Brainscape's Knowledge GenomeTM

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


See full index

MedNeuro Clinical Corr. > Higher Cortical Functions > Flashcards

Higher Cortical Functions Flashcards

1
Q

Thalamic Syndrome

A
  • usually involve damage to lateral group of thalamic nuclei (VPL)
  • initially a contralateral hemianalgesia
  • Soon painful sensation appears with noxious stimuli
  • later pain is provoked by pressure, touch, vibration
  • threshold for pain seems higher, but once threshold is reached, pain has strong emotional overtone to it
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Hypothalamus: Lateral Hypothalamic Area

A
  • induces eating when stimulated

- Ablation causes anorexia and starvation

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

Hypothalamus: Tuberomammillary Nucleus

A
  • important in attention and arousal (actively inhibited during sleep)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Hypothalamus: Medial Pre-optic Nucleus

A

Regulate gonadotropin secretion from adenohypophysis

- sexually dimorphic and is regulated by testosterone

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

Hypothalamus: Supraoptic Area

Suprachiasmatic Nucleus

A
  • dorsal to the optic chiasm
  • receives direct input from retina
  • critical role in control of circadian rhythmicity
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Hypothalamus: Supraoptic Area

Anterior Hypothalamic Area

A
  • Sense heat and response by dissipating excess heat
  • Lesion causes Hyperthermia
  • Stimulatory drive of PS of ANS
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Hypothalamus: Supraoptic Area

Paraventricular Nucleus

A
  • Release neuropeptides

- neurons that synthesize and release ADH, oxytocin, and CRH

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

Hypothalamus: Supraoptic Area

Supraoptic nucleus

A
  • Contains neurons that synthesize AVP and oxytocin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Hypothalamus: Tuberal Region

Dorsomedial Nucleus

A
  • BP regulation

- When stimulated–> aggression and savage behavior

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

Hypothalamic: Tuberal region

Ventromedial Nucleus

A
  • inhibits the urge to eat when stimulated
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Hypothalamic: Tuberal region

Arcuate Nucleus

A
  • produce hypothalamic-releasing factors

- play a prominent role in feeding

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

Hypothalamus: Mammillary region

Posterior Nucleus

A
  • involved in thermoregulation

- poikilothermia

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

Hypothalamus: Mammillary region

Mammillary Nucleus

A
  • receive input from hippocampus via fornix
  • project to ANTERIOR Nucleus of Thalamus
    (mammillothalamic tract)

-Damage is associated with memory disturbances

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

Hypothalamus: Major fiber tracts

A

Fornix: projections from hippocampus

Mammilliothalamic tract: projections from mammillary bodies to thalamus

Stria Terminalis: connects amygdala to hypothalamus

Medial Forebrain bundle:extends through entire hypothalamic zone

Supraopticohypophyseal: conducts fibers from supraoptic–> neurophypophysis (ADH or oxytocin)

Tuberoinfundibular: arcuate nucleus–> hypophyseal portal system (carry neuropeptide releasing or inhibiting factors on anterior pituitary cell)

Hypothalamospinal tract: regulate spinal cord preganglionic neurons of sympathetic or PS ANS

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

Hypothalamus Functions

A 
Homeostasis
Endocrine/Electrolyte
Autonomic NS (Stress response)
Limbic/ emotion
Body temperature, eating/feeding, satiety, metabolism, reproduction
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Lesion to Anterior Hypothalamic Nucleus

A

Hyperthermia

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

Lesion to posterior hypothalamic nucleus

A

Poikolothermia

- lose cold-sensitive neurons and warm sensitive tracts

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

Stress response

A

Flight or flight response

-integrate signaling from pre-frontal cortex, limbic forebrain and brainstem

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

Feeding and Energy Metabolism

A
  • Lateral hypothalamic area (feeding)
  • Ventromedial nucleus (satiety)
  • Arcuate nucleus
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Role of Leptin

A
  • produced by fat cells
  • acts at arcuate nucleus
  • inhibits food intake and activates POMC
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Role of POMC / CART in feeding

A

Increase in satiety/ Decrease food intake

- stimulated by Leptin

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

Role of AgRP/ NPY in feeding

A

Decrease satiety/ Increase food intake

- stimulated by ghrelin

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

Craniopharyngioma

A

Congenital tumor originating from remnants of Rathke’s pouch

  • pressure on optic chiasm results in bi-temporal hemianopsia
  • pressure on hypothalamus leads to hypothalamic syndrome ( adiposity, diabetes insipidus, temp reg. distubances, somnolence)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Hypothalamic memory disturbances

A

Posterior hypothalamic lesions involving mammillary bodies

  • inability to form new memories ( episodic) for context and time specific events
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Klein-Levin Syndrome

A

Hypothalamic disorder in adolescent males

  • hypersomnolence
  • episodic compulsive eating
  • hypersexuality

associated with decrease in dopaminergic tone

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

Horner’s Syndrome

A

Ptosis
Miosis
Anhidrosis

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

Autonomic Dysreflexia

A

disordered autonomic response d/t injury of the spinal cord at T6 or above
Bowel or bladder distention –> pain fibers cannot ascend–> leads to activation of local reflexive sympathetic outflow–> widespread vascoconstriction and elevated BP

Sx: Headache, hypertension, bradcardia, piloerection, pallor

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

Hirschprung’s Disease

A
  • congenital absence of myenteric plexus
  • No peristalsis in denervated colon compared to proximal part of colon which becomes distended

Sx: constipation
Tx: attach normal colon to rectum

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

Hypothalamus: Anterior

A 
PS area
Hyperthermia
insomnia
DI
Emaciation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Hypothalamus: Lateral

A

Drinking center
adipsia
Emaciation
apathy

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

Hypothalamus: Medial

A 
Hyperdipsia
DI
SIADH
Obesity
Rage
Amnesia
Dwarfism
Ipsilateral Horner
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Hypothalamus: Posterior

A 
Sympathehtic area
hypothermia, poikilothermia
hypersomnia
coma, narcolepsy
ipsi Horner's syndrome
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Hypothalamic Nuclei

A

Anterior: Preoptic, supraoptic, suprachiasmatic, anterior

Posterior: Posterior

Medial: ventromedial, dorsomedial, paraventricular, arcuate

Lateral: lateral tuberal nucleus, lateral hypothalamic area

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

Hypothalamic nuclei

ANTERIOR

  • Anterior nuclei
  • Supraptic nuclei
  • Preoptic
  • Suprachiasmatic nuclei
A
  • Anterior nuclei: PS/ Cooling
  • Supraptic nuclei: regulates water intake, ADH
  • Preoptic: sexual & repro function (sexually dimorphic)
  • Suprachiasmatic nuclei: Circadian Rhythm
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Hypothalamic nuclei

MEDIAL:

  • Ventromedial
  • Dorsomedial
  • Paraventricular
  • Arcuate
A
  • Ventromedial: Satiety
  • Dorsomedial: Hunger/ Savage behavior
  • Paraventricular: Oxytocin/ ADH
  • Arcuate: Feeding & controls release of hormones
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Hypothalamic nuclei

LATERAL

  • Lateral hypothalamic area
  • Lateral pre-optic
  • Tuberomammillary nucleus
A
  • Lateral hypothalamic area: Induces eating

- Tuberomammillary nucleus: Wakefulness (activated before sleep)

37
Q

Hypothalamic Nuclei

POSTERIOR

  • Posterior nucleus
  • Mammillary nucleus
A
  • Posterior nucleus: cold sensing (lesion= poikiothermia)

- Mammillary nucleus: project to mammillothalamic tract ( memory disturbance)

38
Q

Diabetes Insipidus

A

loss of water in urine, serum sodium concentration rises (hypernatremia) d/t lack of ADH

39
Q

Syndrome of inappropriate ADH

A

ADH causes water retention–> decreases sodium concentration due to water retention

40
Q

Lesion in superchiasmatic nucleus

A

Fx: regulates circadian rhythm (stimulated by light hitting retina)

Sx: insomnia
(can occur in Alzheimers, people who work at night have inadequate stimulation of this nucleus)

41
Q

Lesion in anterior nucleus

A

Fx: dissipate heat

Sx: hyperthermia
(Often stimulated by endogenous pyrogens) including IL1 and PGE2–> induces fever)
Tx: PGE2 inhibition by aspirin

42
Q

Lesion in Medial Hypothalamus

A

Fx: regulates feeding

Sx: obesity due to over eating
frequently due to craniopharyngioma, pituitary adenoma, also found in Prader-Willi

43
Q

Craniopharyngioma

A

Tumor within hypothalamus
Primarily in children
Tumor expansion–> headaches, bitemporal hemianopia and endocrine disturbance

44
Q

Prader-willi

A

Chromosomal deletion of 15q 11-13 inherited from father

Sx: hyperphagia with eventual obesity, narcolepsy, short stature

45
Q

Sympathetic pathway

A

Neurons originate in the PARAVENTRICULAR nucleus of the hypothalamus.

Descend as the descending hypothalamic fibers in brainstem (lateral in brainstem)

DHF synapase onto cell bodies in Intermediolateral cell column in thoracic cord

Pre-ganglionic neuron exits cord and enters sympathetic chain

Synapse onto ganglia

Post-synaptic neuron sends axon to target

46
Q

Sympathetics to the eye

A

pre-ganglionic fiber exits IML cell column–> Sym chain–> ascends Superior Cervical Ganglion–> Post-ganglionic neuron–> ascends on ICA–> dilator muscle of pupil

47
Q

Miosis d/t Horners

A

Injury to lower trunk of brachial plexus (klumpke): T1 (as DHF descend)

Pancoast Syndome: infiltration of SCG or lower brachial plexus d/t tumor

Dissection of ICA: separation of various layers of artery–> explands artery–> stretches parasympathetics traveling on artery

Cavernous sinus thrombosis: inflammation d/t embolism compress nerves traveling through the sinus

48
Q

Pupillary light reflex

A

Light–> pre-tectal nucleus–> Bi-lateral innervation to Edinger-Westphal nucleus–> ciliary ganglion–> Ciliary constrictor muscle

49
Q

Micturition inhibitory Center

A

Maintain continence: voluntarily inhibitor flow of urine

MIC–> Pontine micturiction center–> IML cell column activated and PS inhibited

Storage ( Internal urinary sphincter activated and detrusor relaxed)

Alpha motor neurons in S2-S4 (pudendal nerve) mediates contraction of external sphincter

50
Q

Hyperactive Spastic Bladder

A

Sx: urinary incontinence

-Underactive sphincter
(too much PS innervation d/t lesion of Sym)

Tx: Anti-cholinergic

51
Q

Hypoactive Flaccid bladder

A

Sx: urinary incontinence

-Overactive sphincter
(too much S d/t lesion of PS)

Tx: Anti-adrenergic or self-catheterization

52
Q

Papez’s circuit

A

Cingulate–> Hippocampus–> fornix–> mammilary bodies–> anterior thalamus–> cingulate

53
Q

Expansion of Papez’s circuit

A

includes hypothalamus, septal area, orbitofrontal cortex, nucleus acumbens and AMYGDALA

54
Q

Fornix

A

Tract between hippocampus and mammillary/ septal nuclei

Major efferent

55
Q

Mammillothalamic tract

A

Tract between Mammillary bodies and Ant. Thalamus

56
Q

Perforant path

A

Tract between Entorhinal cortex and Dentate gyrus (hippocampus)

Major Afferent

57
Q

Outer Core Structures and Fx:

Cingulate Cortex
Orbital Frontal Lobe
Temporal Lobe

A

Cingulate Cortex:

  • Rostral: emotions and motor
  • Caudal: visual spatial and memory

Orbital Frontal Lobe
- personality, behavioral control and self-awareness

Temporal Lobe (hippocampus, parahippocampus, entorhinal cortex)
- memory
58
Q

Inner core Structure and Fx:

Hypothalamus
Amygdala
Septum

A

Hypothalamus: pleasure center, autonomic, endocrine integration

Amygdala: Preservation of self, emotion, social behavior, aggression and defense response, sexual behavior, affect of faces, affective regulation

Septum: preservation of species, sexual behavior and emotionality

59
Q

Stria Terminalis

A

Tract between amygdala with septum, hypothalamus, nucleus accuumbans

60
Q

Ventral amygdalofugal

A

Connects amygdala with hypothalamus, brainstem and septum

61
Q

Medial Forebrain bundle

A

tract between the hypothalamic nuclei and amygdala and brainstem nuclei

62
Q

Kluver Busy Syndrome

A

Cause: bilateral lesion in temporal lobe including amydala, hippocampus and uncus
(Loss of connection)

Sx:

  • increased oral activity
  • Hypersexuality
  • Hypermetamorphosis
  • Placidity: flattened affect, lack of aggressive behavior/ fear
  • Visual agnosia: loss of recognition of people
  • Bulimia
63
Q

Geshwind Syndrome

A

Sensory limbic hyperconnection

Strengthening of synaptic connections

  • increased concern with philosophical, cosmic or religious issues
  • Hyposexuality
  • Hypergraphia
  • Viscosity
64
Q

Addictive drugs

A

Produce potent effects by enhancing mesolimbic DA activity

65
Q

Lesion to Ventromedial nucleus

A

Sx: produces pain, rage or strong aversive reactions, long lasting hyperemotionality

(stimulation of Dorsolateral also produces rage)

66
Q

Lesion to Amygdala

A

Fx: Modulation of experience of emotional reactions

  • normal social interactions
  • role in integration of emotions, fear and memory

Lesion: tameness or reduced emotionality

67
Q

Lesion to Septal Area

A

Sx: increased sexual activity d/t damage from VP shunts

Tumor: results in rage like attacks and increased irribility

68
Q

Lesion to hippocampus

A

Sx: amnestic state

  • Declarative (explicit) memory: Acquisition of facts and events
  • episodic: personal events
  • Semantic: facts
69
Q

Wernicke Korsakoff Syndrome

A

Due to chronic alcoholism and nutritional deficiency (thiamine)

Acute encephalopathy: confusion, disorientation, oculomotor dysfunction, ataxia

Chronic: retrograde amnesia

70
Q

Cingulate gryus

A

Anterior: emotion and motor
Posterior: visuospatial and memory

Lesion: Contralateral neglect (attention)

Sx: apathy, disinhibition, placidity, depression, anxiety, OCD, heightened sexuality, bulimia

Akinetic Mutism

71
Q

Tourette

A

Abnormality in anterior cingulate gyrus–> Affective vocalization

Associated with OCD
Excessive emotional signals (anxiety), motor (tics),
Excessive filtering of emotions and motor behavior ( apathy, akinesis, mutism)

72
Q

Orbital frontal lobe syndrome

A

Disinhibited, tactless, bawdy, boastful, impulsive, inattentive, dress carelessly

73
Q

Frontal/Convexity or dorsolateral

A

Apathetic, slow, little initiative or spontaneity, vacant expression

74
Q

Medial Frontal

A

Akinetic mutism, inert, speechless, loss of drive to speak,

“motionless, mindless, wakefulness”

75
Q

Primary Motor cortex

A

Control Contralateral movement

  • reduced function causes contralateral hemi-paresis
  • Activation ( seizure) causes contralateral clonic movements
76
Q

Jacksonian march

A

seizure in primary motor cortex that travels along gyrus and activates muscle seen on motor homuculus

77
Q

Frontal Eye Fields

A

Voluntary eye movements to the contralateral field

Lesion causes ispilateral gaze preference

78
Q

Broca’s Area

A

Fluency of language

Lesion: Broca’s aphasia= non-fluent aphasia, halting, effortful, few words

(MCA)

79
Q

Pre-frontal cortex

A

Provides order

mediates personality, executive function, ability to sequence and organize tasks, abstract, problem solving

80
Q

Orbital frontal cortex

A

Provides Restraint

- inhibits socially inappropriate behavior

81
Q

Pick’s Disease

A

Frontotemporal dementia: progressive dementia
- affects prefront cortex first ( personality change, irritability, mood changes)

(atrophy of fronto-temporal)

82
Q

Mesiofrontal cortex

A

Provides Initiative
-Mediates motion, goal-directed behavior, MIC

lesion: Akinetic mutism, abulia, incontinence

Cause: NPH (stretch fibers)

83
Q

Gerstmann syndrome

A

Agraphia
Acalculia
Finger agnosia
R/L confusion

Lesion of dominant parietal cortex (angular gyrus)

84
Q

Wernicke’s area

A
  • comprehension of language
  • Fluent aphasia
  • non-sensical gibberish

MCA

85
Q

Conduction aphasia

A
  • inability to repeat, mediated by arcuate fasciulus
86
Q

Global aphasia

A

loss of comprehension, repetition and fluency

87
Q

Hemianopia with macular sparing

A
  • dual blood supply to occipital oole

- primary blood supply is PCA (secondary is MCA)

88
Q

Balint syndrome

A

Lesion of Occipital- Parietal pathway (where)

  • spatial relations
  • Simultanagnosia: inability to perceive visual field as whole
  • Optic ataxia: inability to reach for objects
  • Ocular apraxia: inability to look at objects in visual field using saccades

Cause: MCA/PCA watershed infarcts

89
Q

ACA-MCA watershed infarcts

A 
Cerebral hypoperfusion (stenosis of ICA)
- Man in a barrel syndrome: torso and shoulder paralysis with sparing of the hands and feet

MedNeuro Clinical Corr. (2 decks)

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