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BRS NEUROLOGY > 1b// Cortical organisation and function > Flashcards

1b// Cortical organisation and function Flashcards

1
Q

where is the cerebral cortex?

A

covers entire surface of the brain

contains grey matter and deep nuclei

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2
Q

What is the microscopic organisation fothe cerebral cortex?

A
  • It is organised into layers and columns
    • First layer is the outermost, VI is the innermost
  • Each column has different cells
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3
Q

what do fissures separate?

A

hemispheres and lobes

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4
Q

what are Brodmann maps

A

52 regions based cytoarchitecture (cell size, spacing, packing density and layers)

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5
Q

how are Brodmann maps useful?

A

areas relate to function e.g primary somatosensory (1,2,3), primary motor (4)

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6
Q

what are the different cerebral cortex lobes

A

Frontal
Parietal
Temporal
Occipital

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7
Q

what are the functions of the Frontal lobe?

A

IM CALM
~~~
initiating Motor function
Cognitive executive function
Attention
Language
Memory
~~~

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8
Q

what are the functions of the parietal lobe?

A

sensation - touch/pain
sensory aspects of language
spatial orientation and self-perception

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9
Q

what are the functions of the occipital lobe?

A

processing visual information

gives meaning to images

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10
Q

what are the functions of the temporal lobe

A

processing auditory information
emotions
memories

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11
Q

what is contained in the limbic lobe? (4)

A

amygdala, hippocampus, mamillary body, cingulate gyrus

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12
Q

what are the functions of the limbic lobe?

A 
MEMs and LeaRning
memory
emotion
motivation
learning 
reward
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13
Q

where is the insular lobe?

A

lies deep into lateral fissure

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14
Q

What is the insular lobe associated with?

A

Concerned with visceral sensations,
autonomic control,
and interoception (awareness of inside the body),
auditory processing,
visual-vestibular integration

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15
Q

what is grey matter?

A

neuronal cell bodies and glial cells

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16
Q

what is white matter?

A

myelinated neuronal axons

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17
Q

what are the types of white matter tracts?

A

association fibres, commissural fibres, projection fibres

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18
Q

what are association fibres?

A

connect areas in same hemisphere

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19
Q

what are commissural fibres?

A

connect homologous structures in left and right hemispheres

e.g corpus callosum, anterior commissure

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20
Q

what are projection fibres

A

connect cortex to lower brain structures

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21
Q

what association fibres connect the frontal and occipital lobe?

A

superior longitudinal fasciculus

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22
Q

what association fibres connnect the frontal and temporal lobes, specifically Brocas and Wernickes area?

A

arcuate fasciculus

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23
Q

what association fibres connect the temporal and occipital lobes?

A

Inferior longitudinal fasciculus

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24
Q

what association fibres connect the frontal and temporal lobes?

A

Uncinate fasciculus

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25
Q

What is the difference between long and short association fibres?

A

short fibres connect areas within the same hemisphere

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26
Q

where do commissural fibres pass through

A

corpus callosum

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27
Q

where do projection fibres converge?

A

through the internal capsule (between the thalamus and basal ganglia)

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28
Q

What are deeper to cortex projection fibres called?

A

corona radiata

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29
Q

How are projection fibres classified?

A
  • Afferent= towards cortex
    Efferent= away from cortex
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30
Q

how predictable is function from primary cortices? and what is its symmetry like?

A

easily predictable with left-right symmetry

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31
Q

how predictable is function of secondary/association cortices? And what is its symmetry like?

A

less predictable

left-right symmetry is weak or absent

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32
Q

what are the motor areas of the frontal lobe?

A

primary
supplementary
premotor

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33
Q

Are primary or secondry cortices of the brain organised topographically?

A

primary

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34
Q

what does the primary motor area of the frontal lobe control?

A

fine, discrete, precise voluntary movements

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35
Q

what does the supplementary motor area of the frontal lobe control?

A

planning complex movements, internally cued

provides descending signals to execute movement

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36
Q

what does the premotor area of the frontal lobe control?

A

planning movements, externally cued

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37
Q

what area of the frontal lobe controls fine, discrete voluntary movements?

A

primary motor area

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38
Q

what area of the frontal lobe plans complex, internally cued movements?

A

supplementary motor area

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39
Q

what area of the frontal lobe plans movements that are externally cued?

A

premotor area

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40
Q

what areas are contained in the parietal lobe?

A

primary somatosensory area

somatosensory association area

41
Q

what is controlled by the primary somatosensory area?

A

processes somatic sensations arising from receptors in the body

e.g., fine touch, vibration, propioception, pain and temp

42
Q

what is controlled by the somatosensory association area of the parietal lobe?

A

interpret the significance of sensory information e.g., recognizing an object placed in the hand

awareness of self and personal space

43
Q

what is controlled by the primary visual area of the occipital lobe?

A

processes visual stimuli

44
Q

what is controlled by the visual association area of the occipital lobe?

A

gives meaning and interpretation of visual input

45
Q

what is controlled by the primary auditory area of the temporal lobe?

A

processes auditory stimuli

46
Q

what is controlled by the auditory association area of the temporal lobe?

A

gives meaning and interpretation of auditory input

47
Q

What are the other association areas, and where are they?

A
48
Q

what is the prefrontal cortex responsible for?

A

APPSD
~~~
attention
planning
personality expression
social behaviour
decision making
~~~

49
Q

what is the brocas area responsible for?

A

motor aspect of speech, production of language

50
Q

where is the Brocas area?

A

left frontal lobe, just above sylvian fissure

51
Q

what is Wernicke’s area responsible for?

A

understanding and comprehension of language

52
Q

where is Wernicke’s area found?

A

left temporal lobe, superiorly and caudally

53
Q

what is the result of a frontal lobe lesion?

A

changes in personality, inappropriate behaviour

54
Q

what is the result of a parietal lobe lesion?

A

contralateral neglect
lack of awareness of self on opposite side
lack of awareness of opposite side of extrapersonal space

55
Q

what is the result of a temporal lesion?

A

agnosia (inability to recognise)

possible anterograde amnesia

56
Q

What are the types of temporal lobe lesions?

A
57
Q

What happens if there is bilateral anterior medial temmporal lobe resection?

A

no new memories aka anterograde amnesia

58
Q

What happens in a Broca’s area lesion?

A

expressive aphasia - poor production of speech, comprehension intact

59
Q

What happens in Wernicke’s area lesion?

A

receptive aphasia - poor comprehension of language

60
Q

what would a lesion to the primary visual cortex of the occipital lobe cause?

A

blindness in the corresponding part of the visual field

61
Q

what would a lesion to the visual association area of the occipital lobe cause?

A

deficits in interpretation of visual information e.g prosopagnosia (inability to recognise familiar faces or learn new faces)

62
Q

what are the 4 main methods of assessing cortical function?

A

Positron emission tomography (PET)
functional magnetic resonance imaging (fMRI)
electroencephalography (EEG)
magnetoencephalography (MEG)

63
Q

what is a PET scan?

A

positron emission tomography

demonstrates the blood flow directly to a brain region

64
Q

what is an fMRI scan?

A

basically a PET using radioactive isotopes of glucose

demonstrates amount of blood oxygen in brain regions

65
Q

what is an EEG?

A

electroencephalography

measures electrical signals produced by the brain

event-related potentials/ evoked potentials

66
Q

what is an MEG?

A

measures magnetic signals produced by the brain

event-related potentials/ evoked potentials

67
Q

what are visual evoked potentials?

A

used for encephalography

stimulates visual sensations

68
Q

what are somatosensory evoked potentials?

A

series of waves that reflect sequential activation of neural structures along the somatosensory pathways

69
Q

what is transcranial magnetic stimulation?

A

assesses functional integrity of neural circuits, using electromagnetic induction to stimulate neurones

70
Q

What do each of these lines represent in encephalogropahy?

A
71
Q

what is transcranial direct current stimulation

A

uses low direct current over the scalp to increase or decrease neuronal firing rates

72
Q

What is TMS?

A

to assess cortical function- brain stimulation

* Assess the functional integrity of neural circuits 
* By using electromagnetic induction to stimulate neurons  Transcranial magnetic stimulation (TMS)
73
Q

what is diffusion tensor imaging?

A

scan based on the diffusion of water molecules

74
Q

what is diffusion tensor imaging with tractography?

A

3D reconstruction of brain to assess neural tracts

75
Q

Mnemonic for insular lobe?

A 
Insurance AVIVA
Auditory processing
Visual vestibular integration
Interoception
Visceral sensation
Autonomic control
76
Q

What is tDCS?

A

to assess cortical function- brain stimulation

* Transcranial direct current stimulation (tDCS) Uses low direct current overt the scalp to increase or decrease neuronal firing rates
77
Q

How to tell brocas and wernickes aphasia apart

A

Broca C D Expressive aphasia

Wernickes V U T S Receptive aphasia

78
Q

what is multiple sclerosis?

A

Multiple Sclerosis is an autoimmune disorder which results in the loss of myelin from neurons of the central nervous system i.e., brain and spinal cord.

79
Q

symptoms of MS? (8)

A 
fatigue
difficulty walking
blurred vision
bladder control issues
numbness/tingling
stiffness/spasms
balance/coord issues
cognitive issues
80
Q

How can brain and nerve stimulation help to confirm the central nature of MS?

A
81
Q

What is the word for travelling in the normal direction in a nerve fibre? And vice versa?

A

orthodromic and antidromic

82
Q

Does this make sense?

A
83
Q

what is the inflammation process of MS?

A

driven by perivascular and leptomeningeal (arachnoid and pia mater) immune cell infiltration (CD3 T cells, CD20 B cells)
inflammation - demyelination - axonal loss - neurodegeneration

84
Q

Risk factors for MS. (6)

A 
family history
female
other autoimmune
vit D deficiency as a child
epstein-barr virus 
smoking
85
Q

Types of MS.

A

relapsing-remitting

primary progressive

secondary progressive - may also have relapse/remiss and faster progression than primary

progressive-relapsing - progressive worsening and acute relapses with no remission

86
Q

MS early symptoms

A

ocular pain, blurred vision (optic neuritis)

87
Q

path of projection fibres?

A

corona radiata
to internal capsule
into descending white matter tracts (brainstem/spinal cord)

88
Q

types of association fibres

A

short fibres - U fibres - connect adjacent gyri within same hemisphere
long fibres - connect distal regions within same hemisphere

89
Q

what is an M-wave

A

fast twitch
motor activation - orthrodromic (towards muscle)

electrical stimulus - activates motor axons orthodromically - action potentials - muscle contraction

90
Q

what is an H-reflex

A

slow twitch - orthrodromic sensory activation

electrical stimulus - activates sensory axons orthodromically - action potentials to spinal cords - lower motor neurons - muscle contraction

91
Q

what is an F-wave

A

slowest muscle twitch
antidromic motor activation (goes backwards through spinal cord - opposite of normal motor M wave)

large electrical stimulus only - activates motor axons antidromically - action potentials to spinal cord - backfire to lower motor neurons - muscle contraction

92
Q

what do CNS demyelinations show on an EMG

A

slowed motor neuron latency in CNS so prolonged CMCT (central motor conduction time)

93
Q

calculation for peripheral motor conduction time (PMCT)

A

(M latency + F latency-1) /2

-1 is for turnaround time in spinal cord of F wave

94
Q

how do we measure motor evoked potential latency (total motor conduction time)

A

transcranial magnetic stimulation (TMS)
measured with an EMG to see how long it takes from activation of motor cortex to muscle contraction

95
Q

what is total motor conduction time (TMCT)

A

time taken from stimulation of primary motor cortex by TMS to the contraction of muscle (measured by EMG)

96
Q

what is peripheral motor conduction time measuring

A

time from spinal cord to muscle along motor axon

97
Q

how to calculate central motor conduction time

A

TMCT - PMCT

98
Q

how do we know if there is an issue of conduction of CNS neurons? (MS)

A

longer MEP - could be upper MN, lower MN, both (longer TMCT)

peripheral nerve stim - normal F wave (so normal PMCT) indicates no issue with lower MN

AKA total motor conduction time delayed with normal peripheral motor conduction time

BRS NEUROLOGY (22 decks)

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