Podcast
Questions and Answers
What is the primary consequence of damage to the pre-ganglionic sympathetic neurons originating from T1-L2?
What is the primary consequence of damage to the pre-ganglionic sympathetic neurons originating from T1-L2?
- Locked-in syndrome
- Loss of motor function in the lower limbs
- Central Horner syndrome (correct)
- Contralateral loss of visual acuity
Which of the following deficits is associated with damage to the medial lemniscus in medial pontine syndrome?
Which of the following deficits is associated with damage to the medial lemniscus in medial pontine syndrome?
- Contralateral loss of pain sensation
- Contralateral hemiparesis
- Paralysis of the facial muscles
- Loss of position sense and vibratory sense (correct)
In which condition is the patient likely to maintain only eye and eyelid movement due to bilateral pons lesion?
In which condition is the patient likely to maintain only eye and eyelid movement due to bilateral pons lesion?
- Medial pontine syndrome
- Hemorrhagic stroke
- Central Horner syndrome
- Locked-in syndrome (correct)
What is a characteristic symptom of damage to the abducens nucleus in the context of medial pontine syndrome?
What is a characteristic symptom of damage to the abducens nucleus in the context of medial pontine syndrome?
Which blood vessel is primarily involved in the pathophysiology of locked-in syndrome?
Which blood vessel is primarily involved in the pathophysiology of locked-in syndrome?
What is the result of a lesion in the spinal trigeminal tract?
What is the result of a lesion in the spinal trigeminal tract?
Which of the following best describes the effects of a lesion in the trigeminal lemniscus?
Which of the following best describes the effects of a lesion in the trigeminal lemniscus?
Which cranial nerves are commonly affected in trigeminal neuralgia?
Which cranial nerves are commonly affected in trigeminal neuralgia?
What sensory function is primarily affected by a lesion in the ventral trigeminal tract?
What sensory function is primarily affected by a lesion in the ventral trigeminal tract?
What is a common cause of trigeminal neuralgia?
What is a common cause of trigeminal neuralgia?
What characterizes hypogeusia associated with a VPM lesion?
What characterizes hypogeusia associated with a VPM lesion?
Severing the ipsilateral spinal trigeminal tract is a treatment option for which condition?
Severing the ipsilateral spinal trigeminal tract is a treatment option for which condition?
Which of the following is NOT a symptom of trigeminal neuralgia?
Which of the following is NOT a symptom of trigeminal neuralgia?
What is the clinical presentation associated with damage to the corticospinal tract?
What is the clinical presentation associated with damage to the corticospinal tract?
Which deficit occurs as a result of damage to the medial lemniscus?
Which deficit occurs as a result of damage to the medial lemniscus?
What symptom is associated with damage to the hypoglossal nerve?
What symptom is associated with damage to the hypoglossal nerve?
Which physical sign is associated with Lateral Medullary Syndrome (Wallenburg syndrome)?
Which physical sign is associated with Lateral Medullary Syndrome (Wallenburg syndrome)?
Which deficit is associated with damage to the spinothalamic tract?
Which deficit is associated with damage to the spinothalamic tract?
What happens as a result of damage to the nucleus ambiguus?
What happens as a result of damage to the nucleus ambiguus?
Which condition is characterized by nausea, vomiting, and vertigo due to damage in the lateral medulla?
Which condition is characterized by nausea, vomiting, and vertigo due to damage in the lateral medulla?
Which nerve-related deficit can occur due to damage in Wallenburg syndrome involving the spinal trigeminal nucleus?
Which nerve-related deficit can occur due to damage in Wallenburg syndrome involving the spinal trigeminal nucleus?
What is the primary blood supply to the brainstem?
What is the primary blood supply to the brainstem?
Which condition is characterized by unilateral effects due to a lesion that does not reach the PPRF?
Which condition is characterized by unilateral effects due to a lesion that does not reach the PPRF?
When a patient has UMN signs on the right side, where is the likely lesion located?
When a patient has UMN signs on the right side, where is the likely lesion located?
Which artery is associated with medial medullary syndrome?
Which artery is associated with medial medullary syndrome?
What distinguishes trigeminal motor nucleus lesions from corticobulbar lesions?
What distinguishes trigeminal motor nucleus lesions from corticobulbar lesions?
Which area is not supplied by the anterior circulation?
Which area is not supplied by the anterior circulation?
Which of the following findings is commonly associated with left frontal eye field lesions?
Which of the following findings is commonly associated with left frontal eye field lesions?
What is the primary blood supply of the anterior circulation to the brain?
What is the primary blood supply of the anterior circulation to the brain?
What is the pattern in which the dermatomes of the spinal trigeminal tract spread out from the mouth?
What is the pattern in which the dermatomes of the spinal trigeminal tract spread out from the mouth?
Which fibers terminate closer to the obex in the spinal trigeminal tract?
Which fibers terminate closer to the obex in the spinal trigeminal tract?
What type of reflex does the jaw jerk reflex represent?
What type of reflex does the jaw jerk reflex represent?
Which nerve serves as the afferent limb for the corneal reflex?
Which nerve serves as the afferent limb for the corneal reflex?
Which muscle is primarily involved in the efferent limb of the corneal reflex?
Which muscle is primarily involved in the efferent limb of the corneal reflex?
What effect can upper motor neuron damage have on the jaw jerk reflex?
What effect can upper motor neuron damage have on the jaw jerk reflex?
Which of the following could indicate an issue with the trigeminal motor nucleus?
Which of the following could indicate an issue with the trigeminal motor nucleus?
Which component of the trigeminal reflex is responsible for fast bilateral blinking?
Which component of the trigeminal reflex is responsible for fast bilateral blinking?
Which type of posturing is characterized by flexion of the arms, wrists, and fingers due to a lesion above the midbrain?
Which type of posturing is characterized by flexion of the arms, wrists, and fingers due to a lesion above the midbrain?
What describes apnea in terms of breathing patterns?
What describes apnea in terms of breathing patterns?
Which breathing pattern is associated with lesions in the midbrain and is typified by periods of rapid breathing?
Which breathing pattern is associated with lesions in the midbrain and is typified by periods of rapid breathing?
What condition results from the severe lack of developmental parts of the forebrain?
What condition results from the severe lack of developmental parts of the forebrain?
Which breathing pattern involves irregular spacing and depth, typically resulting from lesions in the caudal pons or rostral medulla?
Which breathing pattern involves irregular spacing and depth, typically resulting from lesions in the caudal pons or rostral medulla?
What characterizes the vegetative state?
What characterizes the vegetative state?
Which event would likely lead to decerebrate posturing?
Which event would likely lead to decerebrate posturing?
Which condition can occur despite the presence of severe brainstem activity?
Which condition can occur despite the presence of severe brainstem activity?
What is the primary function of impedance pneumography in the context of comatose patients?
What is the primary function of impedance pneumography in the context of comatose patients?
Which of the following breathing patterns is characterized by prolonged inspiration?
Which of the following breathing patterns is characterized by prolonged inspiration?
What is a significant indication of the presence of the brainstem function despite loss of forebrain activity?
What is a significant indication of the presence of the brainstem function despite loss of forebrain activity?
What is a notable characteristic of Cheyne-Stokes breathing?
What is a notable characteristic of Cheyne-Stokes breathing?
Which of the following best describes the relationship between brain death and cellular activity?
Which of the following best describes the relationship between brain death and cellular activity?
Which breathing pattern indicates lesions specifically affecting the mid-pons?
Which breathing pattern indicates lesions specifically affecting the mid-pons?
What is a likely consequence of a lesion in the mesencephalic nucleus of the trigeminal nerve?
What is a likely consequence of a lesion in the mesencephalic nucleus of the trigeminal nerve?
Which lesion would most likely result in ipsilateral loss of fine touch sensation in the face?
Which lesion would most likely result in ipsilateral loss of fine touch sensation in the face?
What are the key signs associated with Paratrigeminal (Raeder) Syndrome?
What are the key signs associated with Paratrigeminal (Raeder) Syndrome?
What occurs as a result of a lesion in the spinal trigeminal nucleus?
What occurs as a result of a lesion in the spinal trigeminal nucleus?
Which type of sensory fibers does the trigeminal tract primarily consist of?
Which type of sensory fibers does the trigeminal tract primarily consist of?
Which type of sensation is primarily conveyed by the spinal trigeminal nucleus?
Which type of sensation is primarily conveyed by the spinal trigeminal nucleus?
Where are the primary afferent cell bodies of the mesencephalic trigeminal nucleus located?
Where are the primary afferent cell bodies of the mesencephalic trigeminal nucleus located?
Which of the following statements correctly describes the primary trigeminal sensory nucleus?
Which of the following statements correctly describes the primary trigeminal sensory nucleus?
What is a significant feature of the cerebellar connection from the mesencephalic trigeminal nucleus?
What is a significant feature of the cerebellar connection from the mesencephalic trigeminal nucleus?
What role do secondary (2°) afferent cell bodies play within the trigeminal sensory nuclei?
What role do secondary (2°) afferent cell bodies play within the trigeminal sensory nuclei?
What is the main sensory deficit resulting from damage to the spinothalamic tract?
What is the main sensory deficit resulting from damage to the spinothalamic tract?
Which symptoms are associated with damage to the nucleus ambiguus?
Which symptoms are associated with damage to the nucleus ambiguus?
What neurological condition is characterized by nausea, vomiting, and vertigo due to damage in the lateral medulla?
What neurological condition is characterized by nausea, vomiting, and vertigo due to damage in the lateral medulla?
Which deficit would be expected from disrupting the inferior cerebellar peduncle in Wallenburg syndrome?
Which deficit would be expected from disrupting the inferior cerebellar peduncle in Wallenburg syndrome?
What is a likely consequence of damage to the hypoglossal nerve?
What is a likely consequence of damage to the hypoglossal nerve?
Which cranial nerve is most closely associated with the ipsilateral loss of pain and temperature sensation on the face?
Which cranial nerve is most closely associated with the ipsilateral loss of pain and temperature sensation on the face?
What is the clinical significance of the descending hypothalamospinal tract regarding Horner syndrome?
What is the clinical significance of the descending hypothalamospinal tract regarding Horner syndrome?
Which functional impairment arises due to damage to the vestibular nuclei?
Which functional impairment arises due to damage to the vestibular nuclei?
What syndrome is associated with damage from the anterior spinal artery that affects the medulla?
What syndrome is associated with damage from the anterior spinal artery that affects the medulla?
Which vascular system primarily supplies the brainstem?
Which vascular system primarily supplies the brainstem?
What clinical sign indicates a lesion in the left frontal eye field?
What clinical sign indicates a lesion in the left frontal eye field?
What condition is characterized by a unilateral effect due to a lesion that does not reach the PPRF?
What condition is characterized by a unilateral effect due to a lesion that does not reach the PPRF?
Which statement correctly describes the jaw jerk reflex?
Which statement correctly describes the jaw jerk reflex?
What is a notable functional characteristic of lesions affecting the corticospinal tract?
What is a notable functional characteristic of lesions affecting the corticospinal tract?
In terms of blood supply, which of the following regions is clearly associated with anterior circulation?
In terms of blood supply, which of the following regions is clearly associated with anterior circulation?
Which cranial nerve involvement could indicate degeneration in the trigeminal motor nucleus?
Which cranial nerve involvement could indicate degeneration in the trigeminal motor nucleus?
Which statement correctly describes the anatomy of the spinal trigeminal tract?
Which statement correctly describes the anatomy of the spinal trigeminal tract?
Which of the following best characterizes the jaw jerk reflex?
Which of the following best characterizes the jaw jerk reflex?
What effect does upper motor neuron damage typically have on the jaw jerk reflex?
What effect does upper motor neuron damage typically have on the jaw jerk reflex?
In the context of trigeminal reflexes, what does the efferent limb primarily involve?
In the context of trigeminal reflexes, what does the efferent limb primarily involve?
What is the nature of the corneal (blink) reflex, and how does it function?
What is the nature of the corneal (blink) reflex, and how does it function?
How do upper motor neuron lesions typically affect the jaw jerk reflex?
How do upper motor neuron lesions typically affect the jaw jerk reflex?
Which feature distinguishes the jaw jerk reflex from other reflexes?
Which feature distinguishes the jaw jerk reflex from other reflexes?
What is the defining characteristic of decerebrate posturing?
What is the defining characteristic of decerebrate posturing?
Which type of breathing pattern is commonly associated with lesions in the midbrain?
Which type of breathing pattern is commonly associated with lesions in the midbrain?
What is a common feature of apneustic breathing?
What is a common feature of apneustic breathing?
What is usually the outcome for infants born with anencephaly?
What is usually the outcome for infants born with anencephaly?
Which respiratory pattern results from lesions in the rostral pons?
Which respiratory pattern results from lesions in the rostral pons?
In the context of brainstem function, what does a vegetative state indicate?
In the context of brainstem function, what does a vegetative state indicate?
Which physiological process is estimated by impedance pneumography in comatose patients?
Which physiological process is estimated by impedance pneumography in comatose patients?
What is typically observed in a patient experiencing Cheyne-Stokes breathing?
What is typically observed in a patient experiencing Cheyne-Stokes breathing?
What characterizes ataxic breathing?
What characterizes ataxic breathing?
Which of the following statements is true regarding medical death?
Which of the following statements is true regarding medical death?
What defines hyperpnea in respiratory patterns?
What defines hyperpnea in respiratory patterns?
What does opisthotonos indicate in terms of physical response?
What does opisthotonos indicate in terms of physical response?
What might signify that brainstem function is intact despite loss of higher brain function?
What might signify that brainstem function is intact despite loss of higher brain function?
What does the term 'cluster breathing' refer to in respiration patterns?
What does the term 'cluster breathing' refer to in respiration patterns?
What neurological condition allows for basic movement and reflexes despite severe brain structure failure?
What neurological condition allows for basic movement and reflexes despite severe brain structure failure?
Which sensory function is primarily handled by the spinal trigeminal nucleus?
Which sensory function is primarily handled by the spinal trigeminal nucleus?
What is the primary type of neuron found in the mesencephalic trigeminal nucleus?
What is the primary type of neuron found in the mesencephalic trigeminal nucleus?
Which one of the following best describes the role of the chief trigeminal sensory nucleus?
Which one of the following best describes the role of the chief trigeminal sensory nucleus?
What characteristic distinguishes the mesencephalic trigeminal nucleus from other sensory nuclei?
What characteristic distinguishes the mesencephalic trigeminal nucleus from other sensory nuclei?
In which part of the brainstem are 2° afferent cell bodies found for pain and temperature sensation?
In which part of the brainstem are 2° afferent cell bodies found for pain and temperature sensation?
What are the consequences of a lesion in the mesencephalic nucleus related to jaw muscle function?
What are the consequences of a lesion in the mesencephalic nucleus related to jaw muscle function?
Which statement accurately describes the effect of a lesion in the chief trigeminal nucleus?
Which statement accurately describes the effect of a lesion in the chief trigeminal nucleus?
What does a lesion in the spinal trigeminal nucleus primarily affect?
What does a lesion in the spinal trigeminal nucleus primarily affect?
Which symptom would likely arise from a lesion in the area around the trigeminal ganglion?
Which symptom would likely arise from a lesion in the area around the trigeminal ganglion?
Which reflex is impaired due to lesions affecting proprioception in the jaw muscle?
Which reflex is impaired due to lesions affecting proprioception in the jaw muscle?
What would be a likely consequence of damage to the pre-ganglionic sympathetic neurons originating from the lateral horn of the spinal cord?
What would be a likely consequence of damage to the pre-ganglionic sympathetic neurons originating from the lateral horn of the spinal cord?
Which symptom is most likely associated with damage to the abducens nucleus in the medial pontine syndrome?
Which symptom is most likely associated with damage to the abducens nucleus in the medial pontine syndrome?
What explains the characteristic muscle paralysis in locked-in syndrome?
What explains the characteristic muscle paralysis in locked-in syndrome?
In the context of medial pontine syndrome, what deficits would one expect from damage to the corticospinal tract?
In the context of medial pontine syndrome, what deficits would one expect from damage to the corticospinal tract?
Which outcome is associated with the occlusion of the basilar artery leading to locked-in syndrome?
Which outcome is associated with the occlusion of the basilar artery leading to locked-in syndrome?
What describes the pattern in which dermatomes of the spinal trigeminal tract spread out from the mouth?
What describes the pattern in which dermatomes of the spinal trigeminal tract spread out from the mouth?
Which of the following reflects the nature of the jaw jerk reflex?
Which of the following reflects the nature of the jaw jerk reflex?
Which nerve is responsible for the afferent limb of the corneal reflex?
Which nerve is responsible for the afferent limb of the corneal reflex?
How does upper motor neuron damage to the corticobulbar tract affect the jaw jerk reflex?
How does upper motor neuron damage to the corticobulbar tract affect the jaw jerk reflex?
Which of the following components is responsible for producing fast bilateral blinking in the trigeminal reflex?
Which of the following components is responsible for producing fast bilateral blinking in the trigeminal reflex?
What is the primary path for the mouth fibers in terms of their termination in the spinal trigeminal tract?
What is the primary path for the mouth fibers in terms of their termination in the spinal trigeminal tract?
What tests the integrity of the Trigeminal Motor Nucleus and the Trigeminal Mesencephalic Nucleus?
What tests the integrity of the Trigeminal Motor Nucleus and the Trigeminal Mesencephalic Nucleus?
What is the role of the afferent limb in the corneal reflex?
What is the role of the afferent limb in the corneal reflex?
How does medial medullary syndrome primarily affect the body?
How does medial medullary syndrome primarily affect the body?
What aspect differentiates trigeminal motor nucleus lesions from corticobulbar lesions?
What aspect differentiates trigeminal motor nucleus lesions from corticobulbar lesions?
Under what condition is alternating hemiplegia observed?
Under what condition is alternating hemiplegia observed?
What is the primary source of blood supply to the brainstem?
What is the primary source of blood supply to the brainstem?
What does the presence of upper motor neuron signs on the left side indicate?
What does the presence of upper motor neuron signs on the left side indicate?
What type of brain lesion is indicated if a patient displays a unilateral effect without PPRF involvement?
What type of brain lesion is indicated if a patient displays a unilateral effect without PPRF involvement?
Which area of the brain receives its blood supply from the internal carotid arteries?
Which area of the brain receives its blood supply from the internal carotid arteries?
What is a defining feature of the vertebrobasilar system in relation to brainstem circulation?
What is a defining feature of the vertebrobasilar system in relation to brainstem circulation?
Which condition is associated with the retention of primitive reflexes while lacking development of the forebrain?
Which condition is associated with the retention of primitive reflexes while lacking development of the forebrain?
What breathing pattern is characterized by irregular spacing and depth and is typically associated with the caudal pons or rostral medulla?
What breathing pattern is characterized by irregular spacing and depth and is typically associated with the caudal pons or rostral medulla?
Which condition results from a complete lack of breathing and heartbeat despite the presence of other bodily functions?
Which condition results from a complete lack of breathing and heartbeat despite the presence of other bodily functions?
What describes prolonged inspiration followed by a pause in breathing?
What describes prolonged inspiration followed by a pause in breathing?
Which posturing is defined by extension of the limbs and indicates a lesion located between the red nucleus and vestibular nuclei?
Which posturing is defined by extension of the limbs and indicates a lesion located between the red nucleus and vestibular nuclei?
What is the unique hallmark of Cheyne-Stokes breathing?
What is the unique hallmark of Cheyne-Stokes breathing?
What effect does damage to the medial pontine area have on respiratory patterns?
What effect does damage to the medial pontine area have on respiratory patterns?
In the context of brain death, what does the presence of brainstem reflexes indicate?
In the context of brain death, what does the presence of brainstem reflexes indicate?
What is the primary function of impedance pneumography in the assessment of comatose patients?
What is the primary function of impedance pneumography in the assessment of comatose patients?
Which of the following breathing patterns suggests damage to the rostral pons?
Which of the following breathing patterns suggests damage to the rostral pons?
What characterizes decorticate posturing, and where is it typically located?
What characterizes decorticate posturing, and where is it typically located?
Which state refers to a condition where patients exhibit wakefulness without awareness due to loss of forebrain functioning?
Which state refers to a condition where patients exhibit wakefulness without awareness due to loss of forebrain functioning?
What distinguishes apneustic breathing from other abnormal respiration patterns?
What distinguishes apneustic breathing from other abnormal respiration patterns?
What is a common outcome for children born with anencephaly?
What is a common outcome for children born with anencephaly?
Flashcards
Trigeminal 2nd Order Sensory Neurons (Fine Touch)
Trigeminal 2nd Order Sensory Neurons (Fine Touch)
The second-order sensory neurons of the trigeminal nerve, carrying fine touch information, ascend ipsilaterally in the trigeminal lemniscus to the VPM nucleus of the thalamus.
Trigeminal 2nd Order Sensory Neurons (Pain/Temperature)
Trigeminal 2nd Order Sensory Neurons (Pain/Temperature)
The second-order sensory neurons of the trigeminal nerve, carrying pain and temperature information, ascend contralaterally in the ventral trigeminal tract to the VPM nucleus of the thalamus.
Spinal Trigeminal Tract Lesion
Spinal Trigeminal Tract Lesion
A lesion of the spinal trigeminal tract results in an ipsilateral loss of pain and temperature sensation in the face.
Trigeminal Lemniscus Lesion
Trigeminal Lemniscus Lesion
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VPM Nucleus Lesion
VPM Nucleus Lesion
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Trigeminal Neuralgia (Tic Douloureux)
Trigeminal Neuralgia (Tic Douloureux)
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Causes of Trigeminal Neuralgia
Causes of Trigeminal Neuralgia
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Treatment for Trigeminal Neuralgia
Treatment for Trigeminal Neuralgia
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Pathological Reflex
Pathological Reflex
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Alternating Hemiplegia
Alternating Hemiplegia
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Frontal Eye Field (FEF)
Frontal Eye Field (FEF)
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Primary Motor Cortex
Primary Motor Cortex
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Abducens Nucleus
Abducens Nucleus
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Corticospinal Tracts
Corticospinal Tracts
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Posterior Circulation of the Brain
Posterior Circulation of the Brain
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Contralateral Hemiparesis
Contralateral Hemiparesis
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Contralateral Loss of Position Sense, Vibratory Sense, and Discriminative Touch
Contralateral Loss of Position Sense, Vibratory Sense, and Discriminative Touch
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Hypoglossal Nerve Damage
Hypoglossal Nerve Damage
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Contralateral Loss of Pain and Temperature Sense
Contralateral Loss of Pain and Temperature Sense
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Ipsilateral Loss of Pain and Temperature Sense on the Face
Ipsilateral Loss of Pain and Temperature Sense on the Face
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Dysphagia, Palate Paralysis, Hoarse Voice, Diminished Gag Reflex
Dysphagia, Palate Paralysis, Hoarse Voice, Diminished Gag Reflex
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Ipsilateral Horner Syndrome
Ipsilateral Horner Syndrome
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Nausea, Vomiting, Nystagmus, and Vertigo
Nausea, Vomiting, Nystagmus, and Vertigo
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Organization of Spinal Trigeminal Tract
Organization of Spinal Trigeminal Tract
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Corneal Blink Reflex
Corneal Blink Reflex
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Physiology of Corneal Blink Reflex
Physiology of Corneal Blink Reflex
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Jaw Jerk Reflex
Jaw Jerk Reflex
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Properties of Jaw Jerk Reflex in Health and Disease
Properties of Jaw Jerk Reflex in Health and Disease
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Bilateral nature of Corneal Blink Reflex
Bilateral nature of Corneal Blink Reflex
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Speed of Corneal Blink Reflex
Speed of Corneal Blink Reflex
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Sympathetic Pathway to the Head
Sympathetic Pathway to the Head
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Central Horner Syndrome
Central Horner Syndrome
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Medial Pontine Syndrome
Medial Pontine Syndrome
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Locked-in Syndrome
Locked-in Syndrome
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Basilar Artery Occlusion
Basilar Artery Occlusion
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Decorticate posturing
Decorticate posturing
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Decerebrate posturing
Decerebrate posturing
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Impedance Pneumography (IP)
Impedance Pneumography (IP)
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Hyperpnea
Hyperpnea
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Apnea
Apnea
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Central Neurogenic Hyperventilation
Central Neurogenic Hyperventilation
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Apneustic Breathing
Apneustic Breathing
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Cluster Breathing
Cluster Breathing
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Ataxic Breathing
Ataxic Breathing
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Anencephaly
Anencephaly
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Vegetative State
Vegetative State
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Brainstem
Brainstem
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Brain Death
Brain Death
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Medical Death
Medical Death
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Cardiac Arrest
Cardiac Arrest
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Spinal Trigeminal Tract
Spinal Trigeminal Tract
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Spinal Trigeminal Nucleus/Tract Lesion
Spinal Trigeminal Nucleus/Tract Lesion
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Mesencephalic Nucleus Lesion
Mesencephalic Nucleus Lesion
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Chief Trigeminal Nucleus Lesion
Chief Trigeminal Nucleus Lesion
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Paratrigeminal (Raeder) Syndrome
Paratrigeminal (Raeder) Syndrome
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Blinking Reflex
Blinking Reflex
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Jaw Jerk Reflex in Health and Disease
Jaw Jerk Reflex in Health and Disease
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What is the function of the Mesencephalic trigeminal nucleus?
What is the function of the Mesencephalic trigeminal nucleus?
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What does the Spinal trigeminal nucleus transmit and where do its neurons send their axons?
What does the Spinal trigeminal nucleus transmit and where do its neurons send their axons?
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What type of sensory information is relayed through the Chief/Primary trigeminal sensory nucleus?
What type of sensory information is relayed through the Chief/Primary trigeminal sensory nucleus?
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What happens if the spinal trigeminal tract is damaged?
What happens if the spinal trigeminal tract is damaged?
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What happens if the trigeminal lemniscus is damaged?
What happens if the trigeminal lemniscus is damaged?
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Lateral Medullary Syndrome (Wallenburg Syndrome)
Lateral Medullary Syndrome (Wallenburg Syndrome)
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What is a pathological reflex?
What is a pathological reflex?
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What is alternating hemiplegia?
What is alternating hemiplegia?
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What is medial medullary syndrome (Dejerine syndrome)?
What is medial medullary syndrome (Dejerine syndrome)?
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What is the primary blood supply to the brainstem?
What is the primary blood supply to the brainstem?
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What is the frontal eye field (FEF)?
What is the frontal eye field (FEF)?
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What does the primary motor cortex control?
What does the primary motor cortex control?
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What does the abducens nucleus control?
What does the abducens nucleus control?
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What are the corticospinal tracts?
What are the corticospinal tracts?
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What is the Spinal Trigeminal Tract?
What is the Spinal Trigeminal Tract?
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What Happens with Spinal Trigeminal Tract Damage?
What Happens with Spinal Trigeminal Tract Damage?
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What is the Jaw Jerk Reflex?
What is the Jaw Jerk Reflex?
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What is the Jaw Jerk Reflex Like in Health and Disease?
What is the Jaw Jerk Reflex Like in Health and Disease?
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What is the Corneal Blink Reflex?
What is the Corneal Blink Reflex?
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What are the Properties of the Corneal Blink Reflex?
What are the Properties of the Corneal Blink Reflex?
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What Happens if the Mesencephalic Trigeminal Nucleus is Damaged?
What Happens if the Mesencephalic Trigeminal Nucleus is Damaged?
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What is Paratrigeminal Syndrome?
What is Paratrigeminal Syndrome?
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What does the medial lemniscus carry?
What does the medial lemniscus carry?
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What does the spinal trigeminal tract carry?
What does the spinal trigeminal tract carry?
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What happens when the corticospinal tract is damaged?
What happens when the corticospinal tract is damaged?
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Lateral Medullary Syndrome (Wallenburg Syndrome) - What are the major symptoms?
Lateral Medullary Syndrome (Wallenburg Syndrome) - What are the major symptoms?
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Study Notes
Brainstem Motor 3
- Topic: Common syndromes and some sensory nuclei
- Course: DO-SYS-725 Med Neuro II Lecture 8
- Instructor: Tony Harper, Ph.D
- Date: Thursday Jan 23
- Time: 11am
Learning Objectives
- Explain the functions of the trigeminal nerve's sensory nuclei and identify neuron cell body locations for sensory fiber tracts within the brainstem.
- Recognize and describe the distribution of vertebrobasilar arterial branches to different regions of the brainstem.
- Diagnose common syndromes involving the pons and medulla, given a history and symptoms.
- Predict the level of a lesion causing gaze/cranial nerve disorders with alternating hemiplegia.
- Diagnose the level of a brainstem lesion in a comatose patient based on body posturing and breathing patterns.
Trigeminal Sensory Nuclei
- Mesencephalic trigeminal nucleus: involved in proprioception of mastication muscles; neuron cell bodies are located directly within the nucleus (not the trigeminal ganglion). It sends fibers to cerebellum through superior cerebellar peduncle.
- Chief/Primary trigeminal sensory nucleus: relays fine touch, pressure; contains secondary afferent neuron bodies.
- Spinal trigeminal nucleus: conveys crude touch, pain, and temperature; contains secondary afferent neuron bodies.
- Principle (pontine) sensory nucleus: relays fine touch and pressure; contains secondary afferent neuron bodies.
Trigeminal 1st Order Sensory Neurons
- Trigeminal/Gasserian ganglion: contains first-order neurons for sensory input from head and face.
- Trigeminal nerve: carries sensory and proprioceptive information from face.
- First-order neurons travel to spinal trigeminal tract to synapse for relay.
- Lesions at different locations cause specific sensory deficits.
Trigeminal 2nd Order Sensory Neurons
- Fine touch: 2nd-order neurons ascend ipsilaterally in the dorsal trigeminal tract to the VPM thalamus.
- Pain and temperature: 2nd-order neurons ascend contralaterally in the ventral trigeminal tract to the VPM thalamus.
- Specific pathways and tracts for sensory information relay.
- Lesions affect specific sensory modalities in specific ways (e.g., contralateral vs ipsilateral loss).
Trigeminal Reflexes
- Jaw jerk reflex: Monosynaptic (muscle spindle) reflex involving the trigeminal motor nucleus.
- Corneal reflex: Bisynaptic reflex; involves direct and consensual blinking. Afferent limb involves ophthalmic nerve (V1) branch, and efferent limb involves facial motor nucleus.
Brainstem Vascular Supply
- Anterior circulation (internal carotid arteries)
- Posterior circulation (vertebral arteries, primary brainstem supply). This includes important branches like the paramedian penetrating arteries, which can cause lesions when occluded.
Specific Brainstem Syndromes
- Medial medullary syndrome: Contralateral hemiparesis, loss in position/vibration sense, deviation of tongue (hypoglossal nerve paralysis), and other motor deficits, potentially with bulbar palsy. Caused by anterior spinal artery occlusion.
- Lateral medullary syndrome (Wallenberg syndrome): Contralateral pain/temperature loss in the body, ipsilateral loss on the face, dysphagia, Horner syndrome, and ataxia. Often due to PICA occlusion.
- Medial pontine syndrome: Contralateral hemiparesis, loss in position/vibration sense, paralysis of conjugate (lateral) gaze. Usually caused by paramedian penetrating artery occlusion.
- Locked-in syndrome: Bilateral pons lesion affecting most motor fibers but spares eye muscles; leads to complete paralysis but preserves consciousness. Damage often affects corticospinal and corticobulbar tracts.
Posturing in Coma
- Decorticate: flexion of arms, wrists, and fingers; extension of lower limbs and plantar flexion.
- Decerebrate: extension of arms, wrists, and fingers; more severe extension of lower limbs and plantar flexion, and opisthotonos.
Breathing Patterns in Coma
- Hyperpnea: deeper breathing (not necessarily faster).
- Apnea: absence of airflow.
- Midbrain breathing, Cheyne-Stokes, and apneustic respiration: specific patterns of breathing associated with different brainstem levels in coma.
Anencephaly
- Severe neural tube defect, forebrain failure to develop.
- Brainstem and cerebellum sometimes present, with primitive reflexes, but without higher brain function.
- Prognosis very poor; death occurs very soon after birth.
Brainstem and Death
- Medical death does not equal cellular death (for all cells).
- Modern techniques allow survival and life support after cessation of independent respiration/heartbeat.
- Brainstem death (or vegetative state) is a diagnostic marker for cessation of brain life, distinct from clinical death. This is often legally significant. This is distinct from locked-in syndrome.
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Description
This quiz covers essential concepts related to the functions of sensory nuclei in the brainstem, particularly focusing on the trigeminal nerve. Students will explore common syndromes affecting the pons and medulla, and learn to diagnose brainstem lesions based on clinical presentations. Prepare to identify and understand the critical vascular supply regions in the brainstem.
