neuro 5

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Caudal Ventromedial Medulla: - thrombosis branch of anterior spinal artery

*contralateral hemiparesis = pyramid
*contralateral loss of MVP = medial lemniscus
Rostral ventrolmedial medulla: - thrombosis branch of anterior spinal artery

*contralateral hemiparesis = pyramid
*contralateral loss of MVP = medial lemniscus
*ipsilateral paralysis of tongue = hypoglossal nerve rootlets (LMN)
Lateral medulla (wallenberg's syndrome): - thrombosis of PICA or vertebral artery
(same as a dorsolateral medulla lesion)

*contralateral loss of pain&temp = lateral spinothalamic tract
*ipsilateral pain&temp = spinal tract and nucleus of trigeminal
*dysphagia/dysphonia; ipsilateral loss of gag reflex; tachycardia = nucleus ambiguous (CN X and IX)
*horner's syndrome = descending central sympathetics
* ipsilateral limb ataxia = inferior cerebellar peduncle
* ipsilateral deafness and tinnitus = cochlear nucleu
*nystagmus, nausea, vomiting, vertigo = inferior and medial vestibular nuclei
* ipsilateral loss fo taste; vomiting = solitary nucleus
Pontomedullary angle: - acoustic neuroma

*ipsilateral deafness, tinnitus nystagmus, vertigo = vestibulocochlear nerve
*ipsilateral facial paralysis, dry eye, dry mouth, reduced taste, hyperacusis = facial nerve
*ipsilateral ataxis of limbs = inferior cerebral peduncle
*ipsilateral loss of somesthetic sensations of face, mouth, etc; paralysis of muscles of mastication & jaw reflex loss; loss of corneal blink reflex = trigeminal nerve
*paralysis of soft palate, pharynx & larynx, anesthesia of parynx all ispiateral; dyspnea, dysphagia, hoarsenss, tachycardia = glossopharyngeal & vagus nerves
Facial colliculus: - neoplasm

*ipsilateral facial paralysis = internal genu of facial nerve
*ipsilateral internal strabismus & paralysis of lateral gaze = abducens nucleus
Caudal ventrolateral pons (facial hemiplegia alternans...millard-guber) (abducens hemiplegia alternans): - neoplasm / vascular (basilar artery)

*contralateral hemiparesis = corticospinal tract
*ipsilateral facial nerve signs = facial nerve root

*contralateral hemiparesis = corticospinal tract
*ipsilateral internal strabismus & paralysis of abduction of eye = abducens nerve root
Rostral ventrolateral pons: - neoplasm/vascular

*contralateral hemiparesis = corticospinal tract
* ipsilateral trigeminal nerve signs (loss of jaw jerk reflex, corneal blink reflex, and ipsilateral loss of sensation on face) = trigeminal nerve ROOT
Pontine tegmentum rostral Pontine tegmentum caudal: - neoplasm

* contralateral loss of MVP = medial lemniscus
* contralateral loss of pain&temp from body = spinothalamic tract
* ipsilateral loss of face pain & temp = trigeminal nerve ROOT
* horner's syndrome = desc. sympathetics

- same
- same
* associated cranial nerve signs = facial or abducens nuclei or roots
* iposilateral loss of pain & temp from face = spinal tract nerve V
* nystagmus, vertigo = vestibular nuclei
* horner's syndrome = desecnding sympathetics
Anterior internuclear ophthalmoplegia: - multiple sclerosis

* paralysis of adduction of eye(s).. intact adduction on convergence.. nystagmus of aBducting eye(s) = ascending medial longitudinal fasciculus
Ventral pons: LOCKED-IN Syndrome
- thrombosis of basilar artery

*quadriplegia = corticospinal tracts
*bilateral facial, laryngeal and lingual paralysis = corticobulbar tracts
**eyes are able to move**
Lateral midbrain tegmentum: - neoplasm

*contralateral loss of MVP from body = medial lemniscus & spinothalamic tract
* contralateral loss of pain & temp from face = ventral trigeminothalamic tract
Ventromedial midbrain (oculomotor hemiplegia alternans... Weber's): - aneurysm of posterior communicating artery

* ipsilateral oculomotor nerve signs = oculomotor rootlets
* contralateral hemiparesis = corticospinal tract
* contralateral lower facial weakness = corticobulbar fibers
Superior colliculus (parinaud's): - pinealoma

* paralysis of upward gaze (tracking) = rostra/corticotectal fibers
* loss of papillary light reflex = pretectal area
* paralysis of downoard tracking movements of eyes = caudo-lateral corticotectal fibers
Diencephalong lesion - thalamic syndrome (Dejerine-Roussy syndrome): - occlusion of the thalamogeniculate branch of the posterior cerebral artery!
(peristent pain which is uslaly poorly localized)

*contralateral hemihypalgesia and intense pain (burning sensation) = ventral posterolateral (VPL) thalamic nucleus and adjacent white matter
*contrlateral hemiparesis, babinski sign and hyperreflexia = corticospinal fibers in posterior limb of internal capsule
* homonymous hemianopsia = lateral geniculate nucleus
Internal capsule lesion: (posterior limb)
- capsular stroke; hemorrhages from lenticuolostriate branches of middle cerebral artery

*contralateral hemiparesis and babinksi sign = corticospinal fibers in posterior limb of internal capsule
*contralateral paresis of lower facial muscles and tongue = corticobulbar fibers in genu and posterior limb
*contralateral loss of P&T from face and body, and MVP = interruption of thalamocortical fibers from VPM and VPL to somatosensory cortex
Cerebral cortex vascular syndrome: - middle cerebral artery occlusion (stroke)

* contralateral hemiplegia of lower face, trunk, upper&lower limbs, and babinski sign = primary motor cortex(somatomotor) and CS and CB fibers in posterior limb of internal capsule
*contralateral hemianesthesia of face, trunk, upper&lower extremities = somatosensory & thalamocortical fibers from VPM and VPL in internal capsule (posterior limb)
*homonymous hemianopsia = geniculocalcarine fibers looping through temporal and parietal lobes
Brodmann's # 3, 1, and 2: primary somatosensory region
Brodmann's # 4: primary motor area
Right hemisphere dominance: spatial design
musical ability
recognition of forms, faces, and body image
left hand skills
memory for shapes

unexpected stimuli
global aspects of environment
Preoptic area of hypothalamus: regulation of:
- pituitary gonadotropin secretion
- reproductive, feeding, and steroptypic locomotive behaviors

**medial preoptic area is sexually dimorphic!**
Lateral zone of hypothalamus: Regulation of:
- feeding behavior

Structures include:
medial forebrain bundle, lateral area & nucleus, tuberal nuclei

Composed mostly of fiber pathways
Medial zone of hypothalamus - SUPRAOPTIC/SUPRACHIASMATIC region: Regulation of:
- water balance
- circadian rhythm (suprachiasmatic nucleus)
- body temperature (anterior nucleus)

additional structures.. supraoptic nucleus, paraventricular nucleus (endocrine/autonomic)
Medial zone of hypothalamus - TUBERAL region: Regulation of:
- hormone secretion (an & me)
- satiety (VM nucleus)
- emotional behaviors (DM nucleus)

*ventromedial nucleus, dorsomedial nucleus, arcuate nucleus, median eminence, infundibulum/pituitary stalk
Medial zone of hypothalamus - MAMMILARY region: Regulation of:
- STM (lateral mammilary nucleus ..if lesioned, Korsakoff's syndrome)
- Blood pressure
Periventricular zone of hypothalamus: contains the periventricular nucleus located adjacent to ependymal cells of the 3rd ventricle
Neurosecretory neurons that project to the median eminence via the tuberoinfundibular tract.. Medial preoptic area: GnRH
Neurosecretory neurons that project to the median eminence via the tuberoinfundibular tract.. Paraventricular nucleus: TRH, CRH
Neurosecretory neurons that project to the median eminence via the tuberoinfundibular tract.. Periventricular nucleus: Somatostatin (SRIF)
Neurosecretory neurons that project to the median eminence via the tuberoinfundibular tract.. Arcuate nucleus: Dopamine, GHRH
SFO and OVLT: osmoreception
NTS: baroreceptor (cardiovascular)and oropharyngeal afferents
PVN, SON: vasopression
MPN: visceromotor, somatomotor behavioral
Olfactory bulb (PNS) - 5 layers: - olfactory nerve layer
- glomerular layer: convergence (contains inhib interneurons)
- external plexiform layer
- mitral cell layer
- inner plexiform (granule cell) layer

- olfactory tract (CNS!)
Horner's Syndrome: - ptosis (drooping of eyelid)
- miosis (constriction of pupil)
- anhydrosis and flushing of the skin and face

*from lesioning sympathetic preganglionic pathways at C8 to T2... will produce this syndrome IPSILATERALLY

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Deck Info

Number of cards 35

Created By alstoner