Clinical Neuropsychological testing Flashcards
Clinical neuropsychology
Clinical neuropsychology is a specialty within
psychology that examines the relationship between behavior and brain functioning
in the realms of cognitive, motor, sensory, and emotional functioning.
Neuropsychologists integrate the medical and psychosocial history with the chief
complaint and pattern of performance on neuropsychological procedures. Such
analysis determines whether results are consistent with a particular area of
brain damage or a particular diagnosis
Projective and objective tests
There are two types of tests: objective and projective. Objective tests are
typically pencil-and-paper tests based on specific items and questions. They
yield numerical scores and profiles subject to mathematical and statistical
analysis. Projective tests present stimuli whose meaning is not immediately
obvious. Projective tests presumably have no right or wrong answers. Those being
tested impute meanings to the stimulus, based on psychological and emotional
factors
For the general population, an intelligence quotient (IQ) of 100 corresponds to intellectual ability in the A. 20th percentile B. 25th percentile C. 40th percentile D. 50th percentile E. 65th percentile
The answer is D
An intelligence quotient (IQ) of 100 corresponds to the 50th percentile in
intellectual ability for the general population. Modern psychological testing
began in the first decade of the 20th century when Alfred Binet (1857-1911), a
French psychologist, developed the first intelligence scale to identify mentally
challenged youngsters. The Stanford-Binet Scale is a standardized intelligence
test assessing both cognitive ability and intelligence from age 2 onward. It is
useful for determining the presence of a learning disability, developmental
delay, or brain damage in people with neurological insults. Its components
include general intelligence, visuospatial processing, quantitative reasoning,
fluid reasoning, knowledge, and memory
Neuropsychological deficits associated with left hemispheric damage include all of the following except A. limb apraxia B. visuospatial deficits C. finger agnosia D. aphasia E. right-left disorientation
The answer is B
Many functions are mediated by both the right and left cerebral hemispheres.
However, important qualitative differences between the two hemispheres can be
demonstrated by the presence of lateralized brain injury. Various cognitive
skills that have been linked to the left or right hemisphere in right-handed
people are listed in Table 4.1. Although language is the most obvious area that
is largely controlled by the left hemisphere (with injuries leading to
aphasias), the left hemisphere is also generally considered to be dominant for
limb praxis (i.e., performing complex movements, such as brushing teeth,
commanding, or imitation). The left hemisphere has been associated with a
cluster of deficits identified as Gerstmann syndrome (i.e., finger agnosia,
dyscalculia, dysgraphia, and right-left disorientation). In contrast, the right
hemisphere is thought to play a more important role in controlling visuospatial
abilities and hemispatial attention, which are associated with the clinical
presentations of constructional apraxia and neglect, respectively.
Although lateralized deficits such as these are typically characterized in terms
of damage to the right or left hemisphere, it is important to keep in mind that
the patient’s performance can also be characterized in terms of preserved brain
functions. In other words, it is the intact brain tissue that drives many
behavioral responses following injury to the brain.
Left hemisphere
Right Hemisphere
Aphasia
Visuospatial deficits
Right-left disorientation
Impaired visual perception
Finger agnosia
Neglect
Dysgraphia (aphasic)
Dysgraphia (spatial, neglect)
Dyscalculia (number alexia)
Dyscalculia (spatial)
Constructional apraxia (details) Constructional apraxia (Gestalt)
Limb apraxia
Dressing apraxia
” “
Anosognosia
Neuropsychological referrals are made for
A. establishing a baseline of performance
B. diagnostic purposes
C. ascertaining brain impairment
D. planning for rehabilitation
E. all of the above
The answer is E (all)
Most neuropsychological referrals are made for diagnostic purposes, to ascertain
if brain impairment is present, or to differentiate among neurological or
psychiatric disorders. Other important uses of testing include establishing a
baseline of performance for assessing future change and planning for rehabilitation
and management of behaviors affected by brain impairment. The specific methods
of neuropsychological assessment reflect the individual’s unique presentation of
symptoms and complaints, history and development, the perspective of the
neuropsychologist, and the reason for referral.
A common referral issue involves documentation of level of functioning for a
variety of purposes, including assessment of change or competence, especially in
the presence of diagnoses such as dementia, stroke, and head injury
True statements about projective personality tests include
A. They often focus on latent or unconscious aspects of personality.
B. The variety of responses is limited.
C. They tend to be more direct and structural than objective personality tests.
D. Instructions are usually specific.
E. None of the above
Projective personality tests, in contrast to objective personality instruments,
are more indirect and unstructured. Unlike objective tests, in which the patient
may simply mark "true" or "false" to given questions, the variety of
responses to projective personality tests is almost unlimited. Instructions are
usually general, allowing the patient’s fantasies to be expressed. Patients
generally do not know how their responses will be scored or analyzed, making it
difficult to obtain a desired result. Projective tests typically do not measure one particular personality characteristic such as type A personality (i.e.,
narrow-band measurement) but instead are designed to assess a personality as a
whole (i.e., broad-band measurement).
Projective tests often focus on latent or unconscious aspects of personality.
Obviously, psychologists and others differ in the degree to which they rely on
unconscious information. In many projective techniques, patients are simply
shown a picture of something and asked to tell what the picture reminds them of.
Projective techniques assume that when presented with an ambiguous stimulus such
as an inkblot, for which there are an almost unlimited number of responses, the
patients’ responses will reflect fundamental aspects of their personalities. The
ambiguous stimulus is a sort of screen on which individuals project their own
needs, thoughts, or conflicts. In particular, a schizophrenic patient’s
responses will often reflect a rather bizarre, idiosyncratic view of the world.
Hundreds of different projective techniques have been developed-most of which
are not used widely today.
After taking the Wechsler Adult Intelligence Scale (WAIS), a patient was
found to have poor concentration and attention. Select the WAIS subtest that
most likely screened the patient for these symptoms.
A. block design
B. comprehension
C. arithmetic
D. digit symbol
E. picture completion
The answer is C
The arithmetic subtest uses simple arithmetic tasks to assess attention and
concentration. The block design subtest requires a subject to arrange a series
of pictures to tell a story. This process tests performance and cognitive
styles. The digit symbol subtest requires a subject to match digits and symbols
in as little time as possible, as a test of performance. The comprehension
subtest reveals a subject’s ability to adhere to social consequences and to
understand social judgments when the subject answers questions about how people
should behave. On the picture completion subtest, a subject must complete a
picture with a missing part. Visuospatial defects appear when errors are made on
this picture completion procedure.
The Bender Visual Motor Gestalt Test is administered to assess A. maturation levels in children B. organic dysfunction C. loss of function D. visual and motor coordination E. all of the above
The Bender Visual Motor Gestalt Test, devised by the American neuropsychiatrist
Lauretta Bender in 1938, is a technique that consists of nine figures that are
copied by the subject (Fig. 4.1). It is administered as a means of evaluating
maturation levels in children and organic dysfunction. Its chief applications
are to determine retardation, loss of function, and organic brain defects in
children and adults. The designs are presented one at a time to the subject, who
is asked to copy them onto a sheet of paper. The subject is then asked to copy
the designs from memory (Figs. 4.2 and 4.3); thus, the Bender designs can be
used as a test of both visual and motor coordination and immediate visual memory.
Which is not true of the Wisconsin Card Sorting Test?
A. It assesses abstract reasoning
B. It assesses parietal lobe dysfunction
C. The patient is told during testing whether their responses are correct or
incorrect
D. The examiner records the number of trials required to achieve ten consecutive
correct responses
E. The examiner changes the principle of sorting when the task is mastered
The answer is B
Persons with damage to the frontal lobes or to the caudate nucleus, and some
patients with schizophrenia, give abnormal responses to the Wisconsin Card
Sorting Test (WCST). It does not address parietal lobe damage. This test
assesses abstract reasoning and flexibility in problem solving. Stimulus cards
are presented to patients to sort into groups according to a principle
established by the examiner but unknown to the patient. As the patient sorts the
cards, he or she is told whether the responses are correct or incorrect. The
number of trials required to achieve ten consecutive correct responses is
recorded. When or if the patient has mastered the task, the examiner changes the
principle of sorting, and the number of trials required to achieve correct
sorting is again recorded.
In the Wechsler Adult Intelligence Scale (WAIS),
A. digit span is a subtest of the verbal component of the test
B. its latest revision is designed for persons aged 16 to 60
C. mental retardation corresponds to the lowest 1% of the population
D. the average range of IQ is 100 to 120
E. the verbal scale is more sensitive to normal aging
The answer is A
The Wechsler Adult Intelligence Scale (WAIS) comprises 11 subtests made up of
six verbal (information, comprehension, arithmetic, similarities, digit span,
vocabulary), and five performance (picture completion, block design, picture
arrangement, object assembly, digit symbol) subtests, which yield a verbal IQ, a
performance IQ, and a combined full-scale IQ. The latest edition, the WAIS-III,
is designed for persons 16 to 89 years of age. There are also scales for
children ages 4 to 6.5 and 5 through 15. The average or normal range of IQ is 90
to 110; IQ scores of at least 120 are considered superior. Mental retardation,
defined as IQ below 70, corresponds to the lowest 2.2 percent of the population;
2 of every 100 people have IQ scores consistent with mental deficiency. The
performance scale is more sensitive to normal aging than the verbal scale, which
is more sensitive to education.
An 8-year-old boy is referred for psychological testing by his mathematics instructor after failing a series of examinations since the beginning of the
school year. The boy’s mother states that he complains about not being able to
read as well as the other students. He also complains of difficulty hearing the
teacher.
Which of the following tests of personality, intelligence, and achievement is
most appropriate in assessing the boy’s specific learning challenges?
A. Rorschach Test
B. Wechsler Preschool and Primary Scale of Intelligence
C. Wechsler Intelligence Scale for Children
D. Wide-Range Achievement Test
E. Minnesota Multiphasic Personality Inventory leaflong
The answer is D
The Wide-Range Achievement Test evaluates content-specific foundation in
mathematics, spelling, reading, and sciences. It may test individuals ranging
from ages 5 to 94 and is standardized to account for stratifications in gender,
ethnicity, geographic region, and socioeconomic status. The Rorschach Test is a
projective assessment test that requires interpretation of ink blots. It may be
used to interpret defense mechanisms and thought disorders. The Wechsler
Preschool and Primary Scale of Intelligence tests the ability to organize,
process, and reason by way of picture completion, verbal comprehension, and
block design. It may be completed without reading or writing and is designed for
children between the ages of 4 and 6. The Wechsler Intelligence Scale for
Children uses an identical approach for children and adolescents between the
ages of 6 and 16. The Minnesota Multiphasic Personality Inventory is the most
common objective personality test aimed at determining personality types,
including pathologies and behavioral patterns.
Rorschach Test
Thematic Apperception Test (TAT)
Assesses patient’s personality as a whole
Both
Rorschach Test
Thematic Apperception Test (TAT)
Henry Murray
B
Rorschach Test
Thematic Apperception Test (TAT)
Is often included in a battery of tests for personality assessment
Both
Rorschach Test
Thematic Apperception Test (TAT)
John E. Exner’s Comprehensive System
A
Rorschach test
The Rorschach test was created by Herman Rorschach, a Swiss psychologist, around
1910. The Rorschach test is the most frequently used projective personality
instrument. The test consists of ten ambiguous symmetrical inkblots. Using John
E. Exner’s Comprehensive System, the examiner gives the patient the following
instructions: "You’ll be given a series of inkblots. Look at each inkblot and
tell me what you see." The examiner gives the patient each card and asks,
"What might this be?" The examiner writes down verbatim what the patient says,
along with the initial reaction times and total time spent on each card. After
completion of what is called the free-association phase, the examiner conducts
an inquiry phase to determine important aspects of each response that are
crucial to scoring.
Thematic apperception test
The TAT was designed by Henry Murray and Christina Morgan as part of a normal
personality study conducted in the Harvard Psychological Clinic in 1943. The TAT
consists of a series of 30 picture cards and a blank card. Typically, a patient
is shown ten TAT cards and asked to make up stories about them. The patient is
asked to tell what is going on in the picture, what was going on before the
picture was taken, what the individuals in the picture are thinking and feeling,
and what is likely to happen in the future.
A. Brief Psychiatric Rating Scale (BPRS)
B. Schedule for Affective Disorders and Schizophrenia (SADS)
Ratings are made on the basis of mental status interview and do not
require that the examiner ask any specific questions
A
A. Brief Psychiatric Rating Scale (BPRS)
B. Schedule for Affective Disorders and Schizophrenia (SADS)
Highly structured interview
B
BPRS
To use the BPRS, the psychologist or psychiatrist completes
a mental status interview with the patient and then rates that patient on a
series of 18 psychiatric symptoms such as motor retardation, blunted affect,
conceptual disorganization, anxiety, and guilt. Expanded definitions of each of
these terms are provided to the examiner. The interviewer rates each domain on a
seven-point scale from "not present," the lowest rating, to "extremely
severe," the highest rating. An experienced interviewer can complete the ratings in 2 or 3 minutes. The BPRS has been used extensively in drug outcome
and other studies. The advantages of the BPRS are the reasonably high interrater
reliability, the ease and speed of rating, and the well-defined symptom
description. The BPRS ratings are made on the basis of a mental status interview
and do not require that the examiner ask any specific questions of the patient.
SADS
The SADS is a highly structured interview instrument. The interviewer is
required to ask each patient a series of prescribed questions to ensure that all
relevant areas are addressed. For example, a patient is asked a question similar
to the following: "Have you ever heard voices or other things that weren’t
there or that other people couldn’t hear or see?" Based on the patient’s
response, the examiner asks other detailed, prescribed follow-up questions
concerning hallucinations, or if the response was negative, the interviewer
moves on to the next question in a different area. This approach ensures that
all areas are covered in a comprehensive fashion. The SADS is especially helpful
for establishing a reliable diagnosis. The SADS can also be used as an index of
behavioral severity. Behavioral changes can be determined by repeated administration.
The advantage of the SADS is that it is comprehensive and has reasonably good
reliability. One disadvantage is its length; another is that in the structured
interview the interviewer must read questions from a lengthy booklet, which
makes it difficult to establish eye contact and rapport with the patient. The
SADS has been used for both research and clinical purposes, probably more
frequently for the former.
A. Battery Approach
B. Hypothesis Testing Approach
C. Screening Approach
D. Mental Status Examination
Determines if a diagnosis can be made with less information
C
In the screening approach, the neuropsychologist utilizes a core set of
screening procedures as a first step in determining whether a diagnosis can be
made with less information or whether additional testing is necessary.
Standardized screening approaches have the advantage of uniform normative
reference groups, although many clinicians routinely use a set of tests drawn
from many sources.
In some cases, usually involving an acute or severe cognitive impairment, it is
simply not feasible to administer extensive cognitive examination procedures.
The neuropsychologist might appropriately rely on bedside mental status
examinations or very brief cognitive screening procedures to address the
referral issues
A. Battery Approach
B. Hypothesis Testing Approach
C. Screening Approach
D. Mental Status Examination
May help identify problems that were not mentioned by the patient
A
The battery approach to neuropsychological assessment typically includes a large
variety of tests that measure most cognitive domains as well as sensory and
motor skills. The battery approach has the advantage of identifying problems
that the patient might not have mentioned and that the medical history may not necessarily predict. However, it has the disadvantage of being very time-consuming
A. Battery Approach
B. Hypothesis Testing Approach
C. Screening Approach
D. Mental Status Examination
Is not considered part of neuropsychological testing
D
A. Battery Approach
B. Hypothesis Testing Approach
C. Screening Approach
D. Mental Status Examination
May overlook unexpected areas of deficits
B
The qualitative hypothesis testing approach is characterized by detailed
evaluation of areas of functioning that are related to the patient’s complaints
and predicted areas of impairment, with relatively less emphasis on aspects of
functioning that are less likely to be impaired. The hypothesis testing approach
has been particularly helpful in illuminating the different roles of the two
brain hemispheres. This approach has the advantage of efficiently honing in on
areas of impairment and producing a detailed description of the deficits from a
cognitive standpoint, but it has the shortcoming of potentially overlooking
unexpected areas of deficits
A. Intellectual functioning B. Language C. Executive functions D. Memory E. Visuospatial-constructional
California Verbal Learning Test II
D
A. Intellectual functioning B. Language C. Executive functions D. Memory E. Visuospatial-constructional
Shipley Scale
A
Scale Brief (20 minute) paper and pencil measure of multiple choice vocabulary
and open-ended verbal abstraction
A. Intellectual functioning B. Language C. Executive functions D. Memory E. Visuospatial-constructional
Token Test
B
Systematically assesses comprehension of complex commands using standard token
stimuli that vary in size, shape, and color
A. Intellectual functioning B. Language C. Executive functions D. Memory E. Visuospatial-constructional
Wisconsin Card Sorting Test
C
A. Intellectual functioning B. Language C. Executive functions D. Memory E. Visuospatial-constructional
Rey-Osterreith Complex Figure Test
E
A. Rorschach test B. Luria-Nebraska Neuropsychological Battery C. Halstead-Reitan Battery of Neuropsychological Tests D. Stanford-Binet Intelligence Scale E. None of the above
Consists of ten tests, including the trail-making test and the critical
flicker frequency test
C
The Halstead-Reitan Battery of Neuropsychological Tests consists of
ten tests, including the trail-making test and the critical flicker frequency
test. It was developed in an attempt to improve the reliability of the criteria
used to diagnose brain damage. Assessment data were gathered on a group of
patients with left hemisphere injury, right hemisphere injury, and global
involvement. The trail-making test is a test of visuomotor perception and motor
speed, and the critical flicker frequency test (noting when a flicker light
becomes steady) tests visual perception.
A. Rorschach test
B. Luria-Nebraska Neuropsychological Battery
C. Halstead-Reitan Battery of Neuropsychological Tests
D. Stanford-Binet Intelligence Scale
E. None of the above
Consists of 120 items, plus several alternative tests, applicable to ages
2 years to adulthood
D
The Stanford-Binet Intelligence Scale is one of the tests most frequently used
in the individual examination of children. It consists of 120 items, plus
several alternative tests, applicable to the ages between 2 years and adulthood.
The tests have a variety of graded difficulties, both verbal and performance,
designed to assess such functions as memory, free association, orientation,
language comprehension, knowledge of common objects, abstract thinking, and the
use of judgment and reasoning
A. Rorschach test
B. Luria-Nebraska Neuropsychological Battery
C. Halstead-Reitan Battery of Neuropsychological Tests
D. Stanford-Binet Intelligence Scale
E. None of the above
A test of diffuse cerebral dysfunction to which normal children by the age
of 7 years respond negatively
E
The face-hand test, devised by Lauretta Bender, is a test of diffuse cerebral
dysfunction to which normal children by the age of 7 years respond negatively.
The person, whose eyes are closed, is touched simultaneously on the cheek and
the hand; retesting is done with the person’s eyes open. The results are
considered positive if the person fails consistently to identify both stimuli
within ten trials.
A. Rorschach test
B. Luria-Nebraska Neuropsychological Battery
C. Halstead-Reitan Battery of Neuropsychological Tests
D. Stanford-Binet Intelligence Scale
E. None of the above
Furnishes a description of the dynamic forces of personality through an
analysis of the person’s responses
A
It furnishes a description of the
dynamic forces of personality through an analysis of the person’s responses.
A. Rorschach test
B. Luria-Nebraska Neuropsychological Battery
C. Halstead-Reitan Battery of Neuropsychological Tests
D. Stanford-Binet Intelligence Scale
E. None of the above
Is extremely sensitive in identifying discrete forms of brain damage, such
as dyslexia
B
The Luria-Nebraska Neuropsychological Battery (LNNB) is extremely sensitive in
identifying discrete forms of brain damage, such as dyslexia (an impairment in
the ability to read) and dyscalculia (an inability to perform arithmetical
operations), rather than global forms of damage
Clock drawing
Useful screening technique is sensitive to organization and planning as well as
constructional ability
Rey-Osterreith Complex Figure Test
Ability to draw and later recall a complex geometric configuration; sensitive
visual memory as well as executive deficits in development of strategies and
planning
Finger tapping
Standard measure of simple motor speed; particularly useful for documenting
lateralized motor impairment
Grooved pegboard
Ability to rapidly place notched pegs in slotted holes; measures fine finger
dexterity as well as eye-hand coordination
Wisconsin Card Sorting Test
Measure of problem-solving efficiency is particularly sensitive to executive
deficits of perseveration and impaired ability to flexibly generate alternative
strategies in response to feedback
Trail-Making Test
Requires rapid and efficient integration of attention, visual scanning, and
cognitive sequencing
Beck depression inventory
Brief (5 to 10 minutes) self-report measure that is sensitive to symptoms of
depression; best for screening depression in adults up to late middle-age, who
can be expected to frankly report symptoms; available in standard (21 four-choice
items) or short (13-item) form
Minnesota Multiphasic Personality Inventory 2
This psychometrically developed self-report instrument remains highly useful for
documenting quantitative levels of self-reported symptoms that can be objectively
compared to known populations; drawbacks include administration time (567
true-false questions, requires about 1 to 1.5 hours or more) for frail
individuals, and the emphasis on pathological features for persons who are
generally psychologically healthy; advantages include well-developed validity
scales and availability of many symptom-specific subscales that have been
identified over the years
A. Raven's Progressive Matrices B. Sentence Completion Test C. Shipley Abstraction Test D. Thematic Apperception Test (TAT) E. Wechsler Adult Intelligence Scale (WAIS)
A broad set of complex verbal and visuospatial tasks that are normatively
summarized by three scales
E
A. Raven's Progressive Matrices B. Sentence Completion Test C. Shipley Abstraction Test D. Thematic Apperception Test (TAT) E. Wechsler Adult Intelligence Scale (WAIS)
Impaired performance is associated with posterior lesions of either
cerebral hemisphere
A
Raven’s Progressive Matrices require the patient to complete a design by
selecting the stimulus that completes a design in which a part is omitted from a
multiple-choice pictorial display. Impaired performance is associated with poor
visuoconstructive ability and with posterior lesions of either cerebral
hemisphere, but receptive language deficit may contribute to poor performance in
patients with dominant hemisphere damage.
A. Raven's Progressive Matrices B. Sentence Completion Test C. Shipley Abstraction Test D. Thematic Apperception Test (TAT) E. Wechsler Adult Intelligence Scale (WAIS)
Series of 20 black-and-white pictures depicting individuals of different
ages and sexes involved in a variety of settings
D
The TAT consists of a series of 20 black-and-white pictures that depict
individuals of both sexes and of different age groups involved in a variety of
different settings. For example, on Card 1, a young boy is shown sitting at a
table looking at a violin. Card 2 depicts a farm scene in which a young woman in
the foreground is carrying books in her hands; a man is working in the fields
nearby, and an older woman is seen in the background. Typically, a patient is
shown ten TAT cards and asked to make up stories about them. The patient is
asked to tell what is going on in the picture, what was going on before the
picture was taken, what the individuals in the picture are thinking and feeling,
and what is likely to happen in the future. The stories the patient make up
concerning the pictures, according to the projective hypothesis, reflect the
patient’s own needs, thoughts, feelings, stresses, wishes, desires, and view of
the future
A. Raven's Progressive Matrices B. Sentence Completion Test C. Shipley Abstraction Test D. Thematic Apperception Test (TAT) E. Wechsler Adult Intelligence Scale (WAIS)
More direct than most projective tests in soliciting responses from the
patient
B
direct in soliciting responses from the patient. The patient is simply presented
with a series of incomplete sentences and asked to complete each sentence stem
with the first response that comes to mind. Examples of possible incomplete
sentences are as follows:
My father seldom [horizontal ellipsis]
Most people don’t know that I’m afraid of [horizontal ellipsis]
When I was a child, I [horizontal ellipsis]
When encountering frustration, I usually [horizontal ellipsis]
The purpose of the test is to elicit, somewhat indirectly, information about the
patient that cannot be elicited by other measures. Since the patient responds in
writing, the examiner’s time is limited. The length of time it takes to complete
this test varies greatly, depending on the number of incomplete sentences.
A. Raven's Progressive Matrices B. Sentence Completion Test C. Shipley Abstraction Test D. Thematic Apperception Test (TAT) E. Wechsler Adult Intelligence Scale (WAIS)
Requires the patient to complete logical sequences
C
this test varies greatly, depending on the number of incomplete sentences.
The Shipley Abstraction Test requires the patient to complete logical sequences;
it assesses the patient’s capacity to think abstractly. Because performance on a
test of this type is related to educational background, an accompanying
vocabulary test is also given to the patient, and a comparison is made between
the patient’s performances on the two tests. A low abstraction score in relation
to vocabulary level is interpreted as reflecting an impairment in conceptual
thinking.
A. Frontal lobes B. Dominant temporal lobe C. Nondominant parietal lobe D. Dominant parietal lobe E. Occipital lobe
Patient not able to name common objects
B
A. Frontal lobes B. Dominant temporal lobe C. Nondominant parietal lobe D. Dominant parietal lobe E. Occipital lobe
Patient not able to name a camouflaged object but able to name it when it
is not camouflaged
E
A. Frontal lobes B. Dominant temporal lobe C. Nondominant parietal lobe D. Dominant parietal lobe E. Occipital lobe
Any improper letter sequence in spelling "earth" backward
A
A. Frontal lobes B. Dominant temporal lobe C. Nondominant parietal lobe D. Dominant parietal lobe E. Occipital lobe
The loss of gestalt, loss of symmetry, and distortion of figures
C
A. Frontal lobes B. Dominant temporal lobe C. Nondominant parietal lobe D. Dominant parietal lobe E. Occipital lobe
Two or more errors or two or more 7-second delays in carrying out tasks of
right-left orientation leaflong
D
Non-dominant parietal lobe deficits
Construction apraxia-the loss of gestalt, loss of
symmetry, and distortion of figures-seen in the task of copying the outline of
simple objects, dressing apraxia, topographical disorientation, and difficulties in face recognition, is localized to the nondominant (R) parietal lobe
Occipital lobe deficits
Dysfunction of
the occipital lobes is suggested when a patient cannot name a camouflaged object
but can name it when it is not camouflaged.
Dominant parietal lobe dysfunction
Two or more errors or two or more
7-second delays in carrying out tasks of right-left orientation (e.g., place
left hand to right ear, right elbow to right knee), Lesions in the dominant lobe result in motor aphasia if the lesion is anterior, or sensory aphasia if the lesion is posterior. Other consequences include agraphia with alexia, motor apraxia and bilateral tactile agnosia. Visual agnosia occurs if the parieto-occipital region is affected.
A specific syndrome, Gerstmann syndrome, is associated with lesions of the dominant parietal lobe. This consists of dyscalculia, agraphia, finger agnosia and right-left disorientation. localized to dysfunction
of the dominant parietal lobe.
Balint syndrome
Balint syndrome is caused by bilateral damage to the posterior parietal lobe and is characterized by optic ataxia, oculomotor apraxia and simultanagnosia.
A. Short-term memory loss B. Signs of organic dysfunction C. Korsakoff's syndrome D. Posterior right hemisphere lesion E. Damage to frontal lobes or caudate
Bender visual motor gestalt
B
Signs of organic dysfunction may be screened for by the Bender Visual Motor
Gestalt Test.
A. Short-term memory loss B. Signs of organic dysfunction C. Korsakoff's syndrome D. Posterior right hemisphere lesion E. Damage to frontal lobes or caudate
Benton visual retention test
A
The Benton Visual Retention Test screens for short-term memory loss.
A. Short-term memory loss B. Signs of organic dysfunction C. Korsakoff's syndrome D. Posterior right hemisphere lesion E. Damage to frontal lobes or caudate
Wechsler Memory Scale
C
The Wechsler Memory Scale screens for verbal and visual memory and yields a
memory quotient. The results can reveal whether a subject has amnestic
Korsakoff’s syndrome
A. Short-term memory loss B. Signs of organic dysfunction C. Korsakoff's syndrome D. Posterior right hemisphere lesion E. Damage to frontal lobes or caudate
Wisconsin Card Sorting Test
E
The Wisconsin Card Sorting Test assesses a person’s
abstract reasoning ability and flexibility in problem solving. The results can
reveal whether a person has damage to the frontal lobes or to the caudate.
A. Executive functions B. Attention and concentration C. Visuospatial-constructional D. Motor E. None of the above
Clock drawing and facial recognition
C
Facial Recognition assesses matching and discrimination of
unfamiliar faces. Clock Drawing is a useful screening technique sensitive to
organization and planning as well as constructional ability.
A. Executive functions B. Attention and concentration C. Visuospatial-constructional D. Motor E. None of the above
Finger tapping
D
Finger Tapping is
the standard measure of simple motor speed, particularly useful for documenting
lateralized motor impairment.
A. Executive functions B. Attention and concentration C. Visuospatial-constructional D. Motor E. None of the above
Trail making
A
The Trail-Making Test requires rapid and efficient
integration of attention, visual scanning, and cognitive sequencing
A. Executive functions B. Attention and concentration C. Visuospatial-constructional D. Motor E. None of the above
Digit span
B
Digit Span is the auditory-verbal measure of simple span of attention (Digits
Forward) and cognitive manipulation of increasingly longer strings of digits
(Digits Backward).
A. Executive functions B. Attention and concentration C. Visuospatial-constructional D. Motor E. None of the above
Wisconsin card sorting
A
The Wisconsin Card Sorting Test is a measure of
problem-solving efficiency. It is particularly sensitive to executive deficits
of perseveration and impaired ability to generate alternative strategies in
response to feedback.
A. Immediate memory B. Episodic memory C. Semantic memory D. Recent past memory E. Implicit memory
Memory for automatic skills, like speaking grammatically or driving a car
E
A. Immediate memory B. Episodic memory C. Semantic memory D. Recent past memory E. Implicit memory
Recall of perceived material within 30 seconds of presentation
A
Immediate (or short-term) memory may be defined as the reproduction, recognition,
or recall of perceived material within a period up to 30 seconds after
presentation. It is most often assessed by digit repetition, reversal (auditory),
and memory-for-designs (visual) tests. Both an auditory-verbal task, such as
digit span or memory for words or sentences and a nonverbal visual task, such as
memory for designs or for objects or faces, should be given to assess a
patient’s immediate memory. Patients can also be asked to listen to a standardized
story and then repeat it as accurately as possible. Patients with lesions of the
right hemisphere are likely to show more severe defects on visual nonverbal
tasks than on auditory-verbal tasks. Conversely, patients with left hemisphere
disease, including those who are not aphasic, are likely to show severe deficits
on the auditory-verbal tests, with variable performance on the visual nonverbal
tasks.
A. Immediate memory B. Episodic memory C. Semantic memory D. Recent past memory E. Implicit memory
Memory for specific events, like a phone message
B
A. Immediate memory B. Episodic memory C. Semantic memory D. Recent past memory E. Implicit memory
Retention of information over the past few months, like current events
D
Recent past memory concerns the retention of information over the past few
months. Patients can be asked questions about current events.
Remote memory is the ability to remember events in the distant past. It is
commonly believed that remote memory is well preserved in patients who show
pronounced defects in recent memory, but the remote memory of senile and amnesic
patients is usually significantly inferior to that of normal persons of
comparable age and education. Even patients who appear to be able to recount
their past fairly accurately show gaps and inconsistencies in their recitals on
close examination.
A. Immediate memory B. Episodic memory C. Semantic memory D. Recent past memory E. Implicit memory
Memory for knowledge and facts, like the first president of the United
C
Memory theorists have described three other types of memories: episodic, for
specific events (e.g., a telephone message); semantic, for knowledge and facts
(e.g., the first president of the United States); and implicit, for automatic skills (e.g., speaking grammatically or driving a car). Semantic and implicit
memory do not decline with age, and persons continue to accumulate information
over a lifetime. A minimal decline in episodic memory with aging may relate to
impaired frontal lobe functioning.
