Module 14: Cerebral Cortex: The Higher Cortical Functions Flashcards
Projections from the ventroposterolateral (VPL) nucleus of the thalamus will synapse at which of the following locations?
- Layer IV of the precentral and anterior paracentral gyri
-Layer IV of the postcentral and posterior paracentral gyrus - Layer V of the precentral and anterior paracentral gyri
- Layer V of the postcentral and posterior paracentral gyrus
Layer IV of the postcentral and posterior paracentral gyrus
The majority of the corticospinal tract originates from which of the following layers of primary motor cortex?
- Layer I
- Layer III
- Layer IV
- Layer V
Layer V
The ability to appreciate that a cup is sitting on top of a saucer and that a spoon is positioned to the right side of the cup is an example of what type of visuospatial perception?
- Spatial relations
- Visual-spatial attention
- Body schema
- praxis
Spatial relations
What brainstem stroke syndrome involves the corticospinal tract within the pons, the facial nucleus or nerve fibers in the pons and often the abducens nerve fibers in the pons, anterolateralnsystem and trigeminal nerve fibers
Milard-Gubler Syndrome
Your patient presents with a contralateral hemiplegia, ipsilateral weakness of the muscles of facial expression, ipsilateral abducens palsy (medial strabismus, unable to abduct eye and patient may complain of double vision). contralateral loss of pain/temp on the body and ipsilateral loss of pain/temp on the face. You suspect which stroke syndrome?
A) Milard-Gubler Syndrome
B) Wallenberg Syndrome
C) Michelle Syndrome
Milard-Gubler Syndrome
What brainstem stroke syndrome involves the corticospinal and corticonuclear tracts in the crus cerebri, and the oculomotor nerve fibers; may include the substantia nigra?
Weber Syndrome
Your patient presents with contralateral hemiplegia, contralateral weakness of the lower muscles of facial expression, muscles of the soft palate, tongue and ipsilateral weakness of the SCM/Traps; ipsilateral oculomotor nerve palsy (down/out position of eye, dilated pupil & ptosis). If substantia nigra involved, contralateral Parkinson- like tremor/akinesia or bradykinesia. You suspect which stroke syndrome?
A) Weber Syndrome
B) Raymond Syndrome
C) Carrie - Luber Syndrome
Weber Syndrome
____ involves the corticospinal tract in the pons and the abducens nerve fibers in the pons
A) Milard-Gubler Syndrome
B ) Raymond Syndrome
C ) Wallenberg Syndrome
C ) Raymond Syndrome
Your patient presents with contralateral hemiplegia and ipsilateral abducens palsy (medial strabismus, unable to abduct eye and patient may complain of double vision). You suspect what stroke syndrome?
Medial Medullary Syndrome: (aka Dejerine)
Lateral Medullary Syndrome: (aka Wallenberg)
Raymond Syndrome
Raymond Syndrome
A stroke involving the PICA and the spinotrigeminal tract, anterolateral system, vestibular nuclei, nucleus ambiguous, resitform body (part of inferior cerebellar peduncle) is what type of stroke syndrome?
Lateral Medullary Syndrome: (aka Wallenberg)
Your patient presents with ipsilateral loss of pain/temp sensation on face, contralateral loss of pain/temp on body, vertigo, nystagmus, nausea, vomiting, hoarsness, dysphagia, deviation of uvula to opposite side during phonation, and ataxia. You suspect what stroke syndrome?
Raymond Syndrome
Lateral Medullary Syndrome: (aka Wallenberg)
Medial Medullary Syndrome: (aka Dejerine)
Lateral Medullary Syndrome: (aka Wallenberg)
Which common lacunar stroke syndrome involves the thalamus (VPL), internal capsule or corona radiata; presents clinically with contralateral sensory loss?
Pure sensory
Apraxia
Ataxic hemiparesis
Pure sensory
Which common lacunar stroke syndrome involves the thalamus and posterior limb of internal capsule; presents clinically with a combination of contralateral motor and sensory loss?
A) Sensory-motor stroke
B) Ataxic hemiparesis
C) Pure sensory
A)Sensory-motor stroke
Which common lacunar stroke syndrome involves the internal capsule, pons or corona radiata; presents clinically as a combination of cerebellar and motor symptoms, including weakness and clumsiness, on the ipsilateral side of the body; typically leg & arm ?
A) Pure sensory
B) Sensory-motor stroke
C) Ataxic hemiparesis
C) Ataxic hemiparesis
Which common lacunar stroke syndrome involves the pons, anterior limb, or genu of internal capsule; presents clinically with dysarthria and contralateral paresis/clumsiness of the arm and hand?
Ataxic hemiparesis
Pure Sensory
Dysarthria-Clumsy Hand
Dysarthria-Clumsy Hand
What is the most common lacunar stroke syndrome?
Pure motor hemiparesis
Pure sensory
Aparxia
Pure motor hemiparesis
Reason:
* The most common lacunar syndrome (33-50%). Usually
involves the internal capsule, corona radiata, or basis pontis;
presents clinically with contralateral hemiparesis
Which of the following blood vessels are involved in the lacunar stroke?
- Lenticulostriate arteries of the MCA,
- Thalamogeniculate arteries of the PCA
- Paramedian perforating arteries of the basilar artery
All of the above
What cognitive impairments and visual deficits result from lesions in bilateral cortical branches of the PCA affected by a stroke?
a) Inability to form new semantic or episodic memories; cortical blindness
b) Prosopagnosia; auditory agnosia
c) Impaired language comprehension; neglect syndrome
d) Bilateral ptosis; oculomotor nerve palsy
a) Inability to form new semantic or episodic memories; cortical blindness
Which visual deficit is caused by unilateral cortical branches of the PCA affected by a stroke?
a) Bitemporal hemianopia
b) Quadrantanopia
c) Homonymous hemianopia
d) Binasal hemianopia
c) Homonymous hemianopia
What deficits are associated with a lesion in the penetrating branch of the posterior cerebral artery (PCA)?
a) Ipsilateral hemiparesis
b) Contralateral homonymous hemianopia
c) Loss of all somatic sensation in the contralateral face and body
d) Dysarthria-Clumsy Hand syndrome
c) Loss of all somatic sensation in the contralateral face and body
Your patient presents with contralateral hemiparesis involving the leg; contralateral somatosensory loss involving the leg and frontal lobe behavioral abnormalities. What cerebral artery is affected by the lesion of the stroke?
A) Anterior Cerebral Artery
B) Middle Cerebral Artery
C) Posterior Cerebral Artery
Anterior Cerebral Artery
What key deficit is associated with the ACA-MCA cortical border zone?
a) Facial droop and slurred speech
b) Weakness of the distal limbs, particularly the hands and feet
c) Weakness of the proximal limb girdles of the arm, leg, or both
d) Loss of sensation on one side of the body
c) Weakness of the proximal limb girdles of the arm, leg, or both
What deficits are associated with a lesion in the inferior cortical branch of the Middle Cerebral Artery (MCA)?
a) Contralateral hemiplegia and global aphasia
b) Possible mild weakness of the contralateral face & arm and possible contralateral somatosensory loss; contralateral superior quadrantanopia
c) Bilateral visual field deficits
d) Ipsilateral weakness and ipsilateral facial droop
Correct answer: b) Possible mild weakness of the contralateral face & arm and possible contralateral somatosensory loss; contralateral superior quadrantanopia
What symptoms are likely to occur with a right hemisphere lesion of the Middle Cerebral Artery (MCA)?
a) Broca’s aphasia and right-sided weakness
b) Denial, neglect & disturbed spatial perception
c) Hemianopia and anosognosia
d) Wernicke’s aphasia and apraxia
Correct answer: b) Denial, neglect & disturbed spatial perception
What type of aphasia is associated with a left hemisphere lesion of the Middle Cerebral Artery (MCA)?
a) Conduction aphasia
b) Anomic aphasia
c) Wernicke’s aphasia
d) Transcortical motor aphasia
Correct answer: c) Wernicke’s aphasia
What type of aphasia is associated with a left hemisphere lesion of the Superior Cortical Branch of the Middle Cerebral Artery (MCA)?
a) Broca’s aphasia
b) Wernicke’s aphasia
c) Conduction aphasia
d) Anomic aphasia
a) Broca’s aphasia
What symptoms may be present in a patient with a right hemisphere lesion of the Middle Cerebral Artery (MCA)?
a) Global aphasia
b) Denial, neglect, disturbed spatial perception, & emotional flatness
c) Anomic aphasia
d) Conduction aphasia
Correct answer: b) Denial, neglect, disturbed spatial perception, & emotional flatness
What are the key deficits associated with a stroke in the main stem of the Middle Cerebral Artery (MCA)?
a) Ipsilateral hemiplegia and ipsilateral facial droop
b) Contralateral hemiplegia; contralateral somatosensory loss; contralateral homonymous hemianopia; head and eye deviation toward the side of the lesion (acutely)
c) Bilateral weakness and bilateral sensory loss
d) Ipsilateral ataxia and ipsilateral facial weakness
Correct answer: b) Contralateral hemiplegia; contralateral somatosensory loss; contralateral homonymous hemianopia; head and eye deviation toward the side of the lesion (acutely)
What is agnosia characterized by?
a) Inability to move certain body parts voluntarily
b) Difficulty speaking or forming words
c) Inability to know, name, identify, or extract meaning from visual, auditory, or tactile information
d) Difficulty with memory recall and formation
Correct answer: c) Inability to know, name, identify, or extract meaning from visual, auditory, or tactile information
Which type of agnosia involves the inability to visually recognize objects despite normal sensory function?
a) Social-emotional agnosia
b) Prosopagnosia
c) Visual agnosia
d) Auditory agnosia
Correct answer: c) Visual agnosia
What are the proposed functions of the mirror neuron system?
- A network is initiated when we perform a particular action and observe another individual perform an action.
- FUNCTION: thought to allow us to understand the actions performed by another person and to predict the consequences of their actions by using mental simulation (“Simulation theory”)
- Essential role in MOTOR LEARNING, EMPATHY
What are the proposed functions of the 3 key brain networks?
- Salience Network ~ Switching between the Default Mode Network and the central executive network
Plays a role in identifying the most relevant stimuli to guide attention and behavior for adaptive purposes - Central Executive Network ~ Engages your conscious brain to think and maintain attention on a prioritized task.
- Function: operates during all goal-directed activities and filters out distractors that might interfere with performance.
- Plays a key role in cognitive processing, reasoning, task flexibility, and decision-making.
- Default Mode Network ~ Activates when not performing a task; daydreaming, mind-wandering, thinking about others
What is meant by lateralization of brain functions?
- Lateralization = RIGHT Brain will assist in the explanation of the context.
- LEFT = assist in routines of your day but not fully comprehending. Is great for details and orientation.
