Higher Order Cerebral Functions Flashcards
1
Q
What are unimodel cerebral functions?
A
modality-specific
EX: motor association or visual association
2
Q
What are heteromodal cerebral functions?
A
Bilateral association
Higher order mental and emotional functions
3
Q
Many basic sensory/motor functions in brain are distributed symmetrically and are connected by what?
A
Long association fibers carried by corpus callosum
4
Q
Why are asymmetries noted in certain brain functions?
A
Allow brain to process w/o other side of brain (decrease time for hemis to talk)
5
Q
Handedness skilled complex motor tasks are programmed by which hemi?
A
Dominant
simple movements controlled by each hemi
6
Q
What if patient with Apraxia had a left hemi lesion, would they be able to complete command with left side?
A
No, both hands would be unable to complete task
7
Q
T/F There is bilateral representation of language in many left handers
A
True
8
Q
Right/Left handers will recover more quickly?
A
Left handers
9
Q
Which hemi will:
- Take lead in complex visual-spatial skills
- imparts emotional significance to events and language
- Music perception
A
Non dom hemi
10
Q
Lesion of non dom hemi will lead to what?
A
Neglect
11
Q
What visual-spatial analysis/constructional difficulties will non dom hemi lesions experience?
A
- Drawing pictures
- arranging blocks in specific patterns
- difficulty matching orientation of lines displayed at different angles
12
Q
non dom hemi lesions may experience gestalt difficulties, what are they?
A
overall spatial arrangement - patient can’t look at big picture
13
Q
T/F non dom hemi lesion tend to have mild personality/emotional changes
A
False, tend to have relatively severe personality and emotional changes
14
Q
Non dom hemi or dom hemi have increased likelihood to have delusions and hallucinations?
A
Non dom hemi
15
Q
Capgas Syndrome -
A
nondominant
Patients insist that their friends and family members have all been replaced by identical-looking imposters
16
Q
Fregoli syndrome -
A
nondominant
Patients believe that different people are actually the same person in disguise
17
Q
Reduplicative paramnesia -
A
nondominant
Patients believe that a person, place, or object exists as two identical copies
18
Q
Choose dom (usually rigth)/non dom (usually left) hemi: Musical ability: in untrained musicians, and for complex musical pieces in trained musicians
A
Non dom (right)
19
Q
Choose dom (usually rigth)/non dom (usually left) hemi: Musical ability: sequential and analytic skills in trained musicians
A
Dom (left)
20
Q
Choose dom (usually rigth)/non dom (usually left) hemi: Skilled motor formulation (praxis)
A
dom (left)
21
Q
Choose dom (usually rigth)/non dom (usually left) hemi: Visual-spatial analysis and spatial attention
A
Non dom (right)
22
Q
Choose dom (usually rigth)/non dom (usually left) hemi: prosody (emotion conveyed by tone of voie)
A
Non dom (right)
23
Q
Choose dom (usually rigth)/non dom (usually left) hemi: Language
A
Dom (left)
24
Q
Choose dom (usually rigth)/non dom (usually left) hemi: Arithmetic: sequential and analytical calculating skills
A
dom (left)
25
```
Choose dom (usually rigth)/non dom (usually left) hemi:
Arithmetic: ability to estimate quantity and to correctly line up columns of numbers on the page
```
non dom (right)
26
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Choose dom (usually rigth)/non dom (usually left) hemi:
Sense of directions: following a set of written directions in sequence
```
dom (left)
27
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Choose dom (usually rigth)/non dom (usually left) hemi:
Sense of direction: finding one’s way by overall sense of spatial orientation
```
non dom (right)
28
How do broca's and wernicke's communicate?
Arcuate fasiciculus
29
Which brain area helps with higher motor aspects of speech formation (planning) and syntax (grammer)?
Frontal lobes
30
Which brain area helps with Lexicon (vocabulary bank) and Writing?
Supramarginal Gyrus & Angular Gyrus (Parietal & Temporal Lobes)
31
Which brain area helps with reading?
visual Cortex, Visual Association Cortex
32
Which hemi helps with language network – recognition and production of emotion in our speech?
Non dom hemi
33
T/F The thalamus and basal ganglia will also be involved in language
True
34
Syndromes that relate to aphasia:
| What is Alexia and where would you find damage?
o Impairment in reading ability
o Alexia without aphasia: lesion to the dominant occipital cortex extending to the posterior corpus callosum (often PCA infarct)
35
Syndromes that relate to aphasia:
| What is Agraphia and where would you find damage?
o Impairment in writing ability
| o Agraphia without aphasia: lesions of inferior parietal lobule of language-dominant hemisphere
36
Syndromes that relate to aphasia:
| What is Alexia with Agraphia? Where would you find damage?
o Lesions of dominant inferior parietal lobe, region of angular gyrus
o Aphasia absent or only mild dysnomia and paraphasias
37
Gerstmann's Syndrome
What 4 issues?
Damage to what?
involvement to dominant inferior parietal lobe
1. Agraphia
2. Acalculia - Impaired arithmetic calculating abilities
3. R-L disorientation
4. Finger agnosia - Inability to name individual fingers
38
What are the two streams of information passed along from visual cortex to its association cortex?
Where?
Analyzes motions and spatial relationships between objects
Analyses motion and spatial relationship between body and visual stimuli
What?
Analyzes form
39
Disorders involving the Primary Visual Cortex
| Cortical Blindness - where/what?
Bilateral occipital lobe lesion
| Complete visual loss on confrontation testing (blink to threat – hand to face)
40
Disorders involving the Primary Visual
| Blindsight - where/what?
Performs tasks without conscious visual perception
| Visual cortex lesion
41
Disorders involving the Primary Visual
| Anton's Syndrome - where/what?
Bilateral occipital lobe lesion
| Complete visual loss on confrontation testing + anosognosia (denial of impairments)
42
Syndromes of the Inferior Occipitotemporal Cortex:
| Prosopagnosia -
inability to recognize faces
43
Syndromes of the Inferior Occipitotemporal Cortex:
| Achromatopsia (diff in whole visual field loss or just one eye)?
Difficulty with color perception
Whole visual field involved: Lesions in bilateral inferior occipitotemporal cortex
One eye: contralateral cortical involvement
44
Syndromes of the Inferior Occipitotemporal Cortex:
| Micropsia, macropsia?
Objects appear unusually small or big
45
Syndromes of the Inferior Occipitotemporal Cortex:
| Metamorphopsia
Objects have distorted shape and size
46
Syndromes of the Inferior Occipitotemporal Cortex:
| Cerebral diplopia/polyopia?
Sees two or more of things
| Occipital lobe lesion
47
Dorsolateral Parieto-Occipital Cortex (“Where?):
| Simultanagnosia -
Impaired ability to perceive parts of a visual scene as a whole (visuals constantly moving around to them – difficult to maintain focus on objects)
48
Dorsolateral Parieto-Occipital Cortex (“Where?):
| Optic Ataxia - (what is difference between coordination)
Impaired ability to reach for or point to objects in space under visual guidance (different than coordination = all other sensory is fine, patients do not have problem with finger to nose if they close their eyes and/or once they hit it once, they will improve their visual performance)
49
Dorsolateral Parieto-Occipital Cortex (“Where?):
| Ocular Apraxia -
Difficulty voluntarily directing one’s gaze towards objects in peripheral vision (despite normal CN, may compensate with movement of head to get eyes moving)
50
Dorsolateral Parieto-Occipital Cortex (“Where?):
| Baliant's Syndrome - (what 3 things would you see)
```
Bilateral lesions of DL parieto-occipital cortex
Clinical Triad:
1. Simultanagnosia
2. Optic Ataxia
3. Ocular Apraxia
```
51
Where do we see connections to/from the prefrontal cortex??
Everywhere
52
What are 2 cortical connections of the prefrontal cortex?
o Association cortices
| o Limbic cortex
53
What are 5 subcortical connections of the prefrontal cortex?
```
o Amygdala
o Hippocampus
o Thalamus (via mediodorsal nucleus)
o Basal Ganglia (via caudate nucleus)
o And more…
```
54
What are 3 general functions of the frontal lobe?
1. Restraint (judgement, concentration)
2. Initiative (drive, motivation)
3. Order (abstract reasoning, working memory)
55
What characteristics when dorsolateral front lobe disorder?
apathetic, abulic (abnormal inability to act or make decisions, apathetic, delayed responses)
56
What characteristics when ventromedial front lobe disorder?
impulsive, disinhibited, poor judgement
57
Left hemi frontal lobe disorder vs right?
o Left: associated with depression-like symptoms
| o Right: more associated with behavioral disturbances like mania
58
Frontal lobe syndromes are also called what?
“Dysexecutive Syndrome”
59
Frontal lobe symptoms:
| disinhibition -
Silly behavior, crass jokes, aggressive outbursts
60
```
Frontal lobe symptoms:
Inappropriate jocularity (“witzelsucht”)
```
Seemingly unconcerned about potentially serious matters
61
Frontal lobe symptoms:
Utilization behavior/environmental dependence -
Also called what?
Respond to whatever stimuli at hand, even when not appropriate
“Next bed over syndrome” – will answer questions even if not for them
62
Frontal lobe symptoms:
| Frontal release signs -
Palmar reflex, grasp reflex, sucking reflex, etc
63
Frontal lobe symptoms:
| Paratonia -
Increase in tone, but in a manner in which patient appears to resist the movements of the examiner in almost a willful fashion
64
Frontal lobe symptoms:
| "Frontal gait" -
Shuffling, unsteady, magnetic gait
