Neuropsych (Quiz 8) Flashcards
Define neurology
A branch of medicine that focuses on the nervous system and its disorders
How does Beaujean define neuropsychology?
How does the textbook define it?
How does Beaujean perceive other textbooks to define it?
How neurology impinges on the psyche.
Relationship between brain functioning and behavior
Behavioral expression of neural (dys)function
How is specificity and sensitivity important in neuropsych assessment?
sensitivity reduces false negatives by identifying condition when it is there, and specificity reduces false positives.
What is equifinality and multifinality with levels of relations?
Equifinality: different regions produce the same outcome
Multifinality: same region produces different outcomes.
What’s black box model in neuropsych assessment?
We know that there’s a relation, but we don’t know how exactly they’re connected (eg. many to many connections, but a black box blurring each connection)
How can neurologists simplify and get to one-to-one?
If multifinal, can collapse behaviors and call them one thing (eg. working memory)
Or can find relations between the brain regions (eg. additive, multiplicative, parallel)
What is a parallel relation?
The parts are each sufficient to produce the same result.
What is the purpose of neuropsychological assessment?
To connect nervous system to behavior, so that we can look at behavior to infer what’s happening in the nervous system.
What’s a battery in assessment?
A group of similar instruments (to get a comprehensive assessment)
2 types of batteries
Flexible: can choose which exact instruments to use
Fixed: specific instruments must be used.
Cons of flexible and fixed batteries
Flexible: hard to compare norm samples because they might use different scales
Fixed: use the same scale, so can compare norm samples.
What are the 2 ways to make fixed points?
1) map value onto something in the world. (criterion)
2) use normative (norm)
Neurotology
Branch of medicine focusing on problems related to hearing/balance/facial nerves
contralateral control
we control motor responses on the opposite side of our body
Organicity
mental disorders that are result of organic cause (brain injury)
Brain damage vs. Organicity
Evidence that they’re not unitary concepts. For example, people can have brain damage but not be affected because other parts of the brain take over. This case would not be organicity.
Hard sign vs. Soft sign
Hard sign: Some behavior indicates a definite neurological deficit (eg. reflex performance, cranial nerve damage from neuroimaging)
Soft sign: Some behavior indicates a suggestion of neurological deficit (eg. cannot copy a stimulus figure in drawing, minor motor or sensory deficits)
Most common group that refers people to neuropsychologists. Why?
Neurologists.
They might find no NS basis for the dysfunction and want to see the degree of impairment or see cognitive changes.
Functional vs Organic deficit
Functional: psychological deficit without known physical cause
Organic: deficit with known structural origin
What happens in a neuropsych evaluation?
Case history data examination (history taking), preliminary evaluations/tasks, mental status examination, other necessary tests
Assessing developmental milestones is what part of a neuropsych evaluation?
The history taking part.
Dementia example: why might a good history taking be important here?
Can be actual dementia or pseudodementia, which results from severe depression.
Knowing background would help with answering that.
Noticing one side of mouth is slower to curl than the other when patient smiles can suggest what?
Damage to 7th facial cranial nerve.
Who is the final arbiter of medical questions? Physician or neuropsychologist?
Physician.
Reflexes
involuntary motor responses to stimuli
What is mastication reflex?
chewing reflex.
What is the function of substantia nigra? what disease is related to cell loss in that region?
Parkinson’s
function: produce dopamine (needed for movement)
Idiopathic
(what disease)
unknown origin
eg. Parkinson’s
rapid eye movement sleep behavior disorder
a consequence of what other disorder?
Acting out of dreams with vocalizations or gestures
related to Parkinson’s?
Dyskinesias
what disease can this be result of?
involuntary, jerking-type movements
can be due to medications for Parkinson’s
What psychiatric disorder is a frequent accompaniment of parkinson’s?
Clinical depression
What is deep brain stimulation? What disease can this help?
DBS is an invasive intervention, implanting electrodes in areas of the brain, that can help severe Parkinson’s motor symptoms
Lewy body dementia
Looks like Parkinson’s but isn’t.
Formation of lewy bodies in brain stem, causing Parkinson’s/Alzheimer’s/dementia symptoms
DaTscan
visualizes substantia nigra to see how much dopamine is present. highly specialized.
Deterioration Quotient
Sign of brain damage by a quotient, but not satisfactorily valid as a standalone neuropsych impairment measure.
Abstract reasoning and neuropsychological deficit
A common symptom of neuropsych deficit is ability to think abstractly.
Object Sorting Test
(what kind of test? what is it?)
A type of abstraction test. Sort objects into groups.
Color-Form Sorting Test or Weigl’s Test
(what kind of test? what is it?)
A type of abstraction test. Sort objects of different shapes/colors
Wisconson Card Sorting Test-64 Card Version (WCST-64)
(what kind of test? what is it?)
A type of abstraction test.
Testtaker sorts 64 cards with geometric figures and colors into matching rules that change as test progresses
Assesses frontal lobe functioning
Executive function
Organizing, planning, cognitive flexibility, inhibition of impulses related to frontal/prefrontal lobes
What’s a famous test for executive function?
Tower of Hanoi
Tower of Hanoi
what kind of test?
tests executive function
Porteus Maze Test
what does it test?
Measures executive function.
Trace line to end point of maze?
Clock-drawing test (CDT)
what does it test? what is it?
Tests executive function.
Tells patient to draw face of a clock, with hands indicating a particular time.
cognitive impairment, psychiatric conditions, memoryy deficits, etc.
Trail-making item
what does it test? what is it?
Tests executive function
connect circles in logical way
Field-of-search item
Shown sample of target stimulusp scan field to match the sample.
Confrontation naming
Name each simulus that is presented.
Tests perceptual, semantic, and lexical component
Picture absurdity item
Asked what’s wrong or silly about the picture.
Test of Executive Function in an Emergency (TEFE)
why developed? what is it?
Developed to evaluate ability of cognitively impaired patients to access assistance when there’s emergency.
Perceptual test
Evaluates sensory functioning
Motor test
istruments or proceudres that evaluate ability and mobility
perceptual-motor test
example?
Any instrument or procedure used to find integration or coordination of perceptual and motor abilities
eg. jigsaw puzzle - hand-eye coordination
SCAM-3 Tests
Auditory functioning deficit.
Background noise distinguishing, focusing on one ear, etc.
Bender Visual-Motor Gestalt Test
9 cards with a desgin each.
Asked to copy the cards as best as possible.
Controlled Word Association Test
tests verbal functioning.
examiner says letter of alphabet, then examinees say as many words as they can beginning with that letter.
many brain injuries related
Aphasia
loss of ability to express oneself or understand spoken/written language because of neurological deficit
Reitan-Indiana Aphasia Screening Test (AST)
Variety of tasks, screening tool or combines with other test.
Implicit memory
Accessible only be indirect measures, not by conscious recollection.
California Verbal Learning Test- II
tests memory.
repeat list of words that are read by examiner.
Halstead-Reitan Neuropsychological Battery
27 tests to find presence/absence of organic brain damage.
The Neuropsychological Assessment Battery
has attention, EFs, memory, spatial, lagnuage measures. 3 hours. comprehensive battery.
