Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Aphasia > Exam #1 > Flashcards

Exam #1 Flashcards

1
Q

acquired neurogenic language disorders:

A

aphasia
primary progressive aphasia
alexia (reading disorder only)
agraphia (writing disorder only)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

acquired neurogenic cognitive-linguistic disorders

A

memory
attention
executive functions
(TBI, RHI, Dementias)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

acquired neurogenic speech disorders

A

dysarthrias
apraxia of speech (primary apraxia of speech)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what are the four core elements of aphasia?

A

language disorder, acquired, neurological, multimodal (affecting receptive and expression)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

multimodal

A

affects the way you read, write, speak - affects multiple aspects

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what is the definition of aphasia?

A

an acquired multimodality language disorder caused by focal brain damage in the absence of other cognitive, motor, or sensory impairments
- focal lesion
- sudden onset
- bottom out and then improve…

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

language

A

refers to processing that involves symbols (symbolization) to convey communicative intent

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

receptive language

A

understanding language (comprehension)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

auditory comprehension

A

understanding words and sentences we hear

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

reading

A

understanding written language

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

expressive language

A

gestures or sign language, writing, talking

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

diagram on slide 6

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

prevalence of stroke

A

5th cause of death in the US
Mortality = 8%-12% of ischemic stroke; 37% to 38% of hemorrhagic strokes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

795,000 new cases of stroke are reported each year

A

A stroke happens every 40 seconds.
Every 4 minutes someone dies from stroke.
Up to 80 percent of strokes can be prevented

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Leading cause of disability in the US (300,000 per year)

A

87% of the strokes are ischemic
10% of the strokes are hemorrhagic
3% of the strokes are subarachnoid hemorrhage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

prevalence of aphasia (after a stroke)

A

30-40% of all CVAs have aphasia as the presenting symptom
1 million people (e.g., 1 in 250 individuals) in the US have aphasia
80, 000 new cases of aphasia are reported each year

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Patients with Wernicke’s aphasia tend to be a little older while those with Broca’s aphasia are younger

A

higher incidence of posterior strokes with age

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

People with aphasia have higher healthcare costs (8.5% or $1, 700 attribute cost) and longer length of stay (LOS) in the hospital (6.5%) compared with stroke survivors without aphasia

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

African Americans have nearly twice the risk of first stroke →

A

high blood pressure, smoking, high cholesterol levels, obesity, poor diet, and lack of exercise

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Aphasia and other types of communication disorders facilitate

A

determining localization

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

They facilitate understanding of speech and language organization in the:

A

brain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Primary Progressive Aphasia (PPA) is a…

A

language impairment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Primary Progressive Aphasia (PPA)

A

Insidious onset
Gradual progression and prolong course
Without generalized dementia caused by a neurodegenerative condition that predominantly affects the left perisylvian region of the brain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Cognitive-Linguistic Disorders

A

linguistic deficits, language of generalized intellectual impairment, language of confusion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Linguistic deficits due to right hemisphere lesions

A

Identifiable group of sensory, perceptual and linguistic deficits that occur

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Language of Generalized Intellectual Impairment – associated with dementia

A

Involves:
Verbal and non verbal communication, decreased memory, disorientation, poor judgment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Language of Confusion – associated with traumatic brain injury (TBI)

A

Disorientation
Bizarre confabulative and irrelevant speech
Little awareness of deficit
Disorganized speaking reflects disorganized thinking

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Apraxia of Speech

A

Sensorimotor disorder of articulation and prosody.
It is characterized by difficulty with the capacity to plan/program movements for volitional speech production. So, although aphasia usually co-occurs with apraxia of speech, the nature of the deficit in apraxia is motor planning/programming, not linguistic (has nothing to do with language)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Where will you see people with aphasia?

A

Hospitals
Rehabilitation centers
Skilled nursing facilities
Long-term care facilities
Continuing care retirement communities
Home health agencies
Private practice clinics
Not-for-profit communication disorders clinics
Aphasia centers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Aphasia vs Dysphasia

A

“Technically, dysphasia means impaired language and aphasia means lack of language. There have been calls to use the term ‘aphasia’ regardless of severity. Reasons for doing so include dysphasia being easily confused with the swallowing disorder dysphagia, consumers and speech pathologists preferring the term aphasia, and many languages other than English using a word similar to aphasia. It would appear that the term “aphasia” is more commonly encountered in North America, while “dysphasia” is more frequently found in British literature.”

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Paul Broca (1824- 1880)

A

Paul Broca (1824- 1880)
French neurosurgeon and physical anthropologist.
First to stated that the frontal lobe and left brain is involved in language production.
Based on case studies and pathological evidence gathered from autopsies.
“We speak with the left hemisphere”
Language area = lower, posterior portion of the left frontal lobe at the junction of lateral and central fissures.
Area concerned with motor speech = Broca’s area (a.k.a. Brodmann areas 44 and 45)
Language disorders associated with brain lesions = aphemia. Major symptoms are:
Reduced speech fluency
Agrammatic, telegraphic speech
Many language production errors
Only limited impairment of comprehension of spoken language

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Carl Wernicke (1848 – 1905)

A

German neuropsychiatrist
First to describe a type of aphasia different from symptoms described by Paul Broca.
Based on clinical studies and autopsies of patients who had language disturbances.
Aphasia is caused by lesion in the posterior portion of the left superior temporal gyrus (now a.k.a. Wernicke’s area).

Symptoms are:
Fluent but meaningless speech
Grammatically correct speech
Severe problems in understanding spoken language
Difficulty in comprehending material read silently or orally

Called sensory area

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

localizationist approach

A

Specific function to a specific anatomic structure within the brain.
Broca and Wernicke were localizationists. – this was a praxis question

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

holistic approach

A

John Hughlings Jackson (1864, 1915, 1932)
Brain functions are an integrated unit in formulating and expressing language; therefore a lesion in one area affects functions of most, if not all, areas.
Denies the existence of specific anatomic structures that control equally specific language functions
Aphasia = all aspects of language are disturbed
Thought that Aphasia is more holistic
Pierre Marie (1853 – 1940)
Aphasia is a single disorder (not a collection of multiple disorders distinguished on the basis of the lesion).
Auditory comprehension deficits exist in all the aphasias

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

The study of cases in aphasia intensified after World War II.

A

Aleksandr Luria (1902 – 1977)
Studied patients who suffered war injuries
The brain structure may be primarily responsible for a function and yet the brain works as a whole in the comprehension and production of language.

Norman Geshwind (1926-1984)
Supported the early localizationist view of aphasia with new clinical and anatomic evidence.
Aphasia is a cortical disconnection syndrome.
Aphasia became primarily a clinical issue of how best to classify patients.
Important when classifying aphasia in patients

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Central nervous system =

A

brain, brainstem & spinal cord

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Peripheral nervous system =

A

nerves extending out from brainstem (cranial nerves) and spinal cord (spinal nerves)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Central nervous system = brain & spinal cord

A

Protected by bony encasing
Brain inside cranium

Spinal cord inside spinal canal created by vertebral column

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Central nervous system = brain & spinal cord

A

Meninges = triple layer of tissues surrounding entire brain and spinal cord
Dura mater
Arachnoid
Pia mater

Cerebrospinal fluid = within ventricles inside brain and within meninges surrounding CNS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Central nervous system (CNS)

A

Made up of neurons (nerve cells)
Gray matter = cell bodies, process information
White matter = axons, carry signals to other neurons/structures
Axons often insulated with myelin, creating the whitish color.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

CNS Divisions

A

Telencephalon (new brain)
Diencephalon (between brain)
Brainstem
Cerebellum
Basal ganglia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

Telencephalon

A

Cerebrum/Cortex (left and right hemispheres)
Frontal, parietal, temporal and occipital lobes.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

Diencephalon

A

Subcortical areas: Thalamus, epithalamus, subthalamus, hypothalamus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

Brainstem

A

Midbrain, pons, medulla
Cranial nerves
Reticular activating system (arousal)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

Cerebellum

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

Basal ganglia

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

Cerebral Hemispheres

A

Connected by corpus callosum & anterior/posterior commissure

Sulci and fissures serve as anatomic landmarks separating regions or lobes

4 lobes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

4 lobes:

A

Frontal lobe
Parietal lobe
Temporal lobe
Occipital lobe

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

Corpus callosum

A

a bunch of white matter, and axons, that send information from one side to the other side

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

Cortex
Lobes: within each hemisphere; functions roughly assigned to each

A

frontal, parietal, occipital, temporal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

frontal

A

motor, basic language (left hemisphere), higher level cognition

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

parietal

A

somatosensory, attention

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

occipital

A

visual processing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

temporal

A

auditory, basic language (left hemisphere), prosody (right hemisphere), recognition of objects/faces, memory

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

Prosal prognosia

A

difficulty recognizing faces
- Can happen from right temporal damage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

anatomical landmarks of the cerebellum

A

slide 9 power point 2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

Cortical Localization Maps:

A

Brodmann’s Areas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

insula

A

cortex deep in the sylvian fissure (frontal and temporal lobe)
Plays an important role in language and swallowing functions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

frontal lobe is divided into:

A

Prefrontal area
Premotor area
Supplementary motor area
Motor area (Primary Motor Cortex)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

frontal lobe is important to:

A

Speech production
Higher-level cognitive functions such as working memory, attention, executive functions.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

prefrontal area

A

Higher level cognition:
Executive functioning: planning, goal setting, problem solving, inhibition, personality, judgment…

Working memory (short-term memory)

Attention

Orientation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

JAMIO:

A

judgment, attention, memory (short-term/working), intelligence (thinking), and orientation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

premotor area

A

Pars triangularis (45) and pars opercularis (44) (lower portion) in the left frontal hemisphere are considered the traditional anatomical locations comprising Broca’s area
Related to the production of language

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

premotor area:
Broca’s area

A

Planning/programing of complex motor movement sequences (not execution), across joints or articulators
It figures out what movements need to be made, when, and in what order
Damage causes apraxia of speech

Controls verbal/expressive language
Damage causes Broca’s aphasia

Upper portions program more general mvts (e.g., hands)
Right hemisphere – expressive emotional prosody

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

areas 44 and 45 are related to:

A

Brodmann’s areas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

Damage to broca’s:

A

can be: Aphasia, verbal output or apraxia of speech, related to planning (which movements do I need to make in order to say a word)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

Supplementary Motor Area (SMA)

A

Lies on the top-middle area of the premotor cortex in the frontal lobe

Plays a role in the initiation of self-generated or willed movements (in contrast to imitative movements that bypass the SMA)

It forwards information to the premotor and motor cortices

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

If you have a lesion in the supplementary motor area:

A

you can have apraxia of speech

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

Primary motor cortex (motor strip/cortex/area):

A

pre-central gyrus (4)
Sends nerves to spinal cord and brainstem to innervate the muscles
Called “upper motor neurons” (UMN)
Pyramidal tract or direct activation pathway

Damage leads to paralysis or weakness (paresis) of the muscles (on the opposite site of the body, face)
Hemiplegia, dysarthria

motor strip

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

Motor strip is essential for:

A

carrying-out fine, skilled movements (oral, fingers), more gross movements rely less on motor strip… - more related to the homunculus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

Primary Motor Cortex: Homunculus (“little man”)

A

Two characteristics of the motor strip reflect on the homunculus:

Location: Nerves going to specific body parts leave from specific areas of the motor strip

Degree of skilled motor control/movements exerted over a particular body part. Larger parts in the homunculus indicate that more nerves are devoted to that body part, thus allowing for greater fine/skilled motor control (e.g., hands, fingers and our articulators)

Motor strip is part of the execution system → damage can cause dysarthria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
72
Q

Parietal Lobe

A

Anterior parietal
Superior parietal
Inferior parietal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
73
Q

anterior parietal

A

primary sensory strip (Damage causes loss of feeling)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
74
Q

superior parietal

A

attention (left neglect – right hemisphere), body schema, visual ‘where’ pathway processing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
75
Q

inferior parietal

A

Left hemisphere – has a special role in language processing (reading/writing)
Right hemisphere – emotional prosody comprehension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
76
Q

Post-central gyrus primary central strip

A

responsible for sensory information damage causes loss of feeling

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
77
Q

parietal lobe
angular and supramarginal gyri

A

(left) problems in selecting phonemes, word retrieval, reading, writing, and calculation

These two areas are very much engaged in selecting phonemes, word retrieval, reading, writing, and calculation

”sofa” to “fosa”

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
78
Q

temporal lobe

A

superior temporal
inferior and middle temporal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
79
Q

superior temporal:

A

language processing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
80
Q

superior temporal:

A

Anterior left hemisphere – semantic processing (how do I know that a dog is an animal and an apple is a fruit)
Posterior
Left hemisphere – language comprehension
Right hemisphere – emotional prosody comprehension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
81
Q

Inferior and middle temporal:

A

Episodic and semantic memory
Olfactory processing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
82
Q

Wernicke’s area in terms of semantic processing is in:

A

superior and middle temporal gyrus, but for sure superior gyrus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
83
Q

Primary Auditory Cortex: Heschl’s gyrus

A

(41, 42)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
84
Q

Primary Auditory Cortex: Heschl’s gyrus

A

Receives auditory fibers from the ear via the thalamus
Unilateral damage does not cause deafness (subcortical awareness of sound…where is the sound coming from?)
May result in difficulty interpreting a sound or locating a sound in space

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
85
Q

Secondary Auditory Cortex Wernicke’s area

A

(22)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
86
Q

Secondary Auditory Cortex

A

Processing of auditory information, important to the development and use of language

On left: Processing of speech sounds to identify a word
Wernicke’s aphasia

On right: More involved with music and environmental sounds…

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
87
Q

Temporal lobe is also…

A

auditory information

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
88
Q

Heschl’s gyrus

A

(41 and 42), very engaged in the ability to hear sounds

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
89
Q

Wenicke’s area

A

(22), when you process information from the sound that you hear. Left side: “cup” you hear it and you understand what it means, they may hear it but don’t understand
Right side: can hear but can’t interpret sounds

90
Q

occipital lobe contains:

A

primary visual cortex and secondary visual cortex

91
Q

primary visual cortex

A

Banks of Calcarine fissure (17, 18)

92
Q

Primary Visual Cortex : Banks of Calcarine fissure (17, 18):

A

Receives fibers from eye via the thalamus
Damage does cause blindness in opposite visual half-field…

93
Q

Secondary Visual Cortex:

A

medial and lateral surface of occipital lobe (18 and 19)

94
Q

Secondary Visual Cortex: medial and lateral surface of occipital lobe (18 and 19)

A

enhances interpretation of visual information

95
Q

Perisylvian Cortex/Area

A

Cortex surrounding the sylvian fissure in the left hemisphere

96
Q

Perisylvian cortex/area

A

Zone for the major neurologic components for understanding and producing language
- Broca’s area
- Wernicke’s area
- Supramarginal gyri
- Angular gyri
- Arcuate fasciculus (long association nerve tracts)

97
Q

Sylvian fissure

A

divides the lobes

98
Q

perisylvian area

A

zone for the major neurologic components for understanding and producing language

99
Q

Arcuate fasciculus

A

A bunch of white matter that connects broca’s and Wernicke’s area

100
Q

cerebral connections
how do the parts of the brain interact?

A

association nerve fibers
commissural nerve fibers
projection nerve fibers

101
Q

association nerve fibers

A

connections lining cortical areas within the same hemisphere
short fibers: connect adjacent areas
long fibers: connect distant areas

102
Q

commissural nerve fibers

A

connections linking areas in the two hemispheres

103
Q

projection nerve fibers

A

carry information to cortex (ascending, sensory/afferent)
carry information away from cortex (descending, motor/efferent)

104
Q

axonal tracts: association fibers:

A

communication between cortical areas that within the same hemisphere (intra-hemisphereic)
short association fibers
long association fibers

105
Q

Association fibers, cont.
Superior longitudinal fasciculus

A

b/t frontal and parietal and occipital lobes

106
Q

Arcuate fasciculus

A

runs along with superior longitudinal fasciculus
area (Broca’s and Wernicke’s) connects anterior and posterior speech and language

107
Q

Inferior longitudinal fasciculus

A

connects temporal and occipital lobes
Role in object recognition, memory and visual discrimination

108
Q

Uncinate fasciculus

A

connects anterior frontal and temporal lobes

109
Q

Perpendicular fasciculus

A

Connects temporal, occipital and parietal lobes

110
Q

If you have a rupture in the arcuate fasciculus, it tends to generate a type of aphasia called

A

conduction aphasia

111
Q

association fibers: language network

A

FAT: Frontal Alant Tract (driving of speech)
Dorsal stream - phonological processing (SL/AF)
Ventral stream - semantic processing

112
Q

left peri-sylvian region
dorsal stream:

A

phonological processing

113
Q

dorsal stream: phonological processing:

A

arcuate fasciculus
superior longitudinal fasciculus

114
Q

dorsal stream:

A

learning new vocabulary

115
Q

dorsal stream: learning new vocabulary:

A

heschel gyrus
superior temporal gyrus
broca area
arcuate fasciculus
superior longitudinal fasciculus

116
Q

left peri-sylvian region

A
117
Q

ventral stream: semantic processing

A

inferior fronto-occipital fasciculus
middle temporal gyrus

118
Q

axonal tracts:
commissural fibers:

A

communicate information to cortical areas in the contralateral hemisphere (inter-hemispheric)
- corpus callosum

119
Q

corpus callosum

A

connects the left and right brains

120
Q

axonal tracts:
projection fibers:

A

nerve fibers connecting the cerebral cortex to other sensory or motor centers in the brain

121
Q

afferent neurons

A

are sensory neurons that carry nerve impulses from sensory stimuli towards the central nervous system and brain
sensory of touch

122
Q

efferent neurons

A

are motor neurons that carry neural impulses away from the central nervous system and towards muscles to cause movement

123
Q

laterality issues

A
124
Q

sensory-motor

A

each hemisphere relates to opposite side of body

125
Q

association areas may be proportionally larger on ___ with tertiary areas larger on ___

A

left;
right

126
Q

left brain

A

analytical, sequential, better temporal resolution (see parts, show things in parts)
heavily engaged in language: auditory comprehension, verbal expression, reading and writing

127
Q

right brain

A

simultaneous, gestalt (see whole picture, multi-tasking); better at processing novel information (meanings, intents)
interference and identification of the speaker’s intent (understand jokes, irony, sarcasm, inferencing)

128
Q

left and right brain

A

semantics, pragmatics
right hemisphere is heavier on the pragmatic aspect of language than the left

129
Q

thalamus

A

egg like structure in the middle of the brain
lies beneath the cortex in each hemisphere

130
Q

thalamus function

A

part of the forebrain neural circuitry
- cortex-basal ganglia-thalamic projections

131
Q

thalamus consists of:

A

a collection of subcortical nuclei

132
Q

four main important functions of the thalamus

A
  1. relay/channel
  2. integrate
  3. control
  4. coordinate and synchronize
133
Q

thalamus: relay/channel

A

projections of sensory* (i.e., pain, taste, temperature, audition, and vision) information entering the lower levels of the nervous system to specific cortical areas.
Serves as a channel for sensory information (pain, touch, temperature, taste), all of this info comes from the peripheral nervous system –> thalamus –> lobes
The only sensory information that bypasses the thalamus is smell (olfactory), there is a cranial nerve

134
Q

thalamus: integrate

A

sensorimotor information and project afferent from the basal ganglia, limbic system and cerebellum to the primary and premotor cortices.

135
Q

thalamus: control

A

access of sensory information to the cortex according to the sleep-wake cycle

136
Q

thalamus: coordinate and synchronize

A

activity of widespread cortical areas for arousal and cognitive function (e.g., language, speech, and memory)
- except for olfaction

137
Q

thalamic nuclei

A

slide 35

138
Q

cerebrovascular system

A

blood supply to the brain comes directly from the heart, via the aorta

139
Q

cerebrovascular system

A

branches of the aorta, such as the common carotid, subclavian, and vertebral arteries give rise to cerebral arteries

140
Q

subclavian –>

A

vertebral arteries –> basilar arteries

141
Q

carotid arteries –>

A

internal carotid arteries

142
Q

internal carotid arteries and basilar arteries form the…

A

circle of Willis at the base of the cerebrum

143
Q

How the arteries and veins nourish and provide the brain with blood

A

External carotid: Provide blood supply to face
Internal carotid: keeps going up
Subclavian artery:
Vertebral artery: goes through the spinal column, then becomes the basilar artery
The internal and basilar artery will subdivide and become the cerebral arteries (anterior, middle, and posterior)

144
Q

Circle of Willis (COW)

A

distributes blood to the cerebrum

145
Q

COW and cerebral vascular territories

A

slide 38
COW in relationship to cerebral blood supply distributions

146
Q

how do the ACA, MCA, and PCA and the COW all connect?

A

slide 39

147
Q

cerebral vascular territories

A

slide 40
on transverse and coronal slices

148
Q

anterior cerebral artery
disrupted ACA flow:

A

paralysis and sensory loss to legs and fee
frontal lobe syndrome
abulla
apraxia of speech

149
Q

frontal lobe syndrome

A

executive dysfunction, decreased spontaneity, impaired judgment + concentration (attention)

150
Q

abulla

A

delayed speech initiation, patient’s speech is brief, unelaborated and concrete
takes them a while to talk, not a word retrieval problem - they know - just takes a second for them to initiate speech

151
Q

apraxia of speech

A

supplementary motor area

152
Q

disrupted middle cerebral artery (MCA) flow:

A
  • paralysis and sensory loss (arms, legs, voice)
  • aphasia apraxia of speech, dysarthria (brain left side)
  • visual-spatial deficits, left-side neglect (brain right side)
153
Q

branches of the MCA

A

MCA stroke (anterior/superior division)
MCA stroke (posterior/inferior division)

154
Q

MCA stroke (anterior/superior division)

A
  • contralateral face and arm weakness
  • broca’s aphasia (left side)
  • apraxia of speech
  • dysarthria
155
Q

MCA stroke (posterior/inferior division)

A
  • contralateral sensory loss
  • wernicke’s or conduction aphasia (left side)
    contralateral visual defect
156
Q

disrupted posterior cerebral artery (PCA):

A

homonymous hemianopsia (visual field cut)
pure alexia (or alexia without agraphia) - if you have a stroke

157
Q

watershed regions

A

provides double coverage for areas of overlap between two vascular territories (e.g., ACA & MCA; MCA & PCA)

158
Q

watershed vessels:

A

are small diameter (terminal branches), so they are susceptible to small vessel disease

159
Q

basal ganglia and thalamic vascular territories

A

slide 46

160
Q

basal ganglia blood supply

A

MCA gives rise to the lenticulostriate arteries that supply the basal ganglia
tiny arteries that go to subcortical areas of the brain, goes to basil ganglia, thalamus, and provide blood supply to those areas

161
Q

what causes aphasia?

A

stroke, tbi, braintumor, bacteria and viruses, toxemia, degenerative process

162
Q

cerebrovascular accidents (CVA), stroke, brain attack (all the same thing)
risk factors:

A

hypertension, diabetes, excessive weight, smoking, stress, inactivity, high consumption of alcohol, cholesterol, fat and sodium

163
Q

what can be done to prevent stroke?

A

lifestyle factors (smoking, diet, physical activity)
pharmacological intervention (hypertension medications, anticoagulants, antiplatelets, vasodilators)
surgical intervention (endarterectomy, angioplasty)

164
Q

what is a stroke? (A.k.a., cerebrovascular accident (CVA); brain attack)

A

A temporary/permanent disruption of blood supply to the brain

The most common cause of primary neurogenic speech and language disorders

165
Q

occlusive stroke:

A

thrombotic (blockage of entire artery)
embolic (when you have a build up of fat and it breaks apart and a particle travels away and lodges in a little artery and blocks blood flow)

166
Q

hemorhagic stroke:

A

Irupture of an artery and blood is getting in contact with the brain
ntracerebral: meninges layers
Subarachnoid: meninges layers
Subdural: meninges layers

167
Q

ischemic stroke

A

caused by blockage of blood flow to any area of the brain
- arteries are flexible, elastic, and smooth

168
Q

ischemic stroke

A
  • blockages are commonly caused by atherosclerosis (fatty deposits “plaques” containing cholesterol and other wast products accumulate, narrowing the artery)
169
Q

atherosclerosis

A

arteries become hard, stiff, and thick

170
Q

two types of ischemic stroke:

A

embolism
thrombosis

171
Q

embolism

A

part breaks off and lodges in a smaller artery downstream, more typical type of stroke in younger people (30s, 40s, 50s, 60s)

172
Q

thrombosis

A

accumulation continues until artery is blocked off, more common in older people (70s, 80s)

173
Q

penumbra

A
  • ischemic core of a lesion is dead and cannot regenerate
  • penumbra is the area around the blockage and ischemic core
  • blood perfusion to the penumbra is restricted but function can be restored if edema is reduced
174
Q

what is a transient ischemic attack (TIA)?
(mini-stroke)

A
  • a temporary blockage of the blood supply to any area of the brain
  • usually lasts less than 30 minutes
  • often occur before a full blown stroke
175
Q

causes of TIA

A

a thrombus or embolus
a change in blood pressure

176
Q

following TIA, many people have noticeable challenges with…

A

motor, sensory, cognitive, or linguistic functions

177
Q

FAST

A

face
arm
speech
time

178
Q

drug treatment for ischemic stroke

A
  • anti-platelet drugs
  • anti-coagulants
  • vasodilators
  • clot-busting (thrombolytic) drug
  • tPA - just for an ischemic stroke
179
Q

anti-platelet drugs

A

make platelets less stick and likely to clot
- aspirin in low dosages (81 mg)
- plavix or Ticlid

180
Q

anti-coagulants

A

help prevent formation or extension of clots but do not dissolve clots
- heparin
- coumadin (warfarin)

181
Q

vasodilators

A

prevent the walls of the arteries from tightening/narrowing

182
Q

clot-busting (thrombolytic) drug

A

tPA: tissue plasminogen activator
- injected into artery to dissolve existing clot
- must be used within 3 or 4 hours
- usually requires a CT scan so there is not a risk of bleeding elsewhere

183
Q

surgical tx for ischemic stroke

A
  • Carotid endarterectomy
  • Angioplasty
184
Q

What happens during carotid endarterectomy?

A
  • open the carotid and clear clot out
  • done in the first part of carotid at the neck level
  • when greater than 70% clogged, good results
  • some people can be quite clogged with no symptoms
185
Q

what happens during an angioplasty?

A
  • a balloon-tipped catheter is inserted in the artery
  • balloon is inflated, pushing the clot against the artery wall
  • a stent is inserted to prevent recurrent narrowing
  • newer stents have drugs that help prevent new clotting, scar tissue, build-up
186
Q

Hemorrhagic stroke - types

A
  • bleeding into the brain
  • intra-cerebral hemorrhage
    -aneurysm
187
Q

hemorrhagic stroke - bleeding into the brain - what is it?

A
  • it is toxic to nerve cells
  • space occupying (e.g., subdural hematomas)
188
Q

hemorrhagic stroke - intra-cerebral hemorrhage - what is it?

A
  • common site is lenticulostriate arteries
  • very bad - this is the type of stroke where the blood is in the brain
189
Q

hemorrhagic stroke - aneurysm - what is it?

A
  • ballooning of a weak artery wall
  • can rupture, spilling blood
  • 1-5% of population have these, but asymptomatic
190
Q

How can an aneurysm affect brain function?

A

every time a lobe is squeezed by the ballooning of an artery wall, it affects the function of that lobe, affecting the person and what they can and can’t do

191
Q

Surgical tx for aneurysms:

A
  • clipping
  • embolization (coiling)
192
Q

What is clipping?

A
  • tiny clamp placed at the base of aneurysm keeping blood out of it
  • prevents it from bursting or re-bleeding
193
Q

What is embolization?

A
  • a tiny platinum coil is inserted via a catheter into the aneurysm
  • it fills the aneurysm, causing it to clot and seal off from the artery
  • coiling
194
Q

More hemorrhagic stroke:

A
  • Arteriovenous malformations (AV malformations)
  • Lacunae
195
Q

What is an arteriovenous (AV) malformation?

A
  • congenital tangling of the artery-vein connections
  • can rupture
196
Q

treatment for AV malformations

A
  • smaller ones in accessible locations can be surgically removed
  • embolization: blocking small arteries feeding the AVM, it then shrinks
197
Q

What is a Lacunae?
(aka lacunar infarcts/stroke, or small vessel disease)

A
  • are a special group of deep cerebral infarctions caused by hypertension or single small emboli that block tiny arteries in the brain
    are small subcortical infarcts (<15 mm in diameter) in the territory of the deep penetrating arteries (lenticulostrate arteries)
198
Q

Other aphasia etiologies include:

A

bacteria and viruses

199
Q

what are bacteria and viruses?

A

microscopic organisms that may cause inflammation in the brain

200
Q

neurogenic communication disorders due to bacterial/viral infections:

A
  • encephalopathies
  • meningitis
  • meningoencephalitis
201
Q

what are encephalopathies?

A

infections that affect the cortex

202
Q

what is meningitis?

A

an inflammation of the meninges surrounding the brain

203
Q

what is meningoencephalitis?

A

an inflammation caused by an infection

204
Q

HIV/AIDS

A
  • HIV = Human Immunodeficiency Virus
  • AIDS = Acquired Immunodeficiency Syndrom
205
Q

what is neoplasm?

A
  • An abnormal mass of tissue that forms when cells grow and divide more than they should or do not die when they should
  • New growth of a tumor
206
Q

what are the two major types of tumors?

A
  • Malignant (cancerous)
  • Benign (non-cancerous)
207
Q

Etiologies of tumors:

A
  • primary tumors result from uncontrolled growth of two types of cells (glial cells) and meningeal cells (meningioma)
  • secondary (metastatic) tumors)
208
Q

What are glial (gliomas) cells?

A

cells in the cortex that provide protection, nutrition, blood supply

209
Q

What are secondary (metastatic) tumors?

A
  • spreading tumors arising from elsewhere in the body and travel to the brain via the blood supply or lymphatic system
210
Q

when a person has a tumor in the brain, what can be some of the symptoms?

A
  • anomia
  • loss of vision
  • visual field disturbances
  • memory and attention problems
  • confusion
  • nausea
  • seizure activity
211
Q

what is anomia?

A

when a person is having difficulty finding the words they want to say, word finding and difficulty

212
Q

What are the 3 primary brain tumors?

A
  • Astrocytoma
  • Oliogodendroglioma
  • Gliblastoma multiforme
213
Q

what is Metastatic (or “brain metastases”)?

A
  • may migrate from other parts of the body to the brain via lymphatic or other systems
  • may migrate from primary brain tumor to other sites
214
Q

What is toxemia?

A

the poisoning, irritation, or inflammation of nervous system tissue through exposure to harmful substances

215
Q

what is toxic encephalopathy?

A

brain dysfunctions related to metabolism at the cellular level

216
Q

examples of toxins that are harmful to brain tissues:

A
  • excessive use of alcohol
  • recreational drugs such as methamphetamines (“ecstasy”)
  • excessive usage of certain dietary substances, such as refined sugars
217
Q

Symptoms of toxemia:

A
  • reduced cognitive functioning
  • somnolescence (sleepiness or drowsiness)
  • personality changes
218
Q

Traumatic Brain Injury (TBI)

A

a blow (or jolt) to the head or a penetrating head injury that disrupts the function of the brain

219
Q

Closed Head Injury (CHI):

A
  • the head forcefully hits an object (non-penetrating wound), the brain is not exposed
  • focal damage and diffuse damage to axons
  • effects tend to be broad (diffuse)
  • no penetration to the skull
220
Q

Examples of closed head injury:

A

resulting from a slip and fall, motor vehicle crashes, bike accidents, etc.

221
Q

Open Head Injury:

A
  • an object passing through the skull and piercing the brain (penetrating wound)
  • the brain and meninges are exposed
  • largely focal damage
  • penetration of the skull
  • effects can be just as serious as closed brain injury
222
Q

Examples of open head injury:

A

bullet wounds, knife, etc.

Aphasia (2 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions