Exam VII

Question 1

What comprises the telencephalon?

Answer 1

cerebral cortex, subcortical white matter, basal ganglia

Question 2

Lobes in each cortex

Answer 2

frontal, parietal, occipital, temoral, insula, & “limbic”

Question 3

Layers of the cerebral cortex

Answer 3

molecular, external granule, external pyramidal, internal granule, internal pyramidal, multiform

Question 4

Supragranular layer

Answer 4

layers 1-4, primarily receive sensory information. Layers 1-3 non-specific, layer 4 = specific

Question 5

Layers 5 & 3 of cerebral cortex contain…

Answer 5

cell bodies of motor neurons (pyramidal neurons) whose axons constitute the corticospinal, corticobulbar and corticopontine tracts.

Question 6

Major sulci/fissures

Answer 6

lateral sylvian fissure, central sulcus, interhemispheric (longitudinal) fissure, transverse cerebral fissure.

Question 7

Frontal lobe sulci

Answer 7

precentral (anterior to precentral gyrus), superior (superior frontal gyrus from middle frontal gyrus), inferior (middle frontal from inferior frontal gyrus)

Question 8

Frontal lobe gyri/areas

Answer 8

pre-central gyrus, anterior aspect of paracentral lobule (brodmann area 4) = primary motor area

premotor area (Brodman area 6) = directs the primary motor area in execution of skilled motor activities

Question 9

Primary motor area

Answer 9

Frontal lobe. Origin of corticospinal, corticobulbar, & corticopontine neurons which innervate SC, BS & pontine nuclei LMN’s

Question 10

Premotor area

Answer 10

Frontal lobe. directs movement and planning of movements.

Question 11

Supplementary motor area

Answer 11

involved in planning and initiation of movement

Question 12

Broca’s motor speech area

Answer 12

(Frontal lobe # 44/45) 95% in left hemisphere Lesion = expressive aphasia (non-fluent aphasia)

Question 13

Frontal eye field

Answer 13

Frontal lobe. posterior medial frontal gyrus, causes voluntary conjugate CL eye movements.

Question 14

Cortical control of voluntary horizontal gaze�

Answer 14

Frontal eye fields –> axons cross brainstem & innervate CL abducens neurons, lateral rectus and internuclear neurons (MLF –> CL medial rectus). Right frontal eye field causes eyes to rotate to the left.

Question 15

Lesion to frontal eye fiels

Answer 15

Deviation of eyes ipsilateral to lesion d/t opposite pathway’s tonic input still being intact

Question 16

Frontal lobe: Brodmans areas 9. 10. 11. 12

Answer 16

judgement, rational thinking, projection into the future, social behavior and motivation.

Question 17

What is located in the inferior surface of the frontal lobe?

Answer 17

oribital gyrus, and gyrus rectus: personality, emotions, and behavior.

Question 18

Sulci of the Parietal lobe

Answer 18

post central (posterior to post-central gyrus), interparietal (separates the supraparietal lobule from the infraparietal lobule)

Question 19

Areas of parietal lobe

Answer 19

Superior parietal lobule, Inferior parietal lobule, precuneus, paracental lobule, post-central gyrus

Question 20

Superior parietal lobule

Answer 20

Brodmann areas 5,7: sensory associational cortex.

Astereoagnosis - w/o 3D knowledge

Question 21

Inferior parietal lobule

Answer 21

supramarginal (40) and angular (39) gyri: interpretation of written and spoken language

Question 22

Supramarginal gyrus

Answer 22

integrates kinesthetic memories with auditory commands. Lesion = ideomotor apraxia

Question 23

Angular gyrus

Answer 23

integrates visual, auditory, & tactile information. Damage = inability to read and write (alexia/agraphia)

Question 24

Precuneus

Answer 24

medial surface, sensory associational area.

Question 25

Paracentral lobule (posterior region)

Answer 25

Part of primary sensory cortex, receives sensory input from most of the CL LE.

Question 26

Postcentral gyrus

Answer 26

Brodmans areas 3,1, & 2. 1st somesthetic area (primary sensory cortex). Identifies the location of stimulus and the size and shape of objects.

Question 27

Homunculus

Answer 27

map of the body determined by recording responses from awake individuals during surgery in which different areas are electrically stimulated, & stimulating areas in the body and recording from the cortex.

Question 28

Sulci of the temporal lobe

Answer 28

Superior (separates the superior temporal gyrus from middle temporal gyrus) and inferior (separates the middle temporal gyrus from the inferior temporal gyrus)

Question 29

Areas/gyri of temporal lobe

Answer 29

superior temporal gyrus, inferior surface of temporal lobe

Question 30

Superior temporal gyrus

Answer 30

primary auditory area on superior surface (41/42), auditory associational area i.e. Wernickes area (22)

Question 31

Lesion to Wernickes area

Answer 31

receptive aphasia (auditoru agnosia or FLUENT aphasia)

Question 32

Inferior surface of temporal lobe

Answer 32

occipitotemporal gyrus (visual association), parahippocampal gyrus/uncus (limbic system)

Question 33

Functions of the sense of smell

Answer 33

increase enjoyment and desire for food, increases awareness of potentially harmful substance,s, communication (pheromones)

Question 34

What can anosmia and hyposmia be caused by?

Answer 34

nasal congestion, degeneration of olfactory epithelium from chronic exposure to toxic odorants, head trauma which damages axons of olfactory neurons as they travel through the cribriform plate, tumors in the anterior cranial fossa (may be initial symptom) Seizures originating near the uncus may be preceded by the perception of unpleasant odors (uncinate seizures) Decreased sense of smell --> malnutrition --> decreased energy for therapy

Question 35

Insular lobe (island of Reil)

Answer 35

posterior wall of lateral sylvian fissure. Involved with localization of pain, though to provide emotionally relevant context to sensory experiences.

Question 36

Occipital lobe sulci

Answer 36

parieto-occipital, calcarine

Question 37

Occipital lobe gyri

Answer 37

cuneus gyrus, lingual gyrus, brodmann area 17, brodmann area 18 & 19

Question 38

Cuneus gyrus

Answer 38

Occipital lobe: Right sees inferior L visual field

Question 39

Lingual gyrus

Answer 39

Occipital lobe: R sees superior L visual field

Question 40

Brodmann area # 17

Answer 40

primary visual cortex - located in the walls of the calcarine sulcus & adjacent areas of cuneus & lingual gyri

Question 41

Brodmann areas 18 & 19

Answer 41

Visual association

Question 42

Optic nerve pathway

Answer 42

receptors --> bipolar cells --> ganglion cells --> optic nerve --> optic chiasm --> optic tract --> lateral geniculate nucleus --> pretectal area/superior colliculus --> occipital cortex (cuneus and lingual gyri)

Question 43

Common eye disorders

Answer 43

monocular blindness, bitemporal hemianopsia, homonymous hemianopsia, macular degeneration, cataracts, papilledema, glaucoma

Question 44

pathway for left visual field

Answer 44

located in the walls of the calcarine sulcus & adjacent areas of cuneus & lingual gyri R temporal retina → optic nerve to R optic tract → R lateral geniculate nucleus → R cuneus/lingual gyri

Question 45

Lesions in visual field

Answer 45

Monocular blindness, bitemporal hemoanopsia (tunnel vision) (optic chiasm lesion), Homonymous hemianopsia (optic tract lesion)

Question 46

Homonymous hemianopsia

Answer 46

right homonymous hemianopsia = loss of rt visual field

Question 47

Macular Degeneration

Answer 47

degeneration of centrally located photoreceptros, loss of central vision with increasing difficulty with reading, watching TV or recognizing faces

Question 48

Cataracts

Answer 48

deterioration of the lens, gradual loss of vision with central vision lost first. Difficulty reading, needs to turn head often to locate items in the environment

Question 49

Papilledema

Answer 49

papilla in the termination of the subarachnoid space at the beginning of the optic nerve, increased subarachnoid pressure can cause swelling in the optic disc

Question 50

Glaucoma

Answer 50

increased intraocular pressure which can compress and cause degeneration of the retina --> blindness

Question 51

Sympathetic innervation to the eye

Answer 51

pupilalary dilator muscles in the iris, muellers muscle in the upper eyelid, damaged in Horner's syndrome

Question 52

What makes a hemisphere "dominant"

Answer 52

the hemisphere with language comprehension and production. left in 95% R handed and 75% left handed people

Question 53

Left hemisphere function

Answer 53

``` Handwriting Calculation Intelligence Rationalization Language comprehension Articulation ```

Question 54

Right hemisphere function

Answer 54

``` Drawing/artistic skills Recognition of faces Intuition Gestures Spatial awareness and shapes of objects ```

Question 55

Upper motor neuron

Answer 55

All the neurons that lead to innervation of the alpha and gamma motor neurons

Question 56

UMN lesion

Answer 56

CVA, MS, AMLS, Tumors, TBI, SCI

Question 57

Signs/Sx of UMN lesion

Answer 57

Spasticity, myoplasticity, hyperreflexia, no/minimal muscle atrophy, fibrillations, (+) babinski (corticospinal tract dysfunction)

Question 58

Spasticity

Answer 58

NM overactivity d/t: hyperreflexia - reduced higher level inhibitory control, increased sensitivity to muscle stretch reflex. & UMN hyperactivity of reticulospinal and vestibulospinal tracts, clasped knife phenomena

Question 59

Myoplasticity

Answer 59

adaptive muscular changes that occur in UMN diseases and in normally innervated but immobilized joints - increased # of weak actin/myosin bonds, selective atrophy of type I & II fibers, contracture

Question 60

Modified Ashworth Scale: 0

Answer 60

no increase in tone -This scale does not differentiate between spasticity and contracture

Question 61

Modified Ashworth Scale: 1

Answer 61

Slight increase tone with minimal resistance at end ROM

Question 62

Modified Ashworth Scale: 1+

Answer 62

Slight increase tone with minimal resistance less than half of ROM

Question 63

Modified Ashworth Scale: 2

Answer 63

More marked increase tone through most ROM; affected part easily moved

Question 64

Modified Ashworth Scale: 3

Answer 64

Considerable increase tone; PROM difficult throughout ROM

Question 65

Modified Ashworth Scale: 4

Answer 65

Rigid in flexion and extension