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Neuro II > Exam I > Flashcards

Exam I Flashcards

1
Q

What are the 5 cognitive domains that are tested in a mental status exam?

A
  1. social function/behavior
  2. executive function
  3. memory
  4. language
  5. visual-perceptual-spatial/attention
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2
Q

What is the anatomical loction of memory?

A

mesial temporal lobe, basal forebrain

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3
Q

What is the anatomical loction of executive function?

A

frontal, temporal lobes, subcortical

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4
Q

What is the anatomical loction of social cognition/behavior?

A

frontal, temporal lobes, subcortical

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5
Q

What is the anatomical loction of language?

A

dominant frontotemporaoparietal (usually left)

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6
Q

What is the anatomical loction of visuospatial function?

A

non-dominant parietal (usually right)

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7
Q

Which hemisphere is usually dominant?

A

left hemisphere

95% right handed people

70% left handed people

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8
Q

What are the four avenues of communication? What is the term for a deficit in each?

A
  1. Speech - dysphagia/aphasia
  2. Writing - dysgraphia
  3. Listening - auditory agnosia
  4. Reading - word agnosia
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9
Q

Depression is frequently seen in stroke of what hemisphere?

A

left

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10
Q

What is dyslexia?

A

developmental agnosia

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11
Q

What is alexia?

A

word blindness

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12
Q

What is the difference in how the 2 hemispheres attend to spatial stimuli?

A

right - stimuli on both sides of space

left - stimuli on right side

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13
Q

Deficits in the right hemisphere can lead to what problems?

A
  • extinction
  • inattention
  • spatial neglect
  • emotionla indifference/euphoria
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14
Q

What is the function of the dorsolateral frontal lobe?

What does dysfunction here look like?

A
  • Function
    • judgement, abstract thinking, problem solving
  • Dysfunction
    • impaired planning, perseveration, retrieval deficit, decreased verbal/design fluency
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15
Q

What is the function of the medial frontal lobe?

What does dysfunction here look like?

A
  • Function
    • motivation, initiation
  • Dysfunction
    • mutism, emotional/cognitive/motor apathy, urinary incontinence
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16
Q

What is the function of the orbital frontal lobe?

What does dysfunction here look like?

A
  • Function - emotional / social / sexual restraint
  • Dystunction - disinhibition, witzelsucht, emotionla lability, echopraxia, utilization behavior, impulsiveness, distractibility
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17
Q

Inappropriate hyperactivity of the orbital frontal lobe leads to what condition?

A

OCD

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18
Q

What are you looking for upon clinical presentation when you are assessing frontal lobe function?

A

Affect (passive vs. engaged), look for disinhibition, witzelsucht, confabulation, utilization behavior, perserverance

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19
Q

What tests can you perform to assess frontal lobe status?

A
  • attention
  • word generation
  • abstract
  • reasoning
  • frontal release signs- glabellar tap, grasp, palmomental sign, rooting, snout
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20
Q

The pathological signs in the provided image are indicative of what dysfunction?

A

frontal lobe dysfunction

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21
Q

What are the functions of the temporal lobe?

A

memory

  • short term / working memory
  • long term
    • declarative
      • episodic
      • semantic
    • non-declarative
      • procedural memory
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22
Q

Which hemisphere & lobe mediates verbal memory?

Spatial memory?

A
  • verbal memory
    • left temporal lobe
  • spatial memory
    • right temporal lobe
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23
Q

Describe the general pathway of the circuit of papez

A
  • Circuit of Papez
    • mamillary bodies
    • anterior thymus
    • cingulate gyrus
    • enterorhinal cortex
    • hippocampi & parahippocampi
24
Q

Mamillary bodies are infarcted in what vitamin deficiency?

A

thiamine

vitamin B1

25
Q

How are the roles in memory different fro the hippocampus & frontal lobe?

A
  • Hippocampus
    • encoding episodic information
  • Frontal lobe
    • episodic recollection
26
Q

Where is Wernicke’s area?

Function?

Dysfunction?

A
  • posterior superior temporal gyrus
  • auditory associate cortex
    • memory for word sounds
  • dystunction - sensory aphasia
27
Q

Where is Broca’s area?

Function?

Dysfunction?

A
  • inferior frontal gyrus
  • word programming
    • needed for word production
  • dysfunction - motor aphasia
28
Q

What is the function of the angular gyrus?

Dysfunction?

A
  • memory for how words look
  • dysfunction - dyslexia
29
Q

Identify the type of aphasia:

Fluent - N

Comprehend - N

Repeats - N

A

Global aphasia

30
Q

Identifythe type of aphasia:

Fluent - N

Comprehend - Y

Repeats - N

A

Broca’s aphasia

31
Q

Identify the type of aphasia:

Fluent - Y

Comprehend - N

Repeats - N

A

Wernicke’s aphasia

32
Q

Motor aprosodia is cause by dysfunction where in the brain?

A

non-dominant posterior / inferior frontal gyrus

33
Q

Sensory aprosodia is cause by dysfunction where in the brain?

A

(auditory affective agnosia - impaired emotional perception of speech)

non-dominant posterior / superior temporal gyrus

34
Q

What are the functions of the parietal lobe?

A
  • Spatial attention & awareness
  • Movement programs
35
Q

Damage to which parietal lobe is more commonly produces deficits in spatial attention & awareness?

This causes?

How do you test for this?

A

Right > left

neglect

draw a clock, bisect a line, test for sensory extinction

36
Q

Damage to which parietal lobe is more commonly produces deficits in movement programs?

This causes?

A

left > right

apraxia

37
Q

Identify the type of apraxia that fit with the following definitions:

loss of tool knowledge; not able to pick correct object to use in performing a task

inability to follow particular step / sequence

inability to peform a task when cued

inabilty to imitate a gesture

constructional apraxia

inabiltiy to dress

A
  • Conceptual: loss of tool knowledge; not able to pick correct object to use in performing a task
  • Ideational: inability to follow particular step / sequence
  • Ideomotor: inability to peform a task when cued
  • Conduction: inabilty to imitate a gesture
  • Constructional apraxia: constructional apraxia (righ)
  • Dressing apraxia: inability to dress (right)
38
Q

Gerstmann Syndrom is due to a problem where in the brain?

A

left inferior parietal lobe

39
Q

What are the 4 components of Gerstmann Syndrome?

What function is preserved

A
  • Agraphia: inability to write
  • Acalculia: difficulty in learning or comprehending mathematics
  • Left-right disorientation
  • Finger agnosia: inabilty to distinguish the fingers on the hand

Reading is preserved

40
Q

How do you test the primary somatosensory cortex?

A
  • two point discrimination
  • simultaneous discriminatin
  • stereognosis
  • graphesthesia
  • touch
  • vibration
  • proprioception
41
Q

How do you test the secondary somatosensory cortex?

A

pain & temperature

42
Q

What is the “where” pathway?

It does what?

A

occipital / parietal dorsal pathway

analysis of motion & space

43
Q

Occipital lesions can cause what?

Bilateral occiptal lesions?

A
  • Occipital lesions
    • inferior quadrantanopia
  • Bilatera
    • Balint Syndrome
      • (optic ataxia, oculomotor apraxia, stimultanagnosia)
44
Q

What is the “what” pathway?

It does what?

A

occipital / temporal ventral pathway

analysis of form/color/face/letters

45
Q

What problems could occur with a lesion in the temporal ventral pathway?

A
  • visual agnosia
  • achromatopsia
  • prosopagnosia
  • “Alice in Wonderland” Syndrome
    • micropsia / macropsia
    • metamorphosia
  • Superior quadrantanopia
46
Q

What stroke causes alexia without agraphia?

A

left PCA stroke

47
Q

What symptoms do you see in alexia without agraphia?

A
  • right homonymous hemianopia
  • disconnection syndrome
48
Q

What is the cause & symptoms of Foster-Kennedy Syndrome?

A

ipsilateral anosmia (d/t mass) & optic atrophy

contralateral papilledema

49
Q

What are the basic test you should perform when assessing CNII?

A
  • Visual Fields
  • Funduscopy
  • Papillary reflex
50
Q

Altitudinal scotoma is a what type of defect?

Cause?

A
  • Prechiamal Field Defect
  • d/t retinal branch artery occlusion
51
Q

What type of lesion causes “pie in the sky”?

A

temporal lobe lesion

homonymous superior quadrantanopia

52
Q

What type of lesion causes “pie in the floor”?

A

parietal lobe lesion

contralateral homonymous inferior quadrantanopia

53
Q

What type of lesion causes macular sparing?

A

pituitary tumors

bitemporal hemianopia

54
Q

Identify the indicated lesions

A
55
Q

A female, >70 with sudden severe painful vision loss w/ headache, jaw claudication, anorexia, ESR > 50, CRP >2.45, thrombocytopenia- what is your thought?

A

Arteritic ischemic optic neuropathy

(temporal arteritis & polymyalgia rheumatica)

56
Q

What is a cause of a transient, paninless, monocular blindness?

A

internal carotid artery

Neuro II (30 decks)

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