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Clinical Neuropsychology > Exam 1 > Flashcards

Exam 1 Flashcards

Topics and Questions covered in the first Exam

1
Q

What are the different aspects of cognitive function?

A

4 Classes of Cognitive Function:
1. Receptive Functions: involve the abilities to select, acquire, classify, and integrate information.
2. Memory and Learning: refer to information storage and retrieval.
3. Thinking: concerns the mental organization of reorganization of information.
4. Expressive Functions: are the means through which information is communicated or acted upon.

Each functional class = distinct behaviors but are interdependent

From Lezak Ch. 2 Pg 20

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2
Q

What are the different aspects of emotional function?

A

Depression, anxiety, motivation,
family, social skills, impulsivity

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3
Q

Define

Standardization

A

Consistency in the procedure used to administer and
score a test
* Test norms: where a score on a test ranks in relation
to other scores on that test
* Standardized group: sample of people on which the
norms are based

From Exam 1 Study Guide Slides

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4
Q

Define

Reliability

A

Consistency in measurement
– Internal consistency: whether all aspects of the test
contribute meaningfully
– Test-retest reliability: whether similar results would be
obtained at 2 time points
– Inter-rater reliability: whether similar results would be
found by several raters

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5
Q

Define

Validity

A
  • Whether an assessment measures what it is
    supposed to measure
    – Content validity: whether the test measures all aspects of
    the construct
    – Concurrent and predictive validity: whether the test data
    are consistent with other related constructs
    – Discriminant validity: whether the test is not measuring
    unrelated constructs
    – Ecological validity: how well the assessment data predict
    future behavior or behavioral outcomes
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6
Q

What are the brain imaging techniques and their contributions?

A
  1. Structural Imaging:
    * Image anatomical brain structures in a static fashion
    * Ideal for identifying tumors, hemorrhages etc.
    * Computerized Axial Tomography (CAT scan) and Magnetic Resonance Imaging (MRI)
  2. Functional Imaging:
    * Image brain activity in a dynamic fashion
    * Ideal for identifying changes in brain activity as a function of someone’s feelings, thoughts, or actions
    * Electroencephalography (EEG)
    Event-Related Potentials (ERP)
    Functional Magnetic Resonance Imaging (fMRI)

*

Unit 2 Lectue 1

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7
Q

Define and describe their contributions

Computerized Axial Tomography (CAT scan)

A
  • Related to X-rays absorption (minimally invasive)
  • Absorption of X-ray radiation correlated with tissue density:
  • Advantages: can image simultaneously soft tissues, blood vessels, and bone. Less expesnive and more readily available than MRI
  • Caveats: less spatial resolution than MRI, and it may be harmful (especially for pregnant women and children)

From Unit 2 Lecture 1

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8
Q

Define and describe their contributions

Magnetic Resonance Imaging (MRI)

A
  • Exploits the magnetic properties of organic tissue
  • Advantages:
  • Very good spatial resolution (even sub-mm)
  • Several types of signals can be imaged
  • Non-invasive
  • Disadvantages
  • Bulky and expensive
  • Some subjects cannot undergo MRI

From Unit 2 Lecture 1

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9
Q

Define and describe their contributions

Electroencephalography (EEG)

A

Continuous recording of overall brain activity
* Many clinical applications
* EEG patterns are well established and consistent among individuals =>
EEG recordings detect abnormalities in brain function
* Not as useful for cognitive neuroscience (provides global
activity)

From Unit 2 Lecture 1

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10
Q

Define and describe their contributions

Event-Related Potentials (ERP)

A

How brain activity is modulated in response to a task
* Small, event-related signals embedded in ongoing EEG
* ERP is a change in electrical activity time-locked to specific
events
* Averaging of EEG signals over many events
* Advantages: Direct (measure neuronal activity), Non-invasive,
very good temporal resolution (ms), Relatively inexpensive
* Caveats: poor spatial resolution (cm or more)

From Unit 2 Lecture 1

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11
Q

Define and describe their contributions

Functional Magnetic Resonance Imaging (fMRI)

A

BOLD signal (Blood Oxygen Level Dependent)
* Depends on magnetic properties of hemoglobin
* Measures concentration of deoxyhemoglobin in blood
* Hemodynamic response function: change in BOLD response
over time in response to a stimulus (6-8sec)
* Advantages: Non-invasive, very good spatial resolution
(mm)
* Caveats: poor temporal resolution (seconds), expensive

From Unit 2 Lecture 1

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12
Q

Define

Standard Battery Approach

A

Same tests or “core batteries” given to all
* Tests administered according to standardized rules
* Interpretation based on standardized norms

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13
Q

What are the advantages and disadvantages

PROCESS Battery Approach

A
  • Advantages: * Acknowledges the individuality of the
    patient
  • Exam focuses on most important deficits
  • Emphasizes how a task is failed or solved
  • Useful for clinical case studies
  • Disadvantages:* Test procedure may be biased by clinician
  • Opinion of the clinician is subjective
  • Difficult to teach, because it requires
    experience
  • Does not lend itself to large-scale research
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14
Q

Define

Process approach

A

Exam administered by a neuropsychologist
* Tests not administered in a standard way
* Conclusions based on clinical experience

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15
Q

What are the advantages and disadvantages

STANDARD Battery Approach

A
  • Adavantages: * Comprehensive evaluation of abilities
  • Objective interpretation based on normative
    data
  • Facilitates teaching because of standard
    rules/norms
  • Useful for empirical research
  • Disdavantages: * Time demanding and labor intensive
  • Tests only as good as standardization
  • Relatively inflexible approach to testing
  • Scores may not reflect a single cognitive
    process
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16
Q

What are the 3 dimensions of behavior in neuropsychology?

A
  1. Cognitive Functions: The information handling aspect of behavior
  2. Emotionality: Concerns feelings and motivation
  3. Executive/control Functions: Refers to how behavior is expressed
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17
Q

What are the advantages and disadvantages of the Wechsler Intelligence tests?

A
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18
Q

What are the brain areas involved in attention?

A
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19
Q

Balint Syndrome

A
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20
Q

What are the symptoms of Unilateral Neglect?

A
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21
Q

What are the causes of Balint Syndrom?

A
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22
Q

What are the symptoms of Balint Syndrome?

A
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23
Q

What are the tests for Balint Syndrome

A
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24
Q

Unilateral Neglect

A
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25
Q

What are the causes of Unilateral Neglect?

A
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26
Q

What are the tests for Unilateral Neglect?

A
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27
Q

Achromatopsia is due to ______________.

A

Leison in V4

Look at Unit 4 Lecture 1

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28
Q

Achromatopsia

A
29
Q

Define

Neuropyshcology

A

the study of the
relationships between the brain and
behavior

From Unit 2 Lecture 1

30
Q

Define

Clinical Neuropsychology

A

An **applied science **concerned with the behavioral expression of brain dysfunction

From Lezak Chapter 1

31
Q

Define

Neurology

A

diagnostic and treatment of
central nervous system disorders

From Unit 2 Lecture 1

32
Q

Define

Cognitive Psychology

A

the study of higher cognitive functions and their components, using
unimpaired participants

From Unite 2 Lecture 1

33
Q

List

What are the 6 different purposes of Neuropsychological Assessment?

Any of 6 different purposes may prompt a neuropsychological examination

A
  1. Diagnosis
  2. Patient Care and Planning
  3. Treatment Planning and Remidiation
  4. Treatment Evaluation
  5. Research
  6. Forensic Neuropsychology

Any of 6 different purposes may prompt a neuropsychological examination

From Lezak Chapter 1

34
Q

Explain

Diagnosis

A

Goal: to determine the general level of
cerebral functioning, to identify cerebral
dysfunction, and to localize it. Provide an accurate and unbiased evaluation of a person’s cognitive capacity

From Unit 2 Lecture 1

35
Q

Explain

Patient Care and Planning

A
36
Q

List

Types of Brain Conditions Clinical Neuropsychologists examine

A
  • Traumatic Brain Injury
  • Brain Tumors
  • Epilepsy
  • Autism
  • Dementias, like Alzheimer’s Disease
  • Stroke
  • Multiple sclerosis
  • Learning and attention disorders

From Unit 2 Lecture 1

37
Q

What are the populations that Clinical Neurpsychologist serve?

A

People with concerns about brain function, across the entire age and developmental span:
* Infants
* Children
* Adolescents
* Adulthood
* Old age

From Unit 2 Lecture 1

38
Q

Define

Neuroanatomy

A

normal brain structure and function

From Unit 2 Lecture 1

39
Q

Define

Psychopharmacology

A

the way drugs and
environmental toxins affect the brain

From Unit 2 Lecture 1

40
Q

Define

Neuropathology

A

the way injuries affect the brain

From Unit 2 Lecture 1

41
Q

Define

Neuropsychological Assessment

A

Vast array of tests and
assessments for brain function. Can include:
* Interviewing family or friends
* Formal standardized testing (cognitive,
behavioral or personality)

From Unit 2 Lecture 1

42
Q

Define

Corpus Callosum

A

Connects Left and Right hemispheres of the brain
* Allows each hemisphere access to
information from both sides
* The largest fiber system in the brain
* In humans this bundle of
white matter includes more
than 250 million axons

From Unit 2 Lecture 1

43
Q

Define

Homotopic fibers

A

fibers connect corresponding
sections of the two hemispheres (via the corpus callosum)

From Unit 2 Lecture 1

44
Q

Define

Heterotopic fibers

A

Heterotopic fibers connect different areas of the
two hemispheres

From Unit 2 Lecture 1

45
Q

Define

Ipsilateral fibers

A

Ipsilateral fibers connect different areas of the
same hemisphere

From Unit 2 Lecture 1

46
Q

List

Brain examination methods

A

1). Lesion studies
2). Structural and functional brain
imaging
3). Stimulation methods

From Unit 2 Lecture 1

47
Q

Define

Leison Studies Methods

A
  • Traumatic brain injuries (TBI): Open and close-head trauma
  • Neurological dysfunctions: Stroke; AD; Epilepsy
    Advantages
  • Can tell us if a brain area is critical for a particular function
    Caveats
  • Some forms of brain damage make it hard to localize the lesion
  • Danger in concluding that a function is localized in a region, or the purpose
    of a region is to support that function (neophrenology)
48
Q

Define

STRUCTURAL & FUNCTIONAL Brain Imaging Methods

A

➢STRUCTURAL imaging methods
* Image anatomical brain structures in a static fashion
* Ideal for identifying tumors, hemorrhages etc.
➢ FUNCTIONAL imaging methods
* Image brain activity in a dynamic fashion
* Ideal for identifying changes in brain activity as a function
of someone’s feelings, thoughts, or actions

49
Q

Define

Stimulation Methods

A
  • Transcranial Magnetic Stimulation (TMS)
  • Transcranial Direct Current Stimulation
    (tDCS)
  • Vagus Nerve Stimulation (Surgically implanted devices & Noninvasive devices)
50
Q

Define and describe pros and cons

Transcranial Magnetic Stimulation (TMS)

A
  • Change in the current in the coil => magnetic field that
    interferes with currents in nearby neurons
  • Change in neuronal firing patterns
  • Advantages: non-invasive, allows specificity in the deficit
    produced and strict experimental control, causality, some
    suggestion of beneficial effects (e.g. in depression)
  • Caveats: can only reach surface areas, stimulation is mild,
    restrictions in subject population
51
Q

Define

Transcranial Direct Current Stimulation
(tDCS)

A
  • A more direct stimulation
    method
  • Small electrodes placed on
    the head deliver a constant
    low level of electric
    current, altering neuronal
    excitability
  • Electrodes can be placed
    on top of the desired
    stimulation area
52
Q

Define

Vagus Nerve Stimulation

A
  • Uses a device to stimulate the vagus nerve with electrical
    impulses
  • When the vagus nerve is stimulated, electrical impulses travel to areas of the brain, altering brain activity to treat
    certain conditions
53
Q

Define

Vagus Nerve Stimulation: Surgically implanted devices

A
  • Implantable vagus nerve stimulator has been approved by
    the FDA to treat epilepsy and depression (by sending
    stimulation to areas of the brain that lead to seizures and
    affect mood)
  • Another FDA approved vagus nerve stimulation device is
    used in rehabilitation when recovering from a stroke. When
    someone has trouble using their hand or arm after a stroke, the stimulation helps create new pathways in the brain as the person performs exercises, helping the person regain
    function.
54
Q

Define

Vagus Nerve Stimulation:
Noninvasive devices

A

FDA approved device to treat cluster headaches and migraine in the US. This device stimulates the vagus nerve
when it’s held against the skin of the neck. The stimulation blocks pain signals to prevent or relieve head pain.

55
Q

Define

The Limbic System

A
  • also called the emotional control center
  • includes the amygdala, hippocampus,
    cingulate cortex
56
Q

Define

The Cerebral Cortex

A
  • Cerebral cortex is divided into four lobes: frontal, parietal, temporal and occipital. Each of these lobes is responsible for processing different types of information. Collectively, your cerebral cortex is responsible for the higher-level processes of the human brain, including** language, memory, reasoning, thought, learning, decision-making, emotion, intelligence and personality.**
57
Q

What are the rules of a neuropsychological assessment?

A
  1. Treat each patient as an individual
  2. Tailor the examination to the patient’s needs, abilities, and limitations, and to special examination
    requirements
  3. **Adapt **test procedures to a patient’s condition
  4. Think about what you are doing
58
Q

What are the approaches to neuropsychological assessments?

A

Standard Battery Approach:
- Same tests or “core batteries” given to all
- Tests administered according to standardized rules
- Interpretation based on standardized norms

Process Approach:
- Exam administered by a neuropsychologist
- Tests not administered in a standard way
- Conclusions based on clinical experience

59
Q

What are the advantages and disadvantages of the Standard Approach?

A

Advantages:
1. Comprehensive evaluation of abilities
2. Objective interpretation based on normative data
3. Facilitates teaching because of standard rules/norms
4. Useful for empirical research
Disadvantages:
1. Time demanding and labor intensive
2. Tests only as good as standardization
3. Relatively inflexible approach to testing
4. Scores may not reflect a single cognitive process

60
Q

What are the advantages and disadvantages of the Process Approach?

A

Advantages:
1. Acknowledges the individuality of the patient
2. Exam focuses on most important deficits
3. Emphasizes how a task is failed or solved
4. Useful for clinical case studies
Disadvanates:
1. Test procedure may be biased by clinician
2. Opinion of the clinician is subjective
3. Difficult to teach, because it requires experience
4. Does not lend itself to large-scale research

61
Q

Define

Realiability

A

Reliability: Consistency in measurement
1. Internal consistency: whether all aspects of the test contribute meaningfully
2. Test-retest reliability: whether similar results would be obtained at 2 time points
3. Inter-rater reliability: whether similar results would be found by several raters

62
Q

Define

Validity

A

Validity: Whether an assessment measures what it is supposed to measure
1. Content validity: whether the test measures all aspects of the construct
2. Concurrent and predictive validity: whether the test data are consistent with other related constructs
3. Discriminant validity: whether the test is not measuring unrelated constructs
4. Ecological validity: how well the assessment data predict future behavior or behavioral outcomes

63
Q

Define

Ecological Validity

A

Ecological validity: how well the assessment data predict future behavior or behavioral outcomes

64
Q

What are the 3 dimensions of behavior?

A
  1. Cognitive functions: The information handling aspect of behavior
  2. Emotionality: Concerns feelings and motivation
  3. Executive/control functions: Refers to how behavior is expressed
65
Q

What are the 12 typical areas of assessment?

A
  1. Orientation: Arousal, degree of confusion, time, place
  2. Motor: Balance, ambulation, speech, speech, strength
  3. Memory:Storage, retrieval, declarative, procedural
    4.Sensory/Perception:
    Recognition, familiarity, visual, auditory, tactile
  4. Visual Spatial: Construction, route finding, face rec., spatial processing
  5. Abstract Reasoning: Comprehension, judgment, problem solving, organization, sequencing
  6. Attention: Span, selective, sustained, shifting, neglect, fatigue
  7. Language Skills:Receptive, expressive, articulation, syntax, grammer
  8. Emotional/Social:Depression, anxiety, motivation, family, social skills, impulsivity
  9. Motor: Cerebral dominance, graphic skills, initiation, perseveration
  10. Memory:Verbal, visual, immediate, shortlong term, recognition, encoding
  11. Activities of Daily Life:Toileting, dressing, bathing, feeding
66
Q

Define

Language Production

A

Language Production: the ability to use words, phrases, and sentences to convey information.

66
Q

Define

Language Comprehension

A

Language Comprehension:the ability to understand the messages conveyed by words, phrases, and
sentences.

67
Q
A

Clinical Neuropsychology (4 decks)

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