Week 21 lectures Flashcards

1
Q

What are Brodmann’s Areas? How many layers are in the brain?

A

-A way of classifying different
regions of cortex based on
microscopic appearance and
function

-Cortex has 6 cell layers; The
thickness of different layers in a
region will depend on the
function of that region

-52 cytoarchitectonic areas, each
assigned a number

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2
Q

Primary Cortex

A

responsible for a specific, singular
function: receives sensory information or executes motor
tasks

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3
Q

Association Cortex
What are the two types?

A

shares information with primary
areas and is involved in higher-order processing,
integrating and interpreting information

Unimodal=areas responsible for higher-order processing
of a single sensory or motor modality; located adjacent to
primary areas

Heteromodal=areas responsible for integration from
multiple sensory and/or motor modalities

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4
Q

Which hemisphere is a language primarily processed on?

A

The left side

Left hemisphere in >95% of right-handed people
Left hemisphere in ~70% of left-handed people

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5
Q

Which hemisphere is usually responsible for non-verbal aspects of communication such as prosody

A

The non-dominatne side

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6
Q

Frontal lobe

A

-Largest region of the brain, >1/3 cortex
-Separated from parietal lobe by central sulcus; from
temporal lobes by Sylvian fissure

—motor planning and execution;
restraint, initiative, order, language production, praxis,
eye movements

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7
Q

Primary Motor Cortex

A

(Precentral gyrus, “motor strip”
contains motor homunculus)
Responsible for motor output
to the contralateral side of the body
via the corticospinal tract and
to face via corticobulbar tract
Lesion: may produce upper
motor neuron(UMN) signs:
weakness/paralysis,
hyperreflexia, spastic tone,
Babinski sign

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8
Q

Frontal lobe: motor cortex: Unimodal Association Areas

A

Important for motor planning

1) SUPPLEMENTARY MOTOR AREA (SMA)
2) PREMOTOR CORTEX

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9
Q

Premotor cortex duties and what happens in a lesion here?

A
  • Spatial and sensory guidance of movement, contributes to corticospinal tract esp truncal, proximal muscles
  • Lesion: slowing of anticipated movement, +/- UMN signs
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10
Q

Supplementary Motor Area (SMA) duties and what happens if lesion here?

A
  • Plans, initiates, coordinates complex bimanual actions Also contributes to the corticospinal tract
  • Lesion: inability to perform complex (bimanual) movements,+/-UMN signs
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11
Q

Where are the frontal eye field located?

A

Located in the premotor/prefrontal junction on the lateral convexity (yellow)

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12
Q

Frontal eye field function? What happens in a lesion to this area? (stroke vrs seizure)

A
  • Role in eye movements and selective attention
  • Generate saccades in the contralateral direction
  • Lesion (e.g., stroke): gaze preference toward that side; Excitation (e.g., seizure) will drive the eyes to look in the contralateral direction

“Look toward the Lesion”(stroke

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13
Q
A
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14
Q

What is the function of the prefrontal cortex? 3 major domains?

A

Higher-order processes that require integration of multimodal sensory, motor, limbic information Essential for functioning as “effective and socially appropriate human beings” Blumenfeld 3 major domains: restraint, initiative, order

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15
Q

Lesion to the Somatosensory cortex Symptoms (3)

A

Cortical sensory loss

1) Two-point discrimination
2) Agraphesthesia
3) Astereognosis

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16
Q

Somatosensory association area lesion (3)

A

1) tactile agnosia
2) Visual-spatial navigation issues (get lost easily)
3) sensory inattention ( stimulation bilateral but ignores the affected side)

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17
Q

Primary motor cortex lesion

A

paralysis of the contralateral side, UMN symptoms

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18
Q

Premotor cortex lesion

A

slowing of anticipated movements, +/- UMN symptoms

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19
Q

Supplementary motor area Lesion

A

Bimanual complex movement impaired (can’t play the piano)

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20
Q

Lesion to the frontal eye fields

A

Seizure: Eyes go to the opposite side of the lesion

Stroke: Eyes got o the same side of lesion

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21
Q

Optic radiations lesions

A

loss of vision to the contralateral side

homonymous hemianopia

22
Q

lesion to the cuneus

A

Loss of the lower eye field

23
Q

Lesion to the lingula

A

Loss of the the upper eye fields

24
Q

Lesion to the angular gyrus in the parietal lobe (dominate side) 4 symptoms

syndrome

A

Gerstmann syndrome

1) acalculia
2) Agraphia
3) Left-right disorientation
4) finger agnosia

25
Q

Parietal lobe lesion (Dorsal pathway)

Syndrome? 3 Symptoms?

A

Balint’s syndrome

1) Simultanagnosia (inability to perceive more than one object at a time)
2) Optic ataxia
3) oculomotor apraxia

26
Q

Temporal lesion(Ventral pathway)

A
27
Q

Right lesion to parietal lobe

A

Hemineglect (ignore left side)

28
Q

Left lesion to frontal/parietal lobe

A

Apraxia

29
Q

lesion to pariteal lobe heschls gyrus

A

Cant localize sound

30
Q

What are the 5 lacunar stroke syndromes

A

Pure motor

Pure sensory

mixed motor sensory

dysarthria clumsy hand

ataxic hemiparesis

31
Q

what does ataxia mean

A

Ataxia is typically defined as the presence of abnormal, uncoordinated movements.

32
Q

What does dysarthria mean

A

Dysarthria occurs when the muscles you use for speech are weak or you have difficulty controlling them. Dysarthria often causes slurred or slow speech that can be difficult to understand.

33
Q

Left middle cerebral artery (MCA) syndrome signs/syms (5)

A

Right hemiplegia (precentral gyrus and subcortical pathways)

  • Right hemianesthesia (postcentral gyrus)
  • Right homonymous hemianopsia (optic radiations)
  • Global aphasia (Wernicke’s and Broca’s areas)
  • Left gaze deviation/preference (frontal eye fields)
34
Q

Right middle cerebral artery (MCA) syndrome signs/syms

A

Left hemiplegia (precentral gyrus)

  • Left hemianesthesia (postcentral gyrus)
  • Left homonymous hemianopsia (optic radiations)
  • Left hemineglect (parietal cortex)
  • Right gaze deviation/preference (frontal eye field)
35
Q

Left anterior cerebral artery (ACA) sysns and symptoms (3)

A

Right leg > arm weakness (precentral gyrus)

  • Right leg > arm sensory loss (postcentral gyrus)
  • Frontal lobe behavioral abnormalities - abulia
36
Q

Right anterior cerebral artery (ACA) syns and sym (3)

A

Left leg weakness (precentral gyrus)

  • Left leg sensory loss (postcentral gyrus)
  • Frontal lobe behavioral abnormalities - abulia
37
Q

Left posterior cerebral artery (PCA) signs and symptoms

A

Right homonymous hemianopsia (occipital cortex)

If proximal PCA occlusion:

  • Right hemisensory loss (thalamus)
  • Right hemiparesis (midbrain)
38
Q

Right posterior cerebral artery (PCA)

Signs and symptoms

A
  • Left homonymous hemianopsia (occipital cortex)
  • If proximal PCA occlusion:
  • Left hemisensory loss (thalamus)
  • Left hemiparesis (midbrain)
39
Q

Top of the basilar” stroke syndrome

A

Small perforator arteries supplying the thalamus and midbrain

• Sudden decreased level of consciousness – could be the main finding •

Can get varying degree of following :

• Dysarthria • Visual field deficit • Eye movement abnormalities • Weakness • Ataxia • Numbness

40
Q

Case:

• 52F presented with sudden decreased level of consciousness at work • Eyes closed, unrousable, snoring respirations at time, non verbal • Pupils enlarged bilaterally 8mm and not reactive to light • Moves limbs spontaneously at times • Withdraws to pain in the limbs • Reflexes 2+ and symmetrical

What kind of stroke is this?

A

Midbrain/thalamic stroke

41
Q

Pontine “locked-in syndrome

A

Mid basilar occlusion • Bilateral horizontal gaze palsy (PPRF) • Bifacial weakness (CN VII) • Anarthria • Quadriplegia (corticospinal tracts)

42
Q

Lateral medullary ischemic stroke syndrome

Signs and symptoms

A
  • Due to vertebral artery or PICA occlusion
  • Vertigo, nausea/vomiting (vestibular nuclei) • Ipsilateral Horner’s syndrome - ptosis, miosis, anhydrosis (sympathetic fibers) • Hoarseness, dysarthria, dysphagia (nucleus ambiguus) • Ipsilateral facial numbness (spinal trigeminal nucleus and tract) • Contralateral body numbness (spinothalamic tract) • Ipsilateral ataxia (ICP) • Hiccups • NO WEAKNESS!
43
Q

Cerebellar strokes signs and symptoms

A

Ataxia: (“lack of order”) • Abnormalities in rate, rhythm and force of movement • Ataxia ipsilateral to lesion

  • Midline lesions – truncal/gait ataxia
  • Lateral lesions – limb ataxia •

Nystagmus • Dysarthria • Vertigo, nausea, vomiting

44
Q

What is the blood supply of the Midbrain?

A

The Posterior Cerebral Artery

a little bit of Superior cerebellar artery

45
Q

What is the blood supply of the lateral pons

A

Anterior inferiror cerebellar artery

46
Q

What is the blood supply of the medial pons

A

Basilar artery

47
Q

what is the blood supply of the medial rostral medulla the vertebral artery

A
48
Q

What is the blood supply of the lateral rostral medulla?

A

Posteriror inferior cerebellar artery

49
Q

What is the blood supply fo the cerebellum?

A

PICA

AICA

SCA

50
Q

What is the function fo the midline cerebellum

A

Truncal balance and gait

51
Q

What is the function of the lateral cerebellum

A

ipsilateral limb cooridination

52
Q
A