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Neuro Boards > Anatomic Syndromes > Flashcards

Anatomic Syndromes Flashcards

1
Q

Frontal Lobe Syndromes

A

Orbitofrontal Syndrome
Dorsolateral Frontal/Convexity Syndrome
Mesial Frontal Cortical Syndrome
Broca’s aphasia

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2
Q

Orbitofrontal Syndrome - anatomical function

A

the orbitofrontal area is involved with involuntary action, decision making, and socially appropriate behavior

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3
Q

Orbitofrontal Syndrome - Exam

A

socially inappropriate behavior including Witzelsucht (joking addiction), disinhibition, echopraxia, and utilization behavior (reaching out and using objects in the environment in an automatic behavior i.e. reflexively picking up a phone and bringing it to your ear)

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4
Q

Witzelsucht

A

joking addiction

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5
Q

utilization behavior

A

reaching out and using objects in the environment in an automatic manner i.e. reflexively picking up a phone and bringing it to your ear

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6
Q

Dorsolateral Frontal/Convexity Syndrome - anatomical function

A

involved with executive functions, working memory, and selective attention

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7
Q

Dorsolateral Frontal/Convexity Syndrome - Exam

A

poor attention, motor programming, and immediate recall

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8
Q

Good test to evaluate for dorsolateral abnormalities?

A

Wisconsin Card Sorting Test

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9
Q

Mesial Frontal Cortex Syndrome - AKA

A

medial frontal cortex or anterior cingulate circuit syndrome

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10
Q

Mesial Frontal Cortex Syndrome - anatomical function

A

the mesial frontal cortex mediates motivated behavior, such as initiation of movement or speech

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11
Q

Mesial Frontal Cortex Syndrome - exam

A

amotivation, apathy, and akinesis. Akinetic mutism can be seen in bilateral lesions. patients can be incontinent and may only eat or drink when fed.

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12
Q

Mesial Frontal Cortex Syndrome - treatment

A

methylphenidate

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13
Q

Mesial Frontal Cortex Syndrome - lesion

A

posterior inferior frontal gyrus

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14
Q

Broca’s aphasia - lesion

A

posterior inferior frontal gyrus

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15
Q

Temporal Lobe Syndromes

A

Kluver-Bucy Syndrome
Prosopagnosia/Visual agnosia
Capgras delusion
Apperceptive prosopagnosia
Associative prosopagnosia
Wernicke’s aphasia

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16
Q

Kluver-Bucy Syndrome - Lesion

A

bilateral temporal lesions involving the amygdala

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17
Q

Kluver-Bucy Syndrome - Exam

A

Hypermetamorphosis (urge to touch everything), compulsive eating, and hypersexuality

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18
Q

Prosopagnosia/Visual agnosia

A

failure to identify objects and faces by visual identification
note: may be able to do so by voice

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19
Q

Capgras delusion - Lesion

A

fusiform gyrus, occipito-temporal cortex
more often associated with right hemispheric lesions than left

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20
Q

Capgras delusion - exam

A

variant of prosopagnosia in which a patient believes that a friend, spouse, or a close family member has been replaced by an imposter

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21
Q

Apperceptive prosopagnosia - lesion

A

right occipital temporal area

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22
Q

apperceptive prosopagnosia - exam

A

impaired object recognition. They are unable to recognize faces. However, they may be able to recognize people based on non-face clues (i.e. clothing, skin color, or voice)

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23
Q

Associative prosopagnosia - lesion

A

right anterior temporal area, more often bilateral

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24
Q

associative prosopagnosia - exam

A

impaired object identification. can copy images but cannot identify an image

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25
Q

Wernicke’s aphasia - lesion

A

superior temporal gyrus

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26
Q

Parietal Lobe Syndromes

A

Dominant Parietal Lobe
- Agraphesthesia
- Astereogonsis
- Ideomotorapraxia
- Gerstmann’s syndrome
Non-dominant Parietal Lobe
Balint’s Syndrome

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27
Q

agraphesthesia

A

inability to recognize letters or numbers drawn by fingertip on the patient’s skin

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28
Q

astereogonsis

A

inability to recognize object by touch

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29
Q

ideomotorapraxia

A

impaired understanding of tool functions i.e. can identify a key but can’t explain what a key does

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30
Q

Gerstmann’s syndrome - lesion

A

dominant inferior parietal lobe, AKA dominant angular and surpamarginal gyrus of the parietal lobe

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31
Q

Gerstmann’s syndrome - exam

A

agraphia, acalculia, finger agnosia, and left/right confusion

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32
Q

Non-Dominant Parietal Lobe - Lesion

A

non-dominant angular and supramarginal gyrus

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33
Q

Non-Dominant Parietal Lobe - Exam

A

Anosognosia (unaware of deficit or illness)
Sensory or receptive aprosodia (impaired ability to perceive emotions in others)
Hemineglect
Dressing apraxia

34
Q

Balint’s syndrome - lesion

A

bilateral parietal-occipital lobes

35
Q

Balint’s syndrome - exam

A

Triad
Optic ataxia: the inability to move the hand properly to perform voluntary tasks
Oculomotor apraxia: the inability to voluntarily fixate eyes to specific locations
Simultagnosia: the inability to focus on multiple objects

36
Q

Balint’s syndrome - pathophysiology

A

watershed infarcts, multiple embolic strokes, or PRES

37
Q

Occipital Lobe Syndromes

A

Anton Syndrome
Achromatopsia

38
Q

Anton Syndrome - Lesion

A

bilateral posterior cerebral artery territory infarction. Can also be seen in PRES

39
Q

Anton Syndrome - Exam

A

Cortical blindness (the patient has true blindness, but they deny the presence of this blindness)
- Patients will often confabulate in response. For example, if asked to identify the color of something, rather than saying “I can’t see,” they may say “it’s blue.”

40
Q

Achromatopsia - lesion

A

inferior lip of the occipital lobe, often bilateral
- could also present from a lesion to the thalamus

41
Q

achromatopsia - exam

A

color blindness

42
Q

Limbic Lobe Syndromes

A

Apathy

43
Q

Apathy - lesion

A

anterior cingulate

44
Q

Apathy - exam

A

bilateral lesions can cause akinesis and mutism

45
Q

Subcortical Syndromes

A

Alexia without Agraphia
Limb Kinetic Apraxia

46
Q

Alexia without Agraphia - lesion

A

splenium of the corpus callosum and unilateral occipital lobe
- can be seen after a unilateral posterior cerebral artery stroke

47
Q

Alexia without Agraphia - exam

A

inability to read, but with retained ability to write

48
Q

Limb Kinetic Apraxia - Lesion

A

anterior corpus callosum

49
Q

Limb Kinetic Apraxia - exam

A

inability to perform tasks when aked (i.e. unable to brush hair when given a brush)

50
Q

Brainstem Syndromes

A

Benedikt
Claude
Dejerine
Locked in
Marie-Foix
Mollaret’s
Millard-Gubler
Nothnagle
Parinaud
Wallenberg
Weber

51
Q

Benedikt syndrome - lesion

A

tegmentum of midbrain

52
Q

Benedikt syndrome - symptoms

A

CN III palsy (ipsilesional), ataxia, tremor, and weakness (contralesional)

53
Q

Claude syndrome - lesion

A

tegmentum of midbrain

54
Q

Claude syndrome - symptoms

A

CN III palsy (ipsilesional), ataxia, tremor, and vertical gaze palsy (contralesional)

55
Q

Dejerine syndrome - lesion

A

medial medulla

56
Q

Dejerine syndrome - symptoms

A

CN XII palsy (ipsilesional), hemiplegia and sometimes loss of position and vibration (contralesional)

57
Q

Locked In Syndrome - lesion

A

central pons

58
Q

Locked In Syndrome - symptoms

A

bilateral paralysis below neck

59
Q

Marie-Foix - lesion

A

rostral pons. AICA and circumferential basilar perforators

60
Q

Marie-Foix - symptoms

A

contralateral hypoesthesia to pain and temperature (spinothalamic tract). ipsilateral ataxia (MCP). Contralateral hemiparesis (corticospinal tract)

61
Q

Mollaret’s syndrome - lesion

A

Dentate nucleus, inferior olive, red nucleus

62
Q

Mollaret’s syndrome - symptoms

A

palatal myoclonus

63
Q

Millard-Gubler syndrome - lesion

A

caudal medial pons

64
Q

Millard-Gubler syndrome - symptoms

A

CN VI and VII palsy (ipsilesional), weakness (contralesional)

65
Q

Nothnagle syndrome - lesion

A

tectum of midbrain

66
Q

Nothnagle syndrome - symptoms

A

CN III palsy (ipsilesional), ataxia, and vertical gaze palsy (contralesional)

67
Q

Parinaud syndrome - lesion

A

dorsal midbrain

68
Q

Parinaud syndrome - symptoms

A

paralysis of upward gaze and accommodation

69
Q

Wallenberg syndrome - lesion

A

lateral medulla

70
Q

Wallenberg syndrome - symptoms

A

ataxia, loss of pain and temperature for face, weakness of soft palate, larynx and pharynx, Horner’s (ipsilesional), loss of pain and temperature for body (contralesional)

71
Q

Weber syndrome - lesion

A

medial midbrain

72
Q

Weber syndrome - symtpoms

A

CN III palsy (ipsilesional), weakness, and vertical gaze palsy (contralesional)

73
Q

Charles Bonnet Syndrome - lesion

A

seen in patients with severe vision loss secondary to a variety of pathologies (stroke, macular degeneration, etc)

74
Q

Charles Bonnet syndrome - exam

A

complex visual hallucinations without other psychopathology, and with the self-awareness that the hallucinations are not real

75
Q

Geschwind syndrome - lesion

A

controversial disorder thought to occur in some patients with temporal lobe epilepsy
- some researchers question whether it actually exists

76
Q

Geschwind syndrome - exam

A

presents as a personality syndrome with hypergraphia (compulsive writing), hyper-religiosity, and atypical sexuality (usually hyposexuality)

77
Q

Alien hand syndrome - exam

A

presents with uncontrolled movements of an extremity, in the modern era most often seen in corticobasal degeneration, prion disease, and strokes

78
Q

Alien hand syndrome - frontal variant

A

dominant hemisphere lesion of supplementary motor area or medial prefrontal cortex
presents with right hand impulsively grabbing, groping, and manipulating objects. also can have utilization behavior
usually follows an ACA stroke

79
Q

alien hand syndrome - callosal variant

A

commonly due to callosal hemorrhage, demyelination, or surgery
often has “intermanual conflict” (antagonizing movements of the two hands)
often there are other disconnection symptoms present like apraxia, agraphia, or alexia

80
Q

Alien Hand Syndrome - posterior variant

A

secondary to a non-dominant parietal lobe (posterior postcentral gyrus) lesion
Associated with a strong feeling of estrangement from the affected limb, and abnormal posturing as well as “levetation” of the limb
the variant is the one most commonly caused by corticobasal degeneration, Creutzfeld-Jakob disease, or stroke

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