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Neuro Part 2 > Week 7.2 > Flashcards

Week 7.2 Flashcards

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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
Which structures in the cranium are capable of sensing pain?
- orbits - paranasal sinuses - teeth - dural sinuses - blood vessels
26
What is a migraine?
a severe headache
27
What is a common migraine?
an episodic migraine with two or more of unilateral, throbbing, nausea, photophobia and phonophobia
28
What is a classic migraine?
a migraine with aura
29
What are the most common kinds of aura that precede migraines?
- visual hallucinations | - a unilateral tingling
30
What is the current hypothesis of what causes migraines?
abnormal innervation of large vessels by trigeminal nerve leads to peripheral pain sensitization
31
What is the distinguishing feature of an ophthalmoplegic migraine?
third nerve palsy
32
What is an acephalic migraine?
aura without the following headache, common in older patients
33
What is status migrainosus?
a migraine lasting longer than three days
34
What are some treatments for migraines?
- NSAIDs/narcotics - triptans - antiemetics - caffeine
35
What are triptans?
5HT agonists used as abortive treatments for headaches
36
What are some migraine prophylactics?
- antiepileptics - antidepressants - beta blockers - botulinum toxin
37
How are tension-type headaches treated?
- stress management - exercise - TCAs - SSRIs - NSAIDs
38
What is a transformed migraine?
a form of chronic migraine in which frequency increases until the individual has a continuous low-grade headache between migraines as well
39
What often causes chronic migraines?
the overuse of abortive treatments (most often opioids) by physicians rathe than prophylaxis
40
Describe a cluster headache.
- severe, unilateral and per-orbital | - temporally clustered
41
Chronic secondary headaches are often due to what?
- degenerative joint disease of the neck - TMJ - sinus disease - psychologic problems - refractive eye problems
42
What might suggest a sinister cause of chronic headaches?
- new onset after 35 - focal neural findings and altered mental status - elevated ICP - inflammation, fever, or neck stiffness
43
What are two sinister causes of secondary recurrent headaches?
- pseudotumor cerebri | - giant cell arteritis
44
What is a pseudo tumor cerebri?
resistance to flow in the arachnoid villi causing headaches
45
What are the symptoms of pseudo tumor cerebri?
- headahe - episodic blurred vision - papilledema - normal head imaging
46
How does giant cell arteritis present?
- over 50 - temporal artery tenderness - elevated ESR
47
What are some possible causes of acute severe headache?
- meningitis - subarachnoid hemorrhage - mass lesion
48
What is the internal medullary lamina?
a white mater tract that divides regions of the thalamus
49
What are the thalamic motor nuclei?
VA and VL
50
What are the limbic nuclei of the thalamus?
Anterior and MD
51
Where does input into the VPL and VPM come from?
the DCML/ALS and face, respectively
52
The MD nucleus of the thalamus receives input from where?
the olfactory system
53
The MGN nucleus of the thalamus receives input from where?
the inferior colliculus and projects to the primary auditory cortex
54
What is the pulvinar nucleus?
a thalamic nucleus that receives a broad, multi sensory input and has a broad output to alert us to new visual stimuli
55
The VPL receives input from __ and projects to the ___.
- from DC/ML and ALS | - to the somatosensory cortex
56
Which thalamic nucleus is part of the Papez circuit?
the anterior nucleus
57
Korsakoff's syndrome involves damage to which thalamic nucleus?
the mediodorsal nucleus
58
A lesion to the pulvinar nucleus of the thalamus causes what?
neglect syndrome
59
Thalamic pain occurs following occlusion of what vessel?
the thalamogeniculate artery (branch of PCA)
60
What is thalamic pain syndrome?
a thalamogeniculate occlusion causes a small lacunar stroke that results in contralateral sensory loss followed some time later by an excruciating, intractable pain
61
What are the three parts of the internal capsule?
- anterior limb - genu - posterior limb
62
What fibers are carried in the anterior limb of the internal capsule?
- frontoponteine fibers for cerebello-thalamo-cortico-pontine feedback - other corticothalamic fibers
63
What fibers are carried in the gene of the internal capsule?
corticobulbar fibers
64
What fibers are carried in the posterior limb of the internal capsule?
- corticospinal | - somatosensory, visual, and auditory

Neuro Part 2 (18 decks)

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