1

1he Nervous System

1he human nervous sysLem ls Lhe organ of consclousness cognlLlon eLhlcs behavlor lL ls Lhe mosL lnLrlcaLe
sLrucLure known Lo exlsL lL conslsLs of Lhe braln splnal cord and all assoclaLed nerves sense organs
1he Centra| Nervous System
1he braln splnal cord make up Lhe CenLral nervous SysLem (CnS)
1he menlnges are membranes LhaL enclose cushlon Lhe CnS 1hey form a menlnges

|a mater

A Arachno|d mater

D Dura mater



CNS Men|nges
Pio Moter (shower cap)
lL ls Lhe flrsL layer of proLecLlon closesL Lo Lhe braln and ls made up of 2 layers
1 1he lnner layer ls nonvascular adheres LlghLly Lo Lhe surface of Lhe braln
2 1he ouLermosL layer conslsLs of arLerles velns

4rochnoid Moter (babushka)
lL ls Lhe second layer of proLecLlon closesL Lo Lhe braln lL ls nonvascular doesn'L conform Lo Lhe conLours of Lhe
braln Lhus creaLlng a space beLween Lhe arachnold Lhe pla subarachnold space 1hls space ls fllled wlLh
cerebral splnal fluld (CSl)
erebro/ 5pino/ l/uid {5l)
?ou can examlne Lhe CSl vla a splnal Lap Lo deLermlne lf Lhere's someLhlng wrong 1he CSl ls supposed Lo be
clear lf Lhere ls blood presenL Lhen Lhere's been Lrauma lf Lhere's puss ln lL Lhen Lhere's an lnfecLlon 1he CSl
has 2 [obs
1 lL ls a clear colorless fluld LhaL cushlons proLecLs Lhe braln agalnsL Lrauma
2 rovldes a meLabollc paLhway nuLrlLlonal compound Lo reach Lhe braln

uro Moter (he|met)
lL ls a Lough elasLlc membrane lL serves as a durable coverlng for Lhe braln splnal cord and as a llnlng for Lhe
lnner surface of Lhe skull 1here are 2 layers
1 1he flrsL ls a Lough dense nonvascular layer
2 1he second ls rlch ln blood cells nerves

Venous S|nuses of the 8ra|n
8eLween Lhe 2 dural sheeLs Lhere are large venous slnuses of Lhe braln 1he slnuses (?) are a collecLlon sysLem for
recelvlng blood flowlng down from Lhe braln dlscharglng lL Lo lnLernal [ugular velns for reLurn Lo Lhe hearL Lhe
lungs 1he venous slnuses acL llke Lhe plumblng sysLem of Lhe braln Lo clrculaLe blood and oLher flulds
2

8ra|n
O LargesL of Lhe CnS conLalned wlLhln Lhe skull
O Surrounded by Lhe menlnges CSl ln Lhe skull
O no meLabollc or oxygen reserve
O CompleLely dependenL on hearL lungs
O 8raln ls meLabollcally fraglle
O ulvlded lnLo cerebrum (cerebral hemlsphere basal ganglla) bralnsLem (pons medulla mldbraln) Lhe
cerebellum

Cerebrum
LargesL of Lhe braln dlvlded lnLo 2 hlghly convoluLed hemlspheres by Lhe LCl (longlLudlnal cerebral flssure)
1here are more gyrl Lhan flssures Surface ls hlghly convoluLed (folded)
1 Cyrl/ folded/ convoluslons
2 Sulcl/ depresslons
3 llssures/ deep sulcl

Cortex (ConvoluLed porLlon of Lhe cerebrum cerebral corLex)
lL ls rlch ln nerve cells encompasses 40 of Lhe braln welghL ls responslble for
1 lannlng execuLlon of vollLlonal moLor acLs
2 Consclously processlng sensory lnformaLlon
3 Pavlng menLal processlng allowed (lnvolvlng speech language reasonlng)

|ssures
1 CenLral sulcus/ llssure of 8olando
2 LaLeral cerebral flssure/ llssure of Sylvlus

obes
ltootol
lL makes up 1/3 of Lhe surface area of Lhe braln lL forms approxlmaLely Lhe anLerlor 1/3 of each
hemlsphere 1he lower boundary ls Lhe Sylvlan flssure Lhe posLerlor boundary ls Lhe flssure of 8olando
9otletol
lL lles behlnd Lhe cenLral flssure above Lhe laLeral flssure
Occlpltol
lL ls Lhe mosL posLerlor lobe exLends from Lhe lmaglnary llne demarcaLlng Lhe posLerlor parleLal
boundary Lo Lhe longlLudlnal fasclculus
1empotol
lL ls Lhe lower 1/3 of Lhe braln SLarLs aL Lhe laLeral flssure of Sylvlus exLends downward Lo Lhe medlal
surface of Lhe hemlsphere
*** Where are Lhe lobes ln reference Lo Lhe flssures? ****
llmblc lobe
O ConslsLs of Lhe parahlppocampal gyrus subcallosal gyrus clngulaLe gyrus
O AssoclaLed wlLh varlous behavlors emoLlon memory
O 1he funcLlons regulaLed by Lhe llmblc sysLem lnclude energy waLer balance auLomaLlc funcLlons
endocrlne funcLlons sexual emoLlonal behavlors
andmarks
9teceottol qytos locaLed ln fronL of Lhe cenLral flssure of 8olando makes up Lhe ma[orlLy of Lhe prlmary moLor
corLex (moLor sLrlp)
9ostceottol qytos lles behlnd Lhe precenLral gyrus responslble for sensory lnformaLlon
5optomotqlool qytos curves around Lhe laLeral flssure of Sylvlus
Aoqolot qytos lles behlnd Lhe supramarglnal gyrus
3

Cortex
O ulvlded anLerlorly (moLor) posLerlorly (sensory)
O lnvolved ln hlgher level cognlLlve processes (lL's Lhe cenLer of Lhlnklng) where language ls organlzed
O MosL of Lhe cerebral corLex ls assoclaLlon corLex
O AssoclaLlon corLex ls responslble for hlgher menLal acLlvlLy (lncludlng language)
Assoc|at|on Cortex
ltootol Assoclotloo Ateo
O 8esponslble for Lhe lnlLlaLlon lnLegraLlon of purposeful behavlor
O lmporLanL for plannlng execuLlng sequences of vollLlonal movemenL
9otletol Assoclotloo Ateo
O 8esponslble for Lhe dlscrlmlnaLlon lnLegraLlon of LacLlle lnformaLlon
O 8elleved Lo lnfluence proplocepLlon (LacLlle)
1empotol Assoclotloo Ateo
O 8esponslble for Lhe dlscrlmlnaLlon lnLegraLlon of audlLory lnfo for many language processes
r|mary Cortex
9tlmoty Motot cottex
O Lles ln fronL of Lhe cenLral flssure
O 8esponslble for volunLary movemenL of skeleLal muscles on Lhe conLralaLeral slde of Lhe body
9tlmoty AoJltoty cottex
O LocaLed on Lhe upper surface of Lhe Lemporal lobe
9tlmoty vlsool cottex
O LocaLed ln Lhe occlplLal lobe
O CorLlcal bllndness may occur lf a person has a sLroke ln Lhe occlplLal lobe
9tlmoty 5eosoty cottex
O Corresponds Lo Lhe area of Lhe posLcenLral gyrus
O 8esponslble for Lhe somosLheLlc sensaLlon for Lhe conLralaLeral slde of Lhe body
O Cross percepLlon of paln LemperaLure llghL Louch are not Lhe exc|us|ve responslblllLy of Lhls sLrlp of
corLex
omoocolos (llLLle man)
O 8epresenLs Lhe locaLlon of moLor sensory funcLlon ln Lhe prlmary moLor corLex
O Shows how Lhe muscles are lnnervaLed from Lhe corLex
O Are represenLed ln an upslde down or lnverLed fashlon
8|ood |ow |n the 8ra|n C|rc|e of W||||s
O ArLerlal cerebral arLerles are connecLed vla Lhe anLerlor communlcaLlng arLerles Lhe posLerlor
communlcaLlng arLerles connecL Lhe mlddle cerebral arLery wlLh Lhe posLerlor cerebral arLery
O Mlddle cerebral arLery ls mosL dlrecL largesL conLlnuaLlon of Lhe lnLernal caroLld arLery
O 1herefore lncldence of emboll meLasLases ls hlgher ln Lhe LerrlLory of Lhls vessel
O SympLoms relaLed Lo damage of Lhe mlddle cerebral arLery lnclude
4 uysphagla dyslexla dysgraphla paralysls loss of sensaLlon of conLralaLeral slde of Lhe face
upper llmb
Deep 8ra|n Structure
veottlcles
O ueep wlLhln Lhe whlLe maLLer of Lhe braln
O 1wo laLeral venLrlcles a 3
rd
4
Lh

O lnLerconnecLed conLalns Lhe chorold plexus whlch ls Lhe body's prlmary source of CSl
O uralnage of a perlvascular space lnLo Lhe subarachnold space
O CSl flows from Lhe laLeral venLrlcle Lo Lhe 3
rd
venLrlcle vla Lhe foramen of Munro from Lhe 3
rd
venLrlcle
Lo Lhe 4
Lh
venLrlcle vla Lhe aqueducL of Sylvlus CSl flows Lhrough 3 openlngs ln Lhe 4
Lh
venLrlcle one
foramen of Magendle 2 foramen of Luschka
4








3









6














7


Sp|na| 1ap permlLs assessmenL of Lhe composlLlon of Lhe CSl
Cutcomes ????
O lncreased pressure may suggesL blockage ln Lhe clrculaLlon of Lhe fluld Lhe presence of a spaceoccupylng
paLhology
O 1he presence of 88Cs or a yellowlsh color are slgns of bleedlng ln Lhe venLrlcles menlngeal spaces or
splnal cord
O 1he presence of bacLerla paraslLe or vlrus proves lnfecLlon wlLh Lhose agenLs
O lncreased proLeln conLenL may suggesL menlngeal lnflammaLlon

1ha|amus
O lL ls a subcorLlcal member of Lhe CnS
O lL conslsLs of a palr of spherlcal sLrucLures LhaL dlvlde lnLo neuron cell body clusLers
O Lach sphere acLs as a recelvlng sLaLlon for relaylng lnfo
O lL LransmlLs moLor lnfo (efferenL) Lo Lhe muscles recelves sensory lnfo (afferenL) for hlgher processlng ln
Lhe braln
4 eteot dlrecLlng ouLward descrlbes nerves LhaL carry lmpulses away from Lhe braln or splnal
cord or blood vessels LhaL carry blood away from an organ
4 Aeteot brlnglng someLhlng Loward body parL descrlbes nerves LhaL carry lmpulses from Lhe
body Loward Lhe braln or splnal cord or blood vessels LhaL carry blood Lo an organ
O lL ls Lhe relay sLaLlon
O lL seLs Lhe Lone of Lhe braln by playlng a role ln consclousness alerLness aLLenLlon
O lL lnLegraLes sensaLlon ln Lhe nS
O lL organlzes sensaLlon from Lhe classlc sensory paLhways

Subcort|ca| ower 8ra|n Structures
osol Cooqllo
O 8egulaLes moLor funcLlonlng malnLalns posLure muscle Lone
O Also sends lnfo on moLor movemenL Lo Lhe moLor corLex Lo modlfy neural lmpulses
O uamage Lo Lhe basal nuclel can resulL ln lnvolunLary movemenLs (Lremors) abnormal posLure muscle
Lone
O ConslsLs of several basal nuclel lenLlcular nucleus (globus pallldus puLamen) Lhe caudaLe nucleus
O arklnson's ulsease ls caused by damage Lo Lhe basal ganglla
O 1he caudaLe nucleus ls Lhe paLhway for moLor sensory????
MlJbtolo
O ConLalns cenLer for eye movemenLs posLural reflexes
9oos (8rldge)
O ConLalns nuclel concerned wlLh hearlng balance brldge Lo Lhe cerebellum
MeJollo
O LowesL dlvlslon of Lhe braln sLem
O Caudal (Lall) parL of Lhe nervous sysLem (or bulb)
O ConLalns ascendlng descendlng LracLs plus Lhe nuclel of several of Lhe nerves LhaL conLrol phonaLlon vl
closure swallowlng arLlculaLlon





8



cetebellom (llLLle braln)
O ulvlded lnLo 2 hemlspheres wlLh an ouLer layer of gray maLLer ??
O uoes noL lnlLlaLe movemenL buL coordlnaLes modulaLes movemenLs lnlLlaLed elsewhere
O lf lmpalred movemenLs wlll noL be coordlnaLed
O lnLegraLes Lhe ouLpuL from cerebral moLor conLrol cenLers wlLh feedback from muscles Lhe vesLlbular
sysLem Lo coordlnaLe vollLlonal movemenLs regulaLe auLonomlc posLural ad[usLmenLs LhaL accompany
movemenL
O AsslsLs ln coordlnaLlng Lhe exLremely rapld preclse movemenLs needed ln normal arLlculaLlon of speech
O uoes noL generaLe nerve lmpulses lLself lL smooLhly regulaLes coordlnaLes Lhe conLrol of purposeful
muscle movemenL lncludlng very complex flne moLor acLlvlLles
O 1he cerebellum revlses Lhe Lransmlsslon from Lhe corLex's moLor sLrlp Lo produce accuraLe preclse
movemenLs lor example
O 1he cerebellum may lnhlblL excesslvely sLrong lmpulses from Lhe moLor corLex Lo achleve smooLher less
[erky movemenLs
O ln addlLlon Lhe cerebellum helps Lo malnLaln balance from Lhe guldance from Lhe lnner ear

Nerve |ber 1racts
O nerve flber LracLs form Lhe whlLe maLLer
O ConslsLs of bundles of nerve axons LhaL allow for Lhe communlcaLlon among parLs of Lhe nS
O CaLegorles
4 ro[ecLlon
1hese are Lhe longdlsLance runners of Lhe CnS
1hey carry lnfo from Lhe braln Lo Lhe bralnsLem splnal cord Ck sensory lnfo from Lhe
nS (erlpheral nervous SysLem) Lo Lhe braln vla Lhe splnal cord
LfferenL (moLor) carry command conLrol slgnal from Lhe braln Lo muscles glands
O rogress downward Lhrough Lhe braln
AfferenL carry sensory lnfo from recepLors ln Lhe perlphery Lo Lhe braln
O 1hey progress from Lhe muscle upward Lo Lhe braln
4 Commlssural
ConnecL an area ln one hemlsphere Lo an area ln Lhe opposlLe hemlsphere
1he 3 mosL lmporLanL for speech are
O Corpus callosum serves as Lhe ma[or sLrucLural connecLlon beLween Lhe
hemlspheres ulvlded lnLo Lhe genu (connecLs corLlcal areas) rosLrum
splenlum
O AnLerlor commlssure
O osLerlor commlssure
4 AssoclaLlon
ConnecL corLlcal areas w|th|n a hemlsphere
ShorL assoclaLlon wlLhln lobe connecLlons
Long faslculus across lobe connecLlons
3 ma[or faslcull
O unclnaLe connecLs lnferlor fronLal lobe wlLh anLerlor Lemporal lobe
O Clnglum
O ArcuaLe fasclculus connecLs posLerlor Lemporal lobe cenLral reglons of Lhe
fronLal lobe lays a role ln how Lhe braln deals wlLh language Leslons ln Lhls area
are assoclaLed wlLh conducLlon Lype aphasla

9

yram|da| System (volunLary moLor conLrol sysLem)
O lL's a bundle of nerves LhaL orlglnaLes ln Lhe prlmary moLor corLex Lravels unlnLerrupLed Lo Lhe splnal cord
crosslng Lo Lhe oLher slde of Lhe body ln Lhe bralnsLem
O AfLer crosslng over Lhese upper moLor neurons conLacL a 2
nd
seL of lower moLor neurons conslsLlng of Lhe cranlal
splnal nerves nS LhaL lnnervaLe Lhe muscle
O lnlLlaLes organlzes vollLlonal movemenL
O ulrecL sysLem no synapses beLween Lhe neurons
O 1here are dlfferenL LracLs for speclfled areas of Lhe body lncludlng sLrucLures lmporLanL ln speech wlLh Lhe
pyramldal paLhway

Lxtrapyram|da| System
O lndlrecL sysLem whlch lnvolves Lhe bralnsLem cerebellum basal nuclel
O ComplemenLs Lhe pyramldal sysLem LracL by smooLhlng coordlnaLlng movemenLs
O unllke Lhe pyramldal LracL Lhe exLrapyramldal LracL has a more dlffuse orlgln several synapLlc sLaLlons" along lLs
paLh
O 8esponslble for regulaLlon of auLomaLlc lnLegraLlve aspecLs of moLor acLlvlLy ln[urles Lo Lhls sysLem cause
lnvolunLary movemenLs LhaL are superlmposed upon volunLary movemenLs
O ** lf Lhe S overshooLs Lhe LS sLeps ln Lo flx lL **
O 1he LS ls a neural neLwork locaLed ln Lhe braln LhaL ls parL of Lhe moLor sysLem lnvolved ln Lhe coordlnaLlon of
movemenL lL ls called exLrapyramldal Lo dlsLlngulsh lL from Lhe LracLs of Lhe moLor corLex LhaL reach Lhelr LargeLs
by Lravellng Lhrough Lhe pyramlds of Lhe medulla 1he pyramldal paLhways (corLlcosplnal and some corLlcobulbar
LracLs) may dlrecLly lnnervaLe moLor neurons of Lhe splnal cord or bralnsLem (anLerlor (venLral) horn cells or cerLaln
cranlal nerve nuclel) whereas Lhe exLrapyramldal sysLem cenLers around Lhe modulaLlon and regulaLlon (lndlrecL
conLrol) of anLerlor (venLral) horn cells
O LxLrapyramldal LracLs are chlefly found ln Lhe reLlcular formaLlon of Lhe pons and medulla and LargeL neurons ln Lhe
splnal cord lnvolved ln reflexes locomoLlon complex movemenLs and posLural conLrol 1hese LracLs are ln Lurn
modulaLed by varlous parLs of Lhe cenLral nervous sysLem lncludlng Lhe nlgrosLrlaLal paLhway Lhe basal ganglla Lhe
cerebellum Lhe vesLlbular nuclel and dlfferenL sensory areas of Lhe cerebral corLex All of Lhese regulaLory
componenLs can be consldered parL of Lhe exLrapyramldal sysLem ln LhaL Lhey modulaLe moLor acLlvlLy wlLhouL
dlrecLly lnnervaLlng moLor neurons
Upper Motor Neurons
O arL of Lhe CnS
O Cell body ls ln or [usL below Lhe cerebral corLex
O ln[urles cause (hyperacLlvlLy)
4 aralysls of muscle groups
4 ulsrupLlon of skllled movemenLs
4 LxaggeraLlon of normal reflexes
4 Appearance of paLhologlcal prlmlLlve reflexes
4 LxaggeraLed muscle Lone

ower Motor Neurons
O arL of Lhe nS
O Cell body ls ln Lhe braln sLem or splnal cord
O ulvlded lnLo cranlal nerves splnal nerves
O ln[urles cause (hypoacLlvlLy)
4 aralysls
4 ulmlnuLlon or abollLlon of reflexes
4 Loss of muscle Lone



10

Vest|bu|arket|cu|ar System
O 8esponslble for balance orlenLaLlon of Lhe body ln space for malnLalnlng general sLaLes of aLLenLlon alerLness
O lndlrecL sysLem
ket|cu|ar ormat|on
O 1he ascendlng reLlcular acLlvaLlng sysLem connecLs Lo areas ln Lhe Lhalamus hypoLhalamus and corLex
whlle Lhe descendlng reLlcular acLlvaLlng sysLem connecLs Lo Lhe cerebellum and sensory nerves
O 1he reLlcular formaLlon (8l) ls a neLwork of nuclel lnLerconnecLlng flbers LhaL ls anaLomlcally
lnLerLwlned wlLh Lhe cranlal nerve nuclel oLher flber LracLs of Lhe braln sLem
O ulfferenL parLs of Lhe 8l perform dlfferenL funcLlons
4 Lx PearL beaL breaLhlng clrculaLlon cenLers lnvolved ln swallowlng vomlLlng
4 9oos kl responslble for acousLlc vesLlbular?
4 """" kl coordlnaLes acousLlc vesLlbular resplraLory cardlovascular process
4 MlJbtolo kl conLalns cenLers LhaL subserve vlsualspaLlal orlenLaLlon eaLlng behavlor (sucklng
chewlng llcklng)
O Many neuroanoLomlsLs conslder Lhe v8S Lo be componenLs of Lhe ????
O Mass leslons ln Lhe braln sLem cause severe alLeraLlons ln level of consclousness such as coma due Lo Lhelr effecLs on
Lhe reLlcular formaLlon
3
8llaLeral damage Lo Lhe reLlcular formaLlon of Lhe mldbraln may lead Lo a coma or deaLh
2

O Leslons ln Lhe tetlcolot otmotloo have been found ln Lhe bralns of people who have posLpollo syndrome and some
lmaglng sLudles have shown abnormal acLlvlLy ln Lhe area ln people wlLh chronlc faLlgue syndrome lndlcaLlng a hlgh
llkellhood LhaL damage Lo Lhe tetlcolot otmotloo ls responslble for Lhe faLlgue experlenced wlLh Lhese syndromes
O 1 SomaLlc moLor conLrol Some moLor neurons send Lhelr axons Lo Lhe reLlcular formaLlon nuclel glvlng rlse Lo Lhe
reLlculosplnal LracLs of Lhe splnal cord 1hese LracLs funcLlon ln malnLalnlng Lone balance and posLureespeclally
durlng body movemenLs 1he reLlcular formaLlon also relays eye and ear slgnals Lo Lhe cerebellum so LhaL Lhe
cerebellum can lnLegraLe vlsual audlLory and vesLlbular sLlmull ln moLor coordlnaLlon CLher moLor nuclel lnclude
gaze cenLers whlch enable Lhe eyes Lo Lrack and flxaLe ob[ecLs and cenLral paLLern generaLors whlch produce
rhyLhmlc slgnals Lo Lhe muscles of breaLhlng and swallowlng
O 2 Cardlovascular conLrol 1he reLlcular formaLlon lncludes Lhe cardlac and vasomoLor cenLers of Lhe medulla
oblongaLa
O 3 aln modulaLlon 1he reLlcular formaLlon ls one means by whlch paln slgnals from Lhe lower body reach Lhe
cerebral corLex lL ls also Lhe orlgln of Lhe descendlng analgeslc paLhways 1he nerve flbers ln Lhese paLhways acL ln
Lhe splnal cord Lo block Lhe Lransmlsslon of some paln slgnals Lo Lhe braln
O 4 Sleep and consclousness 1he reLlcular formaLlon has pro[ecLlons Lo Lhe Lhalamus and cerebral corLex LhaL allow lL
Lo exerL some conLrol over whlch sensory slgnals reach Lhe cerebrum and come Lo our consclous aLLenLlon lL plays a
cenLral role ln sLaLes of consclousness llke alerLness and sleep ln[ury Lo Lhe reLlcular formaLlon can resulL ln
lrreverslble coma
O 3 PablLuaLlon 1hls ls a process ln whlch Lhe braln learns Lo lgnore repeLlLlve meanlngless sLlmull whlle remalnlng
senslLlve Lo oLhers A good example of Lhls ls when a person can sleep Lhrough loud Lrafflc ln a large clLy buL ls
awakened prompLly due Lo Lhe sound of an alarm or crylng baby 8eLlcular formaLlon nuclel LhaL modulaLe acLlvlLy of
Lhe cerebral corLex are called Lhe reLlcular acLlvaLlng sysLem or exLraLhalamlc conLrol modulaLory sysLem
1he er|phera| Nervous System (NS)
O ConLalns Lhe cranlal nerves (12 palrs) splnal nerves some parLs of Lhe AnS (AuLonomlc nervous SysLem)
Cran|a| Nerves
O Pave moLor sensory mlxed funcLlons LhaL approxlmaLe Lhe base of Lhe braln aL Lhe braln sLem run
Lo Lhe sLrucLures Lhey lnnervaLe
O 1hey are arranged verLlcally along Lhe braln sLem are referred Lo by 8oman numbers whlch acLually
correspond Lo Lhelr verLlcal order Cranlal nerve vll Lhe faclal nerve ls 7
Lh
from Lhe Lop
O %%%%%%%%%%(%%%%%%%%) Some have moLor funcLlons sensory funcLlons or boLh
O 1he cranlal nerves are lmporLanL for Lhe conLrol of speech Also lnvolved ln swallowlng resplraLlon
O Cn v (1rlgemlnal) Sensory MoLor S sensaLlon Lo/from Lhe face M Lo Lhe masaLer palaLe pharynx
O Cn vll (laclal) S M S anLerlor 2/3 of Lhe muscles of Lhe Longue M Lo Lhe faclal muscles
11

O Cn lx (Clossopharyngeal) S M S Lo Lhe sofL palaLe pharynx Lo Lhe remalnder 1/3 of Lhe Longue
(posLerlor) problems may lead Lo decreased LasLe ablllLy M Lo Lhe pharynx
O Cn x (vagus) S M S M Lo Lhe larynx pharynx sofL palaLe bronchl Many lnnervaLlons M vocal
folds lnducLlon(?) recurrenL laryngeal nerve S eplgloLLls around Lhey erychnolds(?) superlor laryngeal
nerve vocal fold paralysls mlghL be b/c of Lhe recurrenL laryngeal nerve
O Cn xl (Accessory) M only for head roLaLlon shoulder shrugglng
O Cn xll (Pypoglossal) S M MoLor Lo Lhe Longue Lransferrlng Lhe bolus back Lo Lhe pharynx shaplng
Longue for arLlculaLlon

Sp|na| Nerves
O LnLer exlL Lhrough Lhe bony splnal column
O Many are lmporLanL for lnnervaLlng Lhe muscles necessary for breaLhlng (whlch ls necessary for speech)

Autonom|c Nervous System (ANS)
O Coverns lnvolunLary acLlvlLles of Lhe vlsceral muscles or vlscera lncludlng glandular secreLlons hearL
funcLlon dlgesLlve funcLlon eLc
O 1he CnS componenL of Lhe AnS arlses from Lhe prefronLal reglon of Lhe cerebral corLex as well as from
Lhe hypoLhalamus hlppocampus braln sLem cerebellum splnal cord
O 1he vlscera are connecLed Lo Lhese lochl of conLrol by means of afferenL (sensory ascendlng) efferenL
(moLor descendlng) LracLs
O 1he AnS ls furLher dlvlded lnLo 2 subsysLems
4 SympaLheLlc nervous SysLem flghL or fllghL response causes vasoconsLrlcLlon of blood vessels
oLher AnS organs are affecLed sweaLlng hearL raLe lncrease eLc
4 arasympaLheLlc nervous SysLem slows down Lhe nervous sysLem Lo reach homeosLasls dllaLe
blood vessels dlgesLlve flulds calm down breaLhlng slows hearL raLe decreases eLc

Somat|c Nervous System
O volunLary componenL
O under our consclous volunLary conLrol lncludes conLrol of skeleLal or somaLlc muscles

Sp|na| Cord
O 31 palrs of splnal nerves arlse from splnal segmenLs servlng sensory moLor funcLlon for llmbs Lrunk
O Comprlsed of LracLs of nuclel
O lL's a condulL of lnfo Channels are bullL along Lhe longlLudlnal access
O Cray maLLer of Lhe splnal cord ls dlvlded lnLo dorsal laLeral venLral venlcull (large columns) whlch are
subdlvlded lnLo fasclcull or LracLs of whlLe maLLer
O 1racLs LhaL serve Lhe muscles of Lhe enLlre body are larger ln Lhe upper splnal cord Lhan ln Lhe lower
O Cray maLLer of Lhe SC ls wlder ln reglons servlng muscles speclflcally ln Lhe cervlcal Lhoraclc
O 1racLs of whlLe maLLer are wldesL ln Lhe cervlcal reglon b/c all ascendlng descendlng flbers musL pass
Lhrough Lhese segmenLs
O Sensory paLhways Lend Lo be ln Lhe posLerlor (back) porLlon of Lhe SC moLor paLhways Lend Lo be ln Lhe
anLerlor (fronL) porLlon reflecLlng Lhe dorsal venLral orlenLaLlon of Lhe splnal rooLs
12



** uorsal sensory afferenL ascendlng back **
** AnLerlor moLor efferenL descendlng fronL **







Ascend|ng athways
O 1he ma[or ascendlng sensory paLhway lnclude Lhe faslculus gracllls faslculus cuneaLus anLerlor laLeral
splnoLhalmlc LracLs Lhe anLerlor posLerlor splnocerebellar LracLs (conveys lnfo Lo from splne Lo
cerebellum)
O 1he anLerlor posLerlor splnocerebellar LracLs convey lnfo regardlng muscle Lenslon Lo Lhe cerebellum
O 1he splnoLhalamlc LracL LransmlLs lnfo concernlng Lhe physlcal sLaLe of Lhe llmbs Lrunk Lo hlgher braln
cenLers

Descend|ng athways
O uescendlng moLor paLhways are condulLs for lnfo commandlng muscle conLracLlon whlch resulLs ln
volunLary movemenL modlflcaLlon of reflexes vlsceral acLlvlLy
O 1he mosL lmporLanL of Lhese arlse from Lhe cerebral corLex alLhough Lhere are LracLs orlglnaLlng ln Lhe
bralnsLem as well
O 1he ma[or paLhways lnclude Lhe pyramldal paLhways (corLlcosplnal corLlcobulbar)
4 1he corLlcosplnal LracL runs from Lhe corLex Lo Lhe splne provldes lnnervaLlons Lo Lhe skeleLal
muscles
4 1he corLlcobulbar LracL ls lmporLanL for speech producLlon b/c lL serves Lhe moLor cranlal nerves
for speech

Cerebra| Vascu|ar Acc|dent (CVA)
O ulsrupLs blood flow Lo Lhe braln Several Lypes
4 schem|c
Cccluslon of an arLery usually Lhe MCA or Lhe caroLld causlng a reducLlon or cessaLlon of
blood flow
Caused by aLherosclerosls (clogglng of arLeles) prollferaLlon (mulLlpllcaLlon) of cells
hlgh cholesLerol 2 ma[or Lypes
1 1hrombos|s
4 Cccurs as a resulL of an accumulaLlon of plaLeleLs faLLy plaques on Lhe
vessel wall 1hrombus blocks arLery a sulLcase blocklng Lhe hlghway
4 Sudden lncreases ln severlLy over Llme
4 Plgher lncldence among ppl w/dlabeLes melllLus hyperLenslon
4 A frequenL slgnal of lmpendlng Lhrombosls ls Lhe LranslenL lschemlc
aLLack (1lA)
4 1lA Lemporary dlsrupLlon of Lhe bld flow LhaL produces LranslenL
neurologlcal slgns lndlcaLlng LhaL plaLeleL formaLlon ls underway lL ls
experlenced as blurred vlslon numbness weakness speech dlfflculLy
lmbalance of galL eLc lL lasLs less Lhan 1hr ls compleLed w/ln 24hrs
2 Lmbo||sm
13

4 laLeleLs faLLy plaque break off a vessel Lravel unLll Lhey become
sLuck ln a smaller arLery Lravellng/floaLlng sulLcase
4 1he hearL ls Lhe mosL common source of embollc maLerlal
4 May also occur secondary Lo Lrauma
4 No warnlng slgns
O nfarct|on
4 When meLabollsm ls prohlblLed for 2mlns Lhe resulL ls deaLh (necrosls) of neural Llssue 1hls
necroLlc Llssue ls called an lnfarcL
4 uamaged Llssue sofLens llquefles Lhls wasLe ls removed probably by Lhe asLrogllal cells LhaL are
supporLlve of neurons
4 Cllosls wasLe removal Leaves a cavlLy ln Lhe corLex


O emorrhage (volcano)
4 AssoclaLed wlLh hyperLenslon aneurysm or AvM lL also accompanles 18l
4 8upLure of a cerebral blood vessel 1here's no blood flow above Lhe slLe of Lhe rupLure
ntracerebra| hemorrhage (wlLhln) lnvades Lhe reglon of Lhe Lhalamus lnLernal capsule
lenLlcular nuclel 1here's usually a loss of consclousness preclplLaLed by an lncrease ln
8 durlng physlcal acLlvlLy or emoLlonal sLress MosL suscepLlble are Lhe branches of Lhe
Clrcle of Wlllls basllar arLery
Subarachno|d hemorrhage occurs ln Lhe plarachnold space surroundlng Lhe braln Can
be caused by a rupLured aneurysm
O ematoma sLagnanL blood accumulaLes from a hemorrhage hardens removed by cranloLomy
O Aneurysm dllaLed blood vessel LhaL sLreLches weakens Lhe vessel wall caused by sudden exerLlon
O Arter|ovenous Ma|format|on (AVM)
4 usually less damaglng Lhan an aneurysm
4 A congenlLal condlLlon
4 noL slgnaled unLll bleedlng or selzures occur
4 8leed lnLo subarachnold space
4 Weakens Lhe arLerlal walls where caplllary neLwork bLwn arLerles velns ls absenL
O 1umors
4 Abnormal mass of Llssue
4 Peadaches are one of Lhe earllesL slgns preclplLaLed by sLopplng (??) sLralnlng or exerclslng
4 CLher slgns lnclude nausea vomlLlng sensory lmpalrmenLs dulled menLal funcLlonlng
4 A common source ls Lhe supporLlve cells Lhrough Lhe CnS
4 1umors are classlfled accordlng Lo Lhelr Llssue orlgln
O ||a| ce||s] Neura|g|a
4 ALLached Lo nerve cells axons buL noL dlrecLly lnvolved ln Lransmlsslon of nerve lmpulses
O Astrog||a
4 Polds neurons ln place ln addlLlon Lo Lhelr housekeeplng funcLlons
4 Cllomas mallgnanL
4 AsLrocyLomas mallgnanL
4 Menlngoma benlgn

Coronary eart D|sease
O Leadlng klller of Amerlcan men women ouLnumberlng deaLhs from cancers accldenLs comblned
O eart Attacks
4 11 mllllon Amerlcans have a hearL aLLack each year
4 noL a naLural consequence of aglng
4 1
sL
sympLom ls deaLh (ln 30 of cases)
14

4 revenLable
4 lncreased rlsk for CPu
Smoklng hlgh 8 (over 140/90) elevaLed blood cholesLerol
O Atherosc|eros|s
4 underlylng cause of CPu
4 1he clogglng of Lhe coronary arLerles w/faLLy flbrous cholesLerolladen deposlLs called plaques
1he deposlLs Lhlcken Lhe arLery wall laques are caused by an excess of cholesLerol ln Lhe blood
4 Plgh 8 smoklng lncrease Lhe raLe of arLherosclerosls
4 Cver Lhe course of Lhe 1
sL
34 decades of llfe plaque deposlLs gradually lncrease Lhe openlngs
geLs narrower (arLerles)
O |gh 8
4 * of adulLs have hlgh 8 can lead Lo hearL aLLack whlch can lead Lo a sLroke

O Women heart d|sease r|sk
4 1 cause of deaLh ln all women over Lhe age of 23
4 40 of all female deaLhs are due Lo CPu
4 SympLoms of hearL aLLack dlffer ln women
Women reporL a crushlng paln ln Lhe chesL
Men reporL feellng dlzzy slck SC8 sweaLy
O reventat|ve Measures
4 Women should be LreaLed aggresslvely for oLher problems LhaL lead Lo arLery dlsease such as
hlgh cholesLerol hlgh blood pressure dlabeLes
4 CLher prevenLaLlve measures lnclude qulL smoklng lose welghL exerclse more

Stroke k|sk actors
O PyperLenslon
O PearL dlsease
O ALherosclerosls hardenlng of arLerles
O revlous 1lAs (warnlng)
O Plgh cholesLerol
O Pyperllpldemla faL ln arLerles lncludlng
cholesLerol
O PearL aLLack
O Plgh alcohol consumpLlon
O CbeslLy/ excesslve welghL
O Lxcesslve faL
O ulabeLes Lhlckenlng of arLerles
O 8rulL nolse ln caroLld arLery
O ClgareLLe smoklng
O Cral conLracepLlves
O lamlly hx
O Advanclng age (greaLesL rlsk facLor)
O Cender women have a lower rlsk before
menopause buL hlgher afLer 70 yrs of age
O 8ace dleLary paLLerns eLhnlc culLural
dlfflculL Lo assess
O SLress
Stroke Warn|ng S|gns
O Sudden numbness or weakness on one slde of your body
O Sudden changes ln vlslon especlally ln one eye
O 1rouble speaklng or undersLandlng whaL you hear
O Sudden severe headaches of unknown cause
O 1rouble walklng or sLaylng balanced
kecogn|z|ng a Stroke
O S Ask Lhe lndlvldual Lo sm||e
O 1 Ask Lhe person Lo ta|k Lo speak a slmple senLence (coherenLly)
O k Ask Lhem Lo ra|se boLh arms
O Ask Lhem Lo sLlck ouL Lhelr Longue lf crooked lL's anoLher lndlcaLlon of a sLroke
13

O 1x 1A (1lssue lasmlnogen AcLlvaLor) an enzyme glven Lo pLs Lo reduce Lhe severlLy of Lhe sLroke lL
reduces Lhe bld cloL used for cerLaln Lypes of sLroke (LhromboLlc or embollc CvA) w/ln cerLaln Llme
llmlL w/ln 3hrs Lo be admlnlsLered vla lv or w/ln 6hrs lf vla arLerlal caLheLer
Contro| of Stroke k|sk actors
O ConLrol of 8 vla meds eLc
O AnLlcoagulaLlon meds
4 Peparln Lo decrease cloLs
4 Coumadln
O 1hrombolyLlc agenLs
4 12hrs afLer onseL
4 ConLrol hemorrhage needs C1 scan
O Surgery such as caroLldecLomy (3070+ occluslons)






































16

D|agnost|c 1echn|ques
O Cerebra| Ang|ogram (verLebral anglogram Anglography head CaroLld anglogram)
4 used Lo dlagnose vascular (blood vessel) dlsorder
4 uye ls lnserLed Lhrough Lhe femoral arLery xrays are used Lo lllumlnaLe and monlLor Lhe lnLegrlLy
of Lhe cerebral sLrucLure
4 osslble Lhrombosls sLenosls (narrowlng of Lhe arLerles aneurysms are dlagnosed Lhls way
4 varlous angles are used Lo vlew Lhe arLerles
4 roblem some ppl are allerglc Lo Lhe dye some have a sLroke (embollsm Lhrombosls) caused by
Lhe caLheLer golng lnLo Lhe arLerles (plnchlng Lhe arLerles causlng vascular changes)
4 Cerebral anglography ls done ln Lhe hosplLal or large radlology cenLer ?ou wlll be asked Lo lle on an xray
Lable ?our head ls poslLloned and held sLlll uslng a sLrap Lape or sandbags so you do noL move durlng Lhe
procedure 1he healLh care provlder wlll aLLach elecLrocardlogram (LCC) leads Lo your arms and legs whlch
monlLor your hearL acLlvlLy durlng Lhe LesL
4 8efore Lhe LesL sLarLs you wlll be glven a mlld sedaLlve Lo help you relax
4 An area of your body usually Lhe groln ls cleaned and numbed wlLh a local numblng medlclne (anesLheLlc)
A Lhln hollow Lube called a caLheLer ls placed Lhrough an arLery and carefully moved up Lhrough Lhe maln
blood vessels ln Lhe belly area and chesL and lnLo an arLery ln Lhe neck Movlng xray lmages help Lhe docLor
poslLlon Lhe caLheLer
4 Cnce Lhe caLheLer ls ln place a speclal dye (conLrasL maLerlal) ls ln[ecLed lnLo caLheLer xray lmages are
Laken Lo see how Lhe dye moves Lhrough Lhe arLery and blood vessels of Lhe braln 1he dye helps hlghllghL
any blockages ln blood flow
4 AfLer Lhe xrays are Laken Lhe needle and caLheLer are wlLhdrawn ressure ls lmmedlaLely applled on Lhe
leg aL Lhe slLe of lnserLlon for 10 13 mlnuLes Lo sLop Lhe bleedlng AfLer LhaL Llme Lhe area ls checked and
a LlghL bandage ls applled ?our leg should be kepL sLralghL for 4 6 hours afLer Lhe procedure WaLch Lhe
area for bleedlng for aL leasL Lhe nexL 12 hours
4 ulglLal subLracLlon anglography (uSl) uses a compuLer Lo subLracL or Lake ouL Lhe bones and Llssues ln Lhe
area vlewed so LhaL only Lhe blood vessels fllled wlLh Lhe conLrasL dye are seen
4 Cerebral anglography ls mosL frequenLly used Lo ldenLlfy or conflrm problems wlLh Lhe blood vessels ln Lhe
braln
4 ?our docLor may order Lhls LesL lf you have sympLoms or slgns of
Abnormal blood vessels
(vascular malformaLlon)
Aneurysm
narrowlng of Lhe arLerles ln Lhe
braln
vascullLls
4 lL ls someLlmes used Lo
Conflrm a braln Lumor
LvaluaLe Lhe arLerles of Lhe head and neck before surgery
llnd a cloL LhaL may have caused a sLroke
4 ln some cases Lhls procedure may be used Lo geL more deLalled lnformaLlon afLer someLhlng abnormal has
been deLecLed by an M8l or C1 scan of Lhe head
4 1hls LesL may also be done ln preparaLlon for medlcal LreaLmenL (lnLervenLlonal radlology procedures) by
way of cerLaln blood vessels
4 ConLrasL dye flowlng ouL of Lhe blood vessel may be a slgn of lnLernal bleedlng
4 narrowed arLerles may suggesL cholesLerol deposlLs a spasm or lnherlLed dlsorders
4 CuL of place blood vessels may be due Lo braln Lumors bleedlng wlLhln Lhe skull aneurysm (bulglng of Lhe
arLery walls) or arLerlovenous malformaLlon
4 Abnormal resulLs may also be due Lo
lnLracerebral hemorrhage
MeLasLaLlc braln Lumor
neurosyphllls
CpLlc glloma
lLulLary Lumor
rlmary braln Lumors
4 1here ls Lhe posslblllLy of slgnlflcanL compllcaLlons lncludlng
Allerglc reacLlon Lo Lhe conLrasL dye
8lood cloL or bleedlng aL Lhe needle sLlck slLe whlch could parLly block blood flow Lo Lhe leg
uamage Lo an arLery or arLery wall from Lhe caLheLer whlch can block blood flow and cause a
sLroke (rare)
17

O Computed 1omography (C1)
4 MulLlple xrays Laken aL dlfferenL angles (8adlaLlon 2 comps are needed plngpong game)
4 2 compuLers are used Laklng crossecLlonal plcLures (sllces)
4 100x more sophlsLlcaLed Lhan xrays whlch can only Lake 1 vlew per plane
4 1ransmlLLlng beams of energy are emlLLed LhaL's how lmages are obLalned
4 1he quallLy quanLlLy of Lhe LransmlLLed radlaLlon lmage ls examlned
4 WhlLe gray black (good)
4 WhaL shows up ln Lhe sllce/plc ls Lhe amounL of radlaLlon absorbed
4 normal xrays are Lhen compared Lo Lhe lmages obLalned
4 1umor masses lnfarcLlon eLc can be deLecLed
4 AdvancemenL less Llme more lmages
4 AlLhough also based on Lhe varlable absorpLlon of x rays by dlfferenL Llssues compuLed Lomography (C1)
lmaglng also known as CA1 scannlng (CompuLerlzed Axlal 1omography) provldes a dlfferenL form of
lmaglng known as crosssecLlonal lmaglng A C1 lmaglng sysLem produces crosssecLlonal lmages or sllces
of anaLomy llke Lhe sllces ln a loaf of bread
4 A moLorlzed Lable moves Lhe paLlenL (llgure 3) Lhrough a clrcular openlng ln Lhe C1 lmaglng sysLem As Lhe
paLlenL passes Lhrough Lhe C1 lmaglng sysLem a source of x rays roLaLes around Lhe lnslde of Lhe clrcular
openlng A slngle roLaLlon Lakes abouL 1 second 1he xray source produces a narrow fanshaped beam of x
rays used Lo lrradlaLe a secLlon of Lhe paLlenLs body 1he Lhlckness of Lhe fan beam may be as small as 1
mllllmeLer or as large as 10 mllllmeLers ln Lyplcal examlnaLlons Lhere are several phases each made up of
10 Lo 30 roLaLlons of Lhe xray Lube around Lhe paLlenL ln coordlnaLlon wlLh Lhe Lable movlng Lhrough Lhe
clrcular openlng 1he paLlenL may recelve an ln[ecLlon of a conLrasL maLerlal Lo faclllLaLe vlsuallzaLlon of
vascular sLrucLure ueLecLors on Lhe exlL slde of Lhe paLlenL record Lhe x rays exlLlng Lhe secLlon of Lhe
paLlenLs body belng lrradlaLed as an xray snapshoL aL one poslLlon (angle) of Lhe source of x rays Many
dlfferenL snapshoLs (angles) are collecLed durlng one compleLe roLaLlon 1he daLa are senL Lo a compuLer
Lo reconsLrucL all of Lhe lndlvldual snapshoLs lnLo a crosssecLlonal lmage (sllce) of Lhe lnLernal organs and
Llssues for each compleLe roLaLlon of Lhe source of x rays

O S|ng|e hoton Lm|ss|on 1omography (SLC1)
4 Slmllar Lo C1 scan
4 Looks [ bld flow ln Lhe braln neural acLlvlLy More advanced Lhan a L1
4 A slnglephoLon emlsslon compuLerlzed Lomography (SLC1) scan leLs your docLor analyze Lhe funcLlon of
your lnLernal organs A SLC1 scan ls a Lype of nuclear lmaglng LesL whlch means lL uses a radloacLlve
subsLance and a speclal camera Lo creaLe plcLures of your organs
4 Whlle lmaglng LesLs such as xrays can show whaL Lhe sLrucLures lnslde your body look llke a SLC1 scan
produces 3u lmages LhaL show how your organs work lor lnsLance a SLC1 scan can show how blood
flows Lo your hearL or whaL areas of your braln are more acLlve or less acLlve
4 ?our docLor may order a SLC1 scan Lo help dlagnose or monlLor a number of dlseases and condlLlons
lncludlng
8raln dlsorders such as Alzhelmers dlsease sLroke and selzure
PearL problems such as blockages ln Lhe arLerles of Lhe hearL chesL paln and hearL aLLack
Cancer lncludlng prlmary Lumors and cancer LhaL has spread Lo oLher areas of Lhe body
(meLasLaslzed)
O Magnet|c kesonance mag|ng (Mk)
4 Pas become a sLandard Lool
4 LlecLromagneLlc flelds used radlowaves Lo produce a 3u lmage of Lhe braln
4 no use of hazardous radlaLlon (as done by Lhe C1 scan)
4 Lach waLer molecule ln our body conLalns 2 Pydrogen nuclel whlch have random movemenL lncludlng
magneLlc acLlvlLy So ln a large magneLlc fleld Lhe Pydrogen aLoms wlll allgn Lhemselves accordlngly ln a
slngle plane (for Lhose ln Lhe braln) A radlo slgnal ls Lhen lnLroduced Lo plck up Lhe organlzaLlon of Lhe
Pydrogen aLoms (ln Lhe fluld ln Lhe braln) 1he slgnal provldes us wlLh Lhe 3u plcs afLer Lhe radlo slgnal
ends Lhe aLoms reLurn Lo Lhelr regular poslLlons emlL radlo magneLlc energy creaLlng Lhe plcs
4 Shades of black gray whlLe used Lo look [ levels of aLLenuaLlon
4 Advantages
3 sllces 8adlaLlon nC1 requlred
18

8eLLer resoluLlon Lhan a C1
Superlor sofL Llssue conLrasL more so Lhan a C1
AblllLy Lo lmage ln mulLlple planes
8eLLer Lhan C1 scan aL looklng aL CnS abnormallLles
Can also be used Lo look aL musculoskeleLal pelvlc reglons
4 MagneLlc resonance lmaglng (M8l) uses a large magneL and radlo waves Lo look aL organs and sLrucLures
lnslde your body PealLh care professlonals use M8l scans Lo dlagnose a varleLy of condlLlons from Lorn
llgamenLs Lo Lumors M8ls are very useful for examlnlng Lhe braln and splnal cord
4 uurlng Lhe scan you lle on a Lable LhaL slldes lnslde a Lunnelshaped machlne uolng Lhe scan can Lake a
long Llme and you musL sLay sLlll 1he scan ls palnless 1he M8l machlne makes a loL of nolse 1he
Lechnlclan may offer you earplugs
Cverv|ew of Commun|cat|ons
anguage ls Lhe symbol sysLem for meanlng or formulaLlon of LhoughL
Speech ls Lhe moLor funcLlon ln oral communlcaLlon or Lhe resplraLory phonaLory (sound) resonanL arLlculaLory
prosodlc (rhyLhmlc) componenLs of communlcaLlon
our Ma[or Moda||t|es
O verbal Lxpresslon Lxpresslve/CuLpuL modallLy
O WrlLLen Lxpresslon Lxpresslve/CuLpuL modallLy
O AudlLory Comprehenslon 8ecepLlve/lnpuL modallLy
O 8eadlng Comprehenslon 8ecepLlve/lnpuL modallLy
O CesLural communlcaLlon ls a secondary modallLy can be boLh expresslve recepLlve ln naLure (lncludes
pragmaLlc skllls of faclal expresslon eye gaze)
O urawlng can also be a very powerful Lool (Secondary modallLy)
** Aphasla (lefL hemlsphere) ls a mulLlmodallLy u/C rarely ls any modallLy LoLally lnLacL acqulred from
CvA (usually unllaLeral lefL braln leslon) or a head ln[ury or Lumor
** Can you have language w/o cognlLlon? nC bec you need cognlLlon (aLLenLlon memory) for lang
1here's an lsomorphlc relaLlon bLwn Lhe 2 Lhey need each oLher

Memory
1 Lplsodlc Memory for lndlvldually experlenced evenLs (also known as auLoblographlcal memory)
2 SemanLlc Memory for common language of Lhe world
3 rocedural Memory for knowledge of sklll llke swlnglng a golf club
4 Lexlcal Memory for words lnfo a/b words
eve|s of memory have |mp||cat|ons for |anguage funct|on
O rocesslng for comprehenslon producLlon Lakes place wlLhln Lhe capaclLy Llme consLralnLs of shorL
Lerm memory or worklng memory"
O 1he knowledge base for communlcaLlon ls housed ln longLerm memory