Neuro exam 2

Angular gyrus (185-186)

Important language area in the left hemisphere and is associated with reading and math abilities.

What hemisphere is the angular gyrus in?

left hemisphere

What is associated with the angular gyrus?

associated with reading and math abilities. In terms of reading it is involved with visual word form processing.

What will happen if the angular gyrus is damaged?

can result in alexia (i.e., difficulty reading) and acalculia (i.e., difficulty with math skills)

Damage can lead to outer body experiences (OBEs)

What did Hubbard and Ramachandran theorize about the angular gyrus?

its a player in understanding metaphors, Out-of-body experiences, or the experience of floating outside one's body

Auditory cortex (193)

the initial cortical region that receives auditory information from the auditory pathway. It processes both sound intensity and frequency

Broca's area (180)

is located in the inferior frontal gyrus of the frontal lobe and is sandwiched between the premotor cortex (BA 6) and the prefrontal cortex. It is involved in language processing and speech production

What are two parts of Broca's area

an anterior portion called the pars triangularis (BA 45; Latin for the "triangular portion") and a posterior portion called pars opercularis (BA 44; Latin for the "lid portion")

Cingulate cortex (194-195)

is located in the medial surface of the brain between the corpus callosum and the cingulate sulcus. part of the limbic system, our emotional processing center. It receives inputs from the anterior thalamic nuclei and projects to the hippocampus via the parahippocampal gyrus; thus it appears to play a role in memory.

Fusiform gyrus (190-192)

also known as the occipitotemporal gyrus. It is part of the temporal and occipital lobes; This area is important for naming objects as well as recognizing and remembering visual objects that have been seen; functions as a lexicon

Prefrontal cortex

An area in the anterior frontal lobe that plays an important role in cognition, personality, and emotion

Parahippocampal gyrus (189-190)

located on the medial surface of the temporal lobe There are eight components of this region:

Piriform cortex (BA 27)

Periamygdaloid cortex

Presubicular cortex

Parasubicular cortex

Entorhinal cortex (BAs 28, 34)

Prorhinal cortex

Perirhinal cortex (BA 35)

Parahippocampal cortex (BA 36)

Retrograde amnesia (195)

a is a loss of memory before an event occurs, usually memory closer to the traumatic event

Somatosensory association area (185)

BAs 5 and 7;.collectively known as the somatosensory association cortex.

These areas lie on the dorsal part of the parietal lobe

Supramarginal gyrus (186-187)

is just anterior to the angular gyrus in the parietal lobe and wraps around the posterior end of the lateral fissure

appears to be involved with our phonological system, specifically in storing auditory representations of phonemes and phoneme combination

T/F: Both temporal poles appear involved in theory of mind (ToM) and empathy

True

What's theory of mind mean?

is the ability to know you have a mind, that others have a mind, and that their perspectives are different than your own

What does empathy mean?

describes a person's attempts to identify with another person's mental state.

Wernicke's area (193-194)

It is involved in attaching meaning to auditory information, especially speech and language. In other words, it helps us understand what people say to us

What is cerebral palsy (CP)?

a nonprogressive brain disorder that affects movement, posture, and balance

When does the damage that results in CP occur?

CP develops before birth (prenatal), during birth (peri- natal), or shortly after birth (postnatal)

What does CP effect?

Effects motor movement, posture, balance, speech, swallowing

What are the causes of CP?

premature birth, anoxia, infections, brain hemorrhages, jaundice, and head injury

What are the symptoms of CP?

muscle tone issues, dyskinesias, gait problems

What is neuroplasticity?

The adaptive capacity of the brain. AKA Making new connections as a result of learning;

What affects neuroplasticity and how do these factors affect neuroplasticity?

making new connections as a result of learning; when part of the brain is injured and can no longer function, a different part of the brain will assume the loss of function

Identify and describe the 10 principles of neuroplasticity.

1. Use it or lose it: If you don't practice the skills, you will lose the skills or not regain them

2. Use it and improve it: You must practice the skills you want to improve

3. specificity: Specific, functional tasks change the brain more than unspecific, general tasks

4. Repetition matters: More practice is needed to establish a new skill; 3 60-minute sessions weekly. Less practice is needed to maintain a current skill; 1 or 2 60-minute sessions weekly

5. Intensity matters: -For a new skills, 20-25 trials

-To maintain a skill, 12-15 trial

6. Time matters: The brain is most plastic between 4 days to 4 months after insult

7. Salience matters:

Training that is rewarding, functional and motivating is more likely to induce plasticity than tasks that are boring

8. Age matters: The brains of younger people are more plastic than brains of older people

9. transference: Plasticity in response to one PRACTICED SKILL can enhance the acquisition of similar skills

10. interference: Neuroplasticity can be negatively influenced by other factors (e.g., seizures, neurological disorders, etc.)

What are Brodmann's areas?

Divided the brain into 52 areas based on: Brain's gross anatomy and Cellular structure of the brain

Frontal lobe

- Prefrontal cortex- - Broca's area

-Premotor cortex

-Primary motor cortex

Parietal lobe

-Primary sensory cortex

-Somatosensory association cortex

-Angular gyrus

-Supramarginal gyrus

Temporal lobe

- Inferior temporal area

- Parahippocampal gyrus

-Fusiform gyrus-Temporal pole

-Auditory cortex

- Wernicke's area

-Cingulate cortex

Occipital lobe

Visual cortex

Innervate

to provide neural input to

Prefrontal cortex

Ba 9, 10, 11, 46, 47

Associated with cognition, personality, decision-making, and social behavior

Broca's area

Ba 44, 45

Found on third frontal convolution (i.e., inferior frontal gyrus) Area 45 is known as pars triangularis, involved in interpretation of language (syntax) and planning/programming of verbal responses. Area 44 is known as pars opercularis, involved in coordination of speech organs for language production.

Premotor cortex Ba 6

Close relationship to BA 44

BA 6 is Involved in selecting and planning of motor movements; Supplementary motor area (SMA) located at superior part of BA 6 and is involved in sequencing and "turning on" motor plans

Primary motor cortex Ba 4

Sends motor plans developed in BA 6 to the muscles for them to act (e.g., speech muscles)

Primary sensory cortex

Ba 3, 1, 2

Processes sensory information such as: Vibration, Proprioception, Touch, and Stereognosis

sensory association cortex

Ba 5 & 7

Interprets sensory experience during motor movements

This sensory experience is used to refine motor action

Involved in the fine movements associated with speech

Plays role in writing sensory and motor experience

Angular gyrus

Ba 39

Involved in reading and math abilities

Damage can lead to alexia and acalculia

May also be involved in understanding metaphors and our sense of Embodiment

Damage can lead to outer body experiences (OBEs)

Supramarginal gyrus

Ba 40

Closely rated to the angular gyrus (BA 39)

Involved in phonological system; stores auditory representations of phonemes (auditory images) This helps us sound out words

Damage can result in phonological dyslexia, difficulty reading new and nonwords

visual cortex Ba 17, 18, 19

Where information from the eyes is received and processed

Inferior temporal area Ba 20 & 21

Involved in processing of auditory and language information as well as reading facial emotions

May play a role in hallucinations

Parahippocampal gyrus Ba 27, 28, 34, 35, & 36

Located on medial surface of temporal lobe and includes two structures of note.

Hippocampus: associated with declarative memory

Entorhinal cortex (BA 28 and 34): major input/output relax between the cerebral cortex and the hippocampus

Fusiform gyrus

Ba 37

AKA occipitotemporal gyrus

Important in remembering and naming seen objects

Temporal pole

Ba 38

is located on the anterior end of the temporal lobe:

Left: semantic processing, speech comprehension, narrative comprehension

Right: integration of emotion into narratives, identifying familiar voices.

Both: theory of mind, empathy

Primary auditory cortex

Ba 41 & 42

(42 is the secondary auditory cortex, but 41/42 usually discussed as a unit called the primary auditory cortex)

Also known as Heschl's gyrus

Initial cortical region that receives auditory information from the ears via CN VIII and the auditory pathway

Wernicke's area

Ba 22

Involved in attaching meaning to auditory information; Damage can result in Wernicke's aphasia, characterized by verbal jargon and a lack of understanding others' speech

Cingulate cortex

Ba 23-26 & 30-33

BA 25, 32, & 33 anterior cingulate cortex

BA 23 & 24 midcingulate cortex

26 & 31 posterior cingulate cortex

BA 29 & 30 retrosplenial cortex

Sandwiched between corpus callosum and frontal and parietal lobes

Is part of the limbic system and has connections to the prefrontal cortex and hippocampus.

Overall, there appears to be a filter and focus process

Anterior parts: cognitive control, detecting errors, detecting conflicts, and problem solving; ACC filters out irrelevant information

Posterior parts: autobiographical memory, managing risky behavior, and emotional processing;

PCC detects important information

Is each BA solely responsible for specific functions?

Brodmann postulated that each of these areas, either individually or in connection with other areas, is responsible for specific functions

Arcuate fasciculus (163)

connects two important speech and language areas— Broca's area in the inferior frontal gyrus with Wernicke's area in the superior temporal gyrus

What can happen if the arcuate fasciculus is damaged?

can sometimes result in a condition called conduction aphasia, in which patients have difficulty repeating words said to them but have preserved speech fluency and auditory comprehension

Association fiber (161-163)

~Short fibers - connect areas of the cortex within the same lobe

~Long fibers - connect areas of the cortex from one lobe to another in the same hemisphere

Cerebral vascular accident (163-164)

caused by interruption in blood flow to the brain due to a blockage or bleeding in a cerebral artery

Types of strokes

ischemic and hemorrhagic

Ischemic stroke

Involves loss of blood flow to the brain, usually due to a blockage.

A third type of ischemic event is a transient ischemic attack (TIA)

In a TIA, there is a loss of blood flow to the brain, but the loss is temporary, and CVA symptoms resolve in a matter of minutes or within 24 hours.

Hemorrhagic Stroke

Is a bleeding type of CVA

Commissural fiber (161-163)

connect like areas of the brain in opposite hemispheres

Contrecoup injury (166-167)

A brain injury caused by the rebounding of the brain to the opposite site of the skull, causing a second area of damage

Corpus callosum (162)

Is a band of axonal callosal fibers that connects the two cerebral hemispheres. It has three major parts. The anterior part is called the genu, the middle part is the isthmus, and the posterior section is the splenium. Functionally, the corpus callosum allows the cerebral hemispheres to communicate with one another.

Cortex (152)

made up of cell bodies; outermost covering of the brain consisting of densely packed neurons, responsible for higher thought processes and interpretation of sensory input

Coup injury (166-167)

The initial brain injury caused by the brain banging up against the inside of the skull; compare to contrecoup damage

Fasciculus (162-163)

Groups of myelinated fibers; connects two important speech and language areas— Broca's area in the inferior frontal gyrus with Wernicke's area in the superior temporal gyrus

Gray matter (152)

consists of somas and glial cells; ~It is comprised of somas along with dendrites, teledendria, and glial cells

Infarct (163)

Dead tissue; a process known as tissue necrosis; A region of dead brain tissue after a neurological event like a stroke

Projection fiber (161-163)

project from the cerebral cortex to subcortical structures; connect the cortex to the brainstem, spinal cord, or cranial nerves

Superior longitudinal fasciculus (162-163)

bidirectional and connects the back and front of the cerebrum and the four brain lobes so all can communicate with one another

White matter (152)

a fatty white substance that covers axons

Why is gray matter gray?

Neuron cell bodies produce a gray color

Why is white matter white?

These tissues are white b/c of the myelin coating on the axons.

Identify three types of fibers in the brain and the general areas they connect. (161-163)

- association: has 2 types short association fibers- connect areas of the cortex within the same lobe long association fibers- connect areas of the cortex from one lobe to another in the same hemisphere- projections: connect the cortex to the brainstem, spinal cord, or cranial nerves- commissural: connect like areas of the brain in opposite hemispheres (corpus collosum)

What is unique to some people who are left-handed? (162).

~27% of left-handed people have language functions localized in the right hemisphere or bilaterally.

~If their left hemisphere is damaged, they may retain their language abilities or have significantly less impairment than expected

What is the name of the band of fibers that connect Broca's area and Wernicke's area? What is the function? (163)

Arcuate Fibers;

Function: it allows us to listen to a question or comment and make an intelligent response

What is the difference between a CVA (162) and TBI (166) in reference to definition and etiology? Which is worse and why?

Cardio Vascular Accident: involves some kind of interruption to the brain blood supply.

Etiology:

Traumatic Brain Injury: A blow to the brain that impairs functioning

Etiology:

What is the superior longitudinal fasciculus (SLF) and what does it connect?

its an association fiber tract, connects the back and front of the cerebrum and the four brain lobes so all can communicate with one another

What is the difference between a CVA and a TIA? (163)

CVAs involve some kind of interruption to the brain's blood supplythere is a loss of blood flow to the brain, but the loss is temporary CVA symptoms resolve in a matter of minutes or within 24 hoursTransient Ischemic Attack- symptoms resolve in less than 24 hours; often a precursor of a larger stroke

Identify and describe the two kinds of TBI. Which is worse? (166)

open head injury, some object (e.g., bullet, shell fragment, rock) penetrates the skull and causes damage to the brain. Is worseclosed head injury involves forces that cause damage to the brain, but without penetraning the skull

What are two types of closed head injuries and give an example of the etiology? (166-167)

Acceleration- deceleration based: When your head is moving and stops suddenly; car accident

Ex: whiplash

Impact-based: when your head is stationary, and something hits is; baseball bat

Ex: getting hit with a baseball bat

What is a shearing injury to an axon? How does this compare to a 'break' injury?

Damage to the axons; Shearing injuries are more likely to result in neuronal death.

What type of cognitive problems are related to TBI?

- Attention

-Orientation

-Memory

-New learning

-Thought

-Organization

-Reasoning

-Problem solving

-Executive functions

What type of speech/language problems are related to TBI?

-Dysarthria

-Aphasia

-Apraxia of speech

-Hearing loss

-Dysphagia

Upper motor neuron

That part of the pyrami-dal tract that runs from the cortex to the brainstem, thus being entirely housed within the central nervous system

Lower motor neuron

That part of the pyrami-dal tract that runs from the brainstem through the cranial(or spinal) nerves, thus being housed entirely within the peripheral nervous system

Lemniscus

a ribbon of fibers

Viscera

The internal organs of the body

Somatic

pertaining to the body

Interneuron

a neuron that carries nerve impulses from one neuron to another

Paraplegia

paralysis from the waist down

Quadriplegia

paralysis of all four limbs

Hemiplegia

Weakness of one side of the body

Rami

branches of spinal nerves

Ganglia

clusters of neuron cell bodies in PNS

How long is the spinal cord?

17'' to 18''

How wide is it?

1/4'' to 1/2''

What does the spinal cord contain?

Contains both afferent and efferent pathways

What is the function of the spinal cord

to be a communication pathway between brain and body

efferent neurons

(motor) neurons descend, or move away from the brain or spinal column

afferent neurons

(sensory) neurons ascend, or move toward the brain or spinal cord

How are the spinal nerves named?

named for the area of the spinal column where they exit the cord