Book: Brazis et al. (2017) Localization in Clinical Neurology (7th ed.) Flashcards
Involuntarily triggered “passive” attention to external stimuli and basic drives involves the inferior parietal lobe, posterior portion of the superior temporal gyrus, and the inferior portion of the prefrontal cortex. Especially among right-handed individuals, this type of attention tends to be…
lateralized to the right hemisphere.
Visual hallucinations may be associated with a variety of psychiatric, medical, neurologic, and ocular disorders, as well as drug-induced states. When cortical regions are involved, simple visual hallucinations tend to be associated with disturbance of the occipital lobes, and complex visual hallucinations tend to be associated with disturbance of which area of the brain?
temporal lobes.
Depending on the type, perseverative behavior may occur following damage to what part of the brain?
1.frontosubcortical and mesolimbic regions.
2. left temporoparietal cortex.
3. right cortical hemisphere.
When memory is impaired because of severe cortical damage, which of the following are preserved?
- skill-based learning
- attention, language, visuospatial skills
- general intellect
Confabulation is more likely to occur when there is damage to which part of the brain?
thalamus
Amygdalo-hippocampal areas of the medial temporal lobe are important for
retaining information about events and facts.
Active, voluntarily generated attention entails the superior parietal lobule and superior dorsal prefrontal cortex that make up the so-called _____ system.
dorsal
Modulation of emotional behavior involves which structures of the brain?
limbic structures of the temporal lobe.
Attention to previously stored information that is involved in self-relevant, affective decisions, or decisions that involve constructing a mental scene based on memory activates regions of the posterior cingulate, ventromedial prefrontal cortex, inferior parietal lobule, and medial temporal regions in a system referred to as the
default mode network.
Whereas distractibility is more often seen with right hemisphere lesions than with left hemisphere lesions, left frontal lesions are more likely than right hemisphere lesions to produce deficits of
divided attention.
Aphasias that primarily impairs speech comprehension involves damage to the _____ cortex.
temporal
The ability to evaluate the importance of internal and external stimuli for one’s well-being can be compromised by lesions to which part of the brain?
- orbitofrontal regions
- subregions of the cingulate gyrus
- temporal cortical areas.
Visual agnosias result from _____ lesions.
temporooccipital
The ability to read can be impaired by lesions in very different cortical areas. Alexias with differing symptoms may occur following damage to
- left medial occipitotemporal cortex and left parietal lobe (i.e., angular gyrus).
- perisylvian areas that leads to Broca’s aphasia.
- cortical and thalamic tissue that impairs saccadic eye movement.
Lesions of the right hemisphere may impair what behavior?
- speech discourse.
- the ability to get a joke.
- perception of emotional overtones.
Auditory hallucinations
are poorly localized.
When visual hallucinations are associated with seizures, they tend to be
stereotyped
Difficulty with tasks that require understanding of spatial relations may occur following damage to the _____ lobe.
right parietal
Impaired capacity to recognize sounds despite adequate hearing may be verbal, nonverbal, or generalized. Such a disorder is called…
auditory agnosia.
Aphasias that primarily impair speech fluency involve damage to the _____ cortex.
frontal
The neocortex has ____ layers.
6
Which portion of the cerebral cortex is chiefly concerned with planning, initiation, and execution of movements?
pre-Rolandic
The pre-Rolandic portion of the cerebral cortex is chiefly concerned with planning, initiation, and execution of movements.
What portion of the cerebral cortex is chiefly involved in the processing of sensory information?
RETRO-Rolandic.
The cerebellum and the sensory nuclei of the brainstem, including the vestibular complex, provide the motor system with…
Essential feedback information.
Activation of primary, secondary, and multimodal sensory areas is
highly stimulus-specific.
What is the right cerebral hemisphere dominant for?
directed attention and spatial skills.
Brodmann constructed a map of the cortex’s cytoarchitecture which shows how different areas of the cortex
have differing cellular composition.
What is the left cerebral hemisphere dominant for?
temporal sequencing and linguistic thought.
Information about interior homeostasis travels from the brainstem and hypothalamus through the medial thalamus to reach the insula and other structures that make up the
limbic lobe.
Secondary sensory areas process unimodal sensory information, whereas tertiary sensory cortex lying between different secondary sensory areas
integrate multimodal sensory information.
Functional recovery following cortical lesions is mediated by
functional reorganization of the cortex.
Because cortical plasticity following a lesion is mediated by extensive multisynaptic arrays that are susceptible to metabolic disturbances that interfere with the processing of neurotransmitters, toxic metabolic insults, and systemic illnesses affecting the whole brain especially impair functions that
have returned following a focal lesion.
Compared to patients with brainstem and spinal cord lesions, patients with cortical lesions are often
less aware of the extent of deficit.
Because most hemispheric functions are subserved by extensive networks that are often complementary and redundant, a single lesion
may be clinically silent and become symptomatic only when an additional lesion impairs the function of the network.
Compared to lesions of the brainstem or spinal cord, lesions of similar size in the cortex result in
less pronounced deficits.
T/F: Because most cortical functions are subserved by extensive networks, and individual variability in areas of the cortex that represent a particular function, attempting to pinpoint the exact square centimeter of the cortex that always accounts for a deficit is futile.
TRUE
Adequate localization of a cortical lesion requires analysis of multimodal deficits (such as alexia that can result from impairment of one or more functions necessary for reading), and going beyond the obvious disturbance to understand
its structure and the primary defect responsible for it.
Compared to more slowly evolving lesions, sudden lesions generally cause
more severe deficits.
Localized tissue damage results in signs and symptoms that
may change as a function of time since onset.
Compared to deficits caused by lesions to the brainstem and spinal cord, deficits caused by cortical lesions produce more _____ effects.
heterogeneous effects
Of the three classic frontal lobe syndromes, inappropriate affect and poor judgment are most associated with lesions of the
orbitofrontal and ventromedial prefrontal cortex.
Acalculia may develop following lesions to the _____ lobe.
right parietal &
left temporal & left parietal
Impaired tactile and visuospatial coordination, plus a degree of hemineglect may explain why some patients have difficulty dressing. Such dressing apraxia may be associated with damage to the _____ lobe.
right parietal
Agraphia tends to be most prominent when the lesion is localized to the ____ lobe.
right parietal
When a patient has difficulty arranging parts of an object in their correct spatial relationship and neglect the left half of the model, as in some forms of constructional apraxia, the lesion is most likely in the _____ lobe.
right parietal
When a patient imitates without having been asked, spontaneously uses objects, or otherwise shows evidence of an environmental dependency syndrome, a possible location of a frontal lobe lesion is the
inferior portion of one or both anterior frontal regions.
When expressive speech, naming, and repetition are impaired, but with preserved language comprehension, then cortical damage may be localized to the left
inferior frontal gyrus and surrounding tissue.
Grasp, suck, and snout reflexes may betoken a large lesion of the
frontal lobes.
Large left-sided perisylvian lesions caused by middle cerebral artery infarction can cause
anosagnosia.
Damage to the dominant prefrontal convexity may impair
working memory.
