APPLIED NEUROSCIENCE Flashcards
LOBAR FUNCTIONS
FRONTAL TESTS
Similarities e.g. categorisation
Lexical fluency e,.g name items bought in supermarket
Luria motor test (fist, palm, edge) - motor planning
Go-no-Go test
cognitive estimates - e.g. how tall average english women
trail making tests
LOBAR FUNCTIONS
Parietal tests
- Copying shapes :
- Identifying fingers e.g part Gerstmans
- Calculation ability
- Graphesthesia
- Stereognosis
- Two point discrimination
- Visual inattention
Frontal lobe lesion
unilateral
bilateral
unilateral
- contralateral spastic hemiplegia
- elevated mood, talkativeness
- frontal suck sign (grasp and suck)
- anosmia
- motor speech disorder with agraphia or aparaxia (L(
- if L- loss of verbal fluency with perservation
bilateral
- bilateral hemiplegia
spastic bulbar palsy
abulia (lack of drive)
- lot of grasping sucking behavriours
gelastic seizure
an epileptic fit of laughter with L pre-frontal seizures
Parietal lobe lesion
unilateral
bilateral
unilateral
- corticosensory syndrome
- mild hemiparesis
- homonmymous hemianopia
- neglect opposite side of exteral space
- Gerstman syndrome (L)
bilateral
- spatial disorientaton
- tactile agnosia
- dressing and constructional aprazis
- balint syndrome
Temporal lobe lesions
unilateral
bilateral
unilateral
- homonymous upper Quadrantopia
- wernekes aphasia
- impairment in visual agnosia
- impairment in auditory verbal learning
- dysnomia
bilateral
- auditory, visual, olfactory and gustatory hallucinations
- dreamy states with uncinate seizues
- emotional and behavioural changes
- distubrance time perception
- apathy
- hypermetamorphosia (compulsion to attend to all visual stimuli
- kluever-bucxy syndrome -
Occipital lobe lesions
unilateral
Bilateral
UNILATERAL
Contralateral congruent homonomyous hemianoopia
elementary unformed hallucinatons
alexia
visual object agnosia
visual illusions
BILATERAL
cortical blindness
anton syndrome - denial corticol blindness
(ANT denying blind drunk)
loss of perception of colour
balint syndrome (parietooccipital) - Ball - football cant stabilise
Wechsler Adult Intelligence Scale
?hold tests
Most widely used intelligence test in clinical practice.
- verbal IQ e.g. digit span, vocab, comprehension
- performance IQ - block design, picture arrangement
- combined or full-scale IQ.
hold tests = resistant to age related decline e..g vocab, picture completion.
Ravens progressive matrix
whats resistant to organic brain damage?
stroop test?
test for IQ independent of education and cultural influences.
Reading = NART - national adult reading test - taps on previous word knowledge before coming ill.
stroop test = measures shifting abilities and response inhibition.
Wisconison Card Sorting Test
cards different colour, form and number + sort into groups
Damage to frontal lobe = struggle
What tests set-shifting (part of executive functioning?
Trail- Making test (TMT-B)
Wisconsin Card Sort test
Hayling test (sentence completion)
Brixton test
The Wechsler Memory Scale-Revised (WMS-R)
most widely used memory test or adults
scale yields memory Quotient (MQ) = corrected for age and approximates WAIS IQ
- low MQ but preserved I is seen in amnesic conditions
Consciousness
Arousal (wakefullness)
Awareness (attentional processing)
Arousal - depends on Ascending Reticular Activating system
thalamocortical connections generate rhythmical bursts of neuronal activity. Arousal is proportional to degree of synchrony achieved in oscillations
Attention - intact right frontal lobe.
Difference between akinetic mutism and vegetative state vs locked in syndrome
akinetic mutism = anterior cingulate damage but with sleep /wake cycles. no spasicity and rigidity.
Vegetative state = isolated actions of ARAS and thalamus but corticol damage + spasicity and rigidity,
locked in syndrome = total aparalysis below 3rd nerve nuclei
Executive function
what ?
location?
Planning, initation, sequencing, coordinating , impulse
Located = dorsolateral frontal lobe
impulse - go-no-go
Visuospatial ability
neglect?
Directed from visual cortex towards temportal or parietal via
1. dorsal - where
2. Ventral - what
neglect - of personal and extrapersonal space - lesion in R hemisphere - inferior parietal
Left side of personal and extrapersonal space is represented only on right parietal lobe, but right personal and extrapersonal space gets bilateral representation.
Hence, a left-sided lesion rarely results in neglect, but right-sided lesion can result in left-sided neglect
Dressing and constructional apraxia
tests of contructional apraxia
Best considered as visuospatial, rather than motor impairment
- copying 3 D shapes, interlocking pentagones (MMSE) or constructing a clock face
Memory
Explicit
Implicit
working memory
Explicit aka declarative - divided into
- Semantic (meanings/ general knowledge)
- episodic (time locked memory)
Implicit aka procedural
- skills and procedures eg car driving
Working memory - retain information for a few seconds (visuospatial sketch pad and phonological loop)
Brain structures involved in memory
- hippocampus L - verbal, R non verbal. + navigational memory eg animals have navigational place code = animals location in space
- amygdala -rate emotional importance of experience
Long term potentiation
Strengthening of the connection between two neurons on repeated communication is called long-term potentiation - LTP. This may be the neuronal basis of memory.
It is mediated by NMDA mediated Ca 2+ entry in glutamate neurons.
Learning increases branching
and synapse formation and may also influence neurogenesis
Pure word blindness (alexia no agraphia):
Can speak normally and comprehend
what is spoken; can write FINE, CANT READ
Infarct to the left posterior cerebral artery
CORPUS CALLOSUM
Face processing
PROSOPAGNOSIA
commonly fusiform gyrus = FUSIFORM = FACE
BALINT SUNDROME
- simultanagnosia (cant comprehend 2 things at once)
- optic ataxia - cant point
- oculomotor apraxia - cant move eyes to target
- ‘balint do’or = football’
Gerstmann syndrome
four primary symptoms:
1. dysgraphia/agraphia,
2. dyscalculia/acalculia
3. finger agnosia
4. left-right disorientation.
occurs with lesions in the dominant
angular and supramarginal gyri (parietal lobe).
Poor prognostic factors with respect to psychiatric morbidity following head injury
- long duration of loss of consciousness - long PTA (post traumatic amnesia)
- elderly
-chronic alcohol use - diffuse brain damage
- new onset seizures
- focal damage to dominant lobe.
Cranial nerves 1 - 6
1 - olfactory -eg anosmia caused by meningioma
2 - optic nerve - lesions cause hemianopia + pupillary light reflex and convergence/ accommodation
3 - Occulomotor nerve - eye muscles
4- trochlear- SO4
5- trigeminal nerve- opthlamic , maxillary and mandibular - cornea; reflex - sensory loss same side face and weakness muscle of mastication.
6- Abducens nerve - LR 6
Cranial nerves 7-12
7- Facial nerve - motor face and eyelid closure impaired (bells palsy)
8 - Vestibulocochlear - balance + hearing
9 - Glossopharyngeal nerve - sensory innervation posterior third tongue
10- Vagus motor supply pharangeal nerves - gag reflex
11- spinal accessory nerve - spinal root supplies trapwzius and sternocleidomastoid
12 - hypoglossal nerve CN X11- motor for tongue - stick tongue out and deviates to side of paralysis
Dorsolateral prefrontal syndrome
poor planning, executive functioning deficit
deficit in academic performance
