Cultural Competency

Understanding Neuroanatomy

Badge Program Learning Module #2

What is the Central Nervous System?

The Central Nervous System (CNS) is composed of the brain and spinal cord.

The Brain

Let's break down the brain, its key structures, and how it communicates.

Source: Innerbody (n.d.).

What helps to protect the brain?

Cerebrospinal fluid (CSF) is responsible for protecting the brain and spinal cord. It serves as a shock absorber, providing a cushion for the brain. CSF also contributes to buoyancy of the brain; in turn, reducing the brain’s “weight” and preventing compression of blood vessels and nerve tissue. On a pathophysiological level, CSF assists in clearing metabolic waste. (Margetis and Baker, 2025).

Source: Cleveland Clinic (2025)

What helps to protect the brain?

The blood brain barrier (BBB) serves as a regulator on ions, molecules, and cells between the blood and brain. It allows nutrients such as oxygen and glucose to pass, while blocking out harmful substances like toxins, pathogens, and disease. The BBB contributes to CNS homeostasis for proper neuronal function. Weakening of the blood brain barrier can result in: ion dysregulation, altered homeostasis, neuronal dysfunction or degeneration (such as progression of neurological or neurodegenerative diseases) (Daneman and Prat, 2015).

Meninges

The brain is covered by three protective membranes called meninges.

• Dura mater: tough outer layer composed of fibrous connective tissue
• Arachnoid: middle layer, resembles a spider web
• Pia mater: thin, delicate layer on the brain’s surface

In between the arachnoid layer and pia mater is the sub arachnoid space, where CSF flows through. (National Cancer Institute, n.d.)

Source: Cleveland Clinic (2021)

Communication within the brain

Understanding neurons and their role in communication

Neurons

A neuron is a specialized cell that transmitted nerve impulsives. It is responsible for communication in the brain and composed of three parts:

• Cell body (soma): controls the cell’s activities
• Axon: the “transmitter”; long, thin structure where action potentials travel in prep for the release of a neurotransmitter
• Dendrites: the “receiver” of the neuron; receives input from the axons

(Woodruff, n.d) via the Queensland Brain Institute

cell body (soma)

axon

oligodendrocyte

cell membrane

dendrites

axon hillock

node of Ranvier

myelin sheath

axon terminal

synaptic end bulbs

Source: Healthline (2018)Noted to be illustrated by Sophia Smith

(BIAA, 2019)

The Process of Neural Communication

Post-Synaptic Binding

Synaptic Transmission

Vesicular Release

Electrochemical Initation

The neurotransmitters bind to specialized receptors on the receiving (post-synaptic) membrane. This interaction converts the chemical message back into an electrical signal or a specific cellular reaction.

These neurotransmitters are released into the synaptic cleft, the microscopic space between the axon of the sending neuron and the dendrites of the receiving neuron.

When the impulse reaches the presynaptic terminal, it triggers synaptic vesicles (storage sacs) to release chemical messengers called neurotransmitters.

Communication begins when a neuron is stimulated, generating an electrical impulse known as an action potential. This signal originates in the cell body and travels the length of the axon.

Watch this video to learn more!

Source: Interactive Biology (2011)

Source: Lumen Learning (n.d.)

How does this relate to brain injury?

Individuals with brain injuries may sustain damage along these neural pathways, which can delay or even entirely prevent communication between affected neurons and brain regions. For instance, as discussed regarding diffuse axonal injuries (DAI), mechanical shearing forces can stretch or tear the axons. When the structural integrity of the axon is compromised, the action potential cannot effectively propagate. This disruption prevents the transmission of impulses, ultimately leading to a functional disconnect between neurons and the areas of the brain they support.

Neuroprotection and Neuroplasticity

What is the difference and their role in functional recovery

Neuroprotection

Neuroprotection is defined as the strategies and mechanisms utilized to “prevent neuronal degeneration and loss of function” (Whitcup, 2008) Currently approved neuroprotective therapy for treatment of TBI is in the works. The only approved neuroprotective therapy at this time includes tissue plasminogen activator (tPA).

Click here to learn more about TPA

Neuroplasticity

According to Puderbaugh and Emmady (2023), neuroplasticity is "the ability of the nervous system to change its activity in response to intrinsic or extrinsic stimuli by reorganizing its structure, functions, or connections after injuries". Effort-dependent learning drives neuroplasticity, as repeated, challenging practice reshapes the brain’s neural pathways (BIAA, 2019) Ex: A stroke patient practicing grasp-and-release exercises repeatedly (effort-dependent) strengthens synaptic pathways in the motor cortex (neuroplasticity), improving hand function.

Merzenich's Study

A study conducted by Merzenich and his colleagues (1983) paved the way for future research studies.

• Performed surgical finger amputation on adult monkeys
• Found the cortical representations of adjacent digits and palmar surfaces expanded over the area previously represented by the amputated finger

• Suggested that through injury, the brain can repair through axonal sprouting and synaptogenesis (BIAA, 2019)

Cellular Processes Following Traumatic Brain Injury

As discussed in Module #1, alongside the initial/primary injury, an individual may sustain secondary injuries on a pathophysiological level. The following are some processes that may occur:

• Excitotoxicity: Excess glutamate release leads to sodium/calcium overload and neuronal injury

• Edema: Blood–brain barrier disruption causes increased swelling/intracranial pressure and reduced cerebral perfusion

• Oxidative stress: Increased free radicals damage cell membranes, proteins, and DNA

• Apoptosis: Delayed, programmed neuronal cell death occurs days to weeks post-injury

(BIAA, 2019)

Addressing Neuroplasticity through CIMT

One neurorehabilitative method to address neuroplasticity includes constraint induced movement therapy (CIMT). Though primarily used for treatment of stroke, it is known to be beneficial for the treatment of TBIs as well.

• Goal is to improve functional use of affected extremity where an individual engages in mass practice of an activity while the “strong” limb is restrained
• Encourages use of the affected extremity to improve overall motor function
• Noted on transcranial magnetic stimulation to increase the size of the ipsilateral motor cortex, alongside increased activation of the sensorimotor network

(Physiopedia, n.d.)

Brain and Spinal Cord Anatomy

Major Subdivisions of the Brain

• Cerebral Cortex (cerebrum)
• Diencephalon
• Brainstem
• Midbrain
• Pons
• Medullla
• Cerebellum

Source: Garris (2003)

Cerebral Cortex

• Divided into right and left hemisphere
• Five lobes: frontal, parietal, temporal, occipital, insular
• Has gray matter and white matter carrying information throughout the brain
• Each hemisphere controls the opposite side of the body (e.g. damage to the right hemisphere would result in challenges with the left side of the body)
• Left side typically associated with logic and language
• Right side typically associated with spatial ability and holistic processing

Source: Mayo Clinic (n.d.)

Frontal Lobe

• Located at the front of the brain
• Involved in motor planning and execution, executive functioning (including emotional regulation, planning, problem solving), behavioral inhibition

• Contains the primary motor cortex and prefrontal cortex
• Primary motor cortex: initiation and control of voluntary movements
• Prefrontal cortex: higher-order cognitive processing (i.e. problem solving, decision making, working memory, complex behavioral responses)

Source: Labster Theory pages (n.d.)

(Maldonado and Alsayouri, 2023)

Parietal Lobe

• Located behind the frontal lobe
• Interpretation of sensory information, such as vision, hearing, and motor
• Contains the primary sensory cortex (aka the somatosensory cortex)
• Involved in processing information related to touch, pain, temperature, pressure, and proprioception

Source: Labster Theory pages (n.d.)

(Maldonado and Alsayouri, 2023)

Hemi-spatial neglect

• Commonly correlated with damage to posterior parietal cortex
• Individual demonstrates loss of awareness to one’s side of the body (often left sided neglect)
• Tend to not notice or attend to stimuli on their affected side despite intact vision
• Impacts safety and functional ADL performance, where someone may frequently bump into objects on their affected side, groom only one side, and eat food on one side of the plate

Source: Flint Rehab (2021)

Source: Tactus Therapy (n.d.)

Temporal

• Located on the sides of the brain
• Processing sensory information, involved with language, memory, auditory processing

Source: Flint Rehab (2025)

(Maldonado and Alsayouri, 2023)

Occipital

• Interpretation of visual information, visual recognition
• Contains the visual cortex

Source: Flint Rehab (2022)

(Maldonado and Alsayouri, 2023)

Diencephalon

• Thalamus (Cleveland Clinic, 2022)
• “sensory relay station”
• Relays information from all senses (with the exception of smell) to its respective area within the cerebral cortex

• Hypothalamus (Cleveland Clinic, 2022)
• Maintain homeostasis
• Serves as control center for higher-level complex autonomic functions (hunger, thirst, mood, sexual response, body temperature)
• Communicates with pituitary gland to manage the release of body hormones

Source: Lumen Learning (n.d.)

Limbic System

The limbic system is responsible for emotional and behavioral responses. It is composed of two structures: the hippocampus and amygdala Hippocampus: involved in the storage and retrieval of memory Amygdala: involved in emotional processing, such as fight or flight responses and association of memories with emotional experiences (BIAA, 2019)

Source: Cleveland Clinic (2023)

Basal Ganglia

The basal ganglia functions as a “motor refiner”. It helps control conscious movements, inhibiting “unwanted” information from the motor cortex to produce purposeful movement (Young et al., 2023)

Source:KenHub (2023)

Brainstem

Medulla (National Ataxia Foundation, n.d.)

• Responsible for autonomic (involuntary) functions
• Think breathing, blood pressure, digestion, body temperature
• Damage can be life threatening

Pons (BIAA, 2019)

• Serves as a connector, transmitting information between the cerebrum and cerebellum
• Plays a role in control of facial and eye movements, facial sensation, and hearing
• Damage can result in motor dysfunction and paralysis

Brainstem

Midbrain (Physiopedia, n.d.)

• Contributes to processing visual and auditory signals and relaying this information between the brain and spinal cord
• Involved in motor control/reflexes as well as consciousness

Source: Cleveland Clinic (2024)

The Reticular Activating System (RAS)

Located within the brainstem, the RAS is responsible for various functions including:

• Arousal
• Ability to pay attention
• Ability to focus/concentrate
• Modulation of sleep/wake cycles
• Regulating muscle tone, such as in fight or flight responses

After a brain injury, an individual may lose consciousness (e.g. coma). Severity of injury or swelling can impact the reticular activating system. Examples: unaware of their surroundings, unable to respond to simple commands

Source: Integrated Listening Systems (2015)

(Arguinchona and Tadi, 2023)

Cerebellum

• Located in the lower back portion of the brain between the brainstem and cerebral cortex
• Cerebellum = coordination
• The cerebellum helps the body with overall motor coordination and balance (e.g. gait, posture, tone)
• Assists with motor learning, ensuring both precision and timing of movements

(Jimsheleishvili and Dididze, 2023)

Source: howstuffworks (n.d.)

Broca's Area vs Wernicke's Area

Broca’s area

• Located in left frontal-temporal lobe
• Language/speech production

Damage to the Broca’s area can result

• Broca’s aphasia (also known expressive aphasia) where an individual has challenges producing fluent speech
• Can appear slow, labored or “telegraphic”

(Acharya and Wroten, 2023)

Broca's Area vs Wernicke's Area

Wernicke’s area

• Located in left temporal-parietal lobe
• Language comprehension and processing

Damage to the Wernicke’s area can result in

• Wernicke’s aphasia (also known as receptive aphasia) where an individual produces fluent speech, however the content is nonsensical (like a “word salad”)
• Impaired understanding of spoken language

(Lui and Wroten, 2025)

Source: Jack Westin, (n.d.)

Spine and Spinal Cord

Purpose: to protect the spinal cord and nerves (e.g. shearing, blunt trauma), support the weight of the body Total of 33 vertebrae

• 7 cervical
• 12 thoracic
• 5 lumbar
• 5 sacral (fused to form the sacrum)
• 4 coccygeal (fused to form the coccyx)

Source:: Dr. David Oehme (n.d.)

Cervical

• Topmost section of the spine
• C1 (Atlas): supports the skull; enables "up and down" (nodding) motion via the atlanto-occipital joint.
• C2 (Axis): features the dens (a bony pivot); enables "side to side" (rotation) motion via the atlanto-axial joint.

(Physiopedia, n.d.)

Source: Musculoskeletal Key (n.d.)

Thoracic

• Have ribs that articulate at costo-vertebral junctions that allow for expansion and contraction of chest cavity during respiration (BIAA, 2019)

Source: BraceAbility (2014)

Lumbar

• Designed for heavy weight-bearing and structural support
• Spinal cord ends at the conus medullaris, typically tucked between L1 and L2
• Vertically aligned facets prevent slipping and ensure joint stability.
• Features transverse processes (side projections) and posterior spinous processes (rear projections) for muscle attachment

Structural Variations

• Sacralization: L5 fuses to the sacrum (one "less" disc).
• Lumbarization: The sacrum creates an extra mobile segment (one "extra" disc).

Source: The Skeletal System (2022)

(BIAA, 2019)

Sacrum and Coccyx

Sacrum (BIAA, 2019)

• Articulates with the ilia (hip bones) to form the pelvic girdle
• Cauda equina (bundle of nerves roots at end of spinal cord) begin in lumbar and continues through sacral region
• Has sacral foramina where nerves pass through to innervate the lower extremities

Coccyx (Hartline, 2025)

• Remnant of ancestral species
• Minimal function but serves as attachment for muscles, tendons, and ligaments

Source: A.D.A.M (2025)

Spinal Cord

Structurally, the spinal cord exits through a large opening called the foramen magnum at the base of the skull. Information is sent and received through nerve tracts. Nerve Tracts can be afferent or efferent.

• Afferent: ascending tracts that send information to the brain.

• Efferent: descending tracts that receive signals from the brain.

Nerves exit at every vertebral level to facilitate body-wide communication. Unlike the brain, the spinal cord also has gray matter along the inside and white matter on the outside.

(BIAA, 2019)

Spinal Cord

Similar to the brain, the spinal cord has meninges: Dura mater (outer), Arachnoid mater (middle), and Pia mater (inner). Cerebrospinal Fluid (CSF):

• Produced by the choroid plexus

• Exits ventricles via the foramen of Magendie

• Circulates in the subarachnoid space to cushion the cord

(BIAA, 2019)

Source: Bitanihirwe et al. (2022)

Spinal Cord

On a vascular level, both arteries and veins provide the necessary nutrients and oxygen to, drain waste products away from the spinal cord. One important artery, known as the anterior spinal artery, which like it's name suggests runs anterior to the spinal cord, supplying 2/3rds of the spinal cord. There are also two smaller arteries located posteriorly which supply the remaining 1/3rd. (BIAA, 2019)

Ligaments of the Spine

Anterior longitudinal ligament: runs along the front of the vertebral bodes; limits extension Posterior longitudinal ligament: runs along the back side of the vertebral bodies; limits flexion Ligamentum flavum: strongest; forms the posterior surface of the vertebral canal Together these ligaments provide spinal stability. (Ocran, 2023)

Source: Colorado Comprehensive Spine Institute (2016)

Spinal Cord Syndromes

Central Cord: frequently associated with cervical hyperextension injury or arthritic changes by spinal canal narrowing Below level of injury presents as:

• Presents with weakness and numbness greater in the hands and arms rather than legs, and bowel and bladder dysfunction

Brown-Sequard: one side of cord is damaged, such as from a stabbing or gunshot wound Below level of injury presents as:

• Ipsilateral (same) side: loss of motor and proprioception
• Contralateral (opposite) side: loss of pain and temperature sensation

(Bashar and Hughes, 2018)

Source: Christopher & Dana Reeve Foundation Booklet (2022)

Source: Christopher & Dana Reeve Foundation Booklet (2022)

Spinal Cord Syndromes

Anterior Cord: typically result of damage to anterior spinal artery or anterior aspect of spinal cord Below level of injury presents as:

• Loss of pain and temperature sensation
• Loss of motor control

Posterior Cord: typically associated with intraoperative complications with spinal surgery Below level of injury presents as:

• Loss of proprioception

(Bashar and Hughes, 2018)

For more information, check out this great informative booklet regarding spinal cord syndromes here.

Source: Christopher & Dana Reeve Foundation Booklet (2022)

Neuroimaging

Differentiate between common types of imaging (CT vs MRI)

Computed Tomography

Magnetic Resonance Imaging

• Commonly referred as CT scan
• Utilizes x-ray technology to create cross-sectional images
• Slices come together as a 3D image
• Can be safer for individuals who have devices such as pacemakers or metal implants (Mayo Clinic, 2025)
• Typically the first test done after a head injury or suspected stroke (Mayo Clinic, 2025)

• Commonly referred as MRI
• Uses magnets to produce an alignment of protons in the body. With radiofrequency pulses, the protons are knocked out of alignment. As the protons begin to realign, they give off radio signals to then produce an image.
• Highly detailed and sensitive
• Does not utilize radiation

(National Institute of Biomedical Imaging and Bioengineering, n.d.)

Did you also know that there is a specific type of MRI called the fMRI? This type is able to identify blood flow passing through specific brain areas and analyze brain activity during specific tasks (e.g. tapping your fingers, word games) An fMRI is a procedure that may be used to inform considerations for brain surgery. (Mayo Clinic, 2023)

Source: Clover Learning (2024)

Diffusion Tensor Imaging (DTI)

• Specialized type of MRI that analyzes the brain’s white matter
• Analyzes the movement of water along axonal tracts by measuring the rate and direction of water molecule diffusion
• High, organised diffusion is indicative of healthy, intact neural pathways
• Provides a clear map of neural circuits to identify specific areas of axonal damage or degeneration

Source: Psychology Today (2021)

(UC San Diego Health, 2025)

Time to test what you've learned on the Module #2 knowledge check.

References

Acharya, A. B., & Wroten, M. (2023, February 13). Broca aphasia. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK436010/ Arguinchona, J. H., & Tadi, P. (2023, July 24). Neuroanatomy, reticular activating system. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK549835/ Brain Injury Association of America. (2019). The essential brain injury guide (Edition 5.0 rev.). Bashar, J., & Adler Hughes, C. (2018). Spinal cord injury. In H. M. Pendleton & W. Schultz-Krohn (Eds.), Pedretti's occupational therapy: Practice skills for physical dysfunction (8th ed., pp. 907). Elsevier. Cleveland Clinic. (2022, March 16). Hypothalamus. https://my.clevelandclinic.org/health/body/22566-hypothalamus Cleveland Clinic. (2022, March 21). Thalamus. https://my.clevelandclinic.org/health/body/22652-thalamus Daneman, R., & Prat, A. (2015). The blood–brain barrier. Cold Spring Harbor Perspectives in Biology, 7(1), a020412. https://doi.org/10.1101/cshperspect.a020412 Hartline, J. (2025). 8.5.6: Sacrum and coccyx. Biology LibreTexts. https://bio.libretexts.org/Courses/West_Hills_College_-Lemoore/Human_Anatomy_Laboratory_Manual(Hartline)/08%3A_Axial_Skeleton/8.05%3A_Vertebral_Column/8.5.06%3A_Sacrum_and_Coccyx Jimsheleishvili, S., & Dididze, M. (2023, July 24). Neuroanatomy, cerebellum. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK538167/ Lui, F., & Wroten, M. (2025, November 8). Wernicke aphasia. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK441951/

References

Maldonado, K. A., & Alsayouri, K. (2023, March 17). Physiology, brain. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK551718/ Margetis, K., & Baker, S. (2025). Physiology, cerebral spinal fluid. In StatPearls. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK519007/ Mayo Clinic. (2023, September 9). MRI. https://www.mayoclinic.org/tests-procedures/mri/about/pac-20384768 Mayo Clinic. (2025, August 26). Brain CT scan. https://www.mayoclinic.org/tests-procedures/brain-ct-scan/about/pac-20587837 Merzenich, M. M., Kaas, J. H., Wall, J., Nelson, R. J., Sur, M., & Felleman, D. J. (1983). Topographic reorganization of somatosensory cortical areas 3b and 1 in adult monkeys following restricted deafferentation. Journal of Comparative Neurology, 224(4), 591–605. https://doi.org/10.1002/cne.902240408 National Ataxia Foundation. (n.d.). Snapshot: What is the medulla oblongata? https://www.ataxia.org/scasourceposts/snapshot-what-is-the-medulla-oblongata/ National Cancer Institute. (n.d.). Meninges. SEER Training Modules. https://training.seer.cancer.gov/brain/tumors/anatomy/meninges.html National Institute of Biomedical Imaging and Bioengineering. (n.d.). Magnetic resonance imaging (MRI). National Institutes of Health. https://www.nibib.nih.gov/science-education/science-topics/magnetic-resonance-imaging-mri National Institute of Neurological Disorders and Stroke. (2024, December 3). Tissue plasminogen activator for acute ischemic stroke (Alteplase, Activase®). U.S. Department of Health and Human Services, National Institutes of Health. https://www.ninds.nih.gov/about-ninds/what-we-do/impact/ninds-contributions-approved-therapies/tissue-plasminogen-activator-acute-ischemic-stroke-alteplase-activaser Ocran, E. (2023, October 30). Joints and ligaments of the vertebral column (D. Mytilinaios, Ed.). Kenhub. https://www.kenhub.com/en/library/anatomy/joints-and-ligaments-of-the-vertebral-column

References

Physiopedia. (n.d.). Cervical vertebrae. https://www.physio-pedia.com/Cervical_Vertebrae Physiopedia. (n.d.). Constraint induced movement therapy. https://www.physio-pedia.com/Constraint_Induced_Movement_Therapy Physiopedia. (n.d.). Midbrain. https://www.physio-pedia.com/Midbrain Puderbaugh, M., & Emmady, P. D. (2023, May 1). Neuroplasticity. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK557811/ UC San Diego Health. (2025). Diffusion tensor imaging (DTI). https://neurosciences.ucsd.edu/centers-programs/autism/research/dti.html Whitcup, S. M. (2008). Clinical trials in neuroprotection. Progress in Brain Research, 173, 323–335. https://doi.org/10.1016/S0079-6123(08)01123-0 Woodruff, A. (n.d.). What is a neuron? Queensland Brain Institute, University of Queensland. https://qbi.uq.edu.au/brain/brain-anatomy/what-neuron Young, C. B., Reddy, V., & Sonne, J. (2023, July 24). Neuroanatomy, basal ganglia. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK537141/

Image References

A.D.A.M. (2025, April 1). Sacrum [Illustration]. MedlinePlus. https://medlineplus.gov/ency/imagepages/19464.htm Bitanihirwe, B. K. Y., Lizano, P., & Woo, T.-U. W. (2022). Deconstructing the functional neuroanatomy of the choroid plexus: An ontogenetic perspective for studying neurodevelopmental and neuropsychiatric disorders. Molecular Psychiatry, 27(9), 3573–3582. https://doi.org/10.1038/s41380-022-01623-6 BraceAbility. (2014, July 8). [Anatomy of the thoracic region of the back] [Photograph]. https://www.braceability.com/blogs/articles/thoracic-back-pain-causes-symptoms Christopher & Dana Reeve Foundation & Shepherd Center. (2022). Spinal cord syndrome [Booklet]. https://www.christopherreeve.org/wp-content/uploads/2024/04/Spinal-Syndrome-Booklet.pdf Cleveland Clinic. (2022). Brainstem [Image]. https://my.clevelandclinic.org/health/body/21598-brainstem Cleveland Clinic. (n.d.). Cerebrospinal fluid illustration [Image]. Cleveland Clinic. https://my.clevelandclinic.org/-/scassets/images/org/health/articles/cerebrospinal-fluid.jpg Cleveland Clinic. (2023, June 21). Amygdala [Image]. https://my.clevelandclinic.org/health/body/24894-amygdala Cleveland Clinic. (2021). Meninges illustration [Image]. https://my.clevelandclinic.org/-/scassets/images/org/health/articles/22266-meninges.jpg Oehme, D. (n.d.). Spine & disc anatomy [Image]. Dr. David Oehme Neurosurgeon & Spine Surgeon. https://www.doneurosurgery.com/spine--disc-anatomy.html Flint Rehab. (2025, February 14). Anatomy of the temporal lobe [Image]. https://www.flintrehab.com/temporal-lobe-damage/ Flint Rehab. (2022, September 27). Left neglect after stroke: Causes, symptoms, exercises, & treatment [Image]. https://www.flintrehab.com/left-neglect-stroke/

Image References

Flint Rehab. (2022, October 13). The occipital lobe and its functions [Image]. https://www.flintrehab.com/occipital-lobe-stroke/Garris, P. (2003). Major divisions of the brain [Figure]. The Mind Project. https://mind.ilstu.edu/curriculum/virtual_cocaine_lab/Book1.html Hartline, R. (2025, June 24). Sacrum and coccyx. Biology LibreTexts. https://bio.libretexts.org/Courses/West_Hills_College_-Lemoore/Human_Anatomy_Laboratory_Manual(Hartline)/08%3A_Axial_Skeleton/8.05%3A_Vertebral_Column/8.5.06%3A_Sacrum_and_Coccyx Innerbody. (n.d.). Brain anatomy diagram [Image]. https://innerbody.imgix.net/brain.png Jack Westin. (n.d.). Brain areas that control language and speech [Image]. https://jackwestin.com/resources/mcat-content/language/brain-areas-that-control-language-and-speech Integrated Listening Systems. (2015, April 24). Meet the reticular activating system (RAS)! [Image]. https://integratedlistening.com/blog/meet-the-reticular-activating-system-ras Kenhub. (2023). Basal ganglia [mage]. https://www.kenhub.com/en/library/anatomy/basal-ganglia Labster. (n.d.). Frontal lobe [Image]. https://theory.labster.com/frontal-lobe/ Labster. (n.d.). Parietal lobe [Image]. https://theory.labster.com/parietal-lobe/

Image References

Lumen Learning. (n.d.). Communication between neurons (synapse diagram) [Image]. In Anatomy and Physiology. Retrieved February 5, 2026, from https://courses.lumenlearning.com/suny-dutchess-anatomy-physiology/chapter/communication-between-neurons/ Lumen Learning. (n.d.). The diencephalon: Thalamus, hypothalamus, and epithalamus [Image]. https://courses.lumenlearning.com/suny-dutchess-anatomy-physiology/chapter/the-diencephalon-thalamus-hypothalamus-epithalamus/ Mary Free Bed Rehabilitation Hospital. (2015, December 17). Patient benefits from new program at Mary Free Bed [Video]. YouTube. https://www.youtube.com/watch?v=5Ez7LNTLuL8 Mayo Clinic. (n.d.). Brain hemispheres [Image]. https://www.mayoclinic.org/tests-procedures/epilepsy-surgery/multimedia/brain-hemispheres/img-20008029 Musculoskeletal Key. (n.d.). Anatomy of the cervical spine [Image]. https://musculoskeletalkey.com/anatomy-of-the-cervical-spine/ Ocran, E. (2023, October 30). Joints and ligaments of the vertebral column. Kenhub. https://www.kenhub.com/en/library/anatomy/joints-and-ligaments-of-the-vertebral-column Physiopedia. (n.d.). Cervical vertebrae. Retrieved February 7, 2026, from https://www.physio-pedia.com/Cervical_Vertebrae Psychology Today. (2021, February 2). Why white matter matters: Diffusion tensor imaging. https://www.psychologytoday.com/us/blog/the-neurobehavioral-edit/202102/why-white-matter-matters-diffusion-tensor-imaging Tactus Therapy. (n.d.). Left neglect after stroke – definition & treatment exercises [Image]. https://tactustherapy.com/what-is-left-neglect/ The Skeletal System. (2022, May 24). Lumbar vertebrae [Image]. https://www.theskeletalsystem.net/spine-vertebral-column/lumbar-vertebrae.html

Image References

Lumen Learning. (n.d.). Communication between neurons (synapse diagram) [Image]. In Anatomy and Physiology. Retrieved February 5, 2026, from https://courses.lumenlearning.com/suny-dutchess-anatomy-physiology/chapter/communication-between-neurons/ Lumen Learning. (n.d.). The diencephalon: Thalamus, hypothalamus, and epithalamus [Image]. https://courses.lumenlearning.com/suny-dutchess-anatomy-physiology/chapter/the-diencephalon-thalamus-hypothalamus-epithalamus/ Mary Free Bed Rehabilitation Hospital. (2015, December 17). Patient benefits from new program at Mary Free Bed [Video]. YouTube. https://www.youtube.com/watch?v=5Ez7LNTLuL8 Mayo Clinic. (n.d.). Brain hemispheres [Image]. https://www.mayoclinic.org/tests-procedures/epilepsy-surgery/multimedia/brain-hemispheres/img-20008029 Musculoskeletal Key. (n.d.). Anatomy of the cervical spine [Image]. https://musculoskeletalkey.com/anatomy-of-the-cervical-spine/ Ocran, E. (2023, October 30). Joints and ligaments of the vertebral column. Kenhub. https://www.kenhub.com/en/library/anatomy/joints-and-ligaments-of-the-vertebral-column Physiopedia. (n.d.). Cervical vertebrae. Retrieved February 7, 2026, from https://www.physio-pedia.com/Cervical_Vertebrae Psychology Today. (2021, February 2). Why white matter matters: Diffusion tensor imaging. https://www.psychologytoday.com/us/blog/the-neurobehavioral-edit/202102/why-white-matter-matters-diffusion-tensor-imaging Tactus Therapy. (n.d.). Left neglect after stroke – definition & treatment exercises [Image]. https://tactustherapy.com/what-is-left-neglect/ The Skeletal System. (2022, May 24). Lumbar vertebrae [Image]. https://www.theskeletalsystem.net/spine-vertebral-column/lumbar-vertebrae.html

Watch this quick video to learn more about neurons. (Neuroscientifically Challenged, 2014)

Tissue Plasminogen Activator

TPA

tPA is known to be a “clot buster”, involved in the breakdown of blood clots and administered up to 3 hours after the stroke occurs. tPA is administered intravenously in the arm, working to dissolve clots and restore blood flow to the brain during an acute ischemic stroke. (National Institure of Neurological Disorders and Stroke, 2024)

This video is a great example of how CIMT is utilized post stroke. The patient, who has a passion for music and building instruments, addresses his RUE deficits through CIMT. (Mary Free Bed Rehabilitation Hospital, 2015)