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What CN's are in the medulla?
- There are five:
- 7,8,9,10,12
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The Nucleus of the Medulla are:
- Solitary (Sensory) VII, IX, X
- (Taste, visceral sensation)
Vestibular (VIII)
Hypoglossal (XII)
Ambiguus (IX, X)
Dorsal (X)
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Where is the medulla?
The medulla is in the Pons
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Por donde pasa el Hypoglossal nucleus?
- Beteween Pyramids and the Olives!
- (Egiptians and Martinis)
-
Otro nombre para superior and inferior Calliculi?
Corpora quadragemina
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Donde esta el Trigeminal nerve?
Esta en PONS, pero se extiende (arriba) hacia MIDBRAIN y (abajo) hacia MEDULLA
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Lesions anywhere in the BRAINSTEM will cause____ because_____
- 1. diminished facial sensation!
- 2. Trigeminal nerve extends all the way in the Brainstem (Midbrain, Pons, Medulla)
-
Ventral Medulla...
motor (Lower body)
-
Dorsal Medulla
Sensory (Upper body)
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What is MLF?
Medial Longitudial Fasciculus
-
Example of who uses the MLF...
Hunters!
-
MLF controls...
- gaze AND head movement
- (CN's 3,4,6,8)
-
Which artery supplies the midbrain?
PCA
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Which artery supplies the Cerebellum?
PICA
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Which artery supplies the PONS?
Basilar artery (Paramedian and circumferential branches)
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Which artery supplies the Medulla?
PICA and Vertebral arteries (lateral and paramedian branches)
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Signs of Medullary Dysfunction...
- Signs of Medullary Dysfunction...
- THINK of the CN nucleus of the medulla... Remember, there are five.
- Vertigo
- Ataxia
- Nystagmus
- Resp arrest
- Autonomic instability
- hiccups
(CN's 7,8,9,10,12)
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Medial (basal) medullary syndrome, will ONLY affect which CN? Why?
- XII hypoglossal. Because it is the only medial CN. The others are lateral.
- Sign:
- With a Right side lesion...
- Right tongue deviation
- Left body paralysis
- BRAINSTEM LESIONS:
- IPSILATERAL FACE
- CONTRALATERAL BODY
THE MEDULLA IS IN THE BRAIN STEM!
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Pt. with Dysphagia and Hoarseness. Affected Medullary nucleus is:
Nucleus ambiguus (in Medulla).
The Medulla is in the Brain stem.
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Contralateral body pain and temp loss. Tract...
Spinothalamic
(Decussates at: 1-2 vertebrae in cord)
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Pt does not have a gag reflex. Affected CN is...
IX, X
-
Vertigo, nystagmus, N/V. Nuclei affected...
vestibular nuclei
-
Ipsilateral limb ataxia & intention tremor
(inferior cerebellar peduncle)
-
Horner's syndrome, S/S
- ptosis
- miosis
- hydrosis
- (Ipsilateral) (Sympathetic Pathway)!
-
Subarachnoid hemorrhage presents most commonly with...
marlene
severe headache
...and may require analysis of cerebrospinal fluid when neuroimaging is not definitive
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