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Flashcards in 2.4- Stroke II Deck (70):
1

The Primary Motor Cortex is in the frontal lobe. It is _______ to the Central Sulcus and located in the ______________.

anterior to Central Sulcus and located in the Precentral Gyrus

2

Where is the Motor Homunculus?

just anterior to the Central Sulcus in the Precentral Gyrus

3

The Primary Motor Cortex contains cell bodies of the ______ motor neurons that _________.

upper motor neurons that initiate primary voluntary motor activities

4

Motor Homunculus~

Lateral to medial = _______________________

face/tongue to foot and toes

5

The Motor Homunculus has a very large representation of ______, ______, ______, and ______. Why?

face, hands, thumb, foot because they contain many muscles to operate.

6

Why does the Motor Homunculus have a smaller representation of elbow, forearm, and trunk?

relatively few muscles

7

What is the Supplemental and Premotor Area- Area 6 responsible for?

learned motor activities of sequential nature

*sequences and helps initiate specific contractions for skilled activities like writing

*controls trunk and shoulder for postural adjustments

8

Where is the Supplemental and Premotor Area- Area 6?

anterior to primary motor cortex- area 4

9

Where is Broca's Area- Area 44?

at base of Area 4 and 6, motor speech

left hemisphere for most people

10

What is active in higher brain functions and motor activity? What is active in sensory reception and interpretation?

Frontal Lobe

Parietal Lobe

11

What area is just posterior to the Central Sulcus and located in Postcentral Gyrus of Parietal Lobe?

Primary Sensory Cortex- Areas 1, 2, and 3

12

The Primary Sensory Cortex- Areas 1, 2, and 3 receive ___________.

sensation from the sensory receptors of the body- pain, temp, vibration, etc

13

Sensory Homunculus~

Lateral to medial = _____________________

face/tongue to foot/toes

14

The Sensory Homunculus has a large representation of what body parts?

lips and face, hand (esp. thumb and index fingers), and foot (proprioception)

15

Why are the lips and face, hand, and foot largely represented in the Sensory Homunculus?

because of lots of sensory reception in these areas

16

What areas have a smaller representation in the Sensory Homunculus because of their relatively little sensory feedback?

limbs and trunk

17

Where is the Sensory Association Area?

Posterior to the Primary Sensory Area

18

The Sensory Association Area receives input from _____________.

Primary Sensory Area and the Thalamus

19

What integrates and interprets sensory info?

Sensory Association Area

20

__________ - ability to tell size and shape of object by feel

__________ - orientation of body parts

Kinesthesia

Proprioception

21

What area helps with storage of memories linked to past sensory experiences?

Sensory Association Area

22

Sensory Association Area does
1.
2.

1. integrates and interprets sensory info

2. helps with storage of memories linked to past sensory experiences

23

- posterior medial portion of the lobe
- receives impulses from the eyes
- interprets shape, color, movement, size, and location

Primary Visual Cortex- Area 17

24

The Primary Visual Cortex- Area 17 receives ___________ and interprets ________________.

receives impulses from the eyes

interprets shape, color, movement, size, and location

25

Where is the Visual Association Area?

anterior to the primary visual area

26

The Visual Association Area receives _____________.

impulses from the Primary Visual Area and Thalamus

27

What relates visual input to past visual experience for recognition and evaluation?

Visual Association Area

28

What is located superior to the Temporal Lobe near the Lateral (Sylvian) Fissure?

Primary Auditory Area- Area 41 and 42

29

The Primary Auditory Area- Area 41 and 42 interprets _____________________.

basic characteristics of sound such as pitch and rhythm

30

- Auditory Association Area (left hemisphere more people)
- located inferior to the Primary Auditory Cortex

Wernicke's Area- Area 22

31

The Wernicke's Area- Area 22 determines if sound is ______________.

speech, music, or noise

32

How does the Wernicke's Area- Area 22 interpret meaning of speech?

by translating words into thoughts

33

Left Hemisphere Characteristics
1.
2.
3.
4.
5.

1. Right hand control
2. Spoken and written language (Broca & Wernicke's areas)
3. Numeric and scientific skills
4. Sign language
5. Reasoning

34

Right Hemisphere Characteristics
1.
2.
3.
4.

1. Left hand control
2. Musical and artistic awareness
3. Insight and imagination
4. Mental images dealing with sensory info

35

What type of artery lesion is uncommon?

Anterior Cerebral Artery

36

What supplies medial surface of the Frontal lobe and up and over to the superior surface of the Frontal and Parietal Lobes?

Anterior Cerebral Artery

37

Why is an Anterior Cerebral Artery lesion not necessarily a total loss?

because of contributions from the Circle of Willis (depends where the lesion is)

38

Anterior Cerebral Artery~

1. Loss of voluntary motor of ______ on _______ side of body

2. Significant sensory loss of _____ on ______ side of body

motor = LE on opposite side of body

sensory = LE on opposite side of body

39

What are some symptoms of an upper motor neuron lesion (Anterior Cerebral Artery)?
1.
2.
3.

1. increased tone
2. spastic paralysis
3. positive Babinski's reflex

40

What is Ataxia?

uncoordinated gait characterized by wide stance, lifting feet high to take a step, and slap foot down due to proprioceptive loss from feet

41

What artery lesion causes bowel and bladder incontinence?

Anterior Cerebral Artery

42

Why should you not leave Anterior Cerebral Artery lesion patients unattended?

impaired judgment, planning, insight, and self awareness

increased emotion

43

What supplies midbrain, medial surfaces of occipital lobe wrapping up and over to superiolateral portion of occipital lobe, parts of medial and inferior Temporal lobe, Thalamus?

Posterior Cerebral Artery

44

What is Thalamic Pain Syndrome?

intolerable burning pain

- all sensory input is noxious, little control of emotions (related to limbic system)

- all sensation is painful

45

What is Alexia?

loss of ability to read due to loss of association area

46

What is Visual Agnosia?

inability to recognize familiar objects or faces

47

What is Cortical blindness?

inability to process incoming visual info even though the nerve is intact

48

What is the loss of vision in temporal half of one visual field and nasal portion of the other (half crosses and half doesn't)?

*hole in vision

Homonymous Hemianopsia

49

What artery lesion has difficulty making new memories (person will have trouble learning from us)?

Posterior Cerebral Artery

50

What cranial nerve can become paralyzed with a posterior cerebral artery lesion?

Cranial Nerve III- Oculomotor

51

4 symptoms of paralyzed Cranial Nerve III- Oculomotor
1.
2.
3.
4.

1. Loss of constriction of the pupil
2. Can't open eyelid
3. Loss of medial deviation for accommodation
4. Loss of ability to look up, down, and medial
*affected eye would be positioned lateral and down as a result

52

70% of strokes are _____________.

Middle Cerebral Artery

53

What supplies surface of cerebral hemispheres, deep frontal and parietal lobes (includes internal capsule which contains projection fibers running to the primary motor cortex)?

Middle Cerebral Artery

54

Results of Middle Cerebral Artery Blockage:

Motor =

Sensory =

Motor = Hemiplegia of face and greater UE; less loss in LE

Sensory = primarily face and greater UE; less loss in LE

55

What causes Homonymous Hemianopsia in Middle Cerebral Artery?

optic path is affected as it goes back to the opposite side

56

What is Agnosia?

lack of ability to recognize persons and things (loss of primary and association sensory areas)

57

What is Dysphagia?

difficulty swallowing

*Hallmark sign of Middle Cerebral Artery*

58

Middle Cerebral Artery Left Hemisphere lesions~

1.
2.

1. Do have judgment

2. Aphasia- lack of ability to communicate (affects Broca's and Wernicke's because they are on the left)

59

What is Aphasia?

lack of ability to communicate

60

What is Global Aphasia?

can't speak, write, or understand written or oral language

61

- receptive or sensory aphasia
- language comprehension is impaired (can produce sound but it is meaningless)
- generally not frustrated- not aware

Wernicke's Aphasia

62

- motor aphasia
- understand speech, know what to say, but can't make oralmotor structures produce speech
- can count, sing, and swear- not learned in same ways as normal speech
- very frustrated- aware of deficit

Broca's Aphasia

63

What are 3 aphasias affected in the left hemisphere by middle cerebral artery lesion?

Global Aphasia, Wernicke's Aphasia, and Broca's Aphasia

64

Middle Cerebral Artery Right Hemisphere lesions~

1.
2.

1. very impulsive- lack judgment
2. affects language differently- can speak but not as socially appropriate
- no facial expressions
- no intonation of voice
- difficulty with spatial relations

65

If brainstem stroke occurs above crossing (decussation), effects are seen on the ___________

opposite side

66

If brainsteam stroke occurs below the crossing, effects are seen on the _____________

same side

67

What is Alternating Hemiplegia?

involves one side of the head and opposite side of the body b/c of cranial nerves that do not cross

- one half of the body is affected by an upper motor neuron lesion while the opposite side of the face is affected (usually upper motor for body, lower motor for face)

68

What type of brainstem lesion affects the same side of the body and face?

usually upper motor neuron lesion

69

Anterior, Middle, or Posterior Cerebral Artery???

1. Loss of voluntary motor and sensory in LE
2. Affects opposite side of face and greater UE
3. Do not leave unattended
4. Thalamic Pain Syndrome
5. Memory impairment
6. Dysphagia- difficulty swallowing
7. Ataxia
8. Bowel and bladder incontinence
9. Aphasia
10. Homonymous Hemianopsia

1. Anterior
2. Middle
3. Anterior
4. Posterior
5. Posterior
6. Middle
7. Anterior
8. Anterior
9. Middle
10. Posterior and Middle

70

How does Homonymous Hemianopsia differ between the Posterior Cerebral Artery and the Middle Cerebral Artery?

Posterior- affects processing area

Middle- affects track (optic path) coming back