Cortical regions
What are the structures in the CNS and PNS?
CNS: brain, brainstem, cerebellum, spinal cord
PNS: peripheral nerves, cranial nerves (except CN II)
Identify the areas: PICTURE OF CORTEX REGIONS
1: primary motor
2: supplementary motor cortex
3: pre-motor cortex
4: Brocas area
5-7: prefrontal cortex
9: primary sensory cortex
10: secondary somatosensory
11: Primary auditory cortex
12: secondary auditory cortex
13: Temporoparietal association cortex
14: Wernicke's area
15: Temporal association cortex
16: visual association cortex
17: secondary visual cortex
18: primary visual cortex
19: tertiary visual cortex
What are the brain locations and functions for non verbal communication?
Inferior frontal gyrus: in right hemisphere of frontal lobe, produces non verbal communication
Temporoparietal Junction: in right hemisphere, interpretations of non verbal signs: posture, facial expressions
What is structures are in the Caudal Midbrain that are not in any other part of the brainstem?
CN IV (trochlear), inferior colliculi
Which cranial nerves are NOT located in the brainstem?
CN I, II, XI
Olfactory, Optic, Hypoglossal
What is the difference between white matter and grey matter? Where are they located in the brain and spinal cord?
White matter: mostly axons, descending and ascending tracts, In the brain: white matter towards center of cerebrum, In the spinal cord: it is on the outside
Grey matter: cell bodies and dendrites, in the brain: it is more towards the outside, in the brainstem and spinal cord it is in the center
What is the function of the primary, secondary cortices and the temporal association area? What would happen if there was a lesion in each of these areas?
Primary auditory: discrimination of sound (pitch, loudness), Lesion: impaired sound location
Secondary auditory: classification of sounds (environment vs language), Auditory agnosia (unable to recognize sounds)
Temporal association area: works with wernicke's area and memory centers for language comprehension, Lesion: impaired language comprehension
What would it look like if a person had a lesion in the right parietal somatosensory region? What about the left side?
Right side: they would lack spatial perception to the left side because the left side (the one still intact) only provides spatial perception to the right side
Left side: there would be no deficits because the right hemisphere attends to both sides of the body in regards to spatial perception
What structures are in the rostral pons that are not in any other part of the brainstem?
CN V primary motor and sensory nuclei
What is the function of CN I (olfactory)?
Special sensory: smell, can evoke memory and emotions
What lobe are the primary motor, supplementary motor and premotor areas located? What are their functions? If there were a lesion what would happen to each?
Frontal lobe
Primary motor: controls voluntary movement, lesion: contralateral hemiparesis
Supplementary motor: planning, initiation of movement, lesion: wouldn't be able to initiate a movement, difficulty with anti-phase hand movements
Premotor area: controls trunk and girdle movement, postural adjustments, lesion: apraxia, perseveration
What is the function of the primary, secondary and tertiary visual cortices? What would happen if there was a lesion in each area?
Primary: intensity of light, size, shape, location of objects, Lesion: homonymous hemianopia
Secondary: motion analysis, visual spatial relations, Lesion: visual ataxia
Tertiary: color, recognizing objects visually, Lesion: visual agnosia (unable to recognize objects)
What features of the brainstem are at EVERY level?
Spinothalamic tract, medial lemniscus, corticospinal tract, reticular formation, parts of trigeminal complex
What are the structures in caudal pons that are not in any other part of the brainstem?
CN V spinal tract, CN VII (facial) nucleus, CN VI (abducens) nucleus
What is the function of CN II (optic)? What is the CN test for this? What would it look like if there were a lesion?
Function: visual fields, pupillary response
CN test: patient covers one eye, tester brings finger into persons visual field from multiple angles, patient reports when they can see their finger
Lesion: Ipsilateral blindness if CN II is completely interrupted
What lobe are the primary and secondary somatosensory area located in? What are their functions? What would happen if there was a lesion in these areas?
Primary sensory cortex: general sensation (shape, size, location), Lesion: contralateral loss of tactile location and proprioception
Secondary somatosensory: stereognosis (inability to recognize objects by touch), memory of spatial and tactile environment, Lesion: Astereognosis, apraxia (can't perform task when asked)
What is the difference between commissural fibers, association fibers and projection fibers? Give example for each one.
Commissural: crosses the midline, connects the 2 hemispheres, example: corpus callosum
Association: does not cross to the other hemisphere, they connect areas on the same side of the brain, example: superior longitudinal fasciculus and arcuate fasciculus
Projection: travels between cortex and brainstem: allows for connection of forebrain, brainstem and spinal cord, example: corona radiata
*Show brainstem picture- identify structures
Show picture
What structures are in the rostral medulla that are not in any other part of the brainstem?
Spinal trigeminal tract, Hypoglossal nucleus, inferior olivary nucleus, dorsal motor nucleus of vagus nerve
What is the function/location of CN III? What is the CN test? What would it look like if there was a lesion?
Location/Function: rostral midbrain, innervates ALL extraocular muscles EXCEPT superior oblique and lateral rectus. Inferior oblique: elevation and extortion, Superior rectus: elevation and intorsion, Inferior rectus: depression and extortion, Medial rectus: adduction
CN test: tests both CN II (afferent) and III (efferent) pupillary light reflex- shine light in one eye and watch pupils to see if they dilate
Lesion: asymmetric pupils, drooping eyelids, ipsilateral pupil constriction- causes dilated pupil, ipsilateral eye to go lateral and down
Which lobes are the wernicke's and broca's areas located? What are their functions? What would happen if there were a lesion in either of these areas?
Wernicke's: temporoparietal junction (L hemisphere only)
Brocas: producing speech, Wernicke's: comprehension language
Lesion: Brocas- Broca's aphasia, Wernicke's: impaired language comprehension
Describe the flow of language, including cortical regions and their functions.
1: primary auditory cortex: used to discriminate sound
2: secondary auditory cortex: classifies sounds, determines if it is language
3: wernicke's area: auditory comprehension
4: subcortical connections: links wernickes and brocas areas
5: brocas: instructions for producing speech
6: oral and throat region of sensorimotor cortex: cortical output to speech muscles
What are structures in rostral midbrain that are not in any other section of brainstem?
Red nucleus, Superior colliculi, CN III (oculomotor) nucleus
The caudal medulla has NO MLF (medial longitudinal fasciculus)
Has: Central canal, spinal tract and nucleus of trigeminal nerve, Nucleus cuneatus, nucleus gracilis
What is the location/function of CN IV? What CN test would you do? What would it look like if there was a lesion?
Location: caudal midbrain
Function: innervates superior oblique muscle: depression and intorsion
CN test: Ocular movements, CN 3,4,6, start in the middle and make a "H" movement with a pen, watch eyes
Lesion: causes the ipsilateral eye to look slightly upward because the muscles innervated by CN 3 and 6 are unopposed