Clinical Neuropsych - Test 1 Flashcards
What is Clinical Neuropsychology?
-** relationship between brain structure/function and behavior** (“clinical” adds another piece)
- use knowledge of brain structure/function to predict behavior (e.g. treatment planning with patient)
- use observation/knowledge of behavioral symptom profiles to make determinations about brain health and integrity (e.g., make a diagnosis)
1.23.24 Intro
Perspective that brain function is about location. See Franz Gall, Broca, Wernicke.
1 of 3 historical perspectives of brain/behavior
Localization
1.23.24 Intro
“equal potential” to have any function. See Marie Jean Pierre Flourens and Karl Lashley.
Equipotentiality
Integrationist
1.25.24_Methods.pdf
- father of phrenology
- brain “organs” have innate mental faculties and psychological traits
Franz Gall
1.23.24 Intro and 1.25.24_Methods.pdf
- an obsolete theory proposing that if a - given brain area was larger in an individual, then the corresponding skull at that point should be enlarged, indicating a well-developed area of the brain. Conversely, a depression signaled underdeveloped area of the cortex
- involved reading of cranial bumps to ascertain which of the cerebral areas were largest
Phrenology
1.25.24_Methods.pdf
What are some flaws with the theory of phrenology?
- when you feel the head, you’re feeling the skull, not the brain (a misshapen skull does not say anything about the brain)
- multiple places in the brain might be responsible for one trait
- swelling is actually indicative of inflammation (bump would not actually indicate a strength)
“Tan”
1.25.24_Methods.pdf
Cortical localization
- landmark contribution was in understanding the origins of aphasia
- localizationist
- “Tan”
- Broca’s area
Paul Broca
1.25.24_Methods.pdf
- announced that understanding of speech was located in the superior, posterior aspects of the temporal lobe
- no motor deficit accompanied a loss of speech comprehension caused by damage in this area, only the ability to understand speech was interrupted
- fluent aphasia
Carl Wernicke
1.25.24_Methods.pdf
inability to talk because the musculature of speech organs do not receive appropriate brain signals
Broca’s aphasia
patient is still able to talk, but speech makes no sense and sounds like some unknown foreign language; Wernicke
Fluent aphasia
- size over location (how much brain is more important than its placement)
- remaining brain can take over functions of missing tissue (equipotneiality)
- See ablation studies with birds and rats
- proponent of equipotentiality
- “brain operates in integrated fashion, not in discrete faculties, and that mental functions depend on the brain functioning as a whole”
- attacked Broca’s theory (indicated that patient could not speak because lesion had caused general loss of intellect, rather than a specific inability to speak
Marie Jean Pierre Flourens
1.25.24_Methods.pdf
What did Marie Jean Pierre Flourens find?
In ablation studies with rats and birds, Flourens found that removing any part of the brain would cause gneralized disorders of behavior in birds; their brains could make up for lesion in the brain. “if you have sufficient enough brain, it can take over some functions”
- Principle of mass action - the extent behavioral impairments is directly proportional to the mass of the removed tissue.
- Multipotentiality: each part of the brain participates in more than one function.
- More brain that was taken out = more function was lost
- injury location is less important than how much brain is impacted
- See equipotentiality.
Karl Lashley
1.25.24_Methods.pdf
The extent behavioral impairments is directly proportional to the mass of the removed tissue. See Karl Lashley.
Principle of mass action
1.25.24_Methods.pdf
each part of the brain participates in more than one function.
See Karl Lashley.
Multipotentiality
1.25.24_Methods.pdf
What are advantages and disadvantages of explaining behavior using the localization theory?
advantages: you are better able to pinpoint the functions that might be impacted when certain parts of the brain are impacted
disadvantage: you might not think of other possibilities of functional deficits if they are not associated with the area directly impacted
1.25.24_Methods.pdf
What are the advantages and disadvantages of explaining behavior using the equipotentiality theory?
disadvantages - you might have difficulty predicting which functions will be impacted as result of an injury;
advantage: remaining brain can take over functions of missing tissue; may be able to more confidently speak to the amount and severity of function that will be lost (more brain lost = more significant deficits)
1.23.24 Intro
disctinction between the ability to recognize an object and an inability to name it; Freud coinded this term (Freud = founder of psychoanalysis)
agnosia
Consider – you are a neuropsychologist working with a patient recovering from brain injury to their left temporal lobe. What does your conversation look like if you ascribe to localization versus equipotentiality theories of brain organization?
Localization gives you a clearer expectation of what you can expect; This might help you to better prepare and arrange for appropriate treatment to accommodate functional deficits.
Equipotentiality gives you more hope that your brain may be able to regain function through neuroplasticity. MIght be more focused on “how to rebuild” but also may not be able to prepare patients adequately for what deficits to expect.
1.25.24_Methods.pdf
- integrationist theory (both size and location matters in the brain)
- idea of functional units and systems requiring Luria’s 3 areas of brain working together
- behavior results from integration of functional systems – a disruption at any stage can cause deficits, but also plasticity
Alexander Luria
1.25.24_Methods.pdf
Flourens experiments on birds and rats – removing any part of the brain led to generalized disorders of behavior
led to idea that size of injury is more important than the location in determining brain injury’s effects
ablation experiments
Brain stem; responsible for arousal and maintenance of muscle tone
ex. in snowboarding, brain stem needs to be intact so you are conscious, able to stand and maintain muscle tone; arousal; being conscious
Luria’s 1st functional unit
1.25.24_Methods.pdf
Posterior portion of the brain is responsible for reception, integration, and analysis of sensory information
ex. in snowboarding, posterior area needs to be intact so you can sense where you are in relation to your environment, avoid obstacles and other people, be aware of worsening whether etc.; also gives you some enjoyment (wind in hair, pretty mountains, feeling of cold on face)
Luria’s 2nd functional unit
1.25.24_Methods.pdf
Frontal portion of brain is responsible for planning, executing and verifying behavior.
ex. in snowboarding, frontal area needs to be intact so you can choose which routes to take, when to stop for the day, make plans for afterward
Luria’s 3rd functional unit
1.25.24_Methods.pdf
concept that patter of interaction among various areas of the brain is necessary to complete a behavior – each area in the brain can operate only in conjunction with other areas of the brain, thus each area of the brain may play a specific role in many behaviors. See Luria.
functional systems
Luria’s 2nd functional unit is believed to be responsible for receiving and integrating sensory information. True or False?
True
1.25.24_Methods.pdf
any area of the brain can be involved in relatively few or many behaviors
Pluripotentiality
According to the localizationist view, impairments in behavior depend entirely on what exact structures/regions of the brain are injured. True or False?
True
1.25.24_Methods.pdf
The principle of mass action is consistent with the localization viewpoint of brain function. True or False?
False (it is consistent with the equipotentiality theory)
1.25.24_Methods.pdf
- pass through certain tissues of the body easier than others, providing contast to the tissues and substances that the x-rays are not passing through/absorbing the X-ray (i.e., bones)
- depending on tissue density, may show up in grayscale
X-rays
1.25.24_Methods.pdf
- takes X-ray images from different perspectives/angles, then pieces together images to produce a better idea of what is happening in the brain
- ADD TO THIS - supplement with information from the text
Computed transaxial tomography (CT)
1.25.24_Methods.pdf
- Based on measurement of what atoms are doing in different brain tissue
- involves using magnetic field to manipulate how atoms are behaving in the brain
- MRI measures how H atoms align with magnet at different rates – different tissues = different rates of returning to re-alignment – this is what the MRI is capturing
- magnets are always on and are very strong
- much more detail than CT or X-ray
Magnetic Resonance Imaging (MRI)
1.25.24_Methods.pdf
Clinical Considerations of MRI
Resolution - MRI has much more detail than CT or X-ray
Speed - take longer than CTs and X-rays
Contraindications/risks: MRIs are low-risk (no radiation involved, not as risky as X-rays)
Invasiveness - non-invasive; relatively tolerable
Cost - can be expensive
Age - people with claustrophobia, movement disorders (restless leg syndrome); children may not tolerate MRI as
Type of Injury: are you looking at a fracture or an internal injury
MRI is looking at Hydrogen atoms in brain. At rest, H atoms will have electromagentic properties and will rotate around/have magnetic direction to them. When in the MRI, all atoms align to the same magnetic field and are spinning in the same direction. Technologist adds radiofrequency (RF) pulse, which knocks the atoms out of alignment with the MRI’s magnetic field. When the RF pulse is turned off again, the atoms will realign with the magnet. the MRI is measuring how the atoms realign at different rates. Different tissues will have different rates of re-alignment with magnet.
LOOK at book
MRI Physics
1.25.24_Methods.pdf
MRI magnets are always on. True or False?
True
1.25.24_Methods.pdf
Clinical Considerations for Neuroimaging Methods
- Resolution
- Speed
- Contra-indications and risks
- Invasiveness
- Cost
1.25.24_Methods.pdf
Infers white matter organization by measuring direction and magnitude of water diffusion
Looks at ratio of anistropic diffusion to isotropic diffusion, which indicates white matter integrity (if white matter tracts are injured/have holes, water may diffuse isotropically instead)
- LOOK for more information in the book
Diffusion Tensor Imaging (DTI)
1.30.24 Methods Part 2 pdf
- ratio of anistropic to isotropic diffusion (quantitative and “qualitative”)
- DTI allows for analysis of fractional anisotropy (FA), a meausre indicating the overall directionality of water diffusion that is grater in organized white matter tracts and lower in CSF and disorganized fibers
- method used to evaluate white matter fiber tracts
-
can get both quantitative ratio (anistropic to isotropic is 0:1) and qualitative (through FA mapping, you can determine more than just how much water is diffusing, but the direction in which it is diffusing also)
- high FA = white matter is more intact - bright white areas have higher FA
Fractional Anisotropy
3-D reconstruction technique used to assess the neural tracts using data collected by DTI
Maps out tracts of white matter bundles, FA
Tractography
Method of staining brain tissue that marks a few selected individual cells, differentiating the cell body and its extensions. Discovered by Camillo Golgi.
Golgi stain
A dye that stains the cell body of the neuron and is particularly useful for detecting the distribution of cell bodies in specific regions of the brain. Discovered by Franz Nissl
Nissl stain
shows the myelin coating of axons, rendering it useful for mapping pathways in brain tissue
Myelin stain
Considerations about DTI
- Not currently used in standard clinical practice (takes a long time to acquire scan and potentially render image)
- But some significant potential – may be more sensitive to picking up lesions in white matter
1.30.24_Methods_part2.pdf
Isotropic diffusion vs. Anistropic diffusion
isotropic - water will disperse in 360 degrees if it is in free space (what water naturally does)
anistropic - water is operating within barriers and has some directionality
- white matter tracts allow for diffusion in a particular direction and DTI measures how much anistropic diffusion there is compared to isotropic diffusion )if
capitalizes on the fact that neurons work by electrical firing and these electrical signals can be recorded
Find more info in book.
Electroencephalography (EEG)
1.30.24_Methods_part2.pdf
collects information about the magnetic field related to electrical firing
Works on the same principle as EEG, but instead of electrical information, MEG collects information from magnetic signals that are propagated with electrical signals that are emitting information.
NEED more information from book
Magnetoencephalography (MEG)
1.30.24_Methods_part2.pdf
Involves injecting the patient with a temporary radioactive tracer. The tracer latches onto sugars that brain is using as it functions. PET tracks this tracer.
You can infer that brain areas where tracers are located are using more glucose.
Positron Emission Tomography (PET)
1.30.24_Methods_part2.pdf
An indirect measure of brain activity
* based on the hemodynamic response function (HRF)
* The blood oxygenation level dependent (BOLD) signal –> ratio of oxygenated blood to deoxygenated blood
We’re looking for peaks where we see oxygenated blood flowing in the brain and are inferring electrical firing of a neuron based on how much energy is produced.
Red/orange = highest BOLD signals
- NEED more info from book
functional MRI (fMRI)
1.30.24_Methods_part2.pdf
What are some pros and cons of different functional imaging methodologies?
Time: EEG (but also takes a long time to set up) and MEG are fastest; MRI is next; PET can take hours (need to inject tracer and wait for it to get to the brain)
Spatial resolution (the actual image that you are able to see): fMRI resolution is better than PET
Cost: EEG is the cheapest, MRI can be expensive
Portability: EEG is most portable; if you are trying to reach a rare sample, you might want to be able to bring the study to them
Risks:
NEED TO LOOK IN BOOK and AT SLIDE IMAGE
1.30.24 Methods Part 2
“Traditional” brain activation studies
looking at what is lighting up/what is active in the brain; need controls (some participants with no injury or disease)
1.30.24 Methods Part 2
type of study looking at how multiple sections of the brain are connected
- how strong are connections, how strong are the notes
- goes beyond which part of brain is activated and is more about how the brains parts are communicating
Connectivity Studies
1.30.24 Methods Part 2
Task-based versus resting state
task-based design - looking at what is activated when participant is doing a specific task (e.g., choosing which food is better); links task performance and activation of the brain
resting state: looks at what is happening in the brain when it is at rest; found there is a human default mode network
- some areas of brain activation decrease and increase (LOOK into this more)
- resting state doesn’t have to link to any task performance, just shows what is going on at rest (benefits = if someone can’t perform a task, they can still get MRI; gives us a baseline of what is “normal” in a brain)
1.30.24 Methods Part 2
uses a magnet to inflict some sort of change in brain function/activate certain areas in the brain
happens while person is awake
doctor can affect fine motor control and disrupt writing (interrupt signal going from brain to hand)
cannot stimulate more inner neurons in the brain (works well for stimulating motor cortex since that is on the outside of brain)
Transcranial Magnetic Stimulation
1.30.24 Methods Part 2
surgeon puts electrode in the brain and adds an extention lead – looks at the rate of electrical signal …… NEED TO FOLLOW UP ON THIS
much more invasive than TMS
Intracranial brain stimulation
1.30.24 Methods Part 2
True or False: CT, MRI, and DTI are all techniques used to visualize brain structure.
True
1.30.24 Methods Part 2
True or False: PET scans measure brain activation using the BOLD signal, while fMRI scans measure brain activation using radioactive tracers
False (opposite - PET scans measure brain activation using radioactive tracers; BOLD signal is used to measure brain activation in fMRI)
1.30.24 Methods Part 2
True or False: The brain is still active during rest, which enables us to analyze resting state data.
True
1.30.24 Methods Part 2
How have these advances in neuroimaging techniques helped to advance the field of neuropsychology? Are there any ways in which it might hold the field back?
1.30.24 Methods Part 2
Given that part of a neuropsychologist’s job is to help make diagnoses and to infer brain function from observing behavior, do the advances in neuroimaging technology mean that we are all soon going to be out of a job (i.e., you will someday be able to diagnose someone just be looking at a brain scan). Why or why not?
1.30.24 Methods Part 2
Why do we conduct neuropsychological evaluations?
to evaluate cognitive domains as well as factors that might contribute to deficits patient is concerned about
- assist in making differential diagnosis
- informing patient care
- treatment planning
- research
- forensic applications
2.1.24 Neuro Assessment
What are we evaluating in a neuropsych evaluations?
Cognitive domains; other considerations – NEED more
2.1.24 Neuro Assessment
How do we measure cognition?
- psychometrics
- assessing performance
- NEED MORE
2.1.24 Neuro Assessment
Main purposes of a neuropsych evaluation
- assist in making differential diagnosis – ex. 70 year old client with memory problems but also SUD, TBI, and family history of dementia
- inform patient care (provide information about cognitive status, assess capacity/capabilities and limitations, psychoeducation) – ex. stroke with memory issues who needs PT
- Treatment planning (informing treatment/rehab needs) – ex. individual living independently who was diagnosed with FTD (frontotemporal dementia)
- Research
- Forensic applications (compensation, capacity)
2.1.24 Neuro Assessment
What cognitive domains get evaluated?
- Orientation - evaluate whether they know person, place and time
- Attention - ability to focus on something
- Processing Speed - mental reaction time (very sensitive to injury and disease)
- Visuospatial skills - navigation, putting something into space by vizualizing (puzzles, loading dishwasher)
- Language skills - both receptive and expressive (understandign info and communicating thoughts to others)
- Memory - ability to recall (and sometimes learn new) information
- Executive functioning (including abstract reason, problem solving, monitoring)
2.1.24 Neuro Assessment
Other important domains of functioning to consider
- Motor functioning (arm might be sore and affect ability to perform task)
- Emotional functioning (antidepressants could cause brain fog; depression itself may have cognitive impact on individual)
- Activities of Daily Living (burnt out after studying; academics might be fine but other areas of life might be impacted)
- Effort/Motivation (if they are trying to get time off of work; simply don’t take test seriously)
2.1.24 Neuro Assessment
the science of measurement
how we make sure our tests are sound is important because its how we derive diagnoses and treatments
Psychometrics
2.1.24 Neuro Assessment
measures whether test is consistent:
- over time
- across different people
Reliability
2.1.24 Neuro Assessment
- test measures what it is supposed to be measuring
- multiple types of validity (construct, content, and criterion)
Validity
2.1.24 Neuro Assessment
the test measures the construct you are interested in (ex., is it TBI or Alzheimer’s?)
Construct validity
2.1.24 Neuro Assessment
the test’s items or tasks represent the domain or behavior that you want to measure (ex. is 2+2 a good question to assess your knowledge of history?)
Content Validity
2.1.24 Neuro Assessment
the test’s scores relate to some expected outcome (ex. if you score high on a memory test, will you also ace your neuropsych course?)
Criterion Validity
2.1.24 Neuro Assessment
- core battery
- standardized administration
- interpret test scores based on standardized norms
An approach to measuring cognition
Standardized Battery Approach (also know advantages/ disadvantages re: Bias, personalization, training/teaching, use in research, time/costs, reliability?)
Know advantages and disadvantages.
2.1.24 Neuro Assessment
- tests not necessarily standardized
- considers “how” the client performs the task
- interpretations are based on clinical experience
An approach to measuring cognition
Process Approach (also know advantages/ disadvantages re: Bias, personalization, training/teaching, use in research, time/costs, reliability?)
2.1.24 Neuro Assessment
Comparison of scores to an “expected” score that is based on a particular sample/population (usually a “normative” group)
e.g., a 12 year old’s scores compared to other 12 year olds scores
Group/normative comparison
2.1.24 Neuro Assessment
Consider: You have graduated UNL and are happily working in your career of choice, when you begin experiencing some memory problems. The problems have gotten so bad that you believe it would be helpful for you to take some time off. Your employers want documentation of impaired memory issues. You go in for a neuropsych eval. The neuropsychologist has 2 sets of norms. Which one do you want them to use?
The group with higher scores, because your scores would look lower/more impaired among higher scores. (you would be at low end of bell curve)
2.1.24 Neuro Assessment
Considerations for choosing normative data
Culture (collective or invidualistic)
Educational attainment
Vocational status
Socioeconomic status
Psychological History
Medical History
- examine relationships among the test scores, look for patterns consistent with specific disease processes
- requires you to know how each disease/injury would present; need to know the cognitive profile
Pattern Analysis Approach
2.6.24 Neuro Assessment Part 2
Before meeting the client for evaluation, a clinician…
- receives the referral question (from other dr. usually)
- collects data (use multidimensional approach)
- make hypothesis (determine what you think is going on)
- selects tests to administer (based on hypothesis choose test battery; different neuropsychs might choose different tests; tests used may change over time)
2.6.24 Neuro Assessment Part 2
If you were a neuropsychologist trying to get information about your client, where would you look? (e.g., you are evaluating a 13 year old client whose pediatrician suspects has ADHD. Where would you look, who would you ask for clues as to whether the client has ADHD?
- Parents
- Teachers/Schools
- School vs. At-Home
- Pediatrician (observations)
- Look at background
- Family hx - onset
- dietary habits
- child’s medical records, previous injuries
- look at different activities that child is involved in
- social network
- scores on standardized tests; academic performance
2.6.24 Neuro Assessment Part 2
Collecting data from multiple sources
multi-dimensional approach
2.6.24 Neuro Assessment Part 2
When meeting with a client, a clinician…
2.6.24 Neuro Assessment Part 2
- does a clinical interview (with client but also may interview parents, adult siblings, etc.)
- makes behavioral observations (look at how client is behaving when you meet them – speech, eye contact, gait, ability to follow line of thought, etc)
- administers test battery
2.6.24 Neuro Assessment Part 2
After an evaluation, the clinician…
- scores and interprets results (make sense of test scores)
- writes report (document diagnosis, areas of cognitive strengths and weakness)
- provides feedback and recommendations to the client (follow-up w client to help them understand disorder, plan treatment)
2.6.24 Neuro Assessment Part 2
Neuropsychological evaluations are like puzzles in that…
- there are lots of pieces to consider
- we need to determine how the pieces fit together
- in a way that tells the story of the whole individual in their own context
2.6.24 Neuro Assessment Part 2
T/F: Cognition funcitoning is the only thing that a neuropsychologist would assess in their evaluation.
False - NEED TO REVISIT - list other things neuropsychs assess
2.6.24 Neuro Assessment Part 2
T/F: The only purpose of a neuropsych eval is to help with treatment planning.
False - Other purposes are to assist in making a differential diagnosis, inform patient care, research, and forensic applications (worker’s comp, SSDI, competency to stand trial)
2.6.24 Neuro Assessment Part 2
T/F: A pattern analysis approach to assessing cognitive performance involves looking for patterns of strengths and weaknesses that are consistent with what is expected of a disorder or injury.
True
2.6.24 Neuro Assessment Part 2
T/F: You would typically collect data about your client before you administer a battery (or set) of tests to formally assess their cognition.
True
2.6.24 Neuro Assessment Part 2
- Distinctive customs, values, beliefs, knowledge, art, and language of a society of community. These values and concepts are passed on from generation to generation, and they are the basis for everyday behaviors and practices.
- The characteristic attitudes and behaviors of a particular group within society such as a profession, social class, or age group.
As defined by APA
Culture
2.6.24 Neuro Assessment Part 2
identification with, sense of belonging to a particular cultural group
cultural identity
2.6.24 Neuro Assessment Part 2
BLANK can be fluid and dynamic; can intersect with other BLANK
cultural identity(ies)
2.6.24 Neuro Assessment Part 2
Why does culture matter in neuropsychology?
Because an individual’s culture is their basis for everyday behaviors and practices, it plays a significant role in the presentation of their symptoms as well as what those symptoms may mean to that person/their family
Some symptoms that are concerning in one culture may be accepted (or even desireable) in another culture.
2.6.24 Neuro Assessment Part 2
BLANK is defined as the systematic study of brain behavior relationships within the context of human beings recursively engaging in specific cultural practices that organize the development, maintenance, and revision of their cognition and behaviors.
Cultural neuropsychology
2.6.24 Neuro Assessment Part 2
Early neuroscientists saw the brain as BLANK and BLANK.
Static and unchangeable
2.6.24 Neuro Assessment Part 2
idea of neuroplasticity; environment can change brain
study with rats in different environments – rats in enriching environments had 6% difference in cerebral cortex than rats placed in bad environment
Dr. Marian Diamond
2.6.24 Neuro Assessment Part 2
What did Elanor Maguire, et al find?
taxi driver study
- structural MRI study
- taxi drivers’ hippocampus had larger posterior (area dealing with spatial memory/memory for locations) compared to anterior hippocampus (not responsible for spatial memory)
- size of posterior hippocampus was also correlated with their time as a driver (better you knew the city = larger posterior hippocampus BUT negatively correlated with the anterior portion
2.6.24 Neuro Assessment Part 2
What are some influences of culture on behavior and how we interpret behavior?
- Perspective/understanding of symptoms and/or disease (what is atypical differs among cultures, may affect report of symptoms, may affect motivation for assessment)
- Approach to task performance/testing may differ (is person used to testing? expectations for* how* to perform? i.e., more important to go fast or be accurate)
- May influence the way their testing is interpreted (examiner biases; norms)
2.8.24 Culture and Neuropsychology
impacts of your identity as a neuropsychologist
- reactions from the client (your identify might impact client’s rapport, testing, motivation)
- your own biases
- your influence on the direction of the field
How do some of the methods/approaches that Dr. Manly takes in her research differ from those you might think of in the “traditional” sense?
What effect does including cultural factors into account have on the application of research to clinical practice?
How might your personal background/identities contribute
to the field of neuropsychology?
How could we promote inclusivity in neuropsychology?
- community-driven research
- be willing to come to the participant
- minorities in leadership positions
Why review research?
- Consuming research is important (knowledge; informs clinical practice)
- Need to make sure research is objective and rigorous (minimize bias, up to standards, consequences = misinformed, clinical applications–at best, ineffective and at worst does harm)
- need to think critically about what we’re reading
the study of human behavior; specifically, it seeks to describe, esplain, modify, and predict human and animal behavior
Psychology
p. 4
study of how complex properties of the brain allow behavior to occur
a subsection of psychology
Neuropsychology
p. 4
brain cells; billions of them in the brain; infinite number of possible connections among them
Neurons
p. 4
ancient surgical operation that involves cutting, scraping, chiseling, or drilling a pluglike piece of bone from the skull; relieves pressure related to brain swelling
trephination
p. 5
theory of dualism; belief in a soul separate from the body
Rene Descartes
The two conditions that, according to contemporary research methodology, are necessary to attribute a precise cognitive function to a specific anatomic section of the brain:
- destruction of a localized brain site impairs a specific function (Broca met this condition
- double dissociation - symptom A appear in lesions one structure but not with those in another, and that symptom B appear with lesions of the other but not of one
in book
Which of the following is a radiologic procedure:
a. Electroencephalograph
b. Positron Emission Tomography
c. Computed Transaxial Tomography
d. Magntoencephalography
Computed Transaxial Tomography (CT)
T/F: Electromyography (EMG) involves imaging the brain’s metabolism to aid in the diagnosis of peripheral nerve damage.
False - while electromyography does aid in the diagnosis of peripheral nerve damage, it does not image the brain’s metabolism. Instead, EMG involves deep-needle stimulation of a muscle then subsequent measurement of the muscle’s electrical activity
Cerebrospinal fluid surrounding the spinal cord can be obtained through a BLANK, also known as a spinal tap.
lumbar puncture
Explain how computed transaxial tomography (CT) differs from a traditional X-ray of the skull
While X-rays are an effective diagnostic tool for viewing skull
abnormalities or fractures, their 2-dimensional nature limits their usefulness in diagnosing 3-D clinical pathologies. Further, it is difficult to differentiate between brain structures and CSF in an X-ray film. CT, on the other hand, creates a 3-D anatomic image of the brain using multiple X-ray images of the head taken from different angles. The 3-D perspective produced by a CT scan provides a much clearer
image of the brain and its structures. The resulting image can be used to look beyond the skull to assess for abnormalities in the brain (e.g., tumors, traumatic brain injury, etc.)
A neuropsychologist asks a patient their full name, age, and city/state where they live. What are they assessing for?
a. Visuospatial
b. Orientation
c. Memory
d. Language
e. All of the abov
Orientation
T/F: The process approach to neuropsychological testing tailors each examination to the individual patient, and as result, allows the clinician to focus on tasks related to the patient’s most important deficits.
True
The frequency with which a pathological condition is diagnosed in the population tested is the _________
base rate
Why might it be advantageous to conduct a neuropsychological evaluation alongside other diagnostic procedures (e.g., neuroimaging)?
A neuropsychological evaluation can complement other diagnostic techniques by providing descriptive details about an individual and their behavior. While an MRI, CT, PET scan, etc. may help providers understand the location and degree of abnormalities or injuries in the brain, a neuropsychological assessment can provide information about how sugch injuries/abnormalities impact the patient’s day-to-day functions, including their strengths and weaknesses. This information is valuable not only for diagnosis but also offers considerable insight into the patient’s prognosis and helps to inform their treatment plan.
