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Z MD1 neurology > psychology > Flashcards

psychology Flashcards

1
Q

what is a definition of cognition

A

the process of knowing (both applying this knowledge and your internal dialogue/thoughts)

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2
Q

what are the general functions of the frontal lobe?

A

planning, execution, and regulation of behaviour

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3
Q

what are the general functions of the the temporal lobe

A

audition, language, music, memory, emotion

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4
Q

what are the general functions of the the parietal lobe

A

somatic and visuospatial representations (body sensations)

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5
Q

what are the general functions of the the occipital lobe

A

vision

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6
Q

what is the functional division between right and left hemispheres

A

right - specialisation for visuospatial functioning

left - specialisation for language

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7
Q

what are the 3 basic “units” of the CNS according to Luria’s brain-behaviour theory

A

primary - regulation of arousal and muscle tone

secondary - reception, integration and analysis of sensory information

tertiary - planning, executing and verifying behaviour

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8
Q

where are the 3 basic “units” of the CNS according to Luria’s brain-behaviour theory

A

primary - brainstem and associated areas

secondary - posterior cortical regions

tertiary - frontal and prefrontal lobes

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9
Q

what are the 3 principles of pluripotentiality of the brain according to Luria

A
  • each area of the brain operates in conjunction with another
  • no area is singly responsible for voluntary human behaviour
  • each area may play a specific role in many behaviours
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10
Q

what are the 2 subdivisions of behaviour

A

cognition and emotion

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11
Q

what are the core/innate emotions

A

anger, fear, sadness, disgust, happiness

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12
Q

what structures does the limbic system consist of

A

hippocampus, cingulate gyrus, hypothalamus, amygdala, septal area, nucleus accumbens and orbitofrontal cortex

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13
Q

what happens as a result of an amygdala lesion

A

loss of fear

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14
Q

what happens as a result of an orbitofrontal cortex lesion

A

dont understand emotions in others

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15
Q

what is James Lange Theory

A

we experience emotion in response to physiological changes

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16
Q

what is Cannon Bard Theory

A
  • can experience emotion without expressing it physically
  • physiological changes are not unique to specific emotions
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17
Q

what is included in executive function

A

goal directed, purposeful behaviour emotional and social behaviour cognition

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18
Q

what are the “subdivisions” of the pre-frontal cortex and which arteries supply these divisions

A

lateral- middle cerebral artery

orbital - anterior cerebral artery and middle cerebral artery

medial - anterior cerebral artery

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19
Q

which functions are associated with the dorsolateral pre-frontal cortex

A
  • working memeory
  • response selection
  • planning and organising
  • hypothesis generation
  • insight
  • moral judgement
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20
Q

what functions are associated with the medial prefrontal cortex

A

emotional motivation/will

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21
Q

what happens if you have a lesion of the medial prefrontal cortex

A

extreme = akinetic mutism (person lacks the initiation/motivation to do anything)

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22
Q

what functions are associated with the orbitofrontal pre-frontal cortex

A

inhibition of impulsivity - think things through first

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23
Q

what happens if you have a lesion of the orbitofrontal prefrontal cortex

A

have the inability to inhibit responses –> impulsive behaviour

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24
Q

why can you not say a “frontal” defect?

A

because the frontal cortex is connected to places all over the brain (therefore you can lesion any of these connections and have the same behavioural result)

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25
Q

what are the “positive” symptoms associated with executive dysfunction

A

distractability

social disinhibition

emotional instability

perserveration

impulsivity

hypergraphia

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26
Q

what are the “negative” symptoms associated with executive dysnfunction

A

lack of concern

restricted emotion

deficient empathy

failure to complete tasks

lack of initiation

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27
Q

what type of pre-frontal lesion are neuropsychological tests most sensitive for

A

dorsolateral prefrontal cortex lesions

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28
Q

how can you most accurately assess medial and orbitofrontal lesions?

A

clinical judgement and history taking

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29
Q

what does the tower of london test test?

A

planning and the ability to learn from mistakes (DLPFC)

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30
Q

what does the stroop test test?

A

test of your ability to inibit your response

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31
Q

what does the rey complex figure test test?

A

planning

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32
Q

what is aphasia

A

a disturbance in language as a result of brain damage

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33
Q

what does the superior division of the middle cerebral artery supply

A

the sensorimotor cortex and the ventrolateral prefrontal cortex

34
Q

what does the inferior division of the middle cerebral artery supply

A

the temporoparietal cortex and the visual tracts

35
Q

What kind of aphasia is Broca’s aphasia

A

non-fluent

  • loss of grammatical structure
  • intact selection of content
  • takes a long time for them to get the words out
  • right arm and face weakness
  • preserved comprehension
  • highly effortful
36
Q

what kind of aphasia is Wernicke’s aphasia

A

fluent

  • impaired selection of content (make up words, or have paraphasic errors)
  • intact grammatical structure but doesnt make sense
  • impaired comprehension
  • right quadrantanopsia
  • no motor weakness
37
Q

what significant difference is there between Wernicke’s aphasia and conduction aphasia

A

conduction aphasia patients have relatively intact comprehension and do poor repetition of words

38
Q

what part of the brain is affected in conduction aphasia

A

arcuate fasciculus (connects Brocas and Wernicke’s areas)

39
Q

what part of the brain is affected in transcortical motor aphasia

A

cingulate gyrus and/or prefrontal cortex

40
Q

what type of characteristics does a patient have with transcortical motor aphasia

A
  • non-fluent aphasia
  • muteness at most severe
  • repetition is preserved
41
Q

what is the difference between retrograde and anterograde amnesia

A

retrograde - cannot remember things in a period of time before the event

antrograde - inability to form new memories on a day to day basis

42
Q

how would you explain immediate memory

A

the ability to be able to keep information online “working memory”

43
Q

how would you test long-term memory

A

give the pt a list of words, and then ask them to repeat them back to you after 20 minutes

44
Q

what types of memory come under declarative memory

A

episodic (events)

semantic (facts)

45
Q

what types of memory come under non-declarative memory

A

skills/habits

priming/classical conditioning

46
Q

where are the general areas of the brain involved in declarative memory

A

hippocampus, entorhinal cortex, perirhinal cortex (all in the temporal lobe)

47
Q

what is the lateralisation of the hippocampus

A

left - list learning, paired associate learning, story recall

right - visuo-spatial associations, face recall

48
Q

what is the typical presentationof hippocampal sclerosis

A

declarative

memory disturbance

49
Q

what are 3 transient memory disorders

A

transient global amnesia

transient epileptic amnesia

post traumatic amnesia

50
Q

what parts of the brain are affected by “asymptomatic”, “incipient” and “fully developed” alzeihmers disease

A

asymptomatic - transentorhinal

incipient - limbic system

fully developed - neocortical association cortex

51
Q

what psychological test is a good predictor for progression into Alzeihmers disease

A

arbitrary word pairing test

52
Q

What is anxiety

A

an unpleasant subjective or inner state of turmoil or dread over something unlikely to happen

53
Q

how is anxiety different to fear

A

fear is a response to a real or perceived immediate threat, whereas anxiety is the anticipation of a future threat

54
Q

what are the physical symptoms of anxiety

A
  • flushing or pallor
  • increased respiration
  • sweating
  • increased HR
  • nausea
  • feeling faint
55
Q

what are the cognitive symptoms of anxiety

A
  • poor concentration/distractedness
  • guilt
  • worry
  • extreme/irrational thinking
56
Q

what are the affective symptoms of anxiety

A
  • intense fear
  • panic or impending doom
  • feelings of uneasiness
  • apprehension or nervousness
  • needing to escape
57
Q

what are the behavioural symptoms of anxiety

A

fidgeting, restlessness, agitation, tense body posture, nervous habits

58
Q

what is the difference between normal and abnormal anxiety

A
  • response is out of proportion to the level of threat
  • thoughts cannot be reasoned away
  • thoughts are characterized by extreme thinking
  • behaviour that is beyond voluntary control
  • can avoid the situation
59
Q

what is the difference between a fear and a phobia

A

phobia:

  • persistence of the fear over time
  • recognition that the fear is excessive or unreasonable
  • an associated avoidant behavioural response
  • significant interference of the fear in activities of daily life
60
Q

how does blood injury phobia differ from all other phobias?

A

blood injury phobia - the initial sympathetic activity of the SNS is taken over by vagal inhibition –> fainting

61
Q

what are two methods of managing an anxious response

A

relaxation training

exposure therapy

62
Q

what do you tell a patient in preparation for an unpleasant medical procedure

A
  • what the procedure entails and who will be performing it
  • reasons for the procedure
  • typical sensations associated (before, during and after)
  • expected level of discomfort and its duration
  • preparation for possible anxiety
63
Q

information should be presented to a patient at a level of schooling equal to

A

year 10

64
Q

what are the steps of the SPIKES - breaking bad news mechanism

A

S - setting up the interview

P - Perception - assess the patient’s perception

I - Invitation - obtain the patient’s invitation

K - Knowledge - give knowledge and information to the patient

E - Emotions - acknowledge the patients emotions

S - summary and strategy

65
Q

what does the PERCEPTION stage of the SPIKES mechanism entail

A

ask the patient what their understanding is of the procedure and the reason for the procedure before continuing

66
Q

what does the INVITATION stage of the SPIKES mechanism entail

A

asking the patient how much information they would like to know and how they would like you to give the information

67
Q

what is cognition

A

information processing occurring at the level of the mind or brain

68
Q

why is it important to know your patients cognitive status

A

it indicates how well a person may be functioning

  • can impact on decision making capacity and providing informed consent, independent functioning in the community and treatment adherence
69
Q

what things are involved in the language domain of cognition

A

expressive language

receptive language

reading

writing

naming

70
Q

what things are involved in the memory domain of cognition

A

short term recall

long term recall

recognition

episodic (semantic, autobiographical)

procedural

verbal

non-verbal

71
Q

what things are involved in the visuospatial domain of cognition

A

navigation

visual perception (color or motion)

constructional ability

72
Q

what things are involved in the attention domain of cognition

A

arousal or alertness

immediate memory

focussed attention

sustained attention

selective attention

73
Q

what things are involved in the executive function domain of cognition

A

working memory

processing

speed idea generation

planning

mental flexibility

response inhibition

74
Q

what is decision making capacity

A

the capacity requires cognitive skills to understand, make, communicate and execute decisions in everyday life

75
Q

3 things a patient has to have to put a case through to the WHO for a removal of a patients capacityem

A
  • must be an organ level abnormality
  • this pathology much cause a cognitive impairment
  • organ level impairment must lead directly to a disability in decision making capacity
76
Q
A
77
Q

what are expressive and receptive language

A

expressive - able to say what they want to say

receptive - able to comprehend language

78
Q

how would you test for a defect affecting expressive language

A
  • observe spontaneous speech (conversation)
  • asses repetiation of words and phrases
  • naming of common objects
  • Test for a reliable yes/no response and thenask simple questions
79
Q

how would you test for a defect in receptive language

A
  • ask the patient to follow a simple comand and then a complex comand
80
Q

What are the hypotheses for why poststroke depression occurs

A

psychosocial - loss of independence, burden on the family, loss of life roles, unable to engage, loss of control

neurobiological - Lesion location - if the lesion in affecting areas that are critical to normal emotional and mood functioning

neurobiological - proinflammatory cytokines –> cerebral ischaemia may lead to proinflammatory cytokines –> deplete serotonin

genetics - greater risk

Z MD1 neurology (17 decks)

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