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Neurology - Physiology > NEURO LESIONS IN SPECIFIC PARTS OF THE CEREBRUM > Flashcards

NEURO LESIONS IN SPECIFIC PARTS OF THE CEREBRUM Flashcards

1
Q

There are how many brodmann areas?

A

47

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2
Q

surface area of the cortex

A

Unfolded, it has a surface extent of about 4,000 cm2

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3
Q

the allocortex (“other cortex”), is composed of?

A

hippocampus and olfactory cortex

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4
Q

what are the layers of the cortex from the pial to subcortical

A 
the molecular (or plexiform), 
external granular, 
external pyramidal, 
internal granular, 
ganglionic (or internal
pyramidal), and 
multiform (or fusiform) layers
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5
Q

cell types of the cortex

A

types-relatively large
pyramidal cells and smaller, more numerous rounded
(granular) cells-predominate in the neocortex

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6
Q

2 types of neocortex

A

(1) the homol:tjpical cortex, in which the
six-layered arrangement is readily discerned, and (2) the
heterotypical cortex, in which the layers are less distinct.

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7
Q

The precentral cortex
(Brodmann areas 4 and 6, mainly motor region) is dominated by______________, especially
in layer V

A

pyramidal rather than granular cells

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8
Q

the primary sensory cortices, postcentral
gyrus (areas 3, 1, 2), banks of the calcarine sulcus
(area 1 7), and the transverse gyri of Heschl (areas 41 and
42), where layers II and IV are strongly developed for the
receipt of afferent impulses, has been termed __________because of the marked predominance of granular cells

A

granular cortex

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9
Q

Neurons of ___________
send axons to subcortical structures and the spinal cord.
Neurons of layer Vl project mainly to the_______

A

layer V (projection efferents)

thalamus

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10
Q

Another group of disorders known as __________depend not merely on involvement of certain
cortical regions but more specifically on the interruption
of inter- and intrahemispheric fiber tracts

A

disconnection

Syndromes

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11
Q

Area _______of the dominant hemisphere
(Broca area) and the contiguous part of ___________ are “centers” of motor speech and related functions of the lips, tongue, larynx, and pharynx

A

44

area 4

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12
Q

The ________ and anterior parts of the _________, which are the frontal components of the limbic system, take part in the control of respiration, blood pressure, peristalsis, and other autonomic function

A

medial-orbital gyri

cingulate and insular gyri

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13
Q

The ___________ and more
specifically, pyramidal cells of layer V of the pre- and
postcentral convolutions provide most of the cerebral
efferent motor system that forms the pyramidal, or corticospinal, tract

A

frontal agranular cortex (areas 4 and 6)

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14
Q

A tract, the ________, connects
the frontal with the occipital lobe and the ____________connects the orbital part of the frontal lobe with the temporal lobe

A

fronto-occipital fasciculus

uncinate bundle

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15
Q

With regard to behavior and the frontal lobe, the
___________ is in a general sense committed
to the planning, initiation, monitoring, and execution
of all cerebral activity

A

anterior half of the brain

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16
Q

lesions of the frontal lobes give rise

to:

A

a loss of drive, impairment of consecutive planning,
an inability to maintain serial relationships of events,
and to shift easily from one mental activity to another

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17
Q

lesions of these parts cause mutism, contralateral motor

neglect, and impairment of bibrachial coordination

A

Ablation of the right or left supplementan; motor areas
(the parts of area 6 that lie on the medial surfaces of the
cerebral hemispheres)

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18
Q

an important function of the

supplementary motor area is the ________________,

A

ordering of motor tasks

or the recall of memorized motor sequences

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19
Q

_________________________ the dominant
hemisphere result in a reduction or loss of motor
speech, and of agraphia, and apraxia of the face, lips, and
tongue,

A

Destruction of the Broca convolution (areas 44 and

45) and the adjacent insular and motor cortex of

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20
Q

they signify a loss of the
ability to use the lower limbs in the act of walking that
cannot be explained by weakness, loss of sensation, or
ataxia from lesions of frontal lobe

A

gait apraxia

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21
Q

lesions resulting in incontinence

A

Right- or left-sided lesions involving the posterior

part of the superior frontal gyrus, the anterior cingulate gyrus, and the intervening white matter

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22
Q

speech problems associated with frontal lobe disease

A

laconic speech,
lack of spontaneity of speech, telegrammatic speech
(agrammatism), loss of fluency, perseveration of speech, a
tendency to whisper instead of speaking aloud, and dysarthria

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23
Q

lesions that lead to abulia

A

ventromedial

frontal regions or frontal-diencephalic connections

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24
Q

Disinhibition occurs largely

with_________

A

dorsolateral frontal lesions.

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25
Q

These patients, otherwise displaying mental
clarity and despite negative personal and social consequences,
collect massive amounts of useless items such
as newspapers, junk mail, catalogs, food, clothing, and
appliances, often encompassing several categories

A

Pathological collecting behavior (hoarding)

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26
Q

lesions associating with hoarding behavior

A

medial frontal lobe damage, including the cingulate

gyri

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27
Q

In general, the greatest cognitive-intellectual deficits

relate to lesions in the __________

A

dorsolateral parts of the prefrontal lobes

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28
Q

greatest personality, mood, and behavioral changes stem from lesions of the ____________

A

medialorbital

parts,

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29
Q

associations:

left dorsal frontal lesions and _______________, and right side orbitofrontal lesions, with___________

A

anger with hostility

anxiety and depression

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30
Q

Psych tests to check for frontal lobe dysfunction

A 
They include the
Wisconsin card-sorting test, 
the Stroop color-naming test, 
sequencing of pictures, 
"trail making test"
"go-no-go" test
threestep
hand posture test of Luria
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31
Q

abnormaility in Luria test results in this:

A

“kinetic limb apraxia

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32
Q

what is “kinetic limb apraxia

A

the natural kinetic “melody,” or
smoothness of transition from one hand position to the
next is disrupted and there is a tendency to perseverate

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33
Q

Effects of unilateral frontal disease, either left or right

A

A. Contralateral spastic hemiplegia
B. Contralateral gaze paresis
C. Apathy and loss of initiative or its opposite,
slight elevation of mood, increased talkativeness,
tendency to joke inappropriately (witzelsucht), lack
of tact, difficulty in adaptation
D. If entirely prefrontal, no hemiplegia; but grasp
and suck reflexes or instinctive grasping may be
released
E. Anosmia with involvement of orbital parts

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34
Q

Effects of right frontal disease

A

A. Left hemiplegia

B. Changes as in I.B, C, and D

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35
Q

Effects of left frontal disease

A

Right hemiplegia
B. Broca’s aphasia with agraphia, with or without
apraxia of the lips and tongue (see Chap. 23)
C. Sympathetic apraxia of left hand (see

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36
Q

Effects of bifrontal disease

A

A. Bilateral hemiparesis
B. Spastic bulbar (pseudobulbar) palsy
C. If prefrontal, abulia or akinetic mutism, lack of
ability to sustain attention and solve complex
problems, rigidity of thinking, bland affect, social
ineptitude, behavioral disinhibition, inability to
anticipate, labile mood, and varying combinations
of grasping, sucking, obligate imitative movements,
utilization behavior
D. Decomposition of gait and sphincter incontinence

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37
Q

The ________________ supplies blood to the convexity of the temporal lobe,

and the _______________________supplies the medial and inferior aspects, including the hippocampus

A

inferior branch of the middle cerebral
artery

temporal branch of the posterior cerebral artery

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38
Q

The
______________ an integral part of the auditory cortex, lies immediately posterior to the Heschl convolutions, on the superior surface of the temporal lobe

A

planum temporale (area 22),

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39
Q

The middle and inferior temporal gyri (areas 2 1
and 37) receive a massive contingent o f fibers from
the___________and the______________

A

striate cortex (area 1 7)

 parastriate visual
association areas (areas 18 and 1 9 ) .
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40
Q

The superior part of the dominant temporal lobe is

concerned with the ___________

A

acoustic or receptive aspects of language

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41
Q

The most important functions of the hippocampus
and other structures of the hippocampal formation
(dentate gyrus, subiculum, entorhinal cortex, and parahippocampal
gyrus) are___________

A

learning and memory

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42
Q

The temporal

lobes are connected to one another through the _____ and _______

A

anterior

commissure and middle part of the corpus callosum

43
Q

Physiologically, ________ is an integrator of
“sensations, emotions, and behavior” in so far as it relates
the organism’s sensory experiences to emotional meaning
thought it’s proximity to the limbic system

A

the temporal lobe

44
Q

lesions
of the white matter of the central and posterior parts of
the temporal lobe characteristically involve the lower
arching fibers of the _______

A 
geniculocalcarine pathway (Meyer
loop).
45
Q

In ______________, auditory sensations cannot be
distinguished from one another. Such varied sounds as
the tinkling of a bell, the rustling of paper, running water,
and a siren all sound alike

A

agnosia for sounds

46
Q

Also, it was observed that lesions of the right auditory
cortex impaired the recognition of __________ (the temporal sequence of pitches) and of ____________ (the sounding of simultaneous pitches)

A

melody

harmony

47
Q

it appears that the left inferior

frontal region is activated by tasks that involve the ____________

A

identification

of familiar music

48
Q

nondominant hemisphere is important for the _____________________
but that the naming of musical scores and all the semantic
(writing and reading) aspects of music require the integrity
of the ________________

A

recognition
of harmony and melody (in the absence of words),

dominant temporal and probably the frontal
lobes as wel

49
Q

___________i s a failure o f the left temporal
lobe function in decoding the acoustic signals of speech
and converting them into understandable words

A

word deafness

50
Q

It should also be noted that complex
but unformed auditory hallucinations (e.g., the sound of
an orchestra tuning up), as well as entire strains of music
and singing, also occur, inexplicably, with lesions that
appear to be restricted to the ______

A

pons (pontine auditory hallucinosis,

51
Q

Stimulation of this cortical
area for the treatment of intractable tinnitus has elicited
________

A

autoscopy

52
Q

What is autoscopy

A

seeing one’s self from an external

perspective

53
Q

The central
areas identified physiologically with olfaction are the
____________________, i.e., the areas that mediate numerous
visceral functions

A

posterior orbitofrontal, subcallosal, anterior temporal,

and insular cortices

54
Q

Stimulation of the posterior
parts of the___________________of
fully conscious epileptic patients can arouse complex
memories and visual and auditory images, some with
strong emotional content

A

first and second temporal convolutions

55
Q 
The loss of certain visual integrative abilities, particularly
face recognition (prosopagnosia), is usually
assigned to lesions of the\_\_\_\_\_\_\_\_\_\_\_\_
A

inferior occipital lobes

56
Q

difference in dominant vs non-dominant temporal lobectomy

A

With the
former, there is dysnomia and impairment in the learning
of material presented through the auditory sense; with
the latter, there is impairment in the learning of visually
presented material

57
Q

Effects of unilateral disease of the dominant temporal

lobe

A

A. Homonymous contralateral upper quadrantanopia
B. Wernicke’s aphasia (word deafness; auditory
verbal agnosia)
C. Dysnomia or amnesic aphasia
D. Amusia (some types)
E. Visual agnosia
F. Occasionally, amnesic (Korsakoff ) syndrome

58
Q

Effects of unilateral disease of the nondominant temporal

lobe

A

A. Homonymous upper quadrantanopia
B. Inability to judge spatial relationships in some
cases
C. Impairment in tests of visual! y presented nonverbal
material
D. Agnosia for sounds and some qualities of music

59
Q

Effects of disease of either temporal lobe

A

A. Auditory, visual, olfactory, and gustatory
hallucinations
B. “Dreamy” states with seizure (focal temporal
lobe seizure)
C. Emotional and behavioral changes
D. Delirium-confusional states (usually nondominant

60
Q

Effects of bilateral temporal lobe disease

A

A. Korsakoff amnesic defect (hippocampal
formations)
B. Apathy and placidity
C. Kliiver-Bucy syndrome: compulsion to attend to
all visual stimuli, hyperorality, hypersexuality,
blunted emotional reactivity; the full syndrome
is rarely seen in humans

61
Q

This sulcus runs anteroposteriorly from the middle
of the posterior central sulcus and separates the mass
of the parietal lobe into superior and inferior lobules

A

interparietal

sulcus

62
Q

The inferior parietal lobule is composed
of the ______________(Brodmann area 40) and the
____________(area 39).

A

supramarginal gyrus

angular gyrus

63
Q

The architecture
of the postcentral convolution is typical of all primary
receptive areas________________

A

(homotypical granular cortex).

64
Q

the anterior parietal cortex contains
the mechanisms for__________.

______, are organized in the more
posterior, secondary sensory areas

A

tactile percepts

Discriminative tactile
functions

65
Q

The discomfort involved the entire half of the body or

matched the region of cortical hypesthesia; in a few cases, the symptoms were paroxysmal

A

pseudothalamic pain st;ndrome

66
Q

With _______________ there is sometimes
an associated mild hemiparesis, as this portion of
the parietal lobe contributes a considerable number of
fibers to the corticospinal tract

A

anterior parietal lobe lesions,

67
Q

In instances of cortical sensory disturbance, the outstretched
hand may display small random “searching”
movements of the fingers that simulate playing a piano
; these are exaggerated when the eyes
are closed. What is this phenomenon called?

A

(pseudoathetosis)

68
Q

a patient with
a dense hemiplegia, usually of the left side, may be
indifferent to a paralysis, or is entirely unaware of it

A

Anosognosia and hemispatial neglect (AntonBabinski

syndrome)

69
Q

On the other extreme of the conceptual negation
of paralysis are instances of self-mutilation of the
paralyzed limb __________

A

(apotemnophilia).

70
Q

Another common group of parietal symptoms consists
of neglect of one side of the body in dressing and
grooming, recognition only on the intact side of bilaterally
and simultaneously presented stimuli_________

A

(sensory

extinction)

71
Q

Conventional treatments for hemispatial neglect use
_________ and training in visual exploration of the
left side.

A

prismatic glasses

72
Q

what is the use of the mirror in the treatment of hemispatial neglect

A

With a mirror in the right parasagittal plane, the patient
observes the mirror image of their neglected hand and
space and is induced to use that side more naturally

73
Q

When
defects of apraxia are intertwined with agnosic defects,
the term ____________ seems appropriate.

A

apractognosia

74
Q

A special type
of visuospatial disorder, separable from neglect but also
associated with lesions of the nondominant parietal lobe,
is reflected in the patient’s inability to reproduce geometric
figures __________

A

(constructional apraxia)

75
Q

Lesions of Gerstmann

A

The lesion is in the left inferior
parietal lobule (below the interparietal sulcus), particularly
involving the angular gyrus or subjacent white matter of
the left hemisphere.

76
Q

Occasionally, severe left-sided visual
neglect results from a lesion in the _________

Visual neglect can also occur after focal
lesions in the __________

A

right angular gyrus

posterior medial temporal lobe

77
Q

lesions of what side of the parietal lobe?

A

R

78
Q

Effects of unilateral disease of the parietal lobe, right

or left

A

A. Corticosensory syndrome and sensory extinction
(or total hemianesthesia with large acute lesions
of white matter)
B. Mild hemiparesis or poverty of movement (variable),
poverty of movement, hemiataxia (seen
only occasionally)
C. Homonymous hemianopia or inferior quadrantanopia
(incongruent or congruent) or visual
inattention
D. Abolition of optokinetic nystagmus with target
moving toward side of the lesion
E. Neglect of the opposite side of external space
(more prominent with lesions of the right parietal
lobe; see later)

79
Q 
Effects of unilateral disease of the dominant (left)
parietal lobe (in right-handed and most left-handed
patients); additional phenomena include
A

A. Disorders of language (especially alexia)
B. Gerstmann syndrome (dysgraphia, dyscalculia,
finger agnosia, right-left confusion)
C. Tactile agnosia (bimanual astereognosis)
D. Bilateral ideomotor and ideational apraxia

80
Q

Effects of unilateral disease of the nondominant

(right) parietal lobe

A

A. Visuospatial disorders
B. Topographic memory loss
C. Anosognosia, dressing, and constructional apraxias
(these disorders may occur with lesions of
either hemisphere but are observed more frequently
and are of greater severity with lesions of
the nondominant one)
D. Confusion
E. Tendency to keep the eyes closed, resist lid opening,
and blepharospasm

81
Q

Effects of bilateral disease of the parietal lobes

A 
A. Balint syndrome: visual-spatial imperception (simultagnosia),
optic apraxia (difficulty directing gaze),
and optic ataxia (difficulty reaching for objects)
82
Q

The large calcarine fissure courses in an
anteroposterior direction from the pole of the occipital
lobe to the _________

A

splenium of the corpus callosum

83
Q

Area 17 is a typical homotypical
cortex but is unique in that its fourth receptive layer
is divided into two granular cell laminae by a greatly
thickened band of myelinated fibers,__________

A

the external band

of Baillarger.

84
Q

This stripe, also called the line or band of
Gennari, is grossly visible and has given this area its
name, __________

A

striate cortex

85
Q

The largest part of area 17 is the
terminus of the _________ that arrive via the
lateral geniculate

A

retinal macular fibers

86
Q

The occipital lobes are supplied almost exclusively
by the posterior cerebral arteries and their branches,
either directly in most individuals or through an embryologically
persistent branch of the ____________
(“fetal” posterior cerebral artery)

A

internal carotid arteries

87
Q

monkeys with bilateral lesions in the temporal
visual zones lose the ability to _______; with
posterior parietal lesions, there is loss of ability ________

A

identify objects

to locate
objects.

88
Q

EEG findings for cortical blindness

A

With rare exceptions, no cortical
potentials can be evoked in the occipital lobes by light
flashes or pattern changes (visual evoked response),
and the alpha rhythm is lost in the electroencephalogram
(

89
Q

natural hx for recovery from cortical blindness

A

from cortical blindness
through visual agnosia and partially impaired perceptual
function to recovery.

90
Q

Vis u a l A n o so g n os i a (Anto n Syn d ro m e ) lesions

A

The lesions in cases of negation of
blindness extend beyond the striate cortex to involve the
visual association areas.

91
Q

What comprises Vis u a l I l l u s i o n s ( M eta m o rp h o ps i a s )

A

deformation of the image,
change in size, illusion of movement, or a combination
of all thr􀃈ee

92
Q

The illusion of tilting
of the environment or upside-down vision is known to
occur with __________, but occurs more often
with abnormalities of the _________

A

parietooccipital lesions

vestibular system.

93
Q

It is usually the case that the lesions responsible for
visual hallucinations are situated in the _______________ and that elementary
hallucinations have their origin in the________
and complex ones in the _______

A

occipital lobe or posterior part of the temporal lobe

occipital cortex,

temporal cortex

94
Q

distinct processes of visual recognition

A

the construction of a perceptual representation from vision (perception)

and the mapping of this perceptual representation onto stored percepts or engrams of the object’s functions and associations (apperception)

95
Q

In pts with prosopagnosia, how do they identify the person

A

In identifying
persons, the patient depends on other data, such as the
presence and type of glasses or moustache, the type of
gait, or sound of the voice.

96
Q

The patient may be able to describe a familiar
environment from memory and locate it on a map, but
he experiences no sense of familiarity and gets lost when
faced with the actual landscape. What is this?

A

environmental agnosia.

97
Q

The common
form of retinal color blindness is congenital and is readily
tested by the use of ________

A

Ishihara plates

98
Q

___________ is
frequently associated with visual field defects and with
prosopagnosia

A

Achromatopsia

99
Q

no
difficulty with color perception (i.e., they can match
seen colors), but they cannot reliably name them or
point out colors in response to their names

A

color anomia

100
Q

Occipital lobe lesions:

Effects of unilateral disease, either right or left

A

A. Contralateral (congruent) homonymous hemianopia,
which may be central (splitting the
macula) or peripheral; also homonymous
hemiachroma topsia
B. Elementary (unformed) hallucinations-usually
because of irritative lesions

101
Q

Effects of left occipital disease

A

A. Right homonymous hemianopia
B. If deep white matter and splenium of corpus callosum
is involved, alexia without agraphia
C. Visual object agnosia

102
Q

Effects of right occipital disease

A

A. Left homonymous hemianopia
B. With more extensive lesions, visual illusions
(metamorphopsias) and hallucinations (more frequent
with right-sided than left-sided lesions)
C. Loss of topographic memory and visual
orientation

103
Q

Bilateral occipital disease

A

A. Cortical blindness bilateral hemianopias,
B. Anton syndrome (visual anosognosia, denial of
cortical blindness)
C. Loss of perception of color (achromatopsia)
D. Prosopagnosia (impaired face recognition,
bilateral temporooccipital including fusiform
gyrus)
E. Balint syndrome (bilateral dorsal parietooccipital)

Neurology - Physiology (44 decks)

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