Anatomy Flashcards
Primary Sensory Cortex
Areas 3,1,2, post central gyrus
Receives tactile, proprioceptive, pain/temp info
Distinguishes between size, shape, texture of objects
Impairments: loss of ability assess quality and discriminate intensity
Sensory Association Cortex
Areas 5,7, parietal lobe- post to S1
Stereogenesis, recognition of the manipulated item
Pain info processed here
Impairments;: astereogenesis, cortical neglect
Primary Visual Cortex
Area 17, calcerine sulcus
Distinguishes light and dark, location, movement and shapes
Impairments: blindness of opp visual field
Visual Association Cortex
Areas 18-21, surround V1
Analysis of motion/color, recognition of faces, visual memories, hallucinations
Control of visual fixation
Impairments: visual agnosia- inability recognize objects in contralateral field
Prosopagnosia- inability to recognize people’s faces
Primary Auditory Cortex
Area 41, superior temporal gyrus
Receives info from bilat cochlea
Conscious awareness of the intensity of sound
Impairments: loss of ability to localize sound
Auditory Association Cortex
Areas 22, 42, surrounding A1
Wernicke’s area is 22
Classification of sounds as language, music, noise
Impairments: auditory agnosia
L auditory association cortex- inability to understand speech
R side- inability to interpret noises
Vestibular Cortex
Area 40, post to S1
Receives info on head position from vestibulothalamocortical pathways
Impairments: interferes with conscious awareness of head position/movement
Primary Motor Cortex
Area 4, pre central gyrus
Controls contralateral movement
Fine movements
Bilat projections to upper face & back muscles
Motor homunculus- larger area for hands/feet (fine motor); smaller area for trunk/proximal limbs
Impairments:
Contralateral paresis and loss of fractionation of movement
Dysarthria: speech disorders resulting from paralysis, incoordination, or spasticity of the muscles used for speaking
Spastic: damage to UMN -Harsh, awkward speech
Flaccid: damage to LMN (CN IX,X,and/or XII) - Breathy, soft, and imprecise speech
Supplementary Motor Cortex
Area 6, ant to M1
Initiates movement, orientation of head, bimanual movement, sequential movements
Impairments: apraxia- inability to perform movement and/or sequence of movements
Agraphia
Premotor Cortex
Area 6, ant to M1
Controls trunk and girdle muscles
Impairments: apraxia- inability to perform movement and/or sequence of movements
Agraphia
Broca’s Area
Area 44, part of 45
L side: planning mouth movements and grammatical aspects of speech
R side: planning nonverbal communication. gestures, adjusts tone of voice
Impairments: inability to express self by language or symbols, speaking or writing
Prefrontal Cortex
Areas 9,10,12
Controls behavior, interprets sensation, processes emotions and memory
Self-awareness and executive functions- goal setting, planning, executing, monitoring
Impairments: loss of executive thinking, apathy, lack of initiation, lack of goal-directed behavior
Parietotemporal Association Cortex
Junction of parietal, temporal and occipital lobes
Intelligence, problem solving, comprehension of communication, spatial relationships
Impairments: Wernicke’s aphasia- inability to comprehend verbal/written language
Limbic Cortex
Ant and inf frontal lobes
Regulates mood, affect, processing memory
Impairments: personality and emotional changes
Damage to orbitofrontal cortex: inappropriate or risky behavior, poor judgement but intact intellect; social inappropriateness
VA
Ventral anterior thalamus (relay nucleus)
Motor
Project to pre central gyrus, M1
VL
Ventral lateral thalamus
Motor
Project to M1
VPL
Ventral posterior lateral thalamus
Somatosensation of body
Projects to post-central gyrus, S1
VPM
Ventral posterior medial thalamus
Somatosensation of face
Projects to S1
MG
Medial geniculate of thalamus
Hearing
Projects to A1, temporal lobe
LG
Lateral geniculate of thalamus
Vision
Projects to V1, occipital lobe
Basal Ganglia
Caudate nucleus, globus pallidus, putamen, sub thalamic nucleus, substantia niagra
Striatum: caudate + putamen
Lentiform nucleus: putamen and globus pallidus
Motor: movement sequencing, muscle tone, force regulation, & selective motor control
Cognitive: Awareness of body orientation, memory for location of objects, motivation, changing behavior
Limbic System
HOME- homeostatic function, olfaction, memory and emotions
Cingulate gyrus, parahippocampal gyrus, Hippocampal formation, amygdala, septal area, hypothalamus
Corpus Callosum
Primary commissural region of brain, consisting of white matter tracts that connect R/L sides of brain
CN I
Olfactory Nerve
Sensory- smell
Entry/exit: inferior frontal lobe
The only nerve that does not transmit info through thalamus- goes direct to limbic system
Testing: coffee, chocolate one nostril at a time
Anosmia/hyperanosmia
CN II
Optice Nerve
Sensory- vision
Retinal cells-> optic nerve, optic chiasm, optic tract–>
CNS entry/exit: LGN of thalamus (diencephalon)
TESTING: one eye at a time, pupillary reflex
Blindness, hemianopsia
CN III
Occulomotor Nerve
Motor- controls eye mvmts, lifts eyelids, pupil constriction, thickens the lens, EXCEPT lateral rectus and superior oblique
CNS exit/entry: ventral midbrain
TESTING: finger following test, pupil size/reflex, opening eyelid
Double vision, ptosis- eyelid dropping, dilation of pupil
CN IV
Trochlear
Motor- superior Oblique (SO4LR6)
Moves eyes inferiomedially- down & in when walking down stairs
CNS entry/exit: posterior midbrain
Impaired down/in gaze; diplopia, rarely have isolation lesion of CN IV
CN V
Trigeminal: V1 ophthalmic, maxillary, mandibular
Sensory- facial, cornea, ant 2/3 tongue, nasal sinuses, meninges
Motor- muscles of mastication, tensor tympani
CNS exit/entry: lateral pons
TESTING: touch over 3 branches, clench teeth, jaw reflex, corneal reflex
Weakness/atrophy of mastication muscles
Jaw deviates to paralyzed side
Lat meduall/pons lesion: ipsi loss of pain/temp
Supranuclear lesions- no atrophy and contralateral anesthesia
CN VI
Abducens
Motor- lateral rectus mm
CNS entry/ext: pons/medulla junction
Lateral gaze palsy, strabisums (medial rectus unopposed), diplopia
CN VII
Facial Nerve
Sensory: taste ant 2/3 tongue, outer ear
Motor: facial muscles, closes eyes, moves lips, muscles of facial expression, stapedius
Visceral: salivary and lacrimal glands
TESTING: puff cheeks, smile, frown, corneal blink reflex, taste ant 2/3 tongue
Proximal lesion- hyperacussis, absent taste, disrupted secretion of tears/saliva
LMN: total unilateral paralysis of weakness
UMN: sparing of forehead/brow- receives input from bilat cortex
CN VIII
Vestibulocochlear nerve
Sensory: hearing (ipsi nucleus), vestibular- position of head (ipsi nucleus)
TESTING: Rinne test (conductive loss)- 512 running fork on mastoid process; once patient hears it, move it to right near ear, pt should hear it better near ear
Weber test (sensineural loss)- tuning fork on top of skull, localizes to ears, ear with loss will not hear as well
(R/L) HIT
Loss of hearing, vertigo/dysequillibrium
CN IX
Glossopharyngeal Nerve
Sensory: middle ear, pharynx, touch and taste post 1/3 tongue, outer ear, carotid body sinus
Motor: stylopharyngeus mm- elevates pharynx, parotid gland
CNS exit/entry: medulla
TESTING: gag reflex (w/ CN X)
lack of gag reflex or asymmetrical elevation of soft palate
CN X
Vagus Nerve
Sensory: chemo/baroreceptors of aortic arch, larynx/pharynx, trachea, lungs, heart, upper GI, pancreas, gallbladder
carotid sinus reflex (CN IX)
cough reflex
gag reflex
swallowing reflex (CN IX)
Motor: pharyngeal and laryngeal muscles (swallowing and phonation), viscera of abdomen and thorax
CNS exit/entry: medulla
TESTING: Pt says “Ah” normal if soft palate rises, gag reflex (CN IX)
Asymmetrical soft palate, hoarseness, uvula deviates to normal side
CN XI
Spinal Accessory Nerve
Motor: upper traps and sternocleidomastoid
CNS exit/entry: spinal cord and medulla
TESTING: MMT of UT’s and SCM
Weakness/paralysis
CN XII
Hypoglossal Nerve
Motor: ipsilateral tongue
CNS entry/exit: medulla
TESTING: stick-out tongue, supra nuclear lesion tongue deviates to opposite side of lesion, LMN tongue deviates to same side lesion
