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Dnp leadership capstone projects for money define enterprise risk management definition order dissertation on social security numbers now today I want to talk about cortical functional localization the thing that makes brain much more interesting than liver is that different parts do different things it's not all the same if you understand the function of the brain in its different regions you can help to localize disease processes we are looking at the frontal lobes of the brain here is the right and the left hemisphere and between them is the inter hemispheric fissure and as I lift the brain slightly the area of the frontal lobes is sitting on my fingers and the frontal lobe extends all the way back to the central sulcus which is a line that goes on either hemisphere between two gyri that tend to parallel each other the area in front of the central sulcus is called the frontal lobe and the area behind it back about this far to a little notch is called the parietal lobe if we look at this on a lateral view you can see the same landmarks here is that central sulcus separating frontal front parietal here is the knotch separating occipital lobe from parietal lobe and if we arbitrarily draw a line across here from this lateral fissure we have the temporal lobe so we have temporal lobe occipital lobe parietal lobe frontal lobe now what I want to do is to talk about the functions of those different areas now I am showing you the areas and lobes of the brain with respect to their functions so from the central sulcus on this lateral view of the left hemisphere everything in front of this is frontal-lobe and this gyrus that parallels the central sulcus Dupree because it's in front of the precentral gyrus is primary motor cortex and motor function motor function is what you want to associate with the frontal lobe behind the central sulcus the other parallel gyrus is the post central gyrus and it runs parallel and it too has a function it is sensory it is sensory from the body and from the face the posterior region the occipital lobe you want to associate with vision from the opposite half of each eye in other words if this is left hemisphere it is receiving information from the right half of each eye or the right half of each visual field we have here a person who is looking out at their visual world and we're hovering looking down from above and we put up this blue wedge which shows what the left eye sees when the right eye is closed and we put up a red wedge which shows what the right eye sees with the left eye closed now we both open both eyes and we see both the red and the blue wedges the central area between 60 degrees is seen by both eyes this is how we get stereoscopic or binocular depth perception down here in the temporal lobe we want to associate that with audition but most importantly with interpretation and understanding of language this area here coming around like this this superior and posterior part of the temporal gyrus is called Wernicke's area and it is devoted to the interpretation and comprehension of language if we understand language we also speak language speech is a motor function so it should not surprise you that an area in front of the precentral gyrus again in motor cortex is involved with the production of language so we have two language areas a temporal parietal region called Wernicke's for comprehension and a motor expressive area in the frontal lobe called Broca's area this specialization for language in 97% of the people is a left hemisphere function let me turn now and look at the right hemisphere if the left hemisphere is specialized for language is there something important going on in the right hemisphere again our landmarks the central sulcus with parietal lobe the somatic sensation is right behind the central sulcus but this area of parietal lobe this general region of Freud lobe is very important for body image for your perception of your body and its relationship to space and geometry so people with difficulties here have problems navigating have problems recognizing or feeling the opposite side of their body and have a often quite often get lost because language is so important and language is not in this right hemisphere lesions or disease of the right hemisphere is oftentimes much harder to detect and only can be recognized when the disease process has progressed or the lesion has gotten very large in comparison lesions or damage to the left hemisphere where the interpretation of speech or the production of speech these areas are so critical and important to us if these regions are damaged it's very easy to pick this up back to a frontal view of our brain if I were to take my knife or my probe and cut across I would have as you will see now a frontal section through the hemisphere this is the left hemisphere and this is the right hemisphere we have our cerebral cortex and gray matter and we have our sul sy and our gyri or grey matter going over the surface what I want to point out to you is let's imagine that this section came right through the motor cortex right through that precentral gyrus and now I want you to realize that on the surface of this we can map a human being so to speak if this is motor then from the lateral sulcus here up to the inner hemispheric fissure we have a nice orderly display of larynx and mouth and lips and hand very big area devoted to this in humans and then a smaller trunk and leg and foot and genital area and a diagram can show this to you in this diagram the human body has been laid over the surface of the motor cortex and labels have been given the only point I want to stress here is that the face and hand area are much larger in their representation than the area from the wrists to the toes and while you're looking at this you'll see that this sensory postcentral gyrus on the other side in the parietal lobe right behind the central sulcus has the same organization the fact that we have a mapping of the body onto the surface of the cortex means the damage to a particular region here on the lateral surface would involve the hand or the face damage on the medial surface could involve the lower leg this little map we call the homunculus and I like this graphic from the Museum of Natural History in New York that gives you a visual graphic idea of the importance of the lips the vocal cords and the hand in cortical representation what I want to do is to tell you how I very simplistically remember the functions of the lobes of the brain and how it's basically organized I like to think of information coming in through my occipital and temporal and parietal lobes as visual auditory and somatic sensation and being processed and flowing forward to my frontal lobe my frontal lobe is motor and they're the appropriate motor pattern our action is designed so I think of sensory in and motor out the other thing that you have to always remember is the crossing each pathway that you will learn about has a crossing in it but we don't need to understand that now if you think about my left hemisphere it's controlling my right hand left brain right motor left brain controls voluntary motor control of the opposite half of the entire body similarly sensation sensation from my right hand is going to my left parietal lobe right sensation left brain so we have this crossing and we have hemispheric specialization language left spatial orientation right if we can remember this we can go a long way into localizing disease of the cortex you capstone project for med surge cheap State University of New York State College of Optometry.