5 - Cabs Cerebral Hemispheres

Front 1

What are the basic components of the brain?

Back 1

1) the hindbrain at the top of the spinal cord 2) the midbrain 3) the forebrain

Front 2

What is the primary function of the hindbrain?

Back 2

Controls the sensation and movement of the muscles of the face and throat

Front 3

What is the primary function of the midbrain?

Back 3

Controls the movement of the eyes

Front 4

What is the primary function of the forebrain?

Back 4

Contains the cerebral cortex which comprises 80% of the human brain

Front 5

What is a general function of the frontal cortex?

Back 5

organizes the pieces of information from the sensory areas into a meaningful story

Front 6

What is the general function of the amygdala?

Back 6

Adds the emotional shades to memory

Front 7

Which type of memory allows for continuity of our awareness, enables us to compare past/present and make predictions?

Back 7

Working memory- "Ram"- short term

Front 8

What is the main function of the cerebellum?

Back 8

The cerebellum is known for its importance in coordinating movement. It is also vital to the coordination of thought and language.

Front 9

Which section of the brain is most used in planning an action?

Back 9

The pre-frontal cortex links information from motor, sensory and memory association areas in planning an action.

Front 10

Which section of the brain facilitates the integration of the information and timing of the plan?

Back 10

Cerebellum

Front 11

Which part of the brain consists of hard-wired circuits that control fixed actions such as heart and respiratory rates, and reflexes?

Back 11

Brainstem and spinal cord

Front 12

Which part of the brain is the "first floor" and is responsible for directing movement, relaying information about the body to higher brain centers?

Back 12

Basal nuclei (ganglia) and cerebellum

Front 13

Which part of the brain is helpful in maintaining posture?

Back 13

Cerebellum

Front 14

Which part of the brain is the "CEO"?

Back 14

Pre-frontal cortex- responsible for decision making, inhibition and excites the lower floors in their execution?

Front 15

Language is lateralized to which hemisphere in 95% of the population?

Back 15

Left hemisphere

Front 16

Which hemisphere is major for spatial relationships and most emotions?

Back 16

Right hemisphere

Front 17

A stroke involving the non-dominant hemisphere (right) may leave a person with what syndrome?

Back 17

"Hemineglect"- they completely ingonre the left side of their body and the environment

Front 18

The PNS consists of:

Back 18

Cranial and spinal nerves

Front 19

The cerebrum consists of:

Back 19

Telencephalon (cerebral cortex, subcortical white matter and basal nuclei) and the diencephalon (thalamus and hypothalamus)

Front 20

What is the insula thought to be involved in?

Back 20

emotions of addiction, and with social emotions such as lust and disgust, pride and humiliation, guilt and atonement. It is thought to register physical sensations (heat, cold, pain, hunger, thirst, taste and visceral sensations), and interpret them as social emotions

Front 21

What two concepts are connected to the left hemisphere?

Back 21

Handedness and language (dominant hemisphere=left hemisphere, assuming)

Front 22

What is the function of Wernicke's area?

Back 22

Wernicke’s area is a language processing area involved in the comprehension of language (conversion of sounds into meaningful words).

Front 23

Where is Wernicke's area located?

Back 23

Brodmann’s area 22 (also parts of 37, 39 and 40) which is located on the posterior 2/3 of the superior temporal gyrus of the dominant cerebral hemisphere

Front 24

What is Broca's area?

Back 24

Broca’s area is a pre-motor center for speech that is important for sequencing thoughts into sounds.

Front 25

Where is Broca's area located?

Back 25

Triangular and opercular parts of the inferior frontal gyrus of the dominant hemisphere. This lies anterior to the face area of the primary motor cortex on the inferior pre-central gyrus of the frontal lobe. It corresponds to Brodmann’s areas 44 and 45 (also 9, 46 and 47).

Front 26

Why might a person with Broca's aphasia also experience weakness of one side of their lower face? (Likely rt sided)

Back 26

Broca’s area lies anterior to the face area of the primary motor cortex on the inferior pre-central gyrus of the frontal lobe. Thus, a person with a lesion in Broca’s area may also have a weakness of the contralateral lower face.

Front 27

What is dysarthria?

Back 27

Abnormal pronunciation of speech due to lesions of cranial nerves VII, X and XII, or their innvervated muscles, and the syntax and content is normal.

Front 28

What is a "watershed infarct" and what does it cause?

Back 28

Infarct in the lcoation between broca's and wernicke's ara. It results in transcortical aphasia. It spares repetition

Front 29

What type of lesion will most likely cause alexia and agraphia?

Back 29

Lesion of central language processing (might result in aphasia as well)

Front 30

When can agraphia occur without aphasia?

Back 30

A lesion in the inferior parietal lobule (supramarginal gyrus and angular gyrus) of the dominant hemisphere.

Front 31

What causes Gerstmann's syndrome?

Back 31

focal lesion to the angular gyrus within the inferior parietal lobule of the dominant hemisphere.

Front 32

Apraxia

Back 32

inability to carry out a command because the person cannot put together the correct sequence of movements

Front 33

Apraxia can be caused from a lesion to the arcuate fasciculus; True or false?

Back 33

TRUE

Front 34

Which hemisphere is responsible for a person being able to focus their attention?

Back 34

The ability of a person to focus their attention is largely a function of the non-dominant cerebral hemisphere (usually the right cerebral hemisphere).

Front 35

What syndrome causes a person to neglect food on the left side of their plate?

Back 35

Hemineglect; caused by a lesion to the frontal lobe or supramarginal gyrus of the right parietal lobe

Front 36

anosognosia

Back 36

When a person is not aware of their illness

Front 37

Which area of the brain is responsible for attention, abstract reasoning, judgement?

Back 37

Pre-frontal cortex- largest part of the frontal lobe

Front 38

What is the function of the frontal lobe?

Back 38

The functions of the frontal lobe can be categorized into three behaviors which are remembered by the mnemonic, RIO: 1) Restraint (judgment, inhibiting socially unacceptable responses, perseverance, etc.); 2) Initiative (motivation, creativity, curiosity, etc); and 3) Order (abstract reasoning, working memory, sequencing, planning, etc.)

Front 39

How do you test abstract reasoning?

Back 39

Proverbs

Front 40

Person presents with disinhibition, impulsivity and poor judgement; find the lesion:

Back 40

Orbitofrontal (one example)

Front 41

Frontal release signs - where is the lesion?

Back 41

Pre-frontal cortex

Front 42

What are some of the primitive reflexes?

Back 42

grasp, root, snout, and suck reflexes that are normally present in infants between ages 1-3 months.

Front 43

Magnetic gait- name a location for the lesion:

Back 43

Pre-frontal cortex

Front 44

Where is the primary visual cortex located?

Back 44

calcarine fissure (Brodmann area 17) in the occipital lobe, bilaterally.

Front 45

What is the visual pathway route from anterior to posterior?

Back 45

optic nerve → optic chiasm → optic tract → lateral geniculate nucleus of the thalamus → optic radiation (Meyer’s loop is the inferior part+ High tract) → calcarine sulcus (cuneus and lingual gyrus).

Front 46

How does the image on the retina differ from our visual field?

Back 46

upside down and backwards compared to the image in the visual field

Front 47

The right lateral visual field projects to

Back 47

right nasal retina

Front 48

Fibers at the nasal retina do what action?

Back 48

cross to the opposite side at the optic chiasm

Front 49

What does the crossover at the optic tract result in?

Back 49

Due to this crossover, the left optic tract carries all of the image from the right side of the visual field; and the right optic tract carries all of the image from the left side of the visual field.

Front 50

A lesion of the optic nerve will produce

Back 50

monocular visual field loss or scotoma

Front 51

A lesion of the optic chiasm will produce

Back 51

bitemporal hemianopia (loss of the temporal half of the visual field, bilaterally

Front 52

Lesions of the optic tract and optic radiations will produce

Back 52

contralateral homonymous hemianopia

Front 53

a lesion of the inferior pathway (Meyer’s loop) will produce

Back 53

contralateral superior quadrantanopia which is a known as a “pie in the sky” deficit

Front 54

What is the most common cause of 'pie in the sky' deficit?

Back 54

This is usually a result of an infarct in the distribution of the middle cerebral artery, inferior division

Front 55

A lesion of the lingual gyrus of the primary visual cortex causes:

Back 55

contralateral superior quadrantanopia

Front 56

Why is the region of the primary visual cortex corresponsing to the macula/fovea not always affected in a stroke?

Back 56

collateral circulation between the posterior cerebral and middle cerebral arteries; This produces “macular sparing” in which the central field of vision is unaffected.

Front 57

What causes a lacunar infarct?

Back 57

Subcortical infarcts that result from the occlusion of a single, deep penetrating artery. They account for 15-20% of all strokes. They are often a result of HT

Front 58

How do lacunar infarcts typically present?

Back 58

Lacunar infarcts present without cortical symptoms, i.e. there is an absence of aphasia, neglect, and visual field deficits. A pure motor hemiparesis is the most common type and has a good prognosis.

Front 59

What is the main pathway for voluntary movement of the extremities, especially the fine movements performed by the hands and fingers?

Back 59

Corticospinal tract

Front 60

The right primary motor cortex controls movement of the

Back 60

left upper and lower extremities

Front 61

What is the descending motor pathway of the corticospinal tract from the cerebral cortex to the spinal cord?

Back 61

pre-central gyrus → internal capsule → cerebral peduncle (basis pedunculi) → medullary pyramids → decussation at the cervicomedullary junction → lateral corticospinal tract within the spinal cord.

Front 62

The corticospinal tract is an upper or lower motor neuron?

Back 62

Upper motor neuron

Front 63

Where does the corticospinal tract synapse with the lower motor neuron?

Back 63

the anterior (ventral) horn of the spinal cord

Front 64

Where does the lower motor neuron begin

Back 64

Lower Motor neuron begins in the anterior horn of the spinal cord and terminates in the peripheral skeletal muscle

Front 65

What is the name of the upper motor neuron tract that ends in the brain stem?

Back 65

“corticobulbar tract”. It also begins in the primary motor cortex (Brodmann’s area 4), but it ends in the brain stem (“bulb”), where it synapses with cranial nerves which contain lower motor neurons

Front 66

What are the upper motor neuron signs?

Back 66

1) spasticity (spastic paralysis); 2) hyperreflexia; 3) Babinski’ sign; and 4) increased muscle tone

Front 67

LMN signs include:

Back 67

1) fasciculations; 2) atrophy; 3) hyporeflexia; and 4) decreased muscle tone (flaccid paralysis)

Front 68

Where are HAL's legs located?

Back 68

legs on the anterior paracentral lobule within the longitudinal fissure

Front 69

A person who presents with hemiplegia of the left lower extremity, but has little to no weakness of the left upper extremity or face would most likely have a lesion where?

Back 69

Confined to the legs of HAL which lie on the right primary motor cortex within the longitudinal fissure

Front 70

The legs of HAL receive blood supply via the:

Back 70

anterior cerebral artery

Front 71

If a person’s upper extremity and face were weak or paralyzed, which general region and artery would be involved?

Back 71

The more lateral region of the primary motor cortex supplied by the middle cerebral artery would likely be affected

Front 72

The descending upper motor neurons funnel through the cerebral white matter in the:

Back 72

Internal capsule

Front 73

What is the internal capsule?

Back 73

A V shaped structure and is divided into an anterior limb, genu, and posterior limb. The corticobulbar and corticospinal tracts are somatotopically organized such that HAL lies with the Head (face) in the genu, and the Arms and Legs are in order within the posterior limb.

Front 74

A lesion to the internal capsule would likely cause what and why?

Back 74

Since the internal capsule is more compact, a lesion often produces weakness or paralysis of the face, arm and leg on the contralateral side of the body.

Front 75

Lacunar infarcts cause 'smaller' or 'larger' areas of deficit?

Back 75

Smaller

Front 76

What are the arteries involved in a lacunar infarct?

Back 76

Lenticulostriate arteries which are referred to as the “arteries of stroke” because they narrow in HTN and are prone to stroke

Front 77

The corticospinal and corticobulbar tracts travel into the brainstem via the:

Back 77

cerebral peduncles of the midbrain

Front 78

What is the main arterial supply to the midbrain?

Back 78

Posterior cerebral artery

Front 79

What is the other name for the corticospinal tract and why?

Back 79

The corticospinal tract is located within the elevation of the anterior medulla oblongata which is known as the medullary pyramids. For this reason, the corticospinal tract is also called the “pyramidal tract”.

Front 80

What happens at the cervicomedullary junction?

Back 80

At the junction of the medulla oblongata and the spinal cord (cervicomedullary junction), 85% of the corticospinal neurons decussate (crossover) to the opposite side of the spinal cord. The neurons that decussate become the lateral corticospinal tract within the spinal cord, and are the ones responsible for voluntary control of fine movement

Front 81

A lesion above the decussation will cause ipsilateral or contralateral weakness?

Back 81

Contralateral

Front 82

A lesion below the decussation will cause ipsilateral or contralateral weakness?

Back 82

Ipsilateral

Front 83

The basal ganglia (nuclei) consist of the

Back 83

caudate nucleus, putamen, globus pallidus, subthalamic nucleus and the substantia nigra

Front 84

The caudate nucleus and the putamen together are called

Back 84

the “striatum” because of the striated appearance of the cellular bridges which interconnect them

Front 85

The putamen and the globus pallidus together are called

Back 85

lenitiform (lenticular) nucleus. This is because of their lens shape, although they look more like an ice cream cone.

Front 86

where the cervical spinal cord meets the medulla oblongata

Back 86

Cervicomedullary junction

Front 87

A person with a lesion here will eat garbage without feeling disgust:

Back 87

Insula

Front 88

The brain is enhanced by what 2 things?

Back 88

Sleep and exercise

Front 89

What separates the temporal from the parietal lobe?

Back 89

Lateral sulcus of sylvius

Front 90

What separates the parietal from frontal lobe?

Back 90

Central sulcus of rolando

Front 91

Where is the primary auditory cortex found?

Back 91

The superior part of the temporal lobe

Front 92

What part of the brain is responsible for maintaining autonomic function and the force of various drives- such as hunger, thirst, sex or violence?

Back 92

Hypothalamus

Front 93

Brodman's 4

Back 93

Primary motor cortex

Front 94

Brodmans 3,1,2

Back 94

Primary somatosensory cortex

Front 95

Brodman's 44,45

Back 95

Broca's area

Front 96

Brodmans 41/42

Back 96

Heschl's gyrus- primary auditory cortex

Front 97

Brodman's 5/7

Back 97

Stereogensis

Front 98

Brodman's 6

Back 98

Premotor

Front 99

Brodman's 18 and 19

Back 99

Visual association area

Front 100

Brodman's 34

Back 100

Olfactory area

Front 101

Brodmans 22

Back 101

Wernicke's area

Front 102

Lesion to the lower motor neuron affects the whole face or half of face?

Back 102

Whole

Front 103

Lesion to upper motor neuron- affects whole face or half?

Back 103

Half

Front 104

autoimmune disease which results in demyelination of axons; may if severe enough cause direct injury to the grey matter and axons

Back 104

Multiple sclerosis

Front 105

What is the most common initial presentation of MS?

Back 105

some of the first initial presentation of MS involve demyelination within the optic nerve; called optic neuritis. Will have transient monocular blindness (loss of vision in one eye)

Front 106

What is the clinical hallmark of MS?

Back 106

described as having a presentation with two or more deficits that are separated in time and space. Meaning- cannot localize the deficits to one lesion. If person has visual def and weakness in one extremity or altered sensation, the pattern is such that multiple lesions can account for this – MULTIPLE sclerosis. Typically occur over time…

Front 107

What is the omst aggressive (grade V) glial tumor?

Back 107

Glioblastoma - most common primary brain tumor

Front 108

Red flags for headache:

Back 108

New onset over age 50, progressively worsening HA, HA that wakes in the night or is worse in the morning, seizure, focal changes (speech impairment or visual deficits)

Front 109

What is a transtentorial (uncal) herniation?

Back 109

The uncus herniates through the tentorial dura. one of the results of mass effect; because of the proximity of CN3, it can affect the PNS in the pupil and cause a fixed, dilated pupil. Increased ICP that is then affecting nerve 3 to impair the symp innervation within the nerve that is causing the ipsilateral fixed/dilated pupil

Front 110

What happens if you have BL primary visual cortex lesions?

Back 110

Cortical blindness- confabulation

Front 111

Which area is responsible for long term memory?

Back 111

Hippocampus- medial temporal lobe

Front 112

What area is the collater of the brain? Takes info from all over and organizes it together to create memories?

Back 112

Hippocampal formation

Front 113

A lesion to the hippocampal formation will result in what?

Back 113

Anterograde amnesia (50 first dates)

Front 114

What neurotransmitter is essential for long term memory?

Back 114

Dopamine

Front 115

How do dopamine antagonists affect learning?

Back 115

Decreased ability to learn, remember or have motivation

Front 116

If you have a left cerebral lesion in the frontal eye field (infarct)- you wont be able to

Back 116

Look right; eyes will drift left--> "looking lesion"