Session 9 - Group Work Flashcards
1) A psychologist designs an experiment to study patients with a specific brain lesion. The experiment finds that when these particular patients are shown an object in their left visual field, they are unable to verbally name it.
a) Using a diagram, speculate where the lesion is
He is not able to verbalise the object
The right occipital lobe is unable to see the image so the lesion is in corpus callosum, meaning the pathway is unable to cross to the left side for him to verbally name the object.
1) A psychologist designs an experiment to study patients with a specific brain lesion. The experiment finds that when these particular patients are shown an object in their left visual field, they are unable to verbally name it.
b) Given that they are unable to articulate the name of an object, how might the patient be able to indicate what the object is?
Needs to point with his LEFT hand as the right side of the brain controls the left hand - so his left hand will know what it is but his right hand cannot know what it is because the left side of his brain is damaged so doesn’t know what it is, as the fibres from the pathway cannot come from the right side cannot pass to the left side to control the right side - if he was able to control his right side aka left hemisphere he would be able to say it.
1) A psychologist designs an experiment to study patients with a specific brain lesion. The experiment finds that when these particular patients are shown an object in their left visual field, they are unable to verbally name it.
c) What is the clinical relevance of this?
Allows you to localise the lesion
2) In pairs, one of you should attempt to simulate the speech of a patient with either Broca’s or Wernicke’s aphasia.
a) How does dysarthric speech sound and what might cause dysarthria?
Dysarthria is slurred speech
Cerebellar impairment
Alcohol
Facial nerve injury
Stroke
2) In pairs, one of you should attempt to simulate the speech of a patient with either Broca’s or Wernicke’s aphasia.
b) Why do think that Broca’s and Wernicke’s areas are found in their particular locations within the cortex?
Because they are close to their effectors
Broca’s sits next to the motor cortex
Wernicke’s sits next to the primary auditory cortex
2) In pairs, one of you should attempt to simulate the speech of a patient with either Broca’s or Wernicke’s aphasia.
c) Lesions in which other parts of the brain can cause speech difficulties?
Left-sided brain injuries such as
3) A patient has a brain tumour, shown in the MRI scan below (See Workbook)
a) Speculate about what clinical features the patient might have, or develop as the tumour enlarges. Speculate how you might access this part of the brain to resect the tumour, and which structures are at risk during the operation? Hint: you’ve done this in the DR!
Hearing - auditory
Visual
Hippocampus
Leads to collateral quadrantanopia
Craniotomy, retract the frontal lobe
4) A 47 year old man presents to his GP, complaining that he feels ‘tired all the time’ and has started falling asleep during the day. His wife, who is with him, reports that they have recently started sleeping in separate rooms due to his snoring. The GP notes that the man has a BMI of 37 kg/m2.
a) What further questions would you like to ask the man?
How is your sleep quality? - Have you had any hallucinations? - Have you had any problems with your sleep? On average how many hours are you sleeping? How long has this been going on? How long have you been snoring for? Occupation? Stress? Diet? Weight loss? Driving? Alcohol/smoking?
4) A 47 year old man presents to his GP, complaining that he feels ‘tired all the time’ and has started falling asleep during the day. His wife, who is with him, reports that they have recently started sleeping in separate rooms due to his snoring. The GP notes that the man has a BMI of 37 kg/m2.
b) What is the most likely diagnosis?
Sleep apnoea
4) A 47 year old man presents to his GP, complaining that he feels ‘tired all the time’ and has started falling asleep during the day. His wife, who is with him, reports that they have recently started sleeping in separate rooms due to his snoring. The GP notes that the man has a BMI of 37 kg/m2.
c) The man is concerned that he has narcolepsy, which the GP reassures him is very unlikely. What is this condition, and how is it caused?
Narcolepsy is a rare long-term brain disorder that causes a person to suddenly fall asleep at inappropriate times.
Deficiency in orexin which is a neuropeptide that causes wakefulness, hence a deficiency leads to tiredness.
4) A 47 year old man presents to his GP, complaining that he feels ‘tired all the time’ and has started falling asleep during the day. His wife, who is with him, reports that they have recently started sleeping in separate rooms due to his snoring. The GP notes that the man has a BMI of 37 kg/m2.
d) What advice would you give the man to improve his
symptoms?
NHS
- Lifestyle changes – such as losing excess weight, cutting down on alcohol and sleeping on your side
- Using a continuous positive airway pressure (CPAP) device – these devices prevent your airway closing while you sleep by delivering a continuous supply of compressed air through a mask
- Wearing a mandibular advancement device (MAD) – this gum shield-like device fits around your teeth, holding your jaw and tongue forward to increase the space at the back of your throat while you sleep
5) Take a look at this link, showing how to assess GCS.
https: //www.nottingham.ac.uk/nmp/sonet/rlos/neuro/gcs/gcs-part1.html
a) Paste in a table below showing the criteria for assessing
GCS.
Eye Opening Spontaneous 4 To sound 3 To pressure 2 None 1
Verbal Response Orientated 5 Confused 4 Words 3 Sounds 2 None 1
Motor Response Obeys commands 6 Localise to pain 5 Normal flexion 4 Abnormal flexion 3 Extension 2 None 1
5) Take a look at this link, showing how to assess GCS.
https: //www.nottingham.ac.uk/nmp/sonet/rlos/neuro/gcs/gcs-part1.html
b) What score would you give the patient in this video at each
stage? Show your working.
https://www.youtube.com/watch?v=Tc907CSlsFU
Eye opening was spontaneous = 4
Verbal response appeared orientated = 5
Motor response she obeyed command = 6
15/15
To sound = 3
Words = 3
Flexion withdrawal from pain = 4
10/15
None = 1 None = 1 Abnormal flexion (decorticate) = 3 5/15
5) Take a look at this link, showing how to assess GCS.
https: //www.nottingham.ac.uk/nmp/sonet/rlos/neuro/gcs/gcs-part1.html
c) Find an image of a neurological observation chart (sometimes called ‘neuro obs’ chart) and paste it into the space below.
Colour Warmth Movement Sensation Swelling Pulses Venous return Pain score 1-10 Additional comments Initials
https://www.rch.org.au/rchcpg/hospital_clinical_guideline_index/Neurovascular_observations/
5) Take a look at this link, showing how to assess GCS.
https: //www.nottingham.ac.uk/nmp/sonet/rlos/neuro/gcs/gcs-part1.html
d) What essential pieces of information are recorded during
neuro obs? Hint: think about what a completed neuro obs
sheet looks like
Pulse
Movement
Sensation
