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60 Cards in this Set

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Define Broca's aphasia?

Nonfluent aphasia; impaired fluency, repetition, and severe phonemic parphasias. A phonemic paraphasia reflects the correct semantiv target, but the phonemes constituting the word are wrong (e.g., helichopper for helicopter). Relative preservation of comprehension, although prepositions may be impaired

In patient's with Broca's aphasia, where is the lesion usually located?

Language-dominant hemisphere (typically left) frontal operculum (a motor association cortex) , also known as the Broca area or BA 44 and 45

In classic Wernicke aphasia, where is the lesion usually located?

In the language-dominant posterior superior temporal gyrus (auditory association cortex adjacent to the primary auditory cortex), which is called the Wernicke area or BA 22 (posterior portion)

Wernicke aphasia is characterized by?

1. Impaired comprehension


2. Impaired repetition


3. Agrammatic, semantic, and phnemic paraphasias.




Patients with semantic paraphasias use the wrong word, but typically the word is within the correct category or is a supraordinate term

Transcortical aphasias?

Less severe and usually due to a vascular mechanism in the watershed area surrounding the language center in question (Wernicke or Broca)

Conduction aphasia?

Damage to the insula and underlying white matter (arcuate fasciculus), and patients have impaired repetition with preserved fluency and comprehension

Anomic aphasia?

Impaired naming with preserved fluency, comprehension, and repetition

Most frequent cause of anomic aphasia?

Lesion in the language-dominant anterior temporal lobe; often seen as a degenreative syndrome, as a subtype of FTD. Not as the residual of a more severe form of aphasia.

Surface dyslexia, what is it?

Patients lose whole-word recognition and must sound out words, the process is similar to the way a child first learns to read

Phonologic dyslexia, what is it?

Patients lose the ability to sound out words and must read at the whole-word level. They have difficulty reading nonwords (e.g., floink) and distinguishing between visually similar words (e.g., tablet and table)

Localization of phonologic dyslexia? (3)

1. Area of the superior temporal gyrus


2. Inferior parietal lobe


3. Supramarginal gyrus

Alexia without agraphia was first described how?

As a disconnection syndrome in a patient with a lesion damaging the left occipital lobe (causing a right homonymous hemianopia and thus allowing no direct connection within the left hemisphere between visual and comprehension regions) and corpus callosum (thus disconnecting the right visual cortex from the left hemisphere comprehension area.

Alexia without agraphia is most commonly caused by?

A lesion affecting the left (language-dominant) inferior temporal cortex (the "what" pathway in the verbal hemisphere; BA 37)

Inability to perform certain tasks when no other explanation was obvious?

Apraxia, e.g., sensory or motor loss of function

Ideomotor apraxia?

Disordered motor progamming resulting in the inability to perform a skilled movement. The inability is not proportional to weakness, sensory loss, ataxia, or other more basic type of movement disturbance

Ideomotor apraxia can result from lesions where?

1. Motor association cortex


2. Parietal lobe (BA 5 and 7)

Degenerative causes of ideomotor apraxia?

1. Corticobasal ganglionic degeneration and its mimics


2. Degenerative lesion on either side of the brain but typically is more severe when the degenerative atrophy is more pronounced in the left hemisphere

Limb kinetic apraxia?

Loss of fine-movement dexterity

Ideational apraxia?

Semantic paraphasia for movement - that is, substitution of 1 form of movement for another. For example if asked to pantomime the use of a screwdriver, the patient pantomimes the use of a hammer instead

Gait apraxia, what is it?

Not a true apraxia, but siumply a magnetic gait common in NPH; thoguht to reflect compresison of, or damage to, frontal white matter

The inability to recognize objects?

Agnosia; also can't recognize people, wounds, or smells despite intact sensation

Inability to recognize familiar faces is called what? Lesion is usually found where?

1. Prosoprognosia


2. Right occipitotemporal infarctions

Most common cause of prosoprognosia?

Neurodegenerative diseases, such as the right temporal variant of semantic variant FTD

Inability of to compute the simultaneity of a complex visual scene in space and time or to effectively scan the environment?

BAsimtulanagnosia, caused by bilateral superior parietal lobe damage; Balint syndrome consists of this with the additional elements of optic ataxia (impaired visually guided reaching) and ocuylar apraxia (inability to voluntarily fixate gaze on a visual target)

Result of asimultagnosia?

Functionally blind, they lose the ability to integrate the many parts of a scene into a coherent whole and cannot search normally for the target of interest

Anton syndrome?

These patients deny that they are blind. Those with complete loss of primary visual cortices retain thalamic input to the visual association cortex from the pulvinar.

In contrast to patients with Anton syndrome, how do those with "blindsight" see?

They have no cortical vision yet they retain some evidence of function, presumably mediated by the extrafoveal-pulvino-exctrastriate cortex pathway

Difficulty comprehending music is termed?

Amusia

Reduced prosody is called?

Aprosodia; prosody means pattern of stress and intonation

Inability to recognize objects?

Tactile somatosensory agnosia

The ventrolateral somatosensory association cortex consists of? (3)

1. Inferior parietal lobule


2. Parietal operculum


3. Posterior insula (possibly)

True somatosensory agnosia results from damage where?

Ventrolateral somatosensory association cortex

Dorsomedial somatosensory association cortex includes?

1. Brodmann areas 5 and 7

Damage to the dorsomedial somatosensory association cortex results in?

A tactile deficit that is analogous to asimultagnosia, or a disorder in the visual "where" pathway

Define agnosia

Inability to interpret a sensation

What is astereognosis?

Patients with primary somatosensory cortical damage (or ventral posteriolateral thalamic damage) lose elemental somesthetic function, including, importantly, proprioception, and 2-point discrimination and even the sense of touch itself. It is therefore no surprise that within this tactually blinded context patients cannot discern shapes and objects

Hemispatial neglect is usually caused by?

Damage to the parietal cortices, in particular the right parietal, essentially extinguishes consciousness of the contralateral space and is reflected by a widely encompassing spatial perceptual and constructional disorder

What constitutes the angular gyrus syndrome?

1. Alexia


2. Agraphia


3. Anomia with or without additional elements of aphasia


4. Acalculia


5. Constructional apraxia


6. Right-left confusion


7. Finger anomia

Gerstmann syndrome?

1. Acalculia


2. Constructional apraxia


3. Right-left confusion


4. Finger anomia

Gerstmann syndrome is due to damage where?

Left inferior parietal lobe (angular gyrus)

Which brain regions or systems are central in reward and punishment? (3)

1. Hypothalamus


2. Mesolimbic dopaminergic system (VTA and the nucleus accumbens)


3. Orbitofrontal cortex (linked by the medial forebrain bundle)

VTA dopaminergic reward neurons are most strongly activated by?

Rewarding events that are better than expected

Role of basolateral amygdala?

Form associations between sensory cues and rewarding or aversive stimuli. It acts as a fear center without encoding the properties of the stimulus itself.

Akinetic mutism can be caused by?

Butterfly gliomas that cross the anterior corpus callosum as well as anterior cerebral artery territory infarctions

Acquired sociopathy can be caused by a lesion where?

Orbitofrontal cortex, as in the historical case of Phineas Gage

Working memory - anatomy?

Prefrontal cortex

Declarative memory - episodic - anatomy?

1. Medial temporal lobe


2. Medial thalamus, mammillary bodies, basal forebrain cholinergic system

Declarative memory - semantic - anatomy?

1. Hgeteromodal association cortex (particularly left lateral and anterior temporal areas)

Priming memory - anatomy?

1. Occipital cortex


2. Temporal cortex


3. Parietal cortex


4. Frontal cortex

Emotional memory - anatomy?

Amygdala

Procedural (implicit) memory?

1. Striatum


2. Cerebellum

Function of procedural memory?

Motor skill learning

Function of working memory?

Maintain information for a short period after transient exposure to a stimulus to guide behaviour

Function of episodic declarative memory?

Learning and retrieving personal events and facts

Function of semantic declarative memory?

General fund of knowledge

Function of emotional memory?

Associative learning of a link between a perceptual stimulus and its emotional significance

Function of priming memory?

Experience of a stimulus influences later processing of the same or related stimulus

Is memory loss a focal neurologic sign?

Yes

Which anatomical locations should be considered in amnesic patients?

1. Hippocampus


2. Medial temporal lobe


3. Dorsomedial nucleus of the thalamus


4. The hypothalamic and septal region

What is Korsakoff psychosis?

Not a psychosis at all! But a dense amnestic syndrome with prominent confabulation