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83 Cards in this Set
- Front
- Back
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What is the most common language deficit?
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anomia
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Wernicke's vs. Broca aphasia?
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wernicke's receptive
brocas expressive |
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Damage to which area cause mutism?
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damage to supplementary motor cortex
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Seizures in supplementary motor cortex sometimes associated with what?
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stuttering
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What is dysarthria and what is it caused by?
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motor problem, not a language problem cause by primary motor cortex or cerebellar dysfunction (corticobulbar tract, cranial nerves, or cerebellar pathways) so effects articulation
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What is the intracarotid amytal test? aka WADA test?
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measures language and memory function while one hemisphere is anesthetized to assess hemispheric lateralization
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What is prosody?
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the melody of speech, variation in intonation and phrasing
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Which area of brain involved in prosody?
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non-dominant hemisphere, so usually right
-right hemisphere plays role in producing and comprehending affective aspects of speech |
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When is the expressive aspect of speech prosody usually impaired?
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with damage to inferior right frontal lobe
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When is comprehension of prosody/affective aspect of speech impaired?
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damage to right posterior temporal lobe
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What is alexia?
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inability to read, pure word blindness
-can be with or without agraphia |
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Disconnection syndrome?
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damage to corpus callosum prevents transfer of info so "left hemisphere can't express what the right hemisphere sees in the left visual field" for example
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Ataxic dysarthria?
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results from cerebellum dysfunction and characterized by
-slowed speaking rate -distorted consonant and vowel productions -impaired prosodic modulation of sentence utterances |
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Alpha wave?
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-occipital prominence
-bilaterally synchronous -during restful wakefulness with eyes closed |
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Beta wave?
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-frontal prominence
-during attentive wakefulness |
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Theta waves?
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-widespread
-present during drowsiness |
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Delta wave?
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-widespread
-present during sleep (slow wave sleep) |
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What does the EEG actually measure?
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mainly synaptic potentials in pyramidal cells
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Characteristics of slow wave/non-REM sleep?
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-moderate muscle tone
-dec sympathetic activity -dec basal metabolism -EEG increasingly dominated by delta waves -arousal response reduced |
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Characteristics of REM sleep?
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-EEG desynchronized
-lack of tone in postural muscles -frequently associated with dream -high behavioral arousal threshold |
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What is cerveau isole?
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midcollicular transection in brainstem causing permanent sleep/coma
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What is encephale isole?
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a high cervical transection in brainstem that maintains normal sleep/wake cycle
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What does a encephale isole plus CN 5 and 8 cut cause?
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permanent sleep
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What are the rostral and caudal brainstem each needed for?
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rostral = wakefulness
caudal = needed for sleeeeeep |
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Midpontine transection?
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permanently awake
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Destruction of raphe nuclei?
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produce transient insomnia
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What do inhibitors of serotonin do?
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produce insomnia
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True or false: raphe nuclei are serotonergic?
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TRUE
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What happens when 5-hydroxytryptamine, serotonin precursor, is injected into cerebral ventricles?
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SLEEEEEEEEP induction
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Solitary tract and sleep?
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electical stimulation here induces sleep
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What do pharmacologic manipulations of noradrenergic systems do?
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alter REM
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What happens when locus ceruleus is lesioned?
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motor inhibition of REM is ABOLISHED , the neurons in this locus are rich in noradrenalin and we know that manipulation of noradrenergic systems alter REM
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Which nucleus controls circadian rhythms?
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suprachiasmatic
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In a comatose patient how do you rule out locked in state?
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ask them to look up/down
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According to the clinical criteria for brain death which reflexes may be present?
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spinal reflexes but NOT brainstem reflexes since brain death includes cessation of brainstem functions
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Signs of brainstem death??
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-pupils fixed and mid-position
-extraocular movement absent in repsonse to oculocephalics -no corneal response -gag, swallowing, cough to deep suction all absent -may have spinal reflexes, deep tendon reflexes, triple flexion |
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Which NTs are present during wakefulness and non-REM sleep and appear again toward end of REM, possibly playing role in ending episode?
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orexin from lateral hypothalamus
serotonin from raphe nucleus norepinephrine from locus ceruleus |
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When regulating sleep which NT is present during non-REM and REM sleep but NOT during wakefulness?
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GABA from preoptic area
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When is histamine present as a modulator during the sleep cycle?
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during wakefulness and non-REM
comes from tuberomammillary nucleus (hisssss dont want to dream about snakes so not present during REM) |
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When is acetlycholine present in the sleep cycle as a regulator?
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during wakefulness and REM sleep
comes from midbrain reticular formation |
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Barbiturates?
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non-competive agonist at GABA A receptor so facilitate the activity of GABA
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Benzodiazepines?
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bind to receptors located on the GABA receptor complex, facilitates GABA activity by increasing its affinity for its receptor
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What does GABA do at its receptor?
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opens chloride channels which hyperpolarizes inside of membranes, inhibitory
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Opiates?
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act at G-protein coupled metabotropic opiate receptors for endogenous opiate NTs. exogenous opiates inc K+ conductance and decrease calicium conductance so create IPSPs in different areas of CNS
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Gas anesthetics? (sevoflurane, isoflurane, desflurane)
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-highly lipid soluble
-distort neural membranes so that ion channels do not work normally -stabilizes membranes and thus blocks neural activity |
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Barbiturates, benzodiazepines, opiates, gas anesthetics, alcohol - what do they have in common?
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DEPRESSANTS
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Caffeine?
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competitively blocks adenosine receptor so has excitatory effects at neural and behavioral level
-adenosine usually produces inhibitory postsynaptic potentials after binding its receptor |
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Amphetamine?
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dopamine agonist with euphoric effects
-increases release of dopamine -blocks reuptake of dopamine |
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What is the core symptom in primary generalized seizures? Which area of brain involved?
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-loss of consciousness, bilateral from onset
-bilateral cortex and thalamus involved |
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Types of primary generalized seizures?
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-absence (petit mal): brief loss of consciousness, behavior arrest, eyes stare/turn upward, eyelids blink rapidly, last seconds
-generalized tonic clonic (grand mal): sudden, bilaterally symmetrical major motor seizure, loss of consciousness, lasts few minutes; tonic and clonic phases |
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What is the difference between the tonic and clonic phases of a generalized tonic clonic primary generalized seizure?
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-tonic phase: sustained muscle contraction
-clonic phase: intermittent contraction and relaxation of muscle |
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What kind of seizure has the neocortex as its anatomical substrate?
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simple partial seizures
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Signs and symptoms of simple partial seizure?
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depends on cortical region: sensory, motor, or higher functions
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Limbic system involved in which kind of seizure?
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complex partial
-hippocampus most common -amygdala follows as second most -may also start in orbital frontal cortex or cingulate gyrus |
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Core symptoms of complex partial seizures?
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alteration of consciousness - amnesia very common
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Symptoms of complex partial seizures?
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-smell: uncus, amygdala
-taste: insula -vertigo -autonomic or visceral sensations -automatism -amnesia: hippocampus -fear: amygdala -hallucinations -illusions |
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Differentiation of epileptic from psychogenic experiences?
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behaviors and subjective experiences in seizures tend to be highly stereotyped in character
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Signs and symptoms of simple partial seizure?
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depends on cortical region: sensory, motor, or higher functions
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Limbic system involved in which kind of seizure?
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complex partial
-hippocampus most common -amygdala follows as second most -may also start in orbital frontal cortex or cingulate gyrus |
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Core symptoms of complex partial seizures?
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alteration of consciousness - amnesia very common
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Symptoms of complex partial seizures?
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-smell: uncus, amygdala
-taste: insula -vertigo -autonomic or visceral sensations -automatism -amnesia: hippocampus -fear: amygdala -hallucinations -illusions |
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Differentiation of epileptic from psychogenic experiences?
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behaviors and subjective experiences in seizures tend to be highly stereotyped in character
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Jacksonian seizure or march?
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simple or complex partial seizures may start in one site then spread to connected sites, like marching along primary motor cortex
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Secondary generalized seizure?
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simple or complex partial seizure may start at one site then become secondarily generalized when both hemispheres become involved; at this point becomes indistinguishable from primary generalized seizure, both are bilateral and include loss of consciousness
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When is secondary generalizes seizures particularly common?
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for frontal lobe seizures
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Todd's paralysis?
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after a focal seizure may experience postictal (post-seizure) loss of function/weakness at site of onset lasting minutes to hours
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What do most patients do after a generalized tonic-clonic seizure?
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sleeeep
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Kindling?
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low intensity, brief stimulation of amygdala repeated daily produces progressively longer and stronger electrical discharges and gradually induces behavioral seizures; same thing can happen in other cortical regions, esp limbic
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Mirror focus?
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repeated focal seizures in cortex on one side can cause development of epileptic focus in homologous portion of opposite cortex; intially secondary focus dependent on first for its activity but eventually becomes independent and can have its own seizures
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Status epilepticus?
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seizure lasting for 30 min or intermittent seizures going on for 30 min or longer
-may result in brain damage due to exctiotoxicity - hippocampus very vulnerable |
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What kinds of drugs are antiepileptic?
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-GABA agonists
-Na channel blockers -Ca channel blockers |
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What diet is good for epileptics?
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ketogenic
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Paroxysmal depolarization shift?
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intracellular manifestation of hyperexcitable neuron
-giant synaptic potential or intrinsic alteration of membrane properties |
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What facilitates the process of paroxysmal depolarization shift?
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NMDA receptor activation which are particularly abundant in hippocampus, which is the structure most commonly involved in complex partial seizures which is also the most common form of epileptic seizures
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Specifics of ion conductances during PDS?
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normal sodium action potential supplanted by calcium action potentials through activation of NMDA receptors
-prolonged depolarization due to calcium influx followed by afterhyperpolarization from potassium efflux - interictal epileptic spike in EEG |
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Epilepsy EEG manifestations?
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-isolated interictal spike corresponding to high frequency firing of action potentials and the PDSs in underlying tissue
-rhythmic seizure discharge involving large numbers of neurons firing synchronously and this site of origin reflected in behavior |
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Transition from interictal (between seizures) to ictal state?
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isolated epileptic spikes give rise to seizure discharges when the afterhyperpolarization from potassium conductance is diminished
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What conditions tend to be antiepileptic?
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conditions that desynchronize neurons like complex stimulation, wakefulness with eyes open, REM sleep (those that synchronize are proconvulsive)
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Seizures are usually self-limiting but what tends to limit them?
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stopped by engagement of inhibitory processes rather than by exhaustion
-redistribution of ionic pools and metabolic substrate deficiency may contribute |
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Role of basal ganglia and cerebellum in seizures?
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NOT considered sites of seizure onset but may participate in some aspects of seizure expression
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Typical seizure origination?
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gray matter, primarily in neocortex and limbic, sometimes thalamus and brainstem
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What is the "final common pathway" of primary generalized tonic clonic seizures?
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major motor convulsion with all limbs in tonic extension indicating both hemispheres are involved
-also seen in secondary generalized |
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Aura?
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reflects seizure discharge in sensory area
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