Oct11 M3-Memory

Question 1

memory def

Answer 1

ability to recall, consciously or unconsciously, a previous stimulus or task

• involves synaptic changes controlled by conserved fundamental processes
• allows learning (knowledge and skills) and adaptations in behavior

Question 2

known things about memory

Answer 2

• hippocampus important in memory
• memory is bilateral (unlike language and other cognitive fcts). unilateral lesions (like stroke) don’t cause memory loss
• AD (a form of dementia) and other forms of dementia impair memory for recent events but spare memory for remove events

Question 3

diff kinds of memory (dnm the names)

Answer 3

• declarative = depends on conscious awareness. memory of what happened + memory of facts
• non-declarative memory = does not depend on conscious awareness. memory of how to do a task + memory of recognizing objects by their form and structure
• working memory = what’s in your head right now = ability to maintain and manipulate active representations of information

Question 4

HM had a problem with what type of memory (after hippocampi removed)

Answer 4

memory of what happened + of facts (declarative)

Question 5

where is DECLARATIVE memory stored

Answer 5

new info pathway

• transient storage of WORKING memory in the PREFRONTAL cortex
• this memory is transferred via dopaminergic connections of prefrontal cortex to the HIPPOCAMPUS and becomes SHORT-TERM memory
• hippocampus connects to CORTEX where info is consolidated into LONG-TERM memory (area of cortex = what’s relevant to the memory. visual = in visual cortex)

Question 6

how does memory go from short term to long term

Answer 6

1. short-term memory: the hippocampus has strong connections with the cortex
2. recent long-term memory: cortical loops start to form, the hippocampus becomes less imp
3. remote long-term memory: cortical loops are formed. hippocampus connections to cortex are not needed anymore
   * explain why AD pts lose short term and recent long term but not remote long term memory*

Question 7

short term memory def vs long term

Answer 7

immediate present. in the last 30-60 sec. long term is everything else

Question 8

long-term recent memory def

Answer 8

days ago

Question 9

remote long term memory

Answer 9

years ao

Question 10

working memory vs short term memory

Answer 10

working memory involves remembering but ALSO manipulating something (multiplying 3 digits instead of just repeating them)

• bc to multiply 3 digits you need to visualize it in your head
• the working memory can store 5-7 infos at a time

Question 11

what types of memory are important for attention

Answer 11

all types

Question 12

memory and age

Answer 12

as you get older, it is harder to consolidate and remember stuff

Question 13

consolidation meanings

Answer 13

• long-term memory (storing memory in the cortex)
• remembering something you saw or heard or etc. a couple minutes ago that was important or not (like a shirt colour) (unconsciously)
• conscious consolidation would be to link the info to learn to objects (ex of learning deck of cards by assoc each card to an object and the deck is a house with 3 objects in each room)
• is important for memory, related to long-term memory*

Question 14

amygdala role in memory

Answer 14

• is in the medial part of the temporal lobe (in the uncus)
• was ant sup to hippocampus
• adds emotional value to memory so important in NON-DECLARATIVE
• acquire and express fear responses
• add pos or neg value to stimulus
• recognize EMOTION in the facial expression (but damaged amygdala = can still recognize someone’s face)

Question 15

other structures than amygdala important in non-declarative memory (including emotional memory)

Answer 15

• other limbic structures like hippocampus
• basal ganglia (caudate, putamen, globus pallidus) = procedural skills and motor programs
• cerebellum (motor learning and coordination)

Question 16

memory assessment at the bedside

Answer 16

focus on declarative memory and assess

• working memory
• short-term
• long-term

Question 17

hx in pt with memory problem

Answer 17

• ask hx from a family member
• ask what the pt has difficulty remembering
• ask timing
• ask impact on patient
• in older people, it is normal to forget things intermittently*

Question 18

attention vs working memory

Answer 18

• need attention to do use working memory

- working memory is more advances, stresses the system

Question 19

how to test attention

Answer 19

• digit span (purely tests attention)
• backward digit span (requires working memory)
• seral minus 7 starting at 100 (requires working memory)

Question 20

how to test short term memory

Answer 20

• ask them to repeat a list of WORDS immediately (this is called REGISTRATION) (WORKING memory)
• ask them to repeat it 30s later. this is called RECALL = ability to retrieve the words (SHORT TERM memory, except if the pt has been repeating the words in their head in the meantime = working memory still)

Question 21

how to test recent long term memory

Answer 21

• ask them to repeat a list of WORDS immediately (this is called REGISTRATION) (WORKING memory)
• ask them to repeat it 5 min later (CONSOLIDATION = LONG TERM memory)

Question 22

when to test non-verbal memory

Answer 22

in people who can’t repeat because of a non-fluent aphasia with comprehension, or dysphonia, or dysarhtria or early dementia

Question 23

how to test non-verbal memory

Answer 23

-put coins in certain places in the room and show the pt
-ask them 5 min later to point where the coins are
(this would test recent long term memory)

Question 24

how to test remote long term memory

Answer 24

-ask about remove events and knowledge (and make sure it’s appropriate to their age and culture)
-ask if remember what they did last Sunday (with family member telling you if it’s true)
-

Question 25

transient global amnesia def

Answer 25

• unique condition where there is a sudden onset anemia for 2-12 hours causing memory impairment only and no other sx
• not related to ischemia (stroke) and epilepsy bc doesn’t recur (usually one time thing)

Question 26

memory loss in TGA

Answer 26

• temporary retrograde memory loss (can’t remember anything from a certain point in time in the past until onset of TGA). this resolves, they’ll start to remember older and older things progressively as it resolves
• permanent anterograde memory loss during the event (can’t remember anything from time of onset until resolution). will never resolve

Question 27

charact of pt with TGA

Answer 27

is agitated, repeats Qs. asks where they are, who they are. what they’re doing here, normal language
are imp features to be aware of on hx

Question 28

what you find in TGA pt you examine during vs after the event

Answer 28

• during = no new memories forming, can’t recall 3 objects or 3 hidden objects
• after = normal exam except anterograde memory loss

Question 29

ddx of TGA

Answer 29

• receptive aphasia
• delirium
• psychosis

Question 30

TGA vs receptive aphasia

Answer 30

receptive aphasia: there’s impaired language (understanding part) and pt can’t follow commands normally + pt is more relaxed

Question 31

TGA vs delirium

Answer 31

delirium impairs brain fct globally and attention specifically** and is more variable: fluctuating + remember some things and not others

Question 32

TGA vs psychosis

Answer 32

in psychosis, there is impaired and inappropriate thought content (what they’re thinking about isn’t normal)

Question 33

possible cause of TGA

Answer 33

abnormal blood flow to hippocampus during the event

Question 34

Wernicke-Korsakoff (WS) syndrome is what

Answer 34

• acute WS syndrome = ataxia (gait prob), ophthalmoplegia (prob in eye mvmt) and confusion (impaired attention)
• chronic WS syndrome = anterograde and variable retrograde amnesia

Question 35

WS causes

Answer 35

thiamine deficiency

• usually occurs in alcoholics
• sometimes in bariatric surgery

Question 36

cause of WS syndrome

Answer 36

damage to the mamillary body

Question 37

WS tx

Answer 37

prevention of thiamine deficiency with supplementation

Question 38

Alzheimer’s dz (a form of dementia) sx

Answer 38

short term and recent long term memory problems (affects stages before permanent cortical loops form and hippocampus is still needed)
-impairs ability of hippocampus to consolidate new info and long-term memory

Question 39

where Alzheimer’s dz typically starts

Answer 39

temporal and parietal lobes, including hippocampus

Question 40

why long term memories not affected in Alzheimer’s dz at least not at late dz

Answer 40

because AD is initially concentrated (not everywhere) whereas long term memory is spread all over the cortex