Exam 2

Question 1

What is the hippocampus’s role in anterograde and retrograde amnesia ?

Q2

Answer 1

The hippocampus is involved in the formation of memories, not the retrieval

Anterograde amnesia is associated with hippocampal damage

Retrograde amnesia is associated with mammillary body or thalamic nuclei lesions

also… Severe retrograde amnesia is almost always accompanied by anterograde amnesia

Question 2

Describe what a correlation coefficient is… and identify the formula used to calculate it.

Q5 (I still dont understand this answer)

Answer 2

Its values can range from -1 to 1. A correlation coefficient of -1 describes a perfect negative, or inverse, correlation, with values in one series rising as those in the other decline, and vice versa. A coefficient of 1 shows a perfect positive correlation, or a direct relationship. A correlation coefficient of 0 means there is no linear relationship

To calculate the Pearson correlation, start by determining each variable’s standard deviation as well as the covariance between them. The correlation coefficient is covariance divided by the product of the two variables’ standard deviations.

Question 3

Construct versus Content Validity

Answer 3

Construct validity refers to the degree to which a test or other measure assesses the underlying theoretical construct it is supposed to measure

Content validity evaluates how well an instrument (like a test) covers all relevant parts of the construct it aims to measure. Here, a construct is a theoretical concept, theme, or idea: in particular, one that cannot usually be measured directly.

Content and Construct validity are two of the four types of measurement validity, the other two are:

Face validity: Does the content of the test appear to be suitable for its aims?

Criterion validity: Do the results accurately measure the concrete outcome they are designed to measure?

Question 4

9. The hit rate of a test is best when ________

a) the validity coefficient is low
b) the selection ratio is high
c) the base rate is moderate
d) the reliability coefficient is low

Answer 4

c) the base rate is moderate

Base rate is the percentage of cases in a population in which a particular characteristic occurs without the use of a test. If the base rate is higher than the hit rate, then the use of a test for selection is unnecessary– unless the test is intended to make selections better than the base rate.

Question 5

The Geschwind-Galaburda Theory

Q13

Answer 5

Based on observation of the asymmetry of the planum temporale with the left hemisphere being larger than the right in most right handed people. In males, however, there is less asymmetry – which is proposed to be an effect of testosterone in delaying the development of the left hemisphere, although greater development of the right. This theory provides rationale for the greater spatial skills in males, as well as the increased rate of autoimmune disorders in males. Kolb and Whishaw, Fundamentals of Human Neuropsychology – Fifth Edition, 2003, page 663).

Question 6

Abnormalities in what areas of the brain have been proposed to correlate with impairment in autism

Q16

Answer 6

Cerebellum, brain stem, and temporal lobe

Question 7

What areas does the MCA supply?

Answer 7

Lateral frontal and temporal cortex

Question 8

What areas does the PCA supply?

Answer 8

Inferior and medial temporal lobes and occipital cortex

Question 9

What areas does the ACA supply?

Answer 9

Anterior medial surface of the brain from frontal cortex to anterior
parietal lobes.

Question 10

Brain findings associated with reading disorders

Q21

Answer 10

Symmetrical planum temporale
Cortical malformations in the frontal and temporal areas
Reduced insular and frontal lobe volumes

volumes in dominant hemisphere perisylvian areas have not been shown to be reduced.

Question 11

You are informed by the test manual that the test you are using has a reliability coefficient of .81. Therefore, 19 % is due to measurement error. Explain

Q25

Answer 11

If you take a test youre going to have an outcome… it will get you a reliable outcome 81% of the time.

The rest of those outcomes 19% have to be from meausrement error or chance.

Think of finding this percent by subtracting .81 from 1…

Question 12

The Striatum is part of the Basal Ganglia and includes which structures

Q26

Answer 12

The striatum is composed of three nuclei: caudate, putamen, and ventral striatum.

The latter contains the nucleus accumbens (NAcc). The caudate and putamen/ventral striatum are separated by the internal capsule, a white matter tract between brain cortex and brainstem.

Question 13

Which of one of the following statements regarding Heschl’s gyrus is false:

a) Heschl’s gyrus is bilateral and located adjacent to the planum temporale.
b) In almost all individuals, the left-sided Heschl’s gyrus, like the left-sided planum temporale, has greater surface area than its right-sided counterpart.
c) Each Heschl’s gyrus reflects auditory stimulation predominantly from the contralateral ear.
d) Heschl’s gyrus appears to sort auditory stimulation for direction, pitch, loudness, and other acoustic properties rather than words for their linguistic properties

Q32

Answer 13

b

The dominant hemisphere planum temporale, which is integral to language function, has greater surface area than its counterpart. Heschl’s gyrus, which processes the auditory qualities of sound, is bilaterally symmetric.

Question 14

In non-fluent aphasia, why is the arm typically more paretic than the leg?

Answer 14

The motor cortex for the arm is supplied by the middle cerebral artery (MCA), which is usually occluded. The motor cortex for the leg is supplied by the anterior cerebral artery (ACA), which is usually spared

Question 15

What is the difference between positive predictive power and negative predictive power?

Q37

Answer 15

PPV = strong when specificity is high + base rate is not too low
NPV = strong when sensitivity is high + base rate is not different in sample from population

Positive predictive value reflects the proportion of subjects with a positive test result who truly have the outcome of interest. Negative predictive value reflects the proportion of subjects with a negative test result who truly do not have the outcome of interest

Predictive value is determined by the sensitivity and specificity of the test and the prevalence of disease in the population being tested. (Prevalence is defined as the proportion of persons in a defined population at a given point in time with the condition in question.) The more sensitive a test, the less likely an individual with a negative test will have the disease and thus the greater the negative predictive value. The more specific the test, the less likely an individual with a positive test will be free from disease and the greater the positive predictive value.

When the prevalence of preclinical disease is low, the positive predictive value will also be low, even using a test with high sensitivity and specificity. For such rare diseases, a large proportion of those with positive screening tests will inevitably be found not to have the disease upon further diagnostic testing. To increase the positive predictive value of a screening test, a program could target the screening test to those at high risk of developing the disease, based on considerations such as demographic factors, medical history or occupation. For example, mammograms are recommended for women over the age of forty, because that is a population with a higher prevalence of breast cancer.

NPV is related to the base rate, or prevalence, of the condition/disease that one is trying to identify. Therefore, the obtained NPV can be inaccurate, in any given study, if the base rate of the condition in the study sample differs from the base rate of that condition in the population

Question 16

Clinical features of left posterior cerebral artery (PCA) occlusion include:

Q39

Answer 16

Right homonymous hemianopsia and hemianesthesia

however, PCA may supply the thalamus and also result in hemianesthesia. Alexia without agraphia may result

Question 17

A 50 y.o. normotensive man has an episode of sudden loss of vision in the right eye. This persists for 15 minutes ad then rapidly resolves. He has normal neurological and opthalmological examination. The mechanism of this episode is most likely:

a) Demyelination of optic nerve
b) Artery-to-artery embolism involving carotid and ophthalmic arteries
c) Thrombosis in situ in carotid artery
d) Optic nerve compression
e) None of the above

Q40

Answer 17

b

This TIA is known as “amaurosis fugax” due to carotid atherosclerotic disease. This causes transient blindness.

Optic nerve demyelination may cause sudden visual loss but would not resolve so quickly.

Compression of the optic nerve would cause gradual visual loss and reduced papillary light response

Question 18

A 50 y.o. man with atrial fibrillation suddenly becomes “confused.” He is alert and attentive. His speech is fluent but he has difficulty following commands. The following other neurological abnormalities might include:

a) Hemiparesis
b) Acalculia
c) Left lower quadrantanopia
d) Agraphia
e) No focal findings since patient has encephalopathy

Q41

Answer 18

b

Sudden onset indicates vascular etiology. Because patient appears confused and cannot comprehend normally, indicates Wernicke aphasia. This involves the posterior temporal lobe of the dominant hemisphere, and acalculia may also be present.

The visual field fibers pass through this region and ischemia may cause right homonymous hemianopsia. Therefore, patients with Wernicke aphasia may also have accompanying right homonymous hemianopsia but no hemiparesis or hemianesthesia

Question 19

Name some symptoms of carotid artery TIA

Q42

Answer 19

Carotid artery TIA, caused by emboli at common carotid bifurcation, leads to hemispheral TIAs with symptoms of contralateral hemiparesis, hemisensory loss, paresthesias, hemianopsia, transient aphasia, and hemi-inattention

Question 20

If you were a patient demonstrating a general lack of concern about your cognitive deficits, were over the age of 60, and had a clean neurological work-up other than borderline MMSE, the most likely diagnosis to rule out would be _________________, with a likelihood of around ___________.

Q47

Answer 20

a) Alzheimer’s disease, 80%

Question 21

The parvocellular and magnocellular layers of the dorsal lateral geniculate nucleus

a) may represent different visual systems.
b) analyze the same kind of information from the visual field.
c) are connected to the nasal and temporal halves of the retina, respectively.
d) receive input from the contralateral and ipsilateral halves of the visual field, respectively.

Q48

Answer 21

a

Question 22

Difference between ocular apraxia and optic ataxia

Q 50 and 51

Answer 22

Ocular motor apraxia is a deficiency in voluntary, horizontal, lateral, fast eye movements (saccades) with retention of slow pursuit movements. The inability to follow objects visually is often compensated by head movements

Optic ataxia is the lack of coordination between visual input and hand movements. For example, the patients can accurately touch their own body voluntarily, but when given a visually guided task, they are unable to complete it

Question 23

Muscarinic acetylcholine
versus Nicotinic acetylcholine and AD

Q54

Answer 23

Alzheimer’s disease (AD) has become the primary cause of dementia. It shows a progressive cognitive dysfunction with degenerating neurons. Acetylcholine receptors (AChRs) propagate the cognitive ability and it consists of two primary members namely muscarinic (mAChRs) and nicotinic receptors (nAChRs).

The nicotinic receptor is a channel protein that, upon binding by acetylcholine, opens to allow diffusion of cations. The muscarinic receptor, on the other hand, is a membrane protein; upon stimulation by neurotransmitter, it causes the opening of ion channels indirectly, through a second messenger

Muscasrinic is MORE depleted in AD than Nicotinic.

Question 24

The mesolimbic and mesocortical dopamine tracks are each associated with which types of symptoms of Schizophrenia?

Q55

Answer 24

The mesolimbic pathway is a dopamine pathway in the brain that is associated with positive symptoms of schizophrenia, such as hallucinations and delusions.

The mesocortical pathway extends from the ventral tegmental area (VTA) to the cortex, and decreased activity in this pathway is associated with negative symptoms of schizophrenia

Question 25

The most common sites of brain contusion in TBI, due to jagged bony prominences abutting brain tissue in the cranial vaults, are:

Q59

Answer 25

Anterior temporal lobes and orbitofrontal regions

Question 26

What is Hoovers sign?

Q60

Answer 26

Hoover’s sign is a common psychogenic symptom.
Used to detect functional neuro DOs

Hoover’s sign is a motor sign. It is based on the principle of crossed extensor reflex - when one hip is flexed, the contralateral hip is extended

eg) if a person in supine is asked to lift the right leg only, the left heel will dig into the plinth. The examiner holds hand under left heel to feel for the downward pressure.
In non-organic weakness, there is no downward pressure felt

Question 27

Dementia in Parkinson’s Disease is least associated with:

a) Akinesia
b) Rapid progression of the illness
c) Being older
d) tremor

Q62

Answer 27

Dementia is the least closely associated with tremor. According to Kaufman, if dementia occurs at the onset of an illness with parkinsonism, consider diffuse Lewy Body disease in individuals older than 50. In young adults, consider Wilson’s disease, juvenile Huntington’s disease, and drug abuse.

Question 28

Talk to me about the Circle of Willis

Answer 28

Question 29

With an understanding that dementia can happen late in the course of MS or possibly not at all, which MS features are often associated with cognitive impairment?

a) Physical impairments
b) Atrophy
c) Total lesion volume
d) All of the above

Q65

Answer 29

d

Along with A-C, duration of the illness, enlarged cerebral ventricles, corpus callosum atrophy, and cerebral hypometabolism are also associated with MS related cognitive impairme

Question 30

Basilar Artery TIA’ symptoms

Answer 30

vertigo, vomiting, transient global amnesia, and nystagmus are indicative

Vertebrobasilar Artery TIA’s symptoms include those mentioned plus, tinnitus, circumoral paresthesias or numbness, dysarthria, dysphagia, drop attacks, ataxia, and cranial nerve abnormalities

Question 31

Abnormalities with saccades are a hallmark feature of which disease (s)

Q67

Answer 31

Huntingtons and PSP

Question 32

Which seizure type typically is characterized by lip smacking, chewing or other automatic stereotyped movements, emotional changes (e.g., fear, sadness, or déjà vu feelings), as well as hallucinations of auditory, tactile, visual, or olfactory sensory experiences?

a) primary generalized seizure
b) secondary generalized seizure
c) typical simple absence seizures
d) partial (simple or complex) seizure

Q70

Answer 32

d

Partial seizures begin in one part of the brain and may or many not spread to other regions. They usually consist of specific motor, sensory, or psychic alterations, that are often accompanied by stereotyped automatic movements. These seizures often stem from temporal lobe (although about 10% frontal) and accompanied by emotionally changes (fear, sadness, pleasure, déjà vu) Hallucinations or misperceptions are also common ictal phenomena of simple-and complex- partial seizures. Simple partial seizures have no alteration in consciousness as result of seizure discharge. In complex partial seizures there’s always alteration of consciousness.

Primary generalized seizures
Also known as idiopathic seizures, these seizures have no identifiable cause. They are genetic and occur in people who are otherwise healthy.

Secondary generalized seizures
Also known as bilateral tonic-clonic seizures, these seizures have an identifiable cause, such as a tumor, hypoglycemia, or drug overdose

Question 33

A study is conducted to assess the effectiveness of a new anti-anxiety medication. The Beck Anxiety Inventory (BAI) is used to measure anxiety levels. If the mean score of subjects who take the drug is compared to the population mean for anxious subjects on the BAI, the statistical test that would be used would be…

Q72

Answer 33

The one sample t-test is appropriate when a study involves only one sample. It is designed to compare the mean of a single sample to a known population mean. It is a seldom used test as we don’t often have a known population mean (EX of population mean = if we knew from a government survey the national average income for psychologists, then we could take a sample of female psychologists and compare to the known population mean).

Question 34

An experimenter is testing the hypothesis that there is no difference between treatment modalities in regards to the scores obtained by patients on a depression measure. His design calls for two groups— psychodynamic treatment versus a CBT treatment. He uses a t-test to analyze the data at time two as there were no differences between the groups at time 1. The results are: Group 1 BDI mean = 12; Group 2 mean = 8. The t-value exceeds the tabled critical value at the .01 level for a 2-tailed test. He should:

a) Accept the null and conclude the alternative hypothesis is false.
b) Reject the null and conclude the alternative hypothesis is supported.
c) Retain the null and conclude that the alternative hypothesis is supported.
d) Not make an interpretation, as the researcher should have used a one-tailed test

Q73

Answer 34

b

If the results are significant at the .01 level, then you reject the null hypothesis and conclude that the alternative hypothesis is true (i.e., that the means are significantly different).

Question 35

In a study in which a one-way ANOVA is used, the null hypothesis would be that…

Q74

Answer 35

The null hypothesis (H0) of ANOVA is that there is no difference among group means.

An ANOVA is designed to test the hypothesis that group means were drawn from the same population; i.e., that means are equal in the population

Question 36

A drawback of norm-referenced interpretation is that:

a) A person’s performance is compared to the performance of other examinees.
b) It does not permit comparisons of individual examinee’s scores on different tests.
c) It does not indicate where the examinee stands in relation to others of the same population.
d) It does not provide absolute standards of performance.

Q75

Answer 36

d

Norm-referenced interpretation involves comparing an examinee’s score to the scores of others who have taken the same test. A drawback of this type of interpretation is that is does not provide absolute standards of “good” or “bad” performance—the examinee’s score must be interpreted in light of the performance of the norm group as a whole

Question 37

What is the location of pathology that contributes to the classic triad of Wernicke’s encephalopathy?

Q76

Answer 37

mammilary bodies and medial diencephalic structures

Wernicke encephalopathy (WE) is an acute neurological condition characterized by a clinical triad of ophthalmoparesis with nystagmus, ataxia, and confusion. This is a life-threatening illness caused by thiamine deficiency, which primarily affects the peripheral and central nervous systems

Question 38

Sex-dependent penetrance (complete in males; incomplete in females); lack of asymmetry in the planum temporale; smaller neurons in the left medial geniculate nucleus (MGN) compared to the right MGN; and possible involvement of chromosome 6 and 15 are findings associated with what developmental disorder:

Answer 38

Dyslexia

MGN (thalamus) communicates auditory information to aud cortex

Question 39

Rett’s Disorder

Answer 39

X-linked
Rett syndrome is a rare genetic neurological and developmental disorder that affects the way the brain develops. This disorder causes a progressive loss of motor skills and language.

Rett syndrome is seen in females (males die in 1st 12 mo unless they are XXY).

Most babies with Rett syndrome seem to develop as expected for the first six months of life

Rett Syndrome
A slowing of development.
Loss of mobility or function in the hands.
Distinctive hand movements.
Slowed brain and head growth.
Problems with walking, walking on the toes, or a wide-based gait.
Seizures.
Cognitive problems

Question 40

Nuchal rigidity is most likely a sign of which of the following

a) Subarachnoid hemorrhage
b) Transtentorial herniation
c) Communicating hydrocephalus
d) Epidural hematoma

Q85

Answer 40

a) Subarachnoid hemorrhage

Nuchal rigidity, the increased resistance to the passive flexion/extension of the neck, is a clinical sign of meningeal irritation due to the blood extravasation in the subarachnoidal space. Other signs of meningeal irritation include a positive Lasegue sign or Kernig and Brudziski signs.

Lasegue sign or straight leg raising test (SLRT) is a neurodynamic exam to assess nerve root irritation in the lumbosacral area.

Kernig’s sign: Position the patients supine with their hips flexed to 90°. This test is positive if there is pain on passive extension of the knee. Brudzinski’s sign: Position the patients supine and passively flex their neck. This test is positive if this manoeuvre causes reflex flexion of the hip and knee.

Question 41

All valid tests are _______

Answer 41

Reliable

A valid test will always be reliable, but the opposite isn’t true
A test that is reliable is not necesarily valid.

This is because a test could produce the same result each time, but it may not actually be measuring the thing it is designed to measure

Question 42

Infarcts and ischemic events are most common in which cerebral artery?:

Q88

Answer 42

MCA

Question 43

The telencephalon includes

Q91

Answer 43

The cerebral cortex, subcortical white matter, and basal ganglia

The telencephalon, also known as the cerebrum, is the anterior part of the forebrain. The diencephalon, sometimes thought of as the interbrain, is also part of the forebrain, but it is between the telencephalon and the midbrain

Question 44

Which statistical test is used in experimental designs that are most likely to assess causation?

Q92

Answer 44

ANCOVA

Analysis of covariance (ANCOVA) is a method for comparing sets of data that consist of two variables (treatment and effect, with the effect variable being called the “variate”) when a third variable (called the “covariate”) exists

Question 45

When would we use…

Chi square
Pearson r
Discriminate Function Analysis

Answer 45

chi square: when comparing categorical variables
* Exampls: you could use a chi-square test where the categories are “remission” and “no remission” and the groups are “treatment” and “placebo”.

Pearson r: when comparing ratio variables
* Example: you could use Pearson’s r to see if higher BMI is associated with greater diabetes severity

**DFA: **categorical dependent variable and several continuous independent variables you want to use to classify observations into groups.
* Example: when you want to classify patients into disease categories based on their medical test results

Question 46

Alexia without agraphia can be associated with a __________, if ___________ is also affected

a) Right PCA infarct, angular gyrus
b) Left PCA infarct, splenium of corpus callosum
c) Left MCA infarct, angular gyrus
d) Left ACA infarct, splenium of corpus callosum

Q93

Answer 46

Left PCA infarct, splenium of corpus callosum

Question 47

febrile seizures

Answer 47

Febrile seizures occur in about 3-4% of children
One simple febrile seizure is not associated with increased risk for epilepsy
Complex febrile seizures last longer than 15 minutes and may have focal features

The seizures usually last for a few minutes and stop on their own. The fever may continue for some time. Most febrile seizures stop without treatment and don’t cause other health problems.

Question 48

One of the reasons Parkinson’s disease patients do not show symptoms of the disease until they have lost most of their dopamine-containing axons from the substantia nigra is that…

Answer 48

the receptors on the relevant postsynaptic membranes develop denervation supersensitivity

Question 49

Starting at the Aorta, briefly describe the highway for the Vasculature system (as it relates to the main arteries)

Answer 49

Arising from the Aorta

Anterior Circulation
* Common Carotid to Internal Carotid Artery
Anterior Cerebral Artery (ACA)
Middle Cerebral Artery (MCA)

Posterior Circulation
* Vertebral Artery to Basilar Artery
Posterior Cerebral Arteries (PCA)

Anterior & Posterior Circulations meet in an anastomotic ring called the Circle of Willis

Anterior Communicating Artery (AComm)
* Connects left and right hemisphere ACAs

Posterior Communicating Artery (PComm)
* Connects internal carotid to PCAs, linking the anterior and posterior circulation

Question 50

Vasculature: Deep Cerebral Structures

Answer 50

• Lenticulostriate Arteries – Smaller vessels arising from the Middle Cerebral Artery for blood supply to the basal ganglia and internal capsule
  Lacunar infarcts
• Anterior Choroidal Artery – arises from the internal carotid artery and supplies portions of globus pallidus, thalamus, putamen, internal capsule
• Recurrent Artery of Heubner – arises from the Anterior Cerebral Artery and supplies portions of caudate, putamen, globus pallidus, internal capsule