大腦高級(jí)皮層功能障礙演示文稿

1、大腦高級(jí)皮層功能障礙演示文稿第一頁，共三十七頁。優(yōu)選大腦高級(jí)皮層功能障礙第二頁，共三十七頁。cognition functionour ability to perform complex intellectual behaviors such as speaking and writing navigating our way around our environment recognizing other people comprehending time 第三頁，共三十七頁。Cerebral hemisphereCerebellumBrain stem第四頁，共三十七頁。dominant

2、 hemisphere The side of the brain that controls writing and speech is called the dominant hemisphere and the other side is the non-dominant hemisphere.The left hemisphere is dominant in over 90% of right-handed people and in about 60% of left-handed people . 第五頁，共三十七頁。FRONTAL LOBE第六頁，共三十七頁。1.primary

3、 motor cortexthis is located in the percentral gyrus and is concerned with motor function of the opposite side of the body 第七頁，共三十七頁。Supplementary motor and premotor corticesthese areas are concerned with coordinating and planning complex movements .第八頁，共三十七頁。Symptoms from lesions of the motor corte

4、xcontralateral mono-or hemiparesis and facial weakness Supplementary motor and premotor cortices disorders of complex motor planning.第九頁，共三十七頁。2. Brocas area the motor or expressive centre for the productions of speech (dominant hemisphere only ).第十頁，共三十七頁。Symptoms from lesions of the Brocas area ex

5、pressive dysphasia :This comprises non-fluent, hesitant speech with intact comprehension.The patient knows what he or she wants to say but has difficulty finding the correct words ,often producing the wrong word. The ability to repeat words is better than spontaneous speech. Handwriting is also ofte

6、n poor.第十一頁，共三十七頁。3.Prefrontal cortexthe anterior and orbital parts of the frontal cortex govern personality ,emotion, initiative and the ability to plan.第十二頁，共三十七頁。Symptoms from lesions of the Prefrontal cortex causes altered behaviors, including :social disinhibition loss of initiative and interes

7、tinability to solve problems with loss of abstract thought impaired concentration and attention without intellectual or memory decline 第十三頁，共三十七頁。4.The cortical micturition centre this region lies in the paracentral lobule and is involved in the cortical inhibition of voiding of the bladder and bowe

8、l.第十四頁，共三十七頁。Symptoms from lesions of the cortical micturition centre Incontinence of urine and/or faeces Milder symptoms are frequency and urgency of micturition第十五頁，共三十七頁。5.Frontal eye fieldthis is involved in making eye movements to the contralateral side.第十六頁，共三十七頁。Symptoms from lesions of the F

9、rontal eye fieldgaze paresis impairment of eye movements to the contralateral side.This is most commonly seen in a large middle cerebral artery stroke and carries a worse prognosis.rightward gaze第十七頁，共三十七頁。PARIETAL LOBE第十八頁，共三十七頁。1.Primary somatosensory cortex located in the postcentral gyrus concer

10、ned with perceiving complex somatosensory stimuli from the contralateral side of the face and body第十九頁，共三十七頁。Symptoms from lesions of the Primary somatosensory cortex Discriminative sensory impairment of the opposite side of the face and limbs 第二十頁，共三十七頁。3. Use of numbers, e.g. calculation( dominant

11、 hemisphere)第二十一頁，共三十七頁。Gerstmanns syndromeinability to differentiate the right and left sides of the body, inability to distinguish the fingers of the hands(finger agnosia),impairment of calculation (dyscalculia) impairment of writing (dysgraphia).dominant hemisphere第二十二頁，共三十七頁。4.Integration of sen

12、soryIntegration of somatosensory ,visual,and auditory information this allows awareness of the body and its surroundings appropriate movement of the body, and constructional ability. 第二十三頁，共三十七頁。Symptoms from lesions of the parietal lobeApraxiathe dominant parietal lobe Bilateral ideomotor and ideat

13、ional apraxia: the non-dominant parietal lobe Constructional apraxia Dressing apraxia 第二十四頁，共三十七頁。Apraxia(the dominant parietal lobe )inability to carry out a sequence of tasks when there is normal comprehension and intact motor and sensory function Ideomotor apraxia occurs when a patient fails to c

14、opy an action, ideational or conceptual apraxia is more profound ,e.g.the patient fails to understand use of tools and objects at a basic level.第二十五頁，共三十七頁。Symptoms from lesions of the parietal lobeTopographical disorientationthe patient cannot find his or her way around normally familiar spaces e.g

15、.home.第二十六頁，共三十七頁。Symptoms from lesions of the parietal lobeContralateral sensory inattention: neglect of the opposite side of the body For example ,a hemiplegic patient may ignore the paralysed side or there may be denial of the hemiplegia(anosognosia).第二十七頁，共三十七頁。TEMPORAL LOBE第二十八頁，共三十七頁。1. Wernic

16、kes areain the posterior part of the superior temporal gyrus, concerned with comprehension of written and spoken language.第二十九頁，共三十七頁。Symptoms from lesions of the Wernickes areareceptive dysphasia impaired comprehension of speech and written language . fluent but words are replaced with partly corre

17、ct words and an incorrect word related to the word intended (paraphasia)or newly created meaningless words (neologisms)The speech does not make sense and the patient has poor insight into the problem.第三十頁，共三十七頁。2. auditory cortices The dominant temporal lobe is important for the comprehension of spo

18、ken words the non-dominant for the appreciation of sounds and music. 第三十一頁，共三十七頁。Symptoms from lesions of the auditory cortex Auditory agnosia: inability to recognize sounds e.g. ringing of a bell ,whistling of a kettle ,a melody (non-dominant hemisphere).Cortical deafness: bilateral lesions of the

19、primary auditory cortices and is uncommon. Auditory hallucinations can occur in temporal lobe epilepsy.第三十二頁，共三十七頁。3.The limbic system the olfactory and gustatory cortices lie in the medial temporal lobe. The limbic system is important in memory. learning and emotion.第三十三頁，共三十七頁。Symptoms from lesions of the limbic systemOlfactory and gustatory hallucinations :arise from lesions within the medial temporal lobe ,particula