Neuro semester 2

Neuro semester 2 - Neuro Region Frontal Lobe Parietal Lobe...

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Neuro Region Function Blood Supply Signs/Symptoms Frontal Lobe - personality - motor (C/L side) - Broca’s area (speech initiation) - cortical inhibition of bladder and bowel voiding Middle and anterior cerebral artery - Questionnaires - personality changes - motor exam (head moves to affected side) - Broca’s dysphagia: non-fluent, hesitant speech. Good comprehension (motor dysphagia). Handwriting poor; look for coexisting arm and face weakness - bladder and bowel Parietal Lobe - Sensory (C/L side): tactile and proprioception - comprehension of language; numbers/calculations (dominant side) - concept of body image and external environment; ability to construct shapes (non- dominant side) - contains some visual pathways: optic radiation (lower visual field) - Wernicke’s area (integration of auditory and visual input) Middle and anterior cerebral artery - loss of postural sensation, proprioception, pain, temperature, fine touch, touch localisation - loss of lower visual field - appreciation of size, shape, texture and weight may be affected, with astereognosis - perceptual rivalry is characteristic (presented with 2 stimuli, one on either side simultaneously, the patient is only aware of the one C/L to side of lesion) - Wernicke’s dysphagia: comprehension impaired. Speech non-sensical but fluent. Patient unaware of problem. Neologisms: nonexistent words. Paraphrasia: half-right words (sensory dysphagia). Handwriting poor - non-dominant: no longer aware of opposite limbs and denies weakness (anosognosia). Difficulty in dressing (dressing apraxia). Disturbance of geographical memory (geographical agnosia). Cannot copy geometrical pattern (constructional apraxia) - dominant: confusion of left and right limbs. Difficulty in distinguishing fingers on hand (finger agnosia). Disturbance of calculation (acalculia). Disturbance of writing (agraphia)
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Temporal Lobe - Wernicke’s area (integration of auditory and visual input) - auditory cortex - dominant hemisphere: hearing of language - non-dominant hemisphere: hearing of sounds, rhythm and music - learning and memory - olfactory cortex - visual pathway Middle and posterior cerebral artery - Wernicke’s dysphagia (see above) - cortical deafness: difficulty in hearing words (dominant) or appreciating music/rhythm (non-dominant). Auditory hallucinations may occur - disturbance of memory/learning - olfactory hallucinations - aggressive or anti-social behaviour (associated with limbic lobe) - upper quarter visual disturbance Occipital Lobe - visual cortex Posterior cerebral artery - when only the occipital lobe is affected: a central hemianopia field defect occurs (normal peripheral field of vision) - pupillary light reflex is normal - normally caused by vascular disturbance (posterior cerebral artery) Cerebellum - co-ordination of H/L movement - tone - Anterior inferior cerebellar artery - Posterior inferior cerebellar artery - Superior cerebellar artery “HANDSI” - hypotonia - ataxia - nystagmus - dysarthria - stance/gait - inco-ordination - dysmetria: patient “overshoots” the target
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Neuro semester 2 - Neuro Region Frontal Lobe Parietal Lobe...

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