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Neuro Exam 2
Terms in this set (97)
What is histology?
study of cells and how they form organs
What do the Golgi, Nissl stains, myelin staining procedures show of the microscopic structure of the brain?
(a) Golgi stain was the first stain that actually stained neurons. This stains brain cells to be able to look at their structure. Use silver strain to find dead neurons. Not all neurons will take up stain but the ones that do are stained completely black
(b) Nissl stains don't stain axons but show you cell bodies. All cell bodies take them up so you can tell how many cell bodies there are. More numbering information. Dark stain of cell nuclei
(c) Myelin stains dye the myelin back
(d) horseradish peroxidase is used as a tracing procedure. Used primarily for its ability to amplify a weak sign and increase detectability of a target molecule
How do cranial X-rays work in general? What structures or damage show up how?
(a) brain x-rays show the discrimination of low and high density regions in the body
(b) high density regions show up as white
(c) low density regions show up dark
(d) this process is poor for brain imaging because most of the tissue isn't dense. Therefore, you don't get a good picture of the brain and cannot get much information from this.
What are the advantages and disadvantages of cranial X-rays?
advantages- can pick up tumors, skull fractures, and hemorrhages; cheap, simple, and readily available
disadvantages- only 2D images, poor structural resolution (ex. brain regions difficult to discern); cumulative radiation can cause brain and bodily damage (ex. tumors); not good experimental or diagnostic tool
What is the general procedure in angiography? What things can angiographies detect?
(a) An angiography gives us visualization of cerebral vasculature
(b) contrasting dye is injected to show the outline of vasculature
(c) (blood flow throughout the brain) I. during an angiography, a catheter is inserted via an external artery (ex. femoral artery) and guided close to the site of entry of arterial supply of the brain (ex. internal carotid) II. angiographies are used for diagnostic use only and can detect: aneurysms, tumors with new vasculature, and vascular shifting due to lesions or degeneration of brain tissue
(d) successful tumors have access to blood vessels so being able to see these vessels is helpful in diagnosis
What is the general process in computerized axial tomography, how is it different from an X-ray? What disadvantage of X-rays goes for CT scans also?
(a) computerized axial tomography is when an X-ray scanner is rotated slowly, until a measurement has been taken at each angle and a computer constructs the image
(b) the X-ray is delivered as a thin beam, which allows the "slices" of the brain to be constructed along each of the planes of axis
(c) a computer creates a 3D image; discrimination between brain structures is superior to that of skull rays.
(d) disadvantage: CT scan X-rays come with radiation just like cranial xray
Which has the higher radiation dose: a skull X-ray or a head CT? Why is that?
(a) typical skull X-ray has a dose of 0.1 while a CT scan has a dose of 2.0
(b) CT scan is higher because it s sending out multiple x-rays in order to produce the image
How in general does an MRI work? What are the advantages of MRIs?
(a) MRI's involve the application of a powerful magnetic field to image the brain. The magnetic field aligns axes of the natural spin or rotation of atoms in water molecules (especially hydrogen atoms)
(b) a radio frequency signal causes all aligned axes to spin like gyros
(c) released energy is measured and used to visualize the structure of the brain.
(d) uses magnets as you lie in a strong magnetic field and radio frequency waves are directed at your body. Most of the human body is made up of water molecules, which consist of hydrogen and oxygen atoms
(e) advantages- can see edema and small bleeds very well; really good resolution
What does an fMRI measure? How does it work in general, what does subtraction have to do with it? What process is used to visualize brain processing in BOLD imaging?
(a) fMRI measures oxygen consumption in the brain to provide a moving and detailed image of the functioning brain (oxygen in the brain is linked to the part that is being active; will also calculate regional blood flow)
(b) An fMRI is a functional neuroimaging procedure using MRI technology that measures brain activity by detecting associated changes in blood flow
(c) subtraction techniques are used to ensure that a given task or stimulus is responsible for the activity detected in a particular area of the brain
(d) fMRI is using this technology to see a functional view of the brain rather than a structural view.
What is difficult about an fMRI for patients, and what effect does this have for ability to use fMRI?
Difficult because most areas of the brain are active at all times so you need to try to distinguish which parts of the brain are actually being stimulated; patients must stare at a blank wall and have a stimulus applied to determine which part of the brain is being stimulated
What does a DTI visualize? How is this useful?
Diffusion Tensor imaging, DTI is an MRI in which water diffusion at a location is calculated; a DTI shows the preferred direction of diffusion , allows for the visualization of directional fibers; it uses an MRI at a different setting to look at water diffusion, it generates a picture showing where the fibers run- this allows you to see where you have tracts and where there are breaks in them
How does a PET work? What is PET used for?
a PET records emission of radioactivity from injected radioactive chemicals (usually radioactive glucose) to produce a high resolution image; PETs are typically used as a diagnostic tool (epilepsy, Alzheimer's, cancer, etc); the radioactive glucose lights up areas in the brain and helps us examine its structure
What is TMS? What in general is the process? What is it used for?
Transcranial magnetic stimulation- application of intense magnetic fields to temporarily inactivate neurons; used for treatment of depression, mobility in Parkinson's, and Schizophrenia
What is tDCS? What is it used for?
transcranial direct current stimulation- uses scalp electrodes to pass very low amplitude current to the brain to change the excitability of cortical neurons directly below the electrodes
What is magnetoencephalography? What is it used for?
Magnetoencephalography, or MEG scan, is an imaging technique that identifies brain activity and measures small magnetic fields produced in the brain. The scan is used to produce a magnetic source image (MSI) to pinpoint the source of seizures
What is optical imaging? In which types of cases can this be used when fMRI cannot?
Medical optical imaging is the use of light as an investigational imaging technique for medical applications
What types of electrical recording of brain activity are there?
single cell recording, EEG (electroencephalogram) recording, ERP (event related potential) recording
What is the general process in single cell recordings? Who is this processed used with?
An electrode is inserted into the brain, adjacent to a neuron, and the neurons activity is recorded; many neurons can be recorded simultaneously; can record a single action potential or many; this process is most commonly done with animals (I.e. cats and rodents)
What is the general process in an EEG? What can be studied with EEGs?
EEG records electrical potentials or "brain waves" in the brain; reflects the collective and synchronous activity of neurons in the cortex; EEG is used for: sleep studies, monitoring the depth of anesthesia (unconsciousness), and studying normal brain function
ERP, what is it, how does it work?
An ERP is the brief change in a slow wave EEG signal in response to a discrete sensory stimulus; referred to as an evoked stimulus
What is function of averaging in ERPs?
The function of averaging is to provide a more sophisticated method of extracting more specific sensory, cognitive, and motor events. Effectively eliminates other types of sensory information in order to detect specific reaction to specific stimulus
What types of recordings are part of a polysomnogram?
EEG (brain), EOG (eye movements, electrooculo), EMG (electromyogram, movement of muscles, particularly in the face)
What kind of waves during normal awake on an EEG?
Beta waves are alert awake state, highest in frequency, low amplitude
What kind of waves during relaxation on EEG?
alpha waves are during a calm and resting state; slower but increase in amplitude
What 2 weird phenomena during stage 2 sleep on EEG?
during stage 2 sleep there is a slight spindle (very high frequency) and a K complex (high amplitude) on the EEG; occurs every other minute or so; stage 1&2; light sleep, if awoken, it will feel like no sleep at all
What kind of waves during deeper sleep (3 & 4) on EEG? What is NR3?
Delta waves occur in deep sleep; N3 is a stage during NREM sleep; during this stage it is the deepest stage of NREM and EEGs reveal a high amplitude (large) low frequency (slow); dreaming is common during this stage & difficult to wake someone up during this stage
What is the general trend in the amplitude/frequency from awake to deep sleep?
Awake has a small amp and high frequency; deep sleep has a large amp and low frequency
How are the waves on an EEG during coma? How are they different from delta waves?
A coma is not deeper sleep; the EEG for a coma shows very slow, low amp waves; different from delta waves because delta waves have a high amp while coma waves have a low amp and a low frequency
What are the differences between REM and NREM sleep w.r.t. movement of body parts (eyes, limbs, etc.)?
REM sleep=25% - paralyzed from neck down, indicated by EMG; NREM sleep=75% - no REM, heart, brain, and muscles down; during REM there is rapid eye movement; during NREM sleep the body repairs itself and strengthens the immune system
Explain the sleep cycle that one goes through in a normal night (both stages and REM/NREM alternation)
Beta (b4 sleep)
- higher amplitude, lower frequency
Stage 1 - sleep (dozing)
- lower frequency
Stage 2 - deeper sleep than stage 1
Stage 3 - sleep
- high amplitude, low frequency
Stage 4 - Sleep
- more than 40% - delta waves
repeated throughout the night; REM increases and length of delta waves decrease until there is no delta sleep at all
How does the % of REM sleep change during your lifespan? (infants, grandparents)
babies have 80% REM, as you age the number decreases (older people have shorter sleep and therefore less % REM)
What is the circadian rhythm? Which sense acts on which part of the brain? What does the pineal gland have to do with the circadian rhythm?
(a) it's a 24 hour cycle which the body is attuned to. visual stimuli acts on the suprachiasmatic nucleus in the hypothalamus. the pineal gland releases melatonin which makes us sleepy
(b) light entraining- cells trained to recognize day/night time; your eyes send signals to hypothalamus which sends the signal to the body to release melatonin
(c) pineal gland - secretes melatonin and modulates sleep patterns in circadian and season cycles
What did the movie suggest happens during sleep? During which type of sleep does this process happen?
It is restorative, it helps with learning, stages 3 and 4; memory improves and becomes quicker/better
What are the three main views on the function of sleep? Are they exclusive of each other?
(a) learning- has an effect on memory processing
(b) restorative- repair, increases immune function, releases GH
(c) evolutionary- it would be bad to be awake at night because we cannot see at night. Zebras only sleep 2 hours whereas lions sleep for days
What were the findings recently with respect to CSF circulation and sleep?
during sleep, CSF in brain increases dramatically, washing away harmful waste proteins that build up with brain cells during waking hours
What are some of the cognitive effects of sleep deprivation?
increased sleepiness & faster sleep onset, poor mood, poor vigilance, poor executive function, physiological; temperature and blood pressure increase; immune function decreases; hormonal changes, and metabolic functions are affected
What are some physical effects of deprivation?
lower body temperature, higher blood pressure, lower immune function, hormone changes, metabolic changes
What are two ways of classifying insomnia discussed in class?
can't fall asleep & wake up and can't fall back asleep
What are three types of insomnia based on how long they last?
(a) transient insomnia- lasts for less than a week, can be caused by another disorder, changes in sleep environment, timing of sleep, or distress
(b) acute insomnia- inability to consistently sleep well for a period of less than a month, insomnia is present when there is difficulty initiating or maintaining sleep or when the sleep that is obtained is not refreshing
(c) chronic insomnia- lasts longer than a month, can be caused by another disorder or can be the primary disorder; people with high levels of stress hormones or shifts in the levels of cytokines are more likely than others to have chronic insomnia
What are three sleep disturbance patterns that count as insomnia?
What is the incidence of insomnia?
1 in 4
What sleep hygiene measures were discussed in class?
Sleep hygiene- non medical ways to help you sleep -> going to bed ad getting up at specific times, blue light blocking glasses, melatonin and magnesium, low noise/white noise, no red/blue lights
How does blue light have a poor effect on sleep?
it inhibits melatonin release
What happens in sleep apnea (in general)?
Sleeper's tongue relaxes (normal) but then blocks the airway (no breath wakes up a lot)
What is the prevalence of sleep apnea?
3-4% of the population
What is specific about obstructive sleep apnea?
The airway must be obstructed so you can sleep on your back and the tongue will fall back and block the airway; the sensory will wake person up and make them gasp for air; more common
What is central sleep apnea?
the brain stops giving breathing signals; very rare
How much of total sleep apnea is obstructive as opposed to central?
in most cases, sleep apnea is obstructive (80-90%)
What is the main daytime symptom for sleep apnea?
sleepiness during the daytime because they're constantly being woken up, and fatigue
What is the standard therapy for sleep apnea?
(a) CPAP- continuous positive airway pressure - delivers airways pressure and pushes air into system, because of its unpleasantness (strapped to face and dries you out), long term compliance with this therapy is low
(b) a less standardized therapy is EPAP in which "vents" are put into a patient's nostrils. this makes exhaling harder and thus builds up positive airway pressure backwards by giving resistance to breathing out
What is the main problem with this (sleep apnea) therapy?
hard to sleep in, dies everything out, makes people gassy because it pushes air down to the stomach
What is the classification of narcolepsy?
Narcolepsy with cataplexy (lose all tone in body/fall over), likely to want to fall asleep, fall asleep very easily and suddenly during the day, feel sleepy during much of the day and especially during the afternoon, poor concentration and memory
What is the prevalence of narcolepsy?
What are the symptoms of narcolepsy that were discussed in class?
Sleep attack, cataplexy (falling over), hypnagogic hallucination (falling when you're dreaming so your body jerks), sleep paralysis (waking up and can't move)
Explain the difference between cataplexy and sleep paralysis.
cataplexy is losing all tone in body and falling over; sleep paralysis is either when you're waking up or falling asleep, you can't move
What types of drugs are used to treat narcolepsy?
REM sleep inhibitors; stimulants are also sometimes prescribed in order to keep the patients awake (so they don't fall asleep during the day); some antidepressants block REM sleep. these drugs seem to be effective without causing any major problems
Explain the distinction between epilepsy and seizures.
epilepsy is a neurological disorder in which seizures are generated by brain dysfunction; seizures can occur without diagnosis of epilepsy - brain damage, tumors, toxic chemicals, infections, vascular malformations, etc.
What is the prevalence of epilepsy?
1-4% of the population for whom there will be multiple seizures episodes (but 1:20 will have a mild, insignificant seizure once)
Describe the grand mal and petit mal seizure (old) classification
grand mal - loss of consciousness and equilibrium, tonic-clonic convulsions, rigidity=tonus/tremors=clonus, resulting hypoxia may cause brain damage
petit mal - not associated with convulsions, defined as a disruption of consciousness associated with a cessation of ongoing behavior (people who experience will often appear to stare without moving, usually lasting a couple of seconds which can be misunderstood as daydreaming
What is the difference between a partial and generalized seizure?
partial seizures doesn't involve the whole brain - originates in the focus and spreads through fibers to the thalamus
generalized seizure involves the whole brain - originates in focus and spreads through interconnections between the thalamus and cortex throughout the entire brain
Where do they originate?
Seizures originate from a focus and spreads through fibers
In which order are the brain lobes "epileptogenic"?
temporal lobe - most inclined lobe to have seizures/epilepsy 50%; frontal - 20 %; parietal and occipital 5-6% (RARE); temporal - go along wth religious experiences, seeing god
What is the difference between simple and complex partial seizures?
simple- no alterations in consciousness, symptoms - aura, stereotypical motions, tonic, intensive mood experiences (depends where in brain it is)
complex- altered awareness and sensory or motor symptoms
What is a secondarily generalized seizure and what is the "Jacksonian march"?
(a) secondarily generalized seizure - usually partial seizures evolving into generalized seizures, most often with tonic-clonic convulsions. The partial seizures, which were once, limited to one hemisphere of the brain, progress to encompass the entire brain bilaterally
(b) "Jacksonian" march - characteristic features are 1) only occurs on one side of the body and 2) progresses in a predictable pattern from twitching or a tingling sensation or weakness in a finger, a big toe or the corner of the mouth, then marches over a few seconds to the tire hand, foot or facial muscles
What are the stages of an epileptic attack?
(a) aura- involves alterations in smell, taste, visual, hearing and emotional state
(b) seizure- also known as ictus
(c) postictal- drowsiness and confusion, period when the brain recovers from the seizure
What modalities can the aura be associated with?
alterations in smell, taste, visual, hearing and emotional state
What does tonic, cling, atonic, and myotonic mean?
(a) tonic- muscle stiffness, rigidity, high tension in muscles, no contractions
(b) clonic- repetitive jerking movements, muscle convulsions; tonic-clonic - characterized by successive phases of tonic and clonic spasm, mix of jerking ad high tension in muscles
(c) myoclonic- sporadic (isolated) jerking movements, temporary rigidity of one or more muscles, prolonged contraction
(d) atonic - loss of muscle tension, you just call down (seen in narcolepsy and fainting)
Why is the diagnosis 'epilepsy' a lengthy process to establish?
it takes so long to diagnose because you have to rule out any other possible disorders that could be held responsible; determine what type of seizure disorder, decide on therapy
What times of therapy were mentioned for epilepsy in class?
medication- controls about 35% of complex partial seizures, 40% of petit mal, and 50% of tonic clonic; low carb/ketogenic diet- switched to low carb diets for kids with epilepsy; surgery- to remove the affected parts of the brain
How many layers can most parts of the cortex be divided into? What are thought to be the functions of these layers?
6 layers; 1-3 - info gets integrated to different areas around the cortex; 4 - input layer, receives info; 5-6 - output, sends info
What is Brodmann's division of the cortex into separate areas based on (i.e. why did he say these areas were different?)
Brodmann's map which is based on organization, structure and distribution of cortical cells (cytoarchitectonic map); he made distinctions on how cells looked look and how they looked together
What are three parts of all sensory systems?
sensory receptors. neural pathways, central representations in the neocortex/ parts of brain involved in sensory perception
Explain what it means that receptors only respond to a range of stimuli.
responsible to only a narrow band of energy and some only to a certain shaped molecule
What is transaction when you are talking about receptors? What is the "common language" that stimuli gets transducer to?
receptors transduce/convert energy into action potentials
Explain how receptors locate events, detect change and constancy and help to distinguish internal from external stimuli.
receptive fields locate sensory events; receptors allow identification of change and constancy (rapid/slowly adapting receptors); receptors allow distinction between self and other (exteroceptive/interoceptive receptors); receptor density determines sensitivity OR; locate events with receptive fields; determine external vs. internal stimulus with their exteroceptive and interoceptive receptors
How does receptor density determine the sensitivity?
the more receptors you have, the denser in any given areas, the Bettie you can feel/sense (greater the sensitivity)
Explain how stimulation of other types of receptors around a pain receptor can make pain appear less, and how this is an example of an interaction among different sense at the relay level
this is known as message modification, it allows you to block pain signals by interfering/overwhelming pain receptors (I.e. rubbing toe activates the fine touch and pressure receptors around the injury which blocks the pain signal from ascending at the neural relay
What does it mean that sensory systems have multiple representations in the brain?
systems process a large range of spatiotemporal stimuli; the sensory info is coded and is represented in other places in the brain in some form (usually for vision, but also for audition and somatosensation)
Explain the functions of cornea, iris, lens, and retina
(a) cornea - outside of the eye, does 80% of the refraction (light bending), refracts the light into the lens and protects eye from dust, etc.
(b) iris - a circular structure sitting over the lens, regulates the entrance of light into the eye; the lens refracts more light than the cornea; it bends light rays to focus on the retina
(c) the retina - receiving part of the eye, all the other parts are there to make sure its job is done properly, contains rods (B/W) and cones (color)
be able to point out the above structures and the sclera
Which structures refract light, in what proportions do they take care of the refraction?
cornea does 80% of the refraction and lens does 20%
Explain what the fovea and the blind spot on the retina are. How is this related to sensitivity of those areas
(a) the fovea is a small, central pit composed of closely packed cones in the eye; it is located in the center of the macula lute of the retina
(b) the fovea is responsible for sharp central vision (also called foveal vision), which is necessary in humans for activities where visual detail is of primary important, such as reading and driving
(c) blind spot on the retina 1) the place in the visual field that corresponds to the lack of light-detecting photoreceptor cells on the optic disk of the retina where optic nerve passes through the optic disc and 2) since there are no cells to detect light on the optic disc, a part of the field of vision is not perceived. the brain interoperates the blind spot based on surrounding detail and information form the other eye, so they blind spot is not normally percived
What are the three cell layers of retina, and how does the light travel to get to the receptor layer?
Light goes through blood vessels, through gbp layers to get back of eye to react with photoreceptors; 1) 1 layer of photoreceptors (rods and cones) these receive light and actually react (photons) 2) 2 bipolar cell layers: connect between ganglion cell layer, sideways integration 3) ganglion cell layer: neurons that become optic nerve and go into the brain 4) the actual receptors are all the way in the back - the light bas to get though a layer of axons, through a layer of cell bodies that go with the axons, then through bipolar cells, before reaching the photoreceptors
Why does this appear counterintuitive (light travel to receptor layer)?
it appears counterintuitive because you would think that light would travel first through the back of the eye
What is the main pathway for vision called, what is its course? What % of fibers go this way?
(a) geniculostriate pathway - MOST IMPORTANT - 90% of axons
(b) axons convey info to lateral geniculate nucleus (LGN) in thalamus
(c) info then relayed (via optic radiations) to striate cortex
What is the tectopulvinar pathway and what is its course?
it plays a role in visual attention - 10% of axons leaving the retina follow the tectopulvinar path, it goes from the eye to the superior colliculus (or midbrain) to pulvinar in thalamus then to visual areas int temporal and parietal lobes
What are the optic nerve, optic chasm, optic tract, LGN, optic radiation, striate cortex, V1?
(a) optic nerve- the nerve that carries neural impulses from the eye to the brain
(b) optic chasm- axons from one eye run together to the optic chasm and crossover
(c) optic tract- extension of optic nerve, runs info from optic chasm to LGN
(d) LGN- receives info directly from the ritual ganglion cells via the optic tract
(e) optic radiation- axons from relay neurons in the LGN of the thalamus carrying visual info to the primary visual cortex or striate cortex of V1 along the calcimine fissure
(f) striate cortex: processes visual info, located in the back of the brain
(g) V1- primary visual cortex
Which parts of the thalamus take part in the geniculostriate pathway and which in the tectopulvinar pathway?
the geniculostriate pathway includes axons, LGN, optic radiations, and the striate cortex; the tectopulvinar pathway includes the eye, superior colliculus, pulvinar, and temporal and parietal lobes
What is the visual field? Explain the overlap between the visual fields of the R and L eyes.
VF: all points of physical environment perceived by a stable eye at a given moment; visual fields of both eyes overlap extensively in the central portion of each visual hemifield resulting in binocular vision
Explain which fibers from the two "hemifields" or "hemiretinas" or halves of the retina go where before/after the optic chiasm. Which hemifield is nasal and which is temporal?
(a) nasal hemifield/retina: closer to the nose, or "contralateral" (this it the middle of the visual field) the vision from both eyes cross!
(b) temporal hemiretina/field: left of the left eye, right to he right eye, ipsilateral (this is the far side of the visual field)
(c) after reaching the optic chasm, the visual field of the left eye goes to the right part of the primary visual cortex, and the visual field of the right eye goes to the left part of the primary visual cortex
What do "ipsilateral" and "contralateral" mean?
ipsilateral - on the same side; contralateral - on the other side; so vision is contralateral
What are the striate, extra striate, primary, secondary, tertiary visual cortices?
(a) the primary cortex is the striate cortex, it is part of the occipital cortex that receives the fibers of the optic radiation from the lateral geniculate body, and it is the primary receptive area for vision
(b) extra striate cortex is the location of mid-level vision, it is next to the striate cortex and is known as the secondary cortex (sensitive to motion and humans)
(c) tertiary cortices are the inferior temporal and posterior parietal cortex
What are the dorsal & ventral visual stream?
the dorsal stream is the "where" pathway, it helps recognize where objects are in space, it contains a detailed map of the visual field and is also good at detecting and analyzing movements, deals with actions, terminates in the parietal lobe
the ventral visual system is the "what" stream, it travels to the temporal lobe and is involved in object identification, recognition, it helps form object representation
What is the function of ventral & dorsal streams? Which one is 'where/vision for action' and which one is 'what' or 'vision for identification"?
dorsal - vision for action; so you won't trip, acting in space; anterior intraparietal sulcus- object directed grasping
ventral - meant for identification, what is the object?; fusiform face area (face analysis), fusiform body area, parahippocampal place area
What is processed in MT (V5) and V4?
MT/middle temporal (V5)- motion; 905 of the neurons in MT have preference for direction; V4 - does color analysis
What does it mean that the representation in V1 (BA 17) is retinotopic?
V1 has a retinotopic representation meaning each point on the retina is represented by a point on V1 corresponding to a receptor cell; receptors are spread out over the retina, not every area of the retina has the same amount of representation here; retinotopic- the places on the retina where info falls spatially is represented as such- what is next to each other stays next to each other; representation- each part of the retina is presented by small areas on cortex corresponding to number of ganglion cells coming from there; real estate focusing on what you are looking at, what falls on your fovea (it is what is important to you as an organism); maintains spatial relationship of what is lying next to what on retina, is distorted in amount of space- note everything gets equal space, what falls on important part gets more space
What is a scotoma? Know what the effect for the visual field is of lesions along the optic tract.
Scotoma: parts of visual field mission
Lesions in left optic tract causes right sided homonymous hemianopia and vice versa
Hemianopia: blindness in one side of visual field
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