language and cognitive centers Flashcards
the left hemisphere (dominate)
language and processing center
the right hemisphere (non-dominate)
spatial awareness and body awareness
left hemisphere anatomy of language
brocas area, arcuate fasciculus and peri-syvian connections, wernickes area
where is brocas area located
in the left frontal lobe
where is wernikes area located
in the left temporal lobe
development of arcuate fasciculus
white matter that develops within the first 2-3 years of life. this might be why the development of language is so time sensitive
what does the arcuate fasciculus connect
the brocas and wernickes areas
function of brocas area
expressive language
function of wernickes area
language comprehension
what is brocas area supplied by
L. MCA superior division
what is mernickes area supplied by
L MCA inferior division
what is arcurate fasiculus supplies by
both the L MCA superior and inferior devision
what is the most common cause of aphasia
cerebral infarct
what is aphasia
deficit in langage processing caused by a dysfunction in the L (dominate) hemisphere. Affects both spoken and written language
what CN should be tested in a pt with aphasia
CN IX: glossinopherigeal
CN XII: hypoglossal
Expression Aphasia is lesions in the
inferior frontal gyrus of the left hemisphere (Brocas area)
what is the most common etiology of expressive aphasia
infarct of the L MCA superior division
signs and symptoms of expressive aphasia
- decreases fluency of spontaneuous speech
- short phrase length
- telegraphic speech
- naming difficulties
- comprehension is in tact
- reading is slow and effortful
- frustration and depression: pt is aware of deficit
Receptive aphaisa is lesions in the
superior posterior portion of the temporal lobe
(wernickes area)
what is the most commin etiology of receptive aphasia
infarct of the L MCA inferior division territory
signs and symptoms of receptive aphasia
- impaired comprehension
- lacks responce to questions
- speech has normal fluency and grammatical structure
- speech is empty and meaningless
- naming impaired
- commonly associated with visual fuild cut (might want to check CN2)
- pts are unaware of deficits
Occulsion of L stem MCA: massive or global aphasia signs and symptoms
- R hemiplegia
- Front-temporal-parietal lesion
- difficulties with speaking, listening and reading
- limited speech
- impaired auditory comprehension
- brain damage is massive
recovery of aphasis symptoms last longer then 2-3 mo after stroke
- complete recovery is unlikely
- some people improve over years and decades
- need to help both the pt and the family understand the nature of aphasia and learning compensatory strategies for communicating
what is neglect most closely related to
damage to the right temporo-parietal junction and posterior parietal cortex. Right MCA stem
what sensation areas does left sided neglect
visual, auditory, proprioceptive, and olfactory
hemi-neglect syndrome: processing deficit
- unaware of their deficit (anosognosia)
- loss of representation of space on the left
- inattention of space to the left
- MCA stem infarct: right parietal or frontal cortex (global aphasia)
- improvement seen with return of spatial attention in. a few weeks
what time frame of left hemi-neglect would have a poor prognosis
no return or change in 4 weeks after stoke
what is a common difficulty with pt with lesion in the non-dominate (right hemisphere)
- visual-spatial analysis, construction abilites, severe personality or emotional changes
what part of the brain carries out emotional content
cingulate gyrus
interventions for spatial neglect
- forced use
- constraint induced
- patching eye
test for left hemi-spatial neglect
1) place a mark in the middle of the line
2) cross the lines
3) circle the As
4) which fingers are being pointed up
5) draw a house
6) draw a clock
what does the association cortex include
most of the cerebral surface of the human brain and are largely responsible for the complex processing that goes o between the arrival of input in the primary sensory cortex and the generation of behavior
unimodal motor association cortex project predominantly into the
primary motor cortex
what is the unimodal association cortex important for
formulating the motor program for a complex action involving multiple joints
the heteromodal association cortex has
bidirectional connections with both motor and sensory association cortex of all modalities and bidirectional connections with the limbic system
the arrangement of the heteromodal association cortex allows for
the highest-order mental functions. we are intelligent humans through this association
unimodal is (blank) specific
modality specific
heteromodal is (blank) specific
higher order
what areas of the brain are unimodal
- the motor association cortex
- the somatosensory association cortex
heteromodal areas of the brain
- forntal heteromodal association cortex (prefrontal cortex)
- Lateral parietal and temporal heteromodal association cortex
frontal cortex functions
- executive function and complex behavior
partial cortex functions
- attention
- awareness
temporal cortex functions
recognition
association cortex functions
- higher order processing
- motor planning
- language processing and production
- visual- spatial orientation (directional)
- socially appropriate behavior
what are the 3 major divisions of the frontal lobe
1) primary motor cortex
2) premotor cortex - planning movement and speech
3) prefrontal cortex - the executer, higher consciousness and decision making
Functions of the frontal lobe
- restraint (inhibition)
- initiate (motivation)
- order (performing squencing tasks
- working memory
the limbic system functions
- motivation
- balance of the frontal lob and limbic system
- a way for us to connect
- enjoyment
functions of the prefrontal association cortex
(RIO)
- restrain (repress inappropriate behavior)
- Initiative (motivation)
- Order (correctly perform sequencing tasks)
what is the prefrontal association cortex bidirectional connects
- amygdala (emotions)
- thalamus (relay)
- hippocampus (remember)
- BG (plans)
- hypothalamus
signs and symptoms if the frontal lobe is damages
- lack of emotional control (profanities) : due to restraint being gone
- Unable to stick to plans due to organization being gone
- Personality changes
neuroanatomy of the prefrontal cortex
- dorsolateral (DLPFC) : regulation of attention behavior
- Orbitofrontal (OFPFC) : impulse control
The dorsolateral (DLPFC) prefrontal cortex function
- regulation of attention behavior
- attention and working memory, cognitive control, executive functions (develops into adulthood: works with the hippocampus)
- helps us make choices
Orbitofrontal (OFPFC) prefrontal cortex function
- works with the limbic system
- social judgment, impulse control
- involvement is associating things, rewards cognition, personality
- involves in conscious reappraise strategies to emotional regulation
what does the anterior cingulate cortex do
affect, selective attention and social interactions
what does the amygdala do
- emotional stress and learning
- prefrontal activation in threatening and social situations, part of the limbic system, required for fear condition and accurate emotion regulation.
- Survival
what does the hippocampus do
- learning and conscious memory
- facilitate learning and memory processing
short term memory in the prefrontal cortex
acts acts a “scratch-pad” for temporary recall of information which is being processes at any point in time
working memory in the prefrontal cortex
- amygdala: emotional memory
- Hippocampus: long term
- cerebellum: procedural memory
what is the hypothalamus role in emotion regulation
- physiological context of emotion
- ANS endocrine functions on emotion. Changes in BP and HP
- primary output of the limbic system
- connected to frontal lobe, brain stem, reticular formation, hippocampus
- regulates the amount of fear, thirst, sexual drive, and aggression felt
what does the reticular formation do
hightens awareness
what does the prefrontal cortex do for emotion regulation
- modulates emotions
- inhibitory inputs to the amygdala
- component in TBI, loss of emotion modulation
- if it is damages the pt will have hightened emotional responces
function of the cingulate cortex
primary cortical component of the limbic system that is involves in emotional and cognitive processing
function of the olfactory bulb
not part of the limbic system but it is in close proximity to it which is why smells are highly triggering to memories
Apraxia
- dominate hemisphere (left)
- inability to carry an action is response to a command in the abstance of a comprehension deficit
- not well localized int eh brain and can be cause by lesion in different locations
- 1/3 of pts with aphasia have apraxia
types of apraxia
- dyspraxia
- perseveration
- ideation apraxia
dyspraxia
movement based problem; clumsy and unable to manipulate objects appropriately
ex: will put the key in the wrong side
perseveration
performing an action over and over again
ideation apraxia
the pt cannot recall how to perform everyday activities
Attention Deficit Hyperactive Disorder
- brain disorder in the PFC that is characterized by poor attention span and hyperactivity
- impulsivity and hyperactivity
treatments for ADHD
stimulants of dopamine and norepinephrine system increase attention and concentration
ADHD involves daily maturation of what system
DLPFC: dorsal lateral prefrontal cortex
