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NEUR479 > Neuropsychological Disorders > Flashcards

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

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2
Q

diagnostic tests for Alzheimer’s

A

Mini-mental state examination, Montreal Cognitive Assessment (MOCA) - screening measure, does not assess specific function

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3
Q

primary progressive aphasia

A

lose words

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4
Q

semantic dementia

A

lose understanding of word meaning

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5
Q

progressive non-fluent aphasia

A

lose Broca’s area, stops speaking

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6
Q

stroke

A

the sudden disruption of blood flow to the brain

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7
Q

infarct

A

area of dead or dying tissue resulting from an obstruction of the blood vessels

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8
Q

ischemia

A

disorders due to blockage in blood vessels going to the brain

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9
Q

thrombosis

A

formation of a plug or clot in the blood vessel

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10
Q

embolism

A

a clot or plug that is brought through the blood from a larger vessel to a smaller vessel

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11
Q

cerebral arteriosclerosis

A

thickening and hardening of the arteries

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12
Q

cerebral vascular insufficiency or transient ischemia

A

temporary ischemia, disorder has variable nature over passage of time

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13
Q

migraine stroke

A

accounts for a significant number of strokes in younger people, especially women, appears as a transient ischemic attack

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14
Q

symptoms of migraine stroke

A

impaired sensory function, numbness of the skin, difficulties moving, aphasia

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15
Q

cerebral hemorrhage

A

massive bleeding into the brain, most often caused by hypertension/high blood pressure

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16
Q

angioma

A

congenital collection of abnormal blood vessels that divert normal flow of blood, eg. arteriovenous malformation (AVM)

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17
Q

aneurysms

A

vascular dilation, due mostly to congenital defects/hypertension/arteriosclerosis/embolisms/infections

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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!
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19
Q

traumatic brain injuries - open-head injuries

A

TBIs with skull penetration, neurological signs/symptoms are highly specific, may undergo rapid and spontaneous recovery if injury is small and specific

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20
Q

traumatic brain injuries - closed-head injuries

A

coup, countercoup, twisting and shearing of major fiber tracts, bleeding and pressure can result in hematomas, edema: can produce coma, behavioural effects

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21
Q

coup

A

damage at the site of the blow

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22
Q

countercoup

A

damage at the opposite side of the blow due to pushing or pressure

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23
Q

coma

A

loss of consciousness; commonly accompanies closed-head injuries

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24
Q

behavioural effects of TBI

A

impairment of specific functions mediated by the cortex at site of damage, more generalized impairments from widespread trauma throughout brain

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25
Q

brain injuries subsequent to closed head trauma: primary brain injuries, immediate on impact

A
  • coup and contrecoup contusions
  • fiber shearing or stretching
  • macroscopic and microscopic lesions
  • laceration or depression from skull penetration or fracture
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26
Q

brain injuries subsequent to closed head trauma: secondary injuries

A
  • intracranial hemorrhage and edema
  • ischemic or bleed-induced damage
  • increased intracranial pressure or distortion
  • effects of multiple injuries and hypoxia
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27
Q

brain injuries subsequent to closed head trauma: injurious effects, delayed

A

degeneration of gray and white matter, hydrocephalus

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28
Q

what are behavioural assessments for head injury?

A
  • Glasgow Coma Scale

- Posttraumatic Amnesia (PTA)

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29
Q

glasgow coma scale

A

objective indicator of the degree of unconsciousness and of recovery from it: measures eye opening, motor response, verbal response

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30
Q

posttraumatic amnesia

A

measure of severity of injury, correlates with future memory disturbance, no consistent method used for measurement of amnesia

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31
Q

epilepsy

A

brain disorder caused by recurrent seizures

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32
Q

symptomatic seizures

A

seizures identified with a specific cause

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33
Q

idiopathic seizures

A

appear spontaneously, without an apparent cause

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34
Q

what are 3 common symptoms of epilepsy?

A

1) onset of aura - warning of an impending seizures
2) loss of consciousness
3) motor component

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35
Q

what are 4 types of seizures

A

1) focal seizures
2) generalized seizures
3) akinetic seizures
4) myoclonic spasms

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36
Q

focal seizures

A

beings in one place (a focus point) and spreads

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37
Q

Jacksonian focal seizures

A

begins with movement in one part of the body and spreads

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38
Q

complex partial seizures

A

subjective experiences precede the attack, automatisms-automatic behaviours, postural changes

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39
Q

generalized seizures

A

bilaterally symmetrical,

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40
Q

grand mal attack

A

(generalized seizure) tonic stage, clonic stage, postseizures: postictal depression

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41
Q

petit mal attack

A

(generalized seizure) loss of awareness, no motor activity, brief duration

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42
Q

akinetic seizures

A

ordinarily only seen in children, child may collapse without any warning, attacks are short

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43
Q

myoclonic spasms

A

massive seizures, consists of sudden felxion or extension of the body

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44
Q

treatment of epilepsy

A

anticonvulsant drugs (diphenylhydantoin-DPH, dilantin; phenobarbital), surgery, DBS

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45
Q

tumours

A

mass of new tissue that persists and grows independently

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46
Q

benign tumour

A

not likely to recur after removal

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47
Q

malignant tumour

A

likely to recur after removal, progressive and life-threatening

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48
Q

encapsulated tumour

A

distinct entity, puts pressure on the brain (e.g. meningioma)

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49
Q

infiltrating tumour

A

not separated from surrounding tissue, may destroy healthy cells or interfere with cellular functioning (e.g. glioma)

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50
Q

glioma

A

arises from glial cells and infiltrates brain substance

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51
Q

meningioma

A

most benign of tumours, growths attached to the meninges, grows outside brain and well encapsulated

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52
Q

metastatic tumour

A

occurs in brain after tumour cells are transferred from elsewhere

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53
Q

treatments for brain tumours

A
  • surgery
  • radiation
  • chemotherapy
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54
Q

classic migraine

A
  • begins with aura that lasts for 20-40 mins (occurs as a result of vasoconstriction in the occipital cortex)
  • headache
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55
Q

headache

A

occurs as vasodilation takes place, intense pain localized to one side, symptoms may include nausea and vomiting, can last hours-days

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56
Q

common migraine

A

most frequent type (80%), no clear aura, but another signal may presage attack

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57
Q

cluster headache

A

unilateral pain, short duration, but recurs repeatedly for weeks or months before disappearing

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58
Q

hemiplegic migraine and opthamologic migraine

A

relatively rare, loss of movement of limbs on one side and eyes respectively

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59
Q

treatments for migraine

A
  • drugs

- ergotamine compounds (given with caffeine during acute attacks)

60
Q

treatments for tension headaches

A
  • muscle-relaxant drugs
  • minor tranquilizers
  • posture improvements
  • reduction of stress
61
Q

infection

A

invasion of the body by disease-producing microorganisms and subsequent tissue reactions

62
Q

how do infections kill neural cells?

A
  • interference with blood supply
  • disturb glucose or oxygen metabolism
  • alter cell membranes
  • form pus
  • causes edema
63
Q

viral infections

A

caused by virus: encapsulated aggregate of nucleic acid made of either DNA or RNA

64
Q

neurotropic viruses

A

e.g. rabies, polio: virus with special affinity for CNS cells

65
Q

pantropic viruses

A

e.g. mumps, herpes: attacks other body tissues as well as CNS

66
Q

bacterial infections

A

caused by bacteria; microorganism that has no chlorophyll and multiplies by simple division

67
Q

bacterial meningitis

A

infection of the meninges by bacteria

68
Q

brain abscesses

A

secondary to infection elsewhere in the body, cause cell necrosis and multiplication of bacteria increases intracranial pressure

69
Q

mycotic infections

A

invasion of the nervous system by a fungus

70
Q

parasitic infestations

A
  • 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
Q

treatments for CNS infections:

A
  • 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
Q

apraxia

A

inability, in the absence of paralysis or other motor or sensory impairments, to make or copy voluntary movements. usually follows damage to the neocortex

73
Q

ataxia

A

failure of muscle coordination or irregularity of muscular action, commonly follows cerebellar damage

74
Q

athetosis

A

ceaseless slow, sinuous, writhing movements, especially in the hands, due to abnormal function of the extrapyramidal system

75
Q

catalepsy

A

muscular rigidity in which voluntary movements are reduced or absent but posture is maintained. a feature of PD due to da loss

76
Q

cataplexy

A

complete loss of movement and posture during which muscle tone is absent but consciousness is spared

77
Q

chorea

A

literally “to dance” ; refers to a wide variety of ceaseless, jerky movements that appear well-coordinated but are performed involuntarily

78
Q

hemiplegia

A

complete or partial paralysis to one half of the body, usually follows damage to the contralateral motor cortex

79
Q

palsy

A

usually refers to persisting movement disorders due to brain damage acquired perinatally

80
Q

paralysis

A

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
Q

paraplegia

A

paralysis or paresis of the lower torso and legs following spinal-cord damage

82
Q

spasticity

A

increased tone in certain muscle groups that maintain posture against the force of gravity

83
Q

tardive dyskinesia

A

slow, persistent movements, particularly of the mouth and tongue, usually follows long-term treatment with antipsychotic drugs

84
Q

myasthenia gravis

A

severe muscular weakness; muscular fatigue after little effort; caused by insufficient acetylcholine receptors on muscles

85
Q

treatment for myasthenia gravis

A

acetylcholine therapy to relieve symptoms, thymectomy and immunosuppressive drugs

86
Q

poliomyelitis

A

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
Q

occurrence of poliomyelitis is controlled with:

A

Salk and Sabin vaccines

88
Q

multiple sclerosis

A

due to loss of myelin, mainly in motor tracts

89
Q

sclerotic plaques

A

small, hard, circumscribed scars where the myelin sheath has been destroyed

90
Q

paraplegia

A

paralysis of the lower limbs caused by complete transection of the spinal cord

91
Q

immediate symptoms of paraplegia

A

loss of movement, sensation, and reflexes, loss of thermoregulatory activity, loss of bladder control; some reflexes may gradually return

92
Q

Brown-Sequard syndrome

A

unilateral section through the spinal cord

93
Q

if loss is contralateral to the side of section:

A

loss of pain and temperature sensation, fine touch and pressure preserved

94
Q

if loss is ipsilateral to the side of section:

A

preservation of pain and temperature, loss of fine touch and pressure, loss of sensation and voluntary movements distally

95
Q

hemiplegia

A

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
Q

polygraph

A

records brain waves, on EEG

97
Q

electromyogram

A

records muscle activity

98
Q

electrooculogram

A

records eye movements

99
Q

thermometer

A

records body temperature

100
Q

narcolepsy

A

inappropriate and overwhelming attack of sleep, symptoms: sleep attacks, cataplexy, sleep paralysis, hypnagogic hallucinations

101
Q

sleep attacks

A

brief, irresistible attacks of sleep; slow-wave NREM sleep, can occur at any time

102
Q

cataplexy

A

complete loss of muscle tone, person can collapse or fall, probably an attack of REM sleep, occurs at times of emotional excitement

103
Q

sleep paralysis

A

occurs in the transition between wakefulness and sleep, brief paralysis associated with the dream state but the person has woken up

104
Q

hypnagogic hallucination

A

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
Q

insomnia

A

decreased REM, go through more transitions between stages, move more during sleep

106
Q

sleep apnea

A

periodic cessation of respiration during sleep

107
Q

obstructive sleep apnea

A

occurs in dream sleep and may be caused by a collapse of the oropharynx during dream sleep paralysis

108
Q

central sleep apnea

A

CNS disorders, characterized by a failure of the diaphragm and accessory muscles to move, can be caused or aggravated by obesity

109
Q

alzheimer’s disease

A

early impairment of declarative memory, some cognitive fluctuation, usually no motor symptoms, senile plaque density and neurofibrillary tangles

110
Q

dementia with Lewy Body

A

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
Q

Parkinson disease

A

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
Q

FTD with main complaint being behaviour:

A

subtype of FTD = behavioural/dysexecutive (frontal variant FTD or R temporal variant FTD)

113
Q

FTD with main complaint being language:

A

subtype of FTD = primary progressive aphasia (PPA)

fluent = semantic dementia SD, L temporal variant FTD) (non-fluent = progressive non-fluent aphasia (PNFA

114
Q

memory deficits in Alzheimer’s disease:

A

episodic memory, semantic memory, working memory

115
Q

memory deficits in frontotemporal dementia:

A

episodic memory, semantic memory, working memory

116
Q

memory deficits in semantic dementia

A

some episodic memory, semantic memory

117
Q

memory deficits in Lewy body dementia:

A

episodic memory and working memory

118
Q

memory deficits in vascular dementia

A

some episodic/semantic/procedural memory, working memory

119
Q

memory deficits in Parkinson’s diase

A

some episodic/semantic, procedural memory, working memory

120
Q

schizophrenia symptoms:

A

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
Q

biochemical abnormalities in schizophrenia

A
  • dopaminergic function
  • glutamate and glutamate receptors (decreased glutamate transmission)
  • GABA and GABA binding sites
122
Q

in schizophrenia, abnormal DA/GABA/Glu inputs to PFC:

A

impair DLPFC connectivity leading to DLPFC and cognitive dysfunction

123
Q

clinical depression

A

(mood disorder): prolonged feelings of worthlessness and guilt, general slowing of behaviour, disruption of eating/sleeping

124
Q

mania

A

(mood disorder): excessive euphoria, hyperactivity

125
Q

bipolar disorder

A

(mood disorder): periods of depression and mania

126
Q

abnormalities in depression

A
  • 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
Q

sensitization model of bipolar disorder

A

large individual differences in degree of sensitization and drug effects in lab animals and

128
Q

in Huntington’s disease

A

ACh and GABA neurons in the basal ganglia die, so there is no activation of inhibitory dopamine neurons in the substantia nigra

129
Q

3 stages of Tourette’s syndrome

A

1) multiple tics
2) inarticulate cries
3) emission of articular words (echolalia, copralalia)

130
Q

treatment of Tourette’s syndrome

A

antidopaminergic drugs, norepinephrine receptor agonists

131
Q

major disease symptoms of Parkinson’s:

A

muscular rigidity, tremor, involuntary movements, postural disturbances

132
Q

positive symptoms of Parkinson’s

A

tremor at rest, muscular rigidity (cogwheel rigidity - muscles move in series of steps), involuntary movements (akathesia, oculogyric crisis)

133
Q

akathesia

A

cruel restlessness

134
Q

oculogyric crisis

A

involuntary turns of the head and eyes to the side

135
Q

negative symptoms of Parkinson’s

A

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
Q

WAIS

A

Weschler Adult Intelligence Scale = measures intelligence and cognitive ability

137
Q

major neurodegenerative disorder (NCD)

A

substantial cognitive decline, sufficient to interfere with independent function, must not be attributable to another disorder

138
Q

mild neurocognitive disorder (mild NCD)

A

modest cognitive decline, deficits don’t interfere with functioning independently

139
Q

what are 5 types of dementias?

A

1) tauopathies
2) synucleinopathies
3) vascular dementias and vascular cognitive impairment
4) mixed dementias
5) other dementias

140
Q

tauopathies

A

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
Q

synucleinopathies

A

accumulation of alpha-synuclein protein in neurons

  • Lewy body dementia
  • Parkinson’s disease dementia
142
Q

vascular dementias and vascular cognitive impairment

A

injuries to cerebral blood vessels

  • multi-infarct dementia
  • subcortical vascular dementia (binswanger’s disease)
143
Q

mixed dementias

A

combination of disorders such as Alzheimer’s and vascular symptoms

144
Q

other dementias

A
  • prion-related ementias (Creutzfeld-Jakob disease)
  • Huntington’s disease
  • secondary dementias
  • head injury
  • infectious dementias (AIDS dementia, syphilis)
  • drug-related dementias (chronic alcohol)
145
Q

which transmitter systems are changed in Alzheimer’s disease?

A

ACh, noradrenaline, DA, 5-HT and glutamate

NEUR479 (16 decks)

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