Lecture 4 Flashcards

1
Q

What are the 4 lobes of the brain?

A
  • Frontal Lobe
  • Parietal Lobe
  • Temporal Lobe
  • Occipital Lobe
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2
Q

What are the function of the frontal lobe?

A
  • Cognitive functions
  • Movement control
  • Broca’s Area (language/speech)
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3
Q

Broca’s Area is an important region for ________ production, more specifically it is in charge of the _____ aspect of talking.

A
  • language

- motor

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4
Q

What are the functions of the parietal lobe?

A
  • Major sensory center
  • Temperature, taste, touch, and movement
  • Wernicke’s Area (language/speech)
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5
Q

Wernicke’s Area is responsible for the ________ of speech. What does this mean?

A
  • comprehension

- being able to form words that make sense as well as understanding what someone else is saying

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6
Q

What is the function of the temporal lobe?

A
  • Memory center
  • Auditory center
  • Taste, sound, sight, and touch
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7
Q

What is the function of the occipital lobe?

A

-Primary visual center

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8
Q

What is the cortical homunculus?

A

visual representation of what areas of our body and their association to our brain areas

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9
Q

What is the cerebrum?

A

All 4 of the lobes of the brain

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10
Q

What are the 3 major arteries that supply our cerebrum?

A
  • Anterior Cerebral Artery (ACA)
  • Middle Cerebral Artery (MCA)
  • Posterior Cerebral Artery (PCA)
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11
Q

Our deep branches of the MCA perfuse parts of the ___________ and the ___________.

A
  • internal capsule

- basal ganglia

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12
Q

Our deep branches of the PCA perfuse the ____________.

A

thalamus

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13
Q

The thalamus is an important ____ structure that recieves and sends out info regarding _______ information. It is also a _____ center

A
  • relay
  • sensory
  • pain
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14
Q

Our anterior cerebral artery (ACA) comes from our ___________ artery. It passes through our ___________ fissure. It then sweeps back posterior over the ____________.

A
  • internal carotid
  • interhemispheric
  • corpus callosum
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15
Q

The ACA supplies the ______ and _______ surfaces of our brain.

A

anterior and medial

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16
Q

What regions does the ACA perfuse?

A
  • frontal lobe
  • parietal lobe
  • corpus callosum
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17
Q

What is the function of the corpus callosum?

A

interconnects the two hemispheres

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18
Q

What are the 3 (sometimes 4) main questions that are asked when doing a cognitive screen?

A
  • name?
  • do you know where you are?
  • date?
  • 4th is a situatonal question (why are you here?)
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19
Q

CASE 1 - ACA

A

CASE 1 - ACA

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20
Q

What is one of the primary symptoms seen with anterior cerebral artery infarctions?

What is the word used to describe mild weakness after a neurological event?
What word is used to describe profound severe weakness, or even loss of function altogether?

A

-Weakness, but is much more evident in legs than arm

  • hemiparesis
  • hemiplegia
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21
Q

What is the reason ACA infarction causes more weakness in the legs?

A

The ACA travels down the middle of the brain, and this is where our lower extremities are located on the homunculus.

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22
Q

What is apraxia?

A

neurological disorder characterized by the patient having an inability to perform previous learned tasks on command
(example is asking a patient what they’re supposed to do with a hairbrush)

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23
Q

What area is thought to be involved in apraxia?

A

Supplemental motor area (SMA)

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24
Q

Problems with bimanual tasks due to ACA syndrome comes from what structure?

A

corpus callosum

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25
Q

Cognitive dysfunctions comes from what structure in ACA syndrome?

A

pre-frontal cortex/frontal cortex

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26
Q

What is aphasia?

A

loss of ability to produce or understand speech

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27
Q

Transcortical aphasia due to ACA syndrome stems from the __________ hemishpere of the SMA.
Why does transcortical aphasia happen with the ACA?

A
  • dominant
  • although the ACA doesn’t supply Broca’s Area, it does supply the supplementary motor area which is where Broca’s Area sends information to.
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28
Q

What is something that occurs with babies, but may also present itself in ACA syndrome?

A
  • contralateral grasp reflex

- sucking reflex

29
Q

What is alien hand syndrome and what structure is involved?

A
  • patient limbs can act on their own

- SMA (supplemental motor area)

30
Q

ACA syndrome patients will often have urinary incontinence due to what structure?

A

posteromedial aspect of superior frontal gyrus

31
Q

What are the treatment strategies with ACA syndrome?

A
  • key to structure environment to minimize eternal distractions
  • closed chain “big muscle” exercises
  • bimanual activities are great to tackle any UE deficits
  • function-based training - WALK WALK WALK!
32
Q

CASE 2 - MCA

A

CASE 2 - MCA

33
Q

About / of infarctions occur in the middle cerebral artery (MCA)?

A

2/3

34
Q

The MCA travals up the sylvian fissure and splits into ________ and ________ branches.

A

superior and inferior

35
Q

The superior branch of the MCA supplies the lateral and inferior ________ lobe as well as the anterior and lateral _________ lobe.

A
  • frontal

- parietal

36
Q

The inferior branch of the MCA supplies the lateral ________ lobe and lateral _________ lobe.

A
  • temporal

- occipital

37
Q

What is one of the primary weaknesses seen with middle cerebral artery (MCA) syndrome?

What is another big component to an MCA stroke?

A
  • weakness, much more evident in UE and face than at the LE

- high prevalence to language disorder

38
Q

What is global aphasia?

A

Patient will have both motor (Broca) and comprehensive (Wernicke) speech impairements.

39
Q

Language centers are located on the ________ side of our brain.

A

dominant

40
Q

MCA syndrome patient will often have perceptual deficits (unilateral neglect, depth perceptions, spatial relations) which is related to the ___________ hemisphere.

What area is associated with this symptom of MCA syndrome?

A
  • non-dominant

- parietal sensory association cortex

41
Q

What is unilateral neglect?

A

disabling condition in which patients fail to be aware of items to one side

42
Q

Patients with MCA syndrome can present with apraxia just like those with ACA syndrome. What is this?

A

inability to perform previously learned tasks

43
Q

Apraxia often goes hand in hand with what?

A

Aphasia

44
Q

Since the MCA helps supply the occipital lobe, MCA syndrome patients can present with _______ deficits.

A

visual

45
Q

Loss of conjugate gaze to ______ side can occur in MCA syndrome patients.

A

opposite

46
Q

What is pure motor hemiplegia?

What structure is involved?

A
  • Specific kind of MCA stroke where the patient will only have motor loss and nothing else.
  • Internal capsule
47
Q

The MCA has small perforating arteries that branch off and supply deep structures within the cerebrum called what?

A

Lenticulostriate arteries

48
Q

The lenticulostriate arteries supply what structures?

A
  • basal ganglia

- internal capsule

49
Q

Basal ganglia is important for movement __________.

A

initiation

50
Q

Internal capsule is a highway from our primary motor area to the brain stem and is important for carrying infomation for _________.

A

movement

51
Q

What is a lenticulostriate artery blockage called?

A

lacunar infarct

52
Q

Are lenticulostriate arteries susceptible to rupture? Why or why not?

A

Yes, tiny arteries coming off of a bigger artery. BP can rupture

53
Q

Lenticulostriate arteries produce what is referred to as “_______ ______ _____________” when internal capsule involved

A

Pure Motor Hemiparesis

54
Q

There are significant _____ control and ______ planning deficits when basal ganglia involved.

A

motor, motor

55
Q

What are treatment strategies for MCA syndrome?

A
  • incorporate speech strategies into activities
  • upper extremity functional strengthening
  • sensory reintegration is key
56
Q

CASE 3

A

CASE 3

57
Q

The posterior cerebral artery (PCA) supplies the ________ lobe and the ____________ _________ lobe

A
  • occipital

- posteromedial temporal

58
Q

What is contralateral homonymous hemianopsia?

What structure is involved?

A
  • same amount of vision loss in both eyes on one side

- primary structure involved is primary visual cortex or optic radiation

59
Q

What can happen if you have bilateral occipital strokes?

What structure is involved?

A
  • cortical blindness

- bilateral occipital lobe

60
Q

What is agnosia?

A

When a patient loses the ability to recognize familiar objects, faces, places, voices, etc.

61
Q

Visual agnosia due to PCA syndrome affects what structure?

A

occipital lobe (dominant side)

62
Q

Prosopagnosia is a type of agnosia where the patient loses the ability to recognize _______.
What structure is involved?

A
  • faces

- visual association cortex

63
Q

PCA patients can develop dyslexia due to what structure?

A

dominant calcarine lesion

64
Q

PCA patients can have memory deficits on the dominant side of what lobe?

A

temporal

65
Q

On the non-dominant side, patients may have topographic disorientation which is what?

A

lose the ability to use external cues in the environment to find your way (using a map)

66
Q

The PCA also supplies our ________. What is its role?

A
  • thalamus

- important as a pain center and sensory relay station

67
Q

Dysfunction at thalamus can result in involuntary movements such as choreoathetosis and hemiballismus, what are these?

A

choreoathetosis- involuntary movements from face, trunk extremities
hemiballismus- big circular involuntary movements

68
Q

What are treatment strategies for PCA syndrome?

A
  • gradually increase visual challenges as both symptoms improve and/or patient is able to habituate to symptoms
  • visual deficits can significantly impact balance
  • remember to give your patient visual breaks
  • may require external aids initially to assist in improving visual deficits
69
Q

What is locked-in syndrome?

A

Patient cannot move a single muscle in their body except for eyes