Exam 1 Flashcards
Neuropsychology
- scientific study of the relations btwn (changes of) brain function and behavior
- intervention and treatment
What 2 early doctrines emerged to explain brain functioning?
- vitalism
- materialism
Vitalism
- suggests many behaviors are partly controlled by mechanical or logical forces
- also partially self determined
- spiritual and mechanical
Who was a major proponent of vitalism?
Sigmund Freud’s psychoanalyses
Materialism
favors a mechanistic view of the brain (as a machine)
Who was a major proponent of materialism?
Walter Freeman and his lobotomies
Hippocrates
- founder of modern medicine
- believed the brain controlled all senses and movement
- recognized that if r side of brain was damaged, the L side of body was affected and vice versa
Plato
- believed the soul had 3 parts - appetite, reason (located in brain) and temper
Aristotle
- believed the heart to be the source of all mental processes
Cell Doctrine
- ventricular cavities w/n the brain control mental abilities and movement
- Alexandrian period
Phrenology
- beginning of localization theory
- brain consists of number of separate organs, each responsible for a basic psychological trait
- size of the organ = more skill in that area
Who proposed phrenology?
Franz Gall
Who were the two individuals that proposed evidence for localization?
Paul Broca and Carl Wernicke
Paul Broca
- motor speech was localized in the post., inf. region of the L frontal lobe
- case study of “Tan” - could understand but not produce speech
- Broca’s area
Carl Wernicke
- understanding of speech was localize in the sup., post., temporal lobe
- case study of pt who could produce speech but not understand it
- Wernicke’s area
Pierre Florens
- developed ablation experiments, did them on birds at first
- found that more extensive damage = more complications
- found that other tissues can take over function
- equipotentiality theory
Equipotentiality
- mental abilities depend on the brain functioning as a whole
- found that other tissues can take over function
- intro to idea of neuroplasticity
Computed Transaxial Tomography
- 3D perspective of the brain w/ acceptable diff. of brain structures
Angiography
- Technique that uses dye to visualize blood vessels
Electrophysiologic Procedures (EEG)
- recording of the electrical activity of nerve cells
- helps w/ diagnosis of: seizure and sleep disorders, level of coma presence of brain death
Positron Emission Tomography (PET)
- tracks blood flow associated w/ brain activity
Magnetic Resonance Imaging (MRI)
- can provide detailed images of brain structures
- more detailed than PET scan
- can diff. white and gray matter
fMRI
- functional MRI
- provide image of oxygen usage in the brain (active neurons use O2)
What are the four common features of neurons? What is the function?
- cell body
- dendrites
- axon
- terminal synaptic buttons
Cell body of neuron
metabolic center, protein synthesis, DNA located in nucleus
Dendrites
receive info from other cells
Axon
- info/AP is conducted down this to other neurons, muscles or glands
- surrounded by myelin sheaths
Terminal synaptic buttons
- chemical communication w/ other neurons
- main proponent in the release of neurotransmitters
- contain vesicles w/ NTs
Myelin sheath
covers the axon of some neurons and helps speed of impulses
Nodes of Ranvier
gaps btwn myelin
Microglia
- glial cell in CNS
- phagocytic, clean/metabolize debris and dead cells
- increase in number when brain is injured
Astrocytes
- glial cell in CNS
- feet form BBB, provide nutrient (glucose) and structural support, also phagocytic
Oligodendrocytes
- glial cell in CNS
- form myelin sheaths
Schwann cells
- glial cell in the PNS
- form myelin sheaths
Resting membrane potential
- -70 mV
- caused by electrical imbalance btwn inner and outer surface of membrane
What ions maintain resting membrane potential?
- Na+ - outside of membrane, always excitatory
- Cl- - outside of membrane, always inhibitory
- K+ - inside of membrane, always inhibitory
- negatively charged proteins
Action potential
- electrical potential across neuron membrane that raises potential to threshold (-55mV)
What do action potentials result in?
- selectively permeable membrane to ions
- active transport of Na+ and K+
- voltage gated Na+ channels open, letting Na+ go into cell, triggers opening of K+ channels, which moves K+ out of the cell
Where do neurons communicate?
at the synapse
- NTs are released
What occurs when neurons communicate?
- rupture of vesicles that release NTs into the synaptic cleft
- NT binds to binding site and causes the pore to open on the postsynaptic cell
Acetylcholine
- motor control, autonomic nervous system (parasym), memory, sleep/wake
- located at neuromuscular junction
Norepinephrine
- mood!, hormones, arousal, attention, and eating
Serotonin
- sleep/wake cycle, appetite, mood!
Dopamine
- motor behavior!, pleasure/reward!, cognition
Glutamate
- major excitatory NT in the brain
- more likely to cause APs, depol. the cell
GABA
- major inhibitory NT in the brain
- more likely to inhibit APs, repol. the cell
What protects the brain?
- Skull - uneven thickness and bony projections to hold brain in place
- Meninges - Dura mater (tough), Arachnoid membrane (subarachnoid space contains CSF and blood), Pia mater (directly on brain, meningitis occurs here)
Ventricular system
- produces and houses CSF, provides buoyancy and cushioning to brain, and allows for disposal of waste
- blockage results in buildup of pressure
- R lat., L lat., third and fourth
Circle of Willis
- communicating arteries provide blood btwn front and back of brain
- provides protection in that if carotids are tied off, blood flow is not completely blocked in brain
- middle cerebral artery supplies blood to motor areas
What is the brainstem composed of?
- pons - arousal/sleep/wake
- medulla - BP, respirations, HR
What is the reticular activating system?
- pons and medulla functioning together
- imp. for selective attention
- overactivation results in sensory deprivation
- damage could result in coma
Hypothalamus
- works closely w/ pituitary gland
- release of hormones, metabolic function, homeostasis, body temp
- stimulates adrenal gland during stress response
Thalamus
- all sensory info other than smell is processed here then sent to designated lobe
Basal Ganglia
- higher motor function (initiating and planning movements)!!
- cognition and mental flexibility controlled by caudate nucleus
- communicated w/ the cerebellum and red nucleus
Limbic System
- motivation and emotional regulation
- amygdala - fear, emotional memory/conditioning
- hippocampus - learning and (spatial) memory, spatial navigation
Corpus Callosum
- large bundle of fibers that allows simultaneous communication btwn R and L hemispheres
- anterior commissure and hippocampal commissure also contribute to function
Cerebellum
balance and coordination
What are the goals of a neuropsychological assessment?
- diagnose presence of cortical damage (assess cog. function) and localize it
- facilitate pt care
- ID mild disturbances (microscopic damage)
- ID unusual brain organization
- ID cause of disorders
- Rehab
- Help pt and family understand their disorder
Psychometrics
- Science of measuring human traits or abilities.
- standardization of psychological and neuropsychological tests
- neuropsychometrics are sensitive to behavior
Reliability
- stability or dependability of a test score
- test results can be reliable but not valid
Validity
whether or not the test is measuring what it is supposed to measure
Why is it important that neuropsychological tests be reliable and valid?
so that pts are not misdiagnosed
False Positive
test erroneously indicates a condition
What types of test are most commonly used by psychologists?
- achievement - how the ind. has profited from learning and experience (exams)
- aptitude - future functioning (GRE, MCAT)
- behavioral/adaptive - what the pt. habitually does (day to day tasks)
- intelligence - IQ score, working mem., learning, verbal and nonverbal
- neuropsychological - sensitive to all changes in brain
- personality - diff personality traits, i.e. introvert vs. extrovert (MMPI)
- vocational - opinions and attitudes regarding diff. areas like professions
Fixed battery
- comprehensive and fixed set of tests
- EX: Halstead-Reitan Neuropsychological Battery, Wechsler Adult Intelligence Scale, Luria-Nebraska Neuropsychological Battery
What are the pros and cons of a fixed battery?
Cons
- time-consuming, all tests must be conducted
- neuropsychologist may not have seen pt. if tests are given by a tech
- something could be missed, tests cannot be altered to assess all concerns
Pros
- patients are easy to compare and assess b/c tests are standardized
Flexible battery
- selection and administration of an array of tests based on pt’s presenting complaints
What are the pros and cons of a flexible battery?
Cons
- patients cannot be easily compared
- possible bias could cause neuropsych. to miss a test
- no longer standardized
Pros
- tests can be changed/altered to fit concerns
- neuropsych. selects tests, giving the ability to hone in on specific traits
Orientation/Arousal
- pt’s basic awareness of themselves to the world around them
- assessment involves eval. of orientation in terms of place, person and time (What’s the date? What’s your address? What’s your name)
What is the standardized test for orientation?
- Galveston Orientation and Amnesia Test (GOAT)
- assess extent and duration of confusion and amnesia after TBI
- 0-100, 75 or better indicates normal functioning
Sensation and perception
- assess pt.’s visual, auditory, and tactile functional levels
- can be done by optometrist or audiologist
What are the common tests for sensation and perception?
- Halsteid-Reitan Neuropsychological Battery - standardized
- includes a sensory-perceptual examination like tactile testing (feeling and ID objs) - nonstandardized
Attention and Concentration
- sustained attention - paying attention to something over prolonged period of time
- selective attention - paying attention to more than one thing at a time
What are the common tests for attention and concentration?
- Symbol digit modalities test (SDMIT) - #s and symbols, must match each
- d2 test - visual cancellation test
- nonstandardized - digit span test (repeat numbers in instructed order), say the alphabet backwards
Motor Skills
- assess of pt.’s motor control in the upper and lower extremities
- measuring simple and complex motor skills
What is the common test for motor skills?
- standardized - finger-tapping speed from the Halsteid-Reitan and grip strength
- nonstandardized - follow motor commands
Verbal Functions/Language
- assess simple spoken language as well as more complicated areas like:
- word repetition
- naming
- word production
What is the common test for verbal functions/language?
- standardized - the Controlled Oral Word Association (COWA) - name as many words you can starting w/ a specific letter
- standardized - Token test - point and touch diff. colored tokens
- nonstandardized - define words, generating sentences using a specific word
Visuospatial Organization
- assess diff. areas of processing such as spatial orientation, facial recognition, and visual sequencing
What is the common test for visuospatial organization?
- standardized - The Bender Gestalt test - copy geometric shapes, graded on accuracy
- standardized - The Rey-Osterrieth Complex Figure Test - copy abstract shapes, graded on accuracy
- nonstandardized - draw the face of a clock at a certain time, recognition of facial expressions
Memory
- immediate and delayed memory (verbal and visual formats)
What is the common test for memory?
- standardized - Wechsler Memory Scale (WMS) - measures verbal and nonverbal mem
- nonstandardized - repeat a story, recall ability of specific words
Judgement/Problem Solving
- abstract reasoning/insight and problem solving
What is the common test for judgement/problem solving?
- standardized - Trail Making Test B, Wisconsin Card Sorting Test, Tower of London-Drexel University
- nonstandardized - what-if situations
What is the most common test for frontal lobe damage?
- Wisconsin Card Sorting Test - sort cards depending on an unknown set of rules, pt. has to learn rules through trial and error
- shifting of strategies
Malingering
- exaggerating cognitive deficits
- external incentives could play a role in performance (benefits, disability, lawsuits etc.)
- neuropsych are trained specifically to detect this
Language
- L hemi dominant
- R hemi plays a role in appreciation of irony and metaphors
- PET scan studies proved this
Visuospatial ability
- R hemi dominant
- mental rotation
- perception and recognition of faces (fusiform face area)
- direction and distance
Men are more skilled at?
- better spatial abilities
- more skilled at mental rotation of objs and spatial navigation
Attention
- Focal and divided attention = L hemi
- Global and sustained = R hemi
Mathematical ability
- writing and reading numbers = L hemi
- calculations and mental math = R hemi
Perception of music
- Melody = R hemi
- Lyrics = L hemi
Women are more skilled at?
- better language abilities
- superior on verbal fluency, verbal memory, and object location
Handedness
- degree to which an individual preferentially uses one hand
- 96% R handed people are L hemi dominant for language
- 70% L handed people are L hemi dominant for language, the other 30% use both hemis for language which causes deficiency in visuospatial tasks
Commissurotomy
- surgical procedure that severs the corpus callosum so seizures do not spread to other regions
- causes disconnection syndrome
Disconnection Syndrome
- two hemispheres can no longer communicate, act independently
- split brains - sensory information is only sent into one hemi, joe from video an EX
Objects shown in the left visual field are projected into the ____ hemi, which controls the ____ side of the body.
- Right
- Left
Objects shown in the right visual field are projected into the _____ hemi, which controls the _____ side of the body.
- Left
- Right
What are some characteristics of split-brain patients?
- somatosensory effects - impaired IQ, mute, trouble following commands
- visual effects - blindness in one eye
- la main etrangere (the stranger hand) - L hand opposes the R
- EX: R hand buttons a shirt, L hand unbuttons it; R hand picks out a pair of socks, L hand picks out a diff pair
Split brain example
- if a picture of a cat is shown on the R visual field, it will go to the L hemi, pt can SAY cat
- if a picture is shown on the L visual field, it will go to the R hemi, pt cannot say cat, but can DRAW one
- Joe from video
