This document provides an overview of the brain stem, cerebellum, and neuro-ophthalmology. It discusses the gross anatomy and location of cranial nerve nuclei within the brainstem. It also describes pathways involved in horizontal gaze, internuclear ophthalmoplegia, and the facial nerve. Additionally, it outlines the long tracts and blood supply of the brainstem and cerebellum. It provides information on the somatotopy and basic plan of cerebellar connections. Finally, it discusses anisocoria, pupil examination, and the causes of anisocoria.

1. BRAIN STEM, CEREBELLUM and NEURO-OPTHALMOLOGY Submitted to:- AskTheNeurologist.Com in 2007

2. GROSS ANATOMY

3. LATERAL VIEW

4. LOCATION OF CRANIAL NERVE NUCLEI WITHIN BRAINSTEM

5. CRANIAL NERVE 5 Note that although all fibres enter the brainstem at the level of the pons, those concerned with pain and temperature descend as low as C3

6. PATHWAYS INVOLVED IN HORIZONTAL GAZE LEFT FRONTAL EYE FIELD

7. INTERNUCLEAR OPTHALMOPLEGIA ( INO)

8. THE FACIAL NERVE

9. The Long Tracts Note sites of decussation of major tracts : Spinothalamic Cuneate / Gracile Corticospinal

12. Basic Plan of Cerebellar connections DN= Dentate nucleus T = Thalamus RN = Red nucleus Each cerebellar cortex controls ipsilateral side of body Efferents to cortex leave cerebellum via superior cerebellar peduncle Note: red nucleus is present in midbrain and ultimately controls contralateral half of body

13. DSCT= dorsal spinocerebellar tract VSCT= ventral spinocerebellar tract VSCT is crossed in the cord but crosses back within cerebellum

21. Sphincter pupillae muscle

22. Left RAPD AKA Marcus-Gunn pupil For example a patient with multiple sclerosis who is suffering from acute left sided optic neuritis

23. Sphincter pupillae muscle

24. THE END The full lecture can now be accessed at AskTheNeurologist.Com ©