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Neuro3 Brainstem

Neuro3 Brainstem - Midbrain

QuestionAnswer
What structure is located just b/w the Thalamus and the midbrain? (medial to the medial Geniculate) Pretectal Region.
Swelling of what structure could compress the midbrain? Pineal Gland. **Also I am sure cerebellar and Cerebral Swelling would also affect the midbrain.
What is making up the bulk of the raustral pons? 1.Corticospinal fibers (anteriorly). 2.Corticonuclear fibers. **1&2 are called transverse pontine fibers.
What structure wraps around the Superior Cerebellar Peduncle? The Medial Lemnicus, ALS, Lateral Lemniscus ribbon
What two structures are located just inside the Superior Cerebellar Peduncle (in order from Anterior to Posterior) 1.Central Tegmental Tract (CTT). 2.MLF (just anterior to the 4th ventricle)
What type of fibers are contained within the Superior Cerebellar Peduncle? Cerebellothalamic fibers.
Where does the Superior Cerebellar Peduncle Decussate? Midbrain
Where does the Medial Geniculate body recieve fibers from? Inferior Calliculus (auditory)
What structure is located just anterior to the Cerebral Aquaduct in the midbrain? Occulomotor Nuc.
What is the Edinger-Westphal Nuc in control of? where is it located? PNS control over the ciliary body/muscle and the pupillary sphincter muscle. **It is the medial most portion of the occulomotor nucleus.
What is te black pigmented structure located just inside (posterior) to the Cerebral Peduncle? What does it produce? Substantia Niagra. **Produces Dopamine.
What structure is located just inside (posterior) to the Substantia Niagra? Red Nucleus.
What structure connects the two lobes of the thalamus posterior to the base of the 3rd ventricle? Posterior commisure.
Both III and IV enter the orbit via Superior Orbital Fissure, which does NOT pass through the Annulus? IV (innervates the SO muscle).
How will a patient present with Trochlear Palsy? Head will be tipped towards the Contralateral (unaffected) side, elevating the affected eye and lowering the unaffected due to: 1.Ipsilateral eye is extorted OUT & UP. 2.Diplopia on Forward gaze
List two Vascular compression Neuropathies and the structures involved 1.Occulomotor: CNIII compression b/w Posterior Cerebral A and Superior Cerebellar A (could present intermittently due to BP). 2.Trigeminal Neuralgia: CN V is compressed by Superior Cerebellar A (very painful)
How will Cavernous Sinus Syndrom from a Thrombosis present? ACUTE ONSET: 1.Opthalmopalgia. 2.Complete drooping of the eye (CN III palsy). 3.Numb, painful patch of forehead 4.Ptosis. 5.Dilated pupil **Slow Onset: tumor, Aneurysm. Subacute: Infection
What is the most common cause of Cavernous Sinus Syndrome? Neoplasm (slow onset).
How will the eye present with a complete CN III Palsy? Down, out, and Dilated. (only have LR and SO).
Decribe how the fiber radiations from both the Occulomotor Nuc and the edinger-westphal Nuc can cause different affects if damaged? 1.Occ Nuc: Radiations run more laterally. Lesion here will cause occulomotor palsy w/ normal pupillary light reflex. 2.EW Nuc: fibers run more medially. Medial lesion would only damage PNS controll (pupil will be dilated w/ normal muscle control).
Track the Pupillary Light Reflex 1.Retina. 2.Optic N. 3.Optic Tract. 4.Lateral Geniculate. 5.Pretectal Region. 6.Edinger-Westphal's Nuc. 7.CN III. 8.Pupillary Sphincter muscle.
What structure is damaged in Marcus-Gunn Pupil? When is it commonly seen? OPTIC NERVE (Effects wont be seen if in the optic tract). **commonly seen with MS b/c of the high amt os myelin in the optic nerve.
Describe the mechanism behind Marcus-Gunn Pupil? 1.Direct light stimulation: Normal constriction. 2.Indirect light stimulation: Normal constriction. 3.Quickly back to direct light stimulation: Abnormal dilation.
Describe the presentation of a person with a vascular lesion in the Paramedian territory PARAMEDIAN SYNDROME: 1.Oculomotor palsy (III Nuc damage). 2.Bilateral limb ataxia (cerebellarthalamic fiber damage). 3.Triad (Thalamus damaged): Memory loss, Dementia, Sleep disturbance. **Usually see 1&2 or just 3.
Describe the presentation of a person with a vascular lesion in the Short Circumferential territory WEBER SYNDROME: 1.Oculomotor palsy (III radiations damage). 2.Contralateral Spastic Paralysis/Weakness (CST damage in cerebral peduncle). 3.Substantia Niagra damage (no symptoms due to no movement). **also called Superior Alternating Hemiparesis.
What other two symptoms would you see with Weber Syndrome if they are not masked? 1.Limb Ataxia (damage to cerebellarthalamic fibers). 2.Limb Dyskinesia (paladiothalamic fibers from Globus Palatus).
Describe the presentation of a person with a vascular lesion in the Long Circumferential Territory BENEDICT Syndrome: 1.Ipsilateral Occulomotor palsy (III Nuc damage). 2.Contralateral Sensory loss (ML damage). 3.Limb Ataxia (damage to cerebellarthalamic fibers). 4.Limb Dyskinesia (paladiothalamic fibers from Globus Palatus).
How can you differentiate b/w Webers Syndrome and Benedict Syndrome since they BOTH present with Ipsilateral Occulomotor palsy, Limb dyskinesia, Limb ataxia? BENEDICTS: sensory loss. WEBERS: motor loss.
What is Parinaud Syndrome? How will the patient present? Pineal Cyst compresses down onto the tectal region and the posterior commisure. This will disrupt the control of vertical gaze. **Patient will have Upgaze Palsy (inability to look up).
Created by: WeeG
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