Neuro Test 4 Flashcards

Question

emotional lability

Answer 1

The abnormal, uncontrolled expression of emotions * Abrupt mood shifts, usually to anger, depression, anxiety * Involuntary, inappropriate emotional expression in the absence of subjective emotion (pathologic laughter or crying) (laughing or crying with no real reason there?) * Emotion is (may be??) triggered by nonspecific stimuli unrelated to the emotion expressed * May be consistent with person’s mood or incongruent (laughing when sad, crying for no reason) (even during the middle of normal conversation?) * Will have to put increased effort into stopping emotional reactions (and its quite difficult and frustrating for the person)

Answer 2

pseudobulbar? palsy-a condition involving the person having trouble controlling facial muscles and controlling their tongue, muscles of the neck responsible for speaking and swallowing, and one of the associated issues here is emotional lability? or rapid or exaggerated changes in mood ?

Answer 3

The tendency to behave as if one side of the body and/or one side of space does not exist * Damage to right parietal area * Increased hyperactivity of left brain attention so if you see on the image below there ,normal view, you see both hands on both thighs there someone with neglect may perceive only the right side ; the left side just doesn’t exist? so if you ask them to draw pictures of a clock for example, they might only draw on the right side of the clock. he’s seen pepople draw the hours 1-12 and they start at the top and come all the way down and write all of those hours just on one side of the clock in a similar way, you may see them draw one side of an object like a house , should be a fairly symmetrical type object or they may draw something like a cat, trying to copy this picture- they only see the right side?

Answer 4

isolated activation of primary motor cortex * Involuntary, uncontrollable movement of the upper extremity (often doing random, writhing types of movements?) * Moves without intention (or volition?) * Grasps unintentionally * Damage to a variety of cortical and subcortical structures * Leads to frustration, perplexity, annoyance, anger * Treated with visual feedback and sensory stimulation for affected limb

Answer 5

Ischemic: ischemic refers to interruption of the blood supply ; majority of strokes that occur, about 80%? -caused by blockage of blood flow in blood vessel involved there -might be embolus or lodging of thrombus in wall of vessel -and so this blocks flow of blood to downstream tissues? -onset may be abrupt or may gradually worsen over a period of several days -recovery after an ischemic stroke is usually slow and its common for there to be residual deficits Hemorrhagic: hemorrhagic results from a bleed that occurs? -now a hemorrhagic stroke, again’s a bleed and this causes damage by depriving downstream tissues of that bloodflow, that ciruclation -and there’s also extra-vascular blood now in the tissue that puts pressure on the brain tissues; usually the worst deficits occur early on with this type of stroke, and as the edema ? subsides, the symptoms tend to improve ?

Answer 6

this image showing a subarachnoid hemorage there on the right side, bleeding into the subarachnoid space? usually causes a headache, brief loss of consciousness, deficits are progressive, due to the continued bleeding that’s occuring or to the secondary hydrocephalus that may occur because of all of the blood now taking up space in that area?

Answer 7

Malignant: Astrocytoma Glioblastoma Oligodendroglioma Ependymoma Medulloblastoma Lymphoma Metastatic Benign: Meningioma Adenoma Acoustic neuroma

Answer 8

mass of tissue, and this mass , as its growing, can cause compression on the surroudning tissues, and so the effects of that tumor depend on where it is and what its compressing often, the person will have a headache, and there may be other types of deficits, sensory or motor or other kinds of deficits that are occuring depending on the location of that mass; now tumors are typically named for the type of cell that’s involved; most in cns are derived from glia, so gliomas?

Answer 9

consists of sudden attacks of excessive cortical neuronal discharge, and this interferes with brain function

Answer 10

and so a seizure is an involuntary movement that occurs, maybe a disruption of autonomic regulation or may consist of illusions?, hallucinations, auras, they’re not always medical emergencies when someone’s having a seizure? he had an experience- with a med student in a gross anatomy lab , and she had a seizure, and being in a med school theyr’e a lot of drs around and she had a lot of people attending to her and ambulance was called and she went to the ER and it turns out that she typically had these seizures several times a year and her usual reposne would be to go home and rest fo rthe afternoon and she’d be fine the next day after a period of rest and this was a typical presentaiton for her but reponse from everyone else involved was to get her to er to make sure she was ok different types of seizures, a tonic-clonic seizure presents with a contraction of the limbs, followed by extension and then arching of the back for a period of half a minute or so? there may be a an audible sound of a cry becasue of contraction of the chest muscles, forcing air out and then limbs begin to shake in unison after? the shaking has stopped , it may take a period of 10-30 minutes for the person to return to normal ? absence seizrues can be subtle ; may be only the slight turn of the head or a blinking in the eye ; the person won’t necessarily fall over and they may return to normal right after the seizure ends so its a very quick, short event, there may be a period of postictal? disorientation , but the actual seizure’s very short-lived so a seizure can last for a few seconds to more than five minutes ?, at which point, after that five minutes? its now known as status ? epilepticus? so most tonic-clonic seizures last less than 2-3 mins ? absence seizures are seconds in duration then after the active portion of the seizure , there is typically this period called the postictal? period where there may be some confusion before that normal level of consciousness returns postictal periods are mintues long - 3-15 mins long maybe and they could last for hours however? common sx after a seizure, include feeling tired, fatigue, headache, difficulty speaking, , and maybe some abnormal types of behavior fatigue is really common though and as i gave in the exmple with my med student, she had to just rest and then she was fine after a period of rest ?

Answer 11

in a medical emergency, it is key for bystanders to time the seizure because this contributes to the diagnosis and treatment

Answer 12

Corpus callosum = huge fiber bundle connecting the hemisphere * “Split Brain” * Surgical separation with cases of excessive neuronal activity * Limits activity to one hemisphere * Leads to poor communication between hemispheres and may perform conflicting tasks one tx for epilepsy involves separating the hemispheres by performing a callosotomy, essentially splitting the brain, surgically seaprating the hemispheres through the corpus callosum, and this is for excessive neuronal? activity, where the seizrues are difficult to contorl , they’re not able to manage them, and so they may opt for this surgical approach and so this effectively limits the activity of seizure, the excessive neuronal activity to one hemisphere ; the problem with this is that it leads to poor communciation between the hemispheres and so you may end up with some interesting side effects , such as either side of the body, performing conflicting tasks for example, a person may have one hand buttoning up a shirt, while the other hand is unbuttoning it and so usually a perosn’s able to accomodate over time with this and learn to control it and have one beocme the dominant one ?

Answer 13

* Mild TBI: concussion * Moderate to severe: MVA, military, falls, violence

Answer 14

can affect brain function, obviously so the question for you is what kinds of brain injury occur? and we’ll talk about mild tbi these are concussions, concussions is a mild traumatic brain injury and the effect of one concussion may not be all that significant but its the cumulative effects of these concussions over time that can have very delibating consequences there’s also moderate to severe types of tbis mvas most common but these are also common with war-fighting ; a marked increase in these moderate to severe brain injuries occurred after our engagement in some of the recent wars and the inroduction of ieds these moderate to severe brain injuriees can happen from falls , from violence, remerber news story about elderly man who was attacked and beat up with a brick - horrific violent act that had the potential for creating a severe traumatic brain injury so the brain injury occurs from direct impact, acceleration or deceleration of the brain within the skull and also a shock wave that may occur that impacts and compresses the brain tissue

Answer 15

* Coup contrecoup * Diffuse axonal injury injury refers to an injury to opposing sides of the brain the coup injury’s at the site of the blow and the contrecoup injury occurs on the opposite side due to rebound of the tissue inside the cranium tehre’s also you remember looking at the interior ?surfaces of the cranium and there are some ridges and lines and edges where the brain tissue can be damaged against as its forcefully moved within that cranium; (next bullet?) diffuse axonal injury refers to shearing? of the brain tissues, tearing of those long axons, those connecting nerve fibers and this happens whne the brain shifts and rotates inside the skull diffuse axonal? injury usually causes coma, and it causes injury to different parts of the brain, changes in the brain are often microscopic and they may not be evident even on ct scan or magnetic resonance imaging scan ? think of the different densities too of the brain tissue you’ve got various structures inside the brain; he always uses the example of jello that your grandma used to make with the bits and grapes and pieces of pineapple and walnuts inside the jello you’ve got different densities, so as that jello gets shaken up, the different density material or tissues is gonna move at different rates through that and so as that happens, they’re gonna pull and separate some of those fibers ?

Answer 16

* Personality * Cognition * Consciousness * Communication * Memory * Sensory * Autonomic function * Motor * Visual so this isn’t an exhaustive list but realize taht all of these things that occur with control or regulation in the brain can be impacted by traumatic brain injury?

Answer 17

* Working memory: temporary stage (temporary storage and manipulation of information; its goal-relavent information that’s retained for a short time, such as what you want to say next in a conversation ) * Declarative memory: facts, events, concepts, locations (information thats easily declared ; these are the facts, events, concepts, locations) * Procedural: knowing how to perform actions and skills (knowing how to perform actions and the movements that become skill and automatic due to that procedural memory ?)

Answer 18

* Maintains goal-relevant information for a short time * Essential for language, problem-solving, mental navigation, reasoning * Complex mental multitasking requires working memory, is central to cognition this uses prefrontal and temporaparietal association cortexes? cortex? this is one of the association cortex areas * Lateral prefrontal cortex and the temporoparietal association cortex maintain, manipulate, and update information in working memory

Answer 19

* Easily verbalized * Also called conscious or explicit memory * Requires attention during recall * Three stages: * Encoding, * Consolidation, * Retrieval what doing in pt school- trying to encode all of this info in declarative memory and then it must be consolidated and then hope to retrieve it at critcal points in time along your path here? retrieval part must be practiced just like you practice for motor skills - sport or instrument so here’s the areas of the brain involved in declarative memory medial temporal lobe is the hub of this type of memory, and its deep to this area here ?(i think he means the area in the dotted circle that says mtl?) so if we look in this frontal or coronal section, you can see some of the tissues making up this medial temporal lobe, and its the hippocampus and the parahippocampal gyrus, and there’s also an area called the fornix? thats part of this lobe? the temporoparietal association cortex that we talked about with working memory works with this medial temporal lobe to integrate and process perceptual information , and then the lateral prefrontal cortex organizes and categorizes the information for the medial temporal lobe so to retrieve stored memory, this lateral prefrontal cortex generates the cues that are needed or used to search those memories that’re encoded within this lobe here (i think he means the area in the dotted circle that says mtl?)

Answer 20

* Recall of skills and habits (brushing teeth- can do it without much thinking about it cause its in procedural memory?) * Also called nonconscious memory, or implicit memory * Includes perceptual and cognitive skill learning * Perceptual skills include object, pattern, and face recognition * Practice is required to store (and retention?) procedural memories has three motor learning stages here’s some of the areas involved in procedural memory these are the motor and premotor areas,? and there’s also some involvement with the parietal cortex,? and he believes this has to do with the sensation of the movement and then the supplementary motor area and the putamen and the globus pallidus or? of? the basal nuclei?; these are also involved in learning the sequencing of movement for a particular task and then it makes sense also that the cerebellum is involved in its role in adapting movement to changes in the environment, so those adjustments to the movement come from this area, of?? the cerebellum

Answer 21

* Motor learning stages 1. Cognitive–working to understand the steps of the task (like with learning modified gait- had to talk our way through it to get correct sequence initially?) 2. Associative–refining movements to most effective (getting more efficient, requires less thinking and cognition, and you’re increasing in your consistency with performing that skill or task ?) 3.Automatic–“walk and chew gum at the same time” (if you’ve practiced enough, you’d eventually get to automatic stage where the task could be said to be a motor skill, its an automatic skill ; you don’t have to think about it at all- could do it in your sleep; you can perform the motor task with your attention on something else; -his dad’s expression about walk and chew gum- if you couldn’t do that you were the epitome of clumsy ?)

Answer 22

* Comprehension of spoken language occurs in Wernicke’s area * Broca’s area, in the left frontal lobe, provides instructions for language output -Instructions consist of planning the movements to produce speech and providing grammatical function words, such as the articles a, and, and the communication-a two way street it requires transmission or expression and also receipt , so comprehension and expression comprehension of speech occurs in this wernicke’s area , and then broca’s area is involved in expression so you need both of these, you need the ability to receive the communication, and the ability to express in order to communicate effectively

Answer 23

* Interpretation of sensation into meaningful forms * Active process, requiring interaction* among the brain, the body, and the environment * Involves memory of experiences, motivation, expectations, selection of sensory information, and active search for pertinent sensory information *interpreting what you see for example involves the actual visual pathway from retina to visual cortex and then it also brings in memories of other visual experiences , predictions, associations with other senses , and it may involve moving your eyes or your body to get a better view or a better focus so all of this is involved in perception ?

Answer 24

* The area corresponding to Wernicke’s area comprehends spatial relationships, providing schemas of ... * Body * Body in relation to its surroundings * External environment Wernicke’s depends on ability to construct an image of one’s own body and the relation of that to its surroundings , so the body schema is a mental image of the arrangment of the body, and it allows us to navigate in our environment ; we can place ourselves mentally in our environment , and the schema of? the external world allows for bigger navigational tasks , so if you’re trying to plan a route from one site to another within our world, you have to use these body schemas or the schema? of the? external surroundings ? we’ll talk more specifically about some issues involved with this perception when we get into our sync session