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Med Neuro2 Lect8

Med Neuro2 Lect8 Vestibular II

QuestionAnswer
What is responsible for coordinating the movement of both eyes so they are in sync? Brainstem.
What are the 2 ocular muscles involved in Horizontal gaze? What innervates them? 1.Medial Rectus: III 2.Lateral Rectus: VI.
How would you test both Superior and Inferior Rectus? ABDUCT the eye, then: 1.Up: Superior Rectus. 2.Down: Inferior Rectus.
How would you test both Superior and Inferior Oblique? First ADDuct the eye, then: 1.Up: Inferior Oblique. 2.Down: Superior Oblique.
3 motor nerves of the Globe and their origins 1.III Oculomotor: Midbrain (interpeduncular fossa). 2.IV Trochlear: Midbrain (Dorsally below Inferior Calliculus). 3.VI Abducens: Pontomedullary junction.
Which cranial nerve exits the dura just inferoposterior to the Internal Carotid? CN III
Where do CN III, IV, VI, and V1 come together breifly after exiting the dura? Cavernous Sinus
What connect the nuclei of III, IV, VI and VIII within the brainstem? what is its primary function? Median Longitudinal Fascicus: integrates vestibular input to coordinate eye and neck movement.
What is the Median Longitudinal Fasciculus called as it extends into the spinal cord? Medial Vestibulospinal Tract. **Doesn't extend below cervical levels.
Besides III, IV, VI, and VIII, what other CN is influenced/integrated into the Median Longitudinal Fasciculus? CN XII: the tounge must be adjusted when we are laying down to sleep so that we can still breathe.
Where is the vestibular nuclei located? Widest part of the 4th ventricle.
During NORMAL horizontal gaze to the R, what nuclei serves to control that movement? what are its actions? The R VI nuclei will control movement via: 1.Activating the ipsilateral Lateral Rectus. 2.Activating the contralateral CN III & medial rectus. 3.Inhibits Ispilateral CNIII. 4.Inhibits Contralateral CN VI. **Eyes will move together to the R.
Describe the Eye movement if there is a Lesion on the R CN VI? The Ipsilateral (R) Lateral rectus will not contract so NO Abduction. The contralateral CN III will still be activated by brainstem so L Medial Rectus will ADDuct the L eye.
What is a lesion of the CN VI called? List the symptoms/presentation of the eye LATERAL RECTUS PALSY: 1.Internal Strabismus on ipsilateral side (loss of tone to LR). 2.No Ipsilateral abduction w/ NORMAL contralateral adduction. 3.Diplopia on forward gaze, worsens w/ ipsilateral horizontal gaze (classic sign).
Describe symptoms/presentation of a patient with Foville's syndrome? 1.Lateral GAZE Palsy. 2.Facial Palsy on ipsilateral side. **results from CN VI nucleus damage in the brainstem.
Describe the mechanism behind Lateral GAZE Palsy Lesion on CN VI nuclei in brainstem causing: 1.No ipsilateral ABduction. 2.No contralateral ADduction. 3.Diplopia is not necessarily present. **Do still have horizontal gaze towards the side that doesn't have the lesion.
What is it called when a lesion developes B/w CN III and CN VI? What disease is this frequently seen in? Internuclear Opthalmopelegia: 1.Failure to ADduct contralateral eye. 2.Diplopia worsens w/ attempted lateral gaze. **Seen in MS
Why does Internuclear Opthalmopelegia frequently present with MS? It is a heavily myelinated tract which are usually targets of MS when they are located around the ventricles. **Corpus Callosum as well.
Will a patient's eyes drop or remain neutral if they have Internuclear Opthalmopelegia? Remain NEUTRAL. **They still have tone in all muscles.
Created by: WeeG
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