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Y2 BRS Neurology > Cortical Organisation and Function > Flashcards

Cortical Organisation and Function Flashcards

1
Q

How is the cerebral cortex organised microscopically?

A

Layers and columns

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2
Q

What is cytoarchitecture?

A

Cell size, spacing or packing density and

layers

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3
Q

What neurologist identified 52 regions based on cytoarchitecture?

A

Brodmann

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4
Q

What are the functions of the frontal lobe?

A
  1. Regulating and initiating motor function
  2. Language
  3. Cognitive functions (executive function
    [e.g. planning])
  4. Attention
  5. Memory
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5
Q

What are the functions of the parietal lobe?

A
  1. Sensation - touch, pain
  2. Sensory aspects of language
  3. Spatial orientation and self-perception
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6
Q

What are the functions of the occipital lobe?

A
  1. Processing visual information
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7
Q

What are the functions of the temporal lobe?

A
  1. Processing auditory information
  2. Emotions
  3. Memories
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8
Q

What are the functions of the limbic lobe?

A
  1. Learning
  2. Memory
  3. Emotion
  4. Motivation
  5. Reward
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9
Q

What does the limbic lobe include?

A
  1. Amygdala
  2. Hippocampus
  3. Mamillary body
  4. Cingulate gyrus
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10
Q

What are the functions of the insular cortex?

A
  1. Visceral sensations
  2. Autonomic control
  3. Interoception
  4. Auditory processing
  5. Visual-vestibular integration
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11
Q

Where can the insular cortex?

A

Deep within the lateral fissure

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12
Q

What is grey matter?

A

Neuronal cell bodies and glial cells

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13
Q

What is white matter?

A

Myelinated neuronal axons arranged in tracts

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14
Q

What do white matter tracts do?

A

Connect cortical areas

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15
Q

What are 3 types of white matter tracts?

A
  1. Association fibres
  2. Commissural fibres
  3. Projection fibres
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16
Q

What do association fibres do?

A

Connect areas within the same hemisphere

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17
Q

What fibres connect areas within the same hemisphere?

A

Association fibres

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18
Q

What do commissural fibres do?

A

Connect homologous structure in left and right hemispheres

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19
Q

What fibres connect homologous structure in left and right hemispheres?

A

Commissural fibres

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20
Q

What do projection fibres do?

A

Connect cortex with lower brain structures (e.g. thalamus, brain stem and spinal cord)

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21
Q

What fibres connect cortex with lower brain structures (e.g. thalamus, brain stem and spinal cord)?

A

Projection fibres

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22
Q

What types of association fibres are there?

A
  1. Superior Longitudinal Fasciculus
  2. Arcuate Fasciculus
  3. Inferior Longitudinal Fasciculus
  4. Uncinate Fasciculus
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23
Q

What association fibres are long?

A
  1. Superior Longitudinal Fasciculus

2. Arcuate Fasciculus

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24
Q

What association fibres are short?

A
  1. Inferior Longitudinal Fasciculus

2. Uncinate Fasciculus

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25
Q

What does the Superior Longitudinal Fasciculus connect?

A

Connects frontal and occipital lobes

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26
Q

What does the Arcuate Fasciculus connect?

A

Connects frontal and temporal lobes

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27
Q

What does the Inferior Longitudinal Fasciculus connect?

A

Connects temporal and occipital lobes

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28
Q

What does the Uncinate Fasciculus connect?

A

Connects anterior frontal and temporal lobes

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29
Q

What connects frontal and occipital lobes?

A

Superior Longitudinal Fasciculus

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30
Q

What connects frontal and temporal lobes?

A

Arcuate Fasciculus

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31
Q

What connects temporal and occipital lobes?

A

Inferior Longitudinal Fasciculus

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32
Q

What connects anterior frontal and temporal lobes?

A

Uncinate Fasciculus

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33
Q

What types of commissural fibres are there?

A
  1. Corpus callosum

2. Anterior commissure

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34
Q

What types of projection fibres are there?

A
  1. Afferent

2. Efferent

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35
Q

What do projection fibres deep to the cortex radiate as?

A

Corona radiata

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36
Q

Where do projection fibres converge through?

A

Through internal capsule between thalamus and basal ganglia

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37
Q

Where are the motor areas found?

A

Frontal lobe

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38
Q

What does the primary motor area do?

A
  1. Controls fine, discrete, precise voluntary
    movements.
  2. Provides descending signals to execute
    movements.
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39
Q

What does the supplementary motor area do?

A

Involved in planning complex movements (e.g.

internally cued, e.g. speech)

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40
Q

What does the premotor area do?

A

Involved in planning movements (e.g. externally cued)

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41
Q

Where is the somatosensory area located?

A

Parietal lobe

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42
Q

What does the primary somatosensory area do?

A

Processes somatic sensations arising from receptors in the body.

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43
Q

What does the somatosensory association area do?

A
  1. Interpret significance of sensory information, e.g. recognizing an object placed in the hand.
  2. Awareness of self and awareness of personal space
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44
Q

What somatic sensations arise from receptors in the body?

A
  1. Fine touch
  2. Vibration
  3. Two-point discrimination
  4. Proprioception
  5. Pain
  6. Temperature
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45
Q

Where is the visual area located?

A

Occipital lobe

46
Q

What does the primary visual area do?

A

Processes visual stimuli

47
Q

What does the visual association area do?

A

Gives meaning and interpretation of visual input

48
Q

Where is the auditory area located?

A

Temporal lobe

49
Q

What does the primary auditory area do?

A

Processes auditory stimuli

50
Q

What does the auditory association area do?

A

Gives meaning and interpretation of auditory input

51
Q

What does the prefrontal cortex do?

A
  1. Attention
  2. Adjusting social behaviour
  3. Planning
  4. Personality expression
  5. Decision making
52
Q

What does Broca’s area ddo?

A

Production of language

53
Q

What does Wernicke’s area do?

A

Understanding of language

54
Q

What do frontal lobe lesions cause?

A
  1. Changes in personality

2. Inappropriate behaviour

55
Q

What do parietal lesions cause?

A
  1. Contralateral neglect
  2. Lack of awareness of self on left side (if lesion on right hemisphere)
  3. Lack of awareness of left side of extrapersonal space
56
Q

What do temporal lesions cause?

A

Agnosia

57
Q

What is it called if you cannot form new memories?

A

Anterograde amnesia

58
Q

What is anterograde amnesia?

A

Can not form new memories

59
Q

What is agnosia?

A

Inability to recognise

60
Q

What is the inability to recognise called?

A

Agnosia

61
Q

What white motor tract connects Broca’s area and Wernicke’s area?

A

Arcuate fasciculus

62
Q

What does a lesion to Broca’s area cause?

A

Expressive aphasia

63
Q

What does a lesion to Wernicke’s area cause?

A

Receptive aphasia

64
Q

What is expressive aphasia?

A

Poor production of speech, comprehension intact

65
Q

What lesion causes expressive aphasia?

A

Broca’s area

66
Q

What is receptive aphasia?

A

Poor comprehension of speech, production is fine

67
Q

What lesion causes receptive aphasia?

A

Wernicke’s area

68
Q

What lesion leaves speech comprehension intact?

A

Broca’s area

69
Q

What lesion leaves speech production intact?

A

Wernicke’s area

70
Q

What does a lesion in the primary visual cortex cause?

A

Blindness in the corresponding part of the visual field

71
Q

What does a lesion in the visual association area cause?

A

Deficits in interpretation of visual information e.g. prosopagnosia

72
Q

What is prosopagnosia?

A

Inability to recognise familiar faces or learn new faces (face blindness)

73
Q

What is inability to recognise familiar faces or

learn new faces (face blindness) called?

A

Prosopagnosia

74
Q

What imaging techniques can assess cortical function?

A
  1. PET - positron emission tomography

2. fMRI - function magnetic resonance imaging

75
Q

What does PET measure?

A

Blood flow directly to a brain region

76
Q

What does fMRI measure?

A

Amount of blood oxygen in a brain region

77
Q

What encephalography techniques can assess cortical function?

A
  1. EEG - electroencephalography

2. MEG - magnetoencephalography

78
Q

What does EEG measure?

A

Measures electrical signals produced by the the brain

79
Q

What does MEG measure?

A

Measures magnetic signals produced by the brain

80
Q

Describe the localisation of function for primary cortices?

A
  • Function predictable
  • Organised topographically
  • Symmetry between left and right
81
Q

Describe the localisation of function for secondary cortices?

A
  • Function less predictable
  • Not organise topographically
  • Left-right symmetry weak/absent
82
Q

How could encephalography be used to access cortical function?

A
  1. Visual evoked potentials
  2. Event-related potentials/evoked-potentials
  3. Somatosensory evoked potentials
83
Q

How could somatosensory evoked potentials in encephalography be used to access cortical function?

A

Series of waves that reflect sequential activation of neural structures along the somatosensory pathways.

84
Q

What brain stimulation be used to assess cortical function?

A
  1. TMS - transcranial magnetic stimulation

2. tDCS - transcranial direct current stimulation

85
Q

What does TMS do?

A

Uses electromagnetic induction to stimulate neurones

-> assess the functional integrity of neural circuits

86
Q

What can TMS assess in cortical function?

A
  1. Investigate neuronal interactions controlling movement (stimulate primary motor cortex) following spinal cord injury
  2. Investigate whether a specific brain area is responsible for a function e.g. speech
87
Q

What does tDCS do?

A

Uses low direct current over the scalp to increase or decrease neuronal firing rates

88
Q

What imaging techniques can be used to assess structure?

A

DTI - diffusion tensor imaging

89
Q

What is DTI?

A

Based on diffusion of water molecules

90
Q

What is DTI with tractography?

A

3D reconstruction to assess neural tracts

91
Q

What is MS - multiple sclerosis?

A

MS is an autoimmune disorder which results in the loss of myelin from neurons of the CNS

92
Q

What are some of the main symptoms of MS?

A
  • Blurred vision
  • Fatigue
  • Difficulty walking
  • Paraesthesia (numbness or tingling in different parts of the body)
  • Muscle stiffness and spasms
93
Q

What is orthodromic?

A

Travelling in the normal direction in a nerve fibre

94
Q

What is antidromic?

A

Travelling in the opposite direction to the normal in a nerve fibre

95
Q

What is M-wave in peripheral nerve stimulation?

A

The fast response - the activation of the motor axons can cause action potentials to travel along the nerve to cause muscle contraction, a twitch.

96
Q

How can results peripheral nerve stimulation be recorded?

A

EMG - electromyography

97
Q

What is H-reflex in peripheral nerve stimulation?

A

Reflex activation of a muscle - same stimulus cause activation of the sensory axons (feel stimulus).

  • The action potentials can travel along the nerve to the spinal cord.
  • These can then cause the lower motor neurons in the spinal cord to become activated.
  • Action potentials in the motor axons can travel along the motor neuron to the muscle where they cause muscle contraction, a twitch.
98
Q

When can an F wave be seen?

A

With a large enough stimulus

99
Q

What is F-wave in peripheral nerve stimulation?

A

A large electrical stimulus can cause activation of the motor axons to conduct antidromically.

  • These action potentials travel along the motor nerve to the spinal cord (i.e. in the opposite way to normal).
  • These can then cause the lower motor neurons in the spinal cord to become activated.
  • Action potentials in the motor axons can travel along the motor neuron to the muscle where they cause muscle contraction, a twitch.
100
Q

How does cortical motor stimulation using TMS work?

A

The activation of the upper motor neurons causes action potentials to travel along the entire motor pathway (upper and lower motor neurons) to cause muscle contraction.

101
Q

How does cortical motor stimulation using TMS result in?

A

EMG response known as an MEP - motor evoked potential.

102
Q

What is the TMCT?

A

Total Motor Conduction Time:

Time from brain to muscle (MEP latency)

103
Q

What is the PMCT?

A

Peripheral motor conduction time:

time from spinal cord to muscle along motor axon

104
Q

How is PMCT calculated?

A

PMCT = (M latency + F latency-1) /2

105
Q

What is the -1 in PMCT calculation?

A

The -1 is the estimated time for the action potentials arriving at the lower motor neuron cell body to turn around

106
Q

What is CMCT?

A

Central Motor Conduction Time

107
Q

How is CMCT calculated?

A

TMCT - PMCT

108
Q

What is the effect of MS on brain stimulation?

A

Longer than usual MEP latency.

Problem along upper motor neurons, lower motor neurons or both.

109
Q

What is the effect of MS on TMCT?

A

Delayed

110
Q

What is the effect of MS on peripheral nerve stimulation?

A

Normal F wave latency.

No issue with lower motor neurons.

111
Q

What is the effect of MS on brain stimulation?

A

Normal

112
Q

How can we deduce where the problem is in MS?

A

TMCT (brain stimulation) delayed
PMCM (peripheral nerve stimulation) normal

-> problem in CNS

Y2 BRS Neurology (7 decks)

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