Midterm Flashcards
CPT-continuous performance test
- requires subjects to indicate every time a letter other than x appears on the computer screen
- to test vigilance
Trails A & Trails B
- to test visual attention and task switching -> measures time to connect a sequence of number or alternating numbers and letters
- measures psycho-motor speed and flexibility
WAIS (Vocabulary)
to measure premorbid IQ
WAIS (Digit Span)
to measure verbal working memory, attention, encoding,
Corsi Block Tapping Test
o To assess visuo-spatial short term working memory
o Involves mimicking a researcher as he/she taps a sequence of up to 9 identical spatially separated blocks.
SPMSQ (short portable mental status questionnaire)
o A brief instruction to measure the presence and the degree of memory or cognitive impairment
o Measures orientation, memory function related to capacity for self-care, remote memory, and capacity to perform several mental operation
• MMSE (Mini Mental Status Exam)
o To assess mental status in terms of 5 cognitive function areas: orientation, registration, attention and calculation, recall, and language
o Is a screening tool for cognitive impairment with older adults
• AVLT (Ray Auditory Verbal Learning Test)
o to test learning curve, recency and primacy effects, proactive and retroactive interference
• CVLT-II (California Verbal Learning Test)
o to test learning curve, proactive and retroactive interference, semantic memory, forced-choice recognition
• Halstead-Reitan
o to assess the condition and functioning of the brain including type and areas of damage
o Tests include category test, finger oscillation test, seashore rhythm test…
• Nebraska-Luri
o to measure neuropsychological functioning in motor skills, language abilities, intellectual abilities, nonverbal auditory skills, and visual-spatial skills
o to determine whether a significant brain injury is present or to learn more about known brain injuries (left and right hemisphere, and 4 lobes)
• NEPSY
“A Developmental NEuroPSYchological Assessment”
o to measure a child’s neurological status in terms of executive function and attention, language, memory and learning, sensorimotor, visuospatial processing and social perception
• WMS (Wechsler Memory Scale)
o to measure working memory, single-trial learning, learning slops, retention, retrieval
• Anomia
inability to recall names of everyday objects
• Agnosia
inability to process sensory information -> cannot recognize things
• Apraxia
inability to follow a motor command
• Aphasia
inability to communicate
• Acalculia
inability to perform simple arithmetic/mathematical tasks
• Anosognosia
impaired awareness, lack of insight (e.g., lack of self-awareness)
• Agraphia
inability to write, communicate through writing
• Finger Agnosia
inability to distinguish, name or recognize the fingers; inability to identify which finger is touched
• Right-Left Disorientation
inability to identify right and left sides
• Neglect Hemiattention
inability to pay attention to one side of universe
• Basal ganglia
o Learning, memory and unconscious memory such as motor skills and implicit memory (procedural memory)
o Damage -> dysfunctional learning of motor and perceptual-motor skills, working memory
• Frontal lobe
coordination of information -> working memory; the ability to remember what we need to do in the future
o Prefrontal cortex
• executive function: planning complex cognitive behavior
• attention and memory: a store of short-term memory; working memory
• recency memory
o Broca’s area: speech production
• Cerebellum
o The learning of procedural memory
o Motor learning
o Classical conditioning
• Amygdala
o Emotional learning and memory
o Memory consolidation for emotional memory
o Classical conditioning
• Medial temporal lobe
memories with facts and events (Declarative memory)
o Hippocampus in medial temporal lobe
- cognitive map
- encoding of complex memories
- Damage to hippocampus -> anterograde amnesia; impossible to form new semantic memories, not episodic memory (explicit descriptions of actual events (episodic) cannot be learned, but some meaning and knowledge is gained from experiences (semantic))
- Memory consolidation: the slow process by which memories are converted from short to long term memory
- Spatial memory
• Diencephalon
thalamus + hypothalamus
o Thalamus
• Retrieval of memory: “librarian of the brain”
• Basal forebrain
learning and memory
o Acetylcholine is produced in basal forebrain -> damage -> reduced the amount of acetylcholine -> impair learning and memory -> amnesia, confabulation
• Consciousness
a general manifestation of brain activity that may become more or less responsive to stimuli, but has no separable parts
• Attention
refers to receptivity to sensory input for further processing.
major domains of neuropsychological assessment
- General intellectual functioning
- Orientation: x3 (who you are, time, place)
- Attention
- Memory: nonverbal and verbal functioning
- Speech and language function:
- Visuo-construction: putting things together
- Visuo-spatial perception: break up complex images into simple ones
- Executive function
- Problem-solving
- Motor functions strength, speed, dexterity
- Academic achievement
- Clinical observation
- Rating scales
- Adaptive behavior and functioning
- Psychological functioning: psychiatric diagnosis, personality
the major components of a neurology exam
- Mental Status Exam
- Cranial Nerve Exam
- Motor System
- Sensory Exam
• Frontal lobe
o Motor & Premotor Cortex • Primary/Secondary levels of motor Control: basic and integration of motor functioning • Verbal Fluency (the ability to rapidly generate materials or information) & Design Fluency • Spelling o Prefrontal • Tertiary level of motor control • Adaptability of response patterns • Programming & Planning of sequences of behavior • Level of response emission • Verbal regulation • Problem-solving • Voluntary eye movements • Perceptual judgment • Memory (recency) o Broca’s area: speech production o Orbital cortex
• Parietal lobe
o Anterior • Somatosensory perceptions • Tactile perception • Body Sense • Visual object recognition o Posterior • Language • Spatial Orientation & Attention • Symbolic Synthesis • Intentional movement • Cross-modal tactile visual matching • Short-term auditory memory
• Occipital lobe
o Primary visual sensation (points of light, simple forms)
• Completion
o Visual Perception
• Contours, magnitude, orientation, depth
• Stereopsis, brightness, color, movement
o Semantic connotations of visual objects
o Reading
• Temporal lobe
o Audition (all aspects of)
o Vision (Higher aspects of visual perception)
o Language (Receptive)
o Attention
o Cross-Modal Integration
o MEMORY
o Personality (affect, emotion, personal experience)
Meninges
- Dura mater
- Arachnoid membrane
- Pia mater
AMNART (American National Adult Reading Test)
to estimate premorbid IQ
cerebrum
the two cerebral hemispheres
cortex
the outermost layer of cerebrum consisting of mostly cell bodies
gray matter
cell bodies
white matter
myelinated axons
gyrus/gyri
folds of the cortex
sulcus/sulci
grooves of the cortex
parenchyma
generic term for brain tissue
axial
horizontal
dorsal
top
ventral
bottom
rostral
front
coronal plane
Think “crown.” A coronal slice is a slice from one ear to the other.
transverse plane
Means the same as horizontal plane
sagittal plane
vertical plane which passes from anterior to posterior, dividing the brain into right and left halves.
caudal
near the posterior part of the body
meninges
dura mater, arachnoid membrane, pia mater
Layers of the head/brain in order
skull –> dura mater –> blood vessels –> arachnoid membrane –> CSF –> pia mater –> brain
logical memory
memory for story
delirium
- A neuropsychiatric syndrome characterized primarily by impaired attention and disturbed consciousness which results in a “confusional state.
- diffuse cognitive deficits (memory), perceptual disturbances, , sleep-wake cycle alterations, psychomotor disturbance
deficits in retrieval
they can benefit from cued and recognition tests
deficits in encoding
they do not benefit from cued and recognition tests
Selective attention
The ability to maintain a behavioral or cognitive set in the face of distracting or competing stimuli (“freedom from distractibility”)
Vigilance
high level of anticipatory readiness for low probability stimuli
Capacity
How much information one can attend to at a time
Sustained attention
The ability to maintain a consistent behavioral response during continuous and repetitive activity (attentional endurance).
Supervisory Attentional System (SAS)
Executive control of attention. Arousal-Attention-SAS-Cognition. Once awake and altert, the SAS can direct our attention/cognitions.
Focused attention
The ability to respond discretely to specific visual, auditory or tactile stimuli. Intensity of focus.
Focus
Staying free from or blocking out distractions.
Complex Attention
Term used to refer to attentional tasks that require more than simple, basic attention (usually requires some kind of motor component). Essentially anything more complicated than basic attention.
What is typical pattern of cerebral lateralization of language functioning?
95% of right-handed people have left-hemisphere dominance for language, and about 20% of left-handed people have right-hemisphere dominance for language function. Additionally, 20% of the left-handed have bilateral language functions.
What is typical pattern of cerebral lateralization of visuo-spatial functioning?
Each cerebral hemisphere only receives information from one half of the visual field—specifically, from the contralateral hemifield. For example, retinal projections from ganglion cells in the left eye that receive information from the left visual field cross to the right hemisphere at the optic chiasm; while information from the right visual field received by the left eye will not cross at the optic chiasm, and will remain on the left hemisphere.
What are the advantages to CT?
- detects acute hemorrhage and calcified lesions.
- Emergency room diagnostic tool (it takes fewer than 5 min)
- cheaper than MRI
What are the disadvantages to CT?
- can pose the risk of irradiation.
* Difficult to differentiate white matter from grey matter
What are the advantages to MRI?
- Provides much more soft tissue detail.
- Examines a large variety of medical conditions
- It does not use radiation.
What are the disadvantages to MRI?
- takes up to 30 min.
* more expensive than CT
What are the major components of a neurology exam?
• Mental Status Exam • Cranial Nerve Exam • Motor System o Tone and Power: muscle strength and tone o Coordination o Abnormal Movements o Deep Tendon Reflexes and Miscellaneous Signs • Sensory Exam
What aspects of history taking get more emphasis in a neuropsychological exam compared to a clinical diagnostic interview?
• Medical history and neurological history
What neuropsychological abnormalities should you be alert to in a “bed-side exam?”
- Appearance
- Facial movement
- Speech and language
- Attention
- Movement
- Visuospatial function
- Form of thought
- Organization and initiation of behavior
Provide a general definition of attention
the receptivity to sensory input for further processing
What is focused attention?
the ability to respond discretely to specific visual, auditory or tactile stimuli
How can focused attention be assessed?
digit symbol, visual span, Stroop, working memory, digits forward, CPT
What is selective attention?
the ability to maintain a behavioral or cognitive set in the face of distracting or competing stimuli; the ability to focus on one part of the world while ignoring other aspects of the environment that are not important for the task at hand
How can selective attention be assessed?
letter or star cancellation, line bisection
What is tracking (attention)?
the ability to keep track of where you are
How can tracking be assessed?
digits backward, spelling backward, letter number sequencing
What is complex attention?
the ability to flexibly control attention by either switching or dividing attention between more than one thing
How can complex attention be assessed?
digit symbol coding, trail making, color trails
What is vigilance?
high level of anticipatory readiness for low probability stimuli
How can vigilance be assessed?
CPT-continuous performance test (requires subjects to indicate every time a letter other than x appears on the computer screen)
What is mental control?
production, control, or manipulation of familiar or overlearned material
How can mental control be assessed?
The Boston Revision of WMS-III Mental Control, WMS-III also has a measure of mental control
What problems of attention can be caused by a stroke?
unilateral brain lesions–neglect, hemi-attention
focal stroke lesion–impairments in focused attention
What problems of attention can be caused by dementia?
problems with attentional capacity, focused attention, and executive function
What problems of attention can be caused by Multiple Sclerosis?
problems with attentional control and attentional capacity; also causes fatigue
What problems of attention can be caused by hydrocephalus?
problems with attention and information processing; attentional ability fluctuates with ventricular pressure changes
What problems of attention can be caused by head trauma?
Usually frontal lobe damage. This causes impaired focused attention, attentional impairments in response, attentional impairments in response selection and control
What problems of attention can be caused by schizophrenia?
impaired selective, sustained, and focused attention, attention capacity, and information filtering
What problems of attention can be caused by an affective disorder?
impaired focused and sustained attention
depression: errors of omission
mania: errors of commission
What problems of attention can be caused by ADHD?
Executive or self-regulatory dysfunction is often impaired
What are the main functions of the temporal lobes? (easier)
hearing, memory
What are the main functions of the frontal lobes? (easier)
thinking, behavior, executive functioning
What are the main functions of the parietal lobes? (easier)
sensation, perception, and integrating sensory input (primarily with the visual system)
What are the main functions of the occipital lobes? (easier)
visual processing
Trails A and Trails B (easier)
A test of shifting attention and tracking. How much of a decrement in performance occurs when you jump from trails A (basic attention) to trails B (executive functioning).
Continuous Performance Task (easier)
A test of sustained attention and vigilance. A long test that requires a high level of concentration. A high level of anticipatory readiness to respond to a low frequency target.
WAIS Vocabulary (easier)
Premorbid verbal knowledge. Thought to be a “hold” test. Holds its integrity even in the face of severe neurological damage.
WAIS Digit Span (easier)
Digits Forward is basic attention. Digits Backwards is a tracking (any attentional task where you are required to keep track of where you are in the process of solving the task) task.
Corsi Block Tapping Test (easier)
Visual spatial parallel of an auditory digit span. Which blocks does the examiner touch and in what order.
AMNART (easier)
Premorbid verbal knowledge; very influenced by educational background.
SPMSQ (easier)
A general screener for cognitive impairment.
MMSE (easier)
A general screener for cognitive impairment.
AVLT (easier)
Verbal list learning test. One of the predecessors of the CVLT.
CVLT (easier)
Verbal list learning test. Uses Boston Process scoring.
Halstead-Reitan (easier)
Was intended to be a comprehensive neuropsychological fixed battery.
Nebraska-Luria (easier)
Was intended to be a comprehensive neuropsychological fixed battery.
NEPSY (easier)
A comprehensive neuropsyc battery for kids. Has many subtests.
WMS (easier)
A comprehensive battery specifically devoted to the assessment of memory.
Rapid forgetting
little to no savings; percentage of items recalled at immediate or long delay compared with how they did on trial five of CVLT
Alexia
Inability to read
