Exam #4 Info Flashcards
There are __ pairs of cranial nerves. Explain where they exit relative to the brainstem
Twelve11 exit anterior1 exits posterior
What areas of the body do the cranial nerves innervate?
HeadNeckThoraxUpper abdomen
What are the three basic functions of cranial nerves?
Motor innervationSomatosensory and special sensory innervationParasympathetic innervation
Cranial N I Name, Related function, and Connection to brain
OlfactoryFunction: smellConnection to brain: inferior frontal lobe
Cranial N IIName, Related function, and Connection to brain
OpticFunction: visionConnection to brain: diencephalon
Cranial N IIIName, Related function, and Connection to brain
OculomotorFunction: Moves eye up and down, medially; raises upper eyelid; constricts pupil; adjusts the shape of the lens of the eyeConnection to brain: midbrain (anterior)
Cranial N IVName, Related function, and Connection to brain
TrochlearFunction: moves eye medially and downConnection to brain: midbrain (posterior)
Cranial N VName, Related function, and Connection to brain
TrigeminalFunction: facial sensation, chewing, sensation from TMJConnection to brain: pons (lateral)
Cranial N VIName, Related function, and Connection to brain
AbducensFunction: abducts the eyeConnection to brain: between pons and medulla
Cranial N VIIName, Related function, and Connection to brain
FacialFunction: facial expression, closes eye, tears, salivation, tasteConnection to brain: between pons and medulla
Cranial N VIIIName, Related function, and Connection to brain
VestibulocochlearFunction: sensation of head position relative to gravity and head movement; hearingConnection to brain: between pons and medulla
Cranial N IXName, Related function, and Connection to brain
GlossopharyngealFunction: swallowing, salvation and tasteConnection to brain: medulla
Cranial N XName, Related function, and Connection to brain
VagusFunction: regulates viscera, swallowing, speech, tasteConnection to brain: medulla
Cranial N XIName, Related function, and Connection to brain
AccessoryFunction: Elevates shoulders, turns headConnection to brain: spinal cord and medulla
Cranial N XIIName, Related function, and Connection to brain
HypoglossalFunction: moves tongueConnection to brain: medulla
Cranial N I: OlfactoryNormal function
Sensory
Olfactory Nerve
From nasal chemoreceptors to olfactory bulbIn roof of the sinus in porous bone
Olfactory tract
Is what’s seen on gross brain dissectionCarries the smell message to the frontal lobe
Cranial N I: OlfactoryDysfunction
Damage with TBICannot smellLink with Parkinson’s and Alzheimer’s
Cranial N II: OpticNormal function
SensoryConscious vision: Optic tract –> Occipital cortexReflex response: Optic tract –> Midbrain nuclei (superior colliculus)
Optic chiasm
Next location in visual pathway after optic NWhere half of the axons from each retina cross the midline
Optic tract
Connects the axons to the thalamus
Corticobulbar Tract
Cranial Nn cortical tractCortical control over some cranial Nn from the cortex
Cranial nerves are a type of __ nerve
Peripheral
All sensory pathways connect through the ___.
Thalamus
Cranial N II: OpticDysfunction
BlindnessLose depth perceptionDisruption of pupillary light reflex
Cranial Nn III, IV, and VI: oculomotor, trochlear and abducensNormal function
Motor control of six extra ocular musclesParasympathetic innervation of the eyePupillary Light ReflexConsensual Light ReflexAccommodation Reflex
CN III controls which extraocular muscles? What eye movements does it result in?
Medial rectusSuperior rectusInferior rectusInferior obliqueAdducts, elevates and depresses the eye
CN IV controls which extraocular muscles? What eye movements does it result in?
Superior obliqueLook in toward the tip of the nose
CN VI controls which extraocular muscles? What eye movements does it result in?
Lateral rectusMoves the eye laterally
Medial Longitudinal Fasciculus
Wiring bundle that interconnects all CN on both sides of the brainstem and integrates that with the inner ear
What CN does the parasympathetic innervation of the eye travel with?
CN III
What affect does the parasympathetic innervation of the eye have?
Constricts pupil (via pupillary sphincter)Increases curvature of lens for near vision (via ciliary muscle)
Pupillary Light Reflex
Constricts the pupil in the same eye to lightReflex onlyOptic (afferent)Oculomotor (efferent)
Consensual Light Reflex
Constricts the opposite pupil to lightReflex onlyOptic (afferent)Oculomotor (efferent)
Accommodation Reflex
Compensations to focus in near visionDriven by conscious visionPupils constrictEyes converge (adduct)Lens becomes more convex
Cranial N III: OculomotorDysfunction
PtosisAffected eye looks down and outDiplopiaDifficulty moving eye medially, downward and upwardDilation of pupilLoss of pupillary light reflex and consensual light reflexLoss of constriction of pupil for focus on near object
Cranial N IV: TrochlearDysfunction
Cannot look down and inExtorsion
Cranial N VI: AbducensDysfunction
Inability to abduct eyeResting position of eye drifts medially
Cranial N V: TrigeminalNormal function
Mixed sensory and motor3 branchesAfferent pathwaysEfferent pathwaysReflexes
Name the three branches of the trigeminal N
Ophtalmic: of the eyeMaxillary: top of the jawMandibular: bottom of the jaw
Describe the 4 afferent pathways of the trigeminal N.
Discriminitive touch (face, eye, tongue): sensory receptor –> somatosensory cortexProprioception: sensory receptor –> reticular formationNociception (fast pain): nociceptor –> somatosensory cortexNociception (slow pain): nociceptor –> limbic system and cortex
Describe the efferent pathway of the trigeminal N
Muscles of mastication
Describe the two reflexes of the trigeminal N
Blink reflex: input CN V, output CN VIIJaw jerk reflex: input CN V, output CN VII
Cranial N V: TrigeminalDysfunction
Loss of touch, pain, temperature on facePossible loss of blink reflexPossible loss of jaw jerk reflex (jaw deviates toward involved side with active opening)Trigeminal Neuralgia
Trigeminal Neuralgia
Trigeminal N painAllodyniaHyperalgesia
Cranial N VII: FacialNormal Function
Motor function: facial expression musclesParasympathetic: salivary, nasal and lacriminal glandsSensory: taste sensation from anterior 2/3 of tongue
Cranial N VII: FacialDysfunction
Paralysis or paresis of all ipsilateral muscles of facial expression (Bell’s Palsy)
Is Bell’s Palsy a result of UMN or LMN damage?
LMN
Cranial N VIII: VestibulocochlearNormal Function
SensoryTransduction of soundFrequency codingAuditory function within the CNS
Name the two divisions of Cranial N VIII: Vestibulocochlear
Vestibular divisionCochlear division
Explain the transduction of sound.
Air waves are converted to water waves which bend hair cells to create APDifferent set of hair cells for each frequency you hear
Frequency Coding
Different part of the cochlea for every frequency you hear
Name the 3 auditory functions of the vestibulocochlear nerve within the CNS
1) Orientation of head and eyes toward sound (inf colliculus helps localize)2) Increase arousal within CNS (reticular formation)3) Conscious awareness and recognition of sounds (thalamus to auditory cortex)
Cranial N VIII: VestibulocochlearDysfunction
Dizziness/dysequilibriumHearing Loss Difficulty locating sounds in spaceTinitus
Name the two types of hearing loss associated with Vestibulocochlear N Dysfunction
Conductive hearing lossSensorineural hearing loss
Describe conductive hearing loss
Cannot convert air waves to water wavesExcessive wax: prevents the eardrum from moving so air waves cannot get to the middle earOtitis media: air waves reach the middle ear but do not change into water waves
Otitis media
Middle ear infection or fullness/inflammation
Describe sensorineural hearing loss
Problem in sensation or nervous system pathwayHair cells that create AP can become damaged or dieDamage to receptor cells or cochlear nerve
Causes of sensorineural hearing loss
Peripheral nerve (CN VIII)Acoustic neuromaTinnitusCochlear Nuclei/central pathways (i.e. brainstem stroke)
Acoustic neuroma
Tumor that compresses CN VIII almost exclusively so that the AP can never get in to the brainstem
Tinnitus
Ringing in the earSign of damage to the hearing pathway in the ear
Cranial N IX: GlossopharyngealNormal function
Mixed sensory, motor, and autonomic
The sensory component of the glossopharyngeal nerve consists of ___.
Somatosensation from posterior tongue, soft palate and pharynx (sensory part of the gag and swallow reflexes)Taste sensation from the posterior tongue (bitter taste)
Cranial N IX: GlossopharyngealDysfunction
Loss of afferent gag reflexLoss of afferent swallow reflexDecrease salivation
What is a consequence of the loss of a swallow reflex?
Aspiration
Cranial N X: VagusNormal function
Mixed sensory, motor and autonomic
The sensory component of the Vagus N goes to __.
LarynxPharynxViscera
The motor component of the Vagus N goes to __.
LarynxPharynx
The autonomic component of the Vagus N goes to __.
LarynxPharynxTracheaLungsHeartUpper GIPancreasGall bladderLiver
Cranial N X: VagusDysfunction
Difficulty speakingHoarse voiceDifficulty swallowingAssymetric elevation of soft palateLoss of efferent gag reflexLoss of efferent swallow reflexPoor digestion
Cranial N XI: AccessoryNormal function
Motor: trapezius and sternocleidomastoid
Cranial N XI: AccessoryDysfunction of LOWER motor neuron
“Flaccid” paralysis of ipsilateral upper trapezius and sternocleidomastoid
Cranial N XI: AccessoryDysfunction of UPPER motor neuron
“Spastic” paresis of contralateral upper trapezius and sternocleidomastoid
Cranial N XII: HypoglossalNormal Function
Motor: intrinsic and extrinsic muscles of the tongue
Cranial N XII: HypoglossalDysfunction
Atrophy of ipsilateral tongueTongue drifts toward side of lesion when “stuck out”Difficulty speaking and swallowing
Name the three stages of swallowing
Oral stageLaryngeal/Pharyngeal stageEsophageal stage
Which cranial nerves are involved in the oral stage of swallowing and what is their function?
V: moves the jawVII: keeps the mouth closedXII: tongue moves food back and forth to be chewed up and then to the throat for swallowing
Which cranial nerves are involved in the laryngeal/pharyngeal stage of swallowing and what is their function?
IX: sense the presence of foodX: starts the swallow when the context is right
Which cranial nerves are involved in the esophageal stage of swallowing and what is their function?
X: closes the windpipe and squeezes the food down the esophagus
What structures are involved in speaking and which cranial nerve corresponds with that part?
Larynx: CN XSoft palate: CN XLips: CN VIIJaw: CN VTongue: CN XII
Any cranial nerve that has ____ function and innervates ___ is a ___ motor neuron.
SomatomotorSkeletal/striated muscles in the head or neckLower
Name the three systems controlling cranial nerve lower motor neurons.
Corticobulbar Tract (upper motor neurons)Descending limbic pathwaysSensory input (reflexes)
Three inferior to superior divisions of the brainstem and their cranial nerves
Medulla: CN IX, X, XI, XIIPons: CN V, VI, VII, VIIIMidbrain: CN III, IV
Three anterior to posterior divisions of the brainstem
Base (basilar): motorTegmentum: sensoryTectum: eye movements and movements of the head
Describe the pyramids of the medulla
VentralWhite matterCorticospinal tract Voluntary motor
The dorsal medulla contains __ tracts
Sensory tracts of touch and proprioception
The basilar portion of the medulla contains __. (2)
Corticospinal tractsMedial lemniscus
The tegmentum portion of the medulla contains __.
Spinothalamic tractsTigeminothalamic tractsReticular formationAutonomic “control” nucleiCranial nerve nuclei IX, X, XII
The ventral pons contains __.
“Bulge” of pontine nuclei and pontocerebellar fibersCranial nerve roots V, VI, VII, VIII
The dorsal pons contains __.
Cerebellar peduncles
The basilar portion of the pons contains __.
Corticospinal tractPontine nuclei (origin of pontocerebellar fibers)Corticobrainstem tract
The tegmentum portion of the pons contains __.
Medial lemniscus (touch and proprioception)Spinothalamic tractsTrigeminothalamic tractsReticular formationAutonomic “control” nucleiCranial nerve nuclei (V, VI, VII, VIII)
The ventral midbrain contains ___.
Cerebral pedunclesCranial nerve root (III)
The dorsal midbrain contains __.
Superior colliculiInferior colliculiCranial nerve root (IV)
The basilar portion of the midbrain contains __.
Cerebral pedunclesSubstantia nigra
The tegmentum portion of the midbrain contains __.
Red nucleusPedunculopontine nucleusOculomotor complex (CN III, IV)Periaqueductal gray
The tectum portion of the midbrain contains __.
Superior colliculiInferior colliculi
3 functions of the reticular formation
Integrates sensory and cortical information: helps with motor planning and regulating moodRegulates somatic motor activity, autonomic function and consciousnessModulates nociceptive/pain information
What other area of the brain does the reticular formation work with to make the motor plan?
Basal ganglia
2 main functions of the cerebellum
Coordination of movement (gross and fine)Motor planning
Segmental damage in the brainstem
Cranial nerve damageEX: Cranial N VIILower motor neuron damage”All of one side” of the face is paralyzedBell’s palsy
Vertical tract damage in the brainstem
Cortex or corticobrainstem damageUpper motor neuron damage”Lower half of one side” of face paralyzed
If you cannot move the upper OR lower part of the face, what kind of damage to the brainstem is it? (3 terms)
SegmentalCranial N VII damageLower motor neuron damage
If you can move the eye but NOT the mouth on one side of the face, what kind of damage to the brainstem is it? (3 terms)
Vertical tractCortex or corticobrainstem damageUpper motor neuron damage
What 3 tracts and/or nerves will damage to the anteromedial medulla affect?
Corticospinal tractMedial LemniscusHypoglossal N
What affect will damage to the corticospinal tract in the anteromedial medulla result in?
Paralysis of the arm/trunk/legContralateral
What affect will damage to the medial lemniscus tract in the anteromedial medulla result in?
Loss of touch from the bodyContralateral
What affect will damage to the hypoglossal N in the anteromedial medulla result in?
Paralysis of the tongueIpsilateralLower motor neuron damageAtrophy of denervation
In 99% of the brainstem, one sided damage will yield __.
Vertical tract damage = contralateral signs and symptoms (UMN damage)-Dorsal column medial lemniscus-Spinothalamic-CorticospinalCranial N nuclei damage = ipsilateral signs and symptoms (LMN damage)
How can brainstem region damage affect vital function?
Can also damage the cardiovascular and respiratory control centers int he medullaAutonomic signs are ipsilateral with one sided damage to the pons and/or medulla
Name the 4 D’s of Brainstem Region Dysfunction
DysphagiaDysarthriaDiplopiaDysmetria
Dysphagia:DefinitionCranial N InvolvementArea of brain affected
Difficulty swallowingCranial Nerves IX, XProblem of the medulla because that is where CN IX, X are
Dysarthria:DefinitionCranial N InvolvementArea of brain affected
Difficulty in the mechanical production of speechCranial Nerves V, VII, X, XIIEspecially with damage to the pons and medulla
Diplopia:DefinitionCranial N InvolvementArea of brain affected
Double visionCranial Nerves III, IV, VIDamage to the midbrain and top of medulla
Dysmetria:DefinitionTract InvolvementArea of brain affected
Cannot accurately hit a targetSpinocerebellar tract (or bottom of brainstem)Cerebellum-knows what you want to do but not what you are really doing
2 functions of the vestibular system
Keep us visually and physically steady in the worldMaintenance of balance and EQ
2 components of the vestibular system
Peripheral (inner ear and CN VIII)Central (pathway in brainstem and brain)
Semicircular canals
Almost circles off the base of the vestibular apparatus can sense any direction your head moves
Direction of the 3 semicircular canals on each side of the head
Anterior: 45 degrees out toward the frontPosterior: 45 degrees toward the backHorizontal: tipped up 30 degrees
Hair cells of the semicircular canals
In fluid at the base of the canalWhen hair cells bend one way, send more AP (when on the side the head is turning toward)When hair cells bend the other way, send less AP (when on the side the head is turning away from)
Describe the baseline activity of the semicircular canals
Change action potentials with angular acceleration/decelerationAlways send a certain number of AP - ion channels are always leaking and sending AP
Describe the “paired” activity of the semicircular canals
AP increase on the side toward rotation and decrease proportionately on the side away from the rotation
Importance of semicircular canals
Stabilize vision when the head is moving
Hair cells of Otolithic organs
In gel with rocks on top
Baseline activity of otolithic organs
Change action potentials with linear acceleration/deceleration or pull of gravity
Central Vestibular Nuclei
Collect information from every sensory system that sense movement and organize the output so you can move with balance and equilibriumCluster of cells at the base of the pons and medulla (base of CN VII)
5 inputs to vestibular nuclei
Vestibular information (strongest)Visual informationProprioceptive informationTactile informationAuditory information
5 outputs from vestibular nuclei
Medial vestibulospinal tractLateral vestibulospinal tractSpinal accessory N XICerebral cortexMedial Longitudinal FasciculusReticular formationCerebellum
Information carried by the medial vestibulospinal tract from vestibular nuclei
Posture and reflex movement of head and upper body
Information carried by the lateral vestibulospinal tract from vestibular nuclei
Posture and reflex movement of trunk and lower body
Information carried by spinal accessory N XI from vestibular nuclei
Reflex movement of the head
Information carried by the cerebral cortex from vestibular nuclei
Conscious awareness of head movement and position
Information carried by the medial longitudinal fasciculus from vestibular nuclei
Coordinates reflex movements of the eyes through connections with CN III, IV, VI
Information carried by the reticular formation from vestibular nuclei
Can affect level of consciousness and/or produce nausea and vomiting
Information carried by the cerebellum from vestibular nuclei
Can influence posture and eye movements
Retina receives __ information in __ orientation
VisualUpside down and backwards
“Nasal” retina
Receives light information from “temporal” visual field
“Temporal” retina
Receives light information from “nasal” visual field
Name the 5 visual pathways
RetinaOptic nerveOptic chiasmOptic tractVisual information diverges in optic tract
Optic nerve visual pathway
CN IIHas all the axons from one retina
Optic chiasm visual pathway
Axons from the nasal retina cross the midline hereAll the information about the right side of space is on the left side of the brain and vv
Optic tract visual pathway
Chiasm –> thalamusHas all axons that see one side of visual space
3 places visual information diverges in the optic tract
Superior colliculusPretectal areaThalamus –> occipital cortex
The superior colliculus contributes to __.
Orientation and visually guided eye movementsLight information from the eyes to guide reflex movements
The pretectal area contributes to __.
Pupillary reflexesParasympathetic neurons here
The thalamus –> occipital cortex contributes to __.
Conscious sight
A stroke affecting the internal capsule can lead to __.
Body weakness and visual field loss
Two main functions of eye movements
Keep the eyes focused on an object while the head is moving (gaze stabilization)Move the eyes to focus on an object of interest (direction of gaze)
Vestibulo-Ocular Reflex (VOR)
Type of gaze stabilizationFast head movementsInner ear –> eye reflexKeeps eyes steady on an object of interest while the head movesUnconscious and automaticImportant for postural stability during movement
Saccades
Type of direction of gazeWith head still, voluntarily move eyes from one focus point to another
Smooth pursuit
Type of direction of gazeEyes move smoothly to follow an objectTests voluntary control of eye movement
Dorsal stream
Thalamus –> occipital cortex (conscious sight)From visual cortex, pathway goes forward in the brain to motor planning areaVisually guides movement
Ventral stream
Thalamus –> occipital cortex (conscious sight)From visual cortex, pathways goes back in the brain to inferior temporal lobeIdentify and name by vision
Physiologic Nystagmus
Occurs during acceleration/deceleration of the head (when there is a difference in activity of a pair of semicircular canals)Eye “slips” opposite the direction of movement (slow phase = VOR)Eye “catches up” in the direction of movement (fast phase = saccade)
Pathologic Nystagmus
Occurs when there is no appropriate stimulus (acceleration/deceleration of the head)
Disorders of the vestibular and visual systems can occur with damage to any or all of the following: (5)
Peripheral receptorCranial (peripheral) nerveBrainstem nucleiCentral projection axonsCortical reception areas
8 general signs and symptoms of disorders of the vestibular system
VertigoNauseaNystagmusDysequilibriumPostural instabilityImpaired gaze stabilizationOscillopsia
Vertigo
Feeling that you are spinning in the world
Oscillopsia
Lost gaze stabilizationVisual objects appear to “bounce” when the head is moving due to decreased VOR
Unilateral Peripheral Hyperfunction
One inner ear is sending more signals than is appropriate for the current conditionsRock can get into semicircular canals and move through fluid so that even when the head is steady, rock can pull on hairs and send movement signals
Four signs and symptoms of Unilateral Peripheral Hyperfunction; which two are most troublesome to the patient?
DizzinessNauseaReduced gaze stabilizationPostural instability
Unilateral Peripheral Hypofunction
One inner ear is sending fewer signals than is appropriate for the current conditions
Four signs and symptoms of Unilateral Peripheral Hypofunction; which two are most troublesome to the patient?
Reduced gaze stabilizationPostural instabilityDizzinessNausea
Name the 4 lesion locations that can result in visual deficits
Optic nerveOptic chiasmOptic tractOptic radiations
Describe the visual deficit associated with the optic nerve
One eye blindnessLose 1/4 visual space and depth perception
Describe the visual deficit associated with the optic chasm
Bitemporal hemianopsiaNo peripheral vision on either sideTunnel vision
Describe the visual deficit associated with the optic tract
Homonymous hemianopsiaHalf of visual field is lostOne side has no vision
Describe the visual deficit associated with the optic radiations
Same as the optic tractHemianopsiaLose one half of vision
How do you distinguish a CN II issue from a CN III, IV or VI issue?
CN II = visual field problemsCN III, IV, and VI = pointing the eye problems
The thalamus is the __ to the cerebral cortex
Executive assistant
Describe the relay nuclei of the thalamus
Carries all the modalities of sensation to the cortex and everything else going to the cortexEverything passes through with synapses in the thalamus
Significance of a synapse in the thalamus
Can change the strength of the signalsSignals from all areas of the brain can influence the other area’s messages
Name the three types of nuclei in the thalamus
Relay nucleiAssociation nucleiNonspecific nuclei
What pathways are the nonspecific nuclei associated with?
Divergent pain
Two functions of the hypothalamus
Maintains homeostasisModifies endocrine regulation of growth, metabolism, and reproductive organs
Describe the two ways the hypothalamus maintains homeostasis
Modulates the autonomic control centers in the pons and medullaSecretes various substances (hormones, etc) into the bloodstream
Subcortical white matter contains connections to and from __.
The outer (cortical) cell layer
Name the three fiber types of subcortical white matter
Projection fibersCommissural fibersAssociation fibers
Projection fibers of subcortical white matter
Into and out of the cerebrum”Up and down”i.e. Internal CapsuleHas every sensory and motor signal fro the head and the body
Commissural fibers of subcortical white matter
Between hemispheres in the cerebrum”Side to side”i.e. Corpus CallosumAllows hemispheres to compare notes and coordinate with each other
Association fibers of subcortical white matter
Within hemispheres in the cerebrum”Front to back”i.e. ventral and dorsal streams
Basal ganglia has __ functions in addition to motor planning functions
Cognitive
The basal ganglia does motor planning for ___ movements and sends those signals to both the ___.
Postural and voluntary movementsCortex and brainstem
The basal ganglia’s main function __.
Awareness of body orientation in space
The cerebral cortex has ___ histologically separate layers
6
The corticospinal tract is also called the __ tract
Pyramidal
Pyramidal tract
DirectorCorticospinal tract
Extrapyramidal
HelperNot corticospinal tract
Name the 4 primary sensory areas of the cerebral cortex
Primary somatosensoryPrimary auditoryPrimary visualPrimary vestibular
Primary somatosensory
Post central gyrusSense the physical characteristics of things you touch Describes the physical characteristicsShape, texture, size
Primary auditory
Temporal lobeBegin to describe or appreciate the character of soundsLoudness, pitch
The vestibulocochlear (CN VIII) system projects to ___ temporal lobes which is one of the ways we can __
BothLocate sources of sound in 3D space
Primary visual
Back of the occipital lobeBegins to describe the visual characteristics of things you seeHow light or dark something is, the edges of objects, size and shape of objects
Primary vestibular
Input from vestibular nucleiSense circular head movement, linear head movement and pull of gravity
Name the 3 parts of the Sensory association/secondary sensory areas
Somatosensory associationVisual associationAuditory association
Somatosensory association
Parietal lobeMake meaning of the somatosensation areaCan identify an object by its physical characteristics based on what we feel (stereognosis)
Stereognosis
Name objects based on what we feelSomatosensory association area
Visual association
Crosses the boundary of the occipital and temporal lobesBegins to analyze objects based on their movement and colorBecause of extension into the temporal lobe (ventral stream) can name objects on what we see
What stream (dorsal or ventral) is associated with the visual association area?
VentralName objects based on what we see
Auditory association
Primary ear spot in the temporal lobeHelps to classify sound in 3 ways: spoken language, music, other sounds/noises
If the auditory association area determines what you are hearing is speech it __
Sends the message to another area to decode the language
5 areas of the motor planning areas
PremotorSupplementary motorBroca’s areaArea analogous to Broca’s areaPrimary motor
Premotor area
In front of the precentral gyrusFinal planning for postural support of movementTrunk and proximal musclesExecutes postural control before voluntary movement Anticipates postural instability
Supplementary motor
In front of precentral gyrusHelps sequence and initiate movement Active in motor imagery
Broca’s area
Right next to temporal lobe at the bottom of the frontal lobeCreate the motor plan to physically say the words you are thinkingPhysical characteristics of speech
For 95% of people, Broca’s area is on the __ side of the brain
LeftLeft hemisphere is dominant for language
The most common thing seen clinically is ___ weakness and ___ because the left side of the brain was damaged
Right side weaknessInability to create speech
Area analagous to Broca’s area
Right next to temporal lobe at the bottom of the frontal lobeCreates the paraverbal aspects of speechHow I say those words
Primary motor
Precentral gyrusContains the corticopsinal neurons that take the plan to the bodyContains the axons that will descend through the internal capsule, cerebral peduncles and pyramids of the medulla
Emotion
Short term subjective experience
Mood
Sustained, subjective, ongoing emotional response
Emotions signal ___ evaluation of a situation. Explain.
NonconsciousImagine forward negative consequences of a motor plan that was thought ofGut feelings signal this
“Lateralization” of emotion
Positive emotions - left prefrontal cortexNegative emotions - right prefrontal cortex
Name the 2 areas of the brain involved in emotions
AmygdalaOrbital cortex
Amygdala
Small nucleus in the medial temporal lobeDetects emotional and social cues, generates feelings of fear
When fear is sensed the amygdala ___.
Turns on the whole emotional autonomic system and helps with fight or flight
If the amygdala is damaged….
Don’t interpret social cues wellFearless (don’t recognize fear)
Orbital cortex
Prefrontal lobe right above the eyeInhibits undesirable behaviors
Emotions and behavior
Emotion and response to threatsEmotion and decision making
Name the 4 parts of the stress response
Somatic nervous systemAutonomic nervous systemNeuroendocrine systemCortisol
Stress response: somatic nervous system
Increases muscle tension
Stress response: autonomic nervous system
Shunts blood from skin and gut to muscles
Stress response: neuroendocrine system
Enhances cardiac function, relaxes intestines, increases metabolic rateEspecially adrenal medulla
Stress response: cortisol
Mobilizes energy (glucose)Suppresses immune systemServes as anti-inflammatory agentTurns on “memory maker” cells of the hippocampus
Cells of the hippocampus are important in consolidating ___ memories and is important for __.
DeclarativeLTP
Name 4 negative affects of the chronic stress response
Increase blood sugarImmunosuppressionBlood vessel changesDamage to cells of the hippocampus
Chronic stress response: increased blood sugar
Dump too much sugar into the bloodstream all the timeCould lead to adult-onset diabetes
Chronic stress response: immunosuppression
Chronically depressed immune systemCould complicate any therapy we have by making patients less able to fight off infections
Chronic stress response: blood vessel changes
Blood vessels become brittle/stickyDon’t deliver blood as well
Chronic stress response: damage to cells of the hippocampus
Damage to own memory-making system
Working memory Definition
Maintains goal-relevant information for a short time
Working memory is important for __.
Short term potentiationDivergent and convergent problem solving
Working memory takes place in the __.
Prefrontal cortexParietotemporal cortex
Working memory and multi-tasking
NOT the sameWorking memory is rotating thinking about each bit of information in the memory at one time
Declarative memory definition
Facts, faces, dates, placesExplicit or conscious
Name the 3 stages of declarative memory
EncodingConsolidationRetrieval
Encoding stage of declarative memory
Form an impression of what it is you want to rememberRequires that you receive the information to determine if you want to remember it
Consolidation stage of declarative memory
Stabilizes or stores memoriesRequires the hippocampusLTP
Retrieval stage of declarative memory
Process of going and getting the memory and bringing it back into consciousness
Declarative memory: Parietotemporal lobe
PerceivesHelps you gather the information you want to remember
Declarative memory: Medial temporal lobe
ConsolidatesContains the hippocampusStores information
Damage to the medial temporal lobe leads to ___
Problem creating new memoriesPost-traumatic amnesia
Declarative memory: Dorsolateral prefrontal cortex
Processes, organizes and retrievesGoes and gets the information when you need it
Procedural Memory Definition
Skills and habitsPhysical, perceptual and cognitiveImplicit or unconscious
Name and describe the 3 stages of procedural memory
Cognitive: what to doAssociative: how to do itAutonomous: do it
Learning a motor sequence requires __. (3)
Frontal cortexParietal cortexBasal
Learned movement sequences are stored in __. (2)
Supplementary motor areaPutamen/globus pallidus
__ adjust movements to environmental changes (3)
CerebellumParietal cortexMotor cortex
Procedural and declarative memories are created and stored in ___ areas of the brain.
Different
For 95% of people, the __ hemisphere is dominant for language
Left
Comprehension of spoken language occurs in __.
Wernicke’s areaPart of the parietotemporal association areaDecodes spoken language
For 95% of people, Wernicke’s area is on the __ side of the brain.
Left
Comprehension of “nonverbal” and “paraverbal” aspects of spoken language occur in __.
Area corresponding to Wernicke’s areaHelps you pick up disconnect in statements (paraverbal doesn’t match message)
Creation of spoken language occurs in __.
Broca’s areaWhere you create the motor plan to say what you are thinking
Creation of “nonverbal” and “paraverbal” aspects of spoken language occur in __.
Area corresponding to Broca’s area
Creation of motor commands for spoken language occur in __.
Premotor and primary motor areas
Perception
Interpretation of sensation into meaningful forms
Spatial relationships are mediated by __.Name the 3 major components of spatial relationships.
Area corresponding to Wernicke’s area (non-dominant hemisphere of parietotemporal lobe)Body in relation to itselfBody in relation to the outside worldOutside world in relation to itself
Dorsal action stream adjusts limb actions during __.
Visually guided movements
Pathway of the dorsal action stream
Primary visual cortexVisual association cortexSomatosensory association cortexMotor planning cortexPrimary motor cortex
Ventral perception stream helps __.
Identify objects that are seen
Pathway of the ventral perception stream
Primary visual cortexVisual association cortexTemporal lobe
Thalamic injury
Loss of contralateral sensation (esp proprioception)Thalamic pain syndrome
Thalamic Pain Syndrome
Neuropathic pain appears to be coming from other side of the body but is actually coming from the thalamus
Subcortical Injury: Internal Capsule
Contralateral decrease in voluntary movementContralateral decrease in postural control and automatic movement controlContralateral loss of conscious somatosensationPossible visual deficit
Explain the possible visual deficit associated with Internal Capsule Injury
Homonymous hemianopsia = half of visual field is lost Contralateral visual field loss
Basal Ganglia Injury
Behavioral disturbancesSigns and symptoms look like prefrontal damageDifficulty learning new sequencesDifficulty executing old sequences
Primary somatosensory cortex injury
Loss of tactile localization and conscious proprioception
Primary auditory cortex injury
Diminished ability to localize sounds
Primary vestibular cortex injury
Diminished conscious awareness of head position and head movement
Primary visual cortex injury
Homonymous hemianopsia
Secondary somatosensory cortex injury
Asterognosis = inability to identify objects by touch and manipulation
Secondary visual cortex injury
Visual agnosia = inability to recognize objects by sight
Secondary auditory cortex injury
Auditory agnosia = inability to recognize objects by sound
Injury to motor planning areas of the frontal lobe leads to what 3 problems?
ApraxiaMotor perseverationBroca’s aphasia
Apraxia
Breakdown between concept and performanceInability to create a motor plan to move the way you are thinking
Motor perseveration
Uncontrollable repetition of movementCan be motor or speech
Broca’s aphasia
Difficulty expressing oneself using language or symbols
Primary motor cortex injury
Loss of contralateral voluntary movement Dysarthria (hypokinetic)
Dorsolateral prefrontal association cortex injury
Loss of executive functionLoss of motivation and goal-directed behaviorLoss of divergent thinking
Name the 4 problems associated with Parietotemporal association cortex injury
Loss of problem solvingDisturbance of “receptive” communication Difficulty interpreting the nonverbal and paraverbal aspects of communicationDifficulty comprehending spatial relationships
Parietotemporal association cortex injury: Loss of problem solving
Convergent thinking
Parietotemporal association cortex injury: Disturbance of “receptive” communication
Dominant hemisphere (95% = left)Cannot understand language
Parietotemporal association cortex injury: Disturbance of interpreting nonverbal and paraverbal communication
Non-dominant hemisphere (95% = right)
Parietotemporal association cortex injury: Difficulty comprehending spatial relationships
Non-dominant hemisphere (95% = right)Demonstrate left neglect
Left neglect
Neglect the left side of the body because do not understand the spatial relationship of the body to itself
Ventral AND Medial Dorsal association cortex injury
Disturbances of personality and emotionImpaired social judgementApathyLack of insight
Ventral prefrontal syndrome
DisinhibitionLack of concern for consequencesImpulsivenessInappropriate behaviors (verbal or physical)
4 A’s of cerebral cortex disorders
Aphasia: inability to produce/understand speechApraxia: cannot create a motor planAgnosia: cannot identify somethingAstereognosis: cannot identify by touch
Good decisions require a balance between ___.
Amygdala (emotional, impulsive, immediate gratification)ANDDorsolateral prefrontal cortex (rational, planning, goal-oriented)
Emotional Lability
Abnormal, uncontrolled and changeable expression of emotions
Retrograde memory
Old memories that have already been stored
Anterograde memory
New memories that you are storing
Broca’s aphasia
Expressive, motor, nonfluentTrouble expressing and with words
Wernicke’s aphasia
Receptive, sensory, fluentCannot decode and understand language
Global aphasia
Damage to Broca’s and Wernicke’s areasTrouble expressing and understanding
Damage to the area corresponding to Broca’s
Flat affectCannot add the paraverbal
Damage to the area corresponding to Wernicke’s
Difficulty understanding nonverbal communication
Neglect
Typically follows damage to right parietal and/or area corresponding to Wernicke’s areaDisplay a left sided weakness
Inability to use visual information occurs with damage to __.
Dorsal visual streamVentral visual stream
Ipsilateral “Pushing”
Lean toward hemiplegic sideNo clear “sidedness”Speculate a deficit in sensing postural alignment relative to gravity