Cerebrum Clinical Application Flashcards
What is mostly affected following thalamic lesion?
proprioception
Occlusion or hemorrhage of arteries supplying the ____ capsule of subcortical white matter are common
internal
What is performed in cases of intractable epilepsy?
callosotomy
What do lesions or dysfunctions of the caudate/ventral striatum cause?
behavioral disturbances
What is the most common behavioral abnormality secondary to caudate damage?
apathy
Excessive activity of the circuit connecting the caudate, anterior cingulate cortex, and ventral prefrontal cortex is correlated with what?
OCD
What is the result of lesions in the primary somatosensory area?
loss of tactile localization and conscious proprioception
What is the result of lesions in the primary auditory area?
loss of localization of sounds
What is the result of lesions in the primary visual area?
homonymous hemianopia
What is the result of lesions in the primary vestibular area?
change in awareness of head position and movement
What is Agnosia?
the inability to recognize objects when using a specific sense, even though discriminative ability with that sense is intact
What are 3 forms of agnosia?
- Astereognosis
- Visual agnosia
- Auditory agnosia
What is Astereognosis?
the inability to identify objects by touch and manipulation, despite intact discriminative somatosensation
What is Visual agnosia?
The inability to visually recognize objects, despite having intact vision
What does a person who is unable to identify faces visually, despite being able to interpret emotional facial expressions and being able to recognize visually other items in the environment have?
Prosopagnosia
Destruction of the ____ auditory cortex causes auditory agnoisa
secondary
What results if there is a lesion to the left secondary auditory cortex?
the person is unable to understand speech
What results if there is a lesion to the right secondary auditory cortex?
The person is unable to interpret environmental sounds
What is apraxia?
motor agnosia
- the knowledge of how to perform skilled movement is lost
What does constructional apraxia impair?
the ability to draw and to arrange objects correctly in space
What is motor perseveration?
the uncontrollable repetition of a movement
What is Broca’s aphasia?
difficulty expressing oneself using language or symbols
What is dysarthria?
difficult or unclear articulation of speech that is otherwise linguistically normal
What does dysarthria result from?
spasticity or paresis of the muscles used for speaking
What are the 2 types of dysarthria?
Spastic dysarthria
Flaccid dysarthria
Spastic dysarthria is caused by damage to the _____ motor neurons.
upper
What is spastic dysarthria characterized by?
harsh, awkward speech
Flaccid dysarthria is caused by damage to the _____ motor neurons.
lower
What is flaccid dysarthria characterized by?
paresis of speech muscles
What are the 4 A’s of cerebral cortex damage?
- aphasia
- apraxia
- agnosia
- astereognosis
What is the result of lesion to the dorsolateral prefrontal association cortex?
loss of executive function and divergent thinking
What is the result of lesion to the parietotemporal association cortex?
- inability to handle new information effectively
- inability to distinguish relevant from irrelevant information
- difficulty generalizing information
- become upset with even minor changes in routine
What is the result of lesion to the parietotemporal association cortex in the left hemisphere?
Wernicke’s aphasia
What is the result of lesion to the parietotemporal association cortex in the right hemisphere?
neglect and/or difficulty understanding nonverbal communication
What is the result of lesion to the ventral and medial dorsal prefrontal association cortex?
disturbances of personality and emotions
What do lesions that affect the somatic marker circuitry cause?
poor judgment
What is emotional lability?
the abnormal, uncontrolled expression of emotions
What are the 3 aspects of emotional lability?
- Abrupt mood shifts, usually to anger, depression or anxiety
- Involuntary, inappropriate emotional expression in the absence of subjective emotion
- Emotion, triggered by nonspecific stimuli unrelated to the emotional expression
The reward pathway comprises dopamine neurons from where to where?
the ventral tegmental area (VTA) to the ventral striatum
What is the “motivation” neurotransmitter?
dopamine
What can be defined as the loss of behavioral control in response to a stimulus combined with the continued use of a substance, regardless of the negative consequences?
Addiction
The loss of declarative memory is called what?
amnesia
What are 3 language disorders? What do each affect?
- Aphasia: spoken language
- Alexia: comprehension of written language
- Agraphia: the ability to write
What are 4 common types of aphasia?
- Broca’s
- Wernicke’s
- Conduction
- Global
Describe Broca’s aphasia
difficulty expressing or using language
Describe Wernicke’s aphasia
Impaired language comprehension
What is conduction aphasia the result of?
damage to the neurons that connect Wernicke’s and Broca’s areas
What is global aphasia?
The inability to use language in any form
Damage to the right cortex in the area corresponding to Broca’s area may cause what?
flat affect
What is neglect?
the tendency to behave as if one side of the body and/or one side of space does not exist
What side of the body does neglect often affect?
the left side
What are 2 types of neglect?
Personal and Spatial
What is personal neglect?
Unilateral lack of awareness of sensory stimuli, personal hygiene and grooming, movement of the limbs
What is spatial neglect?
Unilateral lack of understanding of spatial relationships, resulting in a deranged internal representation of space
What is lateropulsion?
the powerful pushing away from the less paretic side in sitting, as well as during transfers, standing, and walking
What does loss of consciousness result from? (2 things)
- the movement of the cerebral hemispheres relative to the brainstem (causing torque of the brainstem)
- an abrupt increase in intracranial pressure
ADHD affects -% of children and -% of adults.
2-6
2-4
Girls with ADHD are more likely to be _____ than are boys.
inattentive
Boys with ADHD tend to be what?
hyperactive or impulsive
What are Autism Spectrum Disorders (ASD)?
the abnormal anatomy and connectivity of the limbic and striatal social brain systems
What causes ASD?
An immune attack on brain proteins, in addition to genetic factors
What is epilepsy?
sudden attacks of excessive cortical neuronal discharge, interfering with brain function
What are the 2 main types of generalized epileptic seizures?
- Absence seizures
- Tonic-clonic seizures
What 3 things reduce the capability for understanding and reasoning?
Cognitive disability, dementia, and dyslexia
What are 2 common causes of cognitive disability?
- trisomy 21
- untreated phenylketonuria
What is trisomy 21 aka?
Down’s syndrome
What is phenylketonuria (PKU)?
an autosomal recessive defect in metabolism, resulting in the retention of a common amino acid, phenylalanine (PHE)
What does an accumulation of PHE result in?
demyelination and, later, neuronal loss
What are the most common causes of dementia?
- multiple infarcts
- Alzheimer’s disease (AD)
- diffuse Lewy body disease
- Parkinson’s dementia
- chronic traumatic encephalopathy
What causes Alzheimer’s disease?
Altered brain endothelial cells which leads to blood-brain barrier malfunction and release factors injurious or toxic to neurons
What is the most common learning disability?
dyslexia
What is alien hand syndrome?
the involuntary, uncontrollable movement of the upper limb
What may cause alien hand syndrome?
damage to a variety of cortical and subcortical structures or by callosotomy
What are the 3 approaches to recovering from a stroke?
- Compensation approaches
- Remediation approaches
- Motor control approaches
What are somatoform disorders?
Emotional distress that is subconsciously converted into physical symptoms
_______ disorders are described as inflexible, maladaptive patterns of inner experience and behavior.
Personality
What are the 3 general types of personality disorders?
- eccentric
- acting out
- fearful
What are delusions?
false beliefs, despite evidence to the contrary
What are hallucinations?
sensory perceptions experienced without corresponding sensory stimuli
What is mania?
excessive excitement, euphoria, delusions, and overactivity
What is depression?
a syndrome of hopelessness and a sense of worthlessness, with aberrant thoughts and behavior
People with depression have reduced levels of _____ metabolites in their cerebrospinal fluid.
serotonin
What is anxiety?
the feeling of tension or uneasiness that accompanies anticipating danger
What is panic disorder?
An episode of intense fear that begins abruptly and lasts 10 to 15 minutes.
People with OCD have _____ activity in dorsal, cognitive prefrontal areas combined with
______ activity in ventral, emotion-related prefrontal-striate circuits, and ______ amygdala activity.
decreased
increased
increased
What can defined as a group of disorders consisting of disordered thinking, delusions, hallucinations, lack of motivation, apathy, and social withdrawal?
Schizophrenia
What are neural prostheses?
devices that substitute for a diseased or an injured part of the nervous system to enhance function
What are 2 examples of neural prostheses?
deep-brain stimulation (DBS) and brain-computer interfaces
Deep-Brain Stimulation is most frequently used by those with what disease?
Parkinson’s
Deep-Brain Stimulation to which areas of the brain are effective in treating depression?
ventral striatum or area 25
