Part of UMN descending down but it supplies face & not trunk—corticospinal tract. Q corticobulbar... more Part of UMN descending down but it supplies face & not trunk—corticospinal tract. Q corticobulbar tracts are not found in the spinal cord. Q it has bilateral representation. Meaning it supplies both sides. Q advantage when you cut one side there is no paralysis in the face because the nerve innervation = bilateral. CN 7 nuclei however divided into Upper part & Lower part. Q unilaterally = C/L (i.e.) if there is lesion of corticobulbar tr. on L side pt. = C/L lower facial palsy R lower facial palsy. problem with smiling or whistling (UMN lesion) but in Bell's Palsy = LMN CN 7 that has a lesion – flaccid paralysis (LMN lesion) Brainstem Transection How to determine level of lesion. Lesions in BS CN involvement Pts. Present with ipsilateral CN Q palsy & C/ L hemiplegia. There are various tracts + nucleus + CN in BS. ✩ MEDULLA ✩ CN nuclei in medulla • Spinal nucleus of V; spinal tract • Hypoglossal nucleus CN XII – medullary accessory nucleus • ✩ Solitary Nucleus – visceral senses of touch CN 7, 9; sensory, carotid sinus, + body • Dorsal Motor nucleus of X • Nucleus ambiguous motor innervation to soft palar + pharynx, larynx, CN 9 + 10 laterally • Vestibular nuclei – pontomedullary duration, found @ entry CN 7 Some nuclei located medially or laterally Tracts located medially 1. Medial lemniscus (V, T, P from trunk) 2. Corticospinal tract/ pyramidal (C/L somatic motor innervation to trunk) 3. CN 12 medially (laterally located tracts in medullary are • Q Spinal-thalamic tract carry C/L pain + temp. from trunk • Q Descending spinal trigeminal tract • Ipsilateral pain & temp. from face
Part of UMN descending down but it supplies face & not trunk—corticospinal tract. Q corticobulbar... more Part of UMN descending down but it supplies face & not trunk—corticospinal tract. Q corticobulbar tracts are not found in the spinal cord. Q it has bilateral representation. Meaning it supplies both sides. Q advantage when you cut one side there is no paralysis in the face because the nerve innervation = bilateral. CN 7 nuclei however divided into Upper part & Lower part. Q unilaterally = C/L (i.e.) if there is lesion of corticobulbar tr. on L side pt. = C/L lower facial palsy R lower facial palsy. problem with smiling or whistling (UMN lesion) but in Bell's Palsy = LMN CN 7 that has a lesion – flaccid paralysis (LMN lesion) Brainstem Transection How to determine level of lesion. Lesions in BS CN involvement Pts. Present with ipsilateral CN Q palsy & C/ L hemiplegia. There are various tracts + nucleus + CN in BS. ✩ MEDULLA ✩ CN nuclei in medulla • Spinal nucleus of V; spinal tract • Hypoglossal nucleus CN XII – medullary accessory nucleus • ✩ Solitary Nucleus – visceral senses of touch CN 7, 9; sensory, carotid sinus, + body • Dorsal Motor nucleus of X • Nucleus ambiguous motor innervation to soft palar + pharynx, larynx, CN 9 + 10 laterally • Vestibular nuclei – pontomedullary duration, found @ entry CN 7 Some nuclei located medially or laterally Tracts located medially 1. Medial lemniscus (V, T, P from trunk) 2. Corticospinal tract/ pyramidal (C/L somatic motor innervation to trunk) 3. CN 12 medially (laterally located tracts in medullary are • Q Spinal-thalamic tract carry C/L pain + temp. from trunk • Q Descending spinal trigeminal tract • Ipsilateral pain & temp. from face
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