CNS Exam 1 Flashcards
1
Q
What are the 5 steps of Embryological development?
A
- Neurulation: Formation of the neural crest and neural tube
- Cell Proliferation: within neural tube
- Migration and Aggregation: of cells within definitive locations
- Formation of axonal and dendritic processes
- Synatopgenesis: connections between nerve cell to nerve cells or muscle
2
Q
What are the Embryologic names for Forebrain, Midbrain, and Forebrain?
A
Prosencephalon (Forebrain)
Mesencephalon (Midbrain)
Rhombencephalon (Hindbrain)
3
Q
What are the 2 subdivisions of Prosencephalon?
A
- Telencephalon
- Diencephalon
4
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
5
Q
The Diencephalon is a subdivision of the Prosencephalon. What are the parts (Derivates) of the Diencephalon?
A
- Thalamus
- Hypothalamus
- Epithalamus
6
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
7
Q
The Metencephalon is a subdivision of the Rhombencephalon. What are the parts (Derivates) of the Metencephalon?
A
- Pons
- Cerebellum
8
Q
The Myelencephalon is a subdivision of the Rhombencephalon. What are the parts (Derivates) of the Myelencephalon?
A
- Medulla
9
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
10
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
11
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
12
Q
In the third stage of Embryologic Development (Migration), there are 2 types of migration. What are they?
A
- Radial Migration
- Tangential Migration
13
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)
14
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
15
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)
16
Q
How is Cerebral Spinal Fluid (CSF) formed?
A
Its formed by vascular tufts lying within the ventricles called Choroid Plexus
17
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.
18
Q
In the brain, what are the Meninges?
MNEMONIC - PAD
A
From inside - out:
- Pia Mater
- Arachnoid Mater
- Dura Mater
19
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
20
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
21
Q
In terms of Orientation, where is the Thalamus compared to the Frontal Lobe?
A
The Thalamus is Caudal to the Frontal Lobe
22
Q
In terms of Orientation, where is the Cerebellum compared to the Pons?
A
The Cerebellum is Dorsal to the Pons
23
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
24
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)
25
What is a Multipolar Neuron?
Having several dendrites and axons
*Typical in most mammalian neurons*
26
What is a Bipolar Neuron?
Those with single dendrite and axon
*We see them in our sensory systems, vision and olfaction*
27
What is a Unipolar Neurons?
When both axon and dendrite form a single process coming off a cell body
*Seen in invertebrates*
28
What is a synapses?
Typical communication between the neurons, from an axon terminal of one neuron to the dendrite of the next neuron
29
What is the name of the myelin forming glial cells in the Central Nervous System?
Oligodendrocytes
30
What is the name of the myelin forming glial cells in the Peripheral Nervous System?
Schwann
31
In the CNS, what is Glutamate?
Its an excitatory neurotransmitter
32
In the CNS, what is GABA?
Its an inhibitory neurotransmitter
33
What are the neurotransmitters used in the PNS?
Acetylcholine
34
What are the neurotransmitters in the ANS?
Acetylcholine
Norepinephrine
35
Areas in the CNS mainly made up of Myelinated axons are called what?
White matter
36
Areas in the CNS mainly made up of cell bodies are called what?
Gray matter
37
Where do most local synaptic communication occur in the CNS? What about signals over lager distances?
Gray Matter = local synaptic communication
White matter = signals over larger distances
38
In terms of White and Gray Matter, what is the difference between their location in the brain, Spinal Cord, and brainstem?
- 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.
39
Within the PNS, what are the structure of white matter?
Peripheral Nerves
40
Within the PNS, what are the structures of Gray Matter?
Ganglia (cluster of cell bodies)
41
How many pairs of Cranial nerves are there?
12 pairs
42
How many pairs of Spinal nerves are there? Where do they arise?
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)*
43
Where does the Spinal Cord end? What is below the spinal canal?
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
44
What is the Cervical Enlargement?
- The brachial plexus, which is from C5-T1
45
What is the Lumbosacral Enlargement?
- The lumbosacral plexus, which is from L1-S4
46
Based on function, in the Cervical enlargement and the Lumbosacral enlargement, would there be more gray or white matter? Why?
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.
47
In the Autonomic Nervous System (ANS), what are the two major divisions? For each division what are the final neurotransmitters?
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
48
What are the definitions of Sulci, fissure, and Gyri?
- Sulci are the crevices or infoldings
- Fissure are deep sulci
- Gyri are bumps and ridges between the sulci
49
What are the 4 major lobes of the brain? What Fissure separates them?
- 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
50
The 4 lobes of the brain, what are they related to? Where does this structure lie?
- 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)
51
In the Brain what are the Hemispheres separated by? What structure is within the Hemispheres?
Interhemispheric fissure (Sagittal or longitudinal)
- Within the hemispheres, there is a white matter structure called the Corpus Callosum (Hard Body)
52
What is the Primary Motor Cortex also known as? What does it control?
Also known as the Precentral Gyrus (Located in Frontal Lobe)
- Controls movement in the opposite side of body
53
What is the Primary Sensory Cortex also known as? What does it control?
Also known as Postcentral Gyrus (Located in Parietal Lobe)
- Controls sensation in opposite side of body
54
Where is the Primary Visual Cortex located?
The Occipital Lobe
55
What is the Primary Auditory Cortex also known as? Where is this located?
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
56
What is Neocortex?
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
57
What is the Name and the Main Connection for the first (I) layer of the Neocortex?
Name: Molecular Layer
Main Connection: Dendrites and Axons from other layers
58
What is the Name and the Main Connection for the second (II) layer of the Neocortex?
Name: Small Pyramidal Layer
Main Connection: Cortical-Cortical connection
59
What is the Name and the Main Connection for the third (III) layer of the Neocortex?
Name: Medium Pyramidal Layer
Main Connection: Cortical-Cortical connection
60
What is the Name and the Main Connection for the fourth (IV) layer of the Neocortex?
Name: Granular Layer
Main Connection: Receives inputs from Thalamus
61
What is the Name and the Main Connection for the fifth (V) layer of the Neocortex?
Name: Large Pyramidal Layer
Main Connection: Sends outputs to subcortical structures (Other than Thalamus)
62
What is the Name and the Main Connections for the sixth (VI) layer of the Neocortex?
Name: Polymorphic Layer
Main Connection: Sends outputs to Thalamus
63
What is the Functional area for Brodmann Area 1, 2, 3?
Primary Somatosensory cortex
64
Where is the location for Brodmann Area 1, 2, 3?
Post-Central Gyrus (Parietal Lobe)
65
What is the function of Brodmann Area 1, 2, 3?
Touch
66
What is the Function Area of Brodmann Area 4?
Primary Motor Cortex
67
What is the Location of Brodmann Area 4?
Pre-Central Gyrus (Frontal Lobe)
68
What is the function of Brodmann Area 4?
Voluntary movement control
69
What is the Function Area of Brodmann Area 17?
Primary Visual Cortex
70
What is the Location of Brodmann Area 17?
Banks of Calcarine Fissure (Occipital Lobe)
71
What is the function of Brodmann Area 17?
Vision
72
What is the Function Area of Brodmann Area 18?
Secondary Visual Cortex
73
What is the location of Brodmann Area 18?
Medial and Lateral Occipital Gyri
74
What is the function of Brodmann Area 18?
Vision, depth
75
What is the Function Area of Brodmann Area 19?
Tertiary visual cortex, middle temporal visual area
76
What is the Location of Brodmann Area 19?
Medial and Lateral Occipital Gyri
77
What is the function of Brodmann Area 19?
Vision, color, motion, depth
78
What is the Function Area of Brodmann Area 22?
Higher-order Auditory Cortex
79
What is the Location of Brodmann Area 22?
Superior Temporal Gyrus
80
What is the function of Brodmann Area 22?
Hearing, speech
81
What is the Function Area of Brodmann Area 41?
Primary Auditory Cortex
82
What is the Location of Brodmann Area 41?
Heschl's gyri and superior temporal gyrus
83
What is the function of Brodmann Area 41?
Hearing
84
What is the Function Area of Brodmann Area 42?
Secondary Auditory Cortex
85
What is the Location of Brodmann Area 42?
Heschl's gyri and superior temporal gyrus
86
What is the function of Brodmann Area 42?
Hearing
87
What is the Function Area of Brodmann Area 44?
Broca's area; Lateral premotor cortex
88
What is the Location of Brodmann Area 44?
Inferior Frontal gyrus (Frontal operculum)
89
What is the function of Brodmann Area 44?
Speech, movement, planning
90
Describe the Corticospinal tract.
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
91
What is the difference between Upper Motor Neuron (UMN) and Lower Motor Neuron (LMN)?
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
92
What are the components of the Cerebellum?
Folia, vermis, arbor vitae, tonsils, peduncles.
- Additionally has Anterior, Posterior, and Flocculonodualr Lobe
93
What are the 5 structures that make up the Basal Ganglia?
- 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*
94
What is the function of the Cerebellum and Basal Ganglion?
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*
95
What happens if there is lesion of the Cerebellum?
Ataxia: Disorder associated with coordination and balance
96
What happens if there is a lesion of the Basal Ganglion?
Parkinson's: Hypokinetic movement disorder- movements are infrequent, slow and rigid
97
What are the main Somatosensory Pathways? What are their functions?
- Posterior Column Pathways:
Proprioception, vibration, sense, and fine. discriminative touch
- Anterolateral Pathways:
Pain, temperature sense, and crude touch
98
What is the Monosynaptic Stretch Reflex?
The most well studied reflex arc that provides rapid local feedback for motor control
99
With Monosynaptic stretch reflex, what happens if there is damage anywhere along its pathway?
It can cause the reflex to be diminished or absent
100
How do you assess Monosynaptic stretch reflex?
DTRs, results can be normal, hyper/hypoactive
101
What is the Reticula Formation?
What is the function of the Reticula Formation in Caudal and Rostral portions?
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
102
What is the Limbic System functions? Where is the Limbic system?
- Regulation of emotion
- Memory
- Appetite
- Autonomic function
- Neuroendocrine control
- Olfaction
-- Near the medial edge of the cerebral cortex, (Limbus means edge in latin)
103
What happens if there are lesions in the Limbic system?
- Difficulty forming new memories
- Behavioral changes
- Epileptic seizures (Most commonly arise in medial temporal lobe)
--Fear
--Memory distortions
--Olfactory hallucinations
104
What is the function of the Association Cortex? What are the two types?
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
105
Which is the largest area of association cortex?
Frontal Lobe
106
What function is important in relation of our Association Cortex?
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*
107
Where is Broca's area located? Where is Wernicke's area located? What do they do?
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
108
What is Wernicke's Aphasia?
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.
109
What is Broca's Aphasia?
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
110
With the Association Cortex, what is the Parietal Lobe divided by?
Divided by intraparietal sulcus, then we get:
- Superior Parietal Lobule
- Inferior Parietal Lobule
111
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?
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
112
With the Association Cortex, what would happen if there was a deficit in the non-dominate (Right parietal lobe)?
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
113
With the Association Cortex, what happens if the patient has a lesion in the Frontal Lobe?
*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
114
With the Association Cortex, where is the Visual Association Cortex? What happens if there is a lesion here?
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*
115
What are the two main arteries of the brain? What vein drains blood from the brain?
Internal Carotid arteries
Vertebral Arteries (Basilar A.)
Venous drainage is provided mainly by internal jugular veins
116
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?
The Circle of Willis
- The ACA and MCA branch from the ICA
- The PCA brach from the Vertebrobasilar system
117
Which arteries supply the Brainstem and the Cerebellum?
These arteries arise from the vertebral and basilar arteries:
- Superior Cerebellar Artery (SCA)
- Anterior Inferior Cerebellar Artery (AICA)
- Posterior Inferior Cerebellar Artery ( PICA)
118
Which arteries supply the Spinal Cord?
- 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
119
With an UMN lesion, will the patient have weakness?
Yes
120
With an LMN lesion, will the patient has weakness?
Yes
121
With an UMN lesion, will the patient have atrophy?
No
122
With an LMN lesion, will the patient have atrophy?
Yes
123
With an UMN lesion, will the patient have fasciculations?
No
124
With an LMN lesion, will the patient have fasciculations?
Yes
125
With an UMN lesion, would a patient have increased or decreased reflexes?
Increased
126
With an LMN lesion, would a patient have increased or decreased reflexes?
Decreased
127
With an UMN lesion, would a patient have increased or decreased tone?
Increased
128
With an LMN lesion, would a patient have increased or decreased tone?
Decreased
129
What is Apraxia? What are various ways to test Apraxia?
- **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*
130
What structures are involved in Alertness/Attention?
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
131
What structures are involved in Memory, what general lobes/areas? Damage to these area can cause what?
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
132
What structures are involved in Language? Lesions to what lobes generally affect language?
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
133
What is the difference between Broca's and Wernicke's aphasia?
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.
134
Damage to what area would cause apraxia?
Commonly present in lesions affecting the language areas and adjacent structures of the dominant hemisphere.
135
What lobe/side of the brain deals with spatial awareness? Damage to what lobe/side results in neglect?
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
136
What are causes of impaired consciousness?
- 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
137
On a CT Scan, how are bone or calcifications going to appear?
Hyperdense; Appears white/lighter
138
On a CT Scan, how are air/water going to appear?
Hypodense; Appears dark
139
On a CT Scan, how will the brain appear?
Isodense; Appears gray
140
How would a Hemorrhage appear on a CT Scan?
*The appearance depends on chronicity*
- Acute hemorrhage: Hyperdense
- One-week Post hemorrhage: Clot is broken down-Isodense
- Two-three weeks post hemorrhage: Hypodense
141
What are some advantages and disadvantages of CT Scans?
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
142
With MRIs, what is the difference between Hyperintense and Hypointense?
Hyperintense: Brighter areas
Hypointense: Darker areas
143
Is this image a T1 or T2 MRI image?
T1
144
Is this image a T1 or T2 MRI image?
T2
145
In this Angiogram, what arteries are these?
Vertebral Arteries
146
In this Angiogram, what arteries are circled?
1. Anterior Inferior Cerebellar Artery (AICA)
2. Posterior Inferior Cerebellar Artery (PICA)
147
In this Angiogram, what artery is this?
Anterior Cerebral Artery (ACA)
148
In this Angiogram, what artery is this?
Superior Cerebellar Artery (SCA)
149
In this Angiogram, what artery is this?
Middle Cerebral Artery (MCA)
150
In this Angiogram, what artery is this?
Posterior Cerebral Artery (PCA)
151
What is Neuroplasticity?
*Adaptative capacity of the brain*
- The brain's ability to recognize itself by forming new neural connections throughout life
152
What is the difference between Structural Plasticity and Functional Plasticity?
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
153
What are the 10 principles of Neuroplasticity?
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
154
What is the effect of injury in neuronal function?
- we have interrupting external projections from areas that are injured
155
What is the effect of injury at the cellular level?
- Neural shock-Diaschisis
- Loss of synaptic effectiveness
- Alternative mechanisms are substituted
156
What are factors that affect recovery? (7)
- Genes
- Age
- Size, type and location of lesion
- Onset time
- Experience/you environment
- Pharmacology
- Use/Training
157
In terms of recovery of function in motor control, what is the difference between Spontaneous Recovery and Function induced Recovery?
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
158
What is Neuromodulation?
- Things used to promote neuroplasticity, things like:
--Medications
--Rehabilitation
--Neuromodulation tools: TMS, tDCS, DBS
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What is Brain Derived Neurotrophic Factor (BDNF)?
- 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
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With BDNF, what is recommended for patients with chronic disorders?
Evidence that 30 min at 60% max HR is effective for increasing BDNF in patients with Chronic Disorders
