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Neuroscience BB Exam 3 > Cerebral Cortex > Flashcards

Cerebral Cortex Flashcards

1
Q

The cerebral hemisphere that controls language is called the _______. In most people, language functions are processed in the _______.

A

dominant hemisphere; left hemisphere

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2
Q

Almost all right-handed individuals and about half of left-handed individuals are _______.

A

left cerebral dominant

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3
Q

Language can be selectively impaired (no effect on vision or hearing) by damage to…

A

the parietal-temporal junction or the frontal lobe (aphasia)

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4
Q

What is aphasia?

A

A disturbance of the comprehension and formulation of language, not a disorder of hearing, vision, or motor control

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5
Q

The left (dominant) side of the brain is responsible for:

A
  • Language (writing, speech)
  • Praxis (motor program)
  • Arithmetic, Musical ability (skilled)
  • Sense of direction (via sequence of written directions)

Also, insular cortex (planum temporale) larger on average in left hemisphere

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6
Q

The right (nondominant) side of the brain is responsible for:

A
  • Prosody (emotion of voice)
  • Visual/spatial gestalt
  • Arithmetic, Musical ability (unskilled)
  • Sense of direction (via spatial orientation)
  • Global & selective attention (prefrontal gyrus for motor, posterior parietal cortex for sensory, anterior cingulate gyrus for motivation)
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7
Q

Broca’s Aphasia (nonfluent, expressive aphasia) is caused by…

A

Lesion to pars orbitalis and pars triangularis of inferior frontal gyrus (areas 44, 45) of left hemisphere

Difficulty converting the concept of speech into meaningful sounds (loss of ability to speak fluently)

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8
Q

Broca’s aphasia is characterized by:

A
  • Halting speech
  • agraphia
  • disordered syntax, grammar, and individual word structure
  • intact comprehension
  • frustration and distress regarding condition
  • In most severe form, can’t speak (mutism)
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9
Q

During recovery, a Broca patient first…

A

Recovers habitual phrases first (however slowed, and telegraphic speech is observed)

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10
Q

What are the most common causes of Broca’s aphasia?

A

Tumors and occlusion of M4 (branches of MCA)

Full aphasia results from Broca’s and insular cortex and subjacent white matter

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11
Q

Involvement of M1 (lenticulostriate) in Broca’s aphasia can lead to:

A

Contralateral motor signs and symptoms

  • weakness (paresis) of the lower part of the face
  • lateral deviation of the tongue when it is protruded
  • weakness of the arm
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12
Q

Wernicke Aphasia (fluent, receptive aphasia) is caused by…

A

Lesion to superior temporal gyrus area 22 and supramarginal/angular gyrus (area 37,39,40) of left hemisphere

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13
Q

Wernicke aphasia is characterized by:

A
  • unable to understand what is said to them
  • unable to read (alexia)
  • unable to write comprehensible language (agraphia)
  • display fluent paraphasic speech
  • no recognition of problem (anosognosia)
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14
Q

What is paraphasic speech?

A

Ability to produce clear, fluent, melodic speech at a normal or even faster than normal rate. The content of the speech may be unintelligible because of frequent errors of word choice, inappropriate use of words, or use of made-up nonsense words.

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15
Q

Wernicke aphasia may result from…

A

occlusion of temporal and parietal M4 branches of the MCA - also, hemorrhage into the thalamus (or tumors in the thalamus) may produce Wernicke aphasia by extending laterally and caudally to invade the subcortical white matter

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16
Q

Contralateral homonymous hemianopsia can occur in Wernicke patients if ________

A

damage impinges on optic radiations

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17
Q

What is conduction aphasia (disconnection syndrome)?

A

Disruption of the arcuate fasciculus connecting Broca and Wernicke’s area –> normal comprehension and expression is fluent but difficult exists in translating what is said into an appropriate reply

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18
Q

What is global aphasia?

A

Occlusion of left ICA or proximal MCA (M1) / Lesion to Broca’s and Wernicke’s area as well as the arcuate fasciculus

Lack of fluency of speech, comprehension and repetition in voicing (COMPLETE loss of language)

19
Q

Damage to basal nuclei (such as head of caudate on left side) can result in…

A

Language disorders similar to Wernicke aphasia

20
Q

A right parietal lobe lesion can interfere with…

A

a patient appreciating the prosody of speech

21
Q

What is contralateral neglect?

A

Patient seems to be completely unaware of objects and events in the left half of his or her surrounding space

From a lesion of right parietal association cortex (nondominant)

22
Q

Syndrome of Nondominant Inferior Parietal Lobule:

A
  • topographic memory loss (patient gets lost)
  • anosognosia (no recognition of a problem)
  • asomatognosia (not recognizing one’s body)
  • construction apraxia (cannot draw collective objects; understand spatial relationships)
  • dressing apraxia
  • contralateral hemineglect
  • left homonymous hemianopia

Disorders of affect that can also accompany: reduced ability to understand and appreciate humor, a loss of the ability to appreciate the prosody of speech, and often an inappropriate cheerfulness and lack of concern for or even awareness of the implications of the illness

23
Q

Contralateral hemineglect results from…

A

Lesion to the centers for sensory attention within the (non-dominant) posterior parietal cortex (5,7) causing neglect of anything within the left (typically) visual field
- Serious cases show asomatognosia in which he/she doesn’t recognize left side of body –> dressing apraxia

24
Q

Prosopagnosia typically results from a _________

A

right-sided lesion of temporal lobe

25
Q

Apraxia results from:

A

damage to parietal association cortex, premotor cortex, or supplementary motor cortex

26
Q

What is apraxia?

A

Higher level behavioral disorder involving motor coordination for execution of complex behaviors
- This can affect the muscles of speech; unable to coordinate; no weakening (NOT APHASIA - that’s where internal processing is impaired)

27
Q

Give an example of apraxia.

A

A patient who can visually recognize a hammer, can name it, can explain what it is used for, and has the strength to pick it up, BUT will be unable to demonstrate how it is used to drive a nail into a board.

28
Q

What is agnosia?

A

Loss of ability to interpret sensation (not the loss of the primary sensation); usually confined to a specific modality

Typically results form lesion to the modality specific sensory association area

29
Q

Significant bilateral damage to the prefrontal cortex results in:

A
  • highly distractible, turning from one activity to another accord-ing to the novelty of a new stimulus rather than according to a plan; sometimes described as a lack of consistency of purpose
  • a lack of foresight; not able to anticipate or to predict future events on the basis of past events or present conditions
  • may be unusually stubborn in the face of advice with which they do not agree, and they may also perseverate in the performance of a task
  • displays a profound lack of ambition, a loss of the sense of responsibility, and a loss of a sense of social propriety
30
Q

What is Gerstmann Syndrome (Syndrome of Dominant Inferior Parietal Lobule) ?

A

Lesion of the dominant inferior parietal lobe (angular gyrus) and possibly part of optic radiation

  • R/L disorientation
  • finger agnosia
  • agraphia
  • acalculia
  • right hemianopia (typically resulting from a PCA lesion which affects the optic radiation)
31
Q

What is Frontal Lobe Syndrome?

frontal release signs - normally suppressed in development

A

Unmasking infantile reflexes (grasping, sucking), gait apraxia, sphincteric incontinence (urinary and fecal)

32
Q

What is the Wada Test?

A

Inject sodium amytal into carotid artery –> contralateral paralysis –> assess language function looking for aphasia (indicating dominant hemisphere has been paralyzed)

Been replaced by functional analysis via PET, fMRI, TMS

33
Q

What is alexia without agraphia?

A

Results from lesion to dominant (left) occipital cortex from PCA occlusion involving the splenium of the corpus callosum where fibers cross from one side to the other

PURE word blindness, no vision input to language centers (dominant) causing no language processing leading to alexia, language and motor areas intact so patient DOES NOT have agraphia, right homonymous hemianopsia

CAN’T read, CAN write

34
Q

What is alexia with agraphia?

A

Lesion to the inferior parietal lobule

35
Q

What is dorsolateral syndrome?

A

Lesion to dorsolateral prefrontal cortex

Apathy, lifeless, abulic state, LACK INITIATIVE, devoid of personality, no focus

  • Connected to regions representing the outside world
36
Q

What is orbitofrontal syndrome?

A

Lesion to orbitofrontal prefrontal cortex

Impulsive action and emotionally disinhibited behavior, poor judgment, irritability, euphoria, shoplifting, reckless driving, antisocial, sexually aggressive

  • Connected to regions monitoring internal states
37
Q

What is a left frontal lesion?

A

Lesion to left prefrontal cortex

Depression-like symptoms

38
Q

What is a right frontal lesion?

A

Lesion to right prefrontal cortex

Mania

39
Q

What is prefrontal control of amygdala?

A

Sleep deprivation has been shown to impair the control exhibited by the prefrontal cortex on the amygdala/anterior cingulate cortex

Moodiness and irrational decision-making

40
Q

Attention is much more dominant on the…

A

right (nondominant) side

Different from the visual field; person can see - this applies to attention only.

41
Q

3 domains of frontal lobe function:

A

RIO (restraint, initiative, order)

  • inhibition of inappropriate behaviors
  • motivation to pursue production activities
  • correctly performing sequence of tasks
42
Q

General functions of the prefrontal cortex:

A
  • Working memory
  • Forming predictions about the future
  • Personality
  • Learning new material
  • Selective attention and arousal levels
  • Decision making
  • Planning
43
Q

What are the 4 parallel channels through the basal ganglia?

A
  • Limbic channel (MD, VA)
  • Oculomotor channel (VA, MD)
  • Prefrontal channel (MD, VA)
  • Motor channel (VL, VA)
44
Q

What is the “worry circuit”?

A

Orbital frontal cortex –> basal ganglia

Neuroscience BB Exam 3 (9 decks)

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