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Aphasia - CDIS 631
Neuroanatomy and Aphasia
99
Medical
Graduate
09/16/2008

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Term
What are fissures?
Definition
boundaries for the broad divisions of the cerebrum
Term
What are fissures?
Definition
boundaries for the broad divisions of the cerebrum
Term
Where is the Lateral sulcus/Sylvian fissure?
Definition
Inferior frontal lobe (seperates frontal lobe from temporal lobe)
Term
What is the other name for the Lateral Sulcus?
Definition
Other name: Sylvian Fissure
Term
What is the other name for the Rolandic Fissure?
Definition
Other name: Central sulcus
Term
Where is the central sulcus located?
Definition
located between the primary motor cortex and primary somatosensory cortex (divides brain into anterior and posterior halves).
Term
Where is the longitudinal fissure?
Definition
located through the middle of the brain, dividing the left and right hemispheres
Term
Which lobe comprises 1/3 of the surface of each right/left hemisphere?
Definition
The frontal lobe comprises this fraction of the surface of the right/left hemispheres.
Term
Which lobe represents the highest level of evolution?
Definition
The frontal lobe represents this level of evolution and is larger than any other primate.
Term
What three large areas are contained in the frontal lobe?
Definition
The pre-frontal area, pre-motor area, and primary motor area are all contained in this lobe.
Term
What is the main function of the pre-frontal area?
Definition
Personality, emotional coloring, foresight, and complex decision-making are all functions of this area.
Term
The pre-motor and primary motor areas of the frontal lobe are responsible for what movements?
Definition
These are responsible for voluntary movements.
Term
What part of the frontal lobe is often affected by stroke, with damage presenting as hemi-paresis on the opposite side of the body?
Definition
The primary motor area of the frontal lobe is often affected by stroke which presents this symptoms.
Term
Where is Broca's area located?
Definition
This motor-speech area is located in the frontal lobe.
Term
What is the pre-central gyrus comprised of in the anterior area from the central sulcus?
Definition
The primary motor strip is also known as this area.
Term
This area is responsible for voluntary control of muscles on the contralateral side.
Definition
The primary motor area is responsible for control of this.
Term
How is the motor strip arranged to the muscles? What is the term for this?
Definition
The homunculus is the term used to decribe the map between these two parts of the body.
Term
What is located immediately anterior to the primary motor area?
Definition
The pre-motor or supplementary motor area is located here.
Term
What is Broca's area responsible for?
Remember: Non-fluent aphasia.
Definition
This area is involved in the coordination or programming of motor movements for the production of speech sounds.
Term
Is Broca's area directly involved in the motor movements of speech?
Definition
Neuron fires in this area does not generate impulses
Term
What area is also involved in syntax which involves the ordering of words in speech?
Definition
The Broca's area is involved in syntax and this aspect of speech.
Term
Damage to what part of the brain causes a person to speak disfluently but still able to understand the spoken words of others?
Definition
Damage to Broca's area causes these symptoms in aphasia.
Term
Because damage occurs on the lateral surface of the frontal lobe, broca's aphasia patients may also have this physical symptom.
Definition
Contralateral hemiparesis of the face and upper extremity are physical symptoms of this aphasia due to location of the brain damage.
Term
Neurons for control of the face and upper extremity are located on the lateral surface of the frontal lobe-- an area perfused by which artery?
Definition
The middle cerebral artery is located near the lateral surface of this lobe responsible for face and upper extremity control.
Term
Neurons responsible for control of your ass and lower extremities are located on the medial surface of the frontal lobe-- an area perfused by which artery?
Definition
The anterior cerebral artery is located near this surface of the frontal lobe responsible for control of your ass and lower extremities.
Term
What is the critical area for attention, short-term memory, motivation, and problem-solving?
Definition
The frontal lobe in front of motor and pre-motor area are critical for these mental processes.
Term
Disruption of social behavior, disinhibition, lack of initiative, and short-term memory problems are symptoms of damage to this area of the brain.
Definition
Damage to the frontal lobe can cause these disturbances in mental processes.
Term
The parietal lobe is located where?
Definition
This lobe is located immediately posterior to the central sulcus and anterior to the occipital lobe (not separated by an natural boundary)
Term
What natural boundary divides the parietal and temporal lobes?
Definition
The lateral fissure separates these two lobes.
Term
The parietal lobe is mainly associated with what function?
Definition
This lobe is associated with sensation (touch, kinesthesia, warm/cold, vibration, etc)... remember Primary Somatosensory Cortex.
Term
As far as language, the parietal lobe is involved in what processes?
Definition
This lobe is involved in writing and some aspects of reading.
Term
Post-central gyrus is another name for this area.
Definition
Other name: primary sensory area or sensory strip
Term
These two gyri are located in the parietal lobe.
Definition
The supramarginal gyrus and angular gyrus are located in this lobe.
Term
This gyrus curves around the posterior end of the lateral Sylvian fissure and damage to it can cause conduction aphasia and agraphia.
Definition
The supramarginal gyrus curves around the back end of this fissure and damage can cause these symptoms.
Term
This gyrus lies directly posterior to the supramarginal gyrus and curves around the end of prominant sulcus in the temporal lobe and is involved in the recognition of visual symbols.
Definition
The angular gyrus lies directly posterior to this other gyrus and curves around the prominant sulcus in this lobe.
Term
Damage in the dominant hemisphere of the parietal lobe can cause these symptoms.
Definition
Word-finding problems (anomia), reading/writing deficits (alexia/agraphia), left-right disorientation, finger agnosia, and acalculia are all symptoms of damage to the dominant hemisphere of this lobe.
Term
Acalculia is a condition where patients are unable to perform what tasks?
Definition
This condition means a patient is unable to perform simple mathematical processes... some as simple as counting.
Term
Where is the temporal lobe located?
Definition
This lobe is located below the frontal and parietal lobes and in front of the occipital lobe.
Term
This lobe is bound superiorly by the lateral fissure and an imaginary line anteriorly.
Definition
Temporal lobe is bound by these natural lines.
Term
This lobe is associated with auditory processing and olfaction.
Definition
The temporal lobe is associated with these functions.
Term
As far as language, the temporal lobe is responsible for what functions?
Remember: Wernicke's Area
Definition
Processes for semantics (word meaning) are located in this lobe.
Term
Since these two major areas are in the temporal lobe, damage to it can contribute to language disorders in additional ways.
Definition
The Primary Auditory Cortex/Herschl's gyrus, which are the cortical center for hearing, are located in this lobe.
Term
Wernicke's area, located in the temporal lobe, is responsible for what language processes?
Definition
This area is responsible for critical comprehension and formulation of both spoken and written language.
Term
The occipital lobe is located where?
Definition
This lobe is the small area behind the parietal lobe and does not have prominant sulci for boundaries.
Term
What processes are involved in the occipital lobe?
Definition
Vision and visual processing, as well as recognition of shapes and colors are located within this lobe.
Term
What are the three major types of connecting fibers in the brain?
Definition
Projection fibers, association fibers, and commissure fibers
Term
Projection fibers connect what in the brain?
Definition
These fibers connect the cortex and subcortical structure like the cerebellum, basal ganglia, and brain stem.
Term
Projection fibers connect what in the brain?
Definition
These fibers connect the cortex and subcortical structure like the cerebellum, basal ganglia, and brain stem.
Term
Association fibers connect what within the brain?
Definition
These fibers connect structure within a hemisphere.
Term
The arcuate fasciculus is the most important fiber of this type and connects broca's and wernicke's areas.
Definition
This is the most important association fiber and connects what two areas?
Term
The arcuate fasciculus is important for what two language-related processes?
Definition
Verbal memory and meaningful language production are dependent on this major association fiber.
Term
Commissure fibers connect in this fashion.
Definition
These fibers run horizontally and connect structures between the two hemispheres.
Term
The corpus callosum, which connects the two hemispheres at their bases, is the major connective fiber of this type.
Definition
This is the most important type of commissure fibers.
Term
Damage to the corpus callosum can result in what symptoms?
Definition
Damage to this major commissure fiber can result in disconnection syndromes involving problems in naming, reading, and other functions.
Term
What is the most common cause of aphasia?
Definition
vascular lesion
Term
Brain uses what percent of blood at one time and this percent of O2 to function maximally?
Definition
20% of blood and 25% of O2 is used by this part of the body at any one time.
Term
5-8 seconds of circ interruption may result in what?
Definition
Unconsciousness is the result of this many seconds of circ interruption.
Term
20-25 seconds of blood deprivation in the brain can result in this?
Definition
Elimination of electrical activity in the brain can result in this many seconds of blood deprivation in the brain.
Term
4-6 minutes of vascular interruptions can result in this?
Definition
Irreversible brain damage can result in this amount of time.
Term
The two arterial systems that the brain receives blood from are these.
Definition
The carotid artery and vertebral basilar artery supply blood here.
Term
The external carotid artery supplies blood here.
Definition
Facial muscles, forehead, oral/nasal/orbital cavities (extracranial tissue) receive blood from this artery.
Term
The internal carotid artery delivers blood here.
Definition
This artery is the major source of blood to the brain through two major brances - ACA and MCA.
Term
The vertebral basilar artery is a major source of blood to the brain through this cerebral artery.
Definition
The posterior cerebral artery (PCA) supplies blood to the brain through this artery.
Term
These are the three main cortical arteries.
Definition
Anterior Cerebral Artery (ACA), Middle Cerebral Artery (MCA), and Posterior Cerebral Artery (PCA)
Term
Which hemisphere holds the majority of language processes?
Definition
The left hemisphere holds the majority of these processes.
Term
What part of the brain receives it's blood supply from the ACA?
Definition
The mesial and orbital sectors of frontal lobe AND mesial sectors of temporal lobe get their blood supply from this artery.
Term
What part of the brain receives it's blood supply from the MCA?
Definition
Most of the inferior and lateral sectors of the temporal lobe, lateral sectors of frontal, parietal, and occipital lobes get their blood from this artery.
Term
What part of the brain receives it's blood supply from the PCA?
Definition
The mesial of occipital and temporal lobes get their blood from this artery.
Term
Which of the major cerebral arteries is most commonly affected by CVAs?
Definition
The MCA is most commonly affected by these.
Term
ACA Supplies:
Definition
Medial surface of the cortex as far back as parietal-temporal-occipital sulcus
AND
upper & anterior frontal lobes and anterior corpus callosum
Term
Why do infarctions in the ACA rarely lead to aphasia?
Definition
Since it is out of the primary language zone, infarctions in this artery rarely lead to aphasia.
Other disruptions: paralysis (motor cortex), pragmatics/planning/reasoning, impaired judgment/inhibition/concentration.
Term
The MCA supplies:
Definition
This artery supplies most of the outer convex brain surface, basal ganglia, and posterior and anterior internal capsules.
Term
CVAs in the MCA present with symptoms of:
Definition
CVAs in this artery may create impairments like hemiparesis, visual deficits/neglect, aphasia, and apraxia.
Term
This artery is least commonly affected by strokes but tend to involve migrainous strokes
Definition
The PCA is least likely to be involved in CVAs but do tend to involve this type of stroke.
Term
Common etiologies for PCA CVAs include:
Definition
Embolization from heart, the aortic arch, vertebral artery, basilar artery, and intrinsic atherosclerosis or vasospasm
Term
Impairments for CVAs of the PCA include:
Definition
visual field loss, visual agnosia, disorders of facial recognition, alexia, d/o color vision, and memory loss
Term
Definition of Stroke:
Definition
generic term for a disturbance of brain function caused by sudden vascular disruptions
Term
What are the two types of strokes?
Definition
Ischemic (occlusive) vascular pathology (thrombosis or embolism) and Hemorrhagic (bleeding from ruptured vessels) are the two types of these.
Term
This type of ischemic stroke is due to occlusion of a smaller artery by a clot moving peripherally
Definition
An Embolism is a type of this kind of stroke.
Term
Thrombosis strokes are due to occlusion at atherosclerotic lesions and can occur during this time of day:
Definition
These strokes occue during sleep and periods of low physical activity.
Term
Recurring HAs are a warning sign for this type of hemorrhagic stroke.
Definition
This is a warning sign for a arteriovenous malformation type of stroke
Term
TIAs, HA, and seizures are warning signs for thrombosis, ischemic strokes.
Definition
TIAs, HA, and seizures are warning signs for thrombosis ischemic strokes.
Term
This type of stroke accounts for about 80% of all CVAs.
Definition
Ischemic/Occlusive vascular pathologies account for this percent of CVAs
Term
Artherosclerosis:
Definition
Slow process in which blood particles and fatty deposits accumulate along inner walls and cause narrowing
Term
Arteriosclerosis
Definition
Chronic disease of thickening, hardening, and loss of elasticity of arterial walls result in impaired blood circulation
Term
Cerebral Embolisms come from:
Definition
These strokes are caused by clots that form at another location (heart/large arteries of chest/neck) and a portion of the clot breaks off, travels to brain until it reaches a vessel to small to pass
Term
Thrombus (blood clot) develops at a clogged part of the vessel and...
Definition
this occurs in larger arteries where there's a change in direction and slowly builds until there's a clog
Term
TIAs are mini-warning signs with an obstruction but then this happens
Definition
In this warning sign, the clots generally resolve themselves over time but still indicate occlusions
Term
Ischemic strokes have immediate effects including:
Definition
these strokes have immediate effects that include cell necrosis (death leaving cavities), edema (reducing function of surrounding live cells), and reduced blood flow
Term
Hemorrhagic CVAs account for 20% and result from this:
Definition
weakened cerebral blood vessel that ruptures and bleeds into surrounding brain causing pressure is the cause of this type of stroke
Term
An aneurysm is:
Definition
a ballooning of a weakened region of a blood vessel and may rupture if left untreated
Term
Arteriovenous malformation (AVM) includes:
Definition
cluster of abnormally formed, twisted, and tangled blood vessels
Term
40-60% of aphasias evolve and can be re-classified
Definition
factoid
Term
Spontaneous recovery happens without Tx and may be due to:
Definition
Resolution of local factors such as edema, absorption of damaged tissue, and improvement in circulation can account for this type of recovery
Term
Plasticity of the brain refers to
Definition
the ability of the brain to reorganize and modify functions adapting to internal or external changes
Term
Neuroplasticity exists and poses both challenges and opportunities
Definition
Term
What are personal factors that affect stroke prognosis
Definition
age, handedness, gender, and psychosocial factors
Term
Which strokes recover at which rates?
Definition
Ischemic strokes have greater/sooner recovery whereas hemorrhagic have more rapid recovery after 4-8wks
Term
Risk factors of stroke include:
Definition
HTN, Heart Disease, Diabetes Mellitus, High Cholesterol, Smoking
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