrome |
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Definition
Progressive Deafness
Tinnitus
Vertigo
Spontaneous Horizontal Nystagmus |
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Term
| As the tumor in Cerebellopontine Angle syndrome grows, what might you see? |
|
Definition
Ipsilateral Facial Paralysis
Cerebellar Ataxia on side of lesion
Facial Pain |
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Term
| With Cerebellopontine Angle syndrome, why might you see ipsilateral facial paralysis as the tumor grows? |
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Definition
| Due to proximity to the CN VII |
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Term
| With Cerebellopontine Angle syndrome, why might you see cerebellar ataxia on the side of lesion? |
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Definition
| Compression of cerebellar peduncles |
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Term
| With Cerebellopontine Angle syndrome, why might you see facial pain? |
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Definition
| Pressure of V root if tumor is large |
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Term
| What may cause Weber's Syndrome? |
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Definition
| Occlusion of posterior cerebral arteries |
|
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Term
| Weber's syndrome causes lesion involving what 2 things? |
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Definition
cerebral peduncle
occulomotor nerve |
|
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Term
| Name 6 symptoms present with Weber's Syndrome. |
|
Definition
1. Contra hemiplegia b/c of involvement of corticospinal pathways
2. External strabismus of ipsi eye - unopposed action of CN VI
3. Ipsi ptosis
4. Ipsi pupillary dilation
5. Ipsi loss of adduction of eye beyond midline
6. ipsi loss of upward and downward movment of eye |
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|
Term
| Lesions of the pontine/mesencephalic tegmentum involving significant amounts of reticular activating system |
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Definition
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Term
| Caused by an occlusion of the basilar artery - bilateral innervation of the ventral pons. Lesions of the corticobular and corticospinal tracts. |
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Definition
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Term
| Name 3 symptoms of a person with Locked-In Syndrome |
|
Definition
1. Total Paralysis
2. Unable to speak
3. Fully awake - may be able to slightly move eyes |
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Term
| What does the PICA supply? |
|
Definition
| posterior tips of the rostral medulla |
|
|
Term
| Vascular supply is paramedian branches of vertebral and anterior spinal artery |
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Definition
|
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Term
| Name 3 structures involved in the medial medulla. |
|
Definition
1. Pyramidal Tract
2. Medial Lemniscus
3. Hypoglossal Nucleus and Exiting Nerve |
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|
Term
| Name 3 symptoms that can be seen with a lesion to the medial medulla. |
|
Definition
1. Contra arm and leg weakness
2. Contra decreased position and vibration sense
3. Ipsi tongue weakness |
|
|
Term
| Major blood supply to the pons |
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Definition
|
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Term
| With this syndrome, the cortex is fine, the person has no voluntary movement, limited/no face movment, and can breathe on their own. |
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Definition
|
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Term
| What blood supply goes to the midbrain |
|
Definition
| Posterior Cerebral Arteries |
|
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Term
| What all cranial nerves could possibly be involved with cerebellopontine angle syndrome. |
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Definition
|
|
Term
| This tract controls motor to the face. |
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Definition
|
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Term
| This tract is going to have voluntary movement. |
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Definition
|
|
Term
| Name 2 tracts that run through the pons |
|
Definition
Corticobulbar
Cortiospinal |
|
|
Term
| What is another term for the inferior cerebellar peduncle? |
|
Definition
|
|
Term
| Are there cranial nerves present in the brain stem? |
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Definition
|
|
Term
| Are there cranial nerves present in the spinal cord? |
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Definition
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Term
| If you have a spinal cord injury in the cervical region - T1-2, lateral medulla or any interruption up to the thalamus will result in what syndrome? |
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Definition
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Term
| Injury to what region may cause ataxia (walking with a wide BOS) |
|
Definition
| Inferior Cerebellar Peduncle |
|
|
Term
| Where can you find occulomotor fibers and the red nucleus? |
|
Definition
|
|
Term
| In what 2 syndromes can you find Ptosis? |
|
Definition
|
|
Term
| What artery innervatees the medial lower medulla? |
|
Definition
|
|
Term
| Does Webers effect parasympathetic or sympathetic? |
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Definition
|
|
Term
| Does Horners effect parasympathetic or sympathetic? |
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Definition
|
|
Term
| Name 2 components that if injured can cause a coma. |
|
Definition
RAS - Reticular Activating System - controls level of arousal
Cortex & Basal Ganglia |
|
|
Term
| What artery supplies the olive in the medulla? |
|
Definition
|
|
Term
| If you have a bilateral lesion to the thalamus, can this result in a coma? |
|
Definition
|
|
Term
| If you have a unilateral lesion to the thalamus can this result in a coma? |
|
Definition
|
|
Term
| If you have a unilateral hemisphere dysfunction - a massive head injury to the cortex unilaterally, can this result in a coma? |
|
Definition
|
|
Term
| If you have a bilateral hemisphere dysfunction - a massive head injury to the cortex bilaterally, can this result in a coma? |
|
Definition
|
|
Term
| Barbituates depress the cortex, if you overdose on barbituates, can this result in a coma? |
|
Definition
|
|
Term
| Can you have a coma from an upper midbrain, reticular formation or pontine dysfunction? |
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Definition
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