Class Flashcards

(149 cards)

1
Q

Neurology

A

study of anatomy, physiology, and pathology of the nervous system

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2
Q

Anatomy

A

study of structure

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3
Q

Physiology

A

study of function or structures in motion

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4
Q

Pathology

A

study of disease processes that affect both anatomy and physiology

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5
Q

Neurophysiology

A

how a neuron functions

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6
Q

Nervous system

A

a series of organs that make communication between the brain and body possible

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7
Q

Neurological disorder

A

a disease in the nervous system that impairs a person’s health, resulting in some level of disability

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8
Q

Dorsal Induction

A
  • G.A. 3-7 weeks
  • 3rd week: Period when neural plate is formed
  • 4th week: neural plate wraps around to form the neural tube (process called neurulation)
  • 6th week: ends of neural tube close
  • Brain and spinal cord with develop out of the neural tube
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9
Q

Neural Tube Defects

A

involve failure of neural tube ends to close

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10
Q

Encephalocele

A

when a part of the brain protrudes from the skull

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11
Q

Anencephaly

A
  • brain development ceases at brainstem; child without cerebral hemispheres
  • children who are born with this can live, but most die in the early months or first year of life
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12
Q

Spina bifida

A
  • cyst on back that may or may not involve the spinal cord
  • sometimes the spinal cord is in tact, but a severe form is when the spinal cord gets wrapped up in the cyst
  • children with the severe form can suffer from paralysis in their lower half and struggle with bowel and bladder control
  • look up if it can be operated on in utero
  • 3 levels: 1) occulta, 2) meningocele, 3) myelomenigocele
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13
Q

Caudal Regression Syndrome

A
  • abnormal fetal development of lower spine
  • hypoplasia– not fully developed –> have hypoplasia of the lower half of the body
  • can be missing ribs, vertebrae, hypo plastic pelvis, legs have little control or never developed (extreme case)
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14
Q

Ventral Induction

A
  • G.A. 2-3 months

- Neurodevelopment period when face and brain develop out of superior end of the neural tube

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15
Q

Holoprosencephaly

A
  • failure of brain cleavage
  • the brain does not divide into left and right hemispheres
  • sometimes a cleft lip come with this
  • cyclopsia is another thing that can happen where a child will have one eye in the middle of their head
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16
Q

Alobar form of holoprosencephaly

A
  • no cleavage at all resulting in no distinct cerebral hemispheres
  • no corpus callous
  • most severe form
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17
Q

Semilobar form of holoprosencephaly

A
  • some cleavage and developmental of right and left hemispheres, but incomplete
  • no corpus callosum
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18
Q

Lobar form of holoprosencephaly

A
  • least severe

- brain looks normal, but abnormal connections between hemispheres

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19
Q

Neural Proliferation

A
  • G.A. 3-4 months
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20
Q

Neurogenesis

A
  • the birth of new neurons
  • New neurons become the gray and white matter of the cerebral hemispheres
  • born out of spinal cord and brain stem
  • interruptions in neural proliferation may result in microcephaly where children have abnormally small heads and brains–> usually is accompanied by intellectual disabilities
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21
Q

Neuronal Migration

A
  • G.A. 3-5 months
  • new neurons move in wave-like fashion to their correct position in the cerebral hemispheres
  • a chemical called reeling signals neurons where to stop
  • at about 20 weeks GA, process stops and 6 layers of the cerebral cortex are established
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22
Q

6 layers of cerebral cortex

A

1) Molecular (lamina I)
2) External granular (lamina II)
3) External pyramidal (lamina III)
4) Internal granular (lamina IV)
5) Internal pyramidal (lamina V)
6) Multiform (lamina VI)

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23
Q

Schizencephaly

A
  • clefts in the cerebral hemispheres
  • hole in the brain
  • may or may not have significant deficits because baby brains are fairly plastic and can learn to compensate
  • due to lack of reelin leading to a failure of neurons to migrate to proper places
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24
Q

Lissencephaly

A
  • smooth brain that lacks characteristic sulci and gyri
  • usually has significant intellectual disabilities
  • due to lack of reelin leading to a failure of neurons to migrate to proper places
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25
Cortical Organization and synapse formation
- G.A. 5 months to years - once neurons arrive at intended spot, they sprout dendrites and axons - synapses (connection points) begin to form between neurons - Process known as snaptogenesis - synaptic pruning eliminates unneeded connections - failure in this stage can lead to polymicrogyria--> too many gyri in the cerebral hemispheres
26
Myelination
- G.A. birth to years after birth - myelin is a fatty coating on axons that keeps the electrical signal of the neurons in the neuron so that the electric signals can be more efficient - process reaches its peak at about one year after birth - infants gain greater control of their bodies and begin to develop the ability to communicate verbally - failure in this stage may result in hypomyelination, a reduced ability to form myelin resulting in intellectual disability
27
Multipolar Neurons
- Motor neuron - Pyramidal neuron - Prukinje cell --> found in cerebellum
28
Bipolar Neurons
- Retinal neuron - Olfactory Neuron - Afferent communication
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Unipolar Neruon
- found with pain and touch
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Anaxonic Neuron
- inhibitor in the nervous system
31
Neurons
- building blocks - human brain has 100 billion neurons - specialized function (communication) - communication is electrochemical
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Similarities between neurons and other cells
- have a membrane - have a nucleus - have a cytoplasm, mitochondria and other orangelles
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Differences between neurons and other cells
- have specialized projections | - Communicate with each other through electro chemical transmissions
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Primary purpose of neurons
communication
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Efferent Communication
motor signals from CNS to PNS
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Afferent communication
sensory signals from PNS to CNS
37
Thalamus
- sits above the brain stem (on top of the midbrain) - Gateway to the cerebral cortex - Relays sensory (except smell) - perception of pain, temperature and touch - imparts a sense of pleasantness and noxiousness - maintains cortical arousal, attention, and sleep/wake cycle
38
Derjerine-Roussy Syndrome
- aka Thalamic pain syndrome - usually caused by stroke in the thalamus - Symptoms include Hemiparesis/hemi-plegia, dysesthesia (pain, itching, tingling, burning), slight ataxia - cognition, speech, and language are intact
39
What is the function of the Thalamus?
- imparts a sense of pleasantness and noxiousness | - maintains cortical arousal, attention, and sleep/ wake cycle
40
Thalamic Aphasia
- Fluent verbal output with semantic paraphasias (fluent, but uses substitutions) - mild auditory comprehension issues - mildly impaired to normal repeating skills
41
Hypothalamus
- regulator of the brain - includes the pituitary gland and the mammillary body - autonomic nervous system control - metabolism - water balance - sleep/ wake mechanism - body temp - food intake regulation (hunger and fullness) - secondary sex characteristics
42
Cushing's Disease
- endocrine (hormone) disorder caused by tumor on the pituitary gland - results in high levels of cortisol in the body - Symptoms: moon facies (round face), emotional disturbances, osteoporosis, hypertension (high blood pressure), buffalo hump, obesity, amenorrhea (loss of menstruation), muscles weakness, abdominal stripes
43
Acromegaly
- term means: "extreme lateness" - caused by pituitary tumor - results in pituitary producing too much human growth hormone - symptoms include: large stature, large nose and jaw, large hands, hypertension, and peripheral neuropathy, prominent forehead
44
Epithalamus
- lies above the thalamus - connects to the limbic system - parts: pineal gland-- produces melatonin/ Circadian rhythms; habenula; star medlars projections - functions: sleep/ wake cycle, olfactory reflexes
45
Sub thalamus
- lies below the thalamus - connects basal ganglia to the motor cortex - related to the thalamus in name, but to the basal ganglia in function - damage can result in hemiballism
46
Basal Ganglia
- aka corpus striatum - parts: globus pallidus, putamen, caudate nucleus - functions: regulates complex motor function such as posture, locomotion, balance, arm swinging; inhibits function; coordinates motor behavior - uses dopamine
47
Function of the Basal Ganglia
- regulates complex motor functions such as posture, locomotion, balance, arm swinging - inhibits function - coordinates motor behavior
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Parts of the Basal Ganglia
- globus pallidus - putamen - caudate nucleus
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Basal Ganglia Symptoms
- dyskinesias (impaired movement) 1) Bradykinesia, hypokinesia, akinesia 2) Rigidity (due to increases muscle tone) 3) tics 4) Tremor 5) Dystonia 6) Chorea 7) Athetosis
50
Bradykinesia
slowed movements (seen in Parkinson's)
51
Hypokinesia
reduced movements
52
Akinesia
without movement
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Rigidity
- stiff or tight muscles that resist passive movement to a limb - Ex: a relaxed joint will resist being bent or straightened
54
Tics
- involuntary, repetitive motor or vocal behaviors - Associated with conditions like Tourette syndrome - Example: vocal tic= barking noise
55
Tremor
- Rhythmic shaking - intention tremor-- tremor that occurs when trying to do something voluntarily - resting tremor-- rhythmic shaking that occurs while hand is at rest, but disappears when intentionally using hand - pill-rolling tremor-- associated with parkinson's disease; appear to be rolling something with thumb and first two fingers
56
Dystonia
- characterized by abnormal, sustained, involuntary muscle contractions - results in distorted body postures
57
Chorea
- literally means dance - quick involuntary movements of the hand and/or feet that have a dance-like quality - usually associated with hungtington's disease
58
Athetosis
- Greek for without position | - slow, twisting, involuntary movements of the hands or feet
59
Parkinson's Disease (PD)
- a progressive neurological disease first described by Dr. James Parkinson in 1817 - aka "shaking palsy" - caused by degeneration of midbrain's substantial nigra and loss of dopamine to BG - Symptoms include: muscle rigidity, dyskinesias, resting and pill rolling tremors, shuffling gait, wear voice, dysarthria, flat affect, poor posture, dysphagia
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how many cerebral hemispheres
2 left and right
61
Major layers of the Cerebrum superficial to deep
- surface gray matter (cerebral cortex; neuron somas) - white matter (axons) - deep gray matter (thalamus, basal ganglia) - Ventricles (4)
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Surface of the brain
- gyrus (bumps) - sulcus (divit) - fissure (deep sulcus)
63
Layers of the Cerebral Cortex
- Layer I: glia and neurons - Layer II: small pyramidal cells - Layer III: Large pyramidal cells - Layer IV: non pyramidal cells - Layer V: - Layer VI:
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Frontal lobe
reason planning motor movement speech
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parietal lobe
sensory perception interpretation
66
occipital lobe
vision
67
temporal lobe
memory receptive language
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Language Dominance
- most people are left hemisphere language dominant - 96% of right handers - 85% of ambidextrous - 73% of left handers
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Intra hemispheric connections
- numerous connections within the cerebral hemispheres | - two examples: superior longitudinal fasciculus and arcuate fasciculus
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Neuroplasticity
- the adaptive capacity of the central nervous system
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10 principles of neruoplasticity
1) Use it or loose it -- failure to drive certain brain functions can lead to loss of those functions; tube feedings can lead to loss of swallowing abilities 2) Use it and improve it -- studying; patients with hemiparesis and constraint-induced movement therapy 3) Specificity -- the nature of training experience dictates nature of plasticity 4) Repetition Matters -- induction of plasticity requires sufficient repetition 5) Intensity Matters -- induction of plasticity requires sufficient training intensity 6) Time Matters -- different forms of plasticity occur at different times of training (the earlier the better) 7) Salience Matters -- the training experience must be important or meaningful to include plasticity 8) Age Matters -- training-induced plasticity occurs more readily in younger people; younger brains change faster and more dramatically than older brains 9) Transference -- Plasticity in repose to one training experience can enhance the acquisition of similar behaviors; engaging in exercise might make the brain more plastic for speech therapy 10) Interference -- Plasticity in response to one experience can interfere with the acquisition of other behaviors
72
Pre frontal cortex
- BA 9, 10, 11, 46, 47 - Functionally involved with cognition (executive control), personality, decision making, and social behavior - Phineas Gage and his prefrontal cortex damage
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Frontal Eye Fields
- BA 8 - Controls eye movements (up, down, left, right) - Damage results in eyes deviating toward the side of the injury - involved in uncertainty and hope - sometimes included as part of the prefrontal cortex
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Broca's Area
- BA 44, 45 - 44: pars opercularis--> lid part - 45: pars triangular--> triangular part - Found on third frontal convolution (inferior frontal gyrus) - Area 45 is known as pars triangularis, involved in... - Area 44 is known as pars opercularis, involved in coordination of speech organs for language production - Paul Broca was the first to associate BA 44 and 45 with speech production - Damage here may lead to Broca's Aphasia
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Broca's Aphasia
- confluent, telegraphic speech - impaired repetition - fairly intact auditory comprehension - impaired naming abilities - key characteristic is agrammatism
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Frontal Lobe: Premotor Cortex
- BA 6 - close relationship to BA 44 - selecting and planning of motor movements - supplementary motor area (SMA) located at top of BA 6 and is involved in sequencing and "turning on" motor plans
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Frontal Lobe: Primary Motor Cortex
- BA 4 - sends motor plans developed in BA 6 to the muscles for them to act (like speech muscles) - BA 4 has been mapped to form a homunculus or "little man"
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Parietal Lobe: Primary Sensory Cortex
- BA 1, 2, 3 | - processes somatosensory information like vibration, proprioception, touch, stereognosis
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GCS
- Glasgow Coma Scale - scale goes from 3-15 - 13-15 --> mild brain injury - 9-12 --> Moderate brain injury - 3-8 --> Severe brain injury
80
Soma sensory Association Cortex
- BA 5 and 7 - Interprets sensory experience during motor movements - This sensory experience e is used to refine motor action - Plays a role in sensory and motor experience associated with writing
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Angular Gyrus
- BA 39 - Involved in reading and math abilities - Damage can lead to alexia and alcalculia - May also be important in our ability to interpret metaphors and our sense of embodiment - Damage (or stimulation) can lead to outer body experiences (OBEs) - Damage can also lead to Gerstmann syndrome
82
Supra marginal Gyrus
- BA 40 - Closely related to the angular gyrus (BA 39) - Involved in phonological system; stores auditory representations of phonemes (auditory images)--> helps us sound out words - Damage can result in phonological alexia, difficulty reading new/novel words and non-words
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Occipital Lobe: Visual Cortices
- dorsal stream --> where of vision (BA 18, 19, 7, 39) - ventral stream --> the what of vision (BA 18, 19, 37) - Tertiary Visual Cortex BA 19 - Secondary Visual Cortex BA 18 - Primary Visual Cortex BA 17 - Where information is received and processed is the opposite side of the eyes
84
Synesthesia
- Joined sensations - Usually 2 senses joined --> hear colors, taste shapes, see words as colored - 3-4 senses joined is rare
85
Temporal Lobe: Fusiform Gyrus
- BA 37 - occiptiotemporal gyrus - Important in remembering and naming seen objects - Functions as a visual lexicon - Lesions can cause anomia and lexical agraphia (cannot visualize how to write a word) - Damage can lead to prosopagnosia
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Inferior Temporal Area
- BA 20 and 21 - involved in processing of auditory and language information as well as reading facial emotions - may play a role in hallucination
87
Primary Olfactory Cortex
- BA 38 - Receives and processes olfactory (smell) sensory information from the nose via the olfactory bulbs - has connections to the limbic system (emotional processing system), which explains why smells can evoke emotions and emotional memory - damage can lead to anosmia or a loss of smell
88
Primary Auditory Cortex
- BA 41, 42 - 42 is the secondary auditory cortex but 41/42 usually discussed as a unit called the primary auditory cortex - aka Heschel's gyrus - Initial comical region that receives auditory information from the ears via CN VIII and the auditory pathway - processes sound intensity and frequency - Organized by tones (topographically arranged)
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Hearing
- aka audition - a process whereby acoustic or sound energy waves are changed into neural or electrochemical impulses that are interpreted by the brain
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Two main divisions of the ear
- Peripheral auditory system: outer ear, middle ear, inner ear - Central auditory system: Cranial nerve 8, brainstem, brain
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Peripheral Auditory Stages
1) Outer Ear Stage 2) Middle Ear Stage 3) Inner Ear Stage
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Outer Ear Stage
- The pinna (auricle) locates a sound (acoustic energy) in the environment - It then collects that sound - Finally, the sound is funneled into the middle ear
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Middle Ear Stage
- acoustic or sound energy hits the tympanic membrane - the tympanic membrane begins to vibrate indicating an energy change: acoustic energy has been changed to mechanical energy - the mechanical energy goes through the ossicles (malleus, incus, stapes) - Footplate of steps rocket in and out of the oval window
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Inner Ear Stage
- the rocking of the stapes creates waves in the cochlear fluids - the is another energy change: mechanical energy has been changed into hydraulic energy - these waves disrupt the hair cells in the organ of corti causing a third energy change: hydraulic energy changed to electrochemical energy
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Central Auditory Stages
1) Generation of Neural Impulse 2) Nerve Conduction 3) Brainstem Organization CNC
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Generation of Neural Impulse
- when waves in cochlear fluids disrupts hair cells in the organ of Corti, the hair cells depolarize similar to neurons - signal moves down hair cell, causing release of neurotransmitters (glutamate?) - Neurotransmitters stimulate nerve endings that connect to bottom of hair cells
97
Nerve conduction
- the signal is sent up to the brain - Cranial nerve 8 is the vestibulocochlear nerve - the cochlear branch of this nerve connects into hair cells of the organ of Corti - this nerve conducts the electrochemical impulse to the brainstem
98
Brainstem Organization CNC
- cranial nerve 8 inputs into the brainstem's cochlear nuclear complex (CNC or cochlear nucleus), an area of specialized cells for auditory information - the CNC lies at where the pons and medulla meet - the CNC resembles a fish tail shape - the CNC has some important divisions: posterior/dorsal cochlear nucleus contains pyramidal cells of unknown function; anterior/ventral cochlear nucleus contains 3 different ranges of frequencies; the topographic organization of the cochlea is maintained in the CNC
99
Brainstem organization: SOC
- CNC fibers project to the superior olivary complex (SOC) in the pons; SOC has 2 pars: medial superior olivary complex specializes in low frequency hearing and binaural hearing - lateral superior olivary complex: specializes in higher frequency hearing - both involved in sound localization and the stapedius reflex or acoustic reflex
100
Brainstem organization: LL
- SOC projects 4 tracts through the lateral leminiscus (LL), a tract of 6 total pathways, to the inferior colliculus (IC) of the midbrain - CNC also projects 2 tracts + the CNC's 2 tracts equal the 6 total tracts of the LL
101
Inferior Colliculus (IC)
- auditory center of the midbrain - it maintains the topographic organization that originated in the cochlea - regulates the acoustic startle relax, our sudden movement when an unexpected sound of 80dB or more occurs - Also regulates the vestibulo-ocular reflex
102
Medial Geniculate Body of the Thalamus
- MGB is the auditory center of the thalamus - Acts as a relay station that relays auditory tracts to the auditory parts of the cerebral cortex - Has 3 Parts 1) Ventral division: specializes in relaying frequency, intensity, and binaural information to cortex 2) Medial Division: specializes in relaying intensity and duration of sound 3) Dorsal division: specializes in establishing and maintaining our attention to a sound source
103
Primary Auditory Cortex
- PAC - The PAC occupies BA 41 and 42, found of the superior temporal gyrus (Heschl's gyrus) - This area is topographically organized, like the cochlea and the rest of the central auditory system - Functionally, PAC perceives and discriminates sound - plays some role in interpreting non-word noises that you hear (birds, bells, etc.)
104
Wernicke's Area
- WA - The PAC projects to Wernicke's area (WA), also on the superior temporal gyrus - WA important for attaching meaning to heard speech - Damage to WA can result in Wernicke's aphasia where patients have severe auditory comprehension deficits
105
Broca's Area
- BA - WA projects to BA via the arcuate fascicles - BA recruited for understanding syntactic construction - People with Broca's aphasia have high level auditory comprehension deficits when processing complex syntactic constructions
106
Sensorineural hearing loss
- an inner ear hearing loss usually due to damage to the organ of Corti's hair cells
107
Auditory Processing Disorder
difficulty processing and interpreting auditory language symbols; a dyslexia of the ears
108
Pure word deafness
- Auditory verbal agnosia - people can recognize non speech sounds, but do not recognize speech - a disconnection between the PAC and WA
109
Aphasia
- acquired multimodality language loss that can affect verbal formulation, auditory comprehension, reading, and writing
110
Conceptual Level
- Involves our thoughts, feeling, and ideas - Prefrontal cortex and limbic system probably have primary role at this level - When we want to express ideas to others, we "dress them up" in language (language encoding)
111
Planning Level
- Involves 2 parts: 1) Linguistic planning: language, content, form, and use (or semantics, grammar, and pragmatics) 2) Motor planning: plans and arrangements of phonemes - Premotor cortex (BA 6) important area for motor planning (BA 44/45)
112
Motor Programming Level
- motor programs involve the execution of phonemes in time and space - Programs involve discrete movements of tongue, lips, etc. - Many motor programs make up a motor plan (e.g. blue prints) - Cerebellum, basal ganglia, and supplementary motor area (BA 6) are important areas to motor programming (BA 44/45 for speech)
113
Aphasia
- Linguistic planning issue | - partial or complete acquired language impairment or loss (multi-modality issue)
114
Apraxia
- motor planning and motor programming issue
115
Agnosia
- inability to recognize or perceive sensory information correctly (single-modality issue)
116
Dysarthria
- cannot execute the movements because there is a weakness in the mouth muscles - Motor control circuits, direct motor pathway, indirect motor pathway, final common pathway issue
117
Searching/ groping behavior
- trying to find the motor planning - sign of apraxia of speech - moving the mouth/ finding the space/place etc before saying the sounds
118
Saying "no" and "yes" spontaneously/ period of error free speech
- characteristic of apraxia of speech - period of error free speech--> don't have to think about it so it just pops out without trying... when brought into conscious awareness, it goes away
119
Awareness of incorrect sounds
- communicates that he is aware of his errors and the difficulty - hyper-awareness is another part of apraxia of speech
120
Right hemiplegia
- means left brain damage
121
Motor Control Circuits: Basal Ganglia
- Includes caudate nucleus, putamen, globus pallid us, substantia nigra, and subthalamic nuclei - Regulates motor functioning, especially tone and posture so that we have smooth, precise motor movements - Dyskinesias (i.e. movement disorders [tremor]) result when this system is damaged --> can affect speech
122
Motor control Circuits (part 2): Cerebellum
- coordinates muscle movements so that they are skilled (i.e. precise) and sequential - When this circuit is damaged, speech can become uncoordinated, resulting in a condition known as ataxic dysarthria
123
Levels of Motor Speech System
1) Conceptual 2) Motor Planning 3) Motor Programming 4) 5) 6) 7)
124
Direct Motor Pathway
- aka pyramidal system - Involves lateral motor system -- lateral corticobulbar and corticospinal tracts - Function of pathway- volunteer motor movement of contralateral limbs/speech muscles - This pathway makes few stops; it is very direct - Crosses over (decussates) at medulla/spinal cord juncture - Main center= primary motor cortex (BA 4) - Upper part of tract (brain and spinal cord) = Upper motor neurons (UMN) - Lower part of tract (cranial and spinal nerves) = lower motor neurons (LMN)
125
Upper Motor Neuron Damage
- Spastic muscles --> Hypertonia; Hypereflexia (exaggerated reflexes) - Conus - (+) Babinski sign (abnormal) - No muscle atrophy - No fasciculations
126
Lower Motor Neuron Damage
- Flaccid muscles --> hypotonia; hyporeflexia (no reflexes) - no clonus - no babinski sign - marked atrophy - fasciculations
127
What is cognition?
- the mental process of knowing in which we acquire and act upon knowledge
128
Mental process
things we can do with our minds
129
knowing
to have some kind of information in our minds
130
knowledge
understanding of information and skills obtained through education and/or experience
131
General Cognitive Functions
1) Perceiving 2) Remembering 3) Understanding 4) Judging 5) Reasoning
132
Perceiving
- noticing something with your senses - outer world to inner world (eyes, ears, taste, etc.) - comes in through the sense organs
133
Remembering
- storing information gathered through perception | - outer world to inner world
134
Understanding
- where you attach meaning to the information that has been stored
135
Judging
- to form an opinion about the correctness of information
136
Reasoning
- to do something with the information (e.g. make an argument)
137
Meta cognition
analyzing your own cognition/thinking
138
Attention
- a person's ability to focus (i.e. focused attention) on a stimulus in the environment
139
Attention Types
1) Sustained 2) Selective 3) Alternating 4) Divided
140
Sustained Attention
- focusing on one thing for a long period of time
141
Selective attention
- focusing on a stimulus while filtering out competing stimuli
142
Alternating attention
- shifting focus from one thing to another
143
Divided attention
- focus on 2 stimuli at the same time
144
Pulvinar
sustained and alternating attnetion
145
Superior colliculus
alternating visual attention
146
Posterior parietal lobe
disengagement
147
Frontal eye feilds
visual sustained attention
148
Anterior cingulate gyrus
divided attention?
149
Prefrontal cortex
divided attention