10 - neurological assessment Flashcards
what is neuropsychology?
the study of relationships between the brain and the mind
what does clinical neuropsychology involve?
evaluation (assessment), rehabilitation, treatment of cognitive and neuro-behavioural deficits
what is a neuropsychological assessment?
assessing OBJECTIVELY cognitive function and mental status
who undergoes a neuropsychological assessment?
- children who are not achieving appropriate developmental milestones
- stroke victims
- patients with head injuries
what 3 levels does a full neurological assessment involve?
- basic neurological examination (EEG, GCS). only if applicable
- interviews, history taking (personal factors, social skills, mood)
- assessment of cognitive functions using standardised measures
describe the broad range of things tested in a neurological assessment
- attention and concentration
- verbal intellectual skills
- visuospatial/non-verbal reasoning and problem solving
- working memory and mental flexibility
- auditory memory
- visual memory
- language
- processing speed
- executive function
- mood and anxiety/stress
- test score validity
why conduct a neuropsychological assessment?
- diagnosis/differential diagnosis of disorder/deficits
- identifying treatment needs
- measure changes over time
- identify brain damage
- research
- medico-legal
what can an apparent memory deficit might actually be due to (differential diagnosis)?
- a sensory-perceptual problem
- an attention deficit
- due to anxiety
what cognitive functions are assessed?
- perception
- memory
- language (and speech)
- intellectual ability (higher level cognitive functions — reasoning, problem solving)
what is perception?
our interpretations of what is represented by sensory input
what is memory?
the mental capacity to store and later recall or recognised events that were previously experienced
what does perception involve?
- sensory development and sensory integration
- auditory and visual processing
- visio-spatial functioning
what techniques involve assessing perception?
- object recognition, sound recognition/localisation
- block design
what types of memory are assessed?
- visual and auditory memory
- verbal memory — vocab and declarative knowledge (info we have acquired over time)
- working memory (has limited capacity — needs attention or active work with the information for it to be retained - therefore attention also assessed)
what is crystallised knowledge part of?
verbal memory — info we have acquired over time
what is working memory also known as?
mental work bench — hold info in storage for a brief period of time for further processing
what techniques are used to assess memory?
- digit span tests (working memory)
- visual reproductions (impaired recent memory, visual learning)
- delayed recall tests (auditory and visual declarative memory)
what is assessed in language?
- verbal knowledge/comprehension (inc decoding speech, sound detecting, semantic processing)
- reading skills
- fluency
what techniques can be used to assess language?
- vocabulary knowledge tests (crystallised verbal knowledge)
- reading comprehension tasks (receptive language) (patients have to follow instructions which get increasingly complicated)
- naming tests and letter fluency tasks (expressive language) (eg. Boston naming test)
what is tested in assessing intellectual ability?
- attention and concentration
- processing speed (mental and psychomotor speed)
- abstract/verbal reasoning
- executive functioning (planning, organisation, decision making => prefrontal cortical regions)
what techniques are used to assess intellectual ability?
- card sorting task (attention, executive functioning)
- digit symbol task (mental processing, psychomotor speed)
- WAIS-IV (Wechsler Adult Intelligence Scale) (executive functioning)
name an example of a card sorting task assessing attention and executive functioning
Wisconsin card sorting test
describe the complex figure of rey
subject is asked to reproduce a complicated line drawing, copy, reproduce 10/15 minutes later as accurately as possible
what is the objective of Complex Figure of Rey and what is assessed?
objective : to asses visual-spatial constructional ability and visual memory
assessment of several cognitive processes:
- planning
- perceptual functions
- motor functions
- attention
- working memory
what is Korsakoff syndrome?
- chronic memory disorder
- caused by a severe vitamin B1 deficiency (thiamine def)
- often caused by alcohol misuse
what do these 3 have wrong with them?
what is the Trail Making Test (TMT) a measure of?
measure of attention, speed and mental flexibility
describe the stroop test
what is the stroop test a measure of?
cognitive control
interference of an automatic process (reading) with a more effort-demanding task (naming colours) — requires response inhibiton —this is a difficulty task
affected by age
describe picture completion task
how is standardised testing relevant?
