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17 Cards in this Set
- Front
- Back
What is the function of the Corticonuclear / Corticobulbar Tract? |
Controls muscles of head and face
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Where does the Corticonuclear Tract originate? Project to?
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- Origin: Precentral Gyrus
- Fibers pass with corticospinal tract fibers through corona radiata, internal capsule and cerebral peduncle |
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Where do the Corticonuclear Tract fibers terminate?
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Brainstem motor nuclei:
- CN V (bilateral) - CN VII (contralateral) - CN XII (contralateral tongue) Nucleus Ambiguus (bilateral) - CN IX - CN X (soft palate, pharynx, larynx) Accessory Nucleus (bilateral) - CN XI |
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What happens if there is a lesion to the cortical or internal capsule?
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- Simultaneously affect corticospinal tract and corticonuclear tract
- Contralateral hemiplegia and CN VII and CN XII signs - CN VII - contralateral loss of movement on lower half of face - CN XII - tongue points toward CN XII that is receiving no input (actually pointing away from brain lesion) |
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What is Pseudobulbar Palsy?
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Bilateral lesion of Corticobulbar/Corticonuclear Tract
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What are the symptoms of a bilateral lesion of the Corticonuclear tracts? Na,e?
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- Dysphagia - difficulty swallowing
- Dysarthria - difficulty articulating words - Paresis of tongue - weakness - Loss of emotional control - emotional incontinence * Pseudobulbar Palsy (UMN lesion) - similar to Bulbar Palsy (LMN lesion) * |
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What are the potential causes of Pseudobulbar Palsy?
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- Brainstem infarct
- ALS - MS |
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How can you distinguish between Bell's Palsy and a Corticonuclear Tract lesion?
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- Bell's: 1/2 of forehead can wrinkle - entire half of face cannot move (LMN lesion) - R picture
- Corticonuclear Tract Lesion: all of forehead can wrinkle - only 1/4 of face cannot move (UMN lesion) - L picture |
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What is wrong with this man?
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- Corticonuclear Tract - UMN lesion
- Entire forehead can move because upper half of face receives bilateral innervation - Lower part of face only receives contralateral innervation |
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What is wrong with this man?
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- Bell's Palsy - CN VII / LMN lesion
- Only half of forehead can move because bilateral innervation has been cut in CN VII |
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What happens to the tongue, if the Corticonuclear Tract (UMN) is lesioned?
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Tongue deviates away from lesioned side (but points to CN XII that is not receiving input)
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What happens to the tongue if CN XII (LMN) is lesioned?
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Tongue deviates toward side of lesion
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If a patient is having problems with eye movements, what part of the brainstem is probably affected?
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Usually midbrain
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If a patient is having problems with mastication, facial expression, salivation, lacrimation, etc., what part of the brainstem is probably affected?
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Pons
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If a patient is having problems with salivation, sneezing, respiration, etc., what part of the brainstem is probably affected?
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Medulla
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If a lesion in the brain is more medial, what is probably affected?
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Motor
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If a lesion in the brain is more lateral, what is probably affected?
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Sensory
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