Lobar functions and cognitive testing Flashcards
Lobe assessed during similarities test
Frontal
Test where two objects are compared to test the ability to categorise them
Similarities
Lobe assessed during lexical fluency test
Frontal
Description of lexical fluency test
Naming objects within a category (food, animals) or words starting with a certain letter
Lobe assessed during Luria motor test
Frontal
Description of Luria motor test
Testing ability to learn a pattern.
Hand it placed on the table in the pattern fist, edge, palm
Patient watches someone do this, does it with them, then does it alone
Lobe assessed during go/no go test
Frontal
Description of go/no go test
Person is given a pattern e.g. ‘if I clap once, you clap twice; if I clap twice, you clap once’
Tested on this pattern
Pattern is then changed e.g. ‘if I clap once you clap once; if I clap twice you don’t clap’
Tests response inhibition, set shifting and perseveration
Lobe assessed during cognitive estimates test
Frontal
Description of cognitive estimates test
Questions are asked which are likely not known exactly
E.g. ‘how far can an adult walk in an afternoon’
Tests abstract thinking
Lobe assessed during trails making test
Frontal (although not specific for frontal lobe)
Description of trails A test
Numbers within circles are joined going lowest to highest
Description of trails B test
Alternating numbers and letters are joined lowest to highest i.e. 1 - A - 2 - B etc.
Lobe assessed during proverb interpretation test
Frontal
Lobe assessed during copying shapes test
Parietal
Lobe assessed during test to identify fingers
Parietal
Lobe assessed during testing of simple arithmetic
Parietal
Lobe assessed during testing for graphesthesia (ability to recognise letters or numbers being drawn on the skin without looking)
Parietal
Lobe assessed during testing for graphesthesia (ability to recognise letters or numbers being drawn on the skin without looking)
Parietal
Lobe assessed during testing of right/left discrimination
Parietal
Lobe assessed during testing of stereognosis
Parietal
Description of stereognosis
Ability to recognise objects by palpation
Lobe assessed during testing of two point discrimination
Parietal
Lobe assessed during testing of visual inattention
Parietal
Common tests of visual inattention
Letter or star cancellation
Line bisection
Draw a person
Draw a tree
Domain tested in digit span testing
Attention
Domain tested in trails A test
Attention
Domain tested in Boston naming test
Language
Domain tested in verbal fluency tests
Language
Domain tested in Ray-Osterrieth complex figure test
Visuospatial skills
Domain tested in Wisconsin card sort test
Executive function
Domain tested in Stroop test
Executive function
Domain tested in Trails B test
Executive function
Domain tested in Wechsler memory scale
Memory
Domain tested in Ray auditory verbal learning test
Memory
Lobe assessed during Tower of London test
Frontal
Description of Tower of London test
Two pegs on a board have rings of different colours
Presented with problem solving tasks which have to be solved
Six subsets of a frontal assessment battery
Conceptualisation - similarities, abstract reasoning
Mental flexibility - words beginning with a letter/in a category
Motor programming - Luria
Conflicting instructions - first part of no/go/no
Inhibitory control - second part of no/go/no
Prehension behaviour - ask patient not to touch your hands when you put them out
Features of unilateral frontal lobe lesions
Contralateral spastic hemiplegia Elevation of mood, inappropriate speech Frontal release signs Anosmia If left lobe - motor speech issues, loss of fluency (Broca's aphasia), agraphia
Primitive reflexes which are normal in infancy and usually a sign of frontal lobe disorder if present in adults
Frontal release signs
Examples of frontal release signs
Rooting reflex Sucking reflex Glabellar reflex Palmar grasp Palmomental reflex Snout reflex
Frontal release sign where an object placed in the palm is naturally grasped
Palmar reflex
Frontal release sign where stroking a certain point on the hand causes the chin to twitch
Palmomental reflex
Frontal release sign where the head is turned in the direction of anything that strokes it
Rooting reflex
Frontal release sign where the person naturally sucks if anything touches the roof of its mouth
Sucking reflex
Frontal release sign where the lips are pursed when tapped lightly
Snout reflex
Frontal release sign where blinking is initiated on repetitive tapping of the glabella (if not present blinking will occur the first few times but will then stop out of habituation)
Glabellar reflex
Term for symptoms found in frontal lobe disease where there is the tendency to make puns, tell inappropriate jokes, and be unable to recognise sarcasm
Witzelsucht
Features of a bilateral frontal lobe lesion
Bilateral hemiplegia
Spastic bulbar palsy
Abulia
Sphincter incompetence
Type of seizure where there is a sudden burst of laughter, usually without associated happiness
Gelastic seizure
Lesions associated with a gelastic seizure
Hypothalamic hamartoma
Frontal lobe lesions
Features of a unilateral parietal lobe lesion
Contralateral sensory loss Mild contralateral hemiparesis Inferior homonymous quadrantanopia Astereognosis (tactile agnosia) Apraxias If R lesion - contralateral neglect and anosognosia If L lesion - Gerstmann's syndrome
Features of Gerstmann’s syndrome
Agraphia
Acalculia
Finger agnosia
Right-left confusion
Syndrome usually caused by bilateral parietal or parieto-occipital lesions
Balint syndrome
Features of Balint syndrome
Simultanagnosia - inability to perceive simultaneous events visually
Oculomotor apraxia - inability to fixate the eyes
Optic ataxia - inability to move the hand to a specific place using vision
Features of a unilateral temporal lobe lesion
Homonymous upper quadrantanopia
Complex hallucinations - smell, sound etc.
If L lesion - fluent aphasia (Wernicke’s aphasia), dyslexia, word agnosia
If R lesion - impaired non-verbal memory, impaired musical skills, amusia (difficulty recognising pitch)
Features of a bilateral temporal lobe lesion
Apathy Dream-like states Disturbances of time perception Hypermetamorphopsia (compulsion to attend to all visual stimuli) Amnesia, Korsakoff syndrome Klüver–Bucy syndrome
Features of Klüver–Bucy syndrome
Compulsive eating Hypersexuality Hyperorality (insertion of inappropriate objects into the mouth) Visual agnosia Docility
Syndrome with five core features seen in patients with temporal lobe epilepsy
Geschwind syndrome
Features of Geschwind syndrome
Hypergraphia Hyperreligiosity Atypical sexuality (usually reduced) Non-linear thought patterns, circumstantiality Intensified mental life
Features of a unilateral occipital lobe lesion
Contralateral homonymous hemianopia Elementary lesions Visual illusions Visual agnosia If deep white matter or corpus callosum involved - alexia, colour naming defects
Features of bilateral occipital lobe lesions
Cortical blindness with reactive pupils
Anton syndrome
Achromatopsia
Features of Anton syndrome
Cortical blindness but denial of same
Areas of lesion causing prosopagnosia
Temporo-occipital
Ages Wechsler adult intelligence scale III is designed for
16-89
Three types of IQ yielded in WAIS
Verbal
Performance
Combined/full scale
Verbal tests in WAIS
Similarities Arithmetic Digit span Vocabulary Information Comprehension
Performance tests in WAIS
Picture arrangement Block design Picture completion Digit symbol Matrix reasoning/object assembly
Type of tests within WAIS which are supposed to be age related decline in ability
Hold tests
Type of tests within WAIS which are not supposed to be resistant to age related decline in performance
Non-hold tests
Hold tests within WAIS
Vocabulary
Information
Object assembly
Picture completion
Non-hold tests within WAIS
Block design
Digit span
Similarities
Digit symbol
IQ test which is aimed to be independent of education and cultural influences
Raven’s progressive matrices
IQ test which aims to test premorbid intelligence
National adult reading test
Area of brain affected in Gerstmann’s syndrome
Left angular gyrus
Lobe tested in verbal fluency tests
Frontal