Chapter 9- Dysfunction Of Specific Of Specific Areas Of The Brain

Front 1

which area of the frontal lobe does frontal love syndrome concern?

Back 1

prefrontal areas of the frontal lobe (motor cortex)

Front 2

what are the functions of the prefrontal cortex

Back 2

personality
emotional
decision making
speech

Front 3

what are the personality changes associated with frontal lobe syndrome?

Back 3

abnormalities in personality and behaviour

drive
apathy and abulia
poor personal hygiene
incontinence

Front 4

what are the reflexes associated with frontal lobe syndrome?

Back 4

a return of primitive reflexes

Front 5

when does motor aphasia occur in frontal lobe syndrome?

Back 5

dominant hemisphere

Front 6

damage to the frontal eye field results in which ocular gaze palsy deviation

Back 6

towards the side of the defect

Front 7

what is akinetic mutism and why does it happen

Back 7

complete ignorance of external stimuli caused by bilateral lesions

Front 8

what are the initial symptoms of an acute lesion of the basal parts of the frontal lobe?

Back 8

confusion, motor agitation, aggressiveness

Front 9

what are the positive signs of frontal lobe syndrome?

Back 9

adverse siezeures- epileptic attacks that cause the head and trunk to turn to the opposite side of the lesion

other tonic things can happen such as the fencing posture or pedalling movements

Front 10

what happens when you have a lesion of the pre central gyrus

Back 10

you have mono paresis of the corresponding area of the body or you have contralateral mimic palsy

Front 11

what happens when you have a lesion of post central gyrus?

Back 11

contralateral hypesthesia in elementary sensory modalities

Front 12

what are the positive signs of lesion of the central part of brain?

Back 12

simple partial siezures- are either purely motor etc or mixed
TONIC or CLONIC convulsions on one side of the body or positive signs on one side of the body or circumscribed area

Front 13

what is jacksonian seizure and when does it occur?

Back 13

motor or sensory phenomena that spread in succession to the entire half of the body

found in frontal lobe syndrome (centrally)?

Front 14

temporal lobe deals in what acitivies

Back 14

MEMORYYYYYYYYYYYYYYYY

Front 15

when is the memory affected?

Back 15

when the hippocampus is affected bilaterally

Front 16

what is transient global amnesia and where is it located?

Back 16

temporal lobe is the location
transient, bilateral dysfunction of the hippocampus

Front 17

what are the symptoms of transient global amnesia?

Back 17

loss of short term memory.

loss of events during the attack

can't orientate himself- keeps on asking where am I, what happened?

for 24hrs

Front 18

what is korsakoff syndrome localised and what causes it

Back 18

temporal lobe

lack of thiamine- vit b1 in people with alcoholism

Front 19

what are the symptoms of korsakoffs syn

Back 19

loss of recent memory

they produce confabulations to fill in the gap

Front 20

where is wernickes aphasia located

Back 20

temporal lobe

Front 21

what happens when you have bilateral lesions of the transverse temporal gyri of heschl?

Back 21

cortical deafness

Front 22

what are the visual affects of temporal lobe lesions and why

Back 22

contralateral homonymous upper quadrantanopsia because

the lower part of the optic radiation runs through the temporal lobe

Front 23

what are the positive signs of temporal lobe syndrome

Back 23

complex partial seizures producing medial temporal lobe epilepsy aka pyschomotor epilepsy

AURAS precede the seizure

followed by motor automatisms

Front 24

what are auras?

Back 24

feeling of abdominal discomfort
a fear
deja --etc

Front 25

what are motor automatisms

Back 25

lip puckering,
chewing
swallowing

undressing in public\
abdominal pain in kids

Front 26

what symptoms are seen in lateral temporal lobe epilepsy

Back 26

auditory or visual aura in the beginning-elementary hallucinations

then hand and leg automatisms

Front 27

where do parietal lobe lesions occur that result in parietal lobe syndrome

Back 27

behind the post central gyrus

Front 28

what is the function of the parietal lboe

Back 28

language, usually one side is dominant

Front 29

what parietal lobe is usually more dominant in language

Back 29

left

Front 30

lesion of language dominant parietal lobe leads to what

Back 30

agnosia, acalculia, agraphia = gerstmanns syn

autotopagnosia

apraxia

Front 31

what symptoms are seen when the non dominant parietal lobe is damaged

Back 31

extinction and neglect syndrome

Front 32

what are positive symptoms of parietal lobe syndrome

Back 32

body image

somatic illusions

illusions disturbed posture

Front 33

what is the occipital lobe involved in

Back 33

vision

Front 34

what is seen in unilateral lesions of the occipital lobe?

Back 34

contralateral homonymous hemianopsia- spared macular vision or homonymous quadrantanopsia

Front 35

what is seen in bilateral lesions of occipital lobe

Back 35

cortical blindness

Front 36

are pupillary reflexes seen in cortically blind people

Back 36

yes

Front 37

what are the positive signs of occipital lobe syndrome

Back 37

visual hallucinations- simple and complex
simple are colored circles
complex are people or animals

Front 38

where is the lesion located that causes occipital lobe syndromes

Back 38

occipital pole

more anterior for complex hallucinations

visual illusions

Front 39

visual illusions are what

Back 39

misinterpretation of real images
-macropsia-
-micropsia

Front 40

where does the lesion have to be cause macropsia or micropsia

Back 40

occipitotemporal or occipitopareital border zones

Front 41

what are the positive signs of occipital lobe syndromes

Back 41

flashes of light

Front 42

what is the main function of thalamus

Back 42

relay for all sensory info and somatosensory

Front 43

what happens when u have a lesion of the thalamus

Back 43

loss of sensory info from the entire contralateral sensory info of body

also hemiataxia because all proprioceptive info is lost

PAIN- with hyperpathia perhaps

Front 44

what happens when you have lesion of the lateral geniculate body?

Back 44

contralateral homonymous hemianopsia

Front 45

what other tract may be affected in the event of thalamic lesion

Back 45

corticospinal tract running through the internal capsule

Front 46

what is the typical symptoms of internal capsule syndrome

Back 46

contralateral spastic hemiplegia with central mimic palsy
contralateral hemianaesthesia
contralateral hemianopsia

Front 47

which cranial nerve nuclei are found in the brainstem

Back 47

3-12

Front 48

what other nuclei and structures are found in the brainstem

Back 48

red nucleus

sub nigra

vital autonomic reg centers

Front 49

what is the common cause of unilateral focal lesions of the brainstem

Back 49

vascular-ischemic

Front 50

what is the typical clinical picture of brainstem lesion

Back 50

crossed or alternating hemiplegia syndrome

Front 51

what is a alternating hemiplegia syndrome

Back 51

cranial nerve deficit + contralateral hemisensory defect

Front 52

describe the components of a Midbrain alternating hemiplegia syndrome?

Back 52

ipsilateral CN3 palsy + contralateral hemiparesis - WEBERS syn

Front 53

describe the components of a PONS alternating hemiplegia syndrome?

Back 53

ipsilateral CN7 palsy + contralateral hemiparesis

Front 54

describe the components of a medulla alternating hemiplegia syndrome?

Back 54

ipsilateral CN12 palsy + contralateral hemiparesis
=jacksons syndrome

Front 55

what is wallenbergs syndrome

Back 55

LATERAL MEDULLARY syndrome

Front 56

what lesion causes wallenbergs syn

Back 56

occlusion of the vertebral or posterior inferior cerebellar artery

Front 57

symptoms of wallenberg syndrome

Back 57

VERTIGO and nystagmus
vomiting
sympathetic affection-horners syndrome
ncl ambiguus affection- CN9,10
cerebellar ataxia
ipsilateral hypalgesia

Front 58

what is locked in syndrome

Back 58

QUAdriplegia
can't swallow, speak, mimic
can horizontally move eyes

Front 59

what are the functions that a locked-in person can do

Back 59

vertical eye movements and blink

Front 60

cause of locked-in synd

Back 60

infarction from thrombosis of basilar artery--> extensive lesion of the ventral part of the pons

Front 61

when do decerebrate movements occur

Back 61

lesion of the upper brainstem

Front 62

what are decerebrate movements

Back 62

extension of limbs with internal rotation of arms

Front 63

when do decorticate movements occur

Back 63

lesion above midbrain- bilateral of both hemispheres

Front 64

what are decorticate movements

Back 64

extension of legs flexion and adduction of arms

Front 65

what does transversal spinal cord lesion entail

Back 65

damage of complete cross section of spinal cord

Front 66

what are the acute causes of transection of spinal cord?

Back 66

trauma or ischemia

Front 67

what are the symptoms of transverse spinal cord syn

Back 67

motor, sensory and sphincter disturbances

Front 68

name the 2 types of motor weakness

Back 68

LMN at the lvele of lesion and
UMN below the lesion

Front 69

what is spinal shock

Back 69

inhibition of all spinal cord activity- flaccid paralysis-- which afterwards becomes spastic

Front 70

what are sensory signs at the level of a spinal lesion

Back 70

strip of hyperesthesia or hyperalgesia from a root lesion
complete transection--> anaesthesia below

Front 71

describe bladder dysfunction

Back 71

bladder receives parasympathetic flow from the S2-4 region= sacral micturition centre

--> detrusor and internal sphincter

the PONTINE micturition centre suppresses the parasymp activity of bladder

the FRONTAL cortical centre is responsible for the initiation of voluntary micturition

Front 72

what is the bladder reflex

Back 72

stretch receptors sense critical fillin-->micturition

Front 73

how does transection affect bladder

Back 73

upper centre lose control

reflex arc for urination is intact
detrusor is no longer inhibited during filling and it leads to hyperactivity of it
=autonomic neurogenic bladder

Front 74

what are the immediate changes in the urinary bladder pun sudden spinal cord damage

Back 74

initial flaccid paralysis - atonic detrusor
--> urinary retention

after this neurogenic bladder develops

Front 75

where do the lesions occur- three places that cause flaccid paralysis of bladder and even loss of the reflex emptying arc?

Back 75

conus medullaris

cauda equina

peripheral nerves

-all inactive the sacral centre and signal reflex arc for bladder emptying

Front 76

if the emptying arc for the bladder is lost then how is one to urinate/?

Back 76

when the pressure inside the bladder naturally rises above the pressure of the sphincter
or

by the CREDE manoeuvre

Front 77

what is it called when the bladder cannot empty

Back 77

autonomic bladder

Front 78

if there is a lesion in the cervical spinal cord then what type of plegia or paralysis is seen?

Back 78

quadriplegia
UMN in all four limbs
LMN of neck muscles

Front 79

where does the lesion occur that causes serious ventilatory problems

Back 79

C4- diaphragm

--> hypoventilation

Front 80

lesion of C5-T1 leads to what

Back 80

LMN weakness of the upper extremity (brachial plexus)

there can also be horners syndrome

Front 81

what happens when there is a lesion of the thoracic spinal cord

Back 81

UMN weakness in the lower extremities and
LMN weakness of dorsal, intercostal, abdominal muscles

Front 82

what happens when there is a lesion of the lumbar enlargement

Back 82

paraparesis or plegia
ie L1-4 -> LMN weakness in girdle muscles

Front 83

lesions of the epiconus medullaris lead to what

Back 83

affection of muscles on the anterior and posterior of the leg

-limited plantar flexion and dorsiflexion

Front 84

lesions of the conus medullar is lead to what

Back 84

main signs are perianal, perigenical, sphincter and sexual disturbances

but initially is just the short flexors of the toes

Front 85

what is brown sequard syn

Back 85

one half of the spine is damaged

Front 86

how are pain and temp affected in brown squared synd?

Back 86

they are lost on the contralateral side below the lesion
-SPINOTHALAMIC TRACT

Front 87

how are position and vibration affected in brown sequard

Back 87

they are lost ipsilateral to the lesion
-posterior columns

Front 88

how are the motor fibres affected in brown squared syn

Back 88

there is spastic paralysis below the lesion due to affection of the corticospinal tract

Front 89

what is central cord syndrome

Back 89

central gray matter is lesioned

loss of crossing pain and temp fibres at the level

can frequently involve the anterior horns-- LMN weakness at the lvel

Front 90

if central cord syndrome spreads to the white matter what other tracts are afected/

Back 90

spinothalamic from top to bottom because more medial fibres represent the upper segments of the body

Front 91

extramedullary syndrome causes what 2 things?

Back 91

superficial and deep sensation is disturbed

Front 92

what side of the spinal cord is compressed when superficial sensation is affected?

Back 92

lateral side

spinothalamic fibres

perianogenital area--> up

Front 93

what side of the spinal cord is compressed when deep sensation is affected?

Back 93

posterior

Front 94

what motor affects can be seen in extra medullar syndrome

Back 94

UMN below the lesion
LMN at the level

sharp border can be seen in the UMN weakness

Front 95

what ataxia can be expected when the posterior columns are affected?

Back 95

SPINAL ATAXIA due to lack of propioceptive information

Front 96

when deficiency or condition causes affection of the posterior columns

Back 96

Vit b12 deficiency

tabes dorsalis

Front 97

what happens in amyotrophic lateral sclerosis

Back 97

simultaneous involvement of anterior horn cells--> LMN weakness AND

long tract lesions-- UMN weakness

Front 98

what are the characteristic symptoms of amyotrophic lateral sclerosis?

Back 98

weakness and atrophy of limbs, trunks and bulbar muscles, fasciculations , increased tendon reflexes
pyramidal tract signs and intact sensation