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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
What is the difference between long and short association fibres?
short fibres connect areas within the same hemisphere
26
where do commissural fibres pass through
corpus callosum
27
where do projection fibres converge?
through the internal capsule (between the thalamus and basal ganglia)
28
What are deeper to cortex projection fibres called?
corona radiata
29
How are projection fibres classified?
* Afferent= towards cortex Efferent= away from cortex
30
how predictable is function from primary cortices? and what is its symmetry like?
easily predictable with left-right symmetry
31
how predictable is function of secondary/association cortices? And what is its symmetry like?
less predictable | left-right symmetry is weak or absent
32
what are the motor areas of the frontal lobe?
primary supplementary premotor
33
Are primary or secondry cortices of the brain organised topographically?
primary
34
what does the primary motor area of the frontal lobe control?
fine, discrete, precise voluntary movements
35
what does the supplementary motor area of the frontal lobe control?
planning complex movements, internally cued provides descending signals to execute movement
36
what does the premotor area of the frontal lobe control?
planning movements, externally cued
37
what area of the frontal lobe controls fine, discrete voluntary movements?
primary motor area
38
what area of the frontal lobe plans complex, internally cued movements?
supplementary motor area
39
what area of the frontal lobe plans movements that are externally cued?
premotor area
40
what areas are contained in the parietal lobe?
primary somatosensory area | somatosensory association area
41
what is controlled by the primary somatosensory area?
processes somatic sensations arising from receptors in the body | e.g., fine touch, vibration, propioception, pain and temp
42
what is controlled by the somatosensory association area of the parietal lobe?
interpret the significance of sensory information e.g., recognizing an object placed in the hand | awareness of self and personal space
43
what is controlled by the primary visual area of the occipital lobe?
processes visual stimuli
44
what is controlled by the visual association area of the occipital lobe?
gives meaning and interpretation of visual input
45
what is controlled by the primary auditory area of the temporal lobe?
processes auditory stimuli
46
what is controlled by the auditory association area of the temporal lobe?
gives meaning and interpretation of auditory input
47
What are the other association areas, and where are they?
48
what is the prefrontal cortex responsible for?
APPSD ``` attention planning personality expression social behaviour decision making ```
49
what is the brocas area responsible for?
motor aspect of speech, production of language
50
where is the Brocas area?
left frontal lobe, just above sylvian fissure
51
what is Wernicke's area responsible for?
understanding and comprehension of language
52
where is Wernicke's area found?
left temporal lobe, superiorly and caudally
53
what is the result of a frontal lobe lesion?
changes in personality, inappropriate behaviour
54
what is the result of a parietal lobe lesion?
contralateral neglect lack of awareness of self on opposite side lack of awareness of opposite side of extrapersonal space
55
what is the result of a temporal lesion?
agnosia (inability to recognise) | possible anterograde amnesia
56
What are the types of temporal lobe lesions?
57
What happens if there is bilateral anterior medial temmporal lobe resection?
no new memories aka anterograde amnesia
58
What happens in a Broca's area lesion?
expressive aphasia - poor production of speech, comprehension intact
59
What happens in Wernicke's area lesion?
receptive aphasia - poor comprehension of language
60
what would a lesion to the primary visual cortex of the occipital lobe cause?
blindness in the corresponding part of the visual field
61
what would a lesion to the visual association area of the occipital lobe cause?
deficits in interpretation of visual information e.g prosopagnosia (inability to recognise familiar faces or learn new faces)
62
what are the 4 main methods of assessing cortical function?
Positron emission tomography (PET) functional magnetic resonance imaging (fMRI) electroencephalography (EEG) magnetoencephalography (MEG)
63
what is a PET scan?
positron emission tomography demonstrates the blood flow directly to a brain region
64
what is an fMRI scan?
basically a PET using radioactive isotopes of glucose | demonstrates amount of blood oxygen in brain regions
65
what is an EEG?
electroencephalography measures electrical signals produced by the brain | event-related potentials/ evoked potentials
66
what is an MEG?
measures magnetic signals produced by the brain | event-related potentials/ evoked potentials
67
what are visual evoked potentials?
used for encephalography | stimulates visual sensations
68
what are somatosensory evoked potentials?
series of waves that reflect sequential activation of neural structures along the somatosensory pathways
69
what is transcranial magnetic stimulation?
assesses functional integrity of neural circuits, using electromagnetic induction to stimulate neurones
70
What do each of these lines represent in encephalogropahy?
71
what is transcranial direct current stimulation
uses low direct current over the scalp to increase or decrease neuronal firing rates
72
What is TMS?
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
what is diffusion tensor imaging?
scan based on the diffusion of water molecules
74
what is diffusion tensor imaging with tractography?
3D reconstruction of brain to assess neural tracts
75
Mnemonic for insular lobe?
``` Insurance AVIVA Auditory processing Visual vestibular integration Interoception Visceral sensation Autonomic control ```
76
What is tDCS?
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
How to tell brocas and wernickes aphasia apart
Broca C D Expressive aphasia | Wernickes V U T S Receptive aphasia
78
what is multiple sclerosis?
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
symptoms of MS? (8)
``` fatigue difficulty walking blurred vision bladder control issues numbness/tingling stiffness/spasms balance/coord issues cognitive issues ```
80
How can brain and nerve stimulation help to confirm the central nature of MS?
81
What is the word for travelling in the normal direction in a nerve fibre? And vice versa?
orthodromic and antidromic
82
Does this make sense?
83
what is the inflammation process of MS?
driven by perivascular and leptomeningeal (arachnoid and pia mater) immune cell infiltration (CD3 T cells, CD20 B cells) inflammation - demyelination - axonal loss - neurodegeneration
84
Risk factors for MS. (6)
``` family history female other autoimmune vit D deficiency as a child epstein-barr virus smoking ```
85
Types of MS.
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
MS early symptoms
ocular pain, blurred vision (optic neuritis)
87
path of projection fibres?
corona radiata to internal capsule into descending white matter tracts (brainstem/spinal cord)
88
types of association fibres
short fibres - U fibres - connect adjacent gyri within same hemisphere long fibres - connect distal regions within same hemisphere
89
what is an M-wave
fast twitch motor activation - orthrodromic (towards muscle) electrical stimulus - activates motor axons orthodromically - action potentials - muscle contraction
90
what is an H-reflex
slow twitch - orthrodromic sensory activation electrical stimulus - activates sensory axons orthodromically - action potentials to spinal cords - lower motor neurons - muscle contraction
91
what is an F-wave
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
what do CNS demyelinations show on an EMG
slowed motor neuron latency in CNS so prolonged CMCT (central motor conduction time)
93
calculation for peripheral motor conduction time (PMCT)
(M latency + F latency-1) /2 -1 is for turnaround time in spinal cord of F wave
94
how do we measure motor evoked potential latency (total motor conduction time)
transcranial magnetic stimulation (TMS) measured with an EMG to see how long it takes from activation of motor cortex to muscle contraction
95
what is total motor conduction time (TMCT)
time taken from stimulation of primary motor cortex by TMS to the contraction of muscle (measured by EMG)
96
what is peripheral motor conduction time measuring
time from spinal cord to muscle along motor axon
97
how to calculate central motor conduction time
TMCT - PMCT
98
how do we know if there is an issue of conduction of CNS neurons? (MS)
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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