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MBBS II HNNS > L46,47 - Higher Cortical Functions I&II > Flashcards

L46,47 - Higher Cortical Functions I&II Flashcards

1
Q

Define the cerebral hemispheres (lobes)?

A

 Frontal lobe
 Parietal lobe
 Temporal lobe
 Occipital lobe

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2
Q

Gross structural organization of the cerebral cortex?

A

Laminar organization – 6 layers Composed of glial cells, neurons, each layer has diff. input and output

–I.MolecularorPlexiformlayer

–II.External(Outer)granularlayer

–III.Externalpyramidallayer

–IV.Internal(Inner)granularlayer

–V.Internalpyramidallayer

–VI.Multiform(Polymorphiclayer)

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3
Q

Gross functional organization of the cerebral cortex?

A

Columnar function organization:

“Column” of cells with similar response properties
» Overlapping / nearly identical receptive field

E.g. area 17: process Right eye and Left eye info.

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4
Q

Input of Layer I of cortex?

A

 Brainstem modulatory systems  Other cortical areas

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5
Q

Input and output of Layer II of cortex?

A

 Brainstem modulatory systems  Other cortical areas

Other cortical areas

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6
Q

Input and output of Layer III of cortex?

A

Brainstem modulatory systems

 Other cortical areas  Opposite hemisphere

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7
Q

Input of Layer IV of cortex?

A

 Brainstem modulatory systems

 Thalamus

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8
Q

Input and output of Layer V of cortex?

A

 Brainstem modulatory systems  Other cortical areas

Subcortical structures, e.g.:  Striatum  Superior colliculus

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9
Q

Input and output of Layer VI of cortex?

A

Brainstem modulatory systems

Thalamus

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10
Q

Thalamus input and output at which layer of the cortex?

A

Input at layer IV

Output at layer VI

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11
Q

Which layer of the cortex outputs to subcortical structures?

A

Layer V

Subcortical structures, e.g.:  Striatum  Superior colliculus

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12
Q

2 main types of neurons in the cortical layers?

A

1) Pyramidal neurons: Spiny excitatory (glutamatergic) neurons (majority)
2) Non-spiny inhibitory (GABAergic) interneurons

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13
Q

Compare the neurotransmitter, morphology and abundance of Pyramidal neurons vs interneurons in the cortical layers?

A

Pyramidal:

  • Glutamate
  • Homogeneousmorphology
  • 70‐80%

Interneuron:
- GABA
- Heterogeneous
~20‐30%

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14
Q

Input and output of lateral geniculate nucleus?

A

Input = retinal ganglion cells

Output = Occipital lobe

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15
Q

Input and output of Dorsomedial nucleus of thalamus?

A

Input: Medulla, olfactory cortex

Output: Orbitofrontal cortex, amygdala

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16
Q

Input and output of VPL and VPM of thalamus?

A

Spinothalamic/ DCML input + trigeminothalamic (VPM only)

Postcentral gyrus/ primary somatosensory cortex output + Temporal lobe

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17
Q

Input and output of anterior nucleus of thalamus?

A

Hippocampus, Mammilary body input

Cingulate cortex output

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18
Q

Input and output of medial geniculate nucleus in thalamus?

A

Cochlear nucleus/ central auditory pathway input

Primary auditory cortex output

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19
Q

Output of Pulvinar (anterior, medial, lateral, inferior) of thalamus?

A

Occipital lobe

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20
Q

List the higher cortical areas in the frontal lobe.

A

Premotor, SMA
Primary motor
Speech motor - Broca
Prefrontal

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21
Q

List the higher cortical areas in the Parietal lobe.

A

Primarysomatosensorycortex,somatosensoryassociation area

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22
Q

List the higher cortical areas in the Occipital lobe.

A

Primary visual

Visual association

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23
Q

List the higher cortical areas in the temporal lobe.

A

Primary auditory
Wernicke’s area
Auditoryassociationcortex
Memory

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24
Q

Functions of the frontal lobe. (think about the higher centers there)

A
  • Emotion,personality,socialcontrol,speaking
  • Executivefunction:planning,decision‐making,makingjudgments,attention
  • Controlofmovement
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25
Q

Functions of the Parietal lobe. (think about the higher centers there)

A
  • somatosensoryfunction(e.g.senseoftouch)
  • Interpretationofshapeandtextures
  • Understandingspeechandformulatingwords
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26
Q

Functions of the Occipital lobe. (think about the higher centers there)

A
  • Processesvisualinformation

* Correlationofvisualimageswithpreviousvisualexperience

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27
Q

Functions of the temporal lobe. (think about the higher centers there)

A
  • Mostlyconcernedwithspeechandhearing

* Storageofauditoryexperience

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28
Q

Define the functional categories of cerebral cortex.

A
  • Fourfunctionalcategories:

* Primary motor, primarysensory,unimodalassociationcortex (secondary),multimodalassociationcortex(tertiary)

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29
Q

Purpose of the Primary Sensory functional category of the cerebral cortex?

A

receives thalamocortical fibers from diencephalic relay nuclei related to their functional modality:
 Somatosensory  Visual  Auditory

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30
Q

Function of the Unimodal association cortex?

A

 Adjacent to primary cortex

 Devoted to higher level of information processing:

primary sensory > motor and somatosensory association area > higher‐order somatosenory association area and premotor cortex

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31
Q

Function of Multimodal association areas?

A

receiveinformationfromseveral differentsensorymodalities:

(1)theproductionofaunifiedpercept (2)therepresentationoftheperceptinmemory

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32
Q

Which cognitive functions are executed at the multimodal association areas?

A

–Useoflanguage
–Futureplanning
–Imagineandcreate
–Appreciationofspace,etc.

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33
Q

List all the motor areas in the cerebral cortex?

A
  • Primarymotorcortex(Area4)
  • Premotorcortex(Area6)
  • Frontaleyefield(Area8)
  • Broca’sarea(Area44,45)
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34
Q

Location, function, organization of the Primary motor cortex?

A
  • Locatedintheprecentral gyrus
  • Allowsconsciouscontrolof precise,skilled,voluntary movements(ontheopposite sideofthebody) via direct connection with spinal cord
  • representedinanorderly mannerinthecortex: Homunculi
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35
Q

Describe the mapping of the primary motor cortex?

A

 Body is mapped upside down

 Homunculi: body regions with the greatest number of motor innervations (e.g. hands, face, tongue) are represented by largest areas of motor cortex

 disproportionate representation of the body on the primary motor cortex

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36
Q

Motor function planned in the primary motor area can be executed without additional sensory input. T or F?

A

False

Motor function Need continuous stream of tactile, visual, proprioceptive information for accuracy, proper sequence

37
Q

List all 6 sensory areas in cerebral cortex?

A
  • Primarysomatosensorycortex(Area1,2,3)
  • Visualcortex(Area17)
  • Auditorycortex(Area41,42)
  • Vestibularcortex
  • Gustatorycortex(Area43)
  • Olfactorycortex
38
Q

Location, Input, Mapping and function of primary somatosensory cortex?

A
  • Locatedinthepostcentralgyrus
  • Receivesinformationfromtheskinandskeletalmuscles
  • Homunculi mapping
  • Exhibitsspatialdiscrimination
39
Q

Tract the visual pathway from retina to cortex?

A

Photoreceptor cells (rod, cone) > bipolar cells > ganglion cells

> optic nerve > optic chiasm > optic tract

> lateral geniculate nucleus/body (6 layers of neurons) of the thalamus

> optic radiation to visual cortex:
Right cortex process right temporal + left nasal field, vice versa

40
Q

Which side of the thalamus relays visual information from which side of the visual field (nasal/ temporal)?

A
  • Temporal hemiretina > ipsilateral lateral geniculate nucleus
  • Nasal hemiretina > crosses over at optic chiasm > contralateral lateral geniculate nucleus
41
Q

Tract the pathway for superior visual field quadrant processing? (from retina to cortex)

A

Superior VF > Inferior retinal field quadrant > Lateral half of LGN

> Temporal** optic radiation > Geniculocalcarine tract > Inferior Calcarine bank in visual cortex

42
Q

Tract the pathway for inferior visual field quadrant processing? (from retina to cortex)

A

Inferior VF > Superior retinal field quadrant > Medial half of LGN

> Parietal** optic radiation
Geniculocalcarine tract
Superior calcarine bank in visual cortex

43
Q

Organization of primary visual cortex?

A

Organized in Orientation columns and Ocular dominance columns + blobs (vertical) for color

44
Q

After optic radiation relays visual signal to primary visual cortex, what are the next higher centers?

A
  1. Dorsal stream (magnocellular pathway) Projects to parietal association cortex
  2. Ventral stream (parvocellular pathway) Projects to temporal association cortex

Both Eventually converge onto frontal association cortex

45
Q

Compare the function of the parvocellular and magnocellar pathways for visual processing?

A
  1. Dorsal stream (magnocellular pathway): Processes spatial information: position, motion, speed
  2. Ventral stream (parvocellular pathway): Processes information about form: color, shape, texture
46
Q

Give the lesion site + one example of condition causing: Bitemporal hemianopia (lose lateral visual field)

A

Optic chiasma lesion

i.e. Pituitary adenoma

47
Q

Give the lesion site + one example of condition causing: Monocular amaurosis (one eye lose all vision)

A

Optic nerve lesion

i.e. optic neuritis

48
Q

Give the lesion site + one example of condition causing: Homonymous hemianopia (no ipsilateral temporal + no contralteral nasal field)

A

Optic tract lesion

i.e. Cranio- pharyngioma

49
Q

Give the lesion site + one example of condition causing: Homonymous upper quadrantic hemianopia. (loss of upper quadrant field of the same side in both eyes)

A

Temporalopticradiationlesion

posttemporallobectomy

50
Q

Give the lesion site + one example of condition causing: lowerquadrantic hemianopia (loss of lower quadrant field of same side in both eyes)

A

Parietalopticradiationlesion

e.g.parietal glioma

51
Q

Give the lesion site + one example of condition causing: Dense hemianopia with macular sparing (Half of field loss on same side in both eyes, with normal macula spot)

A

Visualcorticallesion(e.g.occipitallobe infarct)

Central LGN still intact > Macular sparing > 1 of 2 bilateral projections to primary visual cortex still functional

52
Q

Unilateral lesion in the auditory pathway can cause bilateral hearing loss. T or F?

A

False

Cochlear nucleus on each side projects fibers to ipsilateral (superior olivary complex) and contralateral tracts (lateral lemniscus)

Double decussation + bilateral processing means unilateral lesion unlikely to affect hearing

53
Q

How is auditory info processed in the cerebral cortex? Brainstem centre processing?

A

All fibers from cochlear nucleus to primary auditory cortex maintain the tonotopic information pattern

Spatial mapping + Accurate localization of sound processed at cortex

Medial Geniculate body = upstream projection + downstream modulation

Inferior colliculus = Amplitude + frequency modulation, Reflex coordination (head movement + startle reflex), Downstream efferent modulation

Superior olivary complex = Gross localization of sound

Cochlear nucleus = frequency + temporal processing

Cochlear, basillar membrane = frequency + tonotropic map

54
Q

Tract the gustatory pathway from taste buds to cortex?

A

Taste buds (CN VII, IX, X (epiglottis))

> > geniculate, petrosal, nodose ganglia

> > solitary tract + solitary nucleus***

> > central tegmental tract

> > VPM of thalamus

> > Gustatory cortex (area 43)

55
Q

Brief outline of brain areas involved in forming vestibular cortex?

A

Balance needs many snesory integration:

Somatosensory cortex
Posterior insula
Premotor cortex (frontal eye field)
Parietal cortex

56
Q

List some centers in the olfactory cortex?

A
  • Piriform cortex
  • Lateral entorhinal cortex
  • Olfactory tubercule
  • Anterior olfactory nucleus
  • Anterior cortical amygdaloid nucleus
57
Q

List the 4 association areas?

A

Parietal, temporal, Frontal, Limbic association cortices

58
Q

Function of parietal and temporal association cortex?

A
  • Parietalassociationcortex:sensoryguidanceofmotor behaviourandspatialawareness.
  • Temporalassociationcortex:recognitionofsensory stimuli+storageofsemantic(factual)knowledge
59
Q

Function of frontal and limbic association cortex?

A

•Frontal(prefrontal)associationcortex:organizing behaviour + workingmemory. •Limbicassociationcortex:(Locatedintheanteriorventralportionof thetemporallobe)emotion andepisodic(autobiographical)memory

60
Q

List 4 functions of Prefrontal cortex?

A
  • Highercognitivefunction,planning
  • Personalityexpression
  • Decisionmaking,workingmemory
  • Socialbehavior
61
Q

Input and output of prefrontal cortex? Can it evoke movement?

A

Input : Projectionzoneofthemediodorsal nucleusofthethalamus

electricalstimulationdoesnotevoke movements

Highlyinterconnectedwithother cortical,subcorticalareaandbrainstem

62
Q

Consequence of prefrontal cortex dysfunction?

A

psychiatrydisorders,e.g.depression, schizophrenia

drasticand permanentpersonalitychanged

Lack of ability to plan ahead

63
Q

Name of procedure done to limitinterhemisphericspreadof epilepticactivity?

A

cut Corpuscallosum

64
Q

Compare the functions of Wernicke’s and Broca’s areas? Left or right brain?

A

Wernicke’s = comprehensionofwrittenandspokenlanguageand formationofcoherentspeech

Broca’s = motorprogramsofspeechandwriting&raquo_space; primary motor cortex

Normallylocatedinthelefthemisphere (if right-handed)

65
Q

Symptoms and area of brain affected in expressive aphasia?

A

Understandlanguageperfectlyand maybeabletowriteperfectly

Difficulty speaking spontaneously

> > Broca affected

66
Q

Symptoms and area of brain affected in receptive aphasia?

A

unabletonameobjects
unabletounderstandthemeaningofwords
articulatespeechreadily,butusuallynonsensically

> > Wernicke affected

67
Q

Symptoms and area of brain affected in global aphasia?

A

almosttotalreductionofallaspectsofspokenandwrittenlanguage

> > largerlesionsincentralregionaroundlateralsulcus;largeleft middlecerebralarteryinjuries

68
Q

Symptoms and area of brain affected in Conductive aphasia?

A

comprehensionisnormalandexpressionisfluent

Difficulty translating what’s said into appropriate reply

> > interruptionoftheconnections (arcuatefasciculus)linkingtheBrocaandWernickeareas

69
Q

Which association cortex is most highly lateralized in the brain?

A

Parietal association cortex

70
Q

Brain area affected in Contralateral Neglect syndrome i.e. on the left side?

A

Damagetorightparietalassociation cortex(non‐dominant)
= defectinattention, spatialsurrounding, self‐imageontheleft side

71
Q

List 4 cortical dysfunctions?

A

Aphasia
Apraxia
Agnosia
Ataxia

72
Q

Define apraxia and brain areas affected?

A

Difficulty with the motor planning to perform tasks / movements &raquo_space; Cannot internalize, duplicate the spatial relationships

 Parietal association cortex;
 Premotor cortex; or
 Supplementary motor cortex

73
Q

Define agnosia and list 3 subtypes?

A

higher level disorders of sensory perception even though afferent sensory pathways function normally

 Tactile agnosia: cannot recognize objects through touch
 Prosopagnosia: cannot recognize familiar faces / learn new faces
 Visual agnosia: appreciative or associative

74
Q

Clinical presentation of visual appreciative agnosia? (able to identify object? Normal object perception? Draw copy?)

A
  • Cannot draw copy of image
  • Can verbally identify object
  • Cannot see object parts as a unified whole
  • Cannot construct senosry representations of visual stimuli
75
Q

Clinical presentation of visual associative agnosia? (able to identify object? Normal object perception? Draw copy?)

A
  • Can copy image
  • Cannot name objects/ interpret/ understand/ assign meaning
  • Normal sensory representation but faulty association

> > Posterior multimodal association cortex lesion

76
Q

Presentation and brain area affected in optic ataxia?

A

difficultywithvisuallyguidedgraspingandreaching

damagetothedorsomedialparietalcortex

77
Q

Define dementia, area of brain affected and related impairments? How to assess dementia?

A

Clinical syndrome of impaired cognitive function in multiple domains but with preserved consciousness

global dysfunction in cerebral cortex

Deterioration of memory, intellect, concentration, comprehension, specific cortical functions

Mini‐Mental Sate Examination (MMSE)

78
Q

Most common form of dementia? Related genetic factors?

A

Alzheimer’sDisease

Mutationofamyloidprecursor protein(APP),presenilins1(PSEN1)and presenilin2(PSEN2)

79
Q

Pathogenesis of Alzheimer’s?

A
  1. Extracellulardepositionofamyloidplaques***, composedofbeta‐amyloid(Aβ)
  2. Intracellularneurofibrillarytangles(NFT),composed ofaggregatesofhighlyphosphorylatedmicrotubule bindingprotein,Tau
  3. Significantdecreaseinacetylcholinetransferase andlossofcholinergicneurons

> > Memoryloss,deficitsofcognitivefunction, mooddisorders

80
Q

Sequence of brain areas affected in progression of Alzheimer’s

A

Medial temporal lobe

> Lateral temporal, parietal lobes

> Frontal lobe

> Occipital lobe

81
Q

How does functional imaging of cognition work?

A

Cognition = change in energy metabolism of neurons, synaptic activity and strength

i.e. increase cerebral blood flow and volume, increase glucose uptake … etc

82
Q

Principal of PET scans?

A

detectspairsofgamma raysemittedindirectlybyapositron emittingradionuclide(tracer e.g. oxygen-15)

measuredtheflow ofbloodtodifferentpartsofthebrain

83
Q

Principal of fMRI?

A

detectingchangesassociatedwithbloodflow.
Usestheblood‐oxygen‐leveldependent(BOLD) contrast

(BetterresolutionthanPETscan)

84
Q

Principal of EEG?

A

electricalpotentialdifference fromthesummationofpostsynapticpotentialsfrom pyramidalneuronsinthecortex

measured by many electrodes on the scalp

85
Q

What in EEG used to dx?

A

epilepsy,comaandbraindeath

Monitor sleep

86
Q

List the 4 EEG patterns and the cognitive states related?

A

Alpha = awake, relaxed state of wakefulness, eyes closed

Beta = awake, alert, with visual stimuli

Theta = Concentrating of emotional stress in adults, common in brain disorders, common in children

Delta = deep sleep, indicate brain damage in awake adults

87
Q

Principal of Magnetoencephalography MEG?

A

Electromagneticfieldsaregeneratedby theneteffectof currentflowinneurons

•Theeffectofmultipleneuronsexcited togetherinaspecificareagenerates measureablemagneticfield

88
Q

Define neuroplasticity and its function?

A

RemodelingoftheCNS/ Re‐organizationofsynapticnetworks to cause changeinbehavior/sensation

Function:
Learning and memory
Phantom limb sensation (i.e. after amputation)
Cortical remapping of referred sensation (i.e. after stroke)

MBBS II HNNS (57 decks)

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