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ABPP > Attention, consciousness, & neglect > Flashcards

Attention, consciousness, & neglect Flashcards

1
Q

AAA

A

Alertness, attention, awareness

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2
Q

According to Posner’s model, ADHD is associated with deficits in which attentional network?

A

Alerting - difficulty in obtaining the effect of the warning signal, in maintaining the alert state where no warning or of focusing the warning signal to improve orienting

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3
Q

4 aspects of attention according to Cohen, Malloy, & Jenkins

A

Sensory selective attention - process by which sensory input is chosen for additional processing & focus Attentional capacity & focus Sustained attention Response selection & control (strongly associated with exec fx)

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3
Q

Delirium

A

Condition involving alterations in level of arousal/consciousness, difficulty staying alert, disturbance of attention, & impairment in logical stream of thought

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4
Q

According to Posner’s model, autism is associated with deficits in which attentional network?

A

Orienting - clear deficit in ability to shift covertly to a target, whether or not it is toward social events

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4
Q

Allesthesia

A

Erroneously report location of stimulus given to the right side of the body as being on the left

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5
Q

Lethargy

A

State of being awake but drowsy, inactive, & indifferent to external stimuli

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5
Q

Barkley’s definition of ADHD

A

D/o of sustained attention, behavioral inhibition, & exec fx

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6
Q

Environmental factors associated with attentional deficits

A

Poverty assoc. malnutrition & infection, maternal ETOH use & FAS, pregnancy & birth complications, lead exposure, lack of intellectual stimulation

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6
Q

Diagnostic considerations for altered arousal

A

Primary intracranial disease (affects the RAS by compression on brainstem) Systemic disease affecting the CNS Toxins/metabolic conditions Drug withdrawal

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6
Q

Engaging with stimuli involves what part of the thalamus?

A

Pulvinar

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7
Q

Thalamic lesions may produce what type of attentional impairments?

A

Info gating & selection difficulties

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9
Q

Bottom-up modulation (Mesulam)

A

Influence of the ascending reticular activation system; global influence on attention without selectivity for sensory modality or cognitive domain

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10
Q

What is the prefrontal cortex’s role in attention?

A

Response selection, sustained attention, control, switching & searching

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10
Q

Orientation is a reliable integration of

A

Attention, perception, & memory

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11
Q

What is the limbic system’s role in attention?

A

Establishes salience, whereby determining priority of incoming stimuli; limits of attention (hippocampus - memory encoding & retrieval constrain attention)

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11
Q

Describe Posner’s orienting network

A

Ability to select specific info from among multiple sensory stimuli Involves pulvinar, superior colliculus, superior parietal lobe, temporoparietal junction, superior temporal lobe, frontal eye fields, splenium of CC

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11
Q

Individual factors that may influence attention assessment

A

Energy, effort, motivation, cognitive ability, mood state

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13
Q

Describe Posner’s alerting network

A

Ability to increase & maintain response readiness in preparation for an impending stimulus; activity in frontal & parietal regions, particularly of RH, & posterior limb of IC

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14
Q

Motor neglect

A

Failure to respond to stimuli on the CL side of space in absence of obvious weakness; cannot be attributed to sensory deficit or inattention; marked ipsilateral gaze preference common

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16
Q

What are the 3 attention networks according to Posner?

A

Alerting Orienting Executive

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18
Q

What are mental activity variables (Lezak)?

A

Efficiency of mental processes involved in cognitive functions, but do not have unique behavioral end products (i.e., attention, activity rate, consciousness)

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18
Q

Most common sites of damage associated with neglect

A

Inferior parietal lobe, also sometimes in frontal cortex, cingulate gyrus, BG, thalamus, reticular formation

19
Q

Minimally conscious/responsive state

A

Inability to interact consistently with the environment even though some environmental awareness exists (e.g., selective visual tracking, intermittent nonflexive motor activity)

20
Q

What is the link between arousal & attention (Lezak)?

A

D/o of arousal always involves d/o of attention; d/o of attention does not always involve d/o of arousal

22
Q

According to Cohen et al., attentional capacity & focus is influenced by what 2 factors?

A

Energetic factors (motivation, arousal, effort) Structural factors (memory, processing speed, cognitive ability)

22
Q

Endo-evoked vs. exo-evoked

A

In regards to motor extinction, does the patient move the limb on their own (endo) or do they move in response to stimuli (exo)

23
Q

Intensive care unit (ICU) psychosis

A

Development of confusion following major surgery, thought to be related to extended periods in sterile hospital room with minimal stimulation, no regular routine, pain, & frequent staff awakenings

24
Q

Acute confusional state: 6 major groups of causes

A

1) toxic-metabolic encephalopathy 2) environmental stressors in vulnerable individuals 3) multifocal brain lesions 4) epileptic seizures 5) space-occupying lesions 6) focal brain lesions

26
Q

What is the ascending reticular activating system’s role in attention?

A

Provides activating stimulation to cortex to initiate & maintain arousal necessary for initial & sustained attention

27
Q

What are the 3 essential factors of attention, according to Pibram & McGuiness?

A

Arousal (‘primordial attention system’) Activation (basal ganglia) Effort

28
Q

According to Cohen et al., sustained attention is dependent on

A

Task duration, vigilance requirement, reinforcement & target distractor ratio

28
Q

Subcortical lesions may produce what type of attentional impairments?

A

Impairments of arousal, activation, info processing speed

29
Q

Persistent vegetative state

A

Condition of profound nonresponsiveness in the wakeful state that is caused by brain damage; absence of discernible adaptive responses to external environment

30
Q

Sensory neglect

A

Failure to detect stimuli presented on side CL to CNS lesion; extinction to double simultaneous stimulation

31
Q

What other features are associated with delirium?

A

Disturbance in sleep-wake cycle, disorientation to time & place, rambling or incoherent speech, illusions, visual hallucinations, agitation, change in psychomotor behavior

32
Q

Describe Mesulam’s attentional matrix

A

Domain-specific attentional processes (attentional processes to certain stimuli) Domain-independent attention processes (‘bottom-up’ & ‘top-down’)

33
Q

Coma can be caused by damage to

A

B RAS, B diffuse cortex, B lesions of thalamus

33
Q

Hemiasomatognosia

A

Pts deny that the left half of their body belongs to them

35
Q

Stupor

A

Unconscious state from which patient can be partially aroused but can’t reach a fully wakeful state of awareness

36
Q

Allokinesia

A

Pt inappropriately moves the normal limb when asked to move neglected limb

38
Q

Describe Posner’s executive network

A

Monitoring & resolution of conflict between computations in different neural areas Involves cingulate gyrus, insula, parts of the BG, anterior corona radiata Activated during cognitive conflict tasks (e.g., Stroop), behavioral & emotional control

40
Q

Top-down modulation (Mesulam)

A

Parietal, limbic, prefrontal cortex; provides info on context, modulation, significance, & volition

41
Q

3 primary features of acute confusional state

A

Disturbance of vigilance, distractibility, impaired working memory Inability to maintain stream of thought Inability to carry out goal-directed movement

43
Q

What is the dorsolateral frontal cortex’s role in attention?

A

Sequencing, persistence, switching, focus

45
Q

Focal frontal lesions may produce what type of attention impairments?

A

Focused attention, response selection & control

46
Q

According to Hebb, every stimulus has what 2 effects on the brain?

A

To maintain the alert state (increased activity of NE pathways) To activate sensory pathways

47
Q

Twilight state

A

Transient impaired consciousness in which pt may perform certain acts involuntarily without subsequent memory for those acts; may be seen in recovery from general anesthesia

48
Q

Motor extinction

A

A type of motor neglect; the pt does not demonstrate akinesia when asked to move one limb at a time, but doesn’t use affected limb when both are needed

49
Q

Uremia from end-stage renal kidney failure is associated with

A

Deficits in sustained attention; EEG pattern similar to absence epilepsy; toxins assoc. w/ kidney failure ‘attack’ centrecephalic brainstem structures implicated in absence epilepsy

50
Q

Mirksy’s 5 elements of attention

A

Focus (superior temporal & inferior parietal, CC)/execute (inferior parietal & CC) Sustain (rostral midbrain) Shift (prefrontal, frontal association) Encode (hippocampus, amygdala) Stabilize (midline thalamic & brainstem structures)

51
Q

What is the orbital frontal cortex’s role in attention?

A

Response initiation, inhibition

53
Q

According to Posner’s model, anxiety disorders are associated with deficits in which attentional network?

A

Orienting - trouble orienting away from a stimulus with a negative emotional valence

54
Q

Representational neglect

A

When pts are asked to imagine a scene or part of body, may fail to report portions on side opposite lesion

55
Q

Deficits in sustained attention are seen among 1st degree relatives of patients with what disorder?

A

Schizophrenia

56
Q

Demographic & medical risk factors for delirium

A

Age, previous cognitive compromise, chronic medical condition, prolonged hospitalization, sensory deprivation, sleep-wake disturbance, medical procedures with high BP volume loss/exchange, prolonged bypass, occupational exposure to toxins, medications

57
Q

What is the inferior parietal cortex’s role in attention?

A

Spatial selective attention; hemineglect

ABPP (34 decks)

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