Neuroanatomy Flashcards
Pharyngeal innervation
X and XI
Styloglossus
Draws tongue up and back, may draw sides of tongue upward to help make dorsum concave
Afferent neurons
Sensory, transmits information toward the brain
Transcortical motor aphasia site of lesion
Left frontal lobe involving prefrontal and premotor cortices, watershed area between MCA and ACA, lesion superior often anterior to Broca’s area, extend into white matter including white tater below Broca’s, communication between Broca’s area and the pre-motor or supplementary motor area is cut off, lesion near the Broca’s area may also cause damage to connections between Broca’s and the basal ganglia
Efferent neurons
Motor, transmit information away from the brain
MCA
Supplies lateral surface of cortex including major regions of frontal lobe
ACA
Supplies middle portion of parietal/frontal, supplies blood to the corpus callosum and basal ganglia
External CA
Supplies blood to mouth, forehead, nose, face
Internal CA
MCA and ACA, Supplies to the brain
Corticospinal tract
Decusate at medulla, innervates muscle of limb/truck, opposite
Cerebellum
Regulates body posture, equilibrium, and coordinated fine motor movement
Corpus striatum
3 nuclear masses: Globus pallidus, caudate nucleus, and putamen
Extrinsic laryngeal muscles (elevators)
Digastrics (V, VII) , geniohyoids (XII), mylohyoids (V), stylohyoids (VII)
Infrahyoids
Depress larynx (thyrohyoid, omohyoid, sternohyoid, stemothyroid)
CN X
Vagus nerve, larynx, respiratory, GI, cardiac
CN V
Trigeminal nerve, face (sensory) jaw (motor)
Superior longitudinal muscle
Shortens tongue, turns tip upward
CN XI
Spinal accessory, shoulder, arm/throat
Lateral cricoarytenoid
Adduct VF, increase medial compression
CN XII
Tongue movements
Angular gyrus
Parietal lobe
Commissural fibers
Connect cerebral hemisphere, corpus collosum connects two hemispheres at the base
Transverse arytenoid
Adduct VF
Oblique arytenoid
Pull apex of arytenoid in a medial direction
Aryepiglottic folds
Composed of a ring of connective tissues and muscle extending from the tips of the arytenoid cartilages to the larynx. They separate the laryngeal vestibule from the pharynx and help preserve the airway.
Intrinsic laryngeal muscles
Mostly innervated by recurrent laryngeal nerve branch of CN X except cricothyroid innervated by superior laryngeal nerve. Muscles: thyroarytenoids, lateral cricoarytenoids, transverse arytenoids, cricothyroids, posterior cricoarytenoids
Association fibers
Connect within hemisphere, arcuate fasciculus connects Broca’s and Wernicke’s.
Diencephalon
Structure adjacent to the brainstem that contains the hypothalamus and the thalamus
Hemorrhagic
Bleeding in the brain due to ruptured blood vessels; bleeding may be intracerebral (within brain) or extracerebral ( within meninges)
Projection fibers
Cortex, cerebellum, BG, spinal cord, brainstem
Cricothyroid
Lengthen and tense VF, controls pitch
Arytenoid cartilage
Small, Pyramidal shaped cartilage is connected to the cricoid through the cricoarytenoid joint
Extrinsic laryngeal muscles (depressors)
omohyoids, sternothyroids, sternohyoids
Chondroglossus
Depresses tongue
Bernoulli effect
Increased speed of air passing between the VF, “sucking” motion of the VF toward one another
Wernicke’s aphasia
Posterior portion of the superior temporal gyrus in the left hemisphere Brodmann’s 22, posterior region of middle and inferior temporal gyri, damage often extends into parietal lobe affecting the angular gyrus and the supramarginal gyrus
Intrinsic tongue muscles
Innervated by XII. Muscles: superior longitudinal muscle, inferior longitudinal muscle, transverse muscles, vertical muscles
Genioglossus
Forms bulk of tongue, is able to retract tongue, draws tongue downward, draw entire tongue anteriorly to protrude tip or press against alveolar ridges and teeth
Inferior longitudinal muscle
Shortens tongue, pulls tip down
Transverse muscles
Narrow and lengthens tongue, moves tongue left-right
Thyroarytenoid
Internal thyroarytenoid are primary portion of VF that vibrate and produce sound
Broca’s aphasia
Left posterior inferior frontal gyrus (Brodmann 44 and 45), extends into white matter, BG and Insula, frontal operculum, pre-motor areas anterior motor strip, motor areas above and behind Broca’s area
Transcortical motor aphasia core features
Little or no paraphasias, difficulty initiating and organizing responses, fair to excellent auditory comprehension, confrontational naming is preserved, spared repetition, upper extremity rigidity
Hyoglossus
Retracts and depresses tongue
Non fluent aphasia
Limited, agrammatic effortful, halting, slow speech with impaired prosody
Global aphasia site of lesion
Occlusion of MCA prior to its branching causes extensive damage to frontal, temporal, and parietal region’s involving both Broca’s and Wernicke’s, the larger the lesion the more severe the aphasia, due to large area of injury in the Perisylvian area
Aphasia
Acquired communication disorder caused by brain injury affecting four modalities: reading, writing, speaking, listeningNeurogenic, acquired, affects language, excludes sensory and mental deficits
Ischemic
Occlusion of an artery-atherosclerosis or arteriosclerosis (narrowing of the arteries)
Myoelastic-aerodynamic theory
VF vibrate because of the forces and pressure of air and the elasticity of the VF
Lamina propria
Middle layer of the VF, Three layers: superficial (Reinke’s space), intermediate, and deep
CN VII
Tongue (sensory) face (motor)
Posterior cricoarytenoid
Abduct VF
Vertical muscles
Flattens tongue, moves it up and down
Global aphasia core features
Significant loss of language comprehension and expression, impaired reading and writing abilities, auditory comprehension severely impaired, repetition and confrontation naming impaired
Global aphasia treatment
Recovery generally poor, visual action therapy: client is trained to associate drawings with objects and actions, for severe globally aphasic people, goal is to use functional gestures for visually absent stimuli, no verbalization is permitted during training
Transcortical motor aphasia treatment
Reading (can be used to prime language system), pragmatic activities (use pictures to elicit single words), drilling (to increase repetition ability)
Wernicke’s aphasia core features
Paraphasias (word substitutions), neologisms (new words), impaired reading and writing, poor auditory comprehension (primary deficit), impaired repetition and confrontation naming (word finding problems are very common), anosognosia (lack of awareness of their communication problems)
Wernicke’s aphasia treatment
Initial focus auditory comprehension and self-monitoring skills, listening to simple instructions and pointing, slow rate of speech, gestural stop cues, remind patient to listen to him or herself, PACE promoting aphasias communicative effectiveness: Focus is to use new information, describing unknown pictures
Broca’s aphasia core features
Agrammatism, telegraphic speech, good aud comp, aware of deficits, repetition impaired, confrontation and response naming and word finding impaired
Broca’s aphasia treatment
MIT, Helm elicited language program of syntax stimulation (targets agrammatism), response elaboration training (elaborate on picture stimuli discourage from naming), Schuells stimulation approach (Intensive auditory stimulation)
Anomic aphasia site of lesion
Hardest to localize, angular gyrus (parietal lobe), which causes alexia and agraphia, temporal parietal area
Anomic aphasia core features
Word retrieval deficits, naming problems, circumlocutions, reading and writing are variable with abilities ranging from normal to very poor, good auditory comprehension, have awareness of deficits, repetition is not impaired
Anomic aphasia treatment
Promoting aphasics communicative effectiveness (PACE), social approach: conversational approach (practice communicative scenarios with SLP)
Conduction aphasia site of lesion
Damage to the arcuate fasciculus, Broca’s and Wernicke’s are intact but disconnected because of injury to connecting fibers, insula and underlying white matter of left hemisphere, small lesion in Wernicke’s area, lesions also found in perisylvian area of cortex, superior temporal gyrus, primary auditory cortex, auditory association areas
Conduction aphasia core features
Difficulties with word retrieval, good auditory comprehension because Wernicke’s area is not damaged, awareness of deficits, good reading comprehension, impaired repetition, ideomotor apraxia (impaired in performing movements to command and to imitation)
Conduction aphasia treatment
Repetition is target of therapy, word retrieval, productive circumlocution, divergent word retrieval (naming task are convergent)
Transcortical sensory aphasia site of lesion
Lesion in the temporo-parietal region, especially in the posterior potion of the middle temporal gyrus, which is supplied by the posterior branches of the left middle cerebral artery, seen in frontal lobe injuries, supplied by portions of the PCA and in MCA or the watershed areas between them
Transcortical sensory aphasia core features
Fluent, impaired comprehension, relatively spared repetition (Hallmark, differentiating factor between Wernicke’s and Conduction aphasia), alexia, anosognosia
Transcortical sensory aphasia treatment
Treatment approaches could be based on the functional nature of the deficit, no efficacy studies today, refer to intervention methods in theory for fluent aphasia
Left hemisphere
Contains the person’s language center, depending on where the damage occurs speech and language deficits will vary
Right hemisphere
Controls cognitive functioning (thinking skills), damage to the right hemisphere of the brain leaves to cognitive communication problems displayed by impairments in the area of: memory, attention, reasoning, organization, orientation, problem-solving, pragmatics and left side neglect
Open head injury
Penetrating, results when scalp and skull are penetrated, torn or lacerated meninges, and injury extends into brain tissue
Obicularis oris
Primary muscle of the lips, unpaired sphincter muscle, oval ring of intrinsic and extrinsic muscles
Serratus, lavatory costarum brevis/longis
Elevates rib cage
Close head injury
Coup/contrecoup injury, acceleration/deceleration injuries due to forces that tear, stretch, or shear microscopic structures, non-acceleration injuries occur when a head is hit by a moving object
Edema
Brain swelling
Hypoxia
Oxygen deprivation
Parietal pleura
Covers the inside of the thoracic cavity
Ischemic brain damage
Damage due to lack of blood
Infarction
Stroke like effects that result in death of cell tissue
Hemorrhagic
Bleed in the brain (blood clot)
Thrombosis
Occlusion of a blood vessel
Embolism
Traveling mass from blocked artery or tumor, gets lodged in smaller artery and blocks blood flow
TBI etiology
Any damage to the right hemisphere, could be caused by: stroke, tumor, head injury, disease processes
Spinal column
Consists of 32 or 33 vertebrae, 7 cervical vertebrae, 12 thoracic vertebrae, 5 lumbar vertebrae, 5 sacral vertebrae, 3-4 coccygeal vertebrae
Sternum
Manubrium-head, provides attachment for clavicle and first rib, corpus of sternum-body, ribs 2 to 7 attach, xiphoid process-the very bottom part
Rib cage
Consist of 12 pairs of ribs, ribs 1-7: true ribs, because they are attached anteriorly to sternum, ribs 8, 9, 10: false ribs, ribs 11 & 12: floating ribs
Visceral pleura
The serous (wet) membrane that covers the surface of each lung
Cricothyroid
Tensor
Zygomatic
Muscle located from the cheekbone to the mouth, helps draw the corners of mouth up
Lungs
When respiratory system is at rest, lungs are partially inflated to approximately 40% of their total lung capacity, right lung is shorter, broader, and bigger than the left lung because of the liver, right lung has three lobes & left lung has two lobes
Internal intercostals
11 unpaired, Pulls the ribs downward to decrease the diameter of the thoracic cavity for exhalation
External intercostals
11 paired, raise the ribs up and out to increase the diameter of the thoracic cavity for inhalation
Crossbite
Extension of upper teeth beyond the normal line of occlusion
Latissimus dorsi
Stabilizes the posterior abdominal wall for expiration
Rectus abdominus
Flexes vertebral column
Transversus abdominus
Compresses abdomen
Internal oblique abdominus
Compresses abdomen, flexes and rotates trunk
Quadratus lumborum
Supports abdominal compression through bilateral contraction, which fixes abdominal walls
Interarytenoid
Adductor
Thyroid cartilage
Form the anterior and lateral walls of the larynx and protects the larynx
Larynx
Muscularcartilaginous, unpaired, midline structure in the anterior neck, about level C3 to C6
Hard palate
Roof of the mouth covered with a mucous membrane consisting of rugae
Cricoid cartilage
Uppermost tracheal rings, linked with the thyroid cartilage and paired arytenoid cartilages
Thyroarytenoid
Thyromuscularis: more lateral band relaxorThyrovocalis: more medial, forms the main mass of the vibrating vocal fold tensor
Cuneiform cartilage
Located under the mucous membrane that covers the aryepiglottic folds. They served to stiffen the aryepiglottic folds
Lateral cricoarytenoid
Adductor
Conus elasticus
Intrinsic laryngeal membrane sheet made of fiber that has elasticity, goes from thyroid cartilage, cricoid cartilage, and arytenoid cartilage
Hyothyroid membrane
Extrinsic laryngeal membrane goes from thyroid to the hyoid bone
Palatoglossus
Lower the soft palate or raise the back of the tongue
Vocal folds
Three layers: epithelium (outer cover), and lamina propria (middle layer), vocalis muscle
Oral cavity
Responsible for production of all English sounds, except the nasal phonemes
Formant frequencies
Resonances in the vocal tract, vary by person, sex, and age
Nasopharynx
Adds resonance to /m/ /n/ /ng/
Buccinator
Paired cheek muscle
Laryngopharynx and oropharynx
Responsible for adding resonance to sounds produced by the larynx
Glossia
No tongue
Macroglossia
Too large of a tongue
Glossia
No tongue
Zygomatic
Muscle located from the cheekbone to the mouth, helps draw the corners of mouth up
Soft palate
Or velum made of muscular tissue attached to the Palitine bones, relaxes and hangs in the oropharynx
Frontalis
Muscle is unpaired and moves the eyebrows
Microglossia
Too small of a tongue
Subglottal pressure
Builds and when it is sufficient to overcome medial compression, the folds will again blow apart and then begin to approximate because of tissue elasticity, then the Bernoulli effect takes over again
Corniculate cartilage
Sit on the apex of the arytenoids
