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Neurophysiology > Higher Order Cerebral Function > Flashcards

Higher Order Cerebral Function Flashcards

1
Q

what is the difference between unimodal and heteromodal corticies?

A

both are association corties

unimodal are modality specific

heteromodal are higher-order functioning

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2
Q

what is one reason for hemispheric specialization?

A

a reduction in the amount of time it would take to have both hemisphere’s “talk to each other” to accomplish the task

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3
Q

T/F: there is bilateral representation of language centers in many right handers?

A

FALSE
it is observed in 60-70% of LEFT handers

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4
Q

what is our non-dominant hemisphere primarily responsible for?

A
  1. complex visual-spatial skills
  2. imparting emotional significance to events and language
  3. music perception
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5
Q

List some clinical features of a non-dominant hemisphere lesion

A
  1. visual-spatial analysis/constructional difficulties
  2. Gestalt difficulties
  3. tendency toward relatively severe personality and emotional changes
  4. increased likelihood to have delusions and hallucinations (when compared to the dominant hemisphere)
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6
Q

what is meant by constructional difficulties?

A

difficulty judging or matching orientation of lines displayed at different angles

(this person would have a hard time drawing more complex shapes but could draw simple ones)

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7
Q

what are gestalt difficuties?

A

overall spatial arrangement difficulties

(a pt would have difficulty understanding how everything is organized in their visual field, ie. big picture)

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8
Q

List some odd nondominant syndromes

A
  1. capgas syndrome
  2. fregoli syndrome
  3. reduplicative paramnesia
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9
Q

what is capgas syndrome?

A

patient insists that their friends and family members have been replaced by identical-looking imposters

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10
Q

what is fregoli syndrome?

A

patients belive that different people are actually the same person in disguise

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11
Q

what is reduplicative paramnesia?

A

patient believes that a person, place, or object exists as two identical copies

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12
Q

List some dominant (usually left) hemisphere functions

A
  1. Language
  2. skilled motor function (praxis)
  3. Arithmetic: sequential and analytical calculating skills
  4. Musical ability: sequential and analytical skills in trained muscians
  5. Sense of directions: following a set of written directions in sequence
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13
Q

List some non-dominant (usually right) hemisphere functions

A
  1. Prosody (emotion conveyed by tone of voice)
  2. visual-spatial analysis and spatial attention
  3. arithmetic: ability to estimate quantity and to correctly line up columns of numbers on the page
  4. musical ability: in untrained musicians, and for complex musical pieces in trained musicians
  5. sense of direction: finding one’s way by overall sense of spatial orientation
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14
Q

how do Broca’s and Wernicke’s area communicate?

A

arcuate fasciculus

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15
Q

List all the regions of the brain associated with language

A
  1. inferior lateral primary motor cortex
  2. Frontal lobes
  3. supramarginal gyrus and angular gyrus
  4. visual cortex, visual association cortex
  5. Non-dominant hemisphere is also involved
  6. subcotical regions
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16
Q

what is the role of the Frontal Lobe with respect to language processing?

A
  1. higher-order motor aspects of speech formation and planning
  2. syntax
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17
Q

what is the role of the supramarginal and angular gyrus (parietal and tempral lobes) in language?

A
  1. lexicon
  2. writing
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18
Q

what is the role of the visual and visual association cortices in language?

A

reading

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19
Q

List some syndromes related to aphasia

A
  1. Alexia
  2. Agraphia
  3. Alexia with agraphia
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20
Q

what is alexia?

A

an impairment in reading ability

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21
Q

what is agraphia?

A

impairment in writing ability

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22
Q

alexia without aphasia will have a lesion where?

A

dominant occipital cortex extending to the posterior corpus callosum (often PCA infarct)

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23
Q

Agraphia without aphasia will often involve a lesion where?

A

lesion of inferior parietal lobule of language-dominant hemisphere

24
Q

what is alexia with agraphia?

what regions of the brain does it impact?

A

aphasia absent or only mild dysnomia and paraphasias

lesions of dominant inferior parietal lobe, region of angular gyrus

25
Q

what are the symptoms of gerstmann’s syndrome?

A
  1. agraphia
  2. acalculia
  3. R/L disorientation
  4. Finger agnosia
26
Q

a lesion to what region of the brain often results in gerstmann’s syndrome?

A

dominant inferior parietal lobe

(right where the angular gyrus is)

27
Q

List some disorders involving the primary visual cortex

A
  1. Cortical blindness
  2. Blindsight
  3. Anton’s Syndrome
28
Q

What is cortical blindness?

A

complete visual loss on confrontation testing

bilateral occiptial lobe lesion

29
Q

what is blindsight and what causes it?

A

individual can perform a task without conscious visual perception

visual cortex lesion

30
Q

What is Anton’s Syndrome? What causes it?

A

Complete visual loss on confrontation testing + anosognosia

Bilateral occipital lobe lesion

31
Q

List some disorders involving the Inferior Occipitotemporal Cortex

A
  1. Prosopagnosia
  2. Achromatopsia
  3. Micropsia, Macropsia
  4. Metamorphopsia
  5. Cerebral dipopia/polyopia
32
Q

what is archromatopsia?

A

Difficulty with color perception

whole visual field involved = lesions in bilateral inferior occititotemporal cortex

one eye = contralateral cortical involvement

33
Q

what is micropsia and macropsia?

A

objects appear unusually small or big

34
Q

what is metamorphopsia?

A

objects have distorted shape or size

35
Q

what causes cerebral diplopsia/polyopia?

A

occipital lobe lesion

36
Q

List some syndromes of the Dorsolateral Parieto-Occipital Cortex

A
  1. Simultanagnosia
  2. Optic ataxia
  3. ocular apraxia
  4. Baliant’s syndrome
37
Q

what is simultanagnosia?

A

impaired ability to percieve parts of a visual scene as a whole

38
Q

what is optic ataxia?

A

impaired ability to reach for or point to objects in space under visual guidance

39
Q

what is occular apraxia?

A

difficulty voluntarily directing one’s gaze towards objects in peripheral vision

40
Q

what is Baliant’s syndrome?

A

bilateral lesions of DL parieto-occipital cortex

presents with a clincial triad of the following symptoms:

  • simultanagnosia
  • optic apraxia
  • occular apraxia
41
Q

Functions of the frontal lobe can fit into 3 categories, what are they?

A
  1. restraint
  2. initiative
  3. order
42
Q

list some restraint functions of the frontal lobe

A
  1. judgement
  2. foresight
  3. perseverance
  4. delaying gratification
  5. inhibiting socially inappropriate responses
  6. self-governance
  7. concentration
43
Q

List some initiative functions of the frontal lobe

A
  1. curiosity
  2. spontaneity
  3. motivation
  4. drive
  5. creativity
  6. shifting cognitive set
  7. mental flexibility
  8. personality
44
Q

list some Order functions of the frontal lobe

A
  1. abstract reasoning
  2. working memory
  3. perspective taking
  4. planning
  5. insight
  6. organization
  7. sequencing
  8. temporal order
45
Q

what is the difference in symptoms between a dorsolateral and ventromedial orbitofrontal lesion?

A

DL = apthetic, abulic

VM = impulsive, disinhibited, poor judgement

46
Q

what is the difference between a L and R hemisphere frontal lobe lesion?

A

left = associated with depression-like symptoms

right = more associated with behavioral disturbances like mania

47
Q

frontal lobe syndromes are also known as ________________

A

dysexecutive syndrome

48
Q

What types of symptoms are typically observed with an orbitofrontal lobe syndrome?

A

(disinhibited)

  1. impulsive behavior (psuedopsychopathic)
  2. inappropriate jocular affect, euphoria
  3. emotional lability
  4. poor judgement and insight
  5. distractibility
49
Q

what types of symptoms are typically observed with frontal convexity syndrome?

A

(apathetic)

  1. apathy (pseudodepressive)
  2. indifference
  3. psychomotor retardation
  4. motor perseveration and impersistence
  5. stimulus-bound behavior
  6. motor programming deficits
  7. poor word list generation
50
Q

What are some additional frontal lobe lesion symptoms?

A
  1. disinhibition
  2. inappropriate jocularity (witzelsucht)
  3. limited insight
  4. utilization behavior/environmental dependence
  5. frontal release signs
  6. paratonia
  7. frontal gait
51
Q

what is the symptom of disinhibition?

A

silly behavior, crass jokes, aggressive outbursts

52
Q

define inappropriate joculatiry (witzelsucht)

A

seemingly unconcerned about potentially serious matters

53
Q

what is utilization behavior/environmental dependence?

A

respond to whatever stimuli at hand, even when not appropriate

(also called new bed over syndrome)

54
Q

List some frontal release signs

A
  1. palmar reflex
  2. grasp reflex
  3. sucking reflex
55
Q

what is paratonia?

A

increase in tone, but in a manner in which patient appears to resist the movements of the examiner in almost a willful fashion

56
Q

define Frontal gait

A

shuffling, unsteady, magnetic gait

Neurophysiology (9 decks)

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