Neuro final exam

list the domains of cognition

attention, memory, executive functions, social cognition, perception, sensory/motor control

A M EF SC P SMC

name the divisions of attention

focused, sustained, selective, alternating, divided

what is focused attention?

general ability to notice stimulus

what is sustained attention?

ability to maintain attention over time

what is alternating attention?

ability to focus on one thing and filter out and ignore others

what is divided attention?

ability to focus on two tasks at the same time (multitasking)

what are the divisions of memory?

short-term, long-term, working memory

what is working memory?

type of memory where information is manipulated from short-term memory

lasts same length of time as short-term memory

what is short-term memory?

holding space for information to attach recall to it and put it in long-term memory

small amount of information for a short-term

what is long-term memory?

stored information for long period of time

what are the types of long term memory?

declarative and nondeclarative

what are declarative memories and their types?

have to work to remember, consciously recall information

episodic: events

semantic: facts

what are nondeclarative memories and their types?

don’t have to consciously recall, just in your memory

procedural: how to do things like riding a bike

more likely to retain these memories

what is ischemia?

reduced blood supply to an organ

what is an infarct?

small area of dead tissue

what is an artery?

mechanism that carries oxygenated blood to the brain

divided into arterials and capillaries

what is a vein?

carries deoxygenated blood back to heart

same branching system as arteries- divides into veinals and capillaries

what are capillaries?

connect arteries to veins

smallest dimension of branch where blood moves slowly and allows nutrient exchange

terminal extension

the carotid system divides into…

external and internal carotid arteries

internal divides into anterior and middle cerebral arteries

the vertebral basilar system divides into…

posterior cerebral arteries

what is the circle of willis?

protective mechanism of branches of blood supply in the brain that allows alternate circulation if there’s injury

what are the three categories of branches of the circle of willis?

internal carotid

basilar

connection

need to be able to label circle of willis

what is an ischemic penumbra?

area that surrounds infarct

what are the two major artery systems that carry blood to the brain?

carotid artery system and vertebral basilar system

describe the pathway of the carotid system.

ascends both sides of neck, when it reaches the jawline, it splits into two branches- the internal and external carotid arteries

what does the internal branch of the carotid system supply blood to?

large part of brain

enters skull and branches in complex way- anteriorly and middle

the anterior cerebral artery is a branch of the…

internal carotid branch of the carotid system

the vertebral basilar system provides blood supply to…

posterior circulation system of brain and brainstem

describe the pathway of the vertebral basilar system.

arises near level of subclavian arteries and ascends through upper cervical vertebra and eventually merges into one artery (basilar artery), then it branches into posterior cerebral artery

the posterior cerebral artery is a branch of the…

vertebral basilar system

draw and label Circle of Willis

where does the anterior cerebral artery supply in the brain?

orbital and medial cortical surfaces of prefrontal, frontal, parietal lobes

anterior 80% of corpus callosum and caudate head and putamen

where does the middle cerebral arteries supply in the brain?

lateral cortical surface of each hemisphere, internal capsule

emerge through Sylvian fissure

what are the signs and deficits associated with an issue with the anterior cerebral artery?

loss of somatic sensory and paralysis of contralateral leg and foot

mental impairments: lack of spontaneity, easy distraction, problem solving deficits, indecisiveness, altered personality

what are the signs and deficits associated with an issue with the middle cerebral artery?

contralateral hemiplegia and hemianesthesia with spared leg and foot

homonymous hemianopsia

aphasia (dominant)

visual-spatial deficit and constructional apraxia (nondominant)

where does the vertebral arteries supply in the brain?

medulla, cerebellum, choroid plexus of fourth ventricle

where does the basilar artery supply in the brain?

lateral pons, cerebellum, cranial nerves

what are the signs and deficits associated with an issue with the vertebral arteries?

contralateral hemiplegia

loss of discriminative touch, temperature, pain sensation from ipsilateral face

loss of pain and temperature from contralateral limbs

ipsilateral ataxia

vertigo, nystagmus and vomiting

dysphagia and dysarthria

what are the signs and deficits associated with an issue with the basilar artery?

hemiplegia, ataxia, loss of facial sensation, facial paralysis, deafness and nystagmus, vertigo, vomiting

what is collateral circulation?

provision of alternative vascular supply

occurs where vascular supplies overlap

important for recovery

the anterior communicating artery connects the…

two anterior cerebral arteries

the posterior communicating artery connects the…

carotid and posterior systems

what are the watershed zones?

points of anastomoses where capillaries join with other systems through terminal arteries

blood supply from at least two different groups of arteries

why are watershed zones vulnerable to damage?

farthest away from main arterial supply, small capillaries, terminal end of each system, vulnerable to reduction in perfusion from main arterial supply

small terminating capillaries are where lack of perfusion will begin first

what is the blood brain barrier?

mechanism that regulates arterial permeability CNS

lines of defense that allows certain elements through blood supply into brain

keeps out harmful substances and only allows lipid soluble substances across

what are the two components that regulate arterial permeability?

capillaries are lined by tightly packed endothelial cells

endothelial membrane is surrounded by end feet of astrocytes outside of capillary wall

what is cerebrovascular disease?

generic term for any disease that affects blood vessels in the brain

caused by hypertension and atherosclerosis

what is cerebrovascular accident?

when diseases processes in the cerebrovascular system intensify to an occlusion or hemorrhage

what is a transient ischemic attack?

mini stroke that has no lasting issues and resolves quickly

causes extremely elevated risk for stroke

what are the signs of cerebrovascular accident?

sudden onset of weakness or numbness on one side

sudden inability to speak or understand others

sudden difficulty seeing with one or both eyes

sudden loss of balance and/or dizziness

headache with cause

what is atherosclerosis?

disease process resulting in deposit of fat (plaques) in walls of arteries

constricts amount and ease of blood flow

what is hypertension?

disease process resulting in chronically elevated blood pressure

puts pressure on artery walls and may lead to rupture

what is an aneurysm?

blood vessel rupture caused by weakness or thinness in wall of blood vessel

what is arteriovenous malformation?

congenital tangle of abnormal blood vessels

vulnerable to developing aneurysms

what are the different types of CVAs?

occlusive (blockage), hemorrhage (bleeding) and external pressure

what are the two types of occlusive CVAs?

thrombotic: fixed blot

embolic: traveling clot

what are the two types of hemorrhagic CVAs?

aneurysm and AVM

what can cause external pressure CVAs?

tumor causes pressure on arteries

intracranial pressure from brain injury inside brain that causes blood vessels to collapse or occlude

how does the brain process and comprehend auditory input?

primary auditory cortex → left or right side → planum temporale and planum polare → ventral and dorsal streams → Broca’s area

signal begins in primary auditory cortex & decides where info needs to go in the PAC to be further processed (left part of PAC phonology & right part pitch)

signal is then sent to planum temporale (processes semantics and attaches meaning) & planum polare (might be acoustic analysis but don’t know for sure)

syntactic processing also occurs across entirety of superior temporal gyrus

info is then transported to frontal lobe (Broca’s area) through the ventral and dorsal streams

complex syntactic processing and working memory in Broca’s area

what is another name for Wernicke’s area?

planum temporale

what are the two auditory processing pathways that connect the temporal lobe to the frontal lobe?

ventral (2 pathways) & dorsal (2 pathways)

where does the 1st ventral auditory processing pathway connect?

superior temporal gyrus to pars triangularis

where does the 2nd ventral auditory processing pathway connect?

anterior superior temporal gyrus to frontal operculum (covering of insula)

where does the 1st dorsal auditory processing pathway connect?

Wernicke’s area to premotor cortex

where does the 2nd dorsal auditory processing pathway connect?

Wernicke’s area to pars opercularis

the superior temporal gyrus is highly connected to the ____________ and why is this important?

inferior frontal gyrus

explains that these areas of the brain are highly specific for language

how does the brain process and comprehend visual input?

eye → retina → optic nerve → optic chiasm → thalamus → geniculocalcarine tract → primary visual cortex → dorsal and ventral streams

eye gathers written stimuli and passes it on to visual pathways in retina

info from retina is passed down optic nerve to level of optic chiasm where the information crosses

info then travels to thalamus and the geniculocalcarine tract carries it from thalamus to primary visual cortex where it is divided into two streams: dorsal and ventral

dorsal stream processes where information and sends it to inferior parietal lobe and superior occipital lobe

ventral stream processes what information and sends it to inferior occipital lobe and inferior and posterior temporal lobes

The left visual field is processed in the ________ cerebral cortex.

right

where does the dorsal visual processing pathway connect?

primary visual cortex to superior occipital lobe and inferior parietal lobe

where does the ventral visual processing pathway connect?

primary visual cortex to inferior occipital lobe and posterior and inferior temporal lobes

what are the three left hemisphere reading systems?

parietotemporal, occipitotemporal, anterior

what is the function of the parietotemporal left hemisphere reading system?

word analysis (decoding at phoneme level) and comprehension of written and spoken language

what are the associated anatomic locations of the parietotemporal left hemisphere reading system?

angular gyrus, supramarginal gyrus, posterior portion of superior temporal lobe

what is the function of the occipitotemporal left hemisphere reading system?

visual word-form, reading just from the form of the word

what are the associated anatomic locations of the occipitotemporal left hemisphere reading system?

left inferior occipital area, left inferior-posterior temporal area, fusiform gyrus

what is the function of the anterior left hemisphere reading system?

word analysis in spoken language and articulation, silent reading, decoding infrequently encountered words

what are the associated anatomic locations of the anterior left hemisphere reading system?

Broca’s area, premotor areas

explain the oral language production pathway

prefrontal cortex → Broca’s area → SMA → primary motor cortex → UMN → LMN → muscles of speech sound production

prefrontal cortex makes the decision

what are the functions of Broca’s area?

speech motor/articulation, phonological processing, complex syntactic processing, working memory, cognition

sm/a pp csp wm c

what are the parts of Broca’s area?

pars triangularis and pars opercularis

how does the brain produce written language?

prefrontal cortex → Broca’s area → premotor cortex → primary motor cortex →UMN, LMN → muscles of hand

left superior parietal lobe provides visuospatial information as the info travels down the UMN pathway

prefrontal cortex makes decision to write, Broca’s area encodes language

what are the four stages of normal swallowing?

oral preparatory, oral, pharyngeal, esophageal

what happens during the oral preparatory stage of normal swallowing?

bolus is formed, mostly mastication with saliva, oral breathing altered, lips sealed

voluntary

what happens during the oral stage of normal swallowing?

bolus movement- bolus moves from on tongue and tongue moves it posteriorly, maintains nasal breathing, lips sealed

voluntary

what happens during the pharyngeal stage of normal swallowing?

1. bolus makes contact with faucial pillars
2. soft palate elevates
3. VF adduct and close opening to trachea
4. respiration pauses
5. larynx elevates and moves forward
6. epiglottis lowers and covers VF
7. bolus goes down pharynx into esophagus
8. upper esophageal sphincter relaxes

involuntary

what happens during the esophageal stage of normal swallowing?

lower esophageal sphincter relaxes and bolus goes into stomach

peristalsis: smooth muscle movement wave that is meant to push bolus down into stomach

involuntary

what are the nerves involved with the oral preparatory stage?

trigeminal V: chewing

glossopharyngeal IX: gland

facial VII: gland

what are the nerves involved with the oral stage?

facial VII: labial seal, taste

hypoglossal XII: anterior to posterior bolus movement

what are the nerves involved with the pharyngeal stage?

vagus X: soft palate closure, laryngeal elevation

facial VII: laryngeal elevation

trigeminal V: laryngeal, velar closure, pharyngeal constriction

hypoglossal XII: laryngeal elevation

what are the nerves involved with the esophageal stage?

vagus X: upper esophageal sphincter control, esophageal peristalsis

what are the two brainstem nuclei needed for swallowing?

nucleus tractus solitarius and nucleus ambiguous

what does the nucleus tractus solitarius do in swallowing?

sensory swallow center

taste, touch, respiratory, cardiovascular input

what does the nucleus ambiguous do in swallowing?

motor swallow center

innervates muscles

what are the structures in the cortical and subcortical sensory pathway for swallowing?

NTS → pons → hypothalamus → thalamus → primary sensory cortex

what are the structures in the cortical and subcortical motor pathway for swallowing?

inferior primary motor cortex → substantia nigra → reticular formation → medulla and NA

what are the support areas for the subcortical and cortical sensory and motor pathway for swallowing?

insula: mediate motor and sensory info

anterior cingulate cortex: attention

premotor cortex: motor planning

thalamus, basal ganglia: sensory info

what is aspiration?

when bolus penetrates airway below level of vocal cords and enters trachea

what are the clinical indicators of risk for aspiration?

dysphonia, dysarthria, abnormal gag reflex, abnormal volitional cough, cough after swallow, voice change after swallow

what type of information does the dorsal visual processing pathway process?

where

what type of information does the ventral visual processing pathway process?

what