i bc27f85be50b71b1 (79 page)

NO: Ability to construct shapes, awareness

NO: Constructional apraxia, geographic

of external environmenr, and body image

agnosia, dressing apraxia, anosognosia

Wernicke's area

0: Sensory speech (auditory and written)

Wernicke's ( receptive) aphasia

comprehension center

NO: Appreciation of content of emmional

language (e.g., tone of voice)

Optic radiation

Visual tract

Lower homonymous quadrantanopia

GustatOry cortex

Perception of taste

Dysfunction is very uncommon

Temporal

Superior

0: Appreciation of language

0: Decreased ability to hear

lobe

temporal gyrus

NO: Appreciation of music, rhythm,

NO: Decreased ability to appreciate music

(audicory

and sound

cortex)

Middle and

Learning and memory ceorers

Learning and memory deficits

inferior

tern pora I gyri

Limbic lobe and

Affective and emotion center, including

Aggressive or antisocial behaviors

olfaccory

mood, primitive behavior, self

Inability to establish new memories

cortex

preservation, shorr-term memory,

visceral emotion processes, and

interpretation of smell

z

i::

Wernicke's area

See Parietal lobe, above

Wernicke's ( receptive) aphasia

<

�

� ..... '" w

Tab1c 4-1. Continued

N

'"

....

Lobe of

Structure

Function

Dysfunction

>

Cerebrum

� �

Optic radiation

Visual tract

Upper homonymous Quadranranopia

"

'"

Occipital

Striate and

Perception of vision (visual cortex)

Homonymous hemianopsia with or with

J:

>

lobe

parastriare

out macular involvement

Z

"

cortices

�

o

"

o = dominant, ND = nondol11inant.

o

Sources: Data from KW Lindsay, I Bone, R Callander (eds). Neurology and Ncurosurgery Illustrated (2nd cd). Edinburgh, UK: Church.1l

"

Livingscone. 1991; S Gilman. SW Newman (cds). Manrer and Gaez's Esscmials of Clmical Neuroanatomy and Neurophysiology (7th ed).

=t

Philadelphia: FA Davis, 1989;JA Kiernan (ed). lntroduCtion CO Human Neuroscience. Philadelphia: Lippincott, 1987; EN Marieb (cd). Human

�

Anatomy and Physiology (5th ed). San Francisco: Benjamin-Cummings, 200t; and L Thelan, J Davic, M Lough (eds). Cnncal Care Nursing: i'i

>

Diagnosis and Managemcll( (2nd cd). Sr. Louis: Mosby, 1994.

r

i

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!:'

�

Table 4-2. Structure, Function, and Dysfunction of the Diencephalon, Brain Stem, and Cerebellum

Brain Structure

Substructure

Function

Dysfunction

Diencephalon

Thalamus

Specific and association nuclei

Cortical arousal

Altered consciousness

Integrative relay station for all

Signs and symptoms of increased

ascending and descending

ICP

motor stimuli and aU ascending

Contralateral hemiplegia,

sensory stimuli except smell

hemiparesis, or hemianesthesia

Memory

Altered eye movement

Hypothalamus

Mamillary bodies

Autonomic center for sympa

Altered autonomic function and

Optic chiasm

thetic and parasympathetic

vital signs

Infundibulum (stalk) connects

responses

Headache

to the pituitary gland

Visceral center for regulation of

Visual deficits

Forms inferolateral wall of third

body temperature, food

Vomiting with signs and

ventricle

intake. thirst, sleep and wake

symptoms of increased ICP

cycle, water balance

See Chapter 11 for more

Produces ADH and oxytocin

information on hormones and

Regulates anterior pituirary

endocrine disorders

gland

�

Association with limbic system

13

5<

� N '" '"

Table 4-2. Continued

N

'"

'"

Brain Structure

Substructure

Function

Dysfunction

>

n

Epithalamus

Pineal body

Association with limbic system

Dysfunction unknown

�

Posterior commissure. striae

n

>

medulla res, habenular nuclei

'"

'"

and commissure

J:

>

Subthalamus

Substantia nigra

Z

Association with thalamus for

Dyskinesia and decreased motor

"

�

Red nuclei

motor control

control

0

0

Pituitary

Anterior and posterior lobes

Production, storage, and

See Chapter 1 1 for more

'"

�

secretion of reproductive

information on hormones and

0

'"

hormones

endocrine disorders

�

J:

Secretion of ADH and oxytocin

-<

�

Internal capsule

Fiber tracts connecting

Conduction pathway berween

Contralateral hemiparesis or

1)

>

thalamus to the cortex

the cortex and spinal cord

hemiplegia and hemianesthesia

r

JI

Brain stem

'"

'"

Midbrain

Superior cerebellar peduncles

Conduction pathway berween

Contralateral hemiparesis or

>

�

Superior and inferior colliculi

higher and lower brain centers

hemiplegia and hemianesthesia,

�

Medial and lateral lemniscus

Visual reflex

altered consciousness and

eNs IIJ and IV nuclei

Auditory reflex

respiratory pattern, cranial

Reticular formation

nerve palsy

Cerebral aqueduct in its center

Pons

Middle cerebellar peduncles

Conduction pathway between

See Midbrain. above

Respiratory center

higher and lower brain

CNs V-VUI nuclei

centers

Forms anterior wall of fourth

ventricle

Medulla

Decussation of pyramidal tracts

Homeostatic center for cardiac,

See Midbrain, above

Inferior cerebellar peduncles

respiramry, vasomotor

Inferior olivary nuclei

functions

Nucleus cuneatus and gracilis

CNs [x-Xil nuclei

:erebellum

Anterior lobe

Medial portion