Clinical Neuroscience Week 3 - Brainstem; Cranial Nerves

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Questions and Answers

Which cranial nerve is responsible for eye movement and is associated with the midbrain?

  • CN III (Oculomotor nerve) (correct)
  • CN V (Trigeminal nerve)
  • CN I (Olfactory nerve)
  • CN VII (Facial nerve)

Which of the following structures is NOT directly involved in the production of dopamine?

  • Red nucleus
  • Substantia nigra
  • Locus coeruleus (correct)
  • Ventral tegmental area

What is the primary function of reticular formation in the brainstem?

  • Processing and relaying sensory information to the cortex
  • Maintenance of balance and coordination
  • Control of voluntary muscle movement
  • Regulation of sleep and wakefulness (correct)

Which of the following is NOT a hallmark characteristic of decorticate posturing?

<p>Wrists flexed and protruding laterally (C)</p> Signup and view all the answers

Which structure serves as a transition zone between the third and fourth ventricles?

<p>Cerebral aqueduct (D)</p> Signup and view all the answers

What is the primary function of the corticospinal tract?

<p>Controlling voluntary muscle movements (D)</p> Signup and view all the answers

Which of the following is NOT a feature of the pons?

<p>Serves as a transition zone between the third and fourth ventricles (A)</p> Signup and view all the answers

Which of the following structures is located caudal to the brainstem?

<p>Spinal cord (B)</p> Signup and view all the answers

Which of the following nuclei is associated with the production of serotonin?

<p>Raphe nuclei (A)</p> Signup and view all the answers

Which of the following posturing patterns is more likely to be associated with damage to the rostral aspect of the midbrain?

<p>Decerebrate posturing (A)</p> Signup and view all the answers

Which of the following helps identify the midbrain on an image?

<p>Aqueduct of Sylvius (C)</p> Signup and view all the answers

Which brainstem structure plays a crucial role in cerebellar function and the perception of sound?

<p>Olive nuclei (D)</p> Signup and view all the answers

Which of the following is TRUE about the reticular formation?

<p>It plays a vital role in regulating various bodily functions. (D)</p> Signup and view all the answers

Which of the following cranial nerves is NOT typically associated with the pons?

<p>CN IX (Glossopharyngeal nerve) (B)</p> Signup and view all the answers

What is the primary function of the decussation of vertical tracts in the brainstem?

<p>Crossing of neurological signals from one side of the brain to the contralateral side of the body (B)</p> Signup and view all the answers

Which of the following structures is located rostral to the midbrain?

<p>Diencephalon (A)</p> Signup and view all the answers

Which structure is NOT one of the three main components of the brainstem?

<p>Cerebellum (D)</p> Signup and view all the answers

What is the primary function of the reticular activating system?

<p>Influencing sleep and wakefulness (B)</p> Signup and view all the answers

Which blood supply source is most relevant for the brainstem?

<p>Basilar artery (A)</p> Signup and view all the answers

Which of the following best describes the age and function of the brainstem?

<p>An ancient part of the brain, functioning similarly to primitive species (D)</p> Signup and view all the answers

Which function is NOT typically associated with the brainstem?

<p>Integrating sensory input for conscious awareness (C)</p> Signup and view all the answers

What is the primary function of the cranial nerve I?

<p>To detect smell (A)</p> Signup and view all the answers

Which cranial nerve is responsible for visual acuity?

<p>Optic nerve (D)</p> Signup and view all the answers

Where are sensory tracts located in relation to motor and autonomic functions within the brainstem?

<p>Laterally (C)</p> Signup and view all the answers

What is the consequence of damage to the oculomotor nerve?

<p>Impaired eye movement (D)</p> Signup and view all the answers

Which artery primarily supplies blood to the pons?

<p>Basilar artery (D)</p> Signup and view all the answers

What condition is associated with major insult or damage to the brainstem?

<p>Coma (A)</p> Signup and view all the answers

In what situation would one exhibit contralateral deficits related to the optic nerve?

<p>Lesion in the lateral geniculate nucleus (C)</p> Signup and view all the answers

What type of information does the brainstem modulate?

<p>Nociceptive (pain) information (B)</p> Signup and view all the answers

Which cranial nerve is primarily responsible for controlling the superior rectus muscle?

<p>Oculomotor nerve (C)</p> Signup and view all the answers

If an individual loses smell early on, which condition might this indicate?

<p>Parkinson's disease (B)</p> Signup and view all the answers

What is indicated by bitemporal hemianopsia?

<p>Loss of vision in peripheral fields (D)</p> Signup and view all the answers

Which cranial nerve is not considered part of the lower motor neuron system?

<p>Olfactory nerve (D)</p> Signup and view all the answers

What could indicate a vascular issue impacting the brainstem?

<p>Sudden changes in consciousness (B)</p> Signup and view all the answers

Which structure contains primary nuclei essential for the function of the optic nerve?

<p>Lateral geniculate nucleus (B)</p> Signup and view all the answers

What reflex is triggered when the cornea is touched?

<p>Corneal reflex (A)</p> Signup and view all the answers

Which cranial nerve is responsible for facial expression?

<p>Facial nerve (A)</p> Signup and view all the answers

What happens when there is a lesion on the right side of the brain affecting facial muscles?

<p>Weakness only in the lower left facial muscles (B)</p> Signup and view all the answers

In Bell’s Palsy, which symptom is commonly observed?

<p>Drooping eyelid (A)</p> Signup and view all the answers

Which cranial nerve provides sensory information from the posterior ear?

<p>Facial nerve (A)</p> Signup and view all the answers

How is the Rinne test performed?

<p>Placing a tuning fork on the mastoid process (C)</p> Signup and view all the answers

Which cranial nerve is primarily associated with taste from the posterior 2/3 of the tongue?

<p>Glossopharyngeal nerve (B)</p> Signup and view all the answers

Which of the following functions is NOT associated with the facial nerve?

<p>Hearing (D)</p> Signup and view all the answers

What is the primary function of the vestibulocochlear nerve?

<p>Balance and hearing (C)</p> Signup and view all the answers

What sensory function does the glossopharyngeal nerve include?

<p>Taste from the posterior tongue (D)</p> Signup and view all the answers

Which structure is involved in the vestibular function of the vestibulocochlear nerve?

<p>Semicircular canals (B)</p> Signup and view all the answers

What occurs when the cochlear nerve is damaged?

<p>Sensorineural hearing loss (A)</p> Signup and view all the answers

What is the primary muscle impacted by cranial nerve 4 (trochlear)?

<p>Superior oblique (A)</p> Signup and view all the answers

Which cranial nerve is primarily involved in the gag reflex?

<p>Glossopharyngeal nerve (A)</p> Signup and view all the answers

Damage to the facial nerve will primarily result in deficits on which side?

<p>Ipsilateral side (D)</p> Signup and view all the answers

Which cranial nerve is responsible for the pupillary light reflex?

<p>Cranial Nerve 3 (C)</p> Signup and view all the answers

Upon damage to the oculomotor nerve, what type of deficit would be observed?

<p>Only ipsilateral deficits (D)</p> Signup and view all the answers

What is the main function of the abducens nerve (cranial nerve 6)?

<p>Innervates the lateral rectus muscle (B)</p> Signup and view all the answers

Which of the following techniques would be used to test the trochlear nerve?

<p>Convergence test (B)</p> Signup and view all the answers

Which cranial nerve has both motor and autonomic functions?

<p>Cranial Nerve 3 (A)</p> Signup and view all the answers

Cranial nerve 5 is primarily responsible for which actions?

<p>Facial sensation and mastication (C)</p> Signup and view all the answers

What happens to the eye affected by trochlear nerve palsy?

<p>It rests facing upwards (B)</p> Signup and view all the answers

Which type of functional classification is attributed to cranial nerve 6?

<p>Motor (C)</p> Signup and view all the answers

In the context of cranial nerves, what does an isolated trochlear nerve lesion most likely result in?

<p>Ipsilateral vertical misalignment (A)</p> Signup and view all the answers

What type of deficits would an injury to cranial nerve 5 typically present?

<p>Ipsilateral facial sensation loss (B)</p> Signup and view all the answers

Which cranial nerve is the only one that crosses the midline?

<p>Cranial Nerve 4 (D)</p> Signup and view all the answers

During an ocular examination, a patient presents with the eye resting in a medial position. Which cranial nerve may be affected?

<p>Cranial Nerve 6 (A)</p> Signup and view all the answers

What is the effect of shining light on one pupil regarding pupil constriction?

<p>Both pupils constrict (D)</p> Signup and view all the answers

What is the primary function of the vagus nerve regarding the gastrointestinal system?

<p>Dilation for digestion (A)</p> Signup and view all the answers

Which muscles are primarily impacted by the spinal accessory nerve?

<p>Trapezius and sternocleidomastoid (C)</p> Signup and view all the answers

What characteristic finding would suggest a lesion of the hypoglossal nerve?

<p>Deviation of the tongue towards the side of the lesion (A)</p> Signup and view all the answers

Which cranial nerve is primarily responsible for gag and swallowing reflexes?

<p>Cranial Nerve 9 (A)</p> Signup and view all the answers

In the case of a lesion affecting cranial nerves 9 and 10, which of the following findings would likely be observed?

<p>Relaxed muscle tone in the stimulated side of the tongue (D)</p> Signup and view all the answers

What is a hallmark sign of cranial nerve deficits due to vascular issues?

<p>Gait instability or walking challenges (C)</p> Signup and view all the answers

How is the sensory function of the vagus nerve characterized?

<p>Touch and proprioception from the pharynx and larynx (D)</p> Signup and view all the answers

What type of nerve fibers are present in the vagus nerve?

<p>Mixed (D)</p> Signup and view all the answers

What would damage to the medullary pyramids likely result in?

<p>Contralateral tongue weakness (B)</p> Signup and view all the answers

Which cranial nerve has a pathway that crosses over (decussates) in the medulla?

<p>Cranial Nerve 4 (A)</p> Signup and view all the answers

Which clinical condition is associated with lesions affecting cranial nerves due to blood flow issues?

<p>Wallenberg Syndrome (D)</p> Signup and view all the answers

What testing method is suggested for assessing the function of the spinal accessory nerve?

<p>Have the patient shrug shoulders against resistance (C)</p> Signup and view all the answers

What type of deficits might indicate a lesion just prior to the nuclei of a cranial nerve?

<p>Ipsilateral deficits only (A)</p> Signup and view all the answers

What results from damage to cranial nerve 6?

<p>Eye difficulties, particularly in lateral gaze (A)</p> Signup and view all the answers

Which cranial nerve(s) receive bilateral influence from the corticobulbar tracts, yet still demonstrate contralateral deficits?

<p>Cranial nerve 7 (B), Cranial nerve 12 (C)</p> Signup and view all the answers

Which of the following cranial nerve(s) is/are likely to show minimal functional deficits in the event of a unilateral brain injury?

<p>Cranial nerves 5, 9, 10, and 11 (D)</p> Signup and view all the answers

Which of the following is NOT considered a mixed nerve?

<p>Oculomotor (C)</p> Signup and view all the answers

Which statement accurately describes the relationship between the corticobulbar tracts and cranial nerve function?

<p>The corticobulbar tracts influence most cranial nerves bilaterally, with exceptions for cranial nerves 7 and 12. (A)</p> Signup and view all the answers

What is the primary consequence of a complete lesion to the trochlear nerve?

<p>Inability to turn the eye upward and inward. (C)</p> Signup and view all the answers

A patient presents with a right hemispheric stroke. With regard to cranial nerve function, which of the following is most likely to be observed?

<p>Left-sided weakness of the facial muscles. (D)</p> Signup and view all the answers

A patient presents with a deficit specifically on the lesion or nerve itself. What type of deficit would be expected?

<p>Ipsilateral deficit (C)</p> Signup and view all the answers

Which of the following cranial nerve(s) directly contribute to the safe swallowing of food or liquid?

<p>Cranial nerves 9, 10, and 12 (D)</p> Signup and view all the answers

Flashcards

Brainstem

The oldest part of the brain consisting of the midbrain, pons, and medulla.

Midbrain

The superior segment of the brainstem involved in vision, hearing, and motor control.

Pons

The middle part of the brainstem, regulating sleep and relaying messages between different parts of the brain.

Medulla

The lower part of the brainstem, essential for life functions like heart rate and breathing.

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Reticular Activating System

A network of neurons in the brainstem influencing wakefulness and sleep.

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Cranial Nerves

Nerves that emerge directly from the brain, crucial for sensory and motor functions in the head and neck.

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Cerebral Aqueduct

A canal in the midbrain that connects the third and fourth ventricles, allowing cerebrospinal fluid to flow.

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Decussation

The crossing over of nerve fibers from one side of the body to the opposite side in the brainstem.

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Substantia Nigra

A midbrain structure that produces dopamine, important for movement control.

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Red Nucleus

A structure in the midbrain believed to help coordinate motor control, especially walking.

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Decorticate Posturing

A flexed arm posture indicating damage to the brain, arms hugging the core.

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Decerebrate Posturing

An extended limb posture indicating severe brain damage, with arms and legs extended.

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Medulla Oblongata

The lowest part of the brainstem that controls vital autonomic functions like breathing and heart rate.

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Vertical Tracts

Neural pathways that connect the brain to the body, aiding in motor and sensory functions, often crossing sides.

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Reticular Formation

A network of neurons in the brainstem that influences levels of consciousness and bodily functions.

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Ascending Reticular Activating System

Part of the reticular formation responsible for maintaining consciousness and awareness of surroundings.

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Olive Nuclei

Nuclei located in the medulla, assisting in motor coordination and sound perception.

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Brainstem Functions

Governs alertness, sleep, and attention; integrates sensory info.

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Cranial Nerve Nuclei Location

Nuclei related to autonomic/motor function are medial; sensory are lateral.

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Blood Supply to Brainstem

Blood supplied by arteries like internal carotid, basilar, and vertebral arteries.

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Major Brainstem Insults

Damage can lead to disorders of consciousness such as coma or vegetative state.

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Cranial Nerve I – Olfactory

Located in the nasal cavity; responsible for smell detection.

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Cranial Nerve II – Optic

Transmits visual information from the retina to the brain.

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Bitemporal Hemianopsia

Loss of vision in both temporal visual fields due to optic chiasm issues.

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Cranial Nerve III – Oculomotor

Controls most eye movements and pupil constriction; arises from midbrain.

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Cranial Nerve IV – Trochlear

Controls superior oblique muscle for downward eye movement.

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Cranial Nerve VI – Abducens

Responsible for lateral eye movements (abduction).

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Cranial Nerve Lesions

Lesions can lead to ipsilateral or contralateral deficits, depending on location.

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Endorphin Release

CNS floods with endorphins during certain brainstem activities.

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Autonomic Nervous System

Controls involuntary body functions; activated by brainstem reflexes.

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Reflex Activities

Generated in the brainstem as quick, involuntary responses.

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Corticobulbar tracts

Pathways connecting the brain to cranial nerve nuclei, influencing facial and head muscles.

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Cranial nerves influenced

Cranial nerves 5, 7, 9, 10, 11, and 12 receive dual input from both brain hemispheres.

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Contralateral deficits

Loss of function on one side due to brain hemisphere issues, except for some cranial nerves.

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Bilateral influence

Cranial nerves 7 and 12 receive signals from both hemispheres but still show contralateral deficits.

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Parasympathetic nerves

Nerves carrying parasympathetic signals: oculomotor, glossopharyngeal, vagus, and facial.

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Extraocular eye movement nerves

Nerves controlling eye movement: oculomotor, trochlear, and abducens.

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Pure motor nerves

Nerves responsible solely for motor function: oculomotor, trochlear, abducens, accessory, hypoglossal.

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Trochlear nerve

The only cranial nerve that crosses within the brainstem; deficits lead to specific eye alignment issues.

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Vagus Nerve

Cranial nerve that provides somatosensory input and motor innervation to pharynx and larynx.

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Vagus Functions

Regulates heart rate, bronchoconstriction, and digestion.

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Cranial Nerve 9 & 10 Lesions

Lesions cause palatal droop, deviated uvula, and tongue muscle issues.

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Spinal Accessory Nerve

Cranial nerve that controls trapezius and sternocleidomastoid muscles.

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Trapezius Muscle

Muscle that elevates the shoulder; innervated by cranial nerve 11.

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SCM Function

Sternocleidomastoid muscle aids in head rotation and flexion.

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Hypoglossal Nerve

Cranial nerve controlling tongue movements for speech and swallowing.

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Tongue Lesion Response

Lesion causes tongue to deviate towards the side of the damage.

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Medullary Pyramids

Pathways where motor information crosses over; linked to cranial nerve function.

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Cranial Nerve Blood Flow

Blood circulation issues can cause cranial nerve deficits.

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Wallenberg Syndrome

A condition causing mixed sensory and motor loss due to medullary damage.

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Ipsilateral Deficit

A loss of function on the same side as the nerve injury.

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Contralateral Sensory Loss

Sensory loss occurs on the opposite side of the lesion.

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Clinical Nerve Lesion Commonality

Isolated cranial nerve lesions are rare; they often occur in clusters.

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Vagus Reflexes

Helps with gag reflex, swallowing, and gastric processes.

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Motor vs. Sensory

Cranial nerves have mixed functions but can be primarily motor or sensory.

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Trigeminal Nerve

The fifth cranial nerve responsible for facial sensation and motor functions.

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Corneal Reflex

A reflex to close the eyes when the cornea is touched, involving the trigeminal and facial nerves.

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Facial Nerve

The seventh cranial nerve controlling facial expressions and taste for the anterior tongue.

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Pontomedullary Junction

The area where the pons and medulla meet, housing critical cranial nerve nuclei.

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Bell's Palsy

A condition causing facial drooping due to facial nerve damage, affecting half the face.

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Vestibulocochlear Nerve

The eighth cranial nerve responsible for hearing and balance.

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Hearing Tests

Rinne and Weber tests assess different types of hearing loss.

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Glossopharyngeal Nerve

The ninth cranial nerve affecting taste, swallowing, and salivation.

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Ipsilateral Damage

Nerve damage resulting in effects on the same side of the body.

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Contralateral Effects

Nerve damage causing effects on the opposite side of the body.

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Motor Function

The ability to control muscle movements, often assessed in cranial nerve examinations.

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Sensory Information

Data received from sensory receptors regarding the environment.

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Taste Sensation

The perception of flavors, primarily affected by cranial nerves 7 and 9.

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Pharyngeal Muscle Control

The function of the glossopharyngeal nerve in affecting swallowing muscles.

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Oculomotor Nerve (CN 3)

Controls eye movements and autonomic pupil response; exits abdominal side of brainstem.

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Pupillary Light Reflex

Reflex that constricts pupil in response to bright light to protect the eye.

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Trochlear Nerve (CN 4)

Innervates superior oblique muscle; allows eye depression and abducts.

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Trochlear Nerve Palsy

Rare condition causing affected eye to rest upward; may result in double vision.

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Abducens Nerve (CN 6)

Involves lateral rectus muscle for horizontal eye movement, starts in pons.

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Motor Functions of CN 3, 4, 6

All three cranial nerves primarily serve motor functions for eye movement.

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Eye Movement Testing

Assess ocular ROM to check functionality of cranial nerves 3, 4, 6.

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Trigeminal Nerve (CN 5)

Mixed nerve responsible for facial sensation and muscles of mastication; arises from pons.

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Facial Sensation Testing

Light touch comparison across the three facial branches of the trigeminal nerve.

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Muscles of Mastication

Muscles controlled by trigeminal nerve; includes masseter and temporalis.

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Cranial Nerves Overview

Cranial nerves 3, 4, 6 for vision; CN 5 for facial sensation; mostly motor functions.

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Edinger-Westphal Nucleus

Nucleus in the midbrain involved in pupillary light reflex.

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Convergence Test

Assessment where eyes move together to focus on a single target; tests trochlear nerve.

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Study Notes

Brainstem

  • Comprises the midbrain, pons, and medulla oblongata
  • Critical for vital functions: cardiovascular, respiratory, sleep regulation, motor/sensory function.
  • Damage can lead to severe impairment or death.

Midbrain

  • Located superiorly to the pons
  • Connects third and fourth ventricles via the cerebral aqueduct.
  • Key structures: crus cerebri (corticospinal tract), basis pedunculi, tegmentum, tectum.
  • Involved in cranial nerve function (III & IV) and eye movement.
  • Cranial nerve III (oculomotor) controls most eye movements, including upward and medial movements, and elevation of the upper eyelid.
  • Cranial nerve IV (trochlear) innervates the superior oblique muscle, impacting downward and outward eye movement.
  • Red nucleus: facilitates motor coordination, especially walking.
  • Substantia nigra: produces dopamine, crucial for movement. Damage associated with Parkinson's Disease.
  • Axial midbrain section features the cerebral aqueduct, red nucleus, and substantia nigra.
  • Decorticate posturing (arms flexed, legs extended) and decerebrate posturing (all limbs extended, wrists flexed laterally) can occur with midbrain damage.

Pons

  • Located between midbrain and medulla.
  • Acts as a 'bridge'.
  • Relays information between cerebellum and other CNS structures.
  • Houses cranial nerve nuclei (V, VI, VII, VIII).

Medulla Oblongata

  • Situated between pons and spinal cord
  • Contains nuclei for cranial nerves IX, X, XI, XII.
  • Houses nuclei for cranial nerves V & VII.
  • Contains vertical tracts (decussation points for brain – body signaling).
  • Olive nuclei: aid in cerebellar function and sound perception.

Major Motor and Sensory Vertical Tracts

  • Brain signals (e.g., movement) from right side control left body.
  • Sensory information relays through tracts, crossing to the opposite side at the medulla.
  • Medulla acts as a relay point for brain-body communication.

Reticular Formation

  • A complex grouping of nuclei without precise boundaries.
  • Affects bodily functions and higher brain processes.
  • Includes Raphe nuclei (serotonin), Locus coeruleus (norepinephrine), and longitudinal fasciculus.
  • Regulates neuronal activity across the CNS.
  • Ascending reticular activating system: crucial for consciousness, alertness, sleep, attention. Dysfunction implicated in varying states of consciousness.
  • Functions include integrating sensory and cortical information, regulating somatic motor activity, autonomic function, consciousness, and reflex activity.

Blood Supply to the Brainstem

  • Internal carotid, posterior communicating, posterior cerebral, superior cerebellar, pontine, basilar, labyrinthine, anterior/posterior inferior cerebellar, anterior/posterior spinal arteries are key contributors.
  • Vascular issues frequently cause brainstem lesions.

Cranial Nerves

  • 12 paired nerves emerging from the brainstem.
  • Provide motor, sensory, or mixed functionalities.

Cranial Nerve I: Olfactory

  • Sensory nerve for smell.
  • Detects smell starting in the nasal cavity.
  • Doesn't travel through thalamus.
  • Tested by smelling different aromas.

Cranial Nerve II: Optic

  • Sensory nerve for vision.
  • Formed by retinal ganglion axons.
  • Travels through the optic chiasm and lateral geniculate nucleus (thalamus).
  • Ends in the visual cortex.
  • Ipsilateral deficits with optic nerve lesions; contralateral deficits with posterior optic pathway lesions.

Cranial Nerves III, IV, VI: Extraocular Motor

  • Control eye movements.
  • All three are motor nerves that control eye movement.
  • III: Oculomotor - most eye movements
  • IV: Trochlear - superior oblique muscle
  • VI: Abducens - lateral rectus muscle
  • Testing involves assessing range of motion of the eyes while also testing pupillary light response of cranial nerve 3.

Cranial Nerve V: Trigeminal

  • Mixed nerve: motor and sensory.
  • Sensory: ophthalmic, maxillary, mandibular branches.
  • Motor: muscles of mastication.
  • Tested by assessing light touch and the motor responses of chewing, chewing against resistance and palpation of the temporal and masseter muscles.
  • Corneal reflex: involves the trigeminal and facial nerves.

Cranial Nerve VII: Facial

  • Mixed nerve: motor and sensory.
  • Motor function: facial expressions,
  • Sensory: taste (anterior tongue), sensory information from the posterior ear.
  • Parasympathetic innervation: autonomic functions including lacrimal, nasal, and salivary glands and the sweat glands of the face.

Cranial Nerve VIII: Vestibulocochlear

  • Sensory nerve for hearing and balance.
  • Vestibular apparatus influences head movement detection, cochlea influences hearing.
  • Tested by different hearing and balance testing.

Cranial Nerves IX, X: Glossopharyngeal and Vagus

  • Mixed nerves.
  • Involved with swallowing, taste, and autonomic functions (e.g., heart rate, digestion). Testing includes gag reflex and assessment of swallowing.

Cranial Nerves XI, XII: Spinal Accessory and Hypoglossal

  • XI: Motor nerve for trapezius and sternocleidomastoid muscles. Testing includes activities like shrugging and rotating the neck against resistance.
  • XII: Motor nerve for tongue movements. Tested by observing tongue movement (e.g., sticking out the tongue).

Clinical Applications

  • Brainstem damage can lead to altered consciousness (e.g., coma, vegetative state, minimally conscious state).
  • Clinical conditions associated with brainstem damage: Decorticate or Decerebrate posturing; Wallenberg syndrome; Bell's palsy; stroke.*

Clinical Applications (Cranial Nerve Specific)

  • Wallenberg Syndrome : Damage to lateral medulla.
  • Bitemporal hemianopsia : Loss of vision in both temporal fields.
  • Trochlear nerve palsy: Affected eye rests upwards, double vision occurs.
  • Various cranial nerve lesions result in ipsilateral or contralateral deficit; however location/nature of injury will impact type of outcome.
  • Isolated nerve lesions are uncommon; vascular insults are more likely.
  • Stroke can cause contralateral weakness in the lower aspect of the face.

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