Question

Case Scenario: A patient was admitted to Barrow Neurological Center after a serious car accident. Upon assessment, it is found he has a contusion in the main brain stem area. Breathing is affected, and the doctor believes a ventilator will be necessary to allow the brain to heal.

Question: Contralateral control is a phenomenon of the central nervous system. Using the concept of cellular regulation, analyze this phenomenon and how this relates to the patient you are treating.

Answer 1

The function of the brain stem is to control the body functions of breathing, consciousness, blood pressure, heart rate, and swallowing. It also sends messages to the other parts of the body. It consists of three main parts the midbrain, pons, and medulla oblongata. The respiratory center located in the brain stem is responsible for the control of breathing rate and depth. The medulla oblongata maintains the breathing and pons smoothen the breathing pattern. Thus the contusion or bleeding just beneath this brain tissue interpret the sending of signals and receiving of feedback in the respiratory center.

The contralateral phenomenon is the left side of the brain receiving signals and controls the right side of the body. In the same way, the right side of the brain controls the left side of the body. Thus the sensory and motor cortex of specific part of the brain controls specific regions of the brain. The rostral ventral respiratory group(RVRG) axons in the medulla project into the phrenic nuclei to bilaterally innervate as ipsilateral and contralateral. Disruption of one pathway can lead to the function of another pathway. If the ipsilateral is paralyzed, the phrenic pathway crossed the contralateral to become active and restore the function of respiration. Thus this patient breathing is affecter due to contusion on the respiratory center, but the function can be restored through contralateral control.