Anatomy clinical correlates: Cerebral hemispheres

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Anatomy clinical correlates: Cerebral hemispheres

Prerequisite basic sciences

Non-cardiac chest pain and shortness of breath

Anatomy of the abdominal viscera: Blood supply of the foregut, midgut and hindgut

Anatomy of the abdominal viscera: Esophagus and stomach

Anatomy of the abdominal viscera: Innervation of the abdominal viscera

Anatomy of the diaphragm

Anatomy of the inferior mediastinum

Anatomy of the larynx and trachea

Anatomy of the lungs and tracheobronchial tree

Anatomy of the pharynx and esophagus

Anatomy of the pleura

Anatomy of the superior mediastinum

Bones and joints of the thoracic wall

Muscles of the thoracic wall

Vessels and nerves of the thoracic wall

Anatomy clinical correlates: Mediastinum

Anatomy clinical correlates: Pleura and lungs

Anatomy clinical correlates: Thoracic wall

Bronchioles and alveoli histology

Esophagus histology

Trachea and bronchi histology

Alveolar surface tension and surfactant

Anatomic and physiologic dead space

Breathing cycle and regulation

Diffusion-limited and perfusion-limited gas exchange

Gas exchange in the lungs, blood and tissues

Lung volumes and capacities

Pulmonary shunts

Regulation of pulmonary blood flow

Respiratory system anatomy and physiology

Ventilation

Ventilation-perfusion ratios and V/Q mismatch

Zones of pulmonary blood flow

Chewing and swallowing

Enteric nervous system

Esophageal motility

Gastric motility

Gastrointestinal system anatomy and physiology

Aortic dissections and aneurysms: Pathology review

Deep vein thrombosis and pulmonary embolism: Pathology review

Pleural effusion, pneumothorax, hemothorax and atelectasis: Pathology review

Chest X-ray interpretation: Clinical sciences

ECG axis

ECG basics

ECG cardiac hypertrophy and enlargement

ECG cardiac infarction and ischemia

ECG intervals

ECG normal sinus rhythm

ECG QRS transition

ECG rate and rhythm

Trauma

Anatomy of the abdominal viscera: Blood supply of the foregut, midgut and hindgut

Anatomy of the axilla

Anatomy of the pelvic cavity

Anatomy of the urinary organs of the pelvis

Anatomy of the vessels of the posterior abdominal wall

Arteries and veins of the pelvis

Deep structures of the neck: Root of the neck

Fascia, vessels and nerves of the upper limb

Introduction to the cranial nerves

Superficial structures of the neck: Anterior triangle

Superficial structures of the neck: Posterior triangle

Vessels and nerves of the forearm

Vessels and nerves of the gluteal region and posterior thigh

Vessels and nerves of the thoracic wall

Vessels and nerves of the vertebral column

Anatomy clinical correlates: Arm, elbow and forearm

Anatomy clinical correlates: Axilla

Anatomy clinical correlates: Bones, fascia and muscles of the neck

Anatomy clinical correlates: Cerebral hemispheres

Anatomy clinical correlates: Clavicle and shoulder

Anatomy clinical correlates: Eye

Anatomy clinical correlates: Female pelvis and perineum

Anatomy clinical correlates: Heart

Anatomy clinical correlates: Hip, gluteal region and thigh

Anatomy clinical correlates: Male pelvis and perineum

Anatomy clinical correlates: Mediastinum

Anatomy clinical correlates: Pleura and lungs

Anatomy clinical correlates: Skull, face and scalp

Anatomy clinical correlates: Spinal cord pathways

Anatomy clinical correlates: Thoracic wall

Anatomy clinical correlates: Vertebral canal

Anatomy clinical correlates: Vessels, nerves and lymphatics of the neck

Anatomy clinical correlates: Viscera of the neck

Anatomy clinical correlates: Wrist and hand

Eye conditions: Inflammation, infections and trauma: Pathology review

Pleural effusion, pneumothorax, hemothorax and atelectasis: Pathology review

Spinal cord disorders: Pathology review

Traumatic brain injury: Pathology review

Communication of bad news

How to deliver bad news

Assessments

Anatomy clinical correlates: Cerebral hemispheres

USMLE® Step 1 questions

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USMLE® Step 2 questions

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Questions

USMLE® Step 1 style questions USMLE

of complete

USMLE® Step 2 style questions USMLE

of complete

A 77-year-old woman is brought to the emergency department for evaluation of left-sided numbness and unsteady gait. The patient was having dinner with family one hour ago when she suddenly developed numbness in the left side of her body and could no longer sense the temperature of her food. Past medical history includes diabetes mellitus type II, hypertension, and hyperlipidemia. The patient takes metformin, glipizide, amlodipine, losartan, and atorvastatin. Temperature is 37.0°C (98.6°F), pulse is 102/min, respirations are 15/min, and blood pressure is 190/100 mmHg. Neurological examination demonstrates deficits in touch, two-point discrimination, pain, and temperature on the left side of the body and face. Motor strength and speech are normal. Romberg sign is positive. An ischemic stroke involving which of the following areas of the brain is the most likely cause of her clinical findings?  

Transcript

The cerebral hemispheres are two symmetrical halves of the brain that contain billions of neurons and their connections, forming an amazing network of cells which help govern our everyday actions. These cerebral hemispheres consist of the cerebral cortex, subcortical white matter, and gray matter masses called the basal ganglia found throughout the subcortical white matter. Due to the complexity of our brains, the clinical conditions affecting our cerebral hemispheres lead to a variety of abnormal and strange symptoms, so understanding the anatomy of the cerebral hemisphere is crucial in understanding these conditions.

Let’s start with lesions of the cerebral cortex, which is the superficial gray matter of our brains containing billions of neurons responsible for processing information. Depending on which part of the cortex these lesions occur in, it can cause different clinical manifestations.

First, there are lesions of the prefrontal cortex, which is an area responsible for the makeup of a person’s personality and governs social behaviour. So, prefrontal cortex lesions cause frontal lobe syndrome which generally result in personality changes, and can specifically cause problems with planning, initiative, judgment, and social behaviour. Individuals have difficulty making decisions, and may become impulsive and aggressive. Individuals can also exhibit socially unacceptable behavior, where they no longer restrain from saying or doing inappropriate things, and may also no longer care about their clothing and appearance.

Injury to the prefrontal cortex may also contribute to the reemergence of primitive reflexes, such as the grasp reflex, suckling reflex, and groping reflex. Bilateral damage of the prefrontal cortex may lead to incontinence, gait apraxia, and can even lead to akinetic mutism, where awake individuals lack the will or motivation to move or speak, but will follow you with their eyes in response to noise.

Next up, there are injuries to the frontal eye fields which can be found on the middle frontal gyrus - specifically, in Brodmann's area 8. Possible causes of lesions to the frontal eye fields include stroke involving the middle cerebral artery, brain tumors, or injury during neurosurgery.

Elsevier

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