Neuropsychological Disorders Flashcards
1
Q
two-hit hypothesis/diathesis stress model/neurodevelopmental model of schizophrenia
A
developmental vulnerability that then emerges at specific ages of onset in response to stress
2
Q
diagnostic tests for Alzheimer’s
A
Mini-mental state examination, Montreal Cognitive Assessment (MOCA) - screening measure, does not assess specific function
3
Q
primary progressive aphasia
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lose words
4
Q
semantic dementia
A
lose understanding of word meaning
5
Q
progressive non-fluent aphasia
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lose Broca’s area, stops speaking
6
Q
stroke
A
the sudden disruption of blood flow to the brain
7
Q
infarct
A
area of dead or dying tissue resulting from an obstruction of the blood vessels
8
Q
ischemia
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disorders due to blockage in blood vessels going to the brain
9
Q
thrombosis
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formation of a plug or clot in the blood vessel
10
Q
embolism
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a clot or plug that is brought through the blood from a larger vessel to a smaller vessel
11
Q
cerebral arteriosclerosis
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thickening and hardening of the arteries
12
Q
cerebral vascular insufficiency or transient ischemia
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temporary ischemia, disorder has variable nature over passage of time
13
Q
migraine stroke
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accounts for a significant number of strokes in younger people, especially women, appears as a transient ischemic attack
14
Q
symptoms of migraine stroke
A
impaired sensory function, numbness of the skin, difficulties moving, aphasia
15
Q
cerebral hemorrhage
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massive bleeding into the brain, most often caused by hypertension/high blood pressure
16
Q
angioma
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congenital collection of abnormal blood vessels that divert normal flow of blood, eg. arteriovenous malformation (AVM)
17
Q
aneurysms
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vascular dilation, due mostly to congenital defects/hypertension/arteriosclerosis/embolisms/infections
18
Q
how do you treat cerebral vascular disorders?
A
- drug therapy (t-Pa therapy, neuroprotective drugs, antiplatelet agents)
- surgery (relieve pressure, metabolic syndromes increases surgical risk)
- prevention!
19
Q
traumatic brain injuries - open-head injuries
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TBIs with skull penetration, neurological signs/symptoms are highly specific, may undergo rapid and spontaneous recovery if injury is small and specific
20
Q
traumatic brain injuries - closed-head injuries
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coup, countercoup, twisting and shearing of major fiber tracts, bleeding and pressure can result in hematomas, edema: can produce coma, behavioural effects
21
Q
coup
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damage at the site of the blow
22
Q
countercoup
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damage at the opposite side of the blow due to pushing or pressure
23
Q
coma
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loss of consciousness; commonly accompanies closed-head injuries
24
Q
behavioural effects of TBI
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impairment of specific functions mediated by the cortex at site of damage, more generalized impairments from widespread trauma throughout brain
25
brain injuries subsequent to closed head trauma: primary brain injuries, immediate on impact
- coup and contrecoup contusions
- fiber shearing or stretching
- macroscopic and microscopic lesions
- laceration or depression from skull penetration or fracture
26
brain injuries subsequent to closed head trauma: secondary injuries
- intracranial hemorrhage and edema
- ischemic or bleed-induced damage
- increased intracranial pressure or distortion
- effects of multiple injuries and hypoxia
27
brain injuries subsequent to closed head trauma: injurious effects, delayed
degeneration of gray and white matter, hydrocephalus
28
what are behavioural assessments for head injury?
- Glasgow Coma Scale
| - Posttraumatic Amnesia (PTA)
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glasgow coma scale
objective indicator of the degree of unconsciousness and of recovery from it: measures eye opening, motor response, verbal response
30
posttraumatic amnesia
measure of severity of injury, correlates with future memory disturbance, no consistent method used for measurement of amnesia
31
epilepsy
brain disorder caused by recurrent seizures
32
symptomatic seizures
seizures identified with a specific cause
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idiopathic seizures
appear spontaneously, without an apparent cause
34
what are 3 common symptoms of epilepsy?
1) onset of aura - warning of an impending seizures
2) loss of consciousness
3) motor component
35
what are 4 types of seizures
1) focal seizures
2) generalized seizures
3) akinetic seizures
4) myoclonic spasms
36
focal seizures
beings in one place (a focus point) and spreads
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Jacksonian focal seizures
begins with movement in one part of the body and spreads
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complex partial seizures
subjective experiences precede the attack, automatisms-automatic behaviours, postural changes
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generalized seizures
bilaterally symmetrical,
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grand mal attack
(generalized seizure) tonic stage, clonic stage, postseizures: postictal depression
41
petit mal attack
(generalized seizure) loss of awareness, no motor activity, brief duration
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akinetic seizures
ordinarily only seen in children, child may collapse without any warning, attacks are short
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myoclonic spasms
massive seizures, consists of sudden felxion or extension of the body
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treatment of epilepsy
anticonvulsant drugs (diphenylhydantoin-DPH, dilantin; phenobarbital), surgery, DBS
45
tumours
mass of new tissue that persists and grows independently
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benign tumour
not likely to recur after removal
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malignant tumour
likely to recur after removal, progressive and life-threatening
48
encapsulated tumour
distinct entity, puts pressure on the brain (e.g. meningioma)
49
infiltrating tumour
not separated from surrounding tissue, may destroy healthy cells or interfere with cellular functioning (e.g. glioma)
50
glioma
arises from glial cells and infiltrates brain substance
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meningioma
most benign of tumours, growths attached to the meninges, grows outside brain and well encapsulated
52
metastatic tumour
occurs in brain after tumour cells are transferred from elsewhere
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treatments for brain tumours
- surgery
- radiation
- chemotherapy
54
classic migraine
- begins with aura that lasts for 20-40 mins (occurs as a result of vasoconstriction in the occipital cortex)
- headache
55
headache
occurs as vasodilation takes place, intense pain localized to one side, symptoms may include nausea and vomiting, can last hours-days
56
common migraine
most frequent type (80%), no clear aura, but another signal may presage attack
57
cluster headache
unilateral pain, short duration, but recurs repeatedly for weeks or months before disappearing
58
hemiplegic migraine and opthamologic migraine
relatively rare, loss of movement of limbs on one side and eyes respectively
59
treatments for migraine
- drugs
| - ergotamine compounds (given with caffeine during acute attacks)
60
treatments for tension headaches
- muscle-relaxant drugs
- minor tranquilizers
- posture improvements
- reduction of stress
61
infection
invasion of the body by disease-producing microorganisms and subsequent tissue reactions
62
how do infections kill neural cells?
- interference with blood supply
- disturb glucose or oxygen metabolism
- alter cell membranes
- form pus
- causes edema
63
viral infections
caused by virus: encapsulated aggregate of nucleic acid made of either DNA or RNA
64
neurotropic viruses
e.g. rabies, polio: virus with special affinity for CNS cells
65
pantropic viruses
e.g. mumps, herpes: attacks other body tissues as well as CNS
66
bacterial infections
caused by bacteria; microorganism that has no chlorophyll and multiplies by simple division
67
bacterial meningitis
infection of the meninges by bacteria
68
brain abscesses
secondary to infection elsewhere in the body, cause cell necrosis and multiplication of bacteria increases intracranial pressure
69
mycotic infections
invasion of the nervous system by a fungus
70
parasitic infestations
- amebiasis (amebic dysentery: caused by infestation of a protozoan amoeba, results in encephalitis and brain abscesses)
- malaria (transmitted by bites of infected mosquitoes, produces local hemorrhages and subsequent degeneration of neurons)
71
treatments for CNS infections:
- viral infections (no specific antidotes except for rabies)
- bacterial cerebral infections (antibiotics, drain abscesses or do spinal tap to remove fluid)
- mycotic or parasitic infections (antibiotics used to treat associated disorders)
72
apraxia
inability, in the absence of paralysis or other motor or sensory impairments, to make or copy voluntary movements. usually follows damage to the neocortex
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ataxia
failure of muscle coordination or irregularity of muscular action, commonly follows cerebellar damage
74
athetosis
ceaseless slow, sinuous, writhing movements, especially in the hands, due to abnormal function of the extrapyramidal system
75
catalepsy
muscular rigidity in which voluntary movements are reduced or absent but posture is maintained. a feature of PD due to da loss
76
cataplexy
complete loss of movement and posture during which muscle tone is absent but consciousness is spared
77
chorea
literally "to dance" ; refers to a wide variety of ceaseless, jerky movements that appear well-coordinated but are performed involuntarily
78
hemiplegia
complete or partial paralysis to one half of the body, usually follows damage to the contralateral motor cortex
79
palsy
usually refers to persisting movement disorders due to brain damage acquired perinatally
80
paralysis
complete loss of movement (more commonly) or sensation in a part of the body. usually permanent after damage to motor neurons, temporary after damage to motor cortex
81
paraplegia
paralysis or paresis of the lower torso and legs following spinal-cord damage
82
spasticity
increased tone in certain muscle groups that maintain posture against the force of gravity
83
tardive dyskinesia
slow, persistent movements, particularly of the mouth and tongue, usually follows long-term treatment with antipsychotic drugs
84
myasthenia gravis
severe muscular weakness; muscular fatigue after little effort; caused by insufficient acetylcholine receptors on muscles
85
treatment for myasthenia gravis
acetylcholine therapy to relieve symptoms, thymectomy and immunosuppressive drugs
86
poliomyelitis
infectious disease by a virus that has affinity for the spinal cord motor neurons and sometimes motor neurons of cranial nerves, causes paralysis and wasting of the muscles due to motor neurons loss
87
occurrence of poliomyelitis is controlled with:
Salk and Sabin vaccines
88
multiple sclerosis
due to loss of myelin, mainly in motor tracts
89
sclerotic plaques
small, hard, circumscribed scars where the myelin sheath has been destroyed
90
paraplegia
paralysis of the lower limbs caused by complete transection of the spinal cord
91
immediate symptoms of paraplegia
loss of movement, sensation, and reflexes, loss of thermoregulatory activity, loss of bladder control; some reflexes may gradually return
92
Brown-Sequard syndrome
unilateral section through the spinal cord
93
if loss is contralateral to the side of section:
loss of pain and temperature sensation, fine touch and pressure preserved
94
if loss is ipsilateral to the side of section:
preservation of pain and temperature, loss of fine touch and pressure, loss of sensation and voluntary movements distally
95
hemiplegia
loss of voluntary movement on one side of the body, changes in postural tone, and changes in various reflexes: damage is to neocortex and basal ganglia: changes in reflexes (appearance of the Babinski sign, loss of abdominal reflex and cremasteric reflex in males)
96
polygraph
records brain waves, on EEG
97
electromyogram
records muscle activity
98
electrooculogram
records eye movements
99
thermometer
records body temperature
100
narcolepsy
inappropriate and overwhelming attack of sleep, symptoms: sleep attacks, cataplexy, sleep paralysis, hypnagogic hallucinations
101
sleep attacks
brief, irresistible attacks of sleep; slow-wave NREM sleep, can occur at any time
102
cataplexy
complete loss of muscle tone, person can collapse or fall, probably an attack of REM sleep, occurs at times of emotional excitement
103
sleep paralysis
occurs in the transition between wakefulness and sleep, brief paralysis associated with the dream state but the person has woken up
104
hypnagogic hallucination
episodes of auditory, visual, or tactile hallucinations during sleep paralysis as person is waking up or going to sleep, can be frightening and intermixed with real events
105
insomnia
decreased REM, go through more transitions between stages, move more during sleep
106
sleep apnea
periodic cessation of respiration during sleep
107
obstructive sleep apnea
occurs in dream sleep and may be caused by a collapse of the oropharynx during dream sleep paralysis
108
central sleep apnea
CNS disorders, characterized by a failure of the diaphragm and accessory muscles to move, can be caused or aggravated by obesity
109
alzheimer's disease
early impairment of declarative memory, some cognitive fluctuation, usually no motor symptoms, senile plaque density and neurofibrillary tangles
110
dementia with Lewy Body
early impairment in attention and visual-spatial skills, lots of cognitive fluctuation, visual hallucinations, motor symptoms (pronounced rigidity and bradykinesia); seen senile plaque density, some NFT, subcortical Lewy body, lots of cortical Lewy bodies
111
Parkinson disease
impaired executive functioning, some visual hallucinations late in disease course, motor symptoms are the initial manifestation of the disease and are generally unilateral, subcortical Lewy bodies present
112
FTD with main complaint being behaviour:
subtype of FTD = behavioural/dysexecutive (frontal variant FTD or R temporal variant FTD)
113
FTD with main complaint being language:
subtype of FTD = primary progressive aphasia (PPA)
| fluent = semantic dementia SD, L temporal variant FTD) (non-fluent = progressive non-fluent aphasia (PNFA
114
memory deficits in Alzheimer's disease:
episodic memory, semantic memory, working memory
115
memory deficits in frontotemporal dementia:
episodic memory, semantic memory, working memory
116
memory deficits in semantic dementia
some episodic memory, semantic memory
117
memory deficits in Lewy body dementia:
episodic memory and working memory
118
memory deficits in vascular dementia
some episodic/semantic/procedural memory, working memory
119
memory deficits in Parkinson's diase
some episodic/semantic, procedural memory, working memory
120
schizophrenia symptoms:
1) delusions or beliefs that distort reality
2) hallucinations
3) disorganized speech, senseless rhyming
4) disorganized or excessively agitated behaviour
5) other symptoms that cause social or occupational dysfunction
121
biochemical abnormalities in schizophrenia
- dopaminergic function
- glutamate and glutamate receptors (decreased glutamate transmission)
- GABA and GABA binding sites
122
in schizophrenia, abnormal DA/GABA/Glu inputs to PFC:
impair DLPFC connectivity leading to DLPFC and cognitive dysfunction
123
clinical depression
(mood disorder): prolonged feelings of worthlessness and guilt, general slowing of behaviour, disruption of eating/sleeping
124
mania
(mood disorder): excessive euphoria, hyperactivity
125
bipolar disorder
(mood disorder): periods of depression and mania
126
abnormalities in depression
- decreased activity in DL and MPFC (reduced memory and attention)
- increased activity in orbital regions (attempt to inhibit amygdala activity and break persistent negative thoughts)
- increased activity of amygdala (increase HPA axis activity)
- increased activity of thalamus
127
sensitization model of bipolar disorder
large individual differences in degree of sensitization and drug effects in lab animals and
128
in Huntington's disease
ACh and GABA neurons in the basal ganglia die, so there is no activation of inhibitory dopamine neurons in the substantia nigra
129
3 stages of Tourette's syndrome
1) multiple tics
2) inarticulate cries
3) emission of articular words (echolalia, copralalia)
130
treatment of Tourette's syndrome
antidopaminergic drugs, norepinephrine receptor agonists
131
major disease symptoms of Parkinson's:
muscular rigidity, tremor, involuntary movements, postural disturbances
132
positive symptoms of Parkinson's
tremor at rest, muscular rigidity (cogwheel rigidity - muscles move in series of steps), involuntary movements (akathesia, oculogyric crisis)
133
akathesia
cruel restlessness
134
oculogyric crisis
involuntary turns of the head and eyes to the side
135
negative symptoms of Parkinson's
postural disorders (disorders of fixation and equilibrium), righting disorders, locomotive disorders (difficulty initiating stepping, festination-taking steps faster and faster), speech disturbances (lack of tone in voice), akinesia (slowness of movement)
136
WAIS
Weschler Adult Intelligence Scale = measures intelligence and cognitive ability
137
major neurodegenerative disorder (NCD)
substantial cognitive decline, sufficient to interfere with independent function, must not be attributable to another disorder
138
mild neurocognitive disorder (mild NCD)
modest cognitive decline, deficits don't interfere with functioning independently
139
what are 5 types of dementias?
1) tauopathies
2) synucleinopathies
3) vascular dementias and vascular cognitive impairment
4) mixed dementias
5) other dementias
140
tauopathies
accumulation of tau proteins inside neurons
- alzheimer's disease
- corticobasal degeneration (neuron loss and shrinkage in cortex and basal ganglia)
- frontotemporal disorders
- progressive supranuclear palsy (PSP): neuron loss in upper brainstem
141
synucleinopathies
accumulation of alpha-synuclein protein in neurons
- Lewy body dementia
- Parkinson's disease dementia
142
vascular dementias and vascular cognitive impairment
injuries to cerebral blood vessels
- multi-infarct dementia
- subcortical vascular dementia (binswanger's disease)
143
mixed dementias
combination of disorders such as Alzheimer's and vascular symptoms
144
other dementias
- prion-related ementias (Creutzfeld-Jakob disease)
- Huntington's disease
- secondary dementias
- head injury
- infectious dementias (AIDS dementia, syphilis)
- drug-related dementias (chronic alcohol)
145
which transmitter systems are changed in Alzheimer's disease?
ACh, noradrenaline, DA, 5-HT and glutamate
