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Neuro Part 2 > Week 7.2 > Flashcards

Week 7.2 Flashcards

1
Q

What is the posterior association area?

A

a cortical region responsible for processing multimodal sensory information from multiple first order association cortices

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2
Q

What are the two divisions of the posterior association area?

A
  • dorsal stream: unconscious, relationship between objects

- ventral stream: conscious, object recognition

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3
Q

Which hemisphere is a person’s dominant hemisphere?

A

that which is responsible for symbolic reasoning (language)

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4
Q

The Folstein MMSE fails to test what two parts of the brain in any significant way?

A

executive functioning and the non-dominant hemisphere

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5
Q

How do we test the non-dominant hemisphere?

A

construction tasks

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6
Q

What is Broca’s area? Where is it in relationship to Wernicke’s area?

A
  • anterior to Wernicke’s area

- functions in speech production

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7
Q

What is the purpose of the direct fascicle between Wernicke’s and Broca’s areas?

A

allows you to repeat something without understanding it

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8
Q

What three aspects of language do we typically assess?

A
  • fluency
  • comprehension
  • repetition
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9
Q

How does Broca’s aphasia present?

A
  • comprehension intact
  • non-fluent
  • unable to repeat
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10
Q

How does Wernicke’s aphasia present?

A
  • fluent, nonsensical speech
  • repetition absent
  • comprehension absent
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11
Q

What is conduction aphasia?

A

intact comprehension and fluency but absent repetition

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12
Q

What is a trans-cortical sensory aphasia?

A

a lesion that disconnects Wernicke’s area from the posterior association cortex

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13
Q

How does trans-cortical sensory aphasia present?

A
  • fluent speech
  • repetition in tact
  • comprehension absent
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14
Q

Why are trans-cortical sensory and motor aphasias common?

A

because the tracts that connect Wernicke’s and Broca’s to the rest of the cortex often reside in watershed zones

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15
Q

What is alexia without agraphia?

A
  • speech fluency and comprehension in tact
  • ability to write in tact
  • ability to read is absent
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16
Q

What causes alexia without agraphia?

A

one between the visual association cortex and Wernicke’s area caused by a PCA stroke that also affects part of the corpus callosum

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17
Q

Alien hand syndrome is often the result of damage to what part of the brain?

A

the non-dominant hemisphere

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18
Q

How is dementia defined?

A

an acquired persistent intellectual impairment involving at least three domains: language, memory, visuospatial, emotion, executive

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19
Q

What is the primary difference between a cortical and a subcortical dementia?

A

subcortical is more likely to have motor signs

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20
Q

Fronto-temporal dementias often leave what abilities intact?

A
  • memory
  • language
  • construction
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21
Q

Focal dementias are more likely than diffuse ones to have what sort of etiology?

A

a non-degenerative one

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22
Q

What are two non-degenerative etiologies for subcortical dementia?

A
  • subcortical infarcts

- multiple sclerosis

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23
Q

What are the four most prevalent causes of dementia?

A
  • Alzheimer’s
  • Parkinson’s
  • Dementia with Lewy Bodies
  • Vascular Dementia
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24
Q

What is a primary headache?

A

a headache without a known cause

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25
Q

Which structures in the cranium are capable of sensing pain?

A
  • orbits
  • paranasal sinuses
  • teeth
  • dural sinuses
  • blood vessels
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26
Q

What is a migraine?

A

a severe headache

27
Q

What is a common migraine?

A

an episodic migraine with two or more of unilateral, throbbing, nausea, photophobia and phonophobia

28
Q

What is a classic migraine?

A

a migraine with aura

29
Q

What are the most common kinds of aura that precede migraines?

A
  • visual hallucinations

- a unilateral tingling

30
Q

What is the current hypothesis of what causes migraines?

A

abnormal innervation of large vessels by trigeminal nerve leads to peripheral pain sensitization

31
Q

What is the distinguishing feature of an ophthalmoplegic migraine?

A

third nerve palsy

32
Q

What is an acephalic migraine?

A

aura without the following headache, common in older patients

33
Q

What is status migrainosus?

A

a migraine lasting longer than three days

34
Q

What are some treatments for migraines?

A
  • NSAIDs/narcotics
  • triptans
  • antiemetics
  • caffeine
35
Q

What are triptans?

A

5HT agonists used as abortive treatments for headaches

36
Q

What are some migraine prophylactics?

A
  • antiepileptics
  • antidepressants
  • beta blockers
  • botulinum toxin
37
Q

How are tension-type headaches treated?

A
  • stress management
  • exercise
  • TCAs
  • SSRIs
  • NSAIDs
38
Q

What is a transformed migraine?

A

a form of chronic migraine in which frequency increases until the individual has a continuous low-grade headache between migraines as well

39
Q

What often causes chronic migraines?

A

the overuse of abortive treatments (most often opioids) by physicians rathe than prophylaxis

40
Q

Describe a cluster headache.

A
  • severe, unilateral and per-orbital

- temporally clustered

41
Q

Chronic secondary headaches are often due to what?

A
  • degenerative joint disease of the neck
  • TMJ
  • sinus disease
  • psychologic problems
  • refractive eye problems
42
Q

What might suggest a sinister cause of chronic headaches?

A
  • new onset after 35
  • focal neural findings and altered mental status
  • elevated ICP
  • inflammation, fever, or neck stiffness
43
Q

What are two sinister causes of secondary recurrent headaches?

A
  • pseudotumor cerebri

- giant cell arteritis

44
Q

What is a pseudo tumor cerebri?

A

resistance to flow in the arachnoid villi causing headaches

45
Q

What are the symptoms of pseudo tumor cerebri?

A
  • headahe
  • episodic blurred vision
  • papilledema
  • normal head imaging
46
Q

How does giant cell arteritis present?

A
  • over 50
  • temporal artery tenderness
  • elevated ESR
47
Q

What are some possible causes of acute severe headache?

A
  • meningitis
  • subarachnoid hemorrhage
  • mass lesion
48
Q

What is the internal medullary lamina?

A

a white mater tract that divides regions of the thalamus

49
Q

What are the thalamic motor nuclei?

A

VA and VL

50
Q

What are the limbic nuclei of the thalamus?

A

Anterior and MD

51
Q

Where does input into the VPL and VPM come from?

A

the DCML/ALS and face, respectively

52
Q

The MD nucleus of the thalamus receives input from where?

A

the olfactory system

53
Q

The MGN nucleus of the thalamus receives input from where?

A

the inferior colliculus and projects to the primary auditory cortex

54
Q

What is the pulvinar nucleus?

A

a thalamic nucleus that receives a broad, multi sensory input and has a broad output to alert us to new visual stimuli

55
Q

The VPL receives input from __ and projects to the ___.

A
  • from DC/ML and ALS

- to the somatosensory cortex

56
Q

Which thalamic nucleus is part of the Papez circuit?

A

the anterior nucleus

57
Q

Korsakoff’s syndrome involves damage to which thalamic nucleus?

A

the mediodorsal nucleus

58
Q

A lesion to the pulvinar nucleus of the thalamus causes what?

A

neglect syndrome

59
Q

Thalamic pain occurs following occlusion of what vessel?

A

the thalamogeniculate artery (branch of PCA)

60
Q

What is thalamic pain syndrome?

A

a thalamogeniculate occlusion causes a small lacunar stroke that results in contralateral sensory loss followed some time later by an excruciating, intractable pain

61
Q

What are the three parts of the internal capsule?

A
  • anterior limb
  • genu
  • posterior limb
62
Q

What fibers are carried in the anterior limb of the internal capsule?

A
  • frontoponteine fibers for cerebello-thalamo-cortico-pontine feedback
  • other corticothalamic fibers
63
Q

What fibers are carried in the gene of the internal capsule?

A

corticobulbar fibers

64
Q

What fibers are carried in the posterior limb of the internal capsule?

A
  • corticospinal

- somatosensory, visual, and auditory

Neuro Part 2 (18 decks)

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