Neuro Final Study Guide

the brain and spinal cord

• what is this also called

CNS

• neuraxis

cranial and spinal nerves

PNS

what structure creates boundaries for the different lobes of the brain

cortical divisions

enfolding of the cortex during development

gyrus

groovelike depression, seperating gyri

sulcus or fissure

lobe responsible for planning, initiating, emotional responses, concentration, movement, and expressive language

frontal lobe

The Frontal Lobes

• comprises the area from the ____ sulcus to the anterior limit of the ____ cortex dorsal and posterior to the bone case of the eyes.

• The posterior portion of the frontal lobe consists of the precentral gyrus - specialized for control of ______.

• The frontal lobes make us conscious of our actions and ____.

• Comprises the area from the central sulcus to the anterior limit of the cerebral cortex just dorsal and posterior to the bone case of the eyes.

• The posterior portion of the frontal lobe consists of the precentral gyrus - specialized for control of movement.

• The frontal lobes make us conscious of our actions and thoughts.

what region of the cortex is involved in:

• planning and initiating 

• concentration 

• emotional responses 

• disinhibition of behaviors

• memory for habits, motor activities, and expressive language are mediated by the frontal lobes.

• It also plays a role in adapting to change.

prefrontal

Consequences of Frontal Lobe Impairment

1. Loss of simple ____

2. Loss of ability to spontaneously ____

3. Loss of ____ thinking and problem solving

4. p______

5. Inability to ____ on a ____

6. ____changes

7. Changes in _____ and ____behavior

8. Inability to ____

9. Inability to ______complex movements

1. Loss of simple movement

2. Loss of ability to spontaneously interact

3. Loss of flexible thinking and problem solving

4. Perseveration

5. Inability to focus on a task

6. Mood changes

7. Changes in personality and social behavior

8. Inability to speak

9. Inability to sequence complex movements

lobe responsible for hearing, language comprehension (Wernicke's area), and memory

Temporal Lobe

Temporal Lobe

• Located inferior to the _____ _____ (the ____ sulcus) and continues back to the ____lobe.

• The ___ ____ lobe contains Wernicke’s area, important for language _____.

  • This area has connections to Broca’s area (in left ____ lobe), important for speech _____.

• The temporal lobes house the primary and secondary ___ cortex and are involved in ____sensation and perception.

• Located inferior to the Sylvain Fissure (the lateral sulcus) and continues back to the Occipital lobe.

• The left temporal lobe contains Wernicke’s area, important for language comprehension.

  • This area has connections to Broca’s area (in left frontal lobe), important for speech production.

• The temporal lobes house the primary and secondary auditory cortex and are involved in auditory sensation and perception.

Temporal Lobe

• Auditory stimuli are transformed for comprehension of language in the temporal lobes.

• Hearing, some visual perception, and categorization skills are dependent, in part,
  on the temporal lobes. 

• The temporal lobes are also primary sites for projections from the thalamic nuclei.

• Auditory stimuli are transformed for comprehension of ____ in the temporal lobes.

• Hearing, some visual perception, and categorization skills are dependent, in part, on the temporal lobes. 

• The temporal lobes are also primary sites for ____ from the thalamic nuclei.

Consequences of Temporal Lobe Impairment

1. Prosopagnosia: Difficulty _____ _____

2. Difficulty understanding ____words

3. Poor _____ ____ for verbal and visual information

4. __-term memory loss

5. Interference with ___-term memory

6. Increased or decreased interest in _____behavior

7. Inability to ____objects

8. Logorrhea: ______ ____

9. Increased ____behavior

1. Prosopagnosia: Difficulty recognizing faces

2. Difficulty understanding spoken words

3. Poor selective attention for verbal and visual information

4. Short-term memory loss

5. Interference with long-term memory

6. Increased or decreased interest in sexual behavior

7. Inability to categorize objects

8. Logorrhea: Persistent talking

9. Increased aggressive behavior

lobe that is main area for the sense of touch, pressure, pain, and identifying objects

parietal

Parietal Lobes

• Located between the ____ lobe and ___sulcus (the ____Fissure)and superior to the ____ lobe.

• The most anterior region is the post-central gyrus. 

  • This is the main area of ______ for axons carrying information for the sense of touch.

  • Sensations from the body are represented at various parts of the ___-central gyrus.

• Located between the occipital lobe and central sulcus (the Rolandic Fissure)and superior to the temporal lobe.

• The most anterior region is the post-central gyrus. 

  • This is the main area of termination for axons carrying information for the sense of touch.

  • Sensations from the body are represented at various parts of the post-central gyrus.

Parietal Lobe Impairment

1. Inability to attend to ____than one ____at a time

2. Alexia:  Problems with _____

3. ______:  Difficulty writing words

4. Word _____: inability to recognize words

5. ______: Difficulty with math and arithmetical concepts. 

6. Difficulty _____objects

7. Difficulty knowing ___ from ____

what lobe damage do these symptoms indicate

1. Inability to attend to more than one object at a time

2. Alexia:  Problems with reading 

3. Agraphia:  Difficulty writing words

4. Word blindness: inability to recognize words

5. Dyscalculia: Difficulty with math and arithmetical concepts. 

6. Difficulty drawing objects

7. Difficulty knowing left from right

Parietal Lobe Impairment Cont.

1. Lack of awareness of specific ___ ___

2. ______ neglect

3. Inability to focus ____attention

4. Difficulties with ___-____coordination

5. Impaired ______of touch

6. Difficulty with ___ _____movements

7. Difficulty with the functional _____of objects (non-motoric).

1. Lack of awareness of specific body parts

2. Unilateral neglect

3. Inability to focus visual attention

4. Difficulties with eye-hand coordination

5. Impaired perception of touch

6. Difficulty with goal directed movements

7. Difficulty with the functional manipulation of objects (non-motoric).

lobe that includes the primary target for visual information and recognize objects/discriminate features

Occipital Lobe

• Located at the most ____ part of the _____cortex.

• This lobe is the primary target for projections from the ______ and receives ____information from fibers in the ___.

• The retina gets visual input form light, shapes, and shading. This input is then transmitted through the optic nerve to the thalamus and then to the primary visual cortex in the occipital lobe.

• If the visual cortex is damaged, it can lead to blindness or a visual field cut (______).

• Located at the most posterior part of the cerebral cortex.

• This lobe is the primary target for projections from the thalamus and receives sensory information from fibers in the eyes.

• The retina gets visual input form light, shapes, and shading. This input is then transmitted through the optic nerve to the thalamus and then to the primary visual cortex in the occipital lobe.

• If the visual cortex is damaged, it can lead to blindness or a visual field cut (hemianopsia).

A small area of damage can lead to a small blind area, called a _____.

• secondary association areas are important to ____ processing and ____ stimuli to other parts of the brain for analysis.

  • These areas are important to visual processing in order to recognize objects and discriminate features.

A small area of damage can lead to a small blind area, called a scotoma.

• Secondary association areas are important to visual processing and transmit stimuli to other parts of the brain for analysis.

  • These areas are important to visual processing in order to recognize objects and discriminate features.

uncontrollable, excessive, and rapid talking

• what is this a symptom of

loggorhea

• temporal lobe impairment

Occipital Lobe

1. ___ ____cuts

2. Difficulty ______ objects in the environment

3. Difficulty recognizing ____ objects 

4. Inability to recognize _____ of an object in ____

5. Difficulty identifying ____

6. Visual _____ or ______ seeing objects

7. Word _____ or ____to recognize words

8. Difficulties with ____ and writing

1. Visual field cuts

2. Difficulty locating objects in the environment

3. Difficulty recognizing drawn objects 

4. Inability to recognize movement of an object in space

5. Difficulty identifying colors

6. Visual illusions or inaccurately seeing objects

7. Word blindness or inability to recognize words

8. Difficulties with reading and writing

what lobe are these damage too

1. Personality changes, loss of spontaneous interaction, inability to speak, and perseveration

frontal

which lobe damage →Visual field cuts (hemianopsia), color blindness, and visual illusions

occipital

what lobe damage→ Prosopagnosia (facial blindness), difficulty understanding spoken words, and logorrhea

temporal

what lobe damage→ Unilateral neglect, alexia (reading problems), and difficulty knowing left from right

parietal

contra= _____ side

ipsi = ______ side

opposite side

same side

the brain is ____lateral and controls the ______ side of the body

brain is CONTRAlateral and controls the opposite side of the body

• left hemisphere—>right arm/leg and vice versa

• where do motor pathways decussate?

• what happens if damage occurs below that point?

• brainstem/medulla

• weakness shows on the same side if damage occurs below the brainstem

  • right spinal cord damage→ right weakness/paralysis

are speech muscles unilateral or bilateral?

BILATERAL!

• get input from both hemis →one sided brain damage does not completely paralyze speech muscles

Do language mechanisms have bilateral or unilateral control?

UNILATERAL→ most ppl left side dominant and right handed

receptors that provide info about the external enviornment

exterorecptors

provide info about the position of the body

proprioceptors

provide info about inside of the body

interoreceptors

Known as the "fifth lobe," it is involved in interoception ("tuning-in" to ourselves and feeling feelings) and has visceral sensory and motor functions related to speech

• allows us to “feel our feelings”

insula

what are the components of the brainstem

medulla oblongata, pons, and midbrain/mesencephalon

the medulla and pons contain cells of the ____ activating system→ crucial for ____ and _____

reticular activating system→ crucial for arousal and sleep

• The brainstem connects the ___ ___ to the ___ ___ and regulates ___ ___ functions including:

  • Breathing, respiration, swallowing, blood pressure, and eye movements.

  • Regulation of heart rate, vomiting, salivation, sneezing, coughing, and gagging.

• The brainstem connects the cerebral cortex to the spinal cord and regulates primary life functions including:

  • Breathing, respiration, swallowing, blood pressure, and eye movements.

  • Regulation of heart rate, vomiting, salivation, sneezing, coughing, and gagging.

Integrates sensation (sans olfaction)in the nervous system; ascending and descending pathways

thalamus

Autonomic & endocrine function; Controls emotional & escape behavior; Regulates body temperature, food/water intake, sexual and sleep behaviors

hypothalamus

Regulates body’s circadian rhythms

epithalamus (pineal gland)

Projects fibers to many areas and may exert an inhibitory effect on motor pathways

subthalamus

a critical region of the forebrain situated deep beneath the cerebral hemispheres and above the brainstem

• It encloses the third ventricle and serves as the primary relay station and control center for sensory signals, motor functions, endocrine processes, and autonomic regulation

• thalamus, hypothalamus, and epithalamus make this up

diencephalon

structure responsible for regulating and controlling motor movements and muscle tone, planning for movement and giving expression to motor movements

basal ganglia

• Damage to basal ganglia structures:

  • _________–Underactivity of the muscles

    • ex: _____ Disease or _____

  • _______– Overactivity of the muscles

    • ex: ____and ____

• Damage to basal ganglia structures:

  • Hypokinesia –Underactivity of the muscles

    • Parkinson’s Disease or Parkinsonism

  • Hyperkinesia – Overactivity of the muscles

    • Chorea and dystonia

Cerebellum (aka “little brain”)

• ___hemispheres +_____

• Coordination of movements, _____ (conra or ipslateral)

• ____coordination of movement

• ____ stability and fixation

• Learning a novel ____act

• Associated with ______dysarthria

• _2__hemispheres + vermis

• Coordination of movements, ipsilateral

• Fine coordination of movement

• Postural stability and fixation

• Learning a novel motor act

• Associated with ataxic dysarthria

• Spinal Cord – Divided into five regions:

  • Cervical, thoracic, lumbar, sacral, and coccygeal

  • Center of cord is ____ matter

  • Ventral portion contains ____ nuceli

  • Anterior portion contains ____ cells

  • ____matter tracts ascend from and descend to spinal cord, mediating ___ output and ____to limbs & trunk

• Cervical, thoracic, lumbar, sacral, and coccygeal

• Center of cord is gray matter

• Ventral portion contains motor nuceli

• Anterior portion contains horn cells

• White matter tracts ascend from and descend to spinal cord, mediating motor output and sensation to limbs & trunk

how many types of spinal nerves

• how many roots?

2→sensory and motor fibers

• each spinal nerve connected to spinal cord by 2 roots

  • anterior and posterior roots

transmits afferent/motor impulses AWAY from CNS

• Bundles of nerves fibers that transmit nerve impulses away from the CNS (efferent fibers)

• Efferent fibers that go to muscles, cause contraction:  “motor fibers”

• Motor Fibers of spinal nerves originating in the anterior (ventral) horn cells

anterior root

carries efferent/sensory info TO the CNS

• Carry info to CNS about sensations of touch, pain, temperature, and vibration (“sensory fibers”)

• Cell bodies of sensory fibers are a swelling on the posterior root of the spinal nerve:  “posterior root ganglion”

posterior root

High spinal cord injury or lesion (cervical vertebrae)

WHY IS IT DANGEROUS IF IT EFFECTS

• speech production ______ muscles

• partial or complete loss of ____ at ___of lesion

Dangerous because it impacts respiratory muscles; a lesion above the 3rd, 4th, or 5th cervical nerve can cause death because the phrenic nerves (which innervate the diaphragm) are affected

Cervical Lesions (SLP Role): Assessment focuses on respiratory support for speech. Treatment includes implementing equipment like power wheelchairs or environmental controls using sip and puff switches

• swallow therapy

• AAC

• family education

just read

ANS divisions

• ______ is the body's alerting system ("fight or flight," raises heart rate)

• _______is the calming effect ("rest and digest," slows heart rate, increases salivation)
  
  

• sympathetic

• parasympathetic

• Body’s alerting system (fight or flight)

  • Accelerating heart rate

  • Constriction of peripheral blood vessels

  • Raising blood pressure

  • Raise eyelids and dilate pupils

  • Decreases peristalsis & closes sphincters

sympathetic

• Body’s calming effect

  • Conserve & restore energy by slowing heart rate

  • Increasing intestinal peristalsis

  • Opening sphincters

  • Increased salivation

  • Increased secretion of gastrointestinal tract glands

parasympathetic

what is nerve degeneration?

• possible causes

• breakdown/loss of neurons

  • ex: stroke, anoxia, trauma

what is nerve regeneration? (name for it too)

• does it occur throughout life?

• formation of new neural connections (neuroplasticity)

• occurs throughout life with therapy and stimulation

• “cells that fire together, wire together”

A disorder of recognition caused by damage to cortical sensory association areas or pathways

agnosia

lateral spinothalamic tract responsible for

pain and temp

anterior spinothalamic tract responsible for

light touch/pressure

hemianopsia

blindness in half of visual field

anterior roots = _____

posterior roots = ____

• motor

• sensory

tract responsible for voluntary movement of limbs

corticospinal tract

tract responsible for voluntary movement of speech muscles

corticonuclear/corticobulbar tract

tract that connects the cortex to cerebellum

corticopontine

spinocerebellar tract responsible for

• sends info to _____

• proprioception/body position

  • sends info to cerebellum

disorder in performing voluntary learned motor acts caused by lesion in motor association areas and association pathways, in which similar automatic gestures are intact

apraxia

T/F people with apraxia knows what they want to say or do, but there is a disconnect between the brain plan and the programming and execution of the act

TRUE

what are the 2 hallmark signs for apraxia

1. groping behavior

2. inconsistent

   1. frustrating for patient

where does apraxia originate

frontal lobe/premotor areas/Broca’s Area

a disorder in which motor plans are intact but indiv. motor gestures are disturbed

ideomotor apraxia

type of apraxia in performing the steps of complex motor plans

ideational apraxia

a disorder of motor programming of speech

apraxia of speech

a disorder of nonspeech movements of the oral muscles

oral apraxia (buccofacial apraxia)

a neurological and cognitive-motor disorder that impairs a person's ability to perform learned, skilled, or purposeful movements

limb apraxia

what is apraxia caused by (acquired or congenital)

can be acquired (cortical injury/deficit) or congenital (CAS)

disorder in which motor speech programming is distrubed in childhood

childhood apraxia of speech

a neurological motor planning disorder where an individual cannot voluntarily control, sequence, or coordinate mouth muscles—tongue, lips, jaw, and soft palate—for non-speech tasks, such as licking lips or blowing.

oral-motor apraxia

what are the levels of motor planning

• are they distinct

1. motor planning

2. motor programming

3. motor execution

• yes

motor execution disorder caused by weakness/paralysis/incoordination

• what kind of errors

dysarthria

• CONSISTENT ERRORS

what systems of speech are effected by Dysarthria

ALL resonance, respiration, articulation, prosody, phonation

issues with what neurons causes the different types of dysarthria’s

UMN vs LMN

Flaccid Dysarthria

• locus (UMN or LMN)

• primary deficit

• LMN

• weakness

spastic Dysarthria

• locus (UMN or LMN)

• primary deficit

• UMN

• spasticity (muscles continuously stiffen or tighten, making movement difficult or rigid)

Ataxic Dysarthria

• locus (UMN or LMN)

• primary deficit

• cerebellar control circuit

• incoordination

Hypokinetic Dysarthria

• locus (UMN or LMN)

• primary deficit

• basal ganglia control circuit

• rigidity and reduced ROM

Hyperkinetic Dysarthria

• locus

• primary deficit

• basal ganglia control circuit

• involuntary movements

Unilateral UMN

• locus (UMN or LMN)

• primary deficit

• unilateral UMN

• weakness; incoordination; spasticity

Mixed Dysarthria

• locus (UMN or LMN)

• primary deficit

• more than one

• more than one

what are some hallmarks of dysarthria?

• how are muscles?

• coordination?

• resonance?

• rate of speech?

• vocal quality?

• volume/pitch?

• weakness

• reduced coordination

• slurred, mumbled, or difficult to understand speech

• speaking too fast, slow, or choppy bursts

• speaking in monotone voice or trouble controlling volume

• hoarse, strained, breathy

• sounds congested/hypernasal

Sensory system travel to _____ through ____ tracts

• ____ interprets sensory input for movement, communication, and perception

• what are the 3 tracts and what are they responsible for

CNS through sensory tracts

CNS inerprets

• spinocerebellar (dorsal & ventral)

• anterior spinothalamic ( light touch/pressure)

• lateral spinothalamic tract (pain, temp, possible itch)

inability to recognize objects, colors, and pictures

visual agnosia

inability to comprehend speech or nonspeech sounds (pure forms: auditory nonverbal agnosia, and pure word

auditory agnosia

inability to recognize objects by touch; characterized by bilateral parietal lobe lesions

tacticle syndrome

It provides feedback for speech control (tactile for stops, auditory/proprioceptive for vowels)

• ____ is a recognition disorder caused by damage to cortical sensory association areas.

It provides feedback for speech control (tactile for stops, auditory/proprioceptive for vowels)

• Agnosia is a recognition disorder caused by damage to cortical sensory association areas.

what lobe is heavily involved in motor planning

frontal

what areas are important for motor planning

• _____ cortex and ______ motor area

premotor cortex and supplementary motor area

what area is important for speech motor planning

broca’s area

what disorder results from impaired motor planning

apraxia

in apraxia, are the muscles weak?

no