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Neuroanatomy > Cortical and Pediatric Exam (2) > Flashcards

Cortical and Pediatric Exam (2) Flashcards

1
Q

What are key principles of neurodevelopment

A

development of motor control proceeds in head to toe fashion, primitive reflexes normally present in term infant, diminish over 4-6 months, postural reflexes emerge at 3 to 8 months of age

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2
Q

What is the hallmark of an upper motor neuron abnormality in the infant

A

Persistence of primitive reflexes and the lack of development of the postural reflexes

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3
Q

What are the steps of the pediatric neuroexam?

A

1)stop, look, and listen; 2) hands-on part, further clarifies initial observations (game, non-threatening) 3) save all the threatening parts of examination until last

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4
Q

How is somatic growth examined and used in the pediatric exam?

A

measure height and weight and compare percentiles with head circumference

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5
Q

Why do we look for dysmorphic facial features in the pediatric exam?

A

anomalies of the midface are often associated with underlying brain malformations

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6
Q

Where and why is the head circumference measured?

A

largest from frontal to occipital; proportional to brain size, 80% of size by 2

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7
Q

What and why do we do an abdominal exam in the pediatric neuro exam?

A

palpate for visceromegaly which can indicate the presence of one of the
storage diseases

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8
Q

What are you looking for in the spine in pediatric exam?

A

look for scoliosis and any sacral anomalies

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9
Q

What is completed by 28 days of gestation?

A

Formation of the neural tube

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10
Q

What occurs 2 to 4 months gestation neuronally?

A

neuronal proliferation

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11
Q

What occurs 3 to 5 months gestation neuronally?

A

neuronal migration

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12
Q

What is responsible for most of the brain’s growth?

A

Growth of the individual neurons plus elaboration and proliferation of
dendritic and axonal processes and connections (increasing dendritic arborization, synaptogenesis, and axonal connections,)

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13
Q

How much bigger does a neuroblast get by maturity?

A

5-50 microns, 1000x

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14
Q

When does myelination start? Most rapid period? What parallels the time course and pattern?

A

3rd trimester, first two years of life, acquisition of neurodevelopmental milestones

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15
Q

Myelination occurs early for what structures? Why?

A

motor-sensory roots, special senses and the

brainstem; necessary for reflex behavior and survival

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16
Q

The corticospinal tract starts to myelinate when? complete when?

A

36 wks gestation, by second year of life, trunk and upper extremity to lower extremity, correlates to milestones

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17
Q

The areas of the cerebral hemispheres that are first to myelinate are what?

A

posterior portion of the frontal lobes, the parietal lobes and areas of the occipital lobes; followed by frontal and temproal

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18
Q

By the end of the second year, myelination of the cerebrum is what? What still needs myelination?

A

largely completed; interconnections of the association cortex are still being
myelinated into 2nd and 3rd decades of life

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19
Q

What primitive reflexes are tested in the pediatric exam?

A

suck, root, moro, gallant (trunk incurvation), grasp, and ATNR

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20
Q

What postural reflexes are tested in the pediatric exam?

A

positive support reflex, landau, lateral propping, and parachute

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21
Q

Independent walking is achieved between what ages? An infan is delayed when?

A

11-15 months; aren’t walking by 16 months

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22
Q

What are the charcteristics of the toddler’s gait?

A

wide-based, unsteady, Arms held at near shoulder level- high guard position, probably aids in balance

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23
Q

What cortical area is responsible for Attention?

A

dorsolateral frontal lobe/anterior cingulate gyrus

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24
Q

What cortical area is responsible for awareness?

A

Sensation-primary cortex, Perception- association cortex

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25
Q

What cortical area is responsible for motivation?

A

Executive-frontal lobe, Affective- amygdala,

hypothalamus, medial frontal lobes

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26
Q

What cortical area is responsible for memory?

A

hippocampus/limbic

27
Q

What is orbitofrontal lobe function?

A

Personality, social judgment

28
Q

What brodman’s areas correspond with Wernicke’s?

A

41,42

29
Q

What brodman’s areas correspond with Broca’s?

A

44 and 45

30
Q

How is the dorsolateral frontal lobe assessed?

A

conceptualization- similarities, working memory- digit span, spelling words backwards

31
Q

What is the function of the frontal lobe?

A

executive function, judgment, volition and working memory

32
Q

How is the Medial-frontal lobe assessed?

A

mental flexibility and verbal fluency set

generation (names as many words as you can in minute that begin with the letter “s”)

33
Q

What is Korsakoff’s psychosis?

A

antegrade and retrograde memory loss. Patient makes up answers to questions (confabulates). thiamine deficiency. Mamillary bodies/dorsal medial nucleus of the thalamus most effected.

34
Q

Which area of the hippocampus proper is most affected by seizure, ischema and pathological insult?

A

CA1

35
Q

What are the symptoms of an uncinated fit?

A

unpleasant odor spell, dream like state seing and hearing memories

36
Q

What is the connection betwenn Broca’s and Wernike’s? Where is it?

A

arcuate fasciculus, extreme capsule

37
Q

What are the symptoms of Receptive (Wernicke) aphasia?

A

cannot comprehend, fluent, nonsense, jargon, anomia

38
Q

What are the symptoms of Expressive (Broca) aphasia?

A

can comprehend, nonfluent, agrammatic,

39
Q

What are the symptoms of global aphasia?

A

receptive and expressive deficits

40
Q

What are the symtpoms of conduction aphasia?

A

can’t repeat

41
Q

Where is the word association area?

A

parietotemporal cortex

42
Q

What area is involved in speech initiation and categorization?

A

supplementary motor and prefrontal cortex

43
Q

What speech/language functions are impaired in global aphasia?

A

speech, naming, sentence production (absent), word & sentence comprehension, repetition

44
Q

What speech/language functions are impaired in conduction aphasia?

A

speech fluent but paraphrasic, naming and sentence structure paraphrasic, sentence comprehension variable, repetition

45
Q

What speech/language functions are impaired in Broca’s aphasia?

A

nonfluent speech, impaired naming, agramtic sentence production, word and sentence comprehension, repetition

46
Q

What speech/language functions are impaired in Wernicke’s aphasia?

A

naming, sentence production structured but empty, word and sentence comprehension, repetition

47
Q

What are the motor aspects of speech?

A

respiration, phonation, resonance, articulation, prosody

48
Q

What is responsible for phonation?

A

vocal cords

49
Q

What is responsible for resonance?

A

shape of oral cavity

50
Q

What is responsible for articulation?

A

lips, tongue, teeth, oral movements- consonant sounds

51
Q

What is Prosody?

A

rate, phrasing, inflection, emotional content

52
Q

What is spastic speech? Lesion where?

A

low pitch, harsh, strained,slow rate-UNM

53
Q

What is Flaccid speech? Lesion where?

A

hypernasality, soft, muffled, breathy, imprecise articulation- LMN

54
Q

What is ataxic speech? Lesion where?

A

scanning, slow, indistinct, cerebellar

55
Q

What is agnosia?

A

failure to recognize familiar objects

perceived by sensory stimuli

56
Q

What is apraxia?

A

inability to perform purposeful motor

acts on command

57
Q

What is constructional apraxia?

A

inablity to draw objects which require use of visual spatial organization

58
Q

What is Autopagnosia?

A

inabiltiy to recognize body parts

59
Q

What is Anosognosia?

A

unawareness or denial of dysfunction

60
Q

What is Gerstmann Syndrome?

A

Dysfunction of the dominant inferior parietal lobe: Acalculia, Finger agnosia, Agraphia, and Right-left confusion

61
Q

What is achromatopsia?

A

inability to distinguish colors

62
Q

What is visual agnosia?

A

inability to visually identify an object

63
Q

What is Prosopagnosia?

A

inability to identify familiar faces

Neuroanatomy (17 decks)

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