Student Notes - Localization Flashcards
How does a patient with a frontal lobe lesion present? If the lesion is anterior to the pre-central gyrus, what is the consequence to the patient? What if the lesion is extensive? What pathological reflexes are present in a frontal lobe lesion?
1) Apathetic with flat personality
2) Profound intellectual dysfunction
3) Expressive aphasia
4) Grasp reflex, snout reflex, and suck reflex
Remember that if the motor cortex is not involved, there will be no weakness
What effect on language can a temporal lobe lesion have? When does memory loss occur in a temporal lobe lesion? What type of emotional disturbances are seen?
1) Wernicke’s area damage can cause a receptive aphasia. The patient cannot understand what is being told to him. The faculty of this language is located in the dominant hemisphere
2) Memory loss occurs if the temporal lobe lesion is bilateral and extensive
3) Social inhibition and sexual disturbances/inappropriateness
Where is Broca’s area located? Where is Wernicke’s area located?
1) Inferior frontal gyrus
2) Superior temporal gyrus
How are fluency, comprehension, repetition, and naming affected in an expressive aphasia (Broca’s)?
1) Fluency: Impaired
2) Comprehension: Normal
3) Repetition: Impaired
4) Naming: Impaired
How are fluency, comprehension, repetition, and naming affected in an receptive aphasia (Wernicke’s)?
1) Fluency: Normal
2) Comprehension: Impaired
3) Repetition: Impaired
4) Naming: Impaired
How are fluency, comprehension, repetition, and naming affected in a conduction aphasia?
1) Fluency: Normal
2) Comprehension: Normal
3) Repetition: Impaired
4) Naming: Normal
How are fluency, comprehension, repetition, and naming affected in a transcortical motor aphasia?
1) Fluency: Impaired
2) Comprehension: Normal
3) Repetition: Normal
4) Naming: Impaired
How are fluency, comprehension, repetition, and naming affected in an transcortical sensory aphasia?
1) Fluency: Normal
2) Comprehension: Impaired
3) Repetition: Normal
4) Naming: Impaired
How are fluency, comprehension, repetition, and naming affected in a mixed transcortical aphasia?
1) Fluency: Impaired
2) Comprehension: Impaired
3) Repetition: Normal
4) Naming: Impaired
How are fluency, comprehension, repetition, and naming affected in a global aphasia?
1) Fluency: Impaired
2) Comprehension: Impaired
3) Repetition: Impaired
4) Naming: Impaired
How are fluency, comprehension, repetition, and naming affected in an anomic aphasia?
1) Fluency: Normal
2) Comprehension: Normal
3) Repetition: Normal
4) Naming: Impaired
What does damage to the postcentral gyrus in the parietal lobe cause? What functional losses can arise from a lesion to the parietal lobe? What sensory functions generally remain intact when there is a lesion to the parietal lobe? What function is lost if the nondominant parietal lobe is affected?
1) Sensory loss. This is usually light touch and position on the contralateral side
2) Cortical lesions cause a loss of fine sensory dysfunction, i.e. two point discrimination, stereognosis, and graphesthesia
3) Deep pain, temperature, and vibratory sensation are usually intact
4) Visuospatial functions
What do occipital lobe lesions usually cause a loss of function in?
Visual field defects such as homonomous hemianopsia
What manifestation does a basal ganglia lesion cause?
Motor disability on the contralateral side, but no sensory loss
What manifestation does a thalamic lesion cause?
Sensory loss on the contralateral side, but no weakness
What manifestation does a cerebellar lesion cause?
Ataxia and intention tremor on the ipsilateral side
What manifestation does a brainstem lesion cause?
Mixed/crossed sensory and motor findings, i.e. ipsilateral face and contralateral body, cranial nerve abnormalities
What manifestation does a spinal cord lesion cause? What are the three sensory pathways in the spinal cord? What do the posterior columns control? What do the spinothalamic tracts control? What do the anterior spinothalamic tracts control?
1) Sensory/motor level of dysfunction
2) Posterior column, spinothalamic tract, anterior spinothalamic tract
3) Position and vibration; light touch
4) Pain and temperature
5) Light touch
Upon inspection of a patient on physical exam, how do the muscle bulk and fasciculations differ between an upper motor neuron (UMN) lesion, lower motor neuron (LMN) lesion, and myoneural junction?
1) UMN - no wasting, no fasciculations
2) LMN - wasting and fasciculations
3) Myoneural junction - wasting, but no fasciculations
How does power differ between a patient with an upper motor neuron (UMN) lesion, lower motor neuron (LMN) lesion, and myoneural junction?
1) UMN - Decreased strength
2) LMN - Decreased strength
3) Myoneural junction - Decreased strength, fatigue
How does tone differ between a patient with an upper motor neuron (UMN) lesion, lower motor neuron (LMN) lesion, and myoneural junction?
1) UMN - Hypertonic, (+) clonus, spastic
2) LMN - Hypotonic, (-) clonus, flaccid
3) Myoneural junction - Hypotonic, (-) clonus, flaccid
How do reflexes differ between a patient with an upper motor neuron (UMN) lesion, lower motor neuron (LMN) lesion, and myoneural junction?
1) UMN - Hyperreflexic, (+) Babinski
2) LMN - Hyporeflexic, normal plantars
3) Myoneural junction - Hyporeflexic or normoreflexic, normal plantars
