9.3 (clinical) - Examination of higher function

Question 1

What function does the frontal lobe has and how do you test it?

Answer 1

Controls behaviour, inhibition and motivation 
frontal reflexes: pout, snout, grasp 
Proverb interpretation 
Comparison 
Sequences

Question 2

What function does the temporal lobe have and how do you test it?

Answer 2

Memory, emotion, language (dominant hemisphere only), olfaction and hearing
Memory: immediate recall, short term, long term
Lanugage

Question 3

What deficits will people with parietal lobe damage have?

Answer 3

Defects in sensation, sensory inattention, visual inattention, constructural apraxia

Question 4

What is apraxia?

Answer 4

Neurological disorder characterised by the loss of the ability to execute or carry out learned (familiar) movements, despite having the desire and physical ability to carry out the task

Question 5

What is agnosia?

Answer 5

Loss of the ability to recognise objects, persons, sounds, shapes or smells while the specific area is not defective nor is there any significant memory loss

Question 6

How do you test parietal lobe function?

Answer 6

Sensation 
Neglect 
Construction (pentagon) 
Acalculia (serial 7's) 
L-R disorientation 
Finger agnosia 
Agraphia

Question 7

What are the advantages and disadvantages of the MMSE?

Answer 7

Ad: well standardised, easy, good inter-rater reliability, good for progress monitoring

Dis: education dependent, dependent on age, language, crude, normal in R hemisphere and frontal lobe lesions, does not distinguish focal and diffuse lesions, acute confusion and cultural background

Question 8

What do you include in a bedside language examination?

Answer 8

Spontaneous speech 
Naming 
Auditory comprehension 
Repetition (no ifs and or buts) 
Reading 
Writing

Question 9

What are the features of broca’s aphasia and what are the associated signs?

Answer 9

non fluent spontaneous speech 
Naming impaired 
Comprehension intact 
Repetition impaired 
Reading may be impaired 
Writing impaired 

Associated signs: right hemiparesis and hemisensory loss

Question 10

What are the features of Wernicke’s aphasia and what are the associated signs?

Answer 10

fluent spontaneous speech 
Naming impaired (bizarre misnaming) 
Comprehension impaired 
Repetition impaired 
Reading impaired 
Writing well formed paragraphic 

Associated: +/- hemianopia