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Neurophysiology > Cerebral Blood Supply and Clinical Correlates > Flashcards

Cerebral Blood Supply and Clinical Correlates Flashcards

1
Q

What is the function of the Frontal Lobe?

A
  1. Cognitive function
  2. Movement control (primary motor cortex)
  3. motor programming of speech (Broca’s area)
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2
Q

what are some of the functions of the Parietal lobe?

A
  1. major sensory center
  2. somatosensory integration (temperature, taste, touch and movement)
  3. Language comprehension (Wenicke’s area)
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3
Q

what are the main functions of the temporal lobe?

A
  1. memory center
  2. auditory center
  3. taste, sound, sight and touch integration
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4
Q

what is the main function of the occipital lobe?

A

primary visual center

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5
Q

from most lateral to most medial, what body structures are somatopically mapped at the precentral gyrus?

A
  1. Mouth
    1. swallowing
    2. tongue
    3. jaw
    4. lips
  2. Face
  3. HAND
  4. arm
  5. Trunk
  6. Lower extremity
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6
Q

what body structure would you expect to see somatopically mapped in the longitudinal fissure of the precentral gyrus?

A

(between L and R sides)

hip, knee, ankle and toes

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7
Q

from most lateral to most medial, describe where body structures are represented somatopically at the postcentral gyrus

A

most laterally to medially

  1. intra-abdominal
  2. phayrnx
  3. mouth
  4. Face
  5. Arm
  6. Trunk
  7. Leg (at the top)
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8
Q

what arteries make up the anterior circulation of the brain?

A
  1. Internal carotid arteries
  2. Anterior Cerebral arteries
  3. Middle Cerebral arteries
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9
Q

What arteries make up the posterior circulation of the brain?

A
  1. Vertebral arteries
  2. Posterior and Anterior Inferior Cerebellar Arteries
  3. Basilar artery
  4. Pontine arteries
  5. superior cerebellar arteries
  6. Posterior Cerebral artery
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10
Q

What are the 3 major arteries that supply our cerebrum?

A
  1. Anterior Cerebral artery
  2. Middle Cerebral artery
  3. Posterior Cerebral artery
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11
Q

What areas of the brain are perfused by the anterior cerebral artery?

A
  1. anterior and medial surface of the brain
  2. from frontal lobe to anterior parietal lobe
  3. subcortical structures
    1. basal ganglia (anterior internal capsule, inferior caudate nucleus),
    2. anterior fornix
    3. corpus callosum
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12
Q

What are the functions of the areas perfused by the anterior cerebral artery?

A
  1. frontal lobe → cognitive and motor functions
  2. parietal lobe → sensory center
  3. corpus callosum → two way highway that allows hemispheres to communicate
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13
Q

what are some signs and symptoms of a stroke involving the Anterior Cerebral Artery?

A
  1. contralateral hemiparesis or hemiplegia
  2. contralateral hemisensory loss
  3. apraxia
  4. problems w/bimanual tasks
  5. sig. cognitive deficits
  6. lack of spontaneity, motor inaction, slowness and delay
  7. difficulty with executive function tasks
  8. transcoritical aphasia
  9. contralateral grasp reflex
  10. Alien Hand syndrome
  11. Urinary incontience
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14
Q

what is contralaleral hemiparesis or hemipelgia?

what brain structures are involved?

A
  1. weakness effecting one side of the body
  2. motor cortex (frontal lobe)
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15
Q

what is apraxia? what brain structures are involved with it?

A
  1. motor agnosia → knowledge of how to perform a skilled movement is lost
  2. supplementary motor area and corpus callosum
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16
Q

An ACA stroke involving the pre-frontal cortex will include what symptoms?

A
  1. lack of spontaneity
  2. motor inaction
  3. slowness and delay
  4. difficulties with executive function tasks (attention)
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17
Q

what is transcortical aphasia and what brain structures does it involve?

A
  1. aphasia → loss of ability to produce or understand speech
    1. this doesn’t tend to be as severe as Broac’s apahsia (motor) in that they can function a bit better
  2. supplementay motor area (dominant hemisphere)
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18
Q

what area’s/structures of the brain are involved in the contralateral grasp reflex (sucking reflex)?

A

No well understood

maybe corpus callosum and frontal lobe?

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19
Q

what is alien hand syndrome and what regions of the brain are involved with it?

A
  1. involuntary, uncontrollable movement of the upper limb
  2. supplemental motor area
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20
Q

List some ACA treatment strategies

A
  1. structure environment to minimize external distractions
  2. closed chain “big muscle” exercises
  3. bimanual activities to tackle UE deficits
  4. function-based training
21
Q

what areas of the brain does the middle cerebral artery (MCA) perfuse?

A

two branches

  1. entire lateral aspect of the cerebral hemisphere (frontal, temporal, and parietal lobes)
  2. subcortical structures,
    1. internal capsule (posterior portion)
    2. corona radiata
    3. globus pallidus (outer part),
    4. most of the caudate nucleus,
    5. putamen
22
Q

what are the signs and symptoms of MCA syndrome?

A
  1. Contralateral paresis
  2. Contralateral sensory loss
  3. Motor speech impairment
  4. receptive speech impairment
  5. global aphasia
  6. perceptual deficits
  7. apraxia
  8. visual deficits
  9. loss of conjugate gaze to opposite side
  10. pure motor hemiplegia (lacunar stroke)
23
Q

what brain structures are involved with motor speech impairment from MCA syndrome?

A

Broca’s area (dominant hemisphere)

24
Q

what brain structures are involved with recepive speech impairment with MCA syndrome?

A

Wenicke’s area (dominant hemisphere)

25
Q

What is global aphasia and what brain structures are involved with it?

A
  1. also called total apashia
    1. cannot speak fluentyly
    2. cannot communicae verbally
    3. cannot understand language
  2. Broca’s and Wernicke’s areas involved
26
Q

what are some examples of perceptual deficits observed with MCA syndrome?

A
  1. unilateral neglect → tendency to behave as if one side of the body and/or one side space does not exist.
  2. depth perception issues
  3. spatial relations issues
27
Q

what brain structures are involved with perceptual deficits observed with MCA syndrome?

A

parietal sensory association cortex (non-dominant hemisphere)

28
Q

what brain structures are involved with visual deficits observed with MCA syndrome?

A

optic radiation in internal capsule

29
Q

what is “loss of conjugate gaze to opposite side” and what brain structures are involved with it?

A
  1. conjugate gaze is the ability of the eyes to work together/in unison
  2. frontal eye fields or decending tracts
30
Q

what brain structure are involved with pure motor hemiplegia (lucunar stroke)?

A

upper portion of posterior limb of internal capsule

31
Q

what are the small perforating arteries off of the MCA?

A

lenticulostriate arteries → supply deep structures within the cerebrum

basal ganglia and internal capsule

32
Q

what is a major symptom of a lacunar infarct?

A

pure motor hemiparesis

33
Q

List some treatment strategies when treating an stroke involving the MCA

A
  1. Incorperate speech strategies into actions
  2. UE functional strengthening
  3. sensory reintegration is key
34
Q

what regions of the brain are perfused by the posterior cerebral artery (PCA)?

A
  1. occipital lobe
  2. posteromedial temporal lobes
  3. thalamus
35
Q

what are some signs and symptoms that would be observed following a PCA stroke?

A
  1. contralateral homonymous hemianopia
  2. cortical blindness
  3. visual agnosia
  4. prosopagnosia
  5. dyslexia
  6. memory deficit
  7. topographic disorientation
36
Q

what is homonymous hemianopia? what brain structures are involved with this?

A
  1. loss of visual information from the same visual field in both eyes
  2. visual cortex or optic radiation
37
Q

what is cortical blindness? What structures/regions of the brain are impacted?

A
  1. person has no awareness of any visual information due to a lesion in the brain
  2. bilateral occiptal lobe
38
Q

what is visual agnosia? What regions/structures of the brain are involved?

A
  1. inability to visually recognize objects despite having intact vision
  2. occipital lobe (dominant side)
39
Q

what is prosopagnosia? what regions/structures of the brain are involved?

A
  1. a highly specific type of visual agnosia → person is unable to visually ID people’s faces, despite being able to correctly interpret emotional facial expressions and being able to visually recognize other items in environment
  2. visual association cortex
40
Q

what region of the brain is involved with dyslexia resulting from PCA syndrome?

A

dominant calcarine lesion

posterior part of corpus callosum

41
Q

what regions/structures in the brain are responsible for memory deficits observed with PCA syndrome?

A

lesion of inferomedial potions of temporal lobe (dominant side)

42
Q

what is topographic disorientation? what brain regions/structures are involved?

A
  1. inability to orient in the surrounding and find your way around even in a familiar area
  2. nondominant visual area
43
Q

a stroke involving the PCA and affecting the thalamus would have what symptoms?

A
  1. central post-stroke (thalamic) pain
  2. involuntary movements
    1. choreoarthetosis, intention tremor, hemiballismus)
44
Q

describe/define each of the symptoms for a stroke involving the PCA and affecting the thalamus

A
  1. thalamic pain - neurogenic pain, very hard to control
  2. choreoathetosis - involuntary movements
  3. hemiballismus - big involuntary movements
45
Q

List some treatment strategies for PCA syndrome

A
  1. Gradually increase visual challenges as both symptoms improve and/or pt. is able to habituate to symptoms
  2. visual deficts can significantly impact balance
  3. remember to give pt visual breaks
    1. eyes closed, shut off lights, etc
  4. may require external aids initially to assist in improving visual deficits
46
Q

a stroke involving the vertebral arteries and basilar artery is called what?

A

vertebrobasialr artery syndrome

47
Q

what is a standout symptom to a vertebrobasilar artery stroke?

A

locked-in syndrome

48
Q

what is locked-in syndrome

A

pt is cognitively intact but loses ALL motion other than eyes

Neurophysiology (9 decks)

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