cerebrum

Question 1

functions of frontal lobe

Answer 1

• voluntary motor control
• production of language (different than percieving language)
• majority of cognitive functions including:
  short term working memeory
  attention
  behavioral control
  executive functions

Question 2

what are the key motor areas of the frontal lobe?

Answer 2

primary motor cortex (M1)
premotor cortex
supplemental motor area (SMA)
frontal eye fields
broca’s area (left only)

Question 3

what is the primary motor cortex M1 responsible for?

Answer 3

execution of movement
- upper motor neurons send impulses to brainstem and spinal cord

part of frontal lobe

Question 4

what is the premotor cortex responsible for?

Answer 4

preparation for and ensory guidance of movement
- inputs from somatosensory areas, thalamus
- outputs to M1 and contralateral premotor cortex

part of frontal lobe

Question 5

what is hemiparesis?

Answer 5

hemi - half paresis - weakness
weakness, inability to move one side of the body. often caused by lesion of contralateral primary motor cortex or corticospinal tract

Question 6

why would damage to the right primary motor cortex cause contra-lesional (left sided) weakness?

Answer 6

due to the cross over of upper motor neurons at the medulla

Question 7

are the motor neurons damaged in the primary motor cortex upper motor neurons or lower motor neurons?

Answer 7

UMN

Question 8

waht is the supplemental motor area responsible for?

Answer 8

planning of movement, selection of appropriate motor plans and sequences, and coordination of the two sides of the body for complex movements

Question 9

what is the frontal eye fields responsible for?

Answer 9

control of visual attention and voluntary eye movements

Question 10

what is broca’s area?

Answer 10

found only on left side of frontal lobe (typically)
small region in the left hemisphere; key role in speech PRODUCTION

Question 11

what is broca’s aphasia?

Answer 11

non-fluent aphasia; diminished speech output caused by damage to broca’s area (left frontal lobe)

• they understand, they also know what they want to say they just can’t
• sometimes they can write, sometimes not
• it is NOT a memory problem –> production problem
  they sometimes can say words they have access to like yes/no
• they commonly work with speech pathologists

Question 12

frontal lobe: key cognitive areas

Answer 12

• dorsal lateral prefrontal cortex (DLPFC)
• orbital frontal cortex (OFC)
• medial prefrontal cortex (mPFC)

Question 13

what is dorsolateral prefrontal cortex (DLPFC) responsible for?

Answer 13

executive functions and motor planning

Question 14

what are executive functions

Answer 14

attentional control, short term working memory, self control & moderation of social behavior, decision making, judgement, planning, reasoning, problem solving… what else?

Question 15

what is orbital frontal cortex (OFC) responsible for?

Answer 15

sensory integration, learning, prediction and decision making for emotional and reward-related behaviors

Question 16

waht is the medial prefrontal cortex (mPFC) responsible for?

Answer 16

• impulse control
• motivation
• emotional component of decision making
• sociability
• memory

Question 17

functions of parietal lobe

Answer 17

• terminal location for sensations coming in from the somatosensory system (skin, muscles, joints, etc)
• integrates somatosensory sensation with information from the special senses (vestibular) to form an overall perception
• higher order sensory experinces like music appreciation

Question 18

what are the key regions of the parietal lobe

Answer 18

• primary somatosensory cortex (S1)
• posterior parietal cortex (PPC)

Question 19

what is the primary somatosensory cortex (S1) responsible for?

Answer 19

also called post central gyrus!!!
- receives and processes touch, temp, pain, and conscious proprioceptive info from the body

Question 20

what is the posterior parietal cortex (PPC) responsible for?

Answer 20

• motor planning
• visuospatial perception
• spatial attention
• integration of somatosensory
• visual
• auditory INPUT

Question 21

What ‘ order’ of sensory neurons are found in the primary somatosensory cortex?

Answer 21

3rd order

Question 22

apraxia?

Answer 22

difficulty with motorpalnning and coordination leading to loss of ability to execute skilled movement. despite physical ability to perform movement
- injury to frontal lobe (premotor cortex, DLPFC) and parietal lobes (PPC)

Question 23

what is neglect? also called hemispacial neglect or hemi neglect

Answer 23

half the world is not perceived
- reduced awareness of stimuli on one side of the body. often damage to R parietal lobe

(no sensory loss strictly perception loss)

typically
- unaware of 1/2 their body
- typically manifests on left side of body (R parietal lobe)
- r parietal stroke –> there is an ability to overcome

Question 24

why is neglect more common w/ R side lesions?

Answer 24

there are two visual lines come from the right side of the brain - this includes the only line to the left side of the body. (left side vision goes to right side)

Question 25

temporal lobe functions

Answer 25

- aduitory processing (especially language and the identification of objects) - memory/learning through connections with limbic system

Question 26

what is the limbic system

Answer 26

emotional nervous system

Question 27

temporal lobe: key areas

Answer 27

- auditory cortex (A1) - olfactory cortex - medial temporal lobe - wernickes area

Question 28

what is the auditory cortex (A1)

Answer 28

located in temporal lobe, awareness and processing of auditory stimuli

Question 29

what is olfactory cortex

Answer 29

located in temporal lobe - awareness and prcessing of smell

Question 30

what is the medial temporal lobe responsible for?

Answer 30

memory and learning

Question 31

wernicke's area

Answer 31

located on the temporal lobe (a little on parietal) comprehension of written and spoken language

Question 32

what is wernickes aphasia

Answer 32

fluent aphasia; diminished language comprehension - LEFT temporal lobe only ## Footnote how is this different from broccas aphasia?

Question 33

functions of occipital lobe

Answer 33

- visual perception --> color, form, depth perception, distance, object/face recognition, visual info sharing and motion - functions also rely heavily on other brain regions

Question 34

occipital lobe: dorsal visual stream

Answer 34

WHERE an object is

Question 35

occipital lobe: ventral visual stream

Answer 35

WHAT an object is

Question 36

occipital lobe: key areas

Answer 36

- primary visual cortex (V1) - secondary visual cortex (V2, V3, V3a, V4, V5)

Question 37

primary visual cortex (V1)

Answer 37

process and sort incoming visual info and pass correct info to the morespecialized areas of the cortex

Question 38

secondary visual cortex (V2, V3, V3a, V4, V5)

Answer 38

more specialized areas- process motion, color, etc. ## Footnote pass on to dorsal or ventral stream

Question 39

waht deficit would you expect with damage to the left primary visual cortex (V1)

Answer 39

deficit will be contralateral so loss to R visual field from both eyes * lesion at occipital visual cortex: contralateral homonymous hemianopia, with macualr sparing

Question 40

meaning of homonymous hemianopia

Answer 40

same -homo name/designation - nymous half vision loss - half vision loss

Question 41

what is the insular cortex where is it located

Answer 41

- found deep in the lateral sulcus, in between the temporal and parietal lobes - associated w/ eating and digestive functions, autonomicfunction and feelings related to a sensory experience such as pain or pleasure

Question 42

what is the cingulate cortex where is location

Answer 42

- found superior to the corpus callosum - associated w/ basicdrive and motivations such as hunger, emotions and initation

Question 43

look over the new homonculus

Answer 43

Question 44

# integrated motor learning declarative/explecit memory

Answer 44

Question 45

# integrated motor learning non declarative/implicit memory --> procedualr (skills, habits) -->

Answer 45

striatum, cerebellum, motor cortex

Question 46

go look up and label brain scans

Answer 46

Question 47

what arethe 3 cerebral arteries

Answer 47

anteiror cerebral artery (ACA) middle cerebral artery (MCA) posterior cerrebral artery (PCA)

Question 48

what does the ACA supply? where does it course through?

Answer 48

supplies sensory and motor areas of the lower extremity - course around the genu of the corpus callosum ## Footnote genu = bend/knee so courses around the anterior bend of the corpus callosum

Question 49

what does MCA supply?

Answer 49

supplies sensory and motor areas of the UE/face

Question 50

What does PCA supply?

Answer 50

supplies functional territories including the visual cortex adn teh hippocampal formation

Question 51

what do the MCA's supply on the left hemisphere?

Answer 51

supplies the speech centers - brocca's and wernikes

Question 52

homunculus - what does the anterior cerebral artery supply?

Answer 52

motor (precentral gyrus) - trunk, leg, foot, genitals sensory (postcentral gyrus) - trunk, leg, foot, genitals

Question 53

homunculus - what does the middle cerebral artery supply?

Answer 53

motor (precentral gyrus) - arm, hand, face, tongue sensory (postcentral gyrus) - arm, hand, face, tongue

Question 54

posterior cerebral artery - homunculus

Answer 54

occipital lobe and a little bit of temporal lobe

Question 55

cerebral vascualr injury - ischemic stroke what is it? why can it occur?

Answer 55

- interruption of arterial supply to an area results in decreased delivery of oxygenated blood to the tissue - can occur bc of an acute blockage such as from an embolus or the gradual narrowing of the arteiral lumen ( stenosis), as in atherosclerosis diseased carotid artery --> blood clot breaks off and travels --> blood clot lodges in cerebral artery, causing as troke

Question 56

what is infarct

Answer 56

a localized area of ischemic neurosis resulting from sudden adn complete occlusion of arterial blood supply

Question 57

What is a TIA?

Answer 57

transient ischemic attack --> mini stroke

Question 58

cerebral vascular injury - hemorrhagic stroke

Answer 58

- occurs when an artery ruptures, releasing blood into the surrouding tissue; produces diffuse and extensive damage to brain - commonly caused by ruptured aneurysm - aneurysm in cerebral artery breaks open causing bleeding around the brain --> pressure of blood on brain cuases brain tissue death

Question 59

acute vs. chronic: signs and symptoms evolve as you transition fro macute to chronic phases of a stroke hyper acute infarct (0-6hrs)

Answer 59

- blood clot, MMP-9, early BBB disruption - cytotoxic edema

Question 60

tumor

Answer 60

a cancerous or noncancerous mass or growth of abnormal cells in the brain - tumors can start in the brain, or cancer elsewehre in the body can spread to the brain

Question 61

what does contralesional mean?

Answer 61

there is a lesion on the contralateral side example: the patient had a R MCA stroke resulting in contralesional UE paresis

Question 62

go pull up a brain scan answer the following questions: 1. was it an icshemic or hemorrhagic stroke 2. which vessel was impacted? R or L? 3. what does that vessel supply? 4. what is found in the area that vessel supplies? L vs R 5. what would you expect in terms of clinical presentaiton 6. would the R/L or both sides of the body be affected? 7. what time of imaging are you looking at

Answer 62

go do it! you got this!