localization in neurology Flashcards
what is the function of the frontal lobe?
it is the primary motor cortex area also known as brodmann’s area 4 which is responsible for the execution of movement of the contralateral side of the body
what does injury to the frontal lobe cause ?
spastic paralysis
frontal eye fields
brodmann area 8 control of visual attention and eye movements
what is the function of the paracentral lobule
cortical inhibition of bladder and bowel voiding
prefrontal syndromes
orbitofrontal
frontal convexity
medial frontal
if the patient has urinary incontinence where is the lesion most likely to be ?
paracentral lobule
what is the function of the parietal lobe ?
it is the primary somatosensory cortex ( areas 1 2 and 3)
what is the function of the primary somatosensory are a?
helps with discriminative sensation - touch, positions, position and temperature
what does injury to the somatosensory association area caus e?
injury to. area 5 and 7 causes agnosia
what is agnosia ?
Agnosia is the loss of the ability to recognize objects, faces, voices, or places
what is gerstmann syndrome
loss of four specific neurological functions including agraphia, acalculia, finger agnosia and inability to make the distinction between the right and left side of the body when ( this affection happens on the dominant hemisphere)
where is the lesion with grestmanns syndrome ?
near the junction of the temporal and parietal lobes at or near the angular gyrus
sections of the temporal lobe
primary auditory cortex
auditory association cortex
wernicke’s area
what does the dominant part of the parietal lobe control ?
calculation and language
what does the non dominant part of the parietal lobe control ?
sensory visuospatial processing
pathology of the non dominant parietal lobe?
anosognosia
dressing apraxia
geographic agnosia
constructional apraxia
pathology of the dominant parietal lobe?
finger agnosia , acalculia, agraphia ( gerstmann syndrome)
lesion in wernicks area?
Wernicke’s aphasia/receptive aphasia
what is anosognosia ?
inability to accept ones own conditions , lack of insight
what can indicate temporal lobe pathology ?
cortical deafness
difficulty hearing spoken words
memory impairment
aggressive or antisocial behaviour
superior quandrantanopia
what is in the occipital lobe ?
primary visual cortex (striate area
visual association area (parastriate area)
occipital lobe pathology
homonymous hemianopia
Anton’s syndrome
Balints syndrome ( visual agnosia)
colour blindness - inf occipital branch off PCA
prosopagnosia ( face blindness)
you are asked to test for cerebellar syndromes?
finger-nose testing iintention tremor/dysmetria
alternating hand movements ( Dysdiadochokinesia )
examine eye movement
listen to speech
heel to shin coordination
ask the patient to walk
testing the brain stem ?
testing the cranial nerves
homonymous hemaniopia where is the lesion ?
occipital lobe
superior or inferior quadrantopia where is the lesion ?
optic radiation
what does the cavernous sinus syndrome affect ?
combination of CN 3 , 4 and 6
what is the difference between aphasia and dysarthria ?
aphasia is difficulty comprehending speech
dysarthria is characterized by difficulty controlling the muscles used for speech
what are the types of dysarthria
cerebellar
bulbar ( LMN)
pseudo bulbar (UMN)
extrapyramidal
what are the types of dysphasia ?
Wernicks aphasia
Broca’s aphasia
what are the 4 nuclei in the midline of the brainstem ?
the numbers divisible by 12 ,
3
4
6
12
what are the 4 midline structures in the brainstem
all start with M
motor pathway
medial leminiscus
medial longitudinal fasiculus
motor nucleus and nerve
which nuclei are lateral in the brainstem
the non divisible by 12
5
7
8
9
10
11
what are the 4 other structures in the brain stem starting with S
all lateral
spinocerebellar
spinothalamic
sensory nucleus of CN 5
sympathetic pathway
defect in the:
motor pathway
medial leminiscus
medial longitudinal fasiculus
motor nucleus and nerve
defects are:
1.contralateral weakness (hemiparesis)
2.contralateral proprioception loss
3.ipsilateral intranuclear ophthalmoplegia
4. ipsilateral CN function loss
defects in the:
spinocerebellar
spinothalamic
sensory nucleus of CN 5
Sympathetic pathway
defects in the :
ipsilateral ataxia
contralateral pain and temp loss
ipsilateral pain and temp loss in the face
ipsilateral Horner syndrome
horner’s syndrome
miosis
anhidrosis (no face sweating)
ptosis
complete lesion in CN II
lost direct light reflex but the consensual is intact in the same eye q
complete lesion of CN III
loss of both direct and consensual light reflex
where is the lesion in Balint’s syndrome ?
inability to direct voluntary gaze
parieto-occipital lobe pathology
where is the lesion in prospagnosia ?
occipito-temporal lobe pathology
where is the lesion if the patient presents with INO ?
medial longitudinal fasiculus
what are the signs of cerebellar dysfunction ?
limb or gait ataxia
rebound nystagmus
staccato speech
hypotonia
rebound phenomenon
Dysdiadochokinesia
intention tremor
what is the presentation of INO ?
the eye which has the lesion cannot adduct
the other eye shows nystagmus
if there is a single nerve affection of the eye which nerves are more likley to be affected ?
3,4 , 6
in eye movement disorders if single nerve palsies and INO are excluded what is most likely pathogenesis ?
complex ophthalmoplegia :
myasthenia gravis
thyroid disease
if the eye is deviated medially which cranial nerve is affected ?
CN 6
uvula deviation is present in which cranial nerve ?
CN 10
affection of the 5th cranial nerve ?
sensation on the face
motor - ask the patient to clench their teeth
do corneal and jaw jerk
affection of the 7th cranial nerve ?
facial asymmetry and wasting
affection off thee 8th CN ?
whisper in their ear
if abnormal do rinne and weber
what are the section of the spinal cord ?
anterior - spinothalamic tract with decussating
posterior - dorsal column
in between the corticospinal tract
total cord affection ?
spastic quadra pap-paresis
sensory level to all modalities
affection of the spinothalamic and corticospinal tract ?
pain and temp loss below the level
affection of the posterior cord ?
dorsal column and corrticospinal
vibration and JPS loss below level
affection of the central cord ?
pain and temperature loss at the level of the lesion
hemi cord affection ?
ipsilateral hemi paresis
ipsilateral vibration loss
contralateral pain and temp loss
