Exam 2

Question 1

Basal ganglia

Answer 1

caudate, putamen, globus pallidus

Question 2

procedural learning, non declarative memories

Answer 2

basal ganglia

Question 3

deficit in retrieval rather than encoding

Answer 3

basal ganglia

Question 4

lateral inferotemporal cortices - non- MTL memory

Answer 4

long term storage for episodic & semantic information

Question 5

what does the lateral inferotemporal cortices cause?

Answer 5

disease or damage produces retrograde amnesia

Question 6

frontal lobes - Non- MTL memory

What is the left & right responsible for?

Answer 6

involved in active learning and active retrieval processes
The left prefrontal = encoding (images of normal)
Right prefrontal = active retrieval (images of normal)

Question 7

Frontal lobes

-working memory

Answer 7

dorsolateral prefrontal

Question 8

who had surgical damage to hippocampus?

Answer 8

HM

Question 9

who had Viral encephalitis?

Answer 9

clive wearing

Question 10

Neuro disorders & MTL

Answer 10

• surgical damage to hippocampus (HM)
• viral encephalitis (clive wearing)
• brain injury
• alzheimer’s disease

Question 11

MTL Lesions

Answer 11

memory deficits in Encoding (transfer) of new information

Question 12

Neuro disorders & basal ganglia

Answer 12

• retrieval rather than encoding
• non-declarative
  
  • procedural learning
  • priming
• Parkinson’s Disease
• Huntingtons Disease
• Fahr’s disease (“idiopathic calcification of Basal Ganglia”)

examples: teaching someone a list to remember, testing them over & over, & then giving them a random list & then they cannot remember the information from the previous list.

Question 13

where are the memory deficits in the basal ganglia lesions:

Answer 13

memory deficits are in retrieval

Question 14

HM

Answer 14

1953
Henry - a 27 year old man underwent an operation in which the bilateral medical temporal lobes, including the hippocampus formations & parahippocampal gyri, were resected in an attempt to control his medical-refractory epileptic seizures

Question 15

HM’s neuropsychological profile

Answer 15

could recall new info
able to recall memories from childhood
couldn’t recall anything from 11 years leading up to surgery

unable to learn new facts or recall new experiences (given a list of 3-4 words to remember, able to correctly recite them; however, after 5 minutes unable to recall any of the words (even with cues), & no recollection of having been asked to remember words)

able to recall events from childhood & up two several years prior to surgery (LTM)

Unable to recall events in approximately 11 year span leading up to surgery

age 16 - missing 11 years - age 27 - surgery

Question 16

HM’s neuropsychological profile continued

Answer 16

Personality and general intelligence were normal.
FSIQ = 110

Able to learn certain tasks that did not require conscious (explicit) recall • e.g., performance improvement on mirror-drawing on successive days equivalent to normal individuals, despite no recollection of having done the task before • e.g., when “primed” by exposure to a word (PROTRACTER) and then asked to complete the stem PRO-, he chose the word he had previously seen at higher than chance levels, despite no recollection of having seen the task before

Question 17

H.M.’s memory led to intensive investigations on

Answer 17

medial temporal lobes (MTL) role in human memory

Question 18

______________ resection not performed after H.M.

Answer 18

bilateral MTL

Question 19

breakthrough discovery

initial attempt were made to produce amnesic syndrome in monkeys

Answer 19

discovery of multiple memory systems

MTL responsible for rapidly acquired knowledge about recent events (declarative), but not responsible for acquisition of habits (procedural)

procedural characterized by slow accumulation of response biases or motor skills

The previous matching to sample task tapped into procedural learning • New version of task for monkeys - “non-matching to sample:” reward for selecting the novel object on each trial: MTL monkeys demonstrated amnesic syndrome

Question 20

STM

Answer 20

recall of info immediately after presentation or during uninterrupted rehearsal

limited capacity

Question 21

LTM

Answer 21

recall of info after delay interval during which attention is focused away from target items

large capacity

Question 22

why are these terms avoided in clinical practice?

Answer 22

they are avoided given that one person’s temporal definition of STM is another criterion for LTM; best to use descriptive terms`

Question 23

problem for HM

Answer 23

deficit in the TRANSFER of information from STM to LTM

Question 24

declarative (explicit)

Answer 24

directly accessible to conscious recollection

• Facts, data, knowledge, meaning of words
• retrieval is goethe intentional

Question 25

non declarative (implicit)

Answer 25

learning demonstrated through performance; several different memory systems distinct from declarative - procedural (skills leaning) - priming

Question 26

episodic

Answer 26

memory for specific events, episodes in one's life, info assigned to particular point in time

Question 27

semantic

Answer 27

knowledge of general info, not temporally coded, not dependent on particular time or place (knowing what a sandwich is)

Question 28

anterograde

Answer 28

memory for events occurring after specified point in time (onset of injury); refers to new leaning -dory

Question 29

retrograde

Answer 29

memory for events predating a specified pointing time (onset of injury)

Question 30

learning (encoding)

Answer 30

process of acquiring new information, or process that modifies subsequent

Question 31

memory (recall)

Answer 31

the "record" left by a learning process, measured as amount of information retained on recall

Question 32

free recall

Answer 32

spontaneous recall of info without cues or aids

Question 33

CUED recall

Answer 33

retrieval of info with help of cue

Question 34

recongition

Answer 34

target from memory is among array of options; maximally aids retrieval by providing info

Question 35

_____________ help specify the source of the "memory" problem.

Answer 35

retrieval formats

Question 36

if recognition > Free recall

Answer 36

problem is in retrieval process Parkinsons, Huntington's

Question 37

if Recall = recognition (equally poor)

Answer 37

problem is in encoding processes Alzheimer's, Korsakoff's, "MTL" memory problem

Question 38

key structure in memory

Answer 38

hippocampus other structures: Perirhinal, Parahippocampal, Entorhinal, Amygdala

Question 39

visual memory

Answer 39

Perirhinal

Question 40

spatial memory

Answer 40

Parahippocampal

Question 41

unclear functions for memory

Answer 41

entohinal

Question 42

emotion-mediated memories

Answer 42

amygdala

Question 43

damage to MTL disrupts the process of encoding

Answer 43

(I.e., transfer from attentional stores to long-term storage) still unclear whether affects the process of retrieval

Question 44

bilateral damage

Answer 44

global amnesic syndrome marked anterograde memory deficit (global) for declarative info graded retorgrade deficit immediate recall (uninterrupted rehearsal) intact Bilateral MTL or bilateral Paper circuit lesions required for global anterograde deficits. the greater the bilateral damage, the greater the severity

Question 45

unilateral damage

Answer 45

less severe deficits that tend to be material-specific left MTL = verbal Right MTL = nonverbal, topographic unilateral MTL will result in lateral-specific anterograde deficits

Question 46

Papez Circuit

Answer 46

hippocampus: lesions alone produce amnesia projects via the Fornix Mammillary bodies in hypothalamus Then to anterior thalamic nuclei via mammillothalamic tract then to cingulate cortex downtown to entorhinal cortex & back to hippocampus

Question 47

how the Papez circuit functions

Answer 47

- Acquisition & rapid consolidation of particular kinds of associations - several passes of an "event" through the circuit leads to physical changes in neurons that consolidated the memory - once sufficiently strengthened, recall is independent of the hippocampus - injury prevents new memories, but cannot erase CONSOLIDATED or OLD memories

Question 48

memory problems present as difficulty in realizing new information

Answer 48

anterograde episodic memory deficits

Question 49

_____________ not affected by MTL/Papez

Answer 49

non declarative (particularly Procedural)

Question 50

_____________ problems are typically less severe than ______________.

Answer 50

retorgrade memory anterograde

Question 51

the greater the severity too retrograde

Answer 51

the greater the anterograde

Question 52

Retrograde loss is typically with ___________________

Answer 52

episodic info semantic knowledge retained autobiographical info retained

Question 53

memory testing

Answer 53

- Expose the patient to new information, ask her to recall the information. - Standardizes (controls) the exposure of info - only measures learning & memory in the anterograde period - only measures declarative memory - need to test for stimuli type (verbal, nonverbal) - need to test for recall under varying cue formats

Question 54

Common Verbal | Memory tests

Answer 54

- Common Verbal memory tests - memory for stories (e.g., WMS logical memory) - word-lists - Rey AVLT, CVLT, Selective reminding test -paired associations

Question 55

Common Nonverbal | Memory Tests

Answer 55

- Drawing designs - WMS Visual Reproduction - Benton Visual Retention Test - Rey-Osterrieth Complex Figure - Recognition of Nonverbal stimuli - Benton visual retention test - Warrington memory for faces - WMS faces - Continuous visual memory test

Question 56

Rey Auditory Verbal Learning Test (RAVLT)

Answer 56

testing for verbal memory (without grouping/clusteing of categories)

Question 57

The California Verbal Learning Test (CVLT)

Answer 57

memory test with words shown (words are in categories) overtime this test can show recall under varying cue formats

Question 58

Rey - Osterrieth Complex Figure

Answer 58

oPut a complex figure Infront of them and have them copy it | oChange the color of the pen as they are drawing to see their organizational strategy when they are drawing it

Question 59

Basal Ganglia or frontal lobe damage

Answer 59

Memory deficits are in Retrieval (rather than encoding)

Question 60

stages of memory

Answer 60

encoding, storage, retrieval

Question 61

damage to the hippocampus

Answer 61

deficit is at the level of encoding transfer of information from Short term to long term memory

Question 62

chucking

Answer 62

requires frontal lobe function not prototypes Cali test

Question 63

The front lobes

Answer 63

largest region of the brain: 1/3rd of the cerebral cortex Integration of multimedia sensory, motor, limbic information numerous bidirectional cortical & subcortical connections

Question 64

prefrontal area

Answer 64

anterior part, "higher cognitive functions," personality

Question 65

premotor area

Answer 65

modifies motor mints, stores motor

Question 66

primary motor

Answer 66

nerve cells that produce voluntary movement

Question 67

prefrontal area divided into two

Answer 67

``` dorsal lateral (on top) orbital frontal region (by eyes) ```

Question 68

what are the connections with the frontal lobes - 3

Answer 68

Cortical connection Subcortical (underneath the cortical portions) Neurotransmitter Projections

Question 69

Cortical connection

Answer 69

association cortices of temporal, parietal, occipital & limbic

Question 70

subcortical

Answer 70

a. Orbitomedial connects with amygdala b. prefrontal projects to basal ganglia via head of caudate c. connections to anteromedial temporal, hippocampus d. connections to mediodorsal nucleus of thalamus

Question 71

neurotransmitter projections

Answer 71

Frontal lobe revive projections from multiple subcortical brainstem modulatory neurotransmitter systems: dopamine, acetylcholine

Question 72

Functions of frontal lobes

Answer 72

- critical for sophisticated decisions we make - subtle social interaction we engage in - divergent thinking - "seat of personality & intellect"

Question 73

What does RIO stand for?

Answer 73

restrain initiative order -we call these personalities

Question 74

define Restraint

Answer 74

* Judgment * Foresight * Perseverance * Delaying gratification * Inhibiting socially inappropriate responses * Concentration * Self-awareness

Question 75

define Initiative

Answer 75

motivation to pursue positive or produce positive activities ``` o Curiosity o Spontaneity o Motivation o Drive o Creativity o Shifting cognitive set o Mental flexibility o “personality” ```

Question 76

define order

Answer 76

``` • Sequencing • Organization • Planning • Working memory • Temporal order oPutting things in temporal order o“ a week ago I did this, month ago I did this” • Perspective taking • Abstract reasoning ```

Question 77

contradictory behaviors in Frontal Lobe disorders dorsolateral lesions more of a loss

Answer 77

- Apathetic indifference (not caring either way) - Abulia (lack of spontaneous behavior) - Akinesia (loss of spontaneous movement) - Preservation (readapted engagement in a behavior) - Mutism - "pseudo" depression (lacking drive to do anything) - Hypo-sexuality

Question 78

Contradictory Behaviors in FL Disorders Orbitomedial lesions more emotional

Answer 78

- explosive emotional lability - environmental dependency (the women eating her muffin - her brain didnt intervene & say thats not your muffin) - Distractibility - Im-persistence (not wanting to continue to a behavior) - confabulation (gaps in a person's memory are unconsciously filled with fabricated, misinterpreted, or distorted information) - Mania - hypersexuality

Question 79

Disorders Affecting Frontal Lobe neurologic

Answer 79

- head injury - stroke - Pick's/Frontotemporal dementia - Parkinsons - Huntington's - others subcortical Frontal - Lobotomy - Alcohol use disorders

Question 80

Disorders Affecting Frontal Lobe psychiatric

Answer 80

- Schizophrenia - Depression - OCD - ADHD - Psychopathy

Question 81

evaluating executive function Best Test

Answer 81

Best test = Real world behavior, history from family or other may be more revealing than patient exam -observations of behavior during tests of other function may capture deficits better

Question 82

Behavioral observations

Answer 82

- Abulia spontaneity (lacking spontaneous behavior) - Inappropriate jocularity (jocking inappropriate ) - confabulation (answering question with whatever comes to their mind, making things up) - utilization, environmental dependency (a person is highly drawn to a stimulus, using the object for its purpose but the environment is not appropriate) - perseveration, I'm-persistence (repeated behavior even though it doesn't fit the situation) Incontience

Question 83

cognitive tests

Answer 83

Working memory Digits backwards, months backwards Perseveration and set-shifting ability Luria Reciprocal Coordination & Alternating sequences Trailmaking B, Wisconsin Card Sort Inhibition Auditory or visual go-no tests, Stroop Flexibility FAS, figure generation Abstract reasoning Similarities, proverb interpretation, logic

Question 84

Between task perseverations

Answer 84

switching to a different letter...words that begin with A then moving to B...patient starts repeating words words that begin with A would be if instead of writing the peak & the plateau they reverted to ++0

Question 85

within task perseveration

Answer 85

instead of writing ++0 where they were asked to come up with words starting with F, they said "forget, foot, fancy, friend, forget, friend" (repeating words they already said)

Question 86

apraxia

Answer 86

neurological disorder characterized by the inability to perform learned (familiar) movements on command, even though the command is understood & there is a willingness to perform the movement

Question 87

loss of a set

Answer 87

is when they deviate from the rule but its not a previous rule:for the Above example if they said "Apple aardvark banana oranges lemons" thereby going by a different rule they came up with (in this case fruits) - & they aren't reverting to a previous rule (which would be a between task persever)

Question 88

"loss of filter"

Answer 88

would be verbal disinhibition

Question 89

What is a TBI?

Answer 89

non degenerative, non congenital insult to the brain resulting from an external mechanical force applied to the cranium and the intracranial contents, leading to temporary or permanent impairments, functional disability, or psychosocial maladjustment

Question 90

names for TBI

Answer 90

- traumatic brain injury - Head injury (closed vs penetrating) - Concussive injury

Question 91

TBI also commonly have

Answer 91

frontal lobe damage

Question 92

Glasgow Coma Scale

Answer 92

lowest score you can get & not be in a coma = 3

Question 93

GCS Severity Classification

Answer 93

``` Severe = 3-8 Moderate = 9-12 Mild = 13-15 ```

Question 94

mild TBI defined by

Answer 94

13+

Question 95

moderate TBI defined by

Answer 95

GCS 9-12 abnormal findings on CT Operative intracranial lesions Length of hospital stay 48 hours or more

Question 96

TBI Risk Groups Males 2:1 Females

Answer 96

highest risk by age: 0-4 years, 15-19 years "shaken baby" - 2nd leading cause of death for infants < 1 year age 3. Adults 65+ highest rates of TBI - related hospitalizations & death young drivers

Question 97

TBI leading causes

Answer 97

1. Falls (28%) 2. Motor vehicle Crashes (20%) - 31.8% of TBI-related deaths due to traffic accidents 3. being stuck by or against objects (19%) - 2/3rds of firearm related TBI involves suicide intent 4. Assaults (11%)