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129 Cards in this Set
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What is the association cortex responsible for?
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Carries out higher-order information processing
Blumenfeld. P 41 |
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What is the difference between unimodal and multimodal association areas?
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Unimodal: higher order processing, usually for a single sensory or motor modality. --Usually located adjacent to 1^ motor or sensory area.
Multimodal: Integrates fxs from multiple motor &/or sensory modalities. Blumenfeld. P 42 |
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Where is the secondary somatosensory area?
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Upper bank of lateral sulcus (or according to Blumenfeld, in the parietal operculum).
http://quizlet.com/11381772/neuroanatomy-association-cortex-flash-cards/ |
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Where is the somatosensory association cortex?
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Posterior parietal cortex.
?> http://quizlet.com/11381772/neuroanatomy-association-cortex-flash-cards/ |
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What are the three multimodal association areas?
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Posterior parietal
Inferior temporal Frontal. ?> http://quizlet.com/11381772/neuroanatomy-association-cortex-flash-cards/ |
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What is the function of the parietal association area?
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Awareness of and attention to our personal body map and our relationship to the world around us. Neurons respond during attention to interesting or behaviorally meaningful target objects. ?>
http://quizlet.com/11381772/neuroanatomy-association-cortex-flash-cards/ |
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What is each side of the parietal lobe activity association with?
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Right - attention to both sides.
Left - attention to right side. Right sided lesions most significant. ?> http://quizlet.com/11381772/neuroanatomy-association-cortex-flash-cards/ |
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What are some consequences of lesions to the right parietal lobe?
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Contralateral neglect syndrome - inattention to left side of body and extrapersonal space.
Patients fail to acknowledge ownership of left limbs, dress or wash the left side of the body, see objects in the left visual field, or the left side of objects, attend to sounds from the left side, turn to left when navigating familiar territory. ?> http://quizlet.com/11381772/neuroanatomy-association-cortex-flash-cards/ |
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What is the temporal association area responsible for?
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Recognition and identification of complex stimuli. Recognition of specific classes of objects (tools, vegetables, pieces of furniture). Module for recognition of faces. ?>
http://quizlet.com/11381772/neuroanatomy-association-cortex-flash-cards/ |
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What does a lesion to the inferior temporal lobe cause?
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Agnosia - not knowing.
Deficits in object recognition - may be for objects in general, may be for specific class or classes of objects. Deficit in recognition of faces - prosopagnosia. ?> http://quizlet.com/11381772/neuroanatomy-association-cortex-flash-cards/ |
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What is the frontal association area responsible for?
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Integration of complex perceptual information to generate an appreciation of self in relation to the outside world. ?>
http://quizlet.com/11381772/neuroanatomy-association-cortex-flash-cards/ |
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The striatum includes what structures:
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caudate nucleus
putamen globus pallidus |
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Anatomy: Disorders of higher planning and integration of behavior over time (working or active memory) is particularly dependent on:
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DLPFC
Schnider NP Testing chapter on H drive |
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Anatomy of Language Comprehension
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Posterior temporal lobes
Schnider NP Testing chapter on H drive |
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Ideomotor Apraxia
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Inability to perform complex, artificial movements out of their natural context. Most evident in defective pantomime of tool use.
Schnider NP Testing chapter on H drive |
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Ideational Apraxia
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Inability to perform correct sequence of steps
Schnider NP Testing chapter on H drive |
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Anatomy: Ideomotor Apraxia
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Left hemisphere
Schnider NP Testing chapter on H drive |
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Anatomy: Ideational Apraxia
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Left parietal lesions, but may also be seen in the context of frontal planning deficits
Schnider NP Testing chapter on H drive |
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Anatomy: Finger agnosia
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Left inferior parietal
Schnider NP Testing chapter on H drive |
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Anatomy: acalculia
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Left inferior parietal
Schnider NP Testing chapter on H drive |
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Anatomy: R-L confusion
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Left inferior parietal
Schnider NP Testing chapter on H drive |
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Failures of visuospatial processing
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Right inferior parietal
Schnider NP Testing chapter on H drive |
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Anatomy:
Inability to orient oneself in familiar surroundings and to find one's way around a new setting (topographagnosia) |
R hem, either parietal or inferior medial temporo-occipital junction
Schnider NP Testing chapter on H drive |
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Anatomy:
Prosopagnosia |
Fusiform gyrus
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Spontaneous confabulation is thought to be due to:
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Impaired source memory (i.e., a deficit in remembering contextual information about an event) and temporal confusion (i.e., the difficulty in distinguishing irrelevant and old memory traces from relevant and new traces referring to the ongoing reality).
http://www.alzcompend.info/?p=293 |
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True or False:
The ability to learn new motor or cognitive skills (procedural learning) depends on MTLs. |
False
Rather, basal ganglia structures Schnider NP Testing chapter on H drive |
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What is a disorder of spatial processing that is due to left hemisphere damage?
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Gerstmann Syndrome
Schnider NP Testing chapter on H drive |
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Where is the fusiform gyrus?
What disorders are associated with it? |
Temporal lobe, at the medial temporo-occipital junction.
(Located between the occipitotemporal gyrus and the parahippocampal gyrus). Prosopagnosia, Associate object Agnosia Schnider NP Testing chapter on H drive |
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Anatomy
Spontaneous Confabulation |
Posterior orbitofrontal damage or disconnection
Schnider NP Testing chapter on H drive |
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Anatomy
Semantic Fluency |
L temporal
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Greater semantic vs phonemic fluency is seen in what dementias?
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AD
svPPA |
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Anatomy
Phonemic fluency |
Frontal-subcortical function
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Anatomy
Relatively equal mpairment in both semantic and phonemic fluency |
Frontal:
due to poor generativity OR problems maintaining set. |
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Anatomy
Impaired BNT that improves with phonemic cues |
Frontal:
It's a Retrieval deficit |
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Anatomy
Impaired BNT that improves with multiple choice |
Temporal:
Mild semantic loss |
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Anatomy
Impaired BNT that improves with stimulus cue |
Temporoparietal:
Visuospatial problem |
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Anatomy
Phonemic paraphasias are associated with altered _______fx. |
Left DLPFC (helipopter)
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Anatomy
Semantic paraphasias are associated with altered _______fx. |
Temporal lobe
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Anatomy
Figural Fluency |
Right DLPFC
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Anatomy
Stroop Inhibition |
Anterior cingulate, DLPFC
Bruce doesn't think it really tells us about anatomy |
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Diagonal slant on mnmn could be suggestive of:
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Parietal deficits
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Difficulties with persistence on mnmn (lifting pencil a lot) is associated with:
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Parkinsonian tendencies
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Micrographia on mnmn is associated with:
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Parkinsonism
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Macrographia on mnmn may be suggestive of:
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Cerebellar deficits
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Anatomy
Working Memory |
L DLPFC
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Anatomy
Buccofacial apraxia |
Damage to face area within motor strip.
It relates to the execution of motor movements associated with speech. Test by asking patient to: whistle, lick lips, blow out a match, move tongue from side to side. |
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Anatomy
Trails Switching |
DLPFC
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Anatomy
Visual Agnosia |
Bilateral occipital lesions
--the ventral stream --the visual association areas of the occipital lobe |
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What plays an important role in preparing and running off sequences of motor movements.
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Basal ganglia
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What are the main components of the basal ganglia?
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A collection of gray matter nuclei deep within the WM.
Striatum (Caudate and Putamen) Globus Pallidus Subthalamic Nucleus Sustantia Nigra |
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Anatomy
Broca's |
L frontal operculum (3rd frontal convolution of L hemisphere)
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Association Areas
Do what? |
Neural go-betweens that allow the combined analysis of all the sensory systems of the brain.
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2 types of Association Areas
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Unimodal (modality specific)
Heteromodal (Higher Order) |
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3 Classifications of Axons
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Association (same hem; run ant to post)
Commissural (homotopic areas of 1 hem to the other) Projection (up & down. Cross midline) Video |
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Anatomy of Apraxia
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L Supramarginal gyrus
Rama 1 |
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Apraxia
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The ability to create an image of, and execute, skilled movements. We use the image to guide our movements. Apractics can't link the percept with motor action.
Can't translate thought into acton? Rama 1 |
Rama 1
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L angular gyrus
Fxs |
WF
Abstract skills like reading, writing and arithmetic Rama 1 |
Rama 1
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Hemispatial neglect results from damage to:
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Right parietal lobe
Rama 1 |
Rama 1
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Anatomy
Processing of touch, muscles, and joint information and combining it with vision, hearing, & balance to give a sense of our self & the world around it. |
Parietal lobes
Rama 1 |
Rama 1
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Anatomy
Creating a mental model of the spatial layout of the outside world |
R parietal
Gives the ability to grab things, avoid obstacles, etc. Rama 1 |
Rama 1
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Anatomy
The mental awareness you have of your body’s configuration and movement in space |
R superior lobule (just above IPL)
Rama 1 |
Rama 1
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Anatomy
Recognizing faces & objects and linking them to appropriate emotions |
Temporal lobes
Rama 1 |
Rama 1
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Anatomy
Alien Hand |
Anterior Cingulate??????
Corpus collosum???? Rama 1 |
Rama 1
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Anatomy
"Wanting" is crucially dependent on: |
Anterior cingulate
"wanting" as in akinetic mutism or vigilant coma. "I heard you, doc. I just didn't feel like answering" Rama 1 |
Rama 1
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Where is visual information initially discriminated?
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Fusiform gyrus
Rama |
Rama
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The pyramidal tracts are:
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The motor pathway that descends from the cortex down into the spinal cord conveying commands for volitional movements.
Controls VOLUNTARY movements. Rama |
Rama
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Babinski sign indicates:
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Damage to the pyramidal tracts.
UMN lesion anywhere along the corticospinal tract Rama Blumenfeld |
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The extrapyramidal system does what?
What structures comprise it? |
It dampens erratic motions, maintains muscle tone and truncal stability.
Basal ganglia http://pathology.mc.duke.edu/neuropath/nawr/motor-systems.html |
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What structure is most affected in Huntingtons?
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Caudate
http://pathology.mc.duke.edu/neuropath/nawr/motor-systems.html |
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What structure is most affected in Ideopathis Parkinson's?
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Substantia nigra
http://pathology.mc.duke.edu/neuropath/nawr/motor-systems.html |
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UMN reside in _______ and extend from the ________ to the ___________.
LMN extend from the ________ to the __________. |
the precentral gyrus.
Brain to spinal cord. Spinal cord to skeletal muscles of the arms and legs. http://pathology.mc.duke.edu/neuropath/nawr/motor-systems.html |
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Branches & Subbranches of Nervous System
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CNS Brain & Spinal Cord
Somatic Cranial & Spinal nerves Autonomic Symp & Parasympathetic |
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Role of Somatic Nervous System
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Produces movement and transmits incoming sensory info to the CNS, including Vision, Hearing, Pain, Temp, Touch, and Position & Mvmt of Body Parts
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Role of Autonomic Nervous System
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Balances internal organs to either:
Rest & digest: Parasympathetic Nerves OR Fight & Flight: Sympathetic Nerves |
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Protective Membranes in Brain
(from inside to out): |
Pia Mater-clings to surface of brain
Arachnoid Dura Mater |
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ACA irrigates the:
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Medial and dorsal part of the cortex
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What is the major visual center of the brainstem?
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Superior colliculus
Kolb 203 |
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What is the major auditory center of the brainstem?
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Inferior colliculus
Kolb 203 |
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What are the 3 landmarks in the visual cortex?
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- Calcarine sulcus: contains much of the 1^ cortex & divides the upper and lower halves of the visual world.
-Lingual gyrus (ventral surface of each hem) -Fusiform gyru (ventral surface of each hem) |
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What is the 1st place in the cortex where visual information is processed?
What are the precortical stages in visual processing? |
Primary visual cortex.
Precortical stages: retina & LGN UTx site |
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Primary visual cortex is AKA as ___ & ___.
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Striate cortex or V1
UTx site |
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T or F
Damage to V1 can affect vision in just one or both eyes. |
False. Both eyes are always affected.
Kolb p.360 |
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T or F Different parts of the visual field are topographically represented in different parts of V1.
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True. Thus injury to a specific region of V1 produces a loss of vision in a specific part of the visual world.
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Formed visual hallucinations (people, animals, complex scenes) arise from what area of the brain?
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Inferior temporo-occipital visual assn cortex
Blumenfeld p 440 |
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Formed visual hallucinations (people, animals, complex scenes) can be caused by:
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Toxic/metabolic disturbances
ETOH & sedative withdrawal Focal seizures Complex migraine Neurodeg disorders Narcolepsy Midbrain ischemia Psychiatric disorders Release phenomena (in patients with visual deprivation) Blumenfeld p 440 |
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Visual hallucinations that occur in elderly patients as a result of impaired vision is referred to as?
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Charles Bonnet syndrome
Blumenfeld p 440 |
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Name & fx of each class of photoreceptors in the retina:
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Rods: vision in low-level lighting conditions, but poor spatial and temporal resolution.
Cones: detect color. Relatively high spatial and temporal resolution. Blumenfeld p 429 |
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The region of the retina with the highest visual acuity is the:
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Fovea
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Homonymous hemianopia results from:
Where does blindness occur? |
Lesions proximal to the optic chiasm (optic tract, LGN, optic radiations, or V1)
One entire visual field. IOW, it affects info coming from both eyes. Results from |
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If a visual disturbance is restricted to just one eye, where is the damage?
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Outside the brain -- either in the retina or optic nerve.
Kolb p.360 |
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Monocular blindness results from damage to the:
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Eye, Retina or Optic Nerve
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A lesion of the medial region of the optic chiasm produces:
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Bitemporal (bilateral lateral) hemianopia
Because it severs the crossing fibers. The fibers that cross are from medial (nasal) hemiretina fibers which are responsible for temporal (lateral) hemifields. |
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A pituitary tumor can cause what type of vision problem?
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Bitemporal (bilateral lateral) hemianopia
-because the pituitary sits medially next to the optic chiasm, a tumor can put pressure on the medial part of the chiasm |
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Complete cuts of the optic tract, LGN, or V1 can cause:
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Homonymous hemianopia
One entire visual field is affected. IOW, it affects info coming from both eyes. |
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Lesions of the entire optic radiation cause a:
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Contralateral homonymous hemianopia
Blumenfeld p 433 |
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The inferior optic radiations carry information from the inferior OR superior retina (inferior OR superior visual field).
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Inferior retina / Superior visual field
Therefore, temporal lobe lesions can cause a contralateral homonymous superior quadrantanopia. Blumenfeld p 433 |
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What forms Meyer's Loop?
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Fibers of the inferior optic radiations that arc forward into the temporal lobe
Blumenfeld 433 |
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The upper optic radiations pass where?
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Under the parietal lobe.
Therefore, parietal lobe lesions can sometimes cause a contralateral homonymous inferior quadrantanopia |
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Is weakness associated with lesions above the pyramidal decussation Ipsilateral OR Contralateral?
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Contralateral
Blum 32 |
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True or False
UMN and LMNs synapse at the pyramidal decussation. |
False. Below the decussation
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Where is auditory AND written language first perceived?
Where doe is go from there? |
1^ aud cortex: Sup temp lobe AND
1^ visual cortex: Occipital lobe From there, cortical-cortical association fibers convey info to Wernickes's area in the dominant (usually L) hemisphere . Blumenfeld p. 43 |
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Anatomy of deficits in language comprehension
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Werniche's. AKA receptive or sensory aphasia
Superior temporal gyrus. It surrounds the 1^ auditory cortex. Blumenfeld p. 43 |
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Anatomy of deficits in language production
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Broca's. AKA expressive or motor aphasia.
Frontal lobe (left) adjacent to the areas of 1^ motor cortex involved in moving the lips, tongue, face, & larynx. Blumenfeld p. 43 |
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Inferior Parietal Lobule consists of the:
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Supramarginal gyrus and Angular gyrus
Blumenfeld p 25 |
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Angular gyrus surrounds:
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the end of the Superior Temporal Gyrus
Blumenfeld p 25 |
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Supramarginal gyrus surrounds:
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the end of the Sylvian fissure.
Blumenfeld p 25 |
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The limbic cortex consists of what structures?
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thalamus
hypothalamus cingulate gyrus hippocampus amygdala basal ganglia http://its.sdsu.edu/multimedia/mathison/limbic/index.htm |
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Main Somatosensory Pathways
What does each convey? |
Posterior column pathways: PVT
Proprioception, Vibration sense, fine, discriminative Touch Anterolateral Pathways: PTT Pain, Temperature, crude Touch Blumenfeld p 34 |
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The thalami lie just above the _______________ and just behind the _______________________
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above the Brainstem
behind the Basal Ganglia Blumenfeld p 35 |
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The diencephalon is composed of the:
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Thalamus, hypothalamus, and epithalamus
Blumenfeld p 36 |
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Hypothalamus is an important region for control of:
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autonomic, neurodendocrine, limbic and other circuits
Blumenfeld p 36 |
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UMNs are:
They form synapses onto: |
Motor neurons that project via the corticospinal tract (from the cortex down to the spinal cord or brainstem) to LMNs
LMNs Blumenfeld p 33 |
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LMNs are located in the:
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Anterior horns of the central gray matter of the spinal cord OR
in brainstem motor nuclei. Blumenfeld p 33 |
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Lesions in the cerebellum lead to:
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Disorders oin coordination and balance: Ataxia
Blumenfeld p 34 |
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Lesions in the basal ganglia lead to:
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Hypokinetic movement disorders (such as Parkinsonism, in which movements are infrequent, slow and rigid) AND
Hyperkinetic movement disorders (such as Huntington's, which is characterized by dancelike involuntary movements) Blumenfeld p 34 |
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Signs of LMN lesions:
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Weakness
Hyporeflexia Atrophy Fasciculations Blumenfeld p 63 |
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Signs of UMN lesions:
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Weakness
Hyperreflexia Increased tone + Babinski (toes up) Blumenfeld p 63 and 66 |
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Tests for higher-order aspects of sensation (aka: cortical sensation):
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-Graphesthesia (#s)
-Stereognosis (object in hand) -Tactile Extinction on double simultaneous stimulation Note: This can't be tested reliably unless 1^ sensation is intact bilaterally Blumenfeld p 71 |
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Increase tone can be due to:
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UMN lesions OR basal ganglia dysfx
Blumenfeld p 64 |
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Slow or awkward fine finger movements or toe tapping in the absence of weakness can signify:
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A subtle abnormality in the corticospinal pathways
OR Lesions of cerebellum or basal ganglia Blumenfeld p 64 |
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Babinski sign is associated with:
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UMN lesions anywhere along the corticospinal tract.
Blumenfeld p 66 |
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Ataxia is:
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Abnormal movement in coordination disorders. Medium to large amplitude involuntary movements with an irregular oscillatory quality superimposed on and interfering with the normal smooth trajectory of movement. ieL finger-nose-finger
Blumenfeld p 69 |
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To check coordination, test for:
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Ataxia (finger nose finger)
Precision finger tap Dysdiadochokinesia (alternating movements) Heel to shin Blumenfeld p 68 |
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Normal performance on coordination tests depends on:
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The integrated fxing of multiple sensory and motor subsystems including: position sense & visual pathways, LMN, UMN, BG, & cerebellum.
Thus to convincingly demonstrate cerebellar dysfx, joint position sense, vision, strength, & reflexes must be found normal, and the absence of involuntary movements caused by BG lesions must be confirmed. Blumenfeld p 69 |
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Tests of primary sensation
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Pain, temperature, vibration sense, joint position sense, 2-point discrimination
Blumenfeld p 71 |
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With the eyes open, what sensory systems provide input to the cerebellum to maintain truncal stability?
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1.Vision
2. Proprioception 3. Vestibular sense When eyes are open, a patient can usually compensate for a lesion to 2 or 3, but once visual input is removed (Romberg), instability can be brought out. Note that instability can also be due to lesions in other parts of the nervous system, such as UMN, LMN, BG. Blumenfeld p 70 |
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Somatosensory deficits can be caused by lesions in:
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-Peripheral nerves
-Nerve roots -Posterior columns or anterolateral sensory systems in spinal cord or brainstem -Thalamus -Sensory cortex Pain, temperature, vibration sense, joint position sense, 2-point discrimination Blumenfeld p 71 |
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Extinction with intact 1^ sensation is a form of hemineglect most commonly associated with lesions of ______ but, like other forms of neglect, can also be occasionally seen with___________or _________, OR ____
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R parietal lobe
R frontal or subcortical lesions L hemisphere lesions causing mild right hemineglect Blumenfeld p 72 |
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Conversion Disorder vs Somatization Disorder vs Factitious Disorder vs Malingering
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Conversion: patient has sensory or motor deficits without a corresponding focal lesion.
Somatization: Patient has multiple somatic complaints that change over time. Factitious: Patient has conscious control over symptoms and intentionally use them for an ulterior motive that is INTERNAL to the patient (Munchausen's). Malingering: Motive is EXTERIOR to patient. Blumenfeld p 7? |
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