2 brain stem akd

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2 brain stem akd

  1. 1. BRAINSTEM DR ANIL
  2. 2. GROSS ANATOMY OF THE BRAINSTEM
  3. 3. THE MEDULLA: GROSS ANATOMY
  4. 4. INTERNAL STRUCTURE OF THE MEDULLA
  5. 5. THE PONS GROSS ANATOMY
  6. 6. PONS - L. – a bridge
  7. 7. INTERNAL STRUCTURE OF THE PONS
  8. 8. THE MIDBRAIN GROSS ANATOMY
  9. 9. INTERNAL STRUCTURE OF THE MIDBRAIN
  10. 10. BLOOD SUPPLY OF BRAINSTEM
  11. 11. BLOOD SUPPLY• MEDULLA1. 2 VERTEBRAL A2. ANT &POST SPINAL A3. ANT &POST INF CEREBELLAR A4. BASILAR A
  12. 12. PONS• PONTINE BRANCHES OF BASILAR A• ANT INF CEREBELLAR A
  13. 13. MIDBRAIN• BASILAR A-DIRECT BRS• POST CEREBRAL A• SUP CEREBELLAR A• BRS OF POST COMM &ANT CHOROIDAL A
  14. 14. Syndromes
  15. 15. Wallenberg Syndrome• aka lat medullary syndrome• occ. of PICA• Posterolat part of medulla is damaged• Features: a) Inv of spinal nuc & tract of V nerve - ipsilateral loss of pain & temp from face & forehead b) Inv of spinal lemniscus (lat spinothalamic tract) – -contralateral loss of pain & temp from body below face
  16. 16. c) Inv of nuc. Ambiguus – - paralysis of muscles of softpalate, pharynx & larynx- - dysarthria & dysphagiad) Inv of Vestibular nuclei - -giddinessThis combination of sensory loss –“Crossed Hemianaesthesia”
  17. 17. Medial Medullary SyndromeDejerine’s ant bulbar syndrom.b/c vertebral a  Click to edit theXII nerve – i/l paralysis & outline text format atrophy of 1/2 tongue ; deviated to affected side  Second OutlinePyramid c/l hemiplegia/ Level paralysis arm & leg.medial lemniscus (post column − Third Outline fibres) - contralateral loss of Level position & vibra.  FourthThis combination of motor loss – Crossed motor paralysis Outline Level
  18. 18. Millard-Gublar synd• Lesion in lower part of Pons• Incl pyramidal tract• Also inv 6 & 7 nerve fibers• Abd n. i/l med squint• Facial n i/l facial palsy• Corticospinal tract c/l hemiplegia
  19. 19. Pontine H’age• Pontine arteries rupture• Hyperpyrexia – thermoregulatory mech. disrupted• Pinpoint pupils – contraction of sphincter pupillae muscle• Coma – reticular formation lesion• Contralateral UMN paralysis – pyramidal fibres involved
  20. 20. Webers Syndrome• Ipsilateral oculomotor  Click to edit the palsy. outline text format• Contralateral hemiplegia  Second Outline Level − Third Outline Level  Fourth Outline Level
  21. 21. Benedikts syndrome• Fibres of III nerve.  Click to edit the outline text format• Descending motor fibres in cerebral  Second Outline peduncle. Level• Red nucleus and nearby − Third Outline cerebellothalamic Level fibres.  Fourth Outline Level

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