 |
A |
|
 |
- acalcula:
- difficulties with arithmetic;
may be the result of damage to the angular gyrus in the hemisphere
dominant for speech and language
-
- acceleration-deceleration trauma:
- According to Love and Webb (1992)
the most predominant injury type is acceleration-deceleration
trauma. Acceleration-deceleration trauma causes discrete lesions
which affect only certain areas of the brain, occurs when the
head is accelerated and then stopped suddenly, as in a car
accident, and causes discrete, focal lesions to two areas of
the brain, The prefrontal areas and the anterior portion of
the temporal lobes. The brain will suffer contusions at the
point of direct impact and at the site directly opposite the
point of impact due to the oscillation of the brain within
the skull.
It should be noted that brain injuries may occur as a result
of acceleration-deceleration trauma unaccompanied
by impact.
-
- acetylcholine:
- a neurotransmitter for motor neurons
that is involved in the inhibitory function (as is dopamine)
of the basal ganglia
-
- afferent fibers:
- nerve fibers that take messages
from the periphery to the brain; afferent fibers are almost
always sensory fibers
-
- alexia:
- acquired disturbance of reading
due to brain injury (Love and Webb, 1996, p. 314)
-
- agnosia:
- lack of sensory recognition as
the result of a lesion in the sensory association areas or
association pathways of the brain. An example is looking at
a common object but not recognizing it, or associating meaning
with the image.
-
- agraphia:
- acquired disturbance of writing
due to brain injury (Love and Webb, 1996, p. 314)
-
- alexia with agraphia:
- difficulties with reading and
writing; may be the result of damage to the angular gyrus in
the hemisphere dominant for speech and language
-
- alpha
cells:
- the principle lower motor neurons
of the spinal cord (they are located on the ventral aspect
of the cord); they form the main part of the final common pathway
and conduct rapid motor impulses; each alpha cell innervates
approximately 200 muscle fibers
-
- alternating
hemiplegia:
- paralysis of different structures
on each side of the body; this condition may be the result
of a lesion in the brain stem that damages both the nucleus
of a cranial nerve and one side of the upper motor neurons
of the pyramidal tract
-
- amygdala:
- a structure which is attached
to the tail of the caudate nucleus; it is considered to be
a part of the limbic system and is involved in emotion
-
- anastomosis:
- communication or connection between
the separate components of a branching system; as in the Circle of Willis,
anastomosis allows blood carried by different arterial branches
to come together and be redistributed
-
- angular gyrus:
- the gyrus that lies near the superior
edge of the temporal lobe, and immediately posterior to the
supramarginal gyrus; it is involved in the recognition of visual
symbols (Geschwind referred to it as the "association cortex
for association cortices" and "the most important cortical
areas of speech and language"). Lesions in this area can result
in alexia and agraphia.
-
- anomia:
- difficulty with word-finding or
naming; anomia may be the result of damage to the angular gyrus
in the hemisphere dominant for speech and language. According
to Goodglass and Kaplan (1983), anomia can be localized with
the least reliability of any of the aphasic syndromes. Also,
according to Keenan (1975) all patients with Aphasia experience
some problems with word finding.
-
- anosmia:
- a loss of the sense of smell;
may be a result of a lesion on the olfactory pathway
-
- anterior:
- toward the front (opposed to posterior)
anterior
cerebral artery:
- a branch of the internal carotid
artery; the anterior cerebral artery supplies blood to the
medial cortex, some areas of the frontal lobe, and the corpus
striatum
-
- anterior commissure:
- one of the three major groups
of commissural fibers; part of the Circle of Willis, the anterior
commissure connects the temporal lobes, as well as connecting
the temporal lobe to the amygdala and to the opposite occipital
lobe; it is also connected to the corpus callosum
-
- anterior communicating artery:
- an artery which arises from the
internal carotids; it joins together the anterior cerebral
arteries of each hemisphere
-
- aorta:
- the main artery supplying blood
to the body (with the exception of the lungs); it ascends from
the heart then forms an arch, from which two subclavian arteries
arise
-
- aphasia:
- a disturbance of the skills, associations,
and habits of language due to injury to certain brain areas
that are specialized for these functions. Disturbances of language
usage that are due to paralysis or incoordination of the musculature
of speech or writing or poor vision or hearing are not, of
themselves, aphasic." Thus, aphasia can affect auditory comprehension,
oral expression, reading and writing. (Goodglass and Kaplan,
1983)
-
- apraxia:
- comes from the Greek word "praxis," which
means action. According to Halperin (1986 in Chapey, 1986,
p.422), "apraxia of speech is an articulation disorder that
results from impairment due to brain damage, of the capacity
to order the positioning of speech musculature and the sequencing
of muscle movements for volitional production of phonemes and
sequences of phonemes; but it is not accompanied by significant
weakness, slowness, or incoordination of these same muscles
in reflex and automatic acts."
-
- Apraxia of speech is a disruption
of the capacity to program the skilled oral movements necessary
for speech. The problem is with the programming associated
with incorrect neural commands at higher, more central levels.
In the past, apraxia was often classified as a type of articulation
disorder and was in fact called central dysarthria by some.
Now, it is considered a motor planning/programming deficit.
According to Wertz (1984), apraxia of speech "is a neurogenic
phonological disorder, resulting from the sensorimotor impairment
of the capacity to select, program and execute coordinated
movements of the speech musculature for the production of voluntary
speech." In other words, the part of the brain that generates
the motor programs for speech/phonology is damaged. Kearns
and Simmons (1989, in Northern, 1989) reported that research
using spectographic analysis of voice onset time (VOT) supports
the programming position. Includes limb apraxia, oral apraxia,
apraxia of gait, and apraxia of the swallow.
-
- apraxia of gait:
- difficulty with programming the
motor movements involved in walking
-
- apraxia of the swallow :
- inability to swallow volitionally.
-
- apical dendrites:
- a type of dendrite which has a
stalk that is filled with cytoplasm, these appear to be part
of the soma of the neuron to which they are attached; the majority
of apical dendrites are found in the cerebral cortex
-
- Aqueduct of Sylvius (cerebral
aqueduct):
- a channel which connects the third
and fourth ventricles
-
- arachnoid mater:
- the middle layer of the meninges;
in some areas it has projections (arachnoid granulations or
villi) into the sinuses formed by the dura mater
-
- arachnoid villi (arachnoid
granulations):
- projections of the arachnoid mater
into the sinuses formed by the dura mater that transfer cerebrospinal
fluid back into the bloodstream
-
- arcuate fasciculus:
- the groups of fibers that connect
Broca's area with Wernicke's area (these fibers connect to
the angular gyrus) and are located below the supramarginal
gyrus. According to Geschwind, damage to this area results
in Conduction Aphasia.
-
- arteriosclerosis:
- formation of "plaque" consisting
of muscle cells and fats on arterial walls making the flow
of blood through arteries more difficult. Informally, "hardening
of the arteries"
-
- arteries of stroke:
- striata arteries, which are branches
of the middle cerebral arteries
-
- ascending reticular formation
(reticular activating system):
- the component of the reticular
formation that is responsible for the sleep-wake cycle; it
mediates various levels of alertness
-
- aspiration:
- occurs whenever food enters the
airway below the true vocal folds. Aspiration can occur before, during, or after the swallow.
-
- association fibers:
- nerve fibers that connect areas
within the same lobe or between lobes, within the same hemisphere;
the most prevalent type of neuroal tracts found in the cortex
-
- ataxia:
- an incoordination of motor movement;
ataxia results from cerebellar lesions; the term may also be
used to describe the unsteady walk and unusual postures seen
in patients who have suffered injury to the cerebellum
-
- ataxic dysarthria (cerebellar
dysarthria):
- a disorder that results in jerky,
uncoordinated movements of the speech musculature; it is caused
by lesions in the cerebellum
-
- athetosis:
- disorder that causes slow writhing
movements of the entire body but especially of the arms, face
and tongue.
- auditory
association areas:
- Brodmann's areas 21 and 22
-
- auditory comprehension:
- the ability to understand spoken
language
-
- autonomic
nervous system:
- one of the three main divisions
of the nervous system; it innervates the involuntary structures
of the body (e.g., heart, smooth muscles, glands) and is involved
in control of automatic and glandular functions; it is divided
into two parts, the sympathetic and parasypathetic
-
- axon:
- the part of the neuron that allows
it to send messages to other nerve cells; although each neuron
can have only one axon, the axon itself can have many branches
which connects it to many others
-
 |
B |
|
 |
- Barium:
- contrast material, not radioactive,
used during barium and modified barium studies
-
- basal
ganglia:
- the largest subcortical structure
of the brain; it is made up of the caudate nucleus and
the lenticular nucleus;
it is located at the level of the thalamus
-
- basilar artery
(vertebral basilar artery):
- the artery that is formed when
the two vertebral arteries join together at the lower border
of the pons; the basilar artery again divides at the superior
border of the pons to form the posterior cerebral arteries
(other arteries that arise from the basilar prior to this division
include the anterior cerebellar arteries, inferior cerebellar
arteries, posterior cerebellar arteries, and the pontine branches)
-
- basilar dendrites:
- a type of dendrite that does not
have a stalk; these are more numerous than apical dendrites
-
- BDAE:
Boston Diagnostic Aphasia Examination
- developed by Goodglass and Kaplan
in 1972, is currently being revised. (I was asked by the publishing
company to critique/review the upcoming edition. It promises
to be quite good.) At the moment it consists of twenty-seven
subtests divided into the following sections: conversational
and expository speech, auditory comprehension, oral expression,
understanding written language, and writing. The severity of
a patient's aphasia can be rated on a scale from one to seven
based on speech and language characteristics as well as auditory
comprehension. The Boston Naming Test, a test for anomia which was developed to be used along with
the BDAE, is the supplementary instrument most often used in
the evaluation of aphasia (Chapey, 1994).
-
- bilateral innervation:
- both left and right nuclei of
a pair of cranial nerves receive innervation from both the
left and the right motor pyramidal tracts, provides both ipsilateral
and contralateral innervation
-
- biological intelligence:
- the complex cognitive processes
(such as reasoning and judgment) that are mediated by the most
anterior part of the frontal lobe
-
- BDAE: Boston Diagnostic
Aphasia Examination
-
- bradycardia:
- slowed heart rate
-
- Bradykinesia:
- the "reduced speed of movement
of a muscle through its range" (Love & Webb, 1992, p. 146).
-
- brain
stem:
- the midbrain, pons, and medulla
oblongata
-
- bradycardia:
- slow heart rate
-
- broad-based gait:
- a term used to describe the way
in which some patients compensate for problems related to cerebellar
injury by walking with their feet far apart
-
- Broca's aphasia:
- affects the third frontal convolution (both the gyrus and the sulcus) of the left frontal
lobe. ( Broca's area, Brodmann's
area #44)
-
- Characteristics are telegraphic speech, affected
syntax, as well as labored and slow speech, Melodic
Contour is flat and Articulatory
Agility is impaired.
Potential problems include: simplification of consonant clusters
(e.g. t/st, p/spl) and distortion of phonemes, substitutions
are infrequent. A few paraphasias may occur.
They will usually be literal. Repetition is typically impaired, as is Word
finding. Auditory Comprehension is superior to expressive language. The patient's
ability to understand grammatical morphemes will be affected.
So, while it can be said that auditory comprehension is good
in comparison to that of Wernicke's aphasics, it is not
normal.
The Token Test (DeRenzi & Vignolo,
1966), which assesses subtle receptive language dysfunction,
can be used to evaluate the auditory comprehension of Broca's
aphasics and to help distinguish between Broca's aphasia and
verbal apraxia. Also, limb apraxia may not allow the patient
to carry out the instructions, even though he/she understands
them.
Hemiplegia/Hemiparesis of the right side is common in left hemisphere lesions causing
Broca's aphasia (remember, the language center is in the left
hemisphere for more than 90% of the population) The face and
arm are most likely to be affected due to the organization of
the motor strip.Apraxia frequently accompanies
this type of aphasia as it is also caused by lesions to area
44. Broca's aphasics typically have low frustration tolerance.
They are aware of their errors and may respond to them with a catastrophic reaction which might include crying, screaming and yelling, etc.
-
- Broca's area:
- the area of the brain involved
in the programming of motor movements for the production of
speech sounds; it is also involved in syntax; Broca's area
is located on the inferior third frontal gyrus in the hemisphere
dominant for language; injuries here may result in apraxia
or Broca's aphasia
-
- Brodmann's Classification System:
- a map of the cortex developed
by neurologist Korbinian Brodmann that classifies the different
areas of the brain by number
-
- buccinator muscle (oral
cavity):
- holds food in contact with the
teeth. with the obicularis oris and zygomaticus all three are innervated
by the facial nerve (CN. VII).
-
- bulbar lesions:
- injuries to the nuclei of the
cranial nerves located in the brain stem; they are considered
to be lesions of the final common pathway: usually bilateral,
they produce bulbar palsy
-
- bulbar palsy:
- paralysis produced by bulbar lesions
 |
C |
|
 |
- catastrophic reaction:
- crying, screaming and yelling,
etc. by a person with Broca's aphasia as an expression
of low frustration tolerance/awareness of their errors
-
- cauda
equina:
- The continuation of nerve fibers
in the part of the vertebral column that lies below the spinal
cord; cauda equina is Latin for "horse's tail"
-
- caudal:
- "toward the tail," may mean the
same as inferior; an antonym is rostral
-
- caudate nucleus:
- one of the two structures that
make up the basal ganglia; it is divided into a head, body,
and tail and is bounded on one side by the lateral ventricle
-
- central canal:
- the space in the middle of the
grey matter of the spinal cord; it contains cerebrospinal fluid
-
- central sulcus
(fissure of Rolando):
- the deep sulcus that separates
the frontal and parietal lobes
-
- cephalic:
- a synonym of superior; refers
to the upper parts of the nervous system
-
- cerebellar peduncles:
- three pairs of fiber bundles (the
superior cerebellar peduncle, the middle cerebellar peduncle,
and the inferior cerebellar peduncle) which connect the cerebellum
to the brain stem; information passes on these tracts in both
directions, every message that is sent or received by the cerebellum
travels on the cerebellar peduncles
-
- cerebellar dysarthria (ataxic
dysarthria):
- a disorder that results in jerky,
uncoordinated movements of the speech musculature; it is caused
by lesions in the cerebellum
-
- cerebellum:
- It is involved in the coordination
and production of speech, the organization of muscle movement,
coordination of fine motor movement, and balance; it is the
center of a feedback loop involving motor and sensory information; "cerebellum" means "little
brain" in Latin
-
- cerebral dementia:
- may result from anterior cerebral
artery blockages. Confused
language, or a language
indicative of cognitive impairment, may also occur.
-
- cerebral
peduncles:
- fiber bundles that are located
in the brain stem; the cerebral peduncles connect the pons
to the cerebrum
-
cerebral vascular accident:
- is a temporary or permanent loss
of functioning of brain tissue caused by an interruption in
the cerebral blood supply
-
- cerebrospinal fluid:
- a clear liquid produced and found
in the ventricles. It flows through the subarachnoid space
(surrounding the brain and spinal cord), and inside the central
canal of the spinal cord; it functions as a protective cushion
for, brings nutrients to, and removes waste from, the neuraxis
-
- cerebrovascular resistance:
- makes it more difficult for blood
to flow from one area to another. It can be caused by arterial
spasm, a high level of tri-glycerides in the blood which increases
its viscosity, or by elevated levels of cerebral spinal fluid.
-
- cholesterol:
- HDLs or high density lipoproteins
are the "good" cholesterol. LDLs or low density lipoproteins
are the "bad" cholesterol. It is all right to have high levels
of HDLs, but a high concentration of LDLs is a health risk.
Overall cholesterol levels should be under 200.
-
- choroid
plexes:
- structures that produce cerebrospinal
fluid by allowing certain components of blood to enter the
ventricles; formed by a fusing of the pia mater and the ependyma
-
- cingulate gyrus:
- a cortical area (a gyrus) considered
to be a part of the limbic system; it is located immediately
superior to the corpus callosum
-
- Circle
of Willis (Circulus Arteriosus):
- the main arterial anastomatic
trunk of the brain; the Circle of Willis is a point where the
blood carried by the two internal carotids and the basilar
system comes together and is subsequently redistributed by
the anterior, middle, and posterior cerebral arteries
-
- circumlocutions:
- wordy and circuitous description
of unrecalled terms. For example the patient may say "have
one of them up there" when trying to explain he's had brain
surgery.
-
- claustrum:
- a structure considered by some
anatomists to be a part of the basal ganglia
-
- Closed Head Injury (CHI):
- brain injury resulting from coup-contra
coup, acceleration or deceleration injury. Classified as severe, moderate, or mild based on the degree to which consciousness is impaired
immediately after injury. According to Clifton (1989), severe
head injury has been defined as coma for longer than six hours.
Concussion defines mild head injury.
- Secondary damage in CHI includes
widespread or localized edema as well as slowly developing
hemorrhages (Ylvisaker and Szekeres, 1994, in Chapey, 1994).
-
- cocktail hour speech:
- often seen in a person with Wernicke's
Aphasia
-
- cognitive approach:
- introduced by Schuell with the
use of auditory stimuli, evolved through Duffy to use a multi-modality
approach and by Chapey (1994) to use divergent thinking
-
- collateral circulation:
- a safety mechanism of the arterial
system of the brain; collateral circulation involves the redirecting
of blood through a route that is different than normal; it
can be crucial when blockages occur
-
- commissural fibers:
- nerve fibers that connect the
hemispheres of the brain; the corpus callosum, anterior commissure,
and the posterior commissure are composed of commissural fibers
-
- commissurectomy:
- an operation that severs the corpus
callosum; commissurectomies have been used as a treatment for
severe epileptic seizures
-
- completed stroke:
- type most commonly seen, the infarction
of brain tissue has ceased to occur
-
- conduction aphasia:
- a type of aphasia that may be
the result of a lesion to the arcuate fasciculus
- may result from anterior cerebral
artery blockages
-
- conduit d'approche:
- (Goodglass and Kaplan, 1983) patient
is aware of his/her paraphrasitic errors and will produce repeated
approximations of the intended word, as if he is trying to
untangle it
-
- confrontation
naming:
- one way of testing one's word
finding ability
-
- confused language:
- a language indicative of cognitive
impairment that may occur as a result of anterior cerebral
artery blockages and may accompanied by cerebral
dementia, seems
to be the result of cognitive problems with right hemisphere
lesions.
-
- contralateral hyposthesia:
- lack of sensation on side of body
opposite to site of lesion
-
- contralateral
innervation:
- when a cranial nerve, or a portion
of it, receives information only from fibers on the opposite
side of the brain
-
- conus medularis:
- the point at which the spinal
cord ends, just above the small of the back
-
- convolution:
- the corrogated appearance of the
cortex, includes both gyri and sulci
-
- coronal cut:
- a cut that separates the brain
into front and back portions; a cut that runs from ear to ear
-
- corpora quadrigemina:
- consists of the tectum and the
four colliculi which are bumps on the tectum (two superior
colliculi and two inferior colliculi); the corpora quadrigemina
is located on the posterior surface of the midbrain
-
- corpus callosum:
- Latin for "large body," the corpus
callosum is the major group of commissural fibers; it is located
some distance down inside the longitudinal cerebral fissure;
it connects the hemispheres and mainly connects mirror image
sites
-
- corpus striatum:
- the group of structures that includes
the basal ganglia and internal capsule; it is called the "striped
body" because the internal capsule runs between the caudate
nucleus and lenticular nucleus of the basal ganglia, creating
a striped appearance
-
- cortex:
- the layer of cells that cover
the two hemispheres of the brain; its surface is composed of
gyri and sulci
-
- cortical
blindness:
- caused by damage to occipital
lobes, often when blood is cut off in the posterior cerebral
arteries.
-
- corticobulbar
tract:
- the fibers of the pyramidal tract
that synapse with the cranial nerves located in the brain stem
-
- corticopontine tract:
- fibers from the motor strip of
the cortex
-
- corticopontocerebellar tract:
- a fiber tract that brings a copy
of the motor information (including information about the nature,
destination, strength, and speed of the motor impulse being
sent by the precentral gyrus) to the cerebellum from the frontal
lobe; the information travels on this tract from the precentral
gyrus, descending in the internal capsule, then synapsing with
cells in the pons; pontine nuclei then send second order
neurons to the cerebellum on the middle cerebellar peduncle
-
- corticospinal
tract:
- the fibers of the pyramidal tract
that synapse with spinal nerves; these fibers carry information
about voluntary movement to the skeletal muscles; as they descend
they form part of the posterior limb of the internal capsule
-
- coup contre-coup:
- usually due to a fall or a blow
to the head. The coup is the damage to the braim just beneath
the site of impact. Contra-coup is the damage to the opposite
side of the brain as the brain bounces against the skull.
-
- cranial:
- a synonym of superior; cranial
refers to the upper parts of the nervous system
-
- cricopharyngus
m. or pharyngeal-esophageal (P.E) segment:
- separates the pharynx from the
esophagus. At the end of the pharyngeal stage of the swallow,
it must relax to allow the bolus to enter the esophagus. (It
is normally closed to prevent the reflux of food and to keep
air out of the digestive system.)
 |
D |
|
 |
- deep
nuclei of the cerebellum:
- four different nuclei (the dentate
nucleus, the emboliform nucleus, the globose nucleus, and the
fastigial nucleus) located deep within each cerebellar hemisphere
that have axons to the brain stem and thus send messages out
to be conveyed to other parts of the central nervous system;
these nuclei are regulated by Purkinje cells which perform
an inhibitory function.
-
- Dementia:
- Between 30 and 40 percent of Parkinson's
patients suffer from dementia; loss of mental acuity
-
- dendrite:
- the part of the neuron that receives
messages from the axons of other nerve cells; the two types
of dendrites are apical dendrites and basilar dendrites
-
- descending reticular formation:
- the component of the reticular
formation that is involved in autonomic nervous system activity;
it receives information from the thalamus; the descending reticular
formation also plays a role in motor movement
-
- diabetes insipidus:
- the most serious type of diabetes;
diabetes insipidus is caused by lesions in the hypothalamus
or between the pituitary gland and the hypothalamus
-
- diachisis:
- is a kind of post-lesional cerebral
shock resulting in sudden inhibition of function diminishment
and possibly a complete loss of functioning in brain areas
distal to the site of lesion, may be far away from the point
of original damage, usually connected to the infarcted
area by nerve pathways (Steadman, 1997). Cause of diachisis
in unknown; it may be the result of edema, reduced cerebral
blood flow, the release of neurochemicals or other factors
which have not yet been identified. Diachisis can occur after CHI as well as after stroke.
-
- diencephalon:
- the thalamus and hypothalamus
-
- Diffuse Brain Injury:
- wide spread injury, it can impair attention and perception causing problems
like neglect and prosopagnosia. An inability to analyze and synthesize information and a reduction
in the rate of information processing may also result from
wide-spread brain damage. In addition, long term memory and problem solving may
be impaired. Reasoning, both inductive and deductive, may be
involved. Convergent and divergent thinking are the two main
parameters of reasoning. Convergent thinking often produces
single conclusions while divergent thinking is open ended e.g.
how many things can you do with a toothbrush? Pragmatic problems like impaired social judgment, reduced inhibition, and poor
comprehension of abstraction may occur as well.
-
- direct pyramidal tract (ventral
pyramidal tract, anterior corticospinal tract):
- the uncrossed (direct) fibers
of the corticospinal tract that synapse with the spinal nerves
on the ipsilateral side of the body; these fibers travel down
the ventral aspect of the cord
-
- diskinesias:
- disorders of involuntary movement;
may be the result of extrapyramidal tract lesions
-
- divergent thinking:
- a patient with aphasia is required
to produce several creative responses to every stimulus. For
example, the patient might be asked to think of several unusual
ways to make use of an everyday object.
-
- dopamine:
- a neurotransmitter involved in
the inhibitory function of the basal ganglia; it is produced
by the substantia nigra. Lack of dopamine can result in Parkinson's
disease.
-
dorsospinocerebellar tract:
- one of the two main tracts that
bring sensory information from the periphery to the cerebellum;
proprioceptive information from the upper body travels on this
fiber tract; it carries messages received by the reticular
nuclei in various parts of the brain stem from the cortex,
spinal cord, vestibular system and red nucleus; information
from this tract enters the cerebellum on the inferior cerebellar
peduncle
-
- dura
mater:
- Latin for "hard mother," the dura
mater is the most superior of the layers of the meninges; this
tough, inflexible tissue forms several structures that serve
to separate the cranial cavity into compartments and protect
the brain from displacement, as well as forming several vein-like
sinuses that carry blood back to the heart
-
- dysarthria:
- According to Darley, Aronson and
Brown (1975), a speech disorder resulting from a weakness,
paralysis, or incoordination of the speech musculature that
is of neurological etiology. All types of dysarthria result
from damage to the central or peripheral nervous system that
impairs the transmission of neural messages to the muscles
involved in speech. In contrast to apraxia which affects the
brain's capacity to produce the "programs" necessary for coordinated
motor movements, dysarthria results from an inability to send
the proper messages to the musculature. While apraxia affects
articulation and, to some extent, prosody, dysarthria can impair all processes involved in speech production including
respiration, phonation, articulation, resonance and prosody.
Based on etiology, Darley, Aronson and Brown (1969), identified
six different types of dysarthria. These include four forms
of the disorder which are caused by damage to upper motor neurons.
They include spastic, hyperkinetic, hypokinetic,
and ataxic dysarthria.
-
- dysphagia:
- difficulty swallowing,
types can include the
most common type, delayed/absent initiation of the pharyngeal stage of the swallow, disorders
of the pharyngeal stage of the swallow which
are the most prevalent type of dysphagia among the CVA population,
and types associated with site of lesion including brain
stem stroke, subcortical stroke, unilateral left hemisphere
stroke, Unilateral Right Hemisphere Stroke, and multiple
strokes. Therapy strategies may include Icing, Thermal Stimulation, Sensory Stimulation, Suck-Swallow
technique, Chewing, Oral-motor exercises. Posture to facilitate
swallow is also
utilized for therapy, as is selection of food consistencies
and techniques for protecting the airway
-
- Dystonia:
- causes slow jerky movements which
are most likely to occur in the trunk, neck and proximal parts
of the limbs.
 |
E |
|
 |
- Edema:
- swelling, begins two or three
days after a cerebral insult. Only in the area that has been
injured, however, as localized swelling can greatly increase
pressure throughout the whole cranium, the functioning of the
entire brain may be affected. Edema of the brain should begin
to decrease by the beginning of the first week post-injury.
As intracranial pressure returns to normal levels, any behavioral
changes that were caused by the swelling rather than by the
brain injury will disappear.
-
- efferent fibers:
- nerve fibers that take messages
from the brain to the peripheral nervous system; motor fibers
are efferent
-
- Effortful Swallow:
- increases the tongue driving force
by causing exaggerated retraction of the tongue. This helps
to get food past the valleculae. The patient is directed to
squeeze hard with hi/her throat and neck muscles during
the swallow.
*** The above techniques are most often used with patients who
have had brain stem lesions and so have severe dysphagia, but
still have good cognitive ability.
-
- endolymph:
- the fluid that fills the semicircular
canals of the inner ear
-
- ependyma:
- the membranous lining of the ventricles
-
- Epidural Bleeding:
- According to Stedman (1997) epidural
hemorrhaging, also called extra dural, is an accumulation of
blood between the skull and the dura mater. It is usually the
result of acceleration-deceleration trauma. This type of bleeding
results from lesions of the arteries, most commonly the middle
meningeal artery. The
patient is usually unconscious immediately, then lucid briefly,
then loses conscious again from a large clot in the epidural
space. The clot may compress cranial nerves resulting in pupillary
dilation, as well as ipsalateral weakness or paralysis (Pires,1984,
in Urosovich, 1984).
-
- Surgical aspiration of hematomas
resulting from epidural bleeding may be used as a life-saving
technique.
-
- epidural space:
- a potential space between the
dura mater and the skull
-
- esophageal
stage of the swallow:
- involuntary stage where the larynx
returns to its normal position, and the cricopharyngus muscle
contracts to prevent reflux and respiration resumes.
-
- executive function:
- according to Dunkla, 1996, the
executive function regulates and directs cognitive processes.
It organizes behavior, sets goals, and facilitates goal achievement
while inhibiting behavior detrimental to goal completion.
-
- expressive Aphasia:
- most commonly called Broca's
Aphasia, also
called Motor
Aphasia
-
- external carotid artery:
- a division of the common carotid;
the external carotid supplies blood to the face
-
- external granular layer:
- the second most superior layer
of the cortex; it is very dense and contains small granular
cells and small pyramidal cells
-
- external circular layer (of
the pharynx):
- made up of the superior, middle, and inferior
pharyngeal constrictor muscles
-
- external pyramidal layer (medial
pyramidal layer):
- the third most superior layer
of the cortex; it contains pyramidal cells in row formation
and the cell bodies of some association fibers
-
- extraneural factors:
- factors that may include abnormal
blood pressure, cerebrovascular resistance, and arteriosclerosis
may impede collateral circulation
-
- extrapyramidal tract:
- involved in automatic motor movements,
gross motor movements, posture and muscle tone (in combination
with the autonomic nervous system) and facial expression; it
is an indirect, multisynaptic tract; the components of the
extrapyramidal system include the basal ganglia, the red nucleus,
substancia nigra, the reticular formation, and the cerebellum,
consists of neurons that regulate involuntary/automatic movements.
Lesions in the extrapyramidal tract cause various types of diskinesias or disorders
of involuntary movement. The problems mostly commonly affecting
the extrapyramidal tract include degenerative diseases, encephalitis, and tumors.
 |
F |
|
 |
- Facial Nerve (Cranial Nerve
VII):
- innervates the lip muscles including
the obicularis oris and the zygomaticus. The
muscles must contract during the oral preparatory and oral
transport stages of the swallow to prevent food from dribbling
out of the mouth. The facial also innervates the buccinator muscles
of the cheeks. These must remain tense during the oral component
of the swallowing process to prevent the pocketing of food
between the teeth and the cheeks.
Sensory Component carries information about taste from the anterior
2/3 of the tongue.
-
- falx cerebelli:
- separates the lobes of the cerebellum;
the falx cerebelli is formed by the dura mater
-
- falx cerebri:
- separates the lobes of the cerebrum;
the falx cerebri is formed by the dura mater
-
- festinating movements:
- movements which become increasingly
rapid and uncontrolled
-
- final common pathway:
- lower motor neurons traveling to
the muscles of the body on the only route by which information
from any of the upper motor tracts can reach the periphery.
Thus, when lower motor neurons are damaged, the parts of the
body that they innervate are deprived of input from the pyramidal
and extrapyramidal tract as well as cerebellar pathways. Thus,
voluntary, automatic and reflexive movements are all affected.
-
- finger agnosia:
- an inability to recognize objects
through the sense of touch; may be the result of damage to
the angular gyrus in the hemisphere dominant for speech and
language
-
- fissure:
- a particularly deep sulcus
-
- fissure
of Rolando (central sulcus):
- the sulcus that separates the frontal
and parietal lobes
-
- fissure of Sylvius (lateral
fissure):
- the fissure that separates the
frontal and temporal lobes
-
- flaccid
(lower motor neuron) dysarthria:
- the only form of dysarthria that
results from damage to lower motor neurons.
-
- Fluent
Aphasias:
- Fluent aphasias are the result
of lesions affecting the post Rolandic area. Problems
with meaning are associated with posterior lesions.
- Phoneme selection and sequencing
as well as syntax are preserved. Speech is characterized by
a facility of articulation and many long runs of words combined
using a variety of grammatical constructions. However, fluent
speech is not equivalent to meaningful speech. Often the speech
of fluent aphasics sounds like "jabberwocky." Typically,
there are word-finding problems that affect nouns and picturable
action words. Comprehension is typically poor with fluent/posterior
lesion aphasias. (Conduction aphasia would be the exception
to this). The amount and type of paraphasias, the presence
of auditory receptive impairments and of impaired repetition
are variable in fluent aphasias, depending upon the exact site
of lesion.
-
- flocculi:
- the most ancient part of the cerebellum;
the flocculi are part of flocculonodular lobe
-
- flocculonodular lobe:
- the lobe of the cerebellum that
consists of the flocculi and the nodulus; the flocculonodular
lobe is involved in the maintenance of equilibrium
-
- focal
lesions:
- generally small and just in one
area, focal lesions can affect the language and swallowing
centers of the brain, they can cause symptoms similar to those
seen as a result of a left cerebral vascular accident including apraxia, dysarthria, aphasia, dysphagia, agnosia, anomia,
and dysphonia. Focal lesions can also cause more general
impairments that affect language, similar to those resulting
from right hemisphere damage. These include attentional, perceptual
and pragmatic deficits.
-
- foramina of Luschka:
- two lateral openings (along with
the medial foramen of Magendie) which serve to connect the
fourth ventricle to the subarachnoid space
-
- foramen of Magendie:
- a medial opening (along with the
lateral foramina of Luschka) which serves to connect the fourth
ventricle to the subarachnoid space
-
- foramina of Munro (interventricular
foramina):
- two openings which connect the
lateral ventricles to the third ventricle
-
- fornix:
- a subcortical component of the
limbic system; the fornix is a group of fibers that arise from
the hippocampus and connect the rhinencephalon to the thalamus
and hypothalamus; the fornix is connected to the septal nuclei
and the mamillary bodies
-
- fourth ventricle:
- one of the four ventricles of the
brain; it is filled with cerebrospinal fluid; the fourth ventricle
is located between the cerebellum and the pons
-
- frontal
lobe:
- the most anterior lobe of the brain;
it is bounded posteriorly by the central sulcus and inferiorly
by the lateral fissure; this lobe is associated with higher
cognitive functions and is involved in the control of voluntary
muscle movement
-
- fusiform layer (multiform layer):
- the sixth and most inferior layer
of the cortex
 |
G |
|
 |
- GABA:
- Gamma Amino Butric Acid; a neurotransmitter
that is involved in the inhibitory function of the basal ganglia;
it is a glutamate
-
- gag reflex:
- a good example of a true reflex.
It is "triggered" whenever a noxious substance touches
the back of the tongue, back of the pharynx, or soft palate.
The swallow response, on the other hand, cannot be initiated
by touching any particular area in the oral cavity. The gag
reflex and the swallow response also differ in terms of neurological
control. The gag reflex is completely controlled by the brain
stem. The swallow, on the other hand, is only partially controlled
by the brain stem. It also receives cortical input, and input
from muscle spindles, including feedback from tongue movements.
(It is important to note that the gag reflex and the swallow
response are not related. In the past, many physicians
would determine feeding status based on the presence or absence
of a patient's gag. Actually, the presence or absence of
a gag reflex does not predict the status of the swallow response.)
-
- gamma neurons:
- neurons of the final common pathway
(located on the ventral aspect of the spinal cord); these cells
conduct slow motor impulses and their main function is to stretch
muscle spindles; gamma cells are only half as numerous as alpha
cells
-
- ganglionic cells:
- neurons of the autonomic system
that originate within the ganglia of the autonomic nervous
system and project to post-ganglionic neurons
-
- ganglionic layer:
- the fifth layer of the cortex;
it contains small granular cells, large pyramidal cells, and
the cell bodies of some association fibers (the association
fibers that originate here form the Bands of Baillerger and
Kaes Bechterew, which are two large fiber tracts)
-
- Glasgow Coma Scale:
- developed by Jennett and Teasdale
(1989), instrument most frequently used to quantify levels
of consciousness, consists of three categories: eye opening, verbal
responses and motor responses.
-
- Global Aphasia:
- third most common aphasic syndrome
after Broca's and Wernicke's, occurs when there are both anterior
and posterior lesions. All aspects of language are so severely
impaired that there is no longer a distinctive pattern of preserved
vs. impaired components. Articulation may be adequate in the
context of stereotypical utterances. Prognosis is poor.
-
- globus
pallidus:
- the more medial part of the lenticular
nucleus
-
- Glossopharyngeal Nerve
(Craninial Nerve IX):
- considered the major nerve for
the swallowing center, Motor Component innervates the 3 salivary
glands in the mouth. The saliva from these glands mixes with
the chewed up food to form a bolus. Has motor, sensory, and
autonomic nervous system nerve fibers. It, along with the vagus
(CN. X), provides some innervation to the upper pharyngeal
constrictor muscles (Zemlin, 1997). Innervates the stylopharyngeus muscle
which elevates the larynx and pulls it forward during the pharyngeal
stage of the swallow. This action also aids in the relaxation
and opening of the cricopharyngeus muscle. Sensory components
mediate all sensation, including taste, from the posterior
1/3 of the tongue. Also carries sensation from the velum and
the superior portion of the pharynx. A lesion may impair the
gag reflex unilaterally (Zemlin, 1997).
-
- graduated
stick:
- may be used instead of a pacing
board. Graduated sticks have bumps on them at regular
intervals and the patient must touch one bump for every syllable.
Metronomes can also be used to slow speech rate. Patients
are taught to produce one syllable per "tick" on
the metronome.
-
- gyrus:
- a raised fold of brain tissue
 |
H |
|
 |
- hemianopsia:
- loss of sight in one half of the
visual field. damage to either middle cerebral artery can cause
This blindness affects the contralateral aspect of both visual
fields. For example, a blockage in the right middle cerebral
artery will cause left hemianopsia or blindness in the left
visual field of both eyes.
-
- hyposthesia:
- lack or sensation
-
- hemiplegia:
- complete paralysis on one side
-
- hemiparesis:
- partial paralysis on one side
-
- hematomas:
- or pools of congealed blood, in
the parenchyma, the subarachnoid space, or the subdural space,
bleeding due to stroke, hemmorrhage or traumatic brain injury,
tissue is irritated rather than infarcted
-
- Hemophilia:
- is a thinning of the blood which
prevents it from coagulating.
-
- hemorrhagic strokes
- Hemorrhagic stroke occurs when
a cerebral artery ruptures, causing bleeding within the cranium.
Such ruptures may be caused by aneurysms,
weak spots in arterial walls. (Aneurysms can balloon out rather
than bursting. The excess pressure resulting from this swelling
can also damage brain tissue.)
-
- Heschl's
Gyrus (anterior transverse temporal gyrus):
- the primary auditory area; it is
located in the temporal lobe
-
- hippocampus:
- a cortical area classified as part
of the limbic system; it is a gyrus located on the medial edge
of the temporal lobe, it is involved with memory
-
- homunculus:
- "little man"; a pedagogical
device that is used to explain and demonstrate the functioning
of the motor strip
-
- horizontal cut (transverse cut):
- a cut that divides the brain into
upper and lower sections; perpendicular to coronal, medial,
and sagittal cuts
-
- hydrocephalus:
- a condition that occurs when too
much cerebrospinal fluid is produced and the ventricles swell,
resulting in pressure being exerted on the tissue of the brain;
it may be caused by tumors
-
- hydroencephali:
- a rare birth defect in which the
cerebrum is absent and the space where it should be is filled
with cerebrospinal fluid; the term literally means "water
brain"
-
- hyperkinetic dysarthria:
- occur when the extrapyramidal tract
is damaged, specifically the basal ganglia
-
- hypertension:
- blood pressure that is elevated
regardless of activity level; may be a factor in stroke
-
- Hypokinesia :
- "the reduced amplitude of
muscle movement" (Love & Webb, 1992, p. 146).
-
- Hypoglossal Nerve (Cranial Nerve
XII)
- Information about motor movement
is received from the muscle spindles in the tongue via this
nerve, serves as part of the swallowing center that
initiates the swallow. The hypoglossal innervates all extrinsic
and intrinsic tongue muscles. (It is strictly a motor nerve.)
-
- hypopharynx (of
the Pharynx):
- lower portion of the pharynx. It
is also known as the laryngopharynx
-
- hypothalamus:
- a subcortical structure located
immediately below the thalamus, part of it is also anterior
to the thalamus and it forms the floor and part of the lateral
walls of the third ventricle; by controlling the functioning
of the pituitary gland it regulates basic biological functions
(e.g., appetite, body temperature, sex drive)
-
- hypokinetic dysarthria:
- occur when the extrapyramidal tract
is damaged, specifically the substantia nigra
-
- Hyperuricemia:
- a risk factor for CVA, involves
an elevation of the level of uric acid in the blood. (This
is the cause of gout.)
 |
I |
|
 |
- infarction:
- death of tissue
-
- inferior:
- refers to the lower parts of the
nervous system
-
- inferior
cerebellar peduncles (restiform bodies):
- one of the three fiber bundles
called cerebellar peduncles that connect the cerebellum to
the brain stem; the inferior cerebellar peduncle connects the
cerebellum with the vestibular nuclei located in the lower
pons and medulla, and with the reticular formation; proprioceptive
information from the upper body (information that travels along
the dorsospinocerebellar tract) enters the cerebellum on the
inferior cerebellar peduncle
-
- inferior
colliculi:
- structures of the midbrain that
relay auditory information to the medial geniculate bodies
of the thalamus
-
- insula (the Island
of Reil):
- the cortical area that lies below
the fissure of Sylvius; it is considered by some anatomists
as the fifth lobe of the brain; it may be associated with the
viscera
-
- interconnecting fibers:
- nerve fibers that connect structures
within the brain; the two types of interconnecting fibers are
commisural fibers and association fibers
-
- internal
capsule:
- a group of myelinated ascending
and descending fiber tracts that connect the cortex to other
parts of the central nervous system; although the axons that
pass through it descend to the brain stem and spinal cord,
the capsule itself ends within the cerebrum; the internal capsule
is located between the lenticular nucleus and the caudate nucleus
-
- internal carotid artery:
- a division of the common carotid;
the internal carotid arteries supply blood to the brain; the
two main branches of this artery are the anterior
cerebral artery and the middle cerebral
artery, The internal
carotids and basilar arteries are connected
via the Circle of Willis, which allows blood to pass
from one system to another in the event of blockage.
-
- internal granular layer:
- the fourth layer of the cortex;
it is very thin; it contains pyramidal cells in row formation
-
- interneurons:
- association neurons of the spinal
cord; interneurons connect the anterior and posterior horns
of grey matter and are involved in the reflex arc (they function
within the same segment of the spinal cord)
-
- internuncial neurons:
- association neurons of the spinal
cord; internuncial neurons project (ascend) to the brain stem
and cerebellum
-
- intraparnchymal
bleeding:
- can occur at a very slow rate within
structure such as the thalamus, the spontaneous recovery period
following a stroke caused by this type of bleeding may be especially
lengthy. For this reason, it is justifiable to continue therapy
for a longer period of time with patients who have had parenchymal
bleeding than with those who have had other types of hemorrhages.
-
- intraparynchemal hemorrhaging:
- Due to Penetrating Brain Injury
Bleeding within the structures of the brain is usually the
consequence of penetrating head wounds rather than CHI. This
kind of hemorrhaging can occur in the cortex as well as in
subcortical areas. When it is the result of closed head injury,
rather than CVA, it most commonly affects the frontal and temporal
lobes. Most penetrating brain injuries result from high velocity
missiles such as bullets. Low velocity focal injuries (blows
to the head-head hitting windshield) can result in bone fragments
penetrating the brain. There is a high rate of mortality following
penetrating brain injury especially to the brain stem (Brookshire,
1997).
-
- ischemic:
- refers to a lack of blood-bourne
oxygen. Ischemic strokes are more common than hemorrhagic strokes
and may be caused by stenosis or thrombosis of
the arteries, as well as by the presence of thrombo-emboli in
the arteries. Almost always contralateral and therefore unilateral
-
- Island
of Reil (the Insula):
- the cortical area that lies below
the fissure of Sylvius; it is considered by some anatomists
as the fifth lobe of the brain; it may be associated with the
viscera. It has recently been associated with programming for
muscle movement involved in speech.
-
 |
J - K |
|
 |
kinesthesia:
- feedback from muscle spindles (a
more specific term than proprioception)
 |
L |
|
 |
lateral:
- toward the sides
-
- lateral aspect:
- the part of the motor strip that
is located on the lateral surface of the hemisphere; it is
responsible for motor control of the upper body (including
the larynx, face, hands, shoulders, and trunk)
-
- lateral corticospinal tract
(lateral pyramidal tract):
- the fibers of the corticospinal
tract that decussate at the pyramids
-
- lateral fissure (fissure of
Sylvius):
- the fissure that separates the
frontal and temporal lobes
-
- lateral geniculate bodies:
- the thalamic nuclei that receive
visual information from the superior colliculi of the midbrain,
process, and then transmit this information to the cortex
-
- lateral pterygoid muscle
of the oral cavity:
- depresses, opens, and protrudes
the mandible, as well as moving it laterally
-
- lateral ventricles:
- the two large ventricles (filled
with cerebrospinal fluid) that have anterior horns located
in the frontal lobes, inferior horns located in the temporal
lobes, and which also extend posteriorly into the parietal
lobes
-
- left
middle cerebral artery:
- supplies blood to Broca's
area, Wernicke's area, Heschl's
gyrus, angular gyrus and also the areas
of the motor and sensory strips from the
head to the hips.
-
- left-right disorientation:
- an inability to distinguish the
left from the right; may be the result of damage to the angular
gyrus in the hemisphere dominant for speech and language
-
- left side neglect:
- an impairment in the ability to
recognize and respond to stimuli on the left side of the body
-
- lenticular
nucleus (lentiform nucleus):
- one of the two structures that
make up the basal ganglia; it is composed of the globus pallidus
and the putamen; the lenticular nucleus is located between
the caudate nucleus and the Island of Reil with its anterior
aspect attached to the head of the caudate nucleus
-
- levator
veli palatini (oral cavity):
- with the palatoglossal both
raise the velum. They are innervated by the vagus nerve (CN.
X).
-
- limbic
system (rhinencephalon):
- the most ancient and primitive
part of the brain; it is composed of both cortical and subcortical
structures located on the medial, inferior surfaces of the
cerebral hemispheres; the limbic system is involved in the
processing of olfactory stimuli, emotions, motivation, and
memory, and may be involved in cortical speech and language
behavior
-
- literal/phonological
paraphasia:
- More than half of the intended
word is produced correctly. For example, a patient may say
/pun/ instead of /spun/. In addition, transpositions of sounds
can occur, e.g tevilision for television. (Brookshire, 1997).
-
- long association fibers:
- association fibers that connect
areas that are located in different lobes of the brain (e.g.,
the arcuate fasciculus)
-
- longitudinal
fissure (interhemispheric fissure):
- the split or gap between the right
and left cerebral hemispheres that is lined with cortex
-
- lower
motor neurons:
- second order neurons; the cranial
and spinal nerves; the cell bodies of the lower motor neurons
are located in the neuraxis, but their axons synapse with the
muscles of the body, sometimes called the final common
pathway
-
- lumbar puncture (spinal tap):
- a diagnostic procedure in which
a needle is inserted in the lower lumbar section of the vertebral
canal to obtain a sample of cerebrospinal fluid
 |
M |
|
 |
- magnum
foramen:
- the large opening in the base
of the skull
-
- mamillary bodies (mamillary
nucleus):
- subcortical component of the limbic
system (rhinencephalon); the mamillary bodies are connected
to the hippocampus, the thalamus, and the fornix
-
- masked facies:
- Parkinson's patients usually display
little facial expression, so their faces are described as "mask-like."
-
- massa
intermedia (thalamic adhesion):
- the tissue that connects the two
thalamic bodies
-
- masseter muscle of the oral cavity:
- elevates and closes the mandible
-
- MTDDA: Minnesota Test
for Differential Diagnosis
-
- medial:
- toward the center
-
- medial muscle of the oral cavity:
- which also elevates the mandible
and aids in its closure
-
- medial aspect:
- the part of the motor strip that
extends down into the longitudinal cerebral fissure; it controls
the movements of the body from the hips downward
-
- medial
cut:
- a section that divides the brain
into right and left halves of equal size; it separates the
hemispheres from each other; a medial cut is a type of sagittal
cut
-
- medial
geniculate bodies:
- the thalamic nuclei that receive
auditory information from the inferior colliculi of the midbrain,
process, and then transmit this information to the cortex
-
- medulla oblongata:
- the most inferior structure of
the brain stem; the "bulb"; the medulla is involved in circulation
and respiration
-
- Melodic Intonation Therapy:
- (Sparks & Holland, in Chapey,
1994) Melodic intonation therapy, or MIT, uses music
to involve the non-dominant hemisphere in language production.
originally developed by Sparks and Holland for the treatment
of severe non-fluent aphasia. Currently, however, it is frequently
used to treat individuals with apraxia. This technique involves
teaching the patient to sing words or phrases set to simple
melodies. It is hypothesized that this therapy is effective
because the use of music helps involve the right hemisphere
in the production of speech.
-
- Mendelsohn Maneuver:
- helps the patient gain some voluntary
control over the opening and closing of the p.e. segment. The
patient is told to pay attention to the way the thyroid cartilage
goes up and down during swallowing. Then he learns to use muscles
to keep the larynx elevated for several seconds after the swallow.
This should facilitate the opening of the cricopharyngus muscle.
-
- meninges:
- dura mater, arachnoid and pia
mater, three layers of protective tissue that surround the
neuraxis; the meninges of the brain and spinal cord are continuous
and are connected through the magnum foramen
-
- micrographia:
- often seen with parietal lobe
lesion, the "tendency for handwriting to be very small in the
height of the letters and to get progressively smaller as the
person continues to write" (Love and Webb, 1992, p. 146).
-
- midbrain (mesencephalon):
- the most superior part of the
brain stem
-
- middle cerebellar peduncle
(middle brachium pontis):
- the largest of the cerebellar
peduncles; the middle cerebellar peduncle connects the cerebellum
with the pons; through this connection the cerebellum receives
a copy of the information for muscle movement that the pyramidal
tract carries to lower motor neurons
-
- middle
cerebral artery:
- a branch of the internal carotids;
the middle cerebral artery supplies blood to the entire lateral
aspect of each hemisphere (including the lateral motor strip,
lateral sensory strip, Broca's area, Wernicke's area, Heschl's
gyrus, angular gyrus) and to the corpus striatum
-
- middle meningeal artery:
- this artery sometimes ruptures
after traumatic brain injury
-
- Minnesota Test for Differential
Diagnosis: (MTDDA)
- developed by Schuell in 1965.
This comprehensive test assesses the patient's strengths and
weakness in all language modalities.
-
- Mixed dysarthria:
- occurs when both upper and lower
motor neurons are injured, amyotrophic lateral sclerosis (Lou
Gehrig's Disease) is the most frequent cause of mixed dysarthrias.
Etiology is unknown and prognosis is poor.
-
- Mixed Nonfluent Aphasia:
- diagnosis given to patients who
produce language that is similar to the telegraphic speech
characteristic of Broca's aphasia, but cannot be categorized
as actually having Broca's aphasia due to the severity of their
auditory comprehension deficits.
-
- modified barium swallow:
- procedure used to image the swallowing
process is a modified barium swallow, not a true barium swallow. the patient consumes foods of
varying consistencies that have been coated with barium.A true
barium swallow is used to view the esophagus
-
- molecular
commotion:
- (Love and Webb, 1992) a disruption
in the molecular structure of the brain which may cause permanent
changes in both white and grey matter
-
- molecular layer:
- the most superior layer of the
cortex; it contains the cell bodies of neuroglial cells
-
- muscularis uvula (oral
cavity):
- shortens the velum. It is also
innervated by the spinal accessory (CN XI).
-
- Myasthenia Gravis:
- According to Fitz Gerald (1996),
it is caused by the immune system producing antibodies to the
ACh receptor. This disease impairs the ability of nerve fibers
to synapse with the muscles by reducing the number of acetylcholine
(ACh) receptors at the neuromuscular junction. It causes weakness
in muscles throughout the body, especially those involved in
speech and swallowing. This weakness is progressive. In the
morning or after rest, the patient's speech may sound clear.
However, as he becomes fatigued, slurring of speech will increase.
-
- myelin:
- a fatty insulating substance that
covers, at regular intervals, many of the axons in the central
and peripheral nervous system; myelin serves to increase the
speed of transmission of impulses, by allowing them to jump
from one unmyelinated segment to the next (this is called saltatory
conduction)
-
- myotomy:
- the procedure of cutting the cricopharygeus
muscle
 |
N |
|
 |
neuraxis:
- the brain and spinal cord; the
central nervous system
-
- Neuronal
Unmasking:
- (Bach-y-Rita, 1989) Neurons which
are normally quiescent may begin working again after others
have been destroyed. This means that brain processes which
are normally inhibited by higher level controls will be able
to function. This may help in recovery. Negative effects of
unmasking are reflexes and responses like the startle
reflex which are usually
only seen in young children. The Babinski reflex and the patilla reflex may also be abnormal after head injury.
-
- neurons:
- the nerve cells of the central
and peripheral nervous systems; a neuron is composed of an
axon, a soma, and dendrites (while all neurons have one soma
and one axon, some neurons have many dendrites and others have
none)
-
- neurological input for the
swallow
- in the initiation in the swallow
comes from the trigeminal, facial, and glossopharyngeal nerves
-
- neocerebellum:
- the posterior lobe of the cerebellum;
it is considered to be the newest part of the cerebellum; it
is involved in the coordination of muscle movement through
the inhibition of involuntary movement, it is also involved
in fine motor coordination
-
- neologistic paraphasias:
- less than half of the intended
word is produced correctly. In some cases the entire word is
produced incorrectly. Neologisms are also common in the speech
of schizophrenics.
-
- NG tubes and swallowing:
- naso-gastric feeding tube; According
to Logemann (1989), its not necessary to wait until tubes are
removed to begin therapy.
-
- Nodes of Ranvier:
- the segments of axons between
areas of myelin, which are in direct contact with extracellular
fluid
-
- nodulus:
- the narrowest and most inferior
part of the vermis; it is part of the flocculonodular lobe
of the cerebellum
-
- nonfluent aphasias:
- Nonfluent aphasias are the result
of damage to the area of the brain anterior to the central sulcus (Broca's
area)
-
- The flow of speech is more or
less impaired at the levels of speech initiation, the finding
and sequencing of articulatory movements, and the production
of grammatical sequences. Speech is choppy, interrupted, and
awkwardly articulated.
-
- Comprehension appears to be better
than production and in a sense it is. The linguistic competence
underlying both comprehension and production of language is
the same, so both comprehension and production are affected
by a nonfluent aphasia. However, just as it is easier to understand
a second language than to produce it, it is easier for the
patient to understand what is said than to speak. One can often
get by with only comprehending the key words and using non-verbal
cues.
 |
O |
|
 |
obicularis oris:
- lip muscle, with the buccinator
and zygomaticus innervated by the facial nerve (CN. VII).
-
- occipital lobe:
- the most posterior lobe of the
brain; it is associated with vision
-
- olfactory pathways:
- the olfactory pathways originate
in the nasal area and pass posteriorly to enter the temporal
lobe at the hippocampal gyrus; the olfactory tract is immediately
superior to the optic tract
-
- olivary nuclei:
- landmarks in the medulla which
lie posterior to the pyramids; the olivary nuclei are involved
in the processing and relaying of auditory information
-
- operant conditioning:
- a form of behavior modification, used to remediate aphasia. This approach involves
shaping language behavior by helping patients to progress through
a series of tasks presented in fixed order, from least to most
difficult.
-
- oral apraxia:
- an inability to make voluntary, non-speech oral movements
-
- oral preparatory phase of the swallow:
- voluntary, mechanical phase that can be by-passed by
dropping liquid or food into the back of the throat.In this
stage, the food is chewed into smaller pieces and tasted. It
is also mixed with saliva from three pairs of salivary glands,
which are innervated by the glossopharyngeal nerve. The food
and saliva form a bolus of material.
The bolus is kept in the front of the mouth, against the hard
palate by the tongue. The front of the tongue is elevated with
its tip on the alveolar ridge. The back of the tongue is elevated
and the soft palate is pulled anteriorly against it (the
airway is open and nasal breathing continues during this phase).
Labial seal is maintained to prevent food from leaking out
of the mouth. Buccal muscles are tense. Duration of the
oral-preparatory stage is variable (Logemann, 1983, 1997).
-
- oral transport stage of
the swallow:
- voluntary stage, starts with the jaws and lips closed, and
the tongue tip on the alvealor ridge. The pattern-elicited
response is initiated at the end of this phase. Inspiration
is reflexively inhibited at the beginning of this stage. The
food is moved to the back of the mouth by the tongue via an
anterior to posterior rolling motion. The anterior portion
of the tongue is retracted and depressed while the posterior
portion is retracted and elevated against the hard palate.
When the bolus passes the anterior faucial pillars/touches
the posterior wall of the pharynx, the oral stage ends and
the pharyngeal stage begins as the tongue
driving force or the
tongue's plunger action,
forces the bolus into the pharynx. Logemann (1997) describes
the "pharyngeal tongue" which extends from the velum to the
hyoid bone and valleculae. The "oral tongue" which extends
from the tip to the back, adjacent to the velum, functions
during the oral stage of the swallow while the "pharyngeal
tongue" functions during the pharyngeal stage. This stage lasts
one second (Logemann, 1989, 1998; Dobie, 1978).
 |
P |
|
 |
- pacing board
- may be helpful for patients with
dysarthria, divided into sections, the patient must tap one
section every time he pronounces a syllable. As the fingers
cannot move nearly as rapidly as the articulators, this should
slow the rate of speech enough to improve intelligibility.
After reduced rate has been established using the board, the
client can begin to count syllables on his fingers. Eventually,
he should be able to maintain the proper rate without counting
syllables at all. A device called a graduated stick may be used instead of a pacing board. Graduated sticks have
bumps on them at regular intervals and the patient must
touch one bump every time he says a syllable. Metronomes can
also be used to slow speech rate. Patients are taught to produce
one syllable per "tick" on the metronome.
-
- palatoglossal muscle (oral
cavity):
- with the levator veli palatini both raise the velum. They are innervated by the
vagus nerve (CN. X)
-
- palatopharyngus muscle (oral
cavity):
- depresses the velum and constricts
the pharynx. It is innervated by the spinal accessory (CN.
XI).
-
- paleocerebellum:
- the anterior lobe and second oldest
part of the cerebellum; the paleocerebellum receives proprioceptive
input from the spinal cord and controls the anti-gravity muscles
of the body, it thus regulates posture
-
- Pallilalia:
- the compulsive repetition of syllables
sometimes present in hypokinetic dysarthria
-
- paraphasia:
- the production of unintended syllables,
words, or phrases during the effort to speak" (Goodglass & Kaplan,
1983, p. 8). Patients with fluent forms of aphasia exhibit
many more paraphasias than do those with nonfluent types. There
are three types of paraphasias, literal/phonological, neologistic, and semantic/verbal.
-
- parasympathetic nervous system:
- a division of the autonomic nervous
system; it helps to bring the body back to normal
-
- parenchyma
- means "specific cells of a gland
or organ" (Stedman's Concise Medical Dictionary, 1997). Parenchymal
bleeding refers to the flow of blood into brain tissue rather
than into an existing space like the subarachnoid
space or a potential
space like the subdural space. Parenchymal hemorrhages occur most frequently in the putamen,
thalamus, pons, and cerebellum (Coch & Metter, 1994).
-
- paragrammatical:
- (Goodglass and Kaplan, 1983) patients
with Wernicke's Aphasia make grammatical errors but their speech
cannot be considered agrammatical as it does contain complex
syntactical forms
-
- parietal lobe:
- the lobe of the brain which is
immediately posterior to the central sulcus, anterior to the
occipital lobe, and superior to the posterior portion of the
lateral fissure (and thus the temporal lobe); it is associated
with sensation (touch, kinesthesia, perception of temperature,
vibration), writing, and some aspects of reading
-
- Parkinson's Disease:
- a degenerative disease, is probably
the most frequently occurring illness that results from extrapyramidal
tract lesions. It occurs when the dopaminergic neurons of the
substantia nigra are destroyed. Its symptoms include:
Tremor, Festinating movements( these movements can also affect speech), Hypokinetic
dysarthria, weak voice,
and mask-like facial expression. Recent research indicates that
those who acquire the disease prior to age 50 may have genetic
causation.
-
- pattern-elicited response:
- the swallow was previously classified
as a reflex, most sources now disagree and label it pattern-elicited
-
- perilymph:
- fluid of the inner ear; it surrounds
the utricle, saccule, and semicircular canal
-
- peripheral lesions:
- lesions to the axons of the cranial
nerves; these are considered to be lesions of the final common
pathway
-
- peripheral nervous system:
- the cranial nerves and spinal
nerves
-
- peristalsis:
- wave-like motions of muscles that
occur in the esophagus. In some of the literature, the action
of the pharyngeal constrictor muscles is mistakenly called
peristalsis, rather than a stripping action.
-
- pharyngeal-esophageal
(P.E) segment or cricopharyngus m.:
- separates the pharynx from the
esophagus. At the end of the pharyngeal stage of the swallow,
it must relax to allow the bolus to enter the esophagus. (It
is normally closed to prevent the reflux of food and to keep
air out of the digestive system.)
-
- pharyngeal recesses:
- the valleculae is a space or depression between the base of the tongue and
the epiglottis, two pyriform sinuses are located in the pharynx, beside the larynx. They are formed
by the shape of muscle attachments to the pharyngeal walls. Food
boluses can lodge in these recesses.
- pharyngeal stage of
the swallow: (Logemann, 1989, 1997, 1998; Cherney, 1994)
involuntary, and most critical stage of the swallow; airway closure must
occur to prevent the bolus from entering the respiratory system.
Almost simultaneously: 1.Sensory information from receptors in
the back of the mouth and in the pharynx goes to the swallowing
center in the medulla via CN. IX. The palatopharyngeal folds
pull together medially to form a slit in the upper pharynx. The
bolus passes through this slit. 2. The velum is raised, primarily
by the levator and tensor veli palatini muscles. 3. The tongue
is retracted
-
- Has a laryngeal substage in which
three actions occur simultaneously (Obviously, inspiration
is inhibited during the pharyngeal stage of the swallow.) 1.The
larynx and the hyoid bone are pulled both upward and forward. 2.The
true and false vocal folds adduct. (Closure begins at the level
of the true vocal folds and progresses up to the false vocal
folds and then to the ari-epiglottic folds.) 3.The epiglottis
drops down over the top of the larynx, The bolus passes
down on both sides of the epiglottis. If the bolus is liquid,
the epiglottis acts as a ledge to slow its movement through
the pharynx, giving the vocal folds time to adduct and the
larynx time to elevate.
Three factors cause food to move down the pharynx during the
rest of the pharyngeal stage (Cherney, et al., 1994; Logemann,
1983, 1989, 1997): The tongue driving force using the "pharyngeal
tongue", the stripping action of the pharyngeal constrictors
and the presence of negative pressure in the laryngopharynx
The pharyngeal stage ends when the cricopharyngus muscle relaxes.
-
pia
mater:
- the innermost layer of the meninges;
it adheres closely to the brain, descending into the sulci
and fissures of the cortex and fuses with the ependyma to form
the choroid plexes
Pill-rolling tremor:
- Parkinson's patients move
their thumbs and forefingers together as if rolling a small
pill between them. This movement occurs at rest, but subsides
during voluntary movement and sleep.
-
- pituitary gland:
- an endocrine gland of the central
nervous system; secretes a number of different hormones
-
- plaque:
- composed of cholesterol build
up and smooth muscle cells
-
- plunger action or or
the tongue driving force:
- plays a major role in this process.in
the movement of food down the pharynx, according to the latest
research on swallowing disputes the action of the pharyngeal
constrictor muscles as the most critical factor
-
- pneumoencephalography:
- a technique used prior to the
introduction of CT, MRI, and PET technology, in which a small
amount of cerebrospinal fluid is removed from the ventricles
and replaced with an inert gas, allowing the examiner to view
the ventricles in a scan and assess brain pathology
-
- polycythemia:
- a thickening of the blood due
to an increase in the number of cells.
-
- pons:
- the brain stem structure located
between the midbrain and medulla; fibers in it connect the
brain stem to the cerebellum; pons is Latin for "bridge"
-
- Porch Index of Communicative
Ability: (PICA)
- (Porch, 1967) samples fewer language
behaviors than the MTDDA. However, it is known for its elaborate
scoring system, which allows the examiner to differentiate
between responses elicited with different degrees of cueing,
various types of errors, and also to note the immediacy of
the response.
-
- postcentral
gyrus (primary sensory area, sensory strip):
- the area of the brain located
in the parietal lobe immediately posterior to the central sulcus;
this area receives sensory feedback from the muscles, joints
and tendons in the body; the postcentral gyri have lateral
and medial aspects
-
- posterior:
- toward the back (opposed to anterior)
-
- posterior
cerebral arteries:
- arteries that arise from the basilar
artery (before it divides); the posterior cerebral arteries
supply blood to the posterior areas of the brain, including
the medial parts of the occipital lobes, and the inferior areas
of the temporal lobes, as well as supplying blood to the thalamus
and other subcortical structures
-
- posterior commissure:
- one of the three major groups
of commissural fibers
-
- posterior communicating
arteries:
- arteries that arise from the internal
carotid arteries; they join the middle cerebral arteries to
the posterior cerebral arteries
posterior lesions:
- problems with meaning are associated with posterior lesions
-
- post-ganglionic cells:
- neurons of the autonomic nervous
system that are located in its target organs and muscles
-
- post Rolandic area:
- lesions in this area result in
fluent aphasia, these are posterior lesions and result in problems
with meaning
-
precentral gyrus (primary motor area,
motor strip):
- a gyrus in the frontal lobe which
controls the voluntary movements of skeletal muscles; it is
located immediately anterior to the central sulcus and has
a lateral and medial aspect; the cell bodies of the pyramidal
tract are found here
-
- pre-ganglionic cells:
- neurons of the autonomic nervous
system that are located in some of the cranial nerves of the
brain stem and in some spinal nerves; they project to the ganglionic
chains of the autonomic nervous system
-
- premotor areas (supplemental
motor areas):
- Brodmann's Area 6, areas located
immediately anterior to the motor strip; this portion of the
frontal lobe is responsible for the programming of motor movements
(except speech)
-
- presensory areas (secondary
sensory areas or sensory association areas):
- areas located posterior to the
postcentral gyrus; these areas are capable of more detailed
discrimination and analysis than the primary sensory areas
-
- press of speech:
- phenomenon characterizes Wernicke's
aphasics. Patients may speak very rapidly, interrupting others.
It may seem as though the patient is striving for a sense of
closure or a sense that he has actually communicated what he
intended to say (Goodglass and Kaplan, 1983).
-
- primary auditory cortex:
- Brodmann's areas 41 and 42
-
- primary visual area:
- an area located within the occipital
lobe; it receives input from the optic tract; damage to this
area may cause blind spots in the visual field or total blindness
-
- pragmatic approaches:
- use social interaction to improve
the communicating abilities of aphasic patients.
-
- programmed stimulation:
- LaPointe (1990), approach to aphasia
therapy combines behavioral and cognitive methods. He advocated
the use of a hierarchy of therapy tasks based on level of difficulty
employed by behaviorists, but uses the kinds of stimuli employed
by therapists with a cognitive orientation. Several types of programmed
stimulation for aphasics
have been developed by other therapists. Among these are melodic
intonation therapy (Sparks & Holland, in Chapey, 1994) and visual
action therapy VAT (Fitzpatrick & Baresi, 1982).
-
- progressive strokes:
- still evolving, meaning that the
patient's condition is continuing to deteriorate. Progressive
strokes can last for over a week. This condition is usually
the result of a severe hemorrhage.Particular caution should
be used when evaluating the swallowing status of such a patient.
Also, progressive strokes tend to happen to people who have
very poor cerebral vascular health and are therefore at risk
for having another stroke very soon.
-
- promoting aphasic's communicative
effectiveness (PACE):
- developed by G. Albyn Davis, based
on the pragmatic rule of reciprocity; the therapist and the patient participate in a conversation
as equals, each taking turns sending and receiving messages.
According to Davis and Wilcox (1981)PACE is based on the following
four principles, The Exchange of New Information, Free Choice
of Communicative Channels, Equal Participation, Functional
Feedback
-
- proprioception:
- sensory information about pressure,
movement, vibration, position, muscle pain, and equilibrium
that is received by the brain (especially the cerebellum) from
the muscles, joints, and tendons
-
- prosopagnosia:
- inability to recognize faces
-
- pseudobulbar palsy:
- the paralysis that results from
bilateral upper motor neuron lesions of the pyramidal tract;
it produces a paralysis very similar to that seen with bulbar
palsy
-
- putamen:
- the more lateral part of the lenticular
nucleus
-
Purkinje cells:
- radish-shaped cells located in
the cerebellar cortex that regulate and inhibit the firing
of the deep nuclei, thus controlling the output of the cerebellum
-
pyramidal tract:
- a fiber tract that carries messages
for voluntary motor movement to the lower motor neurons in
the brain stem and spinal cord; the pyramidal tract is direct
and monosynaptic, pyramidal tract, which is the most important
of the upper motor neuron tracts, transmits messages directing
voluntary motor movements. It is primarily facilitory (Duffy,
1995).
-
- pyramids:
- landmarks in the medulla which
mark the decussation of the pyramidal tract; they lie on either
side of the medial fissure
 |
Q - R |
|
 |
- rami communicantes:
- the rami of the autonomic nervous
system are the axons of its pre-ganglionic and ganglionic cells
-
- red
nucleus:
- a structure of the midbrain, connects
the cerebellum to the thalamus and spinal cord
-
- reflex arc:
- a reflexive behavior that occurs
when a message from sensory fibers causes a motor reaction
directly, without the impulse having to first be sent to the
brain (e.g., the reflex arc of the spinal nerves)
-
- release phenomenon:
- the rapid firing of motor neurons;
the basal ganglia acts to inhibit this
-
- rigidity :
- If the limbs of a Parkinson's patient
are moved passively, the muscles will often contract involuntarily,
causing rigidity. This rigidity may be constant or intermittent.
Intermittent rigidity is called cogwheel rigidity.
-
- restiform bodies (inferior cerebellar
peduncles):
- one of the three fiber bundles
called cerebellar peduncles that connect the cerebellum to
the brain stem; the inferior cerebellar peduncle connects the
cerebellum with the vestibular nuclei located in the lower
pons and medulla, and with the reticular formation; proprioceptive
information from the upper body (information that travels along
the dorsospinocerebellar tract) enters the cerebellum on the
inferior cerebellar peduncle
-
- reticulocerebellar
tract:
- a fiber tract that carries information
received by the reticular nuclei in the brain stem from the
cortex, spinal cord, vestibular system, and red nucleus to
the cerebellum
-
- reticulospinal tract:
- a fiber tract that runs from the
reticular nuclei of the pons and medulla to the spinal nerves;
it carries information related to the functioning of the autonomic
nervous system (e.g., circulation of the blood, dilation of
blood vessels, respiration, and visceral activity); it is also
involved in somatic motor control like the rubrospinal tract
and also plays an important role in the control of autonomic
functions.
-
- reticular activating system
(ascending reticular formation):
- the component of the reticular
formation that is responsible for the sleep-wake cycle; it
mediates various levels of alertness
-
- reticular
formation:
- a set of interconnected nuclei
that are found throughout the brain stem; the dorsal tegmental
nuclei are located in the midbrain, the central tegmental nuclei
are located in the pons, and the central and inferior nuclei
are located in the medulla; the reticular formation has two
components, the ascending reticular formation and the descending
reticular formation
-
- Reversible Ischemic Neurological
Defect(RINDs):
- RINDs are lengthy TIAs, . The term
RIND is usually applied to attacks that continue for more than
12 hours without interruption, although some RINDs may last
for several days. As is the case with TIAs, RINDs resolve in
complete recovery, however some neurologists do not consider
them temporary. (There is some evidence that RINDs do cause
some subtle neurological damage, but these minor changes are
nothing like the types of disabilities seen after "real" strokes.)
Sometimes, events that last for twenty-four hours are called
TIAs rather than RINDs, so there is some inconsistency in
the application of this terminology.
-
- rhinencephalon (limbic system
or limbic lobe):
- the most ancient and primitive
part of the brain; it is composed of both cortical and subcortical
structures located on the medial, inferior surfaces of the
cerebral hemispheres; the limbic system is involved in the
processing of olfactory stimuli, emotions, and memory
-
- right
hemisphere syndrome:
- blockages of the right middle cerebral
artery due to right hemispher lesions whic can cause left
side neglect, which is an impairment in the ability to
recognize and respond to stimuli on the left side of the body, prosopagnosia or
the inability to recognize faces, and various cognitive
problems, including agnosia.
-
- right hemianopsia:
- visual field deficit due to left
hemisphere lesion, the disorder of vision that most often accompanies
aphasia
-
- rostral:
- "toward the beak," rostral
can mean the same as superior, and is an antonym of caudal
-
- rotational trauma:
- occurs when impact causes the brain
to move within the cranium at a different velocity than the
skull. This results in a shearing of axons by the bones of
the skull. Because this type of injury damages neural connections
rather than gray matter, it can affect a wide array of cerebral
functions and should therefore is likely to cause diffuse injury.
-
- rubrospinal
tract:
- a fiber tract, the fibers of which
descend from the cerebellum through the red nucleus to synapse
with the spinal nerves; this tract carries information important
for skeletal muscle control and the regulation of muscle tone
for posture
 |
S |
|
 |
- sagittal
cut:
- a cut that runs parallel to the
medial cut, but divides the brain into two unequal parts
-
- salpingopharyngus muscle
(of the Pharynx):
- with the stylopharyngus m.
makes up the internal longitudinal layer of the pharynx
-
- secondary auditory areas (auditory
association areas):
- two areas, located in the temporal
lobes, which contribute to the ability to comprehend speech
-
- secondary visual areas:
- areas of the occipital lobe, superior
to the primary visual cortex, that integrate visual information
and give meaning to what is being seen by relating it to prior
experience and knowledge; damage to this area can cause visual
agnosia
-
- second
order neurons:
- there are several types, lower
motor neurons; the cranial and spinal nerves; the cell bodies
of second order neurons are located in the neuraxis, but their
axons can synapse with the muscles of the body
-
- semantic aphasia:
- see Wernicke's Aphasia
-
- septal region:
- subcortical component of the limbic
system; it includes the septal nuclei
-
- septum pellucidum:
- a double walled structure located
between the corpus callosum and the fornix
- association fibers that connect
areas that are located within the same lobe
-
- silent aspiration:
- aspiration of food and liquids
without coughing, can occur as a result of neurological damage.
(If food or liquid enters the respiratory system of a normal,
healthy individual, it induces coughing.) Silent aspiration
can cause pneumonia, with a temperature spike being
the first indication that food or liquids are entering the
lungs.
-
- soma:
- cell body; the part of the neuron
that contains the cell's nucleus and cytoplasm
-
- spastic
dysarthria:
- results from lesions to the pyramidal
tract, characterized by "Generalized hypertonicity, weakness,
immobility, abnormal force physiology, and exaggerated reflexes
of virtually all muscles of the speech mechanism produce obvious
dysfunction of the articulation subsystem. Speech is slow-labored,
and imprecise articulatory efforts, compounded by disturbances
of respiration; resonation, and phonation often render speech
unintelligible" Dworkin (1991, p.188).
-
- spinal
cord:
- the part of the central nervous
system that lies below the magnum foramen, and that extends
downward to just above the cauda equina; it contains the cell
bodies of the spinal nerves and their afferent and efferent
fibers
-
- Spinal
Accessory Nerve (CN. XI):
- Motor Component innervates the palatopharyngeus muscle
which depresses the velum and constricts the pharynx, and so
innervates the muscularis uvula which tenses the velum.
It, along with CN.X, innervates the levator veli palatini.
(CN. XI is strictly a motor nerve.)
-
- spinal
nerves:
- thirty-one pairs of mixed nerves
(sensory and motor) that are second order lower motor neurons
and form part of the final common pathway; they also form a
reflex arc; their motor fibers originate on the ventral part
of the spinal cord at the anterior horns of grey matter and
their roots of sensory fibers are located on the dorsal side
of the spinal cord in the posterior root ganglia; these join
together to form the spinal nerves after they exit the spinal
column; the spinal nerves receive only contralateral innervation
from first order neurons
-
- spinal tap (lumbar puncture):
- a diagnostic procedure in which
a needle is inserted in the lower lumbar section of the vertebral
canal to obtain a sample of cerebrospinal fluid
-
- stenosis:
- a general term that means "narrowing",
in this course it is used to describe arterial narrowing
-
- stripping action:
- pharyngeal constrictor muscles
help move food down toward the esophagus via this action.(This
process should not be confused with peristalsis which
is the wave-like motions of muscles that occur in the esophagus.
In some of the literature, the action of the pharyngeal constrictor
muscles is mistakenly called peristalsis.)
-
- stylopharyngus muscle (of
the Pharynx):
- with the salpingopharyngus m.
makes up the internal longitudinal layer of the pharynx
-
- striata:
- the "artery of stroke";
a branch of the middle cerebral artery; the striata supplies
blood to the corpus striatum
-
- stroke:
- or cerebral vascular accident is
a temporary or permanent loss of functioning of brain tissue
caused by an interruption in the cerebral blood supply. Strokes
can be divided into the categories here are two principle
kinds of strokes, ischemic and hemorrhagic within
which they are categorized completed or progressive.
-
- Subarachnoid
bleeding:
- According to Love and Webb (1992),
bleeding into the subarachnoid space is often the result of
aneurysm. According to FitzGerald (1997), berry aneurysms bleed
directly into the subarachnoid space, because they originate
in the circle of Willis. Strokes in those under 40 are often
the result of ruptured aneurysm (FitzGerald, 1997). TBI is
less likely to cause subarachnoid bleeding
-
- subarachnoid space:
- a space that lies between the arachnoid
mater and pia mater; it is filled with cerebrospinal fluid;
all blood vessels entering the brain and cranial nerves pass
through the subarachnoid space
-
- subcallosal gyrus:
- a cortical area (a gyrus) that
is considered to be a part of the limbic system; it is located
immediately inferior to the corpus callosum
-
- Subcortical
Aphasia:
- Lesions in the anterior subcortical
area involving the limb of the internal capsule and putamen
are associated with sparse language output and impaired articulation.
Posterior subcortical lesions are associated with fluent forms
of aphasia, while lesions of the thalamus may cause a global
aphasia.
-
- subdural bleeding:
- According to Stedman (1997), subdural
hemorrhaging, or the extravasation of blood
in the potential space between the dura mater and the arachnoid
membrane, causes hematomas to form. Chronic hematomas may become
encapsulated by neomembranes. This is often over the frontal
and temporal lobes. As this type of bleeding results from damage
to veins, which contain less blood than arteries, subdural
bleeding is much slower than epidural bleeding. According to
Pires (1984), sometimes days or weeks pass before any symptoms
of hemorrhaging appear. According to Bhatnagar and Andy (1995),
subdural hematoma is usually due to traumatic brain injury,
with bleeding from ruptured blood vessels in the arachnoid
tissue below the dura mater. If not removed the blood will
compress neural tissue causing infarction.
-
- subdural
space:
- a potential space between the dura
mater and the arachnoid mater
-
- substantia
nigra:
- a group of dark colored cell bodies
in the midbrain which produce dopamine; the substantia nigra
is part of the extrapyramidal system
-
- sulcus:
- a groove between two gyri
-
- superior:
- refers to the upper parts of the
nervous system
-
- superior
brachium conjunctivum (superior cerebellar peduncle):
- the fiber tract that connects the
cerebellum to the midbrain; it contains efferent fibers from
the dentate, emboliform, and globose nuclei that send feedback
to the motor cortex, and afferent fibers that carry proprioceptive
information to the cerebellum from the lower body (information
that is carried upward along the spinal cord on the ventrospinocerebellar
tract)
-
- superior
colliculi:
- structures of the midbrain that
relay visual information to the lateral geniculate bodies of
the thalamus
-
- superior sagittal sinus:
- a vein-like sinus that runs across
the top of the brain in an anterior-posterior direction, it
is from dura mater
-
- supraglottic
swallow:
- patient is told to take a breath
and hold it while swallowing and then cough after the swallow.
This results in the voluntary closure of the vocal folds before,
during and after the swallow.
-
- supra supra-glottic swallow:
- This technique closes the entrance
to the airway at the level of the arytenoid cartilages. The
patient follows the same procedure as with the supra-glottic
swallow, but "bears down while holding his breath."
-
- supramarginal
gyrus:
- Brodmann's area 40
-
- swallowing
center:
- believed to be located in the medulla within
the nuclei of the reticular formation; specifically
the nucleus ambiguous When the swallow response is initiated,
this center causes messages to be sent to the glossopharyngeal,
the vagus, and the hypoglossal nerves. The glossopharyngeal is
considered the major nerve for the swallowing center.
-
- sympathetic
nervous system:
- a division of the autonomic nervous
system; it prepares the body for fight or flight
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T |
|
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- Tardive
Dyskinesia:
- a condition which results from
long-term use of anti-psychotic drugs called phenothiazines
-
- TBI: seeTraumatic
Brain Injury
-
- tectum:
- the roof of the brain stem
-
- telegraphic
speech:
- function words or grammatical
morphemes, morphological inflections (e.g. plurals,past
tense),articles, conjunctions and prepositions are omitted.
In addition, nouns, verbs, adjectives and adverbs may be
produced. Output can be restricted to noun-verb combinations.
Sentence length is short. Average utterance length (MLU)
is typically about 2. In extreme cases, the patient may only
be able to produce single word utterances.
-
- temporal
lobe:
- the lobe of the brain that is inferior
to the lateral sulcus and anterior to the occipital lobe; it
is associated with auditory processing and olfaction
-
- temporal
parietal lobe:
- often a site of lesion for Wernicke's
Aphasia (the angular gyrus may also be affected)
-
- temporalis
muscle of the oral cavity:
- elevates, retracts, and assists
in closing the mandible
-
- TBI:
Traumatic Brain Injury:
- According to Adamovich, Henderson,
and Auerbach (1984), as many as 400,000 head injuries occur
in the United States each year. The severity of head injury
has generally been classified as mild, moderate and severe.
Mild head injury has been defined as concussion, while severe
head injury means being in a coma for at least six hours. There
does not appear to be a consensus for a definition of moderate
head injury. Jennett and Teasdale developed the Glasgow Coma
Scale in 1974 (Bach-y-Rita, 1989). It is a numerical scale
that quantifies level of consciousness in response to three
categories: response to pain, ability to open eyes, and ability
to speak.
-
- tensor veli palitini (oral
cavity):
- tenses the velum. It receives innervation
from the trigeminal (CN. V).
-
- tentorium
cerebelli:
- formed by the dura mater, the tentorium
cerebelli separates the cerebrum from the cerebellum
-
- Tentorial
Herniation
- Due to the edema that follows CHI,
brain matter can be forced through the tentorial notch. The
notch is a cavity formed by the the tentorium cerebelli. The
tentorium is a sheath of hard tissue, formed by the dura mater.
According to FitzGerald (1997), it forms a tent above the posterior
fossa. It separates the cerebrum and brain stem from the cerebellum.
Tentorial herniation may cause decortication or removal of
cortical tissue from the underlying white matter. It may also
put excessive pressure on the brain stem and thus affect cranial
nerves involved in vital functions including respiration and
circulation. Symptoms indicating that the brain stem is under
too much pressure include sleepiness, bradycardia (slow heart
rate), confusion, respiratory difficulties, and pupil dilation
(due to pressure on the nuclei of CN III) (Bach-y-Rita, 1989).After
CHI, barbiturate induced coma may be used to manage intracranial
pressure.
-
- thalamic adhesion (massa intermedia):
- the tissue that connects the two
thalamic bodies of the thalamus
-
- thalamus:
- a subcortical structure that receives
and integrates sensory information from the periphery (with
the exception of smell), and sends the information to the cortex
for further processing; the thalamus is composed of two thalamic
bodies and the massa intermedia; it is located inferior to
the caudate nucleus and the fornix and medial to the lenticular
nucleus
-
- third ventricle:
- one of the four ventricles, it
contains cerebrospinal fluid; it lies between the two thalamic
bodies, with the massa intermedia passing through it and the
hypothalamus forming its floor and part of its lateral walls
-
- Thrombosis:
- total blockage of an artery due
to plaque build-up or emboli
-
- TIA: see transient ischemic
attack
-
- Token Test (DeRenzi & Vignolo,
1966):
- assesses subtle receptive language
dysfunction. Can be used to evaluate the auditory comprehension
of Broca's aphasics and helps to distinguish between Broca's
aphasia and verbal apraxia. The test has five parts involving
the manipulation of objects of different colors, shapes, and
sizes and becomes progressively more difficult. It tests receptive
language by by requiring the patient to follow instructions
like "Put the red square on the yellow circle." However
you must be aware that words like "before" which
are grammatical morphemes may be missed due to conceptual or
semantic problems. Also, limb apraxia may not allow the patient
to carry out the instructions, even though he/she understands
them.
-
- topical
disorientation:
- the inability to know location
and strategy to move about in an environment
-
- transcortical aphasia:
- a type of aphasia that may occur
as the result of blockages in the water shed areas of the brain.
Lesions are typically smaller than those that cause Broca's
aphasia and are superior to and often anterior to Broca's area.
Broca's area itself is not affected, but the damage may extend
down into the white matter including the white matter below
Broca's area. Luria (1966) referred to this syndrome as dynamic
aphasia.
Communication between Broca's area and the pre-motor or supplementary
motor area (Brodmann's Area 6) is cut off. Because Wernicke's
area and the arcuate fasciculus are spared these patients have
good repetition (Brookshire, 1997). This type of lesion may also
sever links between Broca's area and basal ganglia and/or
the thalamus, which may affect motor and pre-motor function. In
addition, the damage could cause symptoms by affecting the link
between Broca's area and the limbic system which also
seems to be involved in memory and speech and language.
-
- Characteristics are: Repetition
is much better than other types of speech. In repetition,
grammar and articulation are normal. Articulation in
general is fair to good. Little or no paraphasia is
present. Confrontational naming is well-preserved. The
patient will respond well to prompting with phonemic cues. Auditory
comprehension is fair to excellent. According to Goodglass
and Kaplan (1983) the fluent/nonfluent distinction is not especially
applicable to this syndrome. Sometimes the patient will produce
a grammatically correct, well-articulated sentence.
-
- Transient Ischemic
Attacks (TIAs):
- transient disturbances of the blood
supply to a localized part of the brain, which produce a temporary,
focal lesion. Unlike strokes they resolve in spontaneous and
complete recovery. Symptoms of TIAs mimic those of stroke.and
severe TIAs cannot be differentiated from a stroke until recovery
occurs. TIAs typically last between 2 and 15 minutes, although
such an event could conceivably last as long as 24 hrs. It
is also possible to have a series of many brief TIAs during
one day. For example, a patient might have 10 or more transient
ischemic attacks within a 24 hr. period.
-
- transverse cut:
- a cut that divides the brain into
upper and lower sections; perpendicular to coronal, medial,
and sagittal cuts
-
- Trigeminal
Nerve (Cranial Nerve V):
- both a motor and sensory nerve,
efferent innervates the muscles involved in chewing.
These include the temporalis, the masseter, the medial,
and the lateral pterygoid, also innervates the tensor
veli palatine muscle, which tenses the velum, in addition,
the trigeminal assists the glossopharyngeal nerve in raising
the larynx and pulling it forward during the laryngeal substage
of the pharyngeal swallow. Sensory component sensation, except
taste to the anterior 2/3 of the tongue and information from
the face, mouth and mandible
 |
U |
|
 |
-
- uncinate fit:
- an epileptic seizure that is preceded
by an olfactory hallucination
-
- upper
motor neurons:
- a type of first order neuron that
carries motor impulses; the upper motor neurons remain inside
the neuraxis', they synapse with lower motor neurons
 |
V |
|
 |
-
- Vagus Nerve (Cranial Nerve
X):
- Motor Components include responsibility
for raising the velum as it innervates the glossopalatine and
the levator veli palatine muscles, along with CN. IX
innervates the pharyngeal constrictor muscles, along with CN.
XI innervates the intrinsic musculature of the larynx. It is
responsible for vocal fold adduction during the swallow.
-
- Also innervates the cricopharyngeus
muscle. The vagus controls the muscles involved in the esophageal
stage of the swallow as well as those that control respiration.
(This is the only cranial nerve that influences structures
inferior to the neck.)
-
- Sensory Components include carrying
information from the velum and posterior and inferior portions
of the pharynx and mediation of sensation in the larynx.
-
- valleculae:
- space between the epiglottis and
base of the tongue
-
- velum:
- five muscles which control the
movements of the velum are : palatoglossal and
the levator veli palatini both raise the velum. They
are innervated by the vagus nerve (CN. X). The tensor veli
palatini tenses the velum. It receives innervation from
the trigeminal (CN. V). The palatopharyngus depresses
the velum and constricts the pharynx. It is innervated by the
spinal accessory (CN. XI). The muscularis uvula shortens
the velum. It is also innervated by the spinal accessory. Poor
velopharyngeal closure will affect speech but is not a matter
of great concern in regard to swallowing. Patients may be concerned
about it and believe that it is very important. While the entrance
of food into the nasopharynx may be unpleasant, it is certainly
not life-threatening.
-
- ventral:
- toward the belly
-
- ventricles:
- four spaces within the brain that
are filled with cerebrospinal fluid, they protect the brain
by cushioning it and supporting its weight; they include the
two lateral ventricles, the third ventricle, and the fourth
ventricle
-
- ventrospinocerebellar
tract:
- one of the two main tracts that
bring sensory information from the periphery to the cerebellum;
it is a fiber tract that contains proprioceptive fibers from
the lower body; its axons decussate and travel upward on the
contralateral side of the spinal cord, then cross again and
continue upward ipsilaterally, the fibers then enter the cerebellum
on the superior cerebellar peduncle
-
- Verbal
paraphasias:
- paraphasias in which a word is
substituted for the target word. (The substitution must be
a real word. If it is not, the paraphasia is classified as
neologistic.) Two types of verbal paraphasias: within category/semantic paraphasias
and remote paraphasias. Within category errors involve
the substitution of a word that is closely related to the target
word, as in cat/dog. Remote errors involve the substitutions
of a word that is only distantly related to the target word,
as in sink/dog. Remote paraphasias are, of course, indicative
of more severe language problems than are within category substitutions.
-
- vermis:
- "worm," a thin structure
that separates the hemispheres of the cerebellum from one another
-
- vertebral
arteries:
- one of the two main branches of
the subclavian arteries; the two vertebral arteries ascend
through the spinal column, entering the brain through the magnum
foramen, at the lower border of the pons the two vertebral
arteries join together to form the basilar artery (vertebral
basilar artery)
-
- vestibulocerebellar tract:
- a fiber tract that brings information
from the semi-circular canals of the inner ear via the vestibular
nucleus of the lower pons and medulla to the cerebellum; these
fibers travel to the flocculi on the inferior cerebellar peduncle
-
- vestibulospinal tract:
- a fiber tract which brings information
about the body's position in space to the antigravity muscles;
the fastigial nucleus of the cerebellum sends messages to the
vestibular nuclei in the lower pons and midbrain, from here
the information is sent to lower motor neurons in the brain
stem and spinal cord, runs from the vestibular nuclei located
in the lower pons and medulla to the spinal nerves. It is involved
in balance.
-
- visual
agnosia:
- a condition in which an individual
can see a visual stimuli, but is unable to associate it with
meaning or identify its function; it represents a problem with
meaning and may be a result of damage to the secondary visual
areas
 |
W |
|
 |
-
- watershed
areas:
- areas of the brain that are located
beyond the ends of the vascular systems; these areas are particularly
vulnerable to problems with blood supply
-
- Wernicke's Aphasia:
- also termed semantic
aphasia
-
- lesion is located in the posterior
region of the left superior temporal gyrus or the first gyrus
of the temporal lobe. Brodmann's areas 21 and 42 correspond
to Wernicke's area (FitzGerald, 1997). The damage often extends
into the parietal lobe, affecting the angular gyrus (Brodmann's
area 39). The major impairment is semantic. With
severe Wernicke's aphasia there is usually a severe impairment
in auditory comprehension. Speech, while fluent, is semantically
inappropriate and paraphasic. The speech of Wernicke's patients
is sometime called cocktail hour speech. Comprehension
and expression tend to be equally impaired. Patients with moderate
Wernicke's can get the point in conversations but miss many
specifics (Brookshire, 1997). Articulation is normal, Melodic
Line is unaffected. If one ignores the content, the form
of the patient's speech may sound normal. They have long, grammatically
well formed utterances that contain almost no meaning, speech
is paragrammatical, paraphasias are
common (FitzGerald, 1997). Repetition is typically poor.
Patients may use augmentation. Also due to auditory
comprehension deficits, the patient may repeat the examiner's
words without understanding them. Word finding problems are
very common. Confrontational naming is typically impaired. Auditory
comprehension is impaired.
Alexia with agraphia may be present, and press of speech also
characterizes Wernicke's aphasics
-
- Wernicke's
area:
- an area of the brain, located in
the temporal lobe on the posterior portion of the superior
temporal gyrus, that is associated with the ability to understand
and produce meaningful speech; a lesion in this area will cause
Wernicke's aphasia
 |
X - Z |
|
 |
-
- zygomaticus (oral cavity):
- lip muscle of the oral cavity with
the obicularis oris and buccinator all three are innervated
by the facial nerve (CN. VII).
|