Oct 1st week test takers: Let's team up - thisisonlymyusername

[ArchivalUser]

thanks Antonella, for such a nice explaination & spending so much time for everyones benefit.

[ArchivalUser]

Now, we have subclavia artery that give the branch vertebral artery that is going up true processes transversus and than get into the posterior fossa of the skull true foramen magnum. The two cousin vertebral give the rise to: ASA and PICA
ASA is covering the medial medulla and PICA is covering the posterior-lateral medulla. Than, at the pontomedullary junction, we have the vertebral cousins join into the basilar artery that is basically supply the land of PONS. The LATERAL PONS is supply by the branch called AICA.The rostral pons is by the SUPERIOR CEREBELLAR Artery and the MEDIAL PONS is by the PARAMEDIAN branches.
The inner ear is by the labyrinth artery that is also branch of the basilar artery.
Than, at the rostral end of the midbrain the basilar divides into two PCA (posterior cerebral artery).

To be continued....
Antonella

[ArchivalUser]

@antonella : that is awesome

Okay it took me ONE WHOLE DAY to finish lipoprotein metabolism from goljan...i referred to katzung pharmac's chart n the basic lipid metab as well...for some reason, i find this topic just too confusing but still one day and barely 5 pages done

what is up with the other people? please keep posting how all of you are progressing

[ArchivalUser]

In brain stem we have 9 nerves out of 12.Basically; we do NOT have 1, 2, and 11 in here, so
Forget about them here.
1. In midbrain we have III and IV
2. In PONS we have V, VI, VII, and VIII where V (face +Temperature and pain) enters from the rostral section and 6, 7, 8 from the caudal pons.
3. IN medulla ,we have IX,X and XII
4. They are entering or exiting the ventrolateral part of midbrain, EXCEPT that the Trochlear (IV) exits on the dorsal site of the brain stem.
At the level of the superior collicus is the place for the VERTICAL GAZE and the light reflex.
At the level of the Inferior Collicus is the place of the auditory process sounds.
At the level of the Cerebellar peduncles, we have the CST.
At the level of upper medulla, we can see 9, 10, 12..
First look for the pyramids (place for CST ) ,than find the inferior OLIVARY nucleus that is the house for 9,10,12 nerve .Than be able to identify the Medial Lemniscus (looks like page of open book).Than identify the nucleus of XII and little bit on the right is the SOLITARY nucleus and tract that houses the VII (it is visceral sensory taste nucleus of VII ) and carotid body of IX for the changes of the BP.
Try to identify the AMBIGUIS nucleus for X –LMN for the muscles from the palate, pharynx, and larynx and upper esophagus.
At the level of lower medulla, we have the crossing fibers of MM and CST. Identifies the nucleus gracilis and nucleus cuneatus from the dorsal column.
Identify the STT and the Spinal tract of V
IN brain stem expect CONTRALATERAL DEFICITS.


To be continued..
Antonella

[ArchivalUser]

thisisonlymyusername -So tell me what exactelly you learn about the lipoprotein metabolism today with your own words
Antonella

[ArchivalUser]

Again, we need to remember CONTRALATERAL in the brain stem…except Descending Hypothalamic Tract –ipsylateral lesions.
MC Lesions in brain stem is INSULTS!!!
3, 4,6,12 exiting to brain stem close to MIDLEVEL (medially ventral) and they have similar function and they are MOTOR.
5, 7,9,10 are much lateral
We need to know for each nerve:
1. What I their function
2. When the patient present with a symptoms, where is the lesion and causes
3. Way to test the CN
All motor responses are B/L responces
Antonella
To be continued...

[ArchivalUser]

Light reflex-shine light in one eye, both eyes should constrict. Sensory limb is from II and the Psy axon is with III.
Shine a light:
Right eye constrict, Left eye do not constrict (Lt Optic nerve lesion)

3,4,6 innervate the eye ball –the 6 EOM
The III is moving the eye in all directions bc of the 4 muscles-(MR SIR):
1. Look up and IN, plus in tort (SR)
2. Look down and IN (IR)
3. Pull IN the ey toward the nose (MR)-ADDUCTING the eye-most important
4. Look up and OUT (IO)
Than the PSY part of III is innervating the cilliary muscle (accommodation) and sphincter pupilae to constrict .Also III innervate the levator palpabrae to raise the eyelid.
SUMMARY FUNCTION of III :
1. Moving the eye ball in all directions
2. Raising the eyelid
3. Constricting
4. Part of the Light Reflex


To be continued..
Antonella

[ArchivalUser]

Down and out with lesion of III and dilated blown pupils with uncal herniation.
NERVE IV innervate SO-look DOWN and OUT –depress the eye, plus weak adduction and INTORT also..
VI –ABDUCT true the LR –pull eye away from the nose..
Loss of abduction=PULL IN =internal strabismus
Again SO,SR =INTORTERS
IO IR –EXTORTERS,
Loss of extortion position=DIPPLOPIA and tilts the head away from the lesion

A

[ArchivalUser]

V – Mixed, the largest nerve .Has 3 divisions, V1, V2, and V3
V1 innervate the surface of the eye ball-the cornea + the sensory limb of the corneal blink reflex. The motor limb is from the VII.Both should blink!
V2 –general sensation of tongue, palate
V3 –the motor part the mm of mastication’s. Move the mandible and elevate the + sensory –the 2/3 of the tongue
V 3 nerve to know:
1. Auricotemporal
2. Buccal for chewing
3. Inferior Alveolar that become mental nerve
4. Lingual for the general sensation of 2/3 of the tongue
VII –Mixed
Innervates:
1. Muscles of facial expression, smile +stapedius that protect you form loud sounds
2. Salivatory glands, oral mucosa,lacrimal glands
3. Skin behind the ear
4. Taste 2/3 of the tongue

Bell’s palsy:
1. Dry Eye
2. Hyperacusis
3. Facial expression drops
4. Can’t wrinkle the forehead
5. Numbness of around the mastoid process




Antonella

[ArchivalUser]

VIII –the cochlear part –for hearing and the vestibular part for upright posture to gravity and head turning (vestibular evoke nystagmus)
IX –innervate stylopharyngeus
X –mixed:
1. Symmetrical palate elevation
2. Close the larynx
3. Constrict the Pharynx
4. Touch of the oropharyngeal mucosa
Dropping of the palate, nasal regurgitation, uvula away from the lesion, hoarseness, dysphagia…..

XI innervates the SCM and Trapezius, dropping of the shoulders if lesion…
XII-tongue movement with the styloglossus,hyoglossus,genioglossus…(if right movement than we use the left geioglossus).
If Right lesion-tongue move toward the lesion!!!
Antonella
To be continued..