Neuroanatomy Flashcards
1
Q
Primary Motor Cortex
A
Activating and Controlling motor acts
Get Arms and Legs and such where they need to be
2
Q
Premotor Cortex
A
Complex and Skilled movements
Speech, hand and finger movement
3
Q
Prefrontal Cortex
A
Reasoning, abstract thinking, self-monitoring, planning, decision making, pragmatic function social language
4
Q
Humunculus
A
Lips, Tongue, Larynx control are located near each other
5
Q
Specialized Communication areas
A
Primary Motor Cortex Auditory Cortex Arcuate fasciculus Visual Cortex Wernicke's Area Broca's Area
6
Q
Broca’s Area
A
Speech Production
Only left side
7
Q
Wernicke’s Area
A
Speech Reception
Only on left side
8
Q
Meninges
A
Membranes that envelop the CNS
Function is to protect
9
Q
Types of Meninges
A
Dura Mater
Arachnoid Mater
Pia Mater
10
Q
Arachnoid Mater
A
Vascularized
Function: Cushioning
11
Q
Dura Mater
A
Tough Mother
Most Superficial
12
Q
Pia Mater
A
thin
13
Q
Arcuate Fasciculus
A
Bundles of nerve fibers that work to help different parts of the brain to communicate
14
Q
Frontal Lobe Functions
A
-How we know what we are doing within our environment
-How we initiate activity in response to our environment
-Judgements we make about what occurs in our daily activities
-Controls Emotional Response
-Controls Expressive Language
-Assigns meaning to the words we choose
-Involves word associations
Memory for habits and motor activity
15
Q
Frontal Lobe Disorders
A
Paralysis Sequencing Loss of spontaneity in communicating with others (especially with Transcortical Motor Aphasia) Loss of flexibility in thinking Perseveration Attending Emotionally Labile Changes in social behavior and personality Broca's Aphasia
16
Q
Sequencing
A
Difficulty planning a sequence of cognitive or motor steps
17
Q
Perseveration
A
Persistence of a single thought
18
Q
Attending
A
Inability to focus on a task
19
Q
Emotionally Labile
A
Dramatic mood changes
Spontaneous often
Can be non related to emotions
Cry for no reason,
20
Q
Site of Damage for Broca’s Aphasia
A
Brodmann area 44
21
Q
Broca’s Aphasia symptoms
A
Production -Slow, laborious, and halting -Phonetic distortion -Perseveration (stuck in the tube until it can get out) Agrammatism or telegraphic speech Dysprosody Lots of fillers Relatively Good Comprehension and reading Poor Repetition
22
Q
Frontal Lobe Divisions
A
Primary Motor Cortex
Premotor Cortex
Prefrontal Cortex
23
Q
Parietal Lobe Functions
A
- Gross sensation of pain, temperature, touch, etc…
- Reading
- Naming
- Calculations and Arithmetic
- Cross modal integration of senses
Senses
Why playing the piano is supposed to help you with math.
24
Q
Parietal Lobe Disorders
A
- Contralateral neglect
- Motor apraxia
- tactile agnosia
- Inability to judge spatial relationships
- Anomia
- Agraphia
- Alexia
- Dyscalculia
25
Anomia
Inability to name an object
26
Agraphia
Difficulties with writing
27
Alexia
Difficulties with reading
28
Dyscalculia
Difficulty with doing mathematics
29
Cues that can help with Broca's Aphasia
Phonetic
Visual
Semantic
30
Example of Semantic Cue
The room is ____?
31
Example of Phonetic Cue
D____
| give the first sound
32
Example of Visual Cue
Show a picture of it or show the articulation
33
Emotional Lability
Spontaneous occurrences of emotion that are not what the person is meaning.
34
Melodic Intonation Therapy
Using different parts of the brain to help speech come out. Someone with expressive aphasia and they have difficulty getting words out. Ex. hand tapping, pitch
35
Tactile Agnosia
Can't tell what something is by touching it
36
"A-"
latin for no
- aphasia
- aphonia
- dysphasia- poor swallowing
- dysphonia-
37
Contralateral Neglect
Cortex is not perceiving the information on the opposite side of the body from the brain injury. Have to train the brain to attend to that side. They ignore it and you have to bring their attention to it.
Ignoring the left visual field typically
38
Causes of Contralateral Neglect
Stroke or Traumatic Brain Injury
39
Occipital Lobe Functions
Visual Processing
40
Occipital Lobe Disorders
- Contralateral Visual Field Neglect - signal is not getting processed
- Difficulty with locating objects in environment
- Color Agnosia
- Cortical Blindness
41
Color agnosia
Difficulty Identifying Colors
42
Cortical Blindness
Cortex is not processing what you are seeing,
43
Temporal Lobe Functions
Hearing ability
language comprehension
Lexical comprehension
memory encoding
44
Areas/ Structures in Temporal Lobe
Heschl's Gyrus
Wernicke's Area
Arcuate Fasciculus
45
Temporal Lobe Disorders
| Left Hemisphere
- Hearing/Comprehension deficits
- Aphasia
- Dementia
- Sexual Dysfunction
- Increased aggression and agitation
46
Aphasia Definition
Language Deficits
47
Types of Aphasia
```
Comprehension
Verbal Production
Written Language
Reading
Verbal Memory or Word-Finding
Repetition
```
48
Temporal Lobe Disorders
| Right Hemisphere
```
Nonverbal Memory
Loss in ability to discriminate tones/ musical ability
Deficits in attention
Difficulties with humor and inferences
Pragmatic impairment
```
49
CVA
CerebroVascular Accident
50
Wernicke's Aphasia Production
```
Fluent
Semantically inappropriate
Paraphasias are common
sometimes called "cocktail hour speech"
Augmentation
Prosody still intact
Articulation is normal
Empty Speech
Jargon
Logorrhea/press speech
Circumlocution
Word Finding
```
51
Logorrhea or Press of Speech
Phenomenon characterized by continued talking, with little to no turn taking. Clients often have to be interupted
52
Broca's Aphasia Writing Charateristics
- often write as they talk
- slow and laborious
- frequent misspellings and letter omissions
- often slant down across page
- rarely write in cursive
53
Mr. Tant
The first documented case of Broca's Aphasia
54
Broca's Aphasia Recovery
spontaneous in the first few weeks, after 2 years it is a flatter recovery curve
55
Occipital Lobe Function
Visual Processing
56
Occipital Lobe Disorders
```
Contralateral visual field neglect
Difficulty with locating objects in environment
Color Agnosia
Cortical blindness
› Confabulate descriptions and scenes
```
57
Color Agnosia
Difficulty with identifying colors
58
Temporal Lobe Areas or Structures that are specialized for communication
Heschl's Gyrus
Wernike's Area
Arcuate Fasciculus
59
Heschl's gyrus
Cortical center for hearing
60
Wernicke's Area
Language Comprehansion
61
Arcuate Fasciculus
Axonal bundle connecting Wernicke's area to Broca's area
62
Dementia
Deficits in memory
63
Paraphasias
Close to the word but not quite saying it
64
Augmentation
Complicating a repeated utterance by adding words and paraphasias
65
Prosody intact
Speech sounds normal but content is meaningless
66
Empty Speech
Substituting general words without referents
| for more specific words
67
Jargon
Strings of neologisms with scattered connected words.
68
Circumlocution
Behavior where patient talks around missing words, knowing the concept but not the word.
69
Wernicke's Aphasia Comprehension
Usually impaired
In severe cases patients may not understand single words
Language spoken or in visual form (including their own speech)
may have pure word deafness or blindness.
70
Wernicke's Aphasia- Repetition
Fluent
| Grossly restricted retention span
71
Wernicke's Aphasia Writing
Writing resembles their speech (The letters are well formed and legible, but it often doesn't make sense. Interestingly, most will use cursive)
Paraphasias in the speech usually show up in writing too
Logorrhea also occurs in their writing
72
Anosognosia
Patients tend to show a lack of awareness or outward concern about their communication problems.
73
Limbic Lobe Functions
Autonomic
-Food and water intake
-body temperature
Hormone and neurotransmitter release
74
Neurodiagnostic Techniques
```
X-ray
CT Scan
MRI
PET Scan
EEG
ERP
```
75
X-ray
```
Stuctural
Radiation (film)
2-D, not very detailed
Grey Scale according to detail
Inexpensive
Sometimes used with radio-opaque dyes
```
76
CT Scan- definition
Computerized Tomography
77
CT Scan
Structural
Radiation
>Narrow radiation beam generators rotate axially
around the patient
› Radiation detectors instead of film are used to
analyze the radiation beams
› The scanner moves up or down the body in
regular steps creating a series of image “slices”
3-D, average detail
› Permits visualization of soft tissues not available
from regular X-Ray
78
MRI- Definition
Magnetic Resonance Imaging
79
MRI
```
Structural
No Radiation
3-D, high detail
Relatively expensive
Pace-makers and metal objects interfere with scan
```
80
PET Scan
```
Functional
Some Radiation
Glucose is tagged with a radio-isotope
3-D, average detail
Color-coded
```
81
EEG -Definition
Electroencephalogram
82
EEG
- Measures brain electrical activity; time varying voltages occurring at different frequencies
- Functional measure
- Poor spacial resolution, good temporal resolution
83
ERP-definition
Evoked Related Potential
84
ERP
-Changes in the electrical activity of the
neurons that are temporally associated with
physical stimulus or psychological
processes.
-Either negative or positive peaks
-It’s hard to pick out an ERP from an EEG, so
they will average episodes of the same
task.
85
Nervous Systems
CNS and PNS
86
CNS
brain and spinal cord
87
PNS
exists and extends outside CNS
88
CNS Types of Cells
Neurons
| Neuroglia
89
Neurons
```
-Basic building block of the CNS
-15 billion in the CNS
Three basic sections
1) Dendrites
2) Cell Body
3) Axon
```
90
Neurotransmitters
```
Acetylcholine
Dopamine
Norepinephrine
Serotonin
GABA
Peptides
```
91
Acetylcholine
› Major chemical messenger that controls
voluntary movements
› Acetylcholinestrase: beaks down and dissolves
Acetylcholine in the synaptic gap.
› Myasthenia Gravis: disease characterized by
muscle weakness that becomes worse with
exercise
92
Dopamine
› Facilitates motor function
› Parkinson’s disease: tremor, reduced movement,
dysarthria
› Some recreational drugs (LSD) cause excessive
dopamine release
› El Dopa
93
Norepinephrine
› Regulates sleep, attention, and moods.
| › Treatment of depression
94
Serotonin
› Regulates sleep, emotion, and pain regulation.
› 95% of serotonin found in the peripheral nervous
system.
95
GABA (Glutimate aminobutyric acid)
Regulates Pain Perception
96
Peptides (larger molecules)
Regulate pain perception
97
Neuroglia
Support and protect neurons
40-50 times the number of neurons
4 types in CNS
98
Types of Neuroglia
```
CNS
Astrocytes
Oligodendrocytes
Microglia
Ependymal Cells
PNS- Schwann cells
```
99
Astrocyted
Form supporting network in brain
Form in blood vessel to provide blood-brain barrier
Form scar tissue around dead brain cells
100
Oligodendrocytes
Myelinate axons in the CNS
101
Microglia
Scavengers of the CNS
| Engulf dead brain tissue and remove it from the lesion site
102
Ependymal Cells
Contribute to the blood-brain barrier
| Form lining inside ventricles where the choroid plexus secrete CSF
103
Schwann Cells
Myelinate axons in the peripheral nervous system
104
Brain Protective Systems
Scalp, Skull, Dura Mater, Blood-brain barrier, Cerebral Spinal Fluid (CSF), Collateral circulation
105
Brain vulnerabilities
Acute events and processes
| Insidious events and processes
106
Acute events and proceses
Brain requires a constant supply of oxygen and glucose- especially intolerant of sudden decreases in oxygen, which are often signaled by a rapid decrease in cognitive functioning
107
With oxygen brain tissue can become necrotic in ____ (time)
3-5 Minutes
108
Necrosis
Death of tissue
109
Infarct
Necrosis of brain tissue caused by lack of oxygen (sometimes used to refer to a specific type of stroke)
110
Stroke or Cerebrovascular Accident
| Per year?
500,000
111
Number of living stroke survivors in USA
2 million people
112
Percent of people who return to their pre-stroke living environment, most with some impairment of the ADL's
85%
113
Stroke is the __ leading cause in the US
3rd
114
First major classification of CVA
Ischemic 80%
115
Ischemic
Occlusion within a artery causing decreased overall blood flow; artery walls stay intact.
116
Types of Ischemic CVA
Thrombosis (insidious process)
Embolism (acute process)
TIA (Transient ischemic attack)
117
Thrombosis
Insidious process
| Gradual occlusion of artery, usually by plaque or fatty buildup in areas of slowed blood flow or bifurcation
118
Embolism
```
Acute Process
artery is
occluded by a mass flowing in the
bloodstream, often a disturbed piece of
plaque or fatty buildup.
```
119
Second major classification of CVA
Hemorrhagic (20%)
120
Hemorrhagic
Decreased overall blood flow caused by rupture in the vessel wall
121
Types of hemorrhagic CVA
Intracerebral
| Extracerebral
122
Intracerebral __location
Often in region of brainstem
123
Intracerebral ___
Aneurysm
Elevated blood pressure
AVM (arteriovenous malformation)
124
Aneurysn
ballooning or weakness in vessel wall, usually genetically determined
125
Arteriovenous malformation (AVM)
malformed or tangled mass of arteries and veins, usually genetically determined.
126
Extracerebral hemorrhagic CVA
Bleeding into the space between the meninges often caused by TBI
127
Epidural Hematoma
bleeding between the dura mater and the skull
128
Subdural hematoma
Bleeding between the dura mater and the arachnoid membrane
129
Types of an Extracerebral hemorrhagic CVA
Epidural hematoma
| Subdural hematoma
130
Brain vulnerabilities: acute evens and processes
Brain requires constant supply of oxygen and glucose
| Impact trauma & sudden acceleration or deceleration
131
TBI Incidence in US
7 million incidents each year
132
TBI common causes
2/3 caused by MVA
| most of rest by falls and assault
133
Prevalence of TBI
Occurs more often in Males than in Females
| Most common 15-25 years of age
134
Risk factors for TBI
```
-Alcohol and drug abuse
-School adjustment and social
history
-Socioeconomic status
-Personality type: A>B
-Previous history of TBI
-Participation in sporting events
```
135
Sports that present a higher risk for TBI
1. Boxing
2. Motorcycling
3. Bicycling
4. Rock-climbing
5. Horse-riding
6. Hockey
7. Football
136
First major classification of TBI
Penetrating
137
Penetrating TBI
Perforates or fractures the
skull and penetrates brain tissue.
• Damage is often focal in nature
• Mortality rate is high if in the brainstem area
• However, if patient survives initial injury; prognosis for recovery is often surprisingly
good
138
Second major classification of TBI
Non-Penetrating (Closed-head)
139
Non penetrating TBI
Skull stays intact
140
Types of Non-penetrating TBI
Non-acceleration injury
| Acceleration injury
141
Non-acceleration injury
Head is not moving at time of impact
142
Type of non-acceleration injury
Impression trauma
143
Impression Trauma
Skull deforms at point of impact
144
Types of Acceleration Injury
Linear acceleration injury
| Angular acceleration injury
145
Linear acceleration injury
Linear path of acceleration through center axis
| -coup/contre-coup
146
Angular acceleration injury:
off-center acceleration causing rotation of skull and brain
| -Diffuse Axonal Injury (DAI)
147
Insidious Processes (Types)
```
Brain Tumors
Hydrocephalus
Infections
Toxictes
Metabolic disorders
Nutritional disorders
```
148
Primary brain tumors common age
all ages
149
Brain tumor type that are more common in adults
Metastic Brain Tumors
150
Second most common cause of cancer death in children up to 15 years old
Primary Malignant brain tumors
151
How common brain tumors are as cause of cancer death
second most common cause in people ages 15-34
| third most common cause in males ages 35-54
152
1990 Primary Malignant Brain Tumor stats
1.5% of all cancers diagnosed and 2% of the cancer deaths.
153
Causes of a brain tumor
The cause of primary brain tumors is
unknown.
Environmental agents, familial tendencies, viral causes, and other
possibilities are under investigation.
154
T/F Brain tumors are contagious
FALSE
155
Intracranial Tumors
Abnormal growth of tissue mass
156
Primary Intracranial Tumors
Originate at the site
157
Secondary Intracranial Tumors
Travel to the site. The process by which tumors appear at a secondary site is called metastatic tumors
158
Benign brain tumors
consists of benign (harmless) cells and has distinct boundaries. Surgery alone may cure this type of tumor
159
Malignant brain tumor
These tumor cells are life-threatening. It may be
malignant because it consists of cancer cells that metastasize, or it may be called malignant because of its location in the brain. Thus, a brain tumor composed of benign cells--but located in a
vital area--is still considered malignant.
A malignant brain tumor will often metastasize to other locations in the brain or spinal cord, growing
the way a plant does, with "roots" invading various tissues. Or, they can shed cells that travel to distant
parts of the brain. Some cancerous tumors, however, remain localized. Such brain tumors seldom metastasize outside the brain and spinal cord.
160
Common types of primary brain tumors
```
Most primary brain tumors originate from glial cells
› Astrocytomas
› Ependymomas
› Oligodendrogliomas
Meningiomas
```
161
Meningiomas
Tumors that arise from the dura mater
162
Acoustic Neuromas
Arise from the Schwann cell sheath of the acoustic nerve. It is located in the angle between the
cerebellum and the pons, in the posterior fossa. This tumor grows very slowly.
163
Occurance of Acoustic Neuromas
Occur in adults, particularly in
their middle years. Females are twice as likely to
have this tumor as males.
164
Acoustic neuromas account for ____% of all brain tumors
9%
165
Common symptoms of acoustic neuromas
loss of hearing in one ear and buzzing or ringing in the ear (tinnitus). If the tumor also affects the adjacent 7th nerve (facial nerve), facial paralysis and loss of facial sensation may occur. Other symptoms may include difficulty
in swallowing, impaired eye movement, and taste disturbances
166
Treatment for brain tumors
```
Surgical Resection
› Scalpel
› Laser
› Ultrasonic aspiration
Radiation therapy
› Beam
› Seeds
Chemotherapy
Immunotherapy
Genetic Therapy
```
167
Types of Hydrocephalus
Obstructive
| Nonobstructive
168
Obstructive Hydrocephalus
- where
- treatment
- description
› Cerebral aquaduct (narrow passage between
the 3rd and 4th ventricles)
› Causes increase in ICP (intracranial pressure)
› Often treated by intraventricular shunt
169
types of brain infections
Bacterial
| Viral
170
Bacterial Brain Infections
Bacterial Meningitis
| Brain Abscess
171
Bacterial memingitis
results in a swelling of the meninges
172
Brain Abscess
bacteria, fungus, or parasites
introduced into the brain tissue, usually through
the nasal sinuses or middle ear.
173
Viral Brain Infections
HIV
| Rabies
174
Toxcities
Drug Overdoses
Bacterial: tetanus, botulism
Metals: lead, mercury
175
Types of Metabolic disorders
Severe Hypoglycemia
| Thyroid Disorders
176
Severe Hypoglycemia
Low blood sugar
177
Thyroid Disorders
imbalance in thyroid
hormone, which helps cells convert glucose
into energy
178
Nutritional Disorders
Wernicke's encephalopathy
| Vitamin A Overdose
179
Wernicke’s encephalopathy
caused by Thiamine deficiency
180
Writing form Wernike's Patients
Mostly in Cursive
181
Writing form most common for Broca's patients
Print
182
Ischemic Stroke
Blocks bloodflow
183
Hemorrhagic stroke
bleeding into the brain
184
Limbic System Parts
```
Mammillary body
Pituitary
Amygdala
Hippocampus
Hypothalamus
Thalamus
Fornix
Cingulate Gyrus
```
