Chapter 11: Brain Function and Neurocognitive Disorders Flashcards
What is non-fluent aphasia?
limited ability to produce speech; effortful and with few words
What is fluent aphasia?
able to produce connected speech
2 types of non fluent apahasia categories.
Good understanding of Language (spoken and written)
Poor understanding of language (spoken and written)
What are the 2 categories for fluent aphasia?
- good understanding of language (spoken and written)
- poor understanding of language (spoken and written)
What are the types of non-fluent aphasias that are classified as an individual having a good understanding of language.
- broca aphasia
- transcortical motor aphasia
Broca aphasia
cannot repeat words or sentences
Transcortical motor aphasia.
can repeat words or sentences
What are the features of mixed non-fluent aphasia?
some ability to produce speech
What are the features of global aphasia?
most severe; little to no comprehension or expression
What are types of fluent aphasia that are included in the good understanding of language (written and spoken category)
- conduction aphasia
- anomic aphasia
What is conduction aphasia?
numerous phonemic paraphasias such as “ poon, “soon” or “pone” for “spoon”
Anomic aphasia.
(primary limitation is difficulty retrieving desired words when communicating; “it’s on the tip of my tongue”
What are the categories of fluent aphasia included under poor understanding of language (spoken and written)?
- Wernicke aphasia
- Transcortical sensory aphasia
Features of Wernicke aphasia?
cannot repeat words or sentences
Features of transcortical sensory aphasia.
can repeat words or sentences; speech produced resembles a “word salad” many words and ideas, but doesn’t generally make sense
Enkephalins typically act on what type of receptors?
opiate receptors
Substance P
major transmitter of sensory neurons that convey pain sensation from the periphery especially the skin, into the spinal cord
T/F. There is a new class of antidepressant medications being tested to work on substance P.
true
Compare and contrast the general definition of delirium to the general definition of what a neurocognitive disorder is.
Delirium is an acute onset of impaired cognitive functioning that is fluctuating, brief, and reversible.
Neurocognitive disorder: a loss of cognitive abilities, impairment of social functioning, loss of memory, and/or change in personality that may be progressive or static
Compare and contrast mild neurocognitive disorder with major neurocognitive disorder.
Mild: neurocognitive disorder that is a moderate cognitive decline that has minimal interaction with functioning
Major neurocognitive disorder: significant cognitive decline that interferes with functioning and independence
What are some neuroanatomic findings seen in those with Alzeihmer Disease?
cortical atrophy, flattened sulci, enlarged ventricles
Histopathology of Alzheimer Disease?
senile plaques (amyloid deposits), neurofibrillary tangles, neuronal loss, synaptic loss ,granulovacuolar degeneration of neurons
What chromosome is Alzeimers associated with. What gene is associated to this condition?
chromosome 21 (gene for amyloid precursor protein)
Compare and contrast gender predisposition in patients with Alzheimers vs vascular conditions.
Alzeihmer’s: women> men
Vascular: men > women
What is the avg age of onset in Alzheimer’s vs vascular conditions.
alzeihmers: older age
vascular: younger age
Compare and contrast the deterioration in Alzeihmers to that of Vascular neurocognitive conditions.
Alzeihmers: linear or progressive deterioration
Vascular: stepwise or patchy deterioration
Compare and contrast focal deficits in Alzheimers to vascular Neurocognitive conditions
Alzeihmers: no focal deficits
Vascular: focal deficits
Another name for Pick disease?
Frontotemporal Neurocognitive Disorder
What are some neuroanatomic findings of those with Picks disease?
atrophy in frontal and temporal lobes
Histopathology of Picks disease?
Pick bodies (intraneuronal argentophilic inclusions) and Pick cells (swollen neurons) in affected areas of the brain
Etiology of Picks?
unknown
Features of what other condition may be seen in one who has Picks disease?
Kluver Bucy syndrome (hypersexuality, hyperphagia, passivity)
What is neurocognitive disorder due to prion disease?
a rare spongiform encephalopathy caused by a slow virus (prion)
What does prion disease present with?
neurocognitive disorder, myoclonus, and EEG abnormalities
visual and gait disturbances, choreoathetosis or other abnormal movements
What chromosome is implicated in Huntington disease?
chromosome 4
Compare and contrast location of cause of Huntington to Parkinsons?
Huntington: caudate nucleus
Parkinson: dopaminergic neurons in the substantia nigra
Compare and contrast symptoms of Parkinson’s with that of Huntingtons Disease.
Huntington disease: choreoathetosis, neurocognitive disorder, and psychosis suicidal behavior fairly common
Parkinsons: resting tremor, rigidity, bradykinesia, and gait disturbances
What is neurocognitive disorders with Lewy bodies characterized by?
- hallucinations, parkinsonian features, and extrapyramidal signs
- patients typically have fluctuating cognition, as well as REM sleep behavior disorder
Pathology of neurocognitive disorder due to HIV infection?
HIV directly and progressively destroys brain parenchyma
What is Wilson disease caused by?
ceruloplasmin deficiency
Features of Wilsons disease?
- hepatolenticular degeneration
- kayser-fleischer rings in the eye
- asterixis
What are symptoms of normal pressure hydrocephalus?
- neurocognitive disorder
- urinary incontinence
- gait apraxia
Features of normal pressure hydrocephalus?
- enlarged ventricles
- normal pressure
Treatment of normal pressure hydrocephalus?
shunt placement
What is pseudodementia?
typically seen in older patients with a depressive disorder who appear or have symtpoms of neurocognitive disorder
Best treatment for pseudodementia?
antidepressants
Compare onset of delirium vs neurocognitive disorders.
delirium: acute onset
neurocognitive disorder: insidious onset
Compare and contrast delirum vs neurocognitive disorder how the condition presents?
delirium: fluctuating coarse
neurocognitive disorder: chronic
Compare and contrast the duration of delirium with that of neurocognitive disorder?
delirium: lasts days to weeks
neurocognitive disorder: lasts months to years
Describe how memory is affected with delirium as compared to neurocognitive disorders?
delirium: recent memory problems
neurocognitive disorders: recent then remote memory problems
Describe sleep-wake cycle with delirium compared to neurocognitive disorders.
Delirium: disrupted sleep wake cycle
Neurocognitive disorder: normal sleep wake cycle
Describe disorientation in delirium with that of neurocognitive disorders.
delirium: disorientation
neurocognitive disorders: less disorientation initially
Describe hallucinations in delirium vs neurocognitive disorder.
delirium: hallucinations common
neurocognitive disorders: hallucinations, sundowning
Describe how to treat delirium vs neurocognitive disorders.
delirium: treat underlying condition
neurocognitive disorder: supportive treatment
