Izbrane bolezni in nevrološke motnje Flashcards
Despite her inability to consciously recognize the size,
shape and orientation of visual objects, D.F. displayed
accurate hand movements directed at the same objects.
For example, when she was asked to indicate the width
of blocks with her index finger and thumb, her matches
were variable and unrelated to the actual size of the blocks.
However, when she was asked to pick up blocks of different sizes, the distance between her index finger and thumb
changed appropriately with the size of the object. In other
words, D.F. adjusted her hand to the size of objects she
was about to pick up, even though she did not consciously
perceive their size.
A similar dissociation occurred in her responses to
the orientation of stimuli. When presented with a large
slanted slot, she could not indicate the orientation of the
slot either verbally or manually. However, she was as
good as healthy volunteers at quickly placing a card in
the slot, orienting her hand appropriately from the start
of the movement.
D.F. has bilateral damage to her ventral prestriate cortex,
thus interrupting the flow of the ventral stream
A.T. was able to recognize objects and demonstrate their
size with her fingers. In contrast, the preshape of her hand during
object-directed movements was incorrect. As a consequence,
she could not pick up objects between her fingertips—instead,
the patient made awkward palmar grasps. Although A.T. could
not preshape her hand to pick up neutral objects like blocks,
when presented with a familiar object of standard size, like a
lipstick, she grasped it with reasonable accuracy.
The case of A.T. is in major respects complementary to that of
D.F. A.T. is a woman with a lesion of the occipitoparietal region,
which likely interrupts her dorsal route
Žena pacienta pride in potarna da mož sploh ne ve kdo je kdo, ne loči njene sestre od njene mame in družinski pikniki so res nočna mora. Kakšno vrsto agnozije ima pacient? Kje v možganih je to?
Njuna hčerka pa joče da se ji zdi, da se vse kar teleportira in da ne ve sploh ko ji nekdo maha alneki idk
Možganska patologija povezana s prozopagnozijo je ponavadi povezana z uni ali bilateralno poškodbo fusiformnega obraznega območja (=ventralni del med okcipitalnim in temporalnim režnjem) ali okcipitalnega obraznega območja (=ventrali del okcipitalnega režnja).
Poškodba predela ‘MT’ je povezana z akinetopsia (= ne moreš vidit gibanje, vse je kot nek stop motion)
A 68-year-old patient was referred because he had difficulty finding his way around—even around his own home. The patient
attributed his problems to his “inability to see properly.” It was
found that if two objects (e.g., two pencils) were held in front of
him at the same time, he could see only one of them, whether
they were held side by side, one above the other, or even one
partially behind the other. Pictures of single objects or faces
could be identified, even when quite complex; but if a picture
included two objects, only one object could be identified at a
time—he would perceive the first object, after which it would be
replaced by a perception of the second object, which would then
be replaced by a perception of the first object, and so on. If the
patient was shown overlapping drawings (i.e., one drawn on top
of another), he would see one but deny the existence of the other
izumrtje; unilateralna poškodba možganov v parietalnem režnju (podobno a drugačno od hemispatialnega neglekta)
When tested with
his left hand in his lap, W.M. detected 97.8 percent of the stimuli
presented in his right visual field and only 13.6 percent of those
presented in his left visual field. However, when he was tested
with his left hand extended into his left visual field, his ability to
detect stimuli in his left visual field improved significantly. Further
analysis showed that this general improvement resulted from
W.M.’s greatly improved ability to see those objects in the left
visual field that were near his left hand. Remarkably, this area of
improved performance around his left hand was expanded even
further when he held a tennis racket in his extended left hand
W.M. suffered a stroke in his right posterior cerebral artery. The
stroke affected a large area of his right occipital and parietal
lobes and left him with severe left hemianopsia (a condition in
which a scotoma covers half the visual field). W
He had great difficulty performing intricate responses such as doing up his buttons or picking up
coins, even under visual guidance. Other difficulties resulted
from his inability to adjust his motor output in light of unanticipated external disturbances; for example, he could not keep
from spilling a cup of coffee if somebody brushed against him.
However, G.O.’s greatest problem was his inability to maintain
a constant level of muscle contraction.
The result of his infection was that even simple tasks
requiring a constant motor output to the hand required continual visual monitoring. For example, when carrying a suitcase, he
had to watch it to reassure himself that he had not dropped it.
However, even visual feedback was of little use to him in tasks
requiring a constant force, tasks such as grasping a pen while
writing or holding a cup. In these cases, he had no indication of
the pressure that he was exerting on the object; all he saw was
the pen or cup slipping from his grasp.
An infection had selectively destroyed the somatosensory
nerves of G.O.’s arms.
After her stroke, Mrs. S. could not respond to things on her
left—including objects and parts of her own body. For example,
she often put makeup on the right side of her face but ignored
the left.Mrs. S had a lot of problems but a particularly bothersome one was that
she had difficulty getting enough to eat. When a plate of food
was put directly in front of her, she could see only the food on
the right half of the plate, and she ate only that half, even if she
was very hungry. However, Mrs. S. developed an effective way
of getting more food. If she was still hungry after completing a
meal, she turned her wheelchair to the right in a full circle until the remaining half of her meal appeared once more directly
in front of her. Then, she ate that remaining food, or more
precisely, she ate the right half of it. If she was still hungry after
that, she turned once again in a circle to the right until the
remaining quarter of her meal appeared, and she ate half of
that… and so on.
Kontralateralni neglekt, a massive stroke to the posterior
portions of her right hemisphere
kontralateralni neglekt je najbolj pogosto povezan z lezijo desne posteriorne parietalne skorje
Prideš do osebe domov, normalno te sprejme, se rokuje s teboj in pogovarja itd. Potem pa, kar naenkrat vstane in začne hoditi po prostoru, prijemati predmete, jih postavljati nazaj itd. Kje ima ta oseba lezijo?
Epilepsija -> to je kompleksen napad, navadno posledica epilepsije temporalnega režnja (saj je nek avtomatičen, avtonomen gib brez zavesti)
Pokaži fuziformni girus (in kaj je funkcija) in sekundarni vidni korteks.
Fuziformni girus leži na ventralni površini na meji med okcipitalnim in temporalnim režnjem. Funkcija je povezana s prepoznavo obrazov, zato se mu velikokrat reče tudi fusiform face area FFA. Točno zraven je okcipitalni face area (ventralna površina okcipitalnega režnja)
Kje je sekundarni vidni korteks?
Imenuje se tudi prestriatni vidni korteks. Nahaja se ventralno od primarnega in posteriorno od posterironega parietalnega režnja.
Funkcija: pomemben za stereoskopski vid; to je del dorzalne ‘kako/kje’ poti.
Si zdravnik in greš k pacientu na dom, in VEŠ, da ima možganski tumor. Torej, nekaj časa z njim govoriš normalno, potem pa se začne čudno vesti..V smislu, da začne malo tavati, se te dotikati, se sebe dotikati, nekaj te sprašuje, ne razume dobro, malo hodi okrog, pa momlja in nekaj počne. In to traja do ene 45 min. Potem pa spet normalno govori in funkcionira.. In kakšna je abnormalnost, kje tumor pritiska.
Lezija je v parietalno-temporalnem in sproža žarišče negeneralizirane epilepsije; fokalne.
Pacient gleda skozi okno in ga vprašate, kaj gleda in on reče, da vidi eno vejo, pa dve okni, pa en plakat pa še veliko drugih podrobnosti. Kje je lezija?
Okcipitoparietalno junction, torej je poškodovana dorzalna pot in ne ventralna. Poškodba je bilateralna (ne kot neglekt ko je unilateralna). To se imenuje tudi Balintov sindrom in ga spremljajo:
(1) simultanagnosia (2) optic ataxia, and (3) oculomotor apraxia.
Pokaži angularni girus in pokaži center (girus), ki je za načrtovanje, iniciacijo in motivacijo
Leži v temporalnem in parietalnem režnju ravno posteriorno od Wernickejevega področja. Poškodba v (navadno levem) angularnem girusu povzroči težave pri branju (alexia) in pisanju (agraphia).
Center za načrtovanje, iniciacijo in motivacijo leži v cingularnem girusu.
Pacient je čisto emocionalno indiferenten, NE doživlja čustev, v smislu kot da je nek robot, ne doživlja strahu, na koncu je še poudaril, da v nevarni situaciji ne doživlja strahu. Kje je lezija?
Lezija je na amigdali.
Pacient ne zna brati, zna pa pisati. Kje je tumor in na katere vse dele pritiska?
Leva ventralna pot, pritiska na corpus callosum, zadnji del - je relativno velik tumor.
Kaj je Charles Bonnetov sindrom?
Pacient_ka ima trajno poškodbo optičnega živca (glavkom) kasneje v življenju a še vedno zelo živo halucinira stvari, kar je pogojeno z njihovimi izkušnjami v življenju (kakšnim dražljajem so bili izpostavljeni). Lezija je nekje na poti in lahko tudi v primarnem vidnem korteksu.
