10 - neurological assessment

Question 1

what is neuropsychology?

Answer 1

the study of relationships between the brain and the mind

Question 2

what does clinical neuropsychology involve?

Answer 2

evaluation (assessment), rehabilitation, treatment of cognitive and neuro-behavioural deficits

Question 3

what is a neuropsychological assessment?

Answer 3

assessing OBJECTIVELY cognitive function and mental status

Question 4

who undergoes a neuropsychological assessment?

Answer 4

• children who are not achieving appropriate developmental milestones
• stroke victims
• patients with head injuries

Question 5

what 3 levels does a full neurological assessment involve?

Answer 5

1. basic neurological examination (EEG, GCS). only if applicable
2. interviews, history taking (personal factors, social skills, mood)
3. assessment of cognitive functions using standardised measures

Question 6

describe the broad range of things tested in a neurological assessment

Answer 6

• 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

Question 7

why conduct a neuropsychological assessment?

Answer 7

• diagnosis/differential diagnosis of disorder/deficits
• identifying treatment needs
• measure changes over time
• identify brain damage
• research
• medico-legal

Question 8

what can an apparent memory deficit might actually be due to (differential diagnosis)?

Answer 8

• a sensory-perceptual problem
• an attention deficit
• due to anxiety

Question 9

what cognitive functions are assessed?

Answer 9

• perception
• memory
• language (and speech)
• intellectual ability (higher level cognitive functions — reasoning, problem solving)

Question 10

what is perception?

Answer 10

our interpretations of what is represented by sensory input

Question 11

what is memory?

Answer 11

the mental capacity to store and later recall or recognised events that were previously experienced

Question 12

what does perception involve?

Answer 12

• sensory development and sensory integration
• auditory and visual processing
• visio-spatial functioning

Question 13

what techniques involve assessing perception?

Answer 13

• object recognition, sound recognition/localisation
• block design

Question 14

what types of memory are assessed?

Answer 14

• 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)

Question 15

what is crystallised knowledge part of?

Answer 15

verbal memory — info we have acquired over time

Question 16

what is working memory also known as?

Answer 16

mental work bench — hold info in storage for a brief period of time for further processing

Question 17

what techniques are used to assess memory?

Answer 17

• digit span tests (working memory)
• visual reproductions (impaired recent memory, visual learning)
• delayed recall tests (auditory and visual declarative memory)

Question 18

what is assessed in language?

Answer 18

• verbal knowledge/comprehension (inc decoding speech, sound detecting, semantic processing)
• reading skills
• fluency

Question 19

what techniques can be used to assess language?

Answer 19

• 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)

Question 20

what is tested in assessing intellectual ability?

Answer 20

• attention and concentration
• processing speed (mental and psychomotor speed)
• abstract/verbal reasoning
• executive functioning (planning, organisation, decision making => prefrontal cortical regions)

Question 21

what techniques are used to assess intellectual ability?

Answer 21

• card sorting task (attention, executive functioning)
• digit symbol task (mental processing, psychomotor speed)
• WAIS-IV (Wechsler Adult Intelligence Scale) (executive functioning)

Question 22

name an example of a card sorting task assessing attention and executive functioning

Answer 22

Wisconsin card sorting test

Question 23

describe the complex figure of rey

Answer 23

subject is asked to reproduce a complicated line drawing, copy, reproduce 10/15 minutes later as accurately as possible

Question 24

what is the objective of Complex Figure of Rey and what is assessed?

Answer 24

objective : to asses visual-spatial constructional ability and visual memory

assessment of several cognitive processes:
- planning
- perceptual functions
- motor functions
- attention
- working memory

Question 25

what is Korsakoff syndrome?

Answer 25

• chronic memory disorder
• caused by a severe vitamin B1 deficiency (thiamine def)
• often caused by alcohol misuse

Question 26

what do these 3 have wrong with them?

Answer 26

Question 27

what is the Trail Making Test (TMT) a measure of?

Answer 27

measure of attention, speed and mental flexibility

Question 28

describe the stroop test

Answer 28

Question 29

what is the stroop test a measure of?

Answer 29

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

Question 30

describe picture completion task

Answer 30

Question 31

how is standardised testing relevant?

Answer 31