HIgher cortical function Flashcards
The cortex contains unimodal and multimodal (=multi-sensory) processing areas * "\_\_\_-\_\_\_\_" areas integrate information from multiple senses—these are key for higher cognitive function, not tied to processing of sensory info from one sense * frontal heteromodal(heteromodalcortex refers to a region that receives input from multiple sensory or multimodal areas. * Two major areas ofheteromodalcortex are generally identified)association cortex (prefrontal cortex) + lateral parietal and temporal heteromodal association cortex
The cortex contains unimodal and multimodal (=multi-sensory) processing areas “Multi-sensory” areas integrate information from multiple senses—these are key for higher cognitive function, not tied to processing of sensory info from one sense
* frontal heteromodal association cortex (prefrontal cortex) + lateral parietal and temporal heteromodal association cortex
Language-- a prototypical cognitive function Language is: * Both localized and distributed-- is localized to parts of the brain but these areas are distributed all around the brain \_\_\_ are language deficits resulting from brain damage.\_\_\_ are diagnosed according to the patient's ability to express language.
Language– a prototypical cognitive function Language is:
* Both localized and distributed– is localized to parts of the brain but these areas are distributed all around the brain
Aphasiasare language deficits resulting from brain damage.Aphasiasare diagnosed according to the patient’s ability to express language.
What are the numbers and what is the blue shaded region around?
1- Wernickes4. BrocasAll the blue shaded areas are all part of the multi-modal system. They all have something to do with language.
What are the regions for?What is the significant of area 4, and 5?
- Brocas area - generating words2. Wernickes - understanding words3. Arcute - interconnects Broca’s and Wernicke’s areas4. and 5. Supramarginal and Angular gyrus are important because they are part of the multi-modal association system that is involved with language procsesing.Also, since the arcuate fasciales travel underneath the supramarginal and angular gyrus,if youget localized lesions there,most likely you will also get damage to the arcuate fascicles (which normally connects Brocas and Wernickes to each other).
T/F:Localization of function in human brain is quite variable– Broca’s and Wernicke’s areas are NOT tied down to the same exact location in every person’s brain, when doing surgery, doctor musttest each part of brain via electrical stimulation before proceeding. Therefore, mapping is required prior to epilepsy surgery.
TRUELocalization of function in human brain is quite variable– Broca’s and Wernicke’s areas are NOT tied down to the same exact location in every person’s brain, when doing surgery have to test each part of brain via electrical stimulation before proceeding.Therefore, mapping is required prior to epilepsy surgery.
Language processing displays cerebral dominance: ___ side – _____ of language, expression of substantive content
* Most people are left hemisphere dominant for language Broca’s and Wernicke’s areas are in the ____ hemisphere for 90% of people
- ___ side – comprehension of language, expression of emotional content, ___ (use of inflection and tone to convey meaning, aka not speaking like a robot)
Language processing displays cerebral dominance:
LEFT side – comprehensionof language, expression of substantive content
* Most people are left hemisphere dominant for language Broca’s and Wernicke’s areas are in the LEFT hemisphere for 90% of people
RIGHTside – comprehension of language, expression of emotional content, prosody(use of inflection and tone to convey meaning, aka not speaking like a robot)
Types of Aphasia1. ___ : in the classical form, the patient is not fluent. The patient cannot speak, but can comprehend language. The person has no fluency, cannot repeat words, but comprehends.2. ___ : the patient is not fluent, does comprehend, and is abe to repeat some words to some extent. This is a case that occurs when Broca’s area is intact, but there is a lesion in the multimodal motor areasaround Broca’s area. We still need these areas to develop language, but because Broca’s is intact, the patient can repeat SOME words.3. ___ – complete destruction of everything (both Broca’s and Wernicke’s are destroyed).4. ____ - patients are fluent, can generate words, but the words they are generating are not logical. They speak a lot, but it does not make any sense. These patients are not able to comprehend language either, so when you speak to them, they will not be able to understand the content. Because of this, they cannot repeat words either.5. ___ : patient is fluent, cannot comprehend, but has some ability to repeat words. This is not caused by a lesion in Wernicke’s area itself, but a lesion in the transcortical sensory areas AROUND Wernickes (which again, isnecesarry to comprehend lanaguge). However, even though these regions are lesioned, Wernicke’s and Broca’s are still intact, so the patient can repeat SOME words.6. ___ : patient is not fluent, cannot comprehend, but still has theability to repeat words because their Broca’s and Wernicke’s areas are still intact (they can hear and repeat the word). This is the case when someone has simltaneous damage to the transcorticalmotor and sensory association areas. Broca’s and Wernicke’s are still spared, so patient can still hear and repeat the word.7. ___ - Patient has fluency, has comprehension, but cannot repeat words. The damage is at the arcuate fasciculus. The patient cannot repeat words bceause Broca’s and Wernicke’s is disconnected8. __ ___ - Patient is fluent, comprehends and can repeat words. It is possible to have a very localized lesion. Patient has the general language function, but if you test them they have some difficulty naming things (orange example on youtube).
Types of Aphasia1. Broca’s Aphasia: in the classical form, the patient is not fluent. The patient cannot speak, butcan comprehend language. The person has no fluency, cannot repeat words, but comprehends.2. Transcortical motor lesions: the patient is not fluent, does comprehend, andis able to repeat some words to some extent. This is a case that occurs when Broca’s area is intact, but there is a lesion in the multimodal motor areasaround Broca’s area. We still need these areas to develop language, but because Broca’s is intact, the patient can repeat SOME words.3.global aphasia– complete destruction of everything (both Broca’s and Wernicke’s are destroyed).4. Wernicke’s aphasia- patients are fluent, can generate words, but the words they are generating are not logical. They speak a lot, but it does not make any sense. These patients are not able to comprehend language either, so when you speak to them, they will not be able to understand the content. Because of this, they cannot repeat words either.5. Transcortical sensory aphasia: patient is fluent, cannot comprehend, but has some ability to repeat words. This is not caused by a lesion in Wernicke’s area itself, but a lesion in the transcortical sensory areas AROUND Wernickes (which again, is necesarry to comprehend lanaguge). However, even though these regions are lesioned, Wernicke’s and Broca’s are still intact, so the patient can repeat SOME words.6. Mixed transcortical aphasia : patient is not fluent, cannot comprehend, but still has theability to repeat words because their Broca’s and Wernicke’s areas are still intact (they can hear and repeat the word). This is the case when someone has simltaneous damage to the transcorticalmotor and sensory association areas. Broca’s and Wernicke’s are still spared, so patient can still hear and repeat the word.7. Conduction aphasia- Patient has fluency, has comprehension, but cannot repeat words. The damage is at the arcuate fasciculus. The patient cannot repeat words bceause Broca’s and Wernicke’s is disconnected8. Anomic aphasia- Patient is fluent, comprehends and can repeat words. It is possible to have a very localized lesion. Patient has the general language function, but if you test them they have some difficulty naming things (orange example on youtube).
Aphasias:___ – complete destruction of everything___– BA and WA spared, but hight function/comprehension disrupted___– good comprehension (since that’s WA), but can’t repeat words. They have understanding of their condition, know what they hear and can process it but can get out the words____– “dynamic aphasia,” lesion in anterior superior frontal lobe, usually speak one or two word sentences, severely impaired writing ability____– can’t comprehend but can speak fluently, will just keep talking but may be nonsense (think they’re making sense but they really aren’t)___– multisensory cortex damaged around WA but WA itself is preserved___– lesion of connection between areas, can speak and understand but can’t repeat____– everything checks out (they’re fluent, can comprehend, and can repeat) but still have something going on
* Ask open ended questions to tease out the problem, may not be immediately evident
* Test patient with uncommon words
Usually result of very small focal lesion
Aphasias:Global– complete destruction of everythingMixed transcortical– BA and WA spared, but hight function/comprehension disruptedBroca’s– good comprehension (since that’s WA), but can’t repeat wordsHave understanding of their condition, know what they hear and can process it but can get out the wordsTranscortical motor– “dynamic aphasia,” lesion in anterior superior frontal lobe, usually speak one or two word sentences, severely impaired writing abilityWernicke’s– can’t comprehend but can speak fluently, will just keep talking but may be nonsense (think they’re making sense but they really aren’t)Transcortical sensory– multisensory cortex damaged around WA but WA itself is preservedConduction– lesion of connection between areas, can speak and understand but can’t repeatAnomic– everything checks out (they’re fluent, can comprehend, and can repeat) but still have something going on
* Ask open ended questions to tease out the problem, may not be immediately evident
* Test patient with uncommon words
Usually result of very small focal lesion
Blood supply to language areas is provided by a combination of the ____ and ___ arteries into a “____” area____ mostly supplied by MCA superior division____ mostly supplied by MCA inferior divisionThese areas a re a common source of language deficits as a result from ___.
Blood supply to language areas isprovided by a combination of the ACA and MCAarteries into a “watershed” areaBA’s mostly supplied by MCA superior divisionWA’s mostly supplied by MCA inferior divisionThese areas a re a common source of language deficits as a result from stroke.
Other language related conditionshave variable causes, including damage to visual, attention, or motor brain areas
- ____– inability to read
- ____– inability to write
- ____– is a ____language defecit, NOT a brain anatomical abnormality. This entails haingdifficulty reading words correctly, having deficitsin phonological processing during reading (ex. can’t combine phonologic and visual aspect of words)
Other language related conditionshave variable causes, including damage to visual, attention, or motor brain areas
Alexia– inability to read
Agraphia– inability to write
Dyslexia– is a DEVELOPMENTAL language defecit, NOT a brain anatomical abnormality. This entails haingdifficulty reading words correctly, having deficitsin phonological processing during reading (ex. can’t combine phonologic and visual aspect of words)
Question: a 50 year old male presents with impaired fluency, intact comprehension and impaired ability to repeat words. When asked any question, he always responsd with a single word: “Hodor.”Damage to which cortical area is the most likely cause of this patient’s pattern of impariment?
Question: a 50 year old male presents with impaired fluency, intact comprehension and impaired ability to repeat words. When asked any question, he always responsd with a single word: “Hodor.”Damage to which cortical area is the most likely cause of this patient’s pattern of impariment?This patient hasBroca’s Aphasia.
Attention– directed/selective thought, associated with the ____ lobeBehavioral consequences of attention– enhances detection and recognition, speeds reaction time, is the gateway to memoryNeural substrates of attention– ___ ___ CORTEX (most importantly), but also ____cortex and subcortical structures (___ nucleus of thalamus and ____colliculus)
Attention– directed/selective thought, associated with the parietal lobeBehavioral consequences of attention– enhances detection and recognition, speeds reaction time, is the gateway to memoryNeural substrates of attention– posterior parietal CORTEX (most importantly), but also prefrontalcortex and subcortical structures (pulvinar nucleus of thalamus and superiorcolliculus).
Neglect is the flip side of attention– the ____ ____ lobe is dominant for spatial attention. This is different from language. Where is language localized?
Neglect is the flip side of attention– the RIGHT parietal lobe is dominant for spatial attention.Remember– Language is Left, attention is right (and each hemisphere is responsible for the opposite side’s function)
Explain each picture (red part indicates the lesion)
____ sided stroke = severe attention defecit leading to severe LEFT neglect.___ sidedstroke = minimal RIGHT neglectThe most severe attentional distortion, is caused by a ____ parietal lesion.
Right sided stroke = severe attention defecit leading to severe LEFT neglectLeft sided stroke = minimal RIGHT neglectThe most severe attentional distortion, is caused by a posterior parietal lesion.
