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Fall 2014 Neuro Ophthalmic Disease > Fall 2014: Lecture 8: Week 6: Disorders Of Higher Cortical Function > Flashcards

Fall 2014: Lecture 8: Week 6: Disorders Of Higher Cortical Function Flashcards

1
Q
  1. Primary Visual Cortex = ?
  2. Prestriate Cortex = ?
  3. Extrastriate Cortex = ?
  4. V5 is also called what?
A
  1. Striate Cortex = V1
  2. V2
  3. V3, V4, V5
  4. MT (Middle Temporal Area)
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2
Q

Aphasia

  1. What is it?
  2. Nonfluent Aphasia
    a. AKA?
    b. What is it?
  3. Fluent Aphasia
    a. AKA?
    b. What is it?
A
  1. Hard to understand or make language
  2. a. BROCA’s APHASIA
    b. Can’t Produce Language
  3. a. WERNICKE’s APHASIA
    b. Auditory Comprehension is bad. (Fluent, easily articulated, but PARAPHASIC SPEECH)
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3
Q

Alexia/Agraphia

  1. Alexia: Define
  2. Agraphia: Define
  3. What happens in ALEXIA without AGRAPHIA?
A
  1. Can’t Read
  2. Can’t Write
  3. Pt can still write, but CANNOT READ!
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4
Q

Visual Object Agnosia

  1. What is it?
  2. Involves what pathway?
A
  1. Can’t recognize previously familiar OBJECTS!
    a. Can’t recognize them by sight, but might be able to describe them or recognize them via a different sense.
  2. VENTRAL “What” Pathway
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5
Q

Prosopagnosia

  1. What is it?
    a. They may have to rely on what kinds of cues?
    b. Issues with it?
A
  1. Can’t recognize familiar faces or learn to recognize new faces
    a. like glasses, hairstyle, gait, voice.
    b. Can cause social embarrassment.
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6
Q

Akinetopsia

  1. What is it?
    a. Affects what area?
A
  1. Messes with MOTION PERCEPTION (smooth moving objects look stationary or seem to “JUMP” from place to place.
    a. MT/V5
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7
Q

Cerebral Color Vision Defects

  1. What is it?
  2. Dyschomatopsia: Define
  3. Achromatopsia: Define
  4. Hemiachromatopsia: Define
  5. What tests can be done?
  6. LOCATION?
A
  1. Don’t perceive colors properly. Damage to Visual Cortex
  2. Color looks dull, LESS BRIGHT
  3. Objects appear in shades of gray.
  4. Affects color discrimination in one hemifield.
  5. Ishihara and HRR
  6. Visual Cortex; U/L and C/L in Hemichromatopsia
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8
Q

Simultanagnosia

  1. Define
  2. Test?
  3. Location of injury?
A
  1. Can’t grasp the entire meaning of a picture, but can recognize individual components
  2. “Cookie Theft” Picture
  3. B/L Occipital/Parietal Lobes
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9
Q

Optic Ataxia

  1. Define
  2. Test?
  3. Location?
A
  1. Pt sees the object, but can’t reach for it accurately (Disconnect b/w Visual input and motor system)
  2. Ask Pt to touch various Objects
  3. B/L Occipital/Parietal Lobes
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10
Q

Ocular Motor Apraxia

  1. Define
  2. Test?
  3. Location?
A
  1. Can’t make voluntary saccades to look at an object of interest, despite full ocular motilities
    (Use head movements to change fixation)
  2. Ask Pt to look quickly at various objects
  3. B/L Occipital/Parietal Lobes
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11
Q

Balint Syndrome

  1. TRIAD (What is it?) (SOO)
  2. What pathway?
A
  1. Simultanagosia
    Optic Ataxia
    Ocular Motor Apraxia
  2. DORSAL (“WHERE”) Pathway
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12
Q

Visual Neglect

  1. Define
  2. Test
  3. Location
A
  1. Pts WONT pay attention to STIMULI shown in the LEFT HEMIFIELD, despite full visual fields.
  2. Line Bisection; Clock Drawing
  3. Right Inferior Parietal Lobe
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13
Q

Blindsight

  1. Define
  2. Thought to be due to what?
A
  1. Pts w/Lesions to V1 can detect targets in the blind VF at a rate better than chance. (Spatial location, orientation, color, motion)
  2. Believed to be due to a RESIDUAL FUNCTION in a parallel visual processing pathway.
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14
Q

Anton Syndrome

  1. Define
  2. Location
A
  1. Pts that are cortically blind but are NOT AWARE of their vision loss and insist that they can see. (Pt confabulates Visual perceptions)
  2. B/L Occipital Lobe Lesions
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15
Q
  1. Illusion: Define

2. Hallucination: Define

A
  1. Pt has an ABNORMAL VISUAL PERCEPTION of a viewed object (Object looks WEIRD)
  2. Pt has a visual sensation that doesn’t correspond to a real object. (seeing something that isn’t really there)
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16
Q

Hallucinations

  1. 4 Simple (FSZC)
  2. Complex (4) (PACS)
A
  1. Flashes of Light
    Simple Patterns/Shapes
    Zig-Zag Lines
    Colors
  2. People
    Animals
    Complex Objects
    Scenes
17
Q
  1. Metamorphopsia
  2. Macropsia
  3. Micropsia
  4. Pelopsia
  5. Teleopsia
  6. Phosphenes
A
  1. Objects look Warped or distorted
  2. Objects are perceived as larger than reality
  3. Objects are perceived as smaller than reality
  4. Objects appear closer than reality
  5. Objects appear more distant than reality
  6. Flashes of light
18
Q

Psychiatric Conditions

  1. Schizophrenia: What is it?
    a. Visual Hallucinations in psychiatric conditions are usually associated with what?
A
  1. Most common psychiatric disorder associated w/Visual Hallucinations
    a. with Auditory Hallucinations
19
Q

Ophthalmic Disorders

  1. Metamorphopsia: Occurs when what happens?
    a. Examples?
  2. Micropsia: Occurs when what happens?
    a. Example?
  3. Macropsia: Occurs when what happens?
    a. Example?
  4. Phosphenes: Occurs when what happens?
    a. Examples?
A
  1. when regular arrangement of photoreceptors is disrupted
    a. ERM, Macular Edema, CNV, RPE detachment
  2. Occurs when photoreceptors are pushed apart.
    a. Macular Edema
  3. Occurs when photoreceptors are pushed closer together
    a. ERM
  4. Vitreoretinal Traction
    a. PVD, Retinal Tear
20
Q

Pulfrich Phenomenon

  1. Define.
    a. Cause?
A
  1. Altered perception of motion due to a disparity in neuronal transmission
    a. Optic neuritis causing a conduction delay in one optic nerve compared to the other.
21
Q

Charles Bonnet Syndrome (1)

  1. AKA?
  2. Characterized by what?
  3. Types of Hallucinations?
  4. Patients?
  5. Prevalence
A
  1. RELEASE HALLUCINATIONS
  2. by visual hallucinations associated w/Poor Vision
  3. Simple or Complex
    Persistent or Recurrent
    Usually a pleasant nature, but can be disturbing
    *Static or moving
    *They appear clear compared to normal blurred vision
  4. Acquired Binocular Severe Vision Loss (AMD: MOST COMMON)…MORE COMMON in ELDERLY (Still have intellectual functions)
  5. Underreported due to Pts fear of being labeled as mentally ill. Misdiagnosed due to lack of familiarity of medical professionals w/the condition
22
Q

Charles Bonnet Syndrome (2)

  1. Sensory Deprivation Theory?
    a. Analogous to what Syndrome?
  2. Prognosis?
  3. Tx?
A
  1. Reduced visual stimuli –> Spontaneous discharge in the Visual Cortex
    a. to Phantom Limb Syndrome
  2. Hallucinations usually disappear w/in a year to 18 months
  3. a. Education and reassurance
    b. Interrupting vision for a short time by closing eyes or blinking can help
    c. Meds: Antipsychotics, Antiepileptics, SSRIs
23
Q

Dementia w/Lewy Bodies

  1. Visual Hallucinations are what?
  2. What other characteristics?
A
  1. Complex, Binocular, throughout the entire VF

2. Cognitive Impairment and Parkinsonism

24
Q

Seizures

  1. Hallucinations are typically what?
    a. They may also have what?
  2. Mono or Bino?
  3. What HA type is COMMON?
  4. Episodes tend to occur more frequently than what?
A
  1. Simple, Brief, Flashes of colored spots or shapes
    a. Motion
  2. ALWAYS BINOCULAR
  3. Postictal HA is commone
  4. than Migraine
25
Q

Peduncular Hallucinosis

  1. Visual Hallucinations due to what in the MIDBRAIN?
  2. Hallucinations are typically what?
  3. Damage to what?
  4. What is typically intact?
A
  1. INFARCT
  2. Complex and Mild
  3. to the Ascending RAS!
  4. Insight
26
Q

Narcolepsy

  1. Sleep Attacks
  2. Cataplexy
  3. Sleep Paralysis
  4. When do they get HALLUCINATIONS?
A
  1. Episodes of unwanted sleep
  2. Transient Loss of Muscle tone
  3. Can’t move when the patient first wakes up
  4. When entering sleep or awakening
    a. Visual, auditory, or tactile
    b. Can be unpleasant and disturbing
    c. Usually have the sensation of another person in the room.
27
Q

Drugs: Hallucinogens

  1. What are the 3 main ones?
A
  1. Cocaine, LSD, PCP
    * Produce a functional dissociation b/w Primary sensory cortex and Cortical Association Areas
    * HPPD (Hallucinogen persisting perception disorder)

“Cocaine Bugs”

*Pulsating Geometric Shapes

28
Q

Alcohol Withdrawal

  1. Delirium Tremens
    a. Hallucinations are what 2 things?

b. What drug can help suppress the hallucinations?
c. Other symptoms?

A
  1. a. Visual and Auditory
    b. Benzodiazepines
    c. HAs and Seizures
29
Q

Abnormal Color Perception

  1. Digoxin
  2. Sildenafil
A
  1. Yellowing of Vision (Xanthopsia) w/Toxic Levels

2. Transient Bluish Tinge (Cyanopsia) to vision

Fall 2014 Neuro Ophthalmic Disease (14 decks)

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