L8 Brain Stem Motor III
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Questions and Answers

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?

  • 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?

  • 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?

    <p>Paralysis of conjugate gaze toward the side of the lesion</p> Signup and view all the answers

    Which blood vessel is primarily involved in the pathophysiology of locked-in syndrome?

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

    What is the result of a lesion in the spinal trigeminal tract?

    <p>Ipsilateral loss of pain and temperature sensation in the face</p> Signup and view all the answers

    Which of the following best describes the effects of a lesion in the trigeminal lemniscus?

    <p>Bilateral, asymmetrical sensory disassociation</p> Signup and view all the answers

    Which cranial nerves are commonly affected in trigeminal neuralgia?

    <p>CN V only</p> Signup and view all the answers

    What sensory function is primarily affected by a lesion in the ventral trigeminal tract?

    <p>Contralateral loss of pain and temperature sensation</p> Signup and view all the answers

    What is a common cause of trigeminal neuralgia?

    <p>Irritation by nearby blood vessels</p> Signup and view all the answers

    What characterizes hypogeusia associated with a VPM lesion?

    <p>Loss of taste mostly contralateral to the lesion</p> Signup and view all the answers

    Severing the ipsilateral spinal trigeminal tract is a treatment option for which condition?

    <p>Trigeminal neuralgia</p> Signup and view all the answers

    Which of the following is NOT a symptom of trigeminal neuralgia?

    <p>Loss of fine touch sensation</p> Signup and view all the answers

    What is the clinical presentation associated with damage to the corticospinal tract?

    <p>Contralateral hemiparesis</p> Signup and view all the answers

    Which deficit occurs as a result of damage to the medial lemniscus?

    <p>Contralateral loss of position sense</p> Signup and view all the answers

    What symptom is associated with damage to the hypoglossal nerve?

    <p>Deviation of the tongue to the ipsilateral side</p> Signup and view all the answers

    Which physical sign is associated with Lateral Medullary Syndrome (Wallenburg syndrome)?

    <p>Ipsilateral Horner syndrome</p> Signup and view all the answers

    Which deficit is associated with damage to the spinothalamic tract?

    <p>Contralateral loss of pain and temperature sense on body</p> Signup and view all the answers

    What happens as a result of damage to the nucleus ambiguus?

    <p>Dysphagia and palate paralysis</p> Signup and view all the answers

    Which condition is characterized by nausea, vomiting, and vertigo due to damage in the lateral medulla?

    <p>Lateral medullary syndrome</p> Signup and view all the answers

    Which nerve-related deficit can occur due to damage in Wallenburg syndrome involving the spinal trigeminal nucleus?

    <p>Ipsilateral loss of pain and temperature sense on face</p> Signup and view all the answers

    What is the primary blood supply to the brainstem?

    <p>Vertebral arteries</p> Signup and view all the answers

    Which condition is characterized by unilateral effects due to a lesion that does not reach the PPRF?

    <p>Alternating hemiplegia</p> Signup and view all the answers

    When a patient has UMN signs on the right side, where is the likely lesion located?

    <p>Left corticospinal tract</p> Signup and view all the answers

    Which artery is associated with medial medullary syndrome?

    <p>Anterior spinal artery</p> Signup and view all the answers

    What distinguishes trigeminal motor nucleus lesions from corticobulbar lesions?

    <p>Presence of a pathological reflex</p> Signup and view all the answers

    Which area is not supplied by the anterior circulation?

    <p>Occipital lobe</p> Signup and view all the answers

    Which of the following findings is commonly associated with left frontal eye field lesions?

    <p>Eyes deviate to the right</p> Signup and view all the answers

    What is the primary blood supply of the anterior circulation to the brain?

    <p>Internal carotid arteries</p> Signup and view all the answers

    What is the pattern in which the dermatomes of the spinal trigeminal tract spread out from the mouth?

    <p>Onion skin pattern</p> Signup and view all the answers

    Which fibers terminate closer to the obex in the spinal trigeminal tract?

    <p>Mouth fibers</p> Signup and view all the answers

    What type of reflex does the jaw jerk reflex represent?

    <p>Monosynaptic myotactic stretch reflex</p> Signup and view all the answers

    Which nerve serves as the afferent limb for the corneal reflex?

    <p>V1 Ophthalmic Nerve</p> Signup and view all the answers

    Which muscle is primarily involved in the efferent limb of the corneal reflex?

    <p>Orbicularis oculi muscle</p> Signup and view all the answers

    What effect can upper motor neuron damage have on the jaw jerk reflex?

    <p>It becomes hyper-reflexive</p> Signup and view all the answers

    Which of the following could indicate an issue with the trigeminal motor nucleus?

    <p>Absence of masseter contraction</p> Signup and view all the answers

    Which component of the trigeminal reflex is responsible for fast bilateral blinking?

    <p>Facial motor nucleus</p> Signup and view all the answers

    Which type of posturing is characterized by flexion of the arms, wrists, and fingers due to a lesion above the midbrain?

    <p>Decorticate Posturing</p> Signup and view all the answers

    What describes apnea in terms of breathing patterns?

    <p>Period of low or no airflow</p> Signup and view all the answers

    Which breathing pattern is associated with lesions in the midbrain and is typified by periods of rapid breathing?

    <p>Central Neurogenic Hyperventilation</p> Signup and view all the answers

    What condition results from the severe lack of developmental parts of the forebrain?

    <p>Anencephaly</p> Signup and view all the answers

    Which breathing pattern involves irregular spacing and depth, typically resulting from lesions in the caudal pons or rostral medulla?

    <p>Ataxic Breathing</p> Signup and view all the answers

    What characterizes the vegetative state?

    <p>Loss of forebrain function with a functional brainstem</p> Signup and view all the answers

    Which event would likely lead to decerebrate posturing?

    <p>Lesion in the Red Nucleus</p> Signup and view all the answers

    Which condition can occur despite the presence of severe brainstem activity?

    <p>Vegetative State</p> Signup and view all the answers

    What is the primary function of impedance pneumography in the context of comatose patients?

    <p>Estimates respiratory flow rates</p> Signup and view all the answers

    Which of the following breathing patterns is characterized by prolonged inspiration?

    <p>Apneustic Breathing</p> Signup and view all the answers

    What is a significant indication of the presence of the brainstem function despite loss of forebrain activity?

    <p>Persistence of primitive reflexes</p> Signup and view all the answers

    What is a notable characteristic of Cheyne-Stokes breathing?

    <p>Gradually increasing and decreasing tidal volumes</p> Signup and view all the answers

    Which of the following best describes the relationship between brain death and cellular activity?

    <p>Cellular activity can persist for days</p> Signup and view all the answers

    Which breathing pattern indicates lesions specifically affecting the mid-pons?

    <p>Cluster Breathing</p> Signup and view all the answers

    What is a likely consequence of a lesion in the mesencephalic nucleus of the trigeminal nerve?

    <p>Loss of posterior jaw muscle proprioception</p> Signup and view all the answers

    Which lesion would most likely result in ipsilateral loss of fine touch sensation in the face?

    <p>Lesion in the chief trigeminal nucleus</p> Signup and view all the answers

    What are the key signs associated with Paratrigeminal (Raeder) Syndrome?

    <p>Miosis, ptosis, facial pain, and jaw weakness</p> Signup and view all the answers

    What occurs as a result of a lesion in the spinal trigeminal nucleus?

    <p>Loss of direct and consensual corneal reflexes</p> Signup and view all the answers

    Which type of sensory fibers does the trigeminal tract primarily consist of?

    <p>Sensory fibers that include proprioceptive input</p> Signup and view all the answers

    Which type of sensation is primarily conveyed by the spinal trigeminal nucleus?

    <p>Crude touch, pain, and temperature</p> Signup and view all the answers

    Where are the primary afferent cell bodies of the mesencephalic trigeminal nucleus located?

    <p>Within the mesencephalic trigeminal nucleus</p> Signup and view all the answers

    Which of the following statements correctly describes the primary trigeminal sensory nucleus?

    <p>It relays fine touch and discriminative sensation</p> Signup and view all the answers

    What is a significant feature of the cerebellar connection from the mesencephalic trigeminal nucleus?

    <p>Sends fibers through the superior cerebellar peduncle</p> Signup and view all the answers

    What role do secondary (2°) afferent cell bodies play within the trigeminal sensory nuclei?

    <p>They relay sensory information to the thalamus</p> Signup and view all the answers

    What is the main sensory deficit resulting from damage to the spinothalamic tract?

    <p>Contralateral loss of pain and temperature sense</p> Signup and view all the answers

    Which symptoms are associated with damage to the nucleus ambiguus?

    <p>Dysphagia, palate paralysis, and hoarse voice</p> Signup and view all the answers

    What neurological condition is characterized by nausea, vomiting, and vertigo due to damage in the lateral medulla?

    <p>Wallenburg syndrome</p> Signup and view all the answers

    Which deficit would be expected from disrupting the inferior cerebellar peduncle in Wallenburg syndrome?

    <p>Ipsilateral ataxia</p> Signup and view all the answers

    What is a likely consequence of damage to the hypoglossal nerve?

    <p>Ipsilateral atrophy and fasciculations of the tongue</p> Signup and view all the answers

    Which cranial nerve is most closely associated with the ipsilateral loss of pain and temperature sensation on the face?

    <p>Trigeminal nerve</p> Signup and view all the answers

    What is the clinical significance of the descending hypothalamospinal tract regarding Horner syndrome?

    <p>It is responsible for ipsilateral ptosis, miosis, and anhidrosis.</p> Signup and view all the answers

    Which functional impairment arises due to damage to the vestibular nuclei?

    <p>Nausea, vomiting, and vertigo</p> Signup and view all the answers

    What syndrome is associated with damage from the anterior spinal artery that affects the medulla?

    <p>Medial medullary syndrome</p> Signup and view all the answers

    Which vascular system primarily supplies the brainstem?

    <p>Vertebrobasilar system</p> Signup and view all the answers

    What clinical sign indicates a lesion in the left frontal eye field?

    <p>Eyes deviate to the right</p> Signup and view all the answers

    What condition is characterized by a unilateral effect due to a lesion that does not reach the PPRF?

    <p>Alternating hemiplegia</p> Signup and view all the answers

    Which statement correctly describes the jaw jerk reflex?

    <p>It is classified as a pathological reflex.</p> Signup and view all the answers

    What is a notable functional characteristic of lesions affecting the corticospinal tract?

    <p>Presence of upper motor neuron signs</p> Signup and view all the answers

    In terms of blood supply, which of the following regions is clearly associated with anterior circulation?

    <p>Frontal lobe regions</p> Signup and view all the answers

    Which cranial nerve involvement could indicate degeneration in the trigeminal motor nucleus?

    <p>Trigeminal nerve</p> Signup and view all the answers

    Which statement correctly describes the anatomy of the spinal trigeminal tract?

    <p>Fibers from the back of the head terminate closer to the obex.</p> Signup and view all the answers

    Which of the following best characterizes the jaw jerk reflex?

    <p>A fast bilateral response that tests the integrity of the mandibular nerve.</p> Signup and view all the answers

    What effect does upper motor neuron damage typically have on the jaw jerk reflex?

    <p>It enhances the reflex response.</p> Signup and view all the answers

    In the context of trigeminal reflexes, what does the efferent limb primarily involve?

    <p>Facial Motor Nucleus.</p> Signup and view all the answers

    What is the nature of the corneal (blink) reflex, and how does it function?

    <p>It is a polysynaptic reflex that ensures bilateral blinking.</p> Signup and view all the answers

    How do upper motor neuron lesions typically affect the jaw jerk reflex?

    <p>It becomes hyper-reflexive.</p> Signup and view all the answers

    Which feature distinguishes the jaw jerk reflex from other reflexes?

    <p>It is a monosynaptic myotactic stretch reflex.</p> Signup and view all the answers

    What is the defining characteristic of decerebrate posturing?

    <p>Extension, adduction, and hyperpronation of arms</p> Signup and view all the answers

    Which type of breathing pattern is commonly associated with lesions in the midbrain?

    <p>Central neurogenic hyperventilation</p> Signup and view all the answers

    What is a common feature of apneustic breathing?

    <p>Prolonged inspiratory phase</p> Signup and view all the answers

    What is usually the outcome for infants born with anencephaly?

    <p>Death within days after birth</p> Signup and view all the answers

    Which respiratory pattern results from lesions in the rostral pons?

    <p>Apneustic breathing</p> Signup and view all the answers

    In the context of brainstem function, what does a vegetative state indicate?

    <p>Loss of forebrain function with some brainstem activity</p> Signup and view all the answers

    Which physiological process is estimated by impedance pneumography in comatose patients?

    <p>Respiratory flow rates</p> Signup and view all the answers

    What is typically observed in a patient experiencing Cheyne-Stokes breathing?

    <p>Periodic deep and shallow breathing with an apneic phase</p> Signup and view all the answers

    What characterizes ataxic breathing?

    <p>Irregularity in spacing and depth of breaths</p> Signup and view all the answers

    Which of the following statements is true regarding medical death?

    <p>Bone and skin cells can survive for extended periods post-death.</p> Signup and view all the answers

    What defines hyperpnea in respiratory patterns?

    <p>Breathing that is deeper than normal</p> Signup and view all the answers

    What does opisthotonos indicate in terms of physical response?

    <p>Extension of limbs and back arching</p> Signup and view all the answers

    What might signify that brainstem function is intact despite loss of higher brain function?

    <p>Primitive reflexes and ability to perform autonomic functions</p> Signup and view all the answers

    What does the term 'cluster breathing' refer to in respiration patterns?

    <p>Rapid intervals of breath followed by a prolonged cessation</p> Signup and view all the answers

    What neurological condition allows for basic movement and reflexes despite severe brain structure failure?

    <p>Anencephaly</p> Signup and view all the answers

    Which sensory function is primarily handled by the spinal trigeminal nucleus?

    <p>Crude touch, pain, and temperature</p> Signup and view all the answers

    What is the primary type of neuron found in the mesencephalic trigeminal nucleus?

    <p>Pseudounipolar neurons</p> Signup and view all the answers

    Which one of the following best describes the role of the chief trigeminal sensory nucleus?

    <p>Relays fine touch and discriminative sensation</p> Signup and view all the answers

    What characteristic distinguishes the mesencephalic trigeminal nucleus from other sensory nuclei?

    <p>It contains primary afferent cell bodies</p> Signup and view all the answers

    In which part of the brainstem are 2° afferent cell bodies found for pain and temperature sensation?

    <p>Spinal trigeminal nucleus</p> Signup and view all the answers

    What are the consequences of a lesion in the mesencephalic nucleus related to jaw muscle function?

    <p>Loss of proprioception leading to potential jaw injuries</p> Signup and view all the answers

    Which statement accurately describes the effect of a lesion in the chief trigeminal nucleus?

    <p>Loss of ipsilateral fine touch sensation</p> Signup and view all the answers

    What does a lesion in the spinal trigeminal nucleus primarily affect?

    <p>Ipsilateral pain and temperature sensation</p> Signup and view all the answers

    Which symptom would likely arise from a lesion in the area around the trigeminal ganglion?

    <p>Miosis, ptosis, and facial pain characteristic of Raeder's syndrome</p> Signup and view all the answers

    Which reflex is impaired due to lesions affecting proprioception in the jaw muscle?

    <p>Jaw jerk reflex</p> Signup and view all the answers

    What would be a likely consequence of damage to the pre-ganglionic sympathetic neurons originating from the lateral horn of the spinal cord?

    <p>Reduced sympathetic response and Central Horner syndrome</p> Signup and view all the answers

    Which symptom is most likely associated with damage to the abducens nucleus in the medial pontine syndrome?

    <p>Paralysis of the conjugate gaze toward the lesion side</p> Signup and view all the answers

    What explains the characteristic muscle paralysis in locked-in syndrome?

    <p>Disruption of corticobulbar and corticospinal tracts in the pons</p> Signup and view all the answers

    In the context of medial pontine syndrome, what deficits would one expect from damage to the corticospinal tract?

    <p>Contralateral hemiparesis affecting motor function</p> Signup and view all the answers

    Which outcome is associated with the occlusion of the basilar artery leading to locked-in syndrome?

    <p>Preserved cognitive function with paralysis of nearly all voluntary muscles</p> Signup and view all the answers

    What describes the pattern in which dermatomes of the spinal trigeminal tract spread out from the mouth?

    <p>Onion skin pattern</p> Signup and view all the answers

    Which of the following reflects the nature of the jaw jerk reflex?

    <p>Monosynaptic myotactic stretch reflex</p> Signup and view all the answers

    Which nerve is responsible for the afferent limb of the corneal reflex?

    <p>V1 Ophthalmic N.</p> Signup and view all the answers

    How does upper motor neuron damage to the corticobulbar tract affect the jaw jerk reflex?

    <p>Hyper-reflexive response</p> Signup and view all the answers

    Which of the following components is responsible for producing fast bilateral blinking in the trigeminal reflex?

    <p>Facial Motor Nucleus</p> Signup and view all the answers

    What is the primary path for the mouth fibers in terms of their termination in the spinal trigeminal tract?

    <p>Closer to the obex</p> Signup and view all the answers

    What tests the integrity of the Trigeminal Motor Nucleus and the Trigeminal Mesencephalic Nucleus?

    <p>Jaw Jerk Reflex Test</p> Signup and view all the answers

    What is the role of the afferent limb in the corneal reflex?

    <p>Transmit sensory information</p> Signup and view all the answers

    How does medial medullary syndrome primarily affect the body?

    <p>Results in contralateral hemiparesis due to anterior spinal artery occlusion</p> Signup and view all the answers

    What aspect differentiates trigeminal motor nucleus lesions from corticobulbar lesions?

    <p>Corticobulbar lesions primarily affect the lower face</p> Signup and view all the answers

    Under what condition is alternating hemiplegia observed?

    <p>If the PPRF is not affected, resulting in unilateral effects</p> Signup and view all the answers

    What is the primary source of blood supply to the brainstem?

    <p>Vertebral arteries</p> Signup and view all the answers

    What does the presence of upper motor neuron signs on the left side indicate?

    <p>A lesion located in the right motor pathways</p> Signup and view all the answers

    What type of brain lesion is indicated if a patient displays a unilateral effect without PPRF involvement?

    <p>Alternating hemiplegia</p> Signup and view all the answers

    Which area of the brain receives its blood supply from the internal carotid arteries?

    <p>Cortex</p> Signup and view all the answers

    What is a defining feature of the vertebrobasilar system in relation to brainstem circulation?

    <p>It serves as the main supply for the brainstem and posterior fossa</p> Signup and view all the answers

    Which condition is associated with the retention of primitive reflexes while lacking development of the forebrain?

    <p>Anencephaly</p> Signup and view all the answers

    What breathing pattern is characterized by irregular spacing and depth and is typically associated with the caudal pons or rostral medulla?

    <p>Ataxic breathing</p> Signup and view all the answers

    Which condition results from a complete lack of breathing and heartbeat despite the presence of other bodily functions?

    <p>Brain death</p> Signup and view all the answers

    What describes prolonged inspiration followed by a pause in breathing?

    <p>Apneusis</p> Signup and view all the answers

    Which posturing is defined by extension of the limbs and indicates a lesion located between the red nucleus and vestibular nuclei?

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

    What is the unique hallmark of Cheyne-Stokes breathing?

    <p>Rapid, shallow breathing alternating with apneas</p> Signup and view all the answers

    What effect does damage to the medial pontine area have on respiratory patterns?

    <p>Results in central neurogenic hyperventilation</p> Signup and view all the answers

    In the context of brain death, what does the presence of brainstem reflexes indicate?

    <p>Brain death is not fully established</p> Signup and view all the answers

    What is the primary function of impedance pneumography in the assessment of comatose patients?

    <p>To estimate respiratory flow rates</p> Signup and view all the answers

    Which of the following breathing patterns suggests damage to the rostral pons?

    <p>Cluster breathing</p> Signup and view all the answers

    What characterizes decorticate posturing, and where is it typically located?

    <p>Flexion of limbs; lesion above the midbrain</p> Signup and view all the answers

    Which state refers to a condition where patients exhibit wakefulness without awareness due to loss of forebrain functioning?

    <p>Persistent vegetative state</p> Signup and view all the answers

    What distinguishes apneustic breathing from other abnormal respiration patterns?

    <p>Prolonged inspiratory phase followed by insufficient expirations</p> Signup and view all the answers

    What is a common outcome for children born with anencephaly?

    <p>Normal sensory responsiveness</p> Signup and view all the answers

    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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    Brainstem Motor 3 Lecture Notes (DO-SYS-725)

    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.

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