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Clinical Neuroscience > Exam IV > Flashcards

Exam IV Flashcards

1
Q

Where does the cerebellum receive information from?

A

-receive information from the brain and spinal cord about body positioning and movement

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2
Q

How does the cerebellum exert its force?

A

-it sends information back to the motor systems of the cerebellum and brainstem to correct the movement

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3
Q

What is the main goal of the cerebellum?

A

-To detect erroneous movements and correct them

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4
Q

What is the three main functions of the cerebellum?

A

-provide synergy of movement, maintain upright posture, and maintains muscle tone

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5
Q

What does the lateral regions and intermediate zone of the cerebellum control?

A

-The limbs

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6
Q

What does the vermis and fluccular nodular lobes of the cerebellum control?

A

-Trunk movement

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7
Q

Lesions to the lateral hemisphere of the cerebellum will affect what?

A

-motor planning for extremities (lateral corticocspinal tract)

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8
Q

Lesions to the intermediate zone of the cerebellum will effect what?

A

-Coordination of the distal limbs (corticospinal and rubrospinal tracts)

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9
Q

Lesions to the vermis or flucculonodular lobe will affect what?

A

-Proxial limb and trunk coordination, balance and ocular reflexes

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10
Q

Outputs from the cerebellum go through which nuclei?

A

-Deep cerebellar and vestibular

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11
Q

What are the 4 deep cerebellar nuclei?

A

-Dentate, Emboliform, globase, and fatigial

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12
Q

What is the largest and most lateral deep cerebellar nuclei?

A

-Dentate

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13
Q

Where does the denatae nuclees receive input from?

A

the lateral zones

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14
Q

When is the dentate nucleus active and what does it work on?

A

-it is active before voluntary movement and works on the limbs

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15
Q

What makes up the interform nuclei?

A

-The emboliform and globase nuclei

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16
Q

Where does the interform nucleus receive input from?

A

-The intermediate zones

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17
Q

What does the interform nucleus work on?

A

-The limbs

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18
Q

what does the fatigial nucleus work with?

A

-The vestibular nuclei

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19
Q

what does the fastigial nucleus affect?

A

-The trunk

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20
Q

Where does the fatigeal nucleus receive information from?

A

-the vermis

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21
Q

Where does the vestibular nuclei receive information from?

A

-The vermis and flocculi

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22
Q

What fibers climb into the molecular layer, and split into parrallel fibers?

A

-Mossy layer

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23
Q

What do the mossy fibers become interwoven in?

A

-the perkinjie cells

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24
Q

Where do the mossy fibers send information?

A

-deep cerrebellar and vestibular nuclei

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25
Q

The climbing fibers weave around what?

A

-The perkinjie fibers, then go the the deep cerebellar and vestibular nuclei

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26
Q

What are the excitatory fibers of the cerebellum?

A

-The mossy and climbing fibers

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27
Q

What are the inhibitory fibers of the cerebellum?

A

-Perkinjie fibers

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28
Q

Decreased inhibition from the perkinjie fibers will cause what?

A

-More excitiation from the deep cerebellar and vestibular nuclei

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29
Q

A lesion to the left side of the cerebellum will cause ataxia where?

A

-On the left side (deficits are ispilateral)

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30
Q

Midline lesions of the cerebellum will cause what?

A

-Unsteady gate

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31
Q

Lesions lateral to the vermis will cause what?

A

-Limb ataxia

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32
Q

Output from the intermediate cerebellar hemisphere exits where?

A
  • First exits the superior cerebellar peduncle then crosses

- and crosses back at the pyramidal decussation and ventral tegmental decussation

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33
Q

Fibers from the intermediate cerebellar hemisphere that cross at the pryamidal decussation will influence what motor system?

A

-corticospinal tract

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34
Q

Fibers from the intermediate cerebellar hemisphere that cross and the ventral tegmental decussation will effect what motor system?

A

-Rubrospinal tract

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35
Q

Why dont lesions to the vermis cause unilateral deficits?

A

-the medial motor systems control the trunk bilaterallt

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36
Q

Input from the pontocerebellar fibers brings information from where?

A

-Mainly the primary sensory and motor cortex, but also a aprt of the visual cortex

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37
Q

The dorsal spinocerebellar tract carries information about what?

A

-Unconscious proprioception of the LEs

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38
Q

The cuneocerebellar tract carries information about what?

A

-Unconscious proprioception about the UEs

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39
Q

The ventral spinocerebellar tract carried information about what?

A

-The amount of activity in the descending pathways of the LEs

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40
Q

The rostal spinocerebellar tract carried information about what?

A

-The amount of activity in the descending pathways of the UEs

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41
Q

Where does the dorsal spinocerebellar tract synapse?

A

-The nucleus dorsalis of clark

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42
Q

Information on the right dorsal spinocerebellar tract will send info to what side of the cerebellum?

A

-The right (it does not cross)

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43
Q

Where does information from the dorsal spinocerebellar tract enter the cerebellum?

A

-The inferior cerebellar peduncles

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44
Q

Describe the pathway of Right LE proprioception to the cerebellum

A

-travels in the dorsal spinocerebellar pathway, travels up and synapses and the nucleus dorsalis of clark, enter the right side of the cerebellum via the inferior cerebellar peduncle

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45
Q

Where does the cuneocerebellar tract enter the spinal cord?

A

-at the fascilculus cuneatus

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46
Q

Where does the cuneocerebellar tract synapse?

A

-the external cuneate nucleus

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47
Q

Where does the cuneucerebellar tract end?

A

-The pateral portion of the ipsilateral cerebellum

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48
Q

What 3 arteries supply the cerebellum?

A
  • The superior cerebellar artery
  • AICA
  • PICA
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49
Q

What supplies blood to the superior cerebellum?

A

-The superior cerebellar artery

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50
Q

What is the superior cerebellar artery a branch of?

A

-Basillar artery

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51
Q

What artery supplies the cerebellar peduncles?

A

-The AICA

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52
Q

What does AICA branch from?

A

-The basilar artey

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53
Q

What does PICA branch from?

A

-Vertibral arteries

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54
Q

What are the most common arteries of the cerebellum to infarct?

A

-The PICA and SCA

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55
Q

How can you differentiate between and SCA and PICA infarct?

A

-PICA will have brainstem signs

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56
Q

An AICA infarct will have what other defecits?

A

-Unilateral hearing loss

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57
Q

What are mild symptoms that may hing to a cerebellar hemorrhage?

A

-Stomach ache then posterior head ache before ataxia

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58
Q

What are the signs and symptoms of a cerebellar hemorrhage?

A

-Headache, ataxia and nystagmust

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59
Q

Why would a cerebellar hemorrhage cause nystagmus?

A

-Because it can can CN VI palsy

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60
Q

Truncal ataxia results from lesions to what?

A

-The vermis

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61
Q

Patients with a lesion of the vermis will have what type of gait?

A

-Wide based

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62
Q

A lesion to the intermediate and lateral zone of the cerebellum will cause what?

A

-Limb ataxia

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63
Q

An SCA infarct will cause what?

A

-Truncal and limb ataxia

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64
Q

Though truncal ataxias are commonly bilateral, how can you tell which side the lesion may be on?

A

-The patient may fall or sway towards the side of the lesion

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65
Q

How can you tell the difference between a cerebellar lesion and an DCML lesion?

A

-Position sense should be better with eyes open and worse with eyes closes

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66
Q

Where will headache associated with cerebellar lesions be?

A

-On the side of the lesion

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67
Q

UMN lesions can cause what?

A

-Slow, clumsy movement of extremities

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68
Q

Severe lesions to the DCML can also cause what?

A

-Ataxia

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69
Q

What is in the striatum of the BG?

A

-The caudate and putamen

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70
Q

What is in the lenticular nucleus of the basal ganglia?

A

-Putamen and Globus Pallidus

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71
Q

Where does input from the cortex go to in the BG?

A

-The striatum (caadate and putamen)

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72
Q

Most inputs to the BG are what?

A

-Excitatory (uses glutamate)

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73
Q

Output from the BG goes where and via what?

A

-The thalamus via the globus pallidus an substantia nigra

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74
Q

Resting state occurs due to inhibition of what?

A

-The thalamus

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75
Q

How does the BG inhibit the thalamus?

A

-By sending inhibitory messages via the GP internal segments and substantia nigra pars reticularis

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76
Q

Excitation of what pathway results in movement?

A

-The direct pathway

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77
Q

Which pathway causes inhibition?

A

-indirect pathway

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78
Q

The basal gangle affects what?

A

-Regulation of movement, regulation of eye movements, cognitive processes (prefrontal channel), regulation of emotions (limbic channel)

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79
Q

What might caue parkinsons

A

-Toxic exposure, head traume, estrogen, or mitchondrial dysfunction

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80
Q

What is the average age of onset of PD?

A

-40 to 70

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81
Q

what gender is normally effects by PD?

A

-Males

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82
Q

What are the essential features of PD?

A

-bradykinesia, 4 hertz resting tremor, postural instability, rigidty

83
Q

symptons of PD are what at onset?

A

-Unilateral

84
Q

Patients with PD are more at risk for what?

A

-Falls

85
Q

What can you train to help improve a PD patients step length?

A

-Arm swing

86
Q

What type of resting tremors might a PD patient have?

A

-Pill rolling and rabbit (mouth)

87
Q

What type of rigidity will PD patients have?

A

-Cogwheel

88
Q

What will be the rate of a kinetic tremor of a PD patient?

A

-8 hertz

89
Q

What are some other clinical features of PD?

A
  • Anosmia (loss of smell)
  • Micrographia: (small writing)
  • Orthostatic hypotension
  • dystonia
  • Dementia
90
Q

What will PD not effect?

A
  • strength
  • reflexes
  • babinskis
  • sensory
91
Q

PD patients will respond to what drug?

A

-Levodopa

92
Q

How can you tell PD from parkinsonism

A

-Parkinsonism will not have a resting tremor, will be bilateral from onset, and will not respond to levodopa

93
Q

The degeneration of what leads to PD?

A

-Substantia Nigra

94
Q

The depletion of dopamine also interferes with what?

A

-Learning of new memory

95
Q

What pathway takes over in PD?

A

-Direct

96
Q

What is most effected in huntingtons disease?

A

-The caudate nucleus

97
Q

What are the clinical signs of huntingtons?

A

-Excess movement, depression, OCD, Manic behaviot,

98
Q

What is the average onset of Huntingtons disease?

A

-30-50

99
Q

The degerneration of the caudate nucleus and putamen (straitum) effects what pathway?

A

-Indirect

100
Q

Degenertation of the caudaute nucleus will cause what to enlarge?

A

-The lateral ventricles

101
Q

What is in the limbic cortex?

A

-cingulate gyrus and the parrahippocampal gyrus

102
Q

What is the limbic cortex responsible for?

A

-homeostasis, olfaction, memory and emotion

103
Q

What is the key structure of olfaction in the limbic cortex?

A

-olfactory cortex

104
Q

What is the key function for memory in the limbic cortex?

A

-hippocampal formation

105
Q

What is the key structure for emotions and drive in the limbic cortex?

A

-Amygdala

106
Q

What is the key structure for homeostasis in the limbic cortex?

A

-The hypothalamus

107
Q

What type of communication does the limbic cortex have?

A

-Bidirectional

108
Q

What does the septal areas play a role in?

A

-emotion, learning, automatic responses, drinking, eating, and sexual activity

109
Q

The cingulate gyrus wraps around what?

A

-the corpus callosum

110
Q

the parrahippicampal gyrus is in the medial aspect of the what?

A

-Temporal lobe

111
Q

what does the insular cortex play a role in?

A

-Addiction

112
Q

Lesions to the orbitofrontal lobe will cause what?

A

-a non-emotional state, minimal response to pain, decrease motivation, cognitive perseveration

113
Q

What is usually still intact with an orbitofrontal lobe lesion?

A

-IQ score

114
Q

Lesions to the inferior temproal lobe will cause what impossible?

A

-Learning a visual task

115
Q

What is the septal nuclei responsible for?

A

-Pleasure, modulate memory, desire to eat, reproduce etc

116
Q

Lesions to the septal nuclei are associated with what?

A

-Eating Disorder

117
Q

What is responsible for the emotional response to senations?

A

-The Thalamus

118
Q

Lesions to the hypothalmus may cause a loss of the drive to what?

A

-Eat

119
Q

Lesions to the periaqueductal grey causes what?

A

-mutism, indifference to pain

120
Q

Smell and the sensation of taste takes place where?

A

-The Rhinencephalon

121
Q

Where does smell descrimination take place?

A

-The orbitofrontal olfactory area

122
Q

Odor stimulates unmyelinated axons that attach to what?

A

-The glomerus

123
Q

what type of cells transfer smell to the olefactory nucleus?

A

-Mitral and Tufted cells

124
Q

Smell can cross over to the contralateral olfactory nucleus via what?

A

-The meaidal olfactory stia through the anterior commisure

125
Q

The lateral olfactory stia go where?

A

-Uncrossed to the primary olfactory cortex

126
Q

Fibers from the olfactory tract project where?

A

-the cortical medial nucleus of the amygdala, and the ol factory tubercle

127
Q

What is the role of the amygdala with smell?

A

-connects mind and emotion

128
Q

What is the role of the olfactory tubercle with smell?

A

-Emotional side of smell

129
Q

What re the 3 main nuclei of the amygdala?

A

-Corticomedial, central and Basolateral

130
Q

What are the clinical presentations of a lesion to the amygdala?

A

-flat effect, hypersexuality, disinhibited behavrior, socially embarassing

131
Q

What is Kulver Bucy Syndrome?

A

-Cause by a bilateral lesion to the temporal lobe: symptoms include visual agnosia, hyperreality, hypersexuality

132
Q

Where does the amygdala recieve information from?

A

-sensory systems, mediodorsal thalamus, hypothalamus, septal area, periaqueductal grey, and solitary nucleus

133
Q

Most connections of the amygdala are what and deal with what?

A

-Bidirectional and deal with the emotional aspect of memory

134
Q

Smell and memory are linked where?

A

-The amygdala

135
Q

What is the main output of the amygdala?

A

-Stria Terminalis

136
Q

Where does the stria terminalis run?

A

-Through the anterior commisure to either the septal nuclei or hypothalamus

137
Q

What is the output pathway of the amygdala that projects along the base of the brain?

A

-the ventral amygdalofugal tract

138
Q

What are the two main regions for memory formation?

A

-The medial temporal lobe and the medial deicephalic area

139
Q

What are the two areas of memory formation in the medial temporal lobe?

A

-Hippicampal formation, and the parrahippicampal gyrus

140
Q

What are the two areas of memory formation of the medial diencaphalic area?

A

-mediodorsal and anterior thalamic nuclei, mamillary bodies and the diencephalic nuclei lining the third ventricle

141
Q

What is the main circuit associated with memory and emotions?

A

-The circuit of Papaz

142
Q

Does the circuit of papaz have a more signifiant role in emotion or memory?

A

-Memory

143
Q

What is cerebral lateralization?

A

-When one side of the brain take over primary functino over the otherside to eliminate delay

144
Q

Language is predominently controlled by what hemisphere?

A

-The left (dominant)

145
Q

Perception is predominately in what hemisphere?

A

-The right

146
Q

The left hemisphere is dominate in what percent of right handed people?

A

-95 %

147
Q

The left hemisphere is dominate in what percent of left handers?

A

-60 to 70%

148
Q

What is the function of the posterior parietal and temporal association cortex?

A

-interperates conceptual data, assigns meaning to sensory information

149
Q

What is the role of the frontal association/prefrontal cortex?

A

-deals with planning, control and execution of actions

150
Q

What is the role of the dominant hemisphere?

A

-language, praxis, arithmatic (sequencing). music (sequencing), and sense of direction (sequencing)

151
Q

What is the role of the non-dominant hemisphere?

A

-Emotion of language (tone), spatial analysis and attention, arithmatic (estimation), muscial ability (complex musical ability), direction (over all sense of spatial orientation)

152
Q

Where is brocas areas?

A

-Frontal lobe

153
Q

Where is wenickes area?

A

-Temporal lobe

154
Q

What does brocas area communicate with?

A

-prefrontal and premotor cortex: mainly for higher order motor aspect of speech

155
Q

Wernickes area deal mainly with what?

A

-Speech comprehension

156
Q

What plays a strong role in written language and reading?

A

-Angular gyrus

157
Q

What is the most common cause of aphasia?

A

-Stroke

158
Q

What type of aphasia will a left MCA superior infarct cause?

A

-Brocas aphasia

159
Q

What is another name for brocas aphasia?

A

-nonfluent, motor, or expressive

160
Q

Someone with brocas aphasia may also have what?

A

-Apraxia (frontal lobe involvement)

161
Q

A left MCA inferior division infarct will cause what type of aphasia?

A

-Wernickes

162
Q

A person with wernickes aphasia may also have what?

A

-Visual defecits (optic radiation involvement)

163
Q

An ACA infarct with watershed could cause what type of aphasia?

A

-Brocas

164
Q

A PCA infact with watershed could cause what type of aphasia?

A

-Wernickes

165
Q

A large infacrct to the MCA would cause what?

A

-Global Aphasia

166
Q

What cause conduction aphasia?

A

-lesions to the arcuate fasciculus

167
Q

What is impaired reading?

A

-Alexia

168
Q

What is impaired writing?

A

-Agraphia

169
Q

What is agraphia, aclaculi. R/L disorientatin and finger agnosia?

A

-Gerstmann’s Syndrome

170
Q

What causes cortical deafness?

A

-lesions to hechls gyrus

171
Q

Someone how can not unerstand spoken words but can understand nonverbal sounds has had a lesion to what hemisphere?

A

-Dominant

172
Q

Someone who can understand words but not nonverbal sounds has had a lesion to what?

A

-Nondominant hemisphere

173
Q

What type of apraxia is it when somone cannot plan the movement?

A

-Ideamotor

174
Q

What is ideational apraxia?

A

-When someone uses an object wrong

175
Q

What is aphemia?

A

-Verbal apraxia

176
Q

Lesions to what side of the brain cause noticable neglect of the contralateral side?

A

-Right nondominant

177
Q

Where to attentional rays go from the right hemisphere?

A

-A strong to the right and left side

178
Q

Where do attentional rays from the left hemisphere go?

A

-not as strong and only to the right

179
Q

What lesions will cause neglect?

A

-Right sided and bilateral

180
Q

The right nondominant hemisphere is more known for what?

A

-spatial processing and preceptions

181
Q

Lesions to the periatal association cortex on the right side will cause an inability to do what?

A

-spacially navigate the environment or perceive whats in it

182
Q

Patients with sensory neglect will ignore what?

A

-Stimuli from the contralateral side

183
Q

What will a patient will motor neglect not do?

A

-Move their body parts to the opposite side

184
Q

What neglect is most severe?

A

-Conceptual

185
Q

A person with a nondominant hemisphere lesion will have difficulty with what?

A

-putting things together

186
Q

What is capras syndrome?

A

-think family and friends have been replaced with identical looking imposters

187
Q

What is fragolis syndrome?

A

-beleive different people are the same person in disguise

188
Q

What is reduplicative paramnesia?

A

-beleive that a person, place or thing exists as two identical copies

189
Q

What is the function of the frontal lobe?

A

-RIO: Restraint, Initiative, Order

190
Q

What is restraint as it pertains to the frontal lobe?

A

-good judgment, delaying gratification, inhibiting innapropriate responsese

191
Q

What is initiative as it pertains to the frontal lobe?

A

-Motivation, drive, personality and felxibility

192
Q

What is order as it pertains to the frontal lobe?

A

-to have working memory, planning, sequencing, organization and reasoning

193
Q

What is the largest part of the frontal lobe?

A

-Prefrontal lobe

194
Q

What is the prefrontal cortex responsible for?

A

-executive function

195
Q

What does the prefrontal cortex communicate with?

A

-anterior-cingulate gyrus and orbital frontal cortex

196
Q

What is the function of the prefrontal cortex?

A

-Attention span, motivation, problem solving, understanding social normal and prognostication

197
Q

What does the prefrontal cortex mainly communicate with?

A

-parietal-occipital association cortex

198
Q

Damage to the left prefrontal cortex can also cause what?

A

-Language deficits

199
Q

The dorsolateral prefrontal cortex deals mainly with what?

A

-working memory, learning new material, shifting attention between tasks and intuition

200
Q

The orbitalfrontal lobe (more medial) deal with?

A

-deals with impulse control judgment control and judging social situations

201
Q

Damage to the dorsolateral convexity will cause a patient to appear what?

A

-apathetic, lifeless, ambulic

202
Q

Lesions to the ventromedial orbitofrontal areas will causewhat?

A

-impulsive behavior, poor judgment, and disinhibited behavior

203
Q

Lesions to the left frontal lobe will cause what?

A

-depression

204
Q

Lesions to the right frontal lobe will cause what?

A

-behavioral distrubances

Clinical Neuroscience (3 decks)

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