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Neuropsychology > Exam 2 > Flashcards

Exam 2 Flashcards

1
Q

Basal ganglia

A

caudate, putamen, globus pallidus

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2
Q

procedural learning, non declarative memories

A

basal ganglia

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3
Q

deficit in retrieval rather than encoding

A

basal ganglia

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4
Q

lateral inferotemporal cortices - non- MTL memory

A

long term storage for episodic & semantic information

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5
Q

what does the lateral inferotemporal cortices cause?

A

disease or damage produces retrograde amnesia

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6
Q

frontal lobes - Non- MTL memory

What is the left & right responsible for?

A

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

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7
Q

Frontal lobes

-working memory

A

dorsolateral prefrontal

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8
Q

who had surgical damage to hippocampus?

A

HM

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9
Q

who had Viral encephalitis?

A

clive wearing

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10
Q

Neuro disorders & MTL

A
  • surgical damage to hippocampus (HM)
  • viral encephalitis (clive wearing)
  • brain injury
  • alzheimer’s disease
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11
Q

MTL Lesions

A

memory deficits in Encoding (transfer) of new information

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12
Q

Neuro disorders & basal ganglia

A
  • 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.

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13
Q

where are the memory deficits in the basal ganglia lesions:

A

memory deficits are in retrieval

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14
Q

HM

A

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

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15
Q

HM’s neuropsychological profile

A

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

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16
Q

HM’s neuropsychological profile continued

A

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

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17
Q

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

A

medial temporal lobes (MTL) role in human memory

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18
Q

______________ resection not performed after H.M.

A

bilateral MTL

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19
Q

breakthrough discovery

initial attempt were made to produce amnesic syndrome in monkeys

A

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

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20
Q

STM

A

recall of info immediately after presentation or during uninterrupted rehearsal

limited capacity

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21
Q

LTM

A

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

large capacity

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22
Q

why are these terms avoided in clinical practice?

A

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

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23
Q

problem for HM

A

deficit in the TRANSFER of information from STM to LTM

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24
Q

declarative (explicit)

A

directly accessible to conscious recollection

  • Facts, data, knowledge, meaning of words
  • retrieval is goethe intentional
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25
Q

non declarative (implicit)

A

learning demonstrated through performance; several different memory systems distinct from declarative

  • procedural (skills leaning)
  • priming
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26
Q

episodic

A

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

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27
Q

semantic

A

knowledge of general info, not temporally coded, not dependent on particular time or place

(knowing what a sandwich is)

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28
Q

anterograde

A

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

-dory

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29
Q

retrograde

A

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

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30
Q

learning (encoding)

A

process of acquiring new information, or process that modifies subsequent

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31
Q

memory (recall)

A

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

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32
Q

free recall

A

spontaneous recall of info without cues or aids

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33
Q

CUED recall

A

retrieval of info with help of cue

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34
Q

recongition

A

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

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35
Q

_____________ help specify the source of the “memory” problem.

A

retrieval formats

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36
Q

if recognition > Free recall

A

problem is in retrieval process

Parkinsons, Huntington’s

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37
Q

if Recall = recognition (equally poor)

A

problem is in encoding processes

Alzheimer’s, Korsakoff’s, “MTL” memory problem

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38
Q

key structure in memory

A

hippocampus

other structures: Perirhinal, Parahippocampal, Entorhinal, Amygdala

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39
Q

visual memory

A

Perirhinal

40
Q

spatial memory

A

Parahippocampal

41
Q

unclear functions for memory

A

entohinal

42
Q

emotion-mediated memories

A

amygdala

43
Q

damage to MTL disrupts the process of encoding

A

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

44
Q

bilateral damage

A

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

45
Q

unilateral damage

A

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

46
Q

Papez Circuit

A

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

47
Q

how the Papez circuit functions

A
  • 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
48
Q

memory problems present as difficulty in realizing new information

A

anterograde episodic memory deficits

49
Q

_____________ not affected by MTL/Papez

A

non declarative (particularly Procedural)

50
Q

_____________ problems are typically less severe than ______________.

A

retorgrade memory

anterograde

51
Q

the greater the severity too retrograde

A

the greater the anterograde

52
Q

Retrograde loss is typically with ___________________

A

episodic info

semantic knowledge retained autobiographical info retained

53
Q

memory testing

A
  • 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
54
Q

Common Verbal

Memory tests

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

-paired associations

55
Q

Common Nonverbal

Memory Tests

A
  • 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
56
Q

Rey Auditory Verbal Learning Test (RAVLT)

A

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

57
Q

The California Verbal Learning Test (CVLT)

A

memory test with words shown (words are in categories)

overtime this test can show recall under varying cue formats

58
Q

Rey - Osterrieth Complex Figure

A

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

59
Q

Basal Ganglia or frontal lobe damage

A

Memory deficits are in Retrieval (rather than encoding)

60
Q

stages of memory

A

encoding, storage, retrieval

61
Q

damage to the hippocampus

A

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

62
Q

chucking

A

requires frontal lobe function
not prototypes
Cali test

63
Q

The front lobes

A

largest region of the brain: 1/3rd of the cerebral cortex

Integration of multimedia sensory, motor, limbic information

numerous bidirectional cortical & subcortical connections

64
Q

prefrontal area

A

anterior part, “higher cognitive functions,” personality

65
Q

premotor area

A

modifies motor mints, stores motor

66
Q

primary motor

A

nerve cells that produce voluntary movement

67
Q

prefrontal area divided into two

A 
dorsal lateral (on top)
orbital frontal region (by eyes)
68
Q

what are the connections with the frontal lobes - 3

A

Cortical connection

Subcortical (underneath the cortical portions)

Neurotransmitter Projections

69
Q

Cortical connection

A

association cortices of temporal, parietal, occipital & limbic

70
Q

subcortical

A

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

71
Q

neurotransmitter projections

A

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

72
Q

Functions of frontal lobes

A
  • critical for sophisticated decisions we make
  • subtle social interaction we engage in
  • divergent thinking
  • “seat of personality & intellect”
73
Q

What does RIO stand for?

A

restrain
initiative
order

-we call these personalities

74
Q

define Restraint

A
  • Judgment
  • Foresight
  • Perseverance
  • Delaying gratification
  • Inhibiting socially inappropriate responses
  • Concentration
  • Self-awareness
75
Q

define Initiative

A

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”
76
Q

define order

A 
•	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
77
Q

contradictory behaviors in Frontal Lobe disorders dorsolateral lesions

more of a loss

A
  • 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
78
Q

Contradictory Behaviors in FL Disorders
Orbitomedial lesions

more emotional

A
  • 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
79
Q

Disorders Affecting Frontal Lobe neurologic

A
  • head injury
  • stroke
  • Pick’s/Frontotemporal dementia
  • Parkinsons
  • Huntington’s
  • others subcortical Frontal
  • Lobotomy
  • Alcohol use disorders
80
Q

Disorders Affecting Frontal Lobe psychiatric

A
  • Schizophrenia
  • Depression
  • OCD
  • ADHD
  • Psychopathy
81
Q

evaluating executive function Best Test

A

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

82
Q

Behavioral observations

A
  • 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

83
Q

cognitive tests

A

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

84
Q

Between task perseverations

A

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

85
Q

within task perseveration

A

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)

86
Q

apraxia

A

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

87
Q

loss of a set

A

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)

88
Q

“loss of filter”

A

would be verbal disinhibition

89
Q

What is a TBI?

A

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

90
Q

names for TBI

A
  • traumatic brain injury
  • Head injury (closed vs penetrating)
  • Concussive injury
91
Q

TBI also commonly have

A

frontal lobe damage

92
Q

Glasgow Coma Scale

A

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

93
Q

GCS Severity Classification

A 
Severe = 3-8 
Moderate = 9-12
Mild = 13-15
94
Q

mild TBI defined by

A

13+

95
Q

moderate TBI defined by

A

GCS 9-12

abnormal findings on CT Operative intracranial lesions
Length of hospital stay 48 hours or more

96
Q

TBI Risk Groups

Males 2:1 Females

A

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

97
Q

TBI leading causes

A
  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%)

Neuropsychology (1 decks)

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