CNS Pg No 565 -574
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CNS Pg No 565 -574

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Questions and Answers

Which part of the brain is primarily involved in the storage of long-term memories?

  • Amygdala
  • Neocortex (correct)
  • Prefrontal cortex
  • Hippocampus

    • Episodic memory is based solely on facts and not on personal context.

    False

    What are the three main processes of memory?

    Encoding, Consolidation, Retrieval

    The area of the brain that stores episodic memories is the ______.

    <p>hippocampus</p> Signup and view all the answers

    Match the following types of memory to their descriptions:

    <p>Episodic = Based on time &amp; context Semantic = Based on facts Procedural = Skills and actions Priming = Facilitated processing due to prior exposure</p> Signup and view all the answers

    Which part of the Papez Circuit is described as the gateway of memory?

    <p>Entorhinal cortex</p> Signup and view all the answers

    The mammillary body is involved in memory processing and is associated with Wernicke Korsakoff syndromes.

    <p>True</p> Signup and view all the answers

    What is the initial structure in the Papez Circuit that sends information to the fornix?

    <p>Hippocampus/Subiculum</p> Signup and view all the answers

    The pathway includes the __________ gyrus, which is part of the cingulate cortex.

    <p>Cingulate</p> Signup and view all the answers

    Match the following components of the Papez Circuit to their functions:

    <p>Fornix = Connects hippocampus to mammillary body Mammillary body = Involved in memory processing Thalamus = Relays information to the cortex Cingulate gyrus = Regulates emotional responses</p> Signup and view all the answers

    What is the effect of a unilateral lesion in the primary visual area (17)?

    <p>Contralateral congruent homonymous hemianopia with macular sparing</p> Signup and view all the answers

    Anton's Syndrome results in an intact light reflex despite cortical blindness.

    <p>True</p> Signup and view all the answers

    What syndrome is characterized by optic ataxia and oculomotor apraxia due to bilateral occipital lobe lesions?

    <p>Balint's syndrome</p> Signup and view all the answers

    A person with color agnosia has difficulty in identifying colors due to a lesion in the _____ area.

    <p>visual association</p> Signup and view all the answers

    Match the following conditions with their characteristics:

    <p>Anton's Syndrome = Cortical blindness with confabulation Balint's syndrome = Optic ataxia and oculomotor apraxia Color agnosia = Inability to recognize colors Cerebral achromatopsia = Complete color blindness</p> Signup and view all the answers

    Which type of aphasia is characterized by non-fluent speech, impaired naming, and loss of prosody?

    <p>Broca's aphasia</p> Signup and view all the answers

    In transcortical motor aphasia, comprehension is preserved.

    <p>True</p> Signup and view all the answers

    What is the primary characteristic of jargon speech in sensory aphasia?

    <p>Replacing words with similar sounds</p> Signup and view all the answers

    Pure alexia is associated with a lesion in the __________ gyrus.

    <p>fusiform</p> Signup and view all the answers

    Match the type of aphasia with its respective characteristic:

    <p>Transcortical motor aphasia = Preserved comprehension, impaired repetition Broca's aphasia = Impaired fluency and comprehension Isolation aphasia = Preserved fluency, impaired repetition Global aphasia = Impaired in all aspects of language</p> Signup and view all the answers

    Which of the following is NOT a reversible cause of dementia?

    <p>Alzheimer's Disease</p> Signup and view all the answers

    Trauma can be a reversible cause of dementia.

    <p>True</p> Signup and view all the answers

    What is the most common cause of dementia among older adults?

    <p>Alzheimer's Disease</p> Signup and view all the answers

    Vitamin B₁₂ deficiency can lead to __________, which is associated with dementia.

    <p>peripheral neuropathy</p> Signup and view all the answers

    Match the type of dementia with its description:

    <p>Frontotemporal Dementia = Most common young onset dementia Prion Disease = Caused by abnormal proteins Dementia with Lewy Bodies = Characterized by visual hallucinations Alzheimer's Disease = Atrophy of the entorhinal cortex</p> Signup and view all the answers

    What type of aphasia is characterized by preserved comprehension but difficulty finding the right word?

    <p>Anomic aphasia</p> Signup and view all the answers

    Wernicke's aphasia is associated with preserved comprehension.

    <p>False</p> Signup and view all the answers

    What type of dysarthria originates from damage to lower motor neurons in the brainstem nuclei?

    <p>Flaccid Dysarthria</p> Signup and view all the answers

    Cerebellar dysarthria is characterized by __________ speech.

    <p>slow scanning staccato</p> Signup and view all the answers

    Match the following types of aphasia with their descriptions:

    <p>Conduction aphasia = Unable to repeat accurately Anomic aphasia = Difficulty finding words Transcortical sensory aphasia = Impaired comprehension and repetition Wernicke's aphasia = Impaired comprehension with reading and writing errors</p> Signup and view all the answers

    What is the primary result of abnormal processing of Amyloid Precursor Protein (APP)?

    <p>Production of abnormal forms of amyloid β (Aβ)</p> Signup and view all the answers

    Accumulation of hyperphosphorylated tau proteins occurs inside neurons.

    <p>True</p> Signup and view all the answers

    What are the main protein deposits associated with Alzheimer's disease?

    <p>Amyloid plaques and neurofibrillary tangles</p> Signup and view all the answers

    In diabetes, the accumulation of Aβ42 occurs because the insulin-degrading enzyme (IDE) is ______.

    <p>used up</p> Signup and view all the answers

    Match the following terms related to Alzheimer's disease with their descriptions:

    <p>Cholinesterase inhibitors = Medications that may help with symptoms Atrophy of median temporal lobe = Shrinking of a specific brain region Cerebral Amyloid Angiopathy = Aβ deposition in blood vessel walls Hirano bodies = Abnormal protein deposits observed in neurons</p> Signup and view all the answers

    Which type of memory is primarily associated with driving?

    <p>Procedural</p> Signup and view all the answers

    Associative memory is observed in humans when they associate fear with certain environments.

    <p>False</p> Signup and view all the answers

    What area of the brain is responsible for procedural memory?

    <p>Cerebellum</p> Signup and view all the answers

    The ________ cortex is known as the gateway of memory.

    <p>Entorhinal</p> Signup and view all the answers

    What is the most common cause of dementia?

    <p>Alzheimer's disease</p> Signup and view all the answers

    Cortical dementia includes conditions like Normal pressure hydrocephalus.

    <p>False</p> Signup and view all the answers

    Match the following brain regions with their respective types of memory:

    <p>Amygdala = Conditional Basal ganglia = Procedural Hippocampus = Episodic semantic Prefrontal cortex = All types</p> Signup and view all the answers

    Which area of the brain is primarily involved in executive function?

    <p>Prefrontal cortex</p> Signup and view all the answers

    Episodic memory is primarily associated with the ______ in the brain.

    <p>hippocampus</p> Signup and view all the answers

    Match the types of dementia with their respective characteristics:

    <p>Alzheimer's disease = Most common cause of dementia Diffuse Lewy body dementia = Cognitive fluctuations and visual hallucinations Vascular dementia = Result of impairments to blood flow in the brain Normal pressure hydrocephalus = Enlarged ventricles without increased intracranial pressure</p> Signup and view all the answers

    Which area of the brain is primarily responsible for language comprehension?

    <p>Wernicke's area</p> Signup and view all the answers

    Dysarthria is a language disorder related to comprehension.

    <p>False</p> Signup and view all the answers

    Name the bundle of nerve fibers that connects Broca's area and Wernicke's area.

    <p>Arcuate fasciculus</p> Signup and view all the answers

    The primary area responsible for grammar and syntax in language output is called __________.

    <p>Broca's area</p> Signup and view all the answers

    Which of the following is considered a speech production disorder?

    <p>Dysarthria</p> Signup and view all the answers

    Match the following areas of the brain with their functions:

    <p>Broca's area = Grammar and fluency Wernicke's area = Language comprehension Primary auditory area = Processes auditory information Primary motor cortex = Controls speech production</p> Signup and view all the answers

    The primary auditory area is involved in producing the motor output of speech.

    <p>False</p> Signup and view all the answers

    What part of the brain is crucial for planning movements related to speech output?

    <p>Premotor area</p> Signup and view all the answers

    Study Notes

    Papez Circuit

    • AKA mammillo-thalamic circuit, is a neural pathway involved in memory and emotion
    • It connects the hippocampus, mammillary bodies, thalamus, and cingulate gyrus
    • Lesions to this circuit can cause memory impairments, such as Wernicke-Korsakoff syndrome

    Memory Processes

    • Encoding (registration): The initial process of taking in information
    • Consolidation (storage): Stabilizing and storing memory
    • Retrieval: Accessing stored information

    Memory Classification

    • Duration: A traditional classification based on memory retention time
      • Immediate memory (working memory): Brief retention, usually seconds
      • Short-term memory (recent): Lasts minutes to hours
      • Long-term memory: Lasts for days, years, or a lifetime
    • Mode of Retrieval: A more current classification focused on how memories are accessed
      • Explicit (declarative) memories: Memories that can be consciously retrieved
        • Episodic memories: Autobiographical, based on personal experiences
        • Semantic memories: Factual knowledge
      • Implicit (non-declarative) memories: Memories that are not consciously recalled
        • Procedural: Skills and habits
        • Priming: Exposure to a stimulus influencing subsequent responses
        • Associative (conditional): Learning to associate a stimulus with a response
        • Non-associative: Habitual responses, such as reflexes

    Apathy

    • Reduced motivation and emotional expression
    • Associated with lesions in the medial prefrontal cortex and thalamic connections

    Occipital Lobe

    • Responsible for visual processing
    • Lesions can result in various visual impairments
      • Unilateral lesions: Homonymous hemianopia (blindness in one half of the visual field)
      • Bilateral lesions:
        • Anton's syndrome: Cortical blindness with denial of blindness
        • Balint's syndrome: Difficulty with visual attention, eye movement, and reaching for objects
        • Color agnosia: Inability to recognize colors
        • Cerebral achromatopsia: Inability to perceive colors

    Language vs Speech

    • Language: The cognitive system that enables communication
    • Speech: The motor output of language
    • Damage to specific areas of the brain can lead to disorders of language (aphasia) and speech (dysarthria)

    Aphasia

    • A disruption of the ability to produce or understand language
    • Types of aphasia are classified by the specific areas of the brain affected
      • Motor aphasia: Difficulty producing fluent speech
      • Sensory aphasia: Difficulty understanding language
      • Transcortical motor aphasia: Difficulty initiating speech but can repeat words
      • Broca's aphasia: Non-fluent speech, difficulty repeating words, and impaired comprehension
      • Isolation aphasia: Preserved comprehension but impaired repetition
      • Global aphasia: Severe impairment across all aspects of language

    Dysarthria

    • A disorder affecting the motor production of speech
    • Types of dysarthria are classified by the specific areas of the brain affected
      • Cortical dysarthria: Arising from damage to the cortex
        • Pseudobulbar dysarthria: Spastic speech with labored articulation
      • Bulbar dysarthria: Arising from damage to the brainstem nuclei
        • Flaccid dysarthria: Slurred speech with weak muscle control

    Reversible Causes of Dementia

    • Drugs: Benzodiazepines, tricyclic antidepressants, lithium
    • Endocrine: Hypothyroidism
    • Metabolic: Vitamin B₁₂ deficiency
    • Chronic Infections: Ear infections
    • Normal Pressure Hydrocephalus (NPH): Excess cerebral spinal fluid in the brain
    • Trauma and Tumors
    • Infections: Chronic meningitis
    • Anemia and Autoimmune: Anemia, autoimmune encephalitis

    Young Onset Dementia

    • Dementia diagnosed before the age of 65
    • Causes include:
      • Frontotemporal dementia (Pick's disease): Most common cause
      • Prion disease
      • Dementia with Lewy bodies (DLB)
      • HIV
      • Whipple's disease
      • Tumors (location-specific)

    Pathology of Dementia

    • Alzheimer's Disease: The most common cause of dementia is characterized by:
      • Atrophy of the entorhinal cortex
      • Accumulation of amyloid plaques (outside neurons)
      • Neurofibrillary tangles (inside neurons)
      • Depleted cholinergic neurons
      • Age is the most important risk factor

        • 85 years old: 40% chance of developing Alzheimer's disease

    Pathogenesis of Alzheimer's Disease

    • APP (Amyloid Precursor Protein):
      • Located on chromosome 21
      • Abnormal processing results in abnormal amyloid β (Aβ) formation
      • Normal processing is aided by α-secretase
    • Aβ Amyloid:
      • Produced from APP via β-secretase
      • Different Aβ fragments exist (e.g., Aβ40, Aβ42)
      • Aβ42 accumulation leads to amyloid plaques
        • Extracellular deposits
    • Tau Proteins:
      • Hyperphosphorylated tau proteins form neurofibrillary tangles
        • Intracellular deposits
    • Cerebral Amyloid Angiopathy:
      • Aβ deposition in blood vessels causing microhemorrhages
    • Diabetes and Amyloid:
      • Hyperinsulinemia in diabetes
      • Insulin-degrading enzyme (IDE) breaks down insulin
      • Elevated insulin levels deplete IDE which leads to Aβ42 accumulation
    • Pathology:
      • Atrophy of the medial temporal lobe
      • Lateral temporal lobe and entorhinal cortex atrophy
      • Hirano bodies: Abnormal protein deposits
      • Granulovacuolar degeneration: Abnormal structures in neurons
      • Depletion of cholinergic neurons in nucleus basalis of Meynert

    Neurological Assessment of Aphasia and Dysarthria

    • Aphasia: Language impairment affecting comprehension, repetition, fluency, and naming
      • Anomic aphasia: Difficulty finding words but comprehension remains intact
      • Conduction aphasia: Impaired repetition due to a lesion in the arcuate fasciculus
      • Transcortical sensory aphasia: Impaired comprehension and repetition
      • Wernicke's aphasia: Impaired comprehension, fluency, and repetition
    • Dysarthria: Disorder of speech articulation due to muscle weakness or incoordination
      • Cortical dysarthria: Arises from damage to the cortex
      • Pseudobulbar dysarthria: Spastic speech, strained and effortful
      • Bulbar dysarthria: Arises from damage to the brainstem nuclei
      • Flaccid dysarthria: Slurred speech with weak muscle control

    Implicit Memory

    • Memories that are not consciously recalled
    • Types of implicit memory:
      • Procedural memory: Skills and habits
      • Priming: Exposure to a stimulus influencing subsequent responses
      • Associative (conditional) memory: Learning to associate a stimulus with a response
      • Non-associative memory: Habitual responses, such as reflexes

    Anatomy of Memory

    • Cortical areas involved in memory:
      • Frontal lobe: Prefrontal cortex involved in all types of memory
      • Parietal lobe: Association areas involved in semantic memory
      • Temporal lobe: Hippocampus involved in episodic and semantic memory. Entorhinal cortex: Gateway to long-term memory
      • Occipital lobe: Involved in semantic memory
    • Subcortical areas involved in memory:
      • Amygdala: Conditional memory
      • Cerebellum: Procedural memory
      • Basal ganglia: Procedural memory
    • Entorhinal cortex: Serves as the gateway to long-term memory

    Dementia

    • A major neurocognitive disorder characterized by significant cognitive decline
    • Diagnosis requires cognitive impairment in at least two cognitive domains:
      • Episodic memory
      • Language
      • Complex attention
      • Executive function
      • Social cognition
      • Perceptual motor skills
    • Causes of Dementia:
      • Alzheimer's disease (most common)
      • Diffuse Lewy body disease (DLB) dementia
      • Vascular dementia
        • Multi-infarct dementia
        • White matter dementia (Binswanger disease)
      • Normal pressure hydrocephalus (NPH)
    • Dementia classifications based on areas of the brain affected:
      • Cortical dementia: Affects the outer layer of the brain
      • Subcortical dementia: Affects deeper structures of the brain

    Language and Speech: Areas and Physiology

    • Language: The cognitive system that enables communication
    • Speech: The motor output of language
    • Auditory Pathway: The pathway by which sound is processed in the brain
    • Brain areas involved in speech:
      • Primary motor cortex: Controls muscles involved in speech production
      • Broca's area: Responsible for grammar, syntax, rhythm, and fluency of speech output
      • Primary auditory area: Processes auditory information
      • Wernicke's area: Involved in language comprehension
      • Inferior temporal gyrus: Contains Broca's area
      • Superior temporal gyrus: Contains Wernicke's area
      • Premotor area: Plans movements involved in speech output
      • Sylvian fissure: A prominent groove that separates motor and sensory areas
      • Internal capsule: A neural pathway connecting different brain areas
      • Arcuate fasciculus: Connects Broca's area and Wernicke's area
      • Connecting fibers: Carry information between different brain areas
    • Other areas involved in speech:
      • Brainstem nuclei: Control and coordinate speech movements
      • Peripheral muscles: Larynx (vocal cords), pharynx (palate), and esophagus, responsible for physical speech production

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    Description

    Explore the intricate neural pathway known as the Papez Circuit and its critical role in memory and emotion. This quiz covers the stages of memory processes, including encoding, consolidation, and retrieval, along with different classifications of memory duration and retrieval modes. Test your knowledge on how these elements interact and their significance in understanding memory impairments.

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