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Term 3 > CNS Exam 1 > Flashcards

CNS Exam 1 Flashcards

1
Q

What are the 5 steps of Embryological development?

A
  1. Neurulation: Formation of the neural crest and neural tube
  2. Cell Proliferation: within neural tube
  3. Migration and Aggregation: of cells within definitive locations
  4. Formation of axonal and dendritic processes
  5. Synatopgenesis: connections between nerve cell to nerve cells or muscle
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2
Q

In Stage 1 of Embryological Development- Neurulation, describe what is happening in Day 14?

A

In day 14 the embryo begins in a process of gastrulation that is forming the 3 cellular layers, building blocks. The embryo, called a gastrula, is made up of 3 layers of cells:
- Ectoderm
- Mesoderm
- Endoderm

The entire nervous system is derived from embryonic Ectoderm

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3
Q

In Stage 1 of Embryological Development- Neurulation, describe what is happening in Day 21?

A

When the embryo is around 21 days old, it measures less than 4 millimeters. It begins with the presence of a mesodermal structure called the notochord. The notochord induces the overlying dorsomedial ectoderm to differentiate into neuroectoderm.

  • Neuroectoderm is thicker than general ectoderm and is called the Neural Plate. The margins of the Neural plate (Neural fold) elevate and create a depression between them called the neural groove.
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4
Q

In Stage 1 of Embryological Development- Neurulation, describe what is happening in Day 28?
How long does it take for the neural tube to form?
What happens as the neural groove closes?

A

When the edges of the neural groove fuse, the structure is called the neural tube. The neural tube develops into the entire CNS with is cavity becoming the Ventricular system
- At the time of fusion of the neural tube, a differentiation of cells occurs at the lateral edge of each fold called the neural crest, these then develop into most of the peripheral nervous system
- Closure of the neural groove begins in the future thoracic region then it moves caudally and later cranially. It takes around one week for the neural tube to form.
- As it closes, it separates from the overlying ectoderm. The ends remain open for about 2 weeks and are called the anterior and posterior neuropores.

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5
Q

What are the Embryologic names for Forebrain, Midbrain, and Forebrain?

A

Prosencephalon (Forebrain)
Mesencephalon (Midbrain)
Rhombencephalon (Hindbrain)

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6
Q

What are the 2 subdivisions of Prosencephalon?

A
  • Telencephalon
  • Diencephalon
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7
Q

The Telencephalon is a subdivision of the Prosencephalon. What are the parts (Derivates) of the Telencephalon?

A
  • Cerebral Hemispheres
  • Cerebral Cortex
  • Subcortical White Matter
  • Basal Ganglion
  • Basal Forebrain Nuclei
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8
Q

The Diencephalon is a subdivision of the Prosencephalon. What are the parts (Derivates) of the Diencephalon?

A
  • Thalamus
  • Hypothalamus
  • Epithalamus
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9
Q

What are the Parts of the Mesencephalon (midbrain)?

A

In the future this connects the forebrain to the hindbrain
- Cerebral Peduncles
- Midbrain Tectum
- Midbrain Tegmentum

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10
Q

The Metencephalon is a subdivision of the Rhombencephalon. What are the parts (Derivates) of the Metencephalon?

A
  • Pons
  • Cerebellum
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11
Q

The Myelencephalon is a subdivision of the Rhombencephalon. What are the parts (Derivates) of the Myelencephalon?

A
  • Medulla
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12
Q

During the First stage of Neurulation, there is a imbalance between the rate of the embryo expansion (growing) and the available space, this results in what?

A

This results in the development of Flexures of the brain

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13
Q

What are the 2 Primary Flexures of the Brain?
What is the third flexure?

A

The Two Primary Flexures are:
- Cephalic Flexure, which marks the division between the brain and the brainstem
- Cervical Flexure, which is the junction of the Spinal Cord to the Brain

The 3rd Flexure is:
- The Pontine Flexure, which is found on the dorsum and is the future site of the cerebellum

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14
Q

The fluid-filled cavities within the neural tube develop in to what? What do they contain?

A

Develops into the Brain Ventricles, which contain Cerebrospinal Fluid

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15
Q

The second stage of Embryological development is Cell Proliferation. When does this start stage start?
What are the dorsal/ventral portions called and what do they do in the future?

A

This stage starts when the neural tube starts with the appearance of the Sulcus Limitans, a bilateral furrow along the inner surface of the neural tube which divides the tube into Ventral and Dorsal portions.

  • The dorsal portion is called the Alar Plate, the future binding site of sensory neurons and tracts
  • The ventral portions is called the basal plate, the future site primarily for motor system development
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16
Q

In the second stage of Embryologic development (Cell Proliferation) following the closer of the neural tube, postmitotic cells are pushed externally and are divided into 3 layers. What are the 3 layers and what do they later become?

A
  • Germinal (Ependymal) Layer: This is the inner layer, this then becomes the lining of the central canal and ventricles- these cells develop cilia that help move Cerebral Spinal Fluid (CSF)
  • Mantle Layer: This becomes the GREY MATTER of the spinal cord due to the cell bodies there-The Sulcus Limitans appears, above is the Alar Plate (sensory) and below is the Basilar Plate (motor)
  • Marginal Layer: The outermost layer that contains most of the processes from the cell bodies of the mantle- It becomes the WHITE MATTER
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17
Q

In the second stage of Embryologic development (Cell Proliferation), how does the brain increase in size? (5)

A
  • Growth in dendrites
  • Growth in axons
  • Vascularization
  • Myelination
  • Development of synapses
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18
Q

In the third stage of Embryologic Development (Migration), there are 2 types of migration. What are they?

A
  • Radial Migration
  • Tangential Migration
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19
Q

In the third stage of Embryologic Development, where does the Radial Migration occur? What does active migration require?

A

This occurs from the Spinal cord through the Telencephalon. Active Migration requires Radial Glia Cells; transient elongated cells that serve as a template for neuroblast migration.

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20
Q

In the third stage of Embryologic Development, where does the Tangential Migration occur? How do the Glial cells run?

A

This occurs mostly in structures within the brainstem (Inferior to the olivary nucleus) and occurs late in the migration process. The glial cells run oblique or parallel to the neural tube and the neuroblast may use existing axons in addition to the glial cells to reach its destination. They pass from one to another tangentially.

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21
Q

What are some defects in the 3rd stage of embryological development?

A
  • Dyslexia
  • Lissencephaly (“Smooth brain” results in motor and mental retardation)
  • Microencephaly (Small brain results in mental retardation)
  • Macrogyria (Some folding but not normal have less gyri)
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22
Q

In stage 4 of Embryological development (Cell Differentiation), what happens?

A
  • There is the formation of axonal and dendritic processes
  • Development of cranial nerves
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23
Q

In the 5th stage of Embryological development (Synaptogenesis), what happens?

A

Development and change of synapses occurs throughout life
- Synaptogenesis is strongly correlated with changes in the patterns of transfer of information within the nervous system therefore it is correlated with all known types of permanent learning.
- The process involved in growth of neural processes and synaptogenesis are the bases for neural plasticity

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24
Q

Which parts of our brain controls our basic functions necessary for survival: respiration, BP, and HR?

A

Brainstem: Midbrain, Pons, Medulla

(Also the most evolutionary ancient parts of the brain)

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25
Q

How is Cerebral Spinal Fluid (CSF) formed?

A

Its formed by vascular tufts lying within the ventricles called Choroid Plexus

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26
Q

How does the CSF circulate? Where does it leave?

A
  • CSF circulates from the lateral ventricles to the third ventricle, and then leaves the ventricular system via foramina in the fourth ventricle to percolate around the outside surface of the brain and spinal cord.
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27
Q

In the brain, what are the Meninges?
MNEMONIC - PAD

A

From inside - out:
- Pia Mater
- Arachnoid Mater
- Dura Mater

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28
Q

In the brain there is a Dura Mater structure called the Falx Cerebri, where is it and what does it do?

A
  • This structure dips in-between the cerebral hemispheres between the longitudinal fissure
  • This is a very tough and very thick layer for the purpose of keeping the our brain from moving around in the skull
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29
Q

What are the differences in terms of Orientation of the Brain (Midbrain) and Spinal Cord?

A

Above the Midbrain:
- Anterior = Rostral
- Posterior = Caudal
- Superior = Dorsal
- Inferior = Ventral

Below the Midbrain (like Spinal cord)
- Anterior = Ventral
- Posterior = Dorsal
- Superior = Rostral
- Inferior = Caudal

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30
Q

In terms of Orientation, where is the Thalamus compared to the Frontal Lobe?

A

The Thalamus is Caudal to the Frontal Lobe

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31
Q

In terms of Orientation, where is the Cerebellum compared to the Pons?

A

The Cerebellum is Dorsal to the Pons

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32
Q

In terms of Orientation, where is the Anterior horn of the SC compared to the Posterior horn of SC?

A

The Anterior horn of SC is Ventral to Posterior horn of SC

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33
Q

In neurons, what do Dendrites and Axons do? What are Glia Cells?

A

Dendrites are the processes that receive information into the cell

Axons are acting to carry information away

  • Everything outside of the neuron or nerve-cell is considered glial cells (Support cells)
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34
Q

What is a Multipolar Neuron?

A

Having several dendrites and axons

Typical in most mammalian neurons

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35
Q

What is a Bipolar Neuron?

A

Those with single dendrite and axon

We see them in our sensory systems, vision and olfaction

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36
Q

What is a Unipolar Neurons?

A

When both axon and dendrite form a single process coming off a cell body

Seen in invertebrates

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37
Q

What is a synapses?

A

Typical communication between the neurons, from an axon terminal of one neuron to the dendrite of the next neuron

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38
Q

What are Chemical Synapses? Where are they stored?
Where are they released and binded?

A

They are the transmission of neurotransmitters, they are typically stored in the synaptic vesicles.

  • They are released from the pre-synaptic terminal of the neuron -> then they bind to the neurotransmitter receptor on the post-synaptic neuron, giving rise to either excitation or inhibition of the post-synaptic neuron.
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39
Q

Why are Myelin Sheath important?

A

Myeline sheath covers axons allowing for speed of transmission of action potential

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40
Q

What is the name of the myelin forming glial cells in the Central Nervous System?

A

Oligodendrocytes

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41
Q

What is the name of the myelin forming glial cells in the Peripheral Nervous System?

A

Schwann

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42
Q

In the CNS, what is Glutamate?

A

Its an excitatory neurotransmitter

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43
Q

In the CNS, what is GABA?

A

Its an inhibitory neurotransmitter

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44
Q

What are the neurotransmitters used in the PNS?

A

Acetylcholine

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45
Q

What are the neurotransmitters in the ANS?

A

Acetylcholine
Norepinephrine

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46
Q

Areas in the CNS mainly made up of Myelinated axons are called what?

A

White matter

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47
Q

Areas in the CNS mainly made up of cell bodies are called what?

A

Gray matter

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48
Q

Where do most local synaptic communication occur in the CNS? What about signals over lager distances?

A

Gray Matter = local synaptic communication

White matter = signals over larger distances

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49
Q

In terms of White and Gray Matter, what is the difference between their location in the brain, Spinal Cord, and brainstem?

A
  • In the Cerebral Hemisphere, Gray matter is in the outside, white matter in in the inside
  • In the Spine, white matter is on the outside, gray matter is on the inside
  • In the brainstem, gray matter and white matter regions are found both on the inside and outside, although most of the outside is white matter.
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50
Q

Within the CNS, what are the structures of white matter? what do they do?

A
  • Tracts: white matter communication
  • Fascicles: Like a white matter freeway (where info comes or goes)
  • Lemniscus: Same as the fascicles
  • Bundle: Multiple white matter tracts
  • Commissure: white matter pathway that connects structures on the left and right sides of our brain
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51
Q

Within the PNS, what are the structure of white matter?

A

Peripheral Nerves

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52
Q

Within the PNS, what are the structures of Gray Matter?

A

Ganglia (cluster of cell bodies)

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53
Q

How many pairs of Cranial nerves are there?

A

12 pairs

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54
Q

How many pairs of Spinal nerves are there? Where do they arise?

A

31 pairs

  • Arise from spinal cord segments and give rise to both sensory and motor nerve roots on each side of the body.

(Motor=Efferent) ; (Sensory=Afferent)

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55
Q

Where does the Spinal Cord end? What is below the spinal canal?

A

The spinal cord ends at L1 or L2.

  • Below the spinal canal contains a collection of nerve roots known as Cauda Equina (latin for horses tail), which continues down their exit points
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56
Q

What is the Cervical Enlargement?

A
  • The brachial plexus, which is from C5-T1
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57
Q

What is the Lumbosacral Enlargement?

A
  • The lumbosacral plexus, which is from L1-S4
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58
Q

Based on function, in the Cervical enlargement and the Lumbosacral enlargement, would there be more gray or white matter? Why?

A

There is more Gray Matter in these segments causing the overall thickness of the cord to be greater. There is a greater amount of cell synapses also.

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59
Q

In the Autonomic Nervous System (ANS), what are the two major divisions? For each division what are the final neurotransmitters?

A

Sympathetic = “Fight or Flight”; Also known as the Thoracolumbar Branch of the ANS
(Involved with pupil and bronchial dilation, cardiac acceleration, etc.)
- Norepinephrine

Parasympathetic = “Rest and Digest”; Also known as Cranial Sacral Division of the ANS
- Acetylcholine

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60
Q

What are the definitions of Sulci, fissure, and Gyri?

A
  • Sulci are the crevices or infoldings
  • Fissure are deep sulci
  • Gyri are bumps and ridges between the sulci
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61
Q

What are the 4 major lobes of the brain? What Fissure separates them?

A
  • Frontal: Extends back to the Central Sulcus
  • Temporal: Separated from the Frontal lobe by Sylvian/lateral fissure
  • Parietal: Bounded anteriorly by Central Sulcus, (when viewed on medial aspect) Pareito-occipital sulcus separates the Parietal and Occipital lobe
  • Occipital
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62
Q

The 4 lobes of the brain, what are they related to? Where does this structure lie?

A
  • They are related to the Insular Cortex
    This is the convergence of the frontal, parietal and temporal complex
  • This lies deep in the Sylvian Fissure and its considered an additional region to cortices (additional region of cerebral cortex)
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63
Q

In the Brain what are the Hemispheres separated by? What structure is within the Hemispheres?

A

Interhemispheric fissure (Sagittal or longitudinal)

  • Within the hemispheres, there is a white matter structure called the Corpus Callosum (Hard Body)
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64
Q

What is the Primary Motor Cortex also known as? What does it control?

A

Also known as the Precentral Gyrus (Located in Frontal Lobe)

  • Controls movement in the opposite side of body
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65
Q

What is the Primary Sensory Cortex also known as? What does it control?

A

Also known as Postcentral Gyrus (Located in Parietal Lobe)

  • Controls sensation in opposite side of body
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66
Q

Where is the Primary Visual Cortex located?

A

The Occipital Lobe

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67
Q

What is the Primary Auditory Cortex also known as? Where is this located?

A

Transverse Gyri of Heschl

  • Best described as 2 finger-like gyri that lies inside the Sylvian Fissure on the superior surface of the temporal lobe
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68
Q

What is Neocortex?

A

A 6 cell layer structure based on looking at a component of the gray matter cerebral cortex.

  • This has been labeled in roman numerals
    I-VI, continuing from the surface and moving in
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69
Q

What is the Name and the Main Connection for the first (I) layer of the Neocortex?

A

Name: Molecular Layer

Main Connection: Dendrites and Axons from other layers

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70
Q

What is the Name and the Main Connection for the second (II) layer of the Neocortex?

A

Name: Small Pyramidal Layer

Main Connection: Cortical-Cortical connection

71
Q

What is the Name and the Main Connection for the third (III) layer of the Neocortex?

A

Name: Medium Pyramidal Layer

Main Connection: Cortical-Cortical connection

72
Q

What is the Name and the Main Connection for the fourth (IV) layer of the Neocortex?

A

Name: Granular Layer

Main Connection: Receives inputs from Thalamus

73
Q

What is the Name and the Main Connection for the fifth (V) layer of the Neocortex?

A

Name: Large Pyramidal Layer

Main Connection: Sends outputs to subcortical structures (Other than Thalamus)

74
Q

What is the Name and the Main Connections for the sixth (VI) layer of the Neocortex?

A

Name: Polymorphic Layer

Main Connection: Sends outputs to Thalamus

75
Q

What is the Functional area for Brodmann Area 1, 2, 3?

A

Primary Somatosensory cortex

76
Q

Where is the location for Brodmann Area 1, 2, 3?

A

Post-Central Gyrus (Parietal Lobe)

77
Q

What is the function of Brodmann Area 1, 2, 3?

A

Touch

78
Q

What is the Function Area of Brodmann Area 4?

A

Primary Motor Cortex

79
Q

What is the Location of Brodmann Area 4?

A

Pre-Central Gyrus (Frontal Lobe)

80
Q

What is the function of Brodmann Area 4?

A

Voluntary movement control

81
Q

What is the Function Area of Brodmann Area 17?

A

Primary Visual Cortex

82
Q

What is the Location of Brodmann Area 17?

A

Banks of Calcarine Fissure (Occipital Lobe)

83
Q

What is the function of Brodmann Area 17?

A

Vision

84
Q

What is the Function Area of Brodmann Area 18?

A

Secondary Visual Cortex

85
Q

What is the location of Brodmann Area 18?

A

Medial and Lateral Occipital Gyri

86
Q

What is the function of Brodmann Area 18?

A

Vision, depth

87
Q

What is the Function Area of Brodmann Area 19?

A

Tertiary visual cortex, middle temporal visual area

88
Q

What is the Location of Brodmann Area 19?

A

Medial and Lateral Occipital Gyri

89
Q

What is the function of Brodmann Area 19?

A

Vision, color, motion, depth

90
Q

What is the Function Area of Brodmann Area 22?

A

Higher-order Auditory Cortex

91
Q

What is the Location of Brodmann Area 22?

A

Superior Temporal Gyrus

92
Q

What is the function of Brodmann Area 22?

A

Hearing, speech

93
Q

What is the Function Area of Brodmann Area 41?

A

Primary Auditory Cortex

94
Q

What is the Location of Brodmann Area 41?

A

Heschl’s gyri and superior temporal gyrus

95
Q

What is the function of Brodmann Area 41?

A

Hearing

96
Q

What is the Function Area of Brodmann Area 42?

A

Secondary Auditory Cortex

97
Q

What is the Location of Brodmann Area 42?

A

Heschl’s gyri and superior temporal gyrus

98
Q

What is the function of Brodmann Area 42?

A

Hearing

99
Q

What is the Function Area of Brodmann Area 44?

A

Broca’s area; Lateral premotor cortex

100
Q

What is the Location of Brodmann Area 44?

A

Inferior Frontal gyrus (Frontal operculum)

101
Q

What is the function of Brodmann Area 44?

A

Speech, movement, planning

102
Q

Describe the Corticospinal tract.

A

A pathway of upper motor neuron from motor cortex to lower motor neuron in contralateral spinal cord

  • Firstly starts at the Pre-central gyrus (motor complex), then goes to the pyramidal decussation (this is where it goes contralaterally), then goes to the anterior horn
103
Q

What is the difference between Upper Motor Neuron (UMN) and Lower Motor Neuron (LMN)?

A

UMN: Motor neurons that project from the cortex down to spinal cord or brainstem

LMN: Located in anterior horn of gray matter of spinal cord or in brainstem motor nuclei

104
Q

What are the components of the Cerebellum?

A

Folia, vermis, arbor vitae, tonsils, peduncles.
- Additionally has Anterior, Posterior, and Flocculonodualr Lobe

105
Q

What are the 5 structures that make up the Basal Ganglia?

A
  • Caudate Nucleus
  • Putamen
  • Globus Pallidus
  • Subthalamic nucleus
  • Substantia Nigra

The Caudate Nucleus and Putamen together are called striatum
Putamen and Globus Pallidus together are called lenticular nucleus

106
Q

What is the function of the Cerebellum and Basal Ganglion?

A

Both act to modulate the output of the corticospinal and other descending motor systems.
- Both receive major inputs from motor cortex, they also intern project back to motor cortex via thalamus
In other words they are both feedback systems designed to refine movement

107
Q

What happens if there is lesion of the Cerebellum?

A

Ataxia: Disorder associated with coordination and balance

108
Q

What happens if there is a lesion of the Basal Ganglion?

A

Parkinson’s: Hypokinetic movement disorder- movements are infrequent, slow and rigid

109
Q

What are the main Somatosensory Pathways? What are their functions?

A
  • Posterior Column Pathways:
    Proprioception, vibration, sense, and fine. discriminative touch
  • Anterolateral Pathways:
    Pain, temperature sense, and crude touch
110
Q

What is the Monosynaptic Stretch Reflex?

A

The most well studied reflex arc that provides rapid local feedback for motor control

111
Q

How is the Monosynaptic stretch reflex information transmitted?
What causes muscle to contract

A

It begins with specialized receptors-muscle spindles. This info is transmitted to the distal processes of sensory neurons and is then conveyed via the dorsal roots into the spinal cord gray matter.
- In Gray matter, multiple synapses with sensory neurons to include some direct synapse onto LMN in the anterior horn. LMNs project via the ventral roots back out to the muscle, causing it to contract.

112
Q

With Monosynaptic stretch reflex, what happens if there is damage anywhere along its pathway?

A

It can cause the reflex to be diminished or absent

113
Q

How do you assess Monosynaptic stretch reflex?

A

DTRs, results can be normal, hyper/hypoactive

114
Q

What is the Reticula Formation?
What is the function of the Reticula Formation in Caudal and Rostral portions?

A

This structure extends from Medulla to Midbrain.
- More caudal portions in medulla and lower pons tend to be more involved mainly in motor and autonomic functions
- Rostral portions in upper pons and midbrain plays an important role in regulating level of consciousness influencing higher areas through modulation of thalamic and cortical activity

115
Q

What is the Limbic System functions? Where is the Limbic system?

A
  • Regulation of emotion
  • Memory
  • Appetite
  • Autonomic function
  • Neuroendocrine control
  • Olfaction

– Near the medial edge of the cerebral cortex, (Limbus means edge in latin)

116
Q

What happens if there are lesions in the Limbic system?

A
  • Difficulty forming new memories
  • Behavioral changes
  • Epileptic seizures (Most commonly arise in medial temporal lobe)
    –Fear
    –Memory distortions
    –Olfactory hallucinations
117
Q

What is the function of the Association Cortex? What are the two types?

A

Higher-order information processing

  • Unimodal: For a single sensory or motor modality, usually located adjacent to primary motor or sensory are.
  • Heteromodal: Integrates functions from multiple sensory and/or motor modalities
118
Q

Which is the largest area of association cortex?

A

Frontal Lobe

119
Q

What function is important in relation of our Association Cortex?

A

Language

  • Perceived first by the Primary Auditory Cortex in the temporal lobe (At the transverse gyrus heschl)
  • Then perceived by Primary Visual Cortex
    From here we have cortical-to-cortical connections with Broca’s and Wernicke’s area
120
Q

Where is Broca’s area located? Where is Wernicke’s area located? What do they do?

A

Broca’s area is found in the left frontal lobe

Wernicke’s area is found in the left or dominate hemisphere in out temporal lobe

  • In charge of making our language fluent, as well as having intact auditory comprehension
121
Q

What is Wernicke’s Aphasia?

A

Wernicke’s Aphasia, (also referred to as receptive aphasia, or sensory fluent aphasia), individuals have deficits in their language comprehension. So they dont have an issue with primary hearing. Patients with Wernicke’s Aphasia dont sense their communication sound off, these patients are very pleasant.

122
Q

What is Broca’s Aphasia?

A

This is referred to as motor aphasia or expressive aphasia, the patient is not able to articulate. Patients generally get frustrated, they understand what they want to say they are just unable to articulate or express themselves

123
Q

With the Association Cortex, what is the Parietal Lobe divided by?

A

Divided by intraparietal sulcus, then we get:
- Superior Parietal Lobule
- Inferior Parietal Lobule

124
Q

With the Association Cortex, what would happen if there was a deficit in the Inferior Parietal Lobule on the left or dominate hemisphere? What would they have difficulty with?

A

The patient may have something referred to as Gerstmann’s Syndrome.
They would have difficulty with calculations, they would have issues with right-left confusion (within their own body), they would have issues with finger agnosia (inability to identify fingers by name), and difficulty with written language

  • They may also have apraxia, the inability to execute a motor plan generally upon command
125
Q

With the Association Cortex, what would happen if there was a deficit in the non-dominate (Right parietal lobe)?

A

The patient will lack of spatial awareness, the person will lack the perception of space and even neglect that contralateral side (right sided brain damage causes left neglect) For example, a patient may draw a clock without filling in the left side of the clock

  • With a more severe case, pt. can have something called Anosognisia. This is the lack of knowledge of their entire disease altogether, they may not have acknowledgement at all that their body part is their body part.

A patient may also develop extinction, this is where a tactile stimulus or a visual stimulus is perceived normally when its presented to one side of the body only, but when its presented on the side opposite of the lesion simultaneously with the normal side the patient neglects the stimulus on the side opposite the lesion

126
Q

With the Association Cortex, what happens if the patient has a lesion in the Frontal Lobe?

A

Pt. may exhibit Personality and Cognitive functioning

  • Frontal Release signs: Normal reflexes seen in infants (Grasp, root, suck, and snout)
  • Perseveration: Difficulty when asked to perform a sequence of actions or to change from 1 activity to another, instead they just repeat one action over and over
  • Disinhibited Behaviors: Impaired judgement, a cheerful lack of concern about one’s illness, inappropriate joking
  • Abulic: Loss or impairment of the ability to make decisions or act independently
  • Magnetic Gait: Feet in close contact to the ground
  • Urinary Incontinence
127
Q

With the Association Cortex, where is the Visual Association Cortex? What happens if there is a lesion here?

A

This is in the Parietal-Occipital Lobe as well as the Inferior Temporal Lobe.

Lesions may and could involve several impairments such as:
- Prosopagnosia: Inability to recognize faces
- Achromatopisa: Inability to recognize colors (colorblind)
- Palinopsia: Persistence or reappearance of an object viewed earlier (Deja vu)

Pt. may have seizures if their association cortex is damaged and can cause elaborate visual hallucinations

128
Q

What are the two main arteries of the brain? What vein drains blood from the brain?

A

Internal Carotid arteries
Vertebral Arteries (Basilar A.)

Venous drainage is provided mainly by internal jugular veins

129
Q

When the anterior and posterior blood supplies from the carotid and vertebrobasilar systems joint together, they make what? What arteries arise from the Internal Carotid? What artery arises from the Vertebrobasilar system?

A

The Circle of Willis

  • The ACA and MCA branch from the ICA
  • The PCA brach from the Vertebrobasilar system
130
Q

Which arteries supply the Brainstem and the Cerebellum?

A

These arteries arise from the vertebral and basilar arteries:
- Superior Cerebellar Artery (SCA)
- Anterior Inferior Cerebellar Artery (AICA)
- Posterior Inferior Cerebellar Artery ( PICA)

131
Q

Which arteries supply the Spinal Cord?

A
  • Anterior Spinal Artery: which runs along the ventral surface of the cord in midline
  • Posterior Spinal Artery: runs along the right and left dorsal surfaces of the cord
132
Q

With an UMN lesion, will the patient have weakness?

A

Yes

133
Q

With an LMN lesion, will the patient has weakness?

A

Yes

134
Q

With an UMN lesion, will the patient have atrophy?

A

No

135
Q

With an LMN lesion, will the patient have atrophy?

A

Yes

136
Q

With an UMN lesion, will the patient have fasciculations?

A

No

137
Q

With an LMN lesion, will the patient have fasciculations?

A

Yes

138
Q

With an UMN lesion, would a patient have increased or decreased reflexes?

A

Increased

139
Q

With an LMN lesion, would a patient have increased or decreased reflexes?

A

Decreased

140
Q

With an UMN lesion, would a patient have increased or decreased tone?

A

Increased

141
Q

With an LMN lesion, would a patient have increased or decreased tone?

A

Decreased

142
Q

What is Apraxia? What are various ways to test Apraxia?

A
  • Apraxia means inability to follow a motor command, when this inability is not due to a primary motor deficit or a language impairment, its caused by a deficit in higher-order planning or conceptualization of the motor task.
  • You can test for Apraxia by asking the pt. to do complex task, using commands such as “pretend to comb your hair”, pt. with apraxia will perform awkward movements that only minimally resemble those requested, despite having intact comprehension and otherwise normal motor exam. This is sometimes called ideomotor apraxia
143
Q

What structures are involved in Alertness/Attention?

A

Brainstem reticular formation, bilateral thalami or cerebral hemispheres.

  • Level of consciousness is severely impaired in damage to the brainstem reticular formation and in bilateral lesions of the thalami or cerebral hemisphere. It may also be mildly impaired in unilateral cortical or thalamic lesion s
144
Q

What structures are involved in Memory, what general lobes/areas? Damage to these area can cause what?

A

Limbic memory structures located in the medial temporal lobes and medial diencephalon

  • Damage to these areas causes two characteristic forms of amnesia, which usually co-exist.
    –Anterograde amnesia is difficulty remembering new facts and events occurring after lesion onset
    –Retrograde amnesia is impaired memory of events for a period of time immediately before the lesion onset, with relative sparing of earlier memories
145
Q

What structures are involved in Language? Lesions to what lobes generally affect language?

A

Lesions usually in the dominant (usually left), frontal lobe (including Broca’s area, the left temporal and parietal lobes, including Wernicke’s area) , subcortical white matter and gray matter structors, including thalamus and caudate nucleus; as well as non-dominate hemisphere

146
Q

What is the difference between Broca’s and Wernicke’s aphasia?

A

Broca’s: occurs when there is damage to broca’s area (Frontal lobe on left or dominant hemisphere). Pt. have intact auditory comprehension, they have a hard time expressing what they want to say.

Wernicke’s: occurs when there is damage to wernicke’s area (Temporal lobe on left or dominant area). Pt. have auditory comprehension that is impaired, they dont understand whats being said to them.

147
Q

Damage to what area would cause apraxia?

A

Commonly present in lesions affecting the language areas and adjacent structures of the dominant hemisphere.

148
Q

What lobe/side of the brain deals with spatial awareness? Damage to what lobe/side results in neglect?

A

Hemineglect is most common in lesions of the right (nondominant) parietal lobe (causing pt. to neglect the left side)
- Left sided neglect can also occasionally be seen in right frontal lesions, in right thalamic or basal ganglia lesions and rarely in lesions of the right midbrain

149
Q

What are causes of impaired consciousness?

A
  • Common causes are toxic or metabolic factors
  • Generalized impaired attention and cooperation are relatively nonspecific abnormalities that can occur in may different focal brain lesions; in diffuse abnormalities such as dementia, delirium, or encephalitis; and in behavior and mood disorders
150
Q

On a CT Scan, how are bone or calcifications going to appear?

A

Hyperdense; Appears white/lighter

151
Q

On a CT Scan, how are air/water going to appear?

A

Hypodense; Appears dark

152
Q

On a CT Scan, how will the brain appear?

A

Isodense; Appears gray

153
Q

How would a Hemorrhage appear on a CT Scan?

A

The appearance depends on chronicity

  • Acute hemorrhage: Hyperdense
  • One-week Post hemorrhage: Clot is broken down-Isodense
  • Two-three weeks post hemorrhage: Hypodense
154
Q

What are some advantages and disadvantages of CT Scans?

A

Advantages:
- Low cost
- Accessible in any ER
- Fast (takes 5-10 min)
- More bone details
- Screening test (CVA)

Disadvantages:
- Doesn’t detect brainstem and cerebellar stroke
- Images are not so clear
- Radiation

155
Q

With MRIs, what is the difference between Hyperintense and Hypointense?

A

Hyperintense: Brighter areas
Hypointense: Darker areas

156
Q

Is this image a T1 or T2 MRI image?

A

T1

157
Q

Is this image a T1 or T2 MRI image?

A

T2

158
Q

In this Angiogram, what arteries are these?

A

Vertebral Arteries

159
Q

In this Angiogram, what arteries are circled?

A
  1. Anterior Inferior Cerebellar Artery (AICA)
  2. Posterior Inferior Cerebellar Artery (PICA)
160
Q

In this Angiogram, what artery is this?

A

Anterior Cerebral Artery (ACA)

161
Q

In this Angiogram, what artery is this?

A

Superior Cerebellar Artery (SCA)

162
Q

In this Angiogram, what artery is this?

A

Middle Cerebral Artery (MCA)

163
Q

In this Angiogram, what artery is this?

A

Posterior Cerebral Artery (PCA)

164
Q

What is Neuroplasticity?

A

Adaptative capacity of the brain

  • The brain’s ability to recognize itself by forming new neural connections throughout life
165
Q

What is the difference between Structural Plasticity and Functional Plasticity?

A

Structural Plasticity: Changes in the organization and numbers of connections among neurons.
- Unmasking of “silent” synapses
- Collateral sprouting

Functional Plasticity: Changes in the efficiency or strength of synaptic connections
- It can happen during therapeutic interventions

166
Q

What are the 10 principles of Neuroplasticity?

A
  1. Use it or lose it
  2. Use it and improve it
  3. Specificity (Plasticity specific to training)
  4. Repetition matters
  5. Intensity matters
  6. Time matters
  7. Salience matters (training experience must be meaningful)
  8. Age matters
  9. Transference (training can lead to other similar skill)
  10. Interference (brain changes results in bad habits can interfere with learning good habits
167
Q

What is the effect of injury in neuronal function?

A
  • we have interrupting external projections from areas that are injured
168
Q

What is the effect of injury at the cellular level?

A
  • Neural shock-Diaschisis
  • Loss of synaptic effectiveness
  • Alternative mechanisms are substituted
169
Q

What are factors that affect recovery? (7)

A
  • Genes
  • Age
  • Size, type and location of lesion
  • Onset time
  • Experience/you environment
  • Pharmacology
  • Use/Training
170
Q

In terms of recovery of function in motor control, what is the difference between Spontaneous Recovery and Function induced Recovery?

A

Spontaneous Recovery: neuronal changes that result from the repair processes occurring within the CNS. This occurs immediately following injury and results in function being restored in neuronal tissue

Function induced Recovery: the ability of the nervous system to modify itself in response to changes in the environment. Characterized by receptive field being altered, response time improving, and evoked responses show increased strength and responsivity

171
Q

What is Neuromodulation?

A
  • Things used to promote neuroplasticity, things like:–Medications
    –Rehabilitation
    –Neuromodulation tools: TMS, tDCS, DBS
172
Q

What are some techniques that may prime motor learning?

A
  • TMS {Transcranial Magnetic Stimulation}: Increases or decreases corticomotor excitability, to drive motor learning
  • tDCS {Transcranial Direct Current Stimulation}: low-intensity direct electrical current to the brain, used with people with epilepsy, PD and depression
  • DBS {Deep Brain Stimulation}: requires implanting of the device within the brain tissue in a specific mapped area, helps with tremor, rigidity, slowness
  • Aerobic Exercise
173
Q

What is Brain Derived Neurotrophic Factor (BDNF)?

A
  • A protein encoded by BDNF gene
  • A key mediator of motor learning and getting the brain ready for neuroplasticity
  • When there are enhances in BDNF level this leads to increased BDNF gene expression in Hippocampus, Cerebral Cortex, and Cerebellum
174
Q

With BDNF, what is recommended for patients with chronic disorders?

A

Evidence that 30 min at 60% max HR is effective for increasing BDNF in patients with Chronic Disorders

Term 3 (44 decks)

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