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Board Review Series - Fix J.D.

Fix J.D. Board Review Series - London, 1995. - 430 p.
Download (direct link): boardreviewseries1995.djvu
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Anterior gray horn
Lower motor neuron in
spinal accessory (XI) nerve

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Figure 9-10. Corticobulbar pathways of the brainstem. Corticobulbar fibers arise from the face area of the motor
cortex and innervate motor (GSE and SVE) cranial nerve nuclei of CN V, CN VII, CN IX, CN X, CN XI, and CN
XII. Direct corticobulbar fibers to the ocular motor nerves, CN III, CN IV, and CN VI, have not been demonstrated.
Interruption of corticobulbar fibers results in an upper motor neuron (UMN) lesion. (Reprinted with permission
from Carpenter MC: Core Text of Neuroanatomy, 3rd ed. Baltimore, Williams & Wilkins, 1985, p 129.)

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16 / Neuroanatomy
7. Inferior cerebellar peduncle (see Figure 1-6)
-connects the cerebellum to the medul la.
8. Anterior lobe
-lies anterior to the primary fissure.
9. Posterior lobe
-is located between the primary and posterolateral fissures.
10. Flocculonodular lobe
ólies posterior to the posterolateral fissure.

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160 / Neuroanatomy
receives bilateral input; the lower face division of the facial nucleus rece ives
only contralateral input (Figure 9-11). -innervate the ipsilateral spinal
nucleus of CN XI, which supplies the stern o-
cleidomastoid muscle and the contralateral spinal nucleus of CN XI, whi ch
innervates the trapezius muscle, -the orbicularis oculi muscle receives a
variable number of crossed and
uncrossed fibers; the paresis therefore varies from patient to patie nt.
Face area of
motor cortex

UMN lesion of
corticobulbar tract ód
(e.g., stroke of
internal capsule) Facial nucleus of pons
Upper face division
Lower face division
LMN lesion of CN VII
(e.g., Bell's palsy)
Muscles of facial expression
Orbicularis oculi
Orbicularis oris
Figure 9-11. Corticobulbar innervation of
the facial nerve (CN VII) nucleus. An upper motor neuron (UMN) lesion (e.g., a stroke involving the internal
capsule) results in contralateral weakness of the lower face and spares the upper face. A lower motor neuron
(LMN) lesion (e.g., Bell's palsy) results in paralysis of facial muscles in both the upper and the lower face.
(Reprinted with permission from Fix JD: High-Yield Neuroanatomy. Baltimore, Williams & Wilkins, 1995, p 58.)

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