Higher brain functions Flashcards

1
Q

Neglect

A
  • usually left neglect, right hemisphere lesion of parietal lobe
  • motor neglect - don’t use limb contralaertal to lesion
  • other lesions: striatum, thalamus, frontoparietal, cingulate gyrus, prefrontal cortex

Cause: stroke, stroke, post-ictal

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2
Q

Aprosodia

A

-doesn’t understand intonation, or speak with emotions

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3
Q

Alien Hand

A

-left hand - usually after corpus callosum surgery

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4
Q

Hallucinations

A

-vivid in Dementia with Lewy bodies

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5
Q

Semantic Dementia

A

-Language: lose meaning of words and objects
fluent, repeition ok
-Visual recog defecits
-Lesion: bilateral temporal lobe and inferolateral cortex

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6
Q

Paraphasias

A

-language issue
Semantic - use wrong words
Phonemic - use sound substitution - words sound alike

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7
Q

Examining language

A
  1. spontaneous speech
  2. auditory comprehension
  3. naming
  4. repeition
  5. writing
  6. reading
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8
Q

Wht are non-fluent aphasias

A

broca’s
globl
transcortical motor
mixed

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9
Q

what are fluent aphasias

A

wenicke’s
conduction
anomic
transcortical sensory

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10
Q

Conduction aphasia

A

-poor repetition, poor naming
-good: fluency, comphrension
lesion; arcuate fasciculus

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11
Q

Wernicke’s aphasia

A
  • poor comprehension, repetition, naming
  • good: fluency

lesion: superior temporal lobe

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12
Q

Broca’s aphasia

A
  • poor: non-fluent, repetition, naming
  • good: comprehension

lesion: inferior frontal lobe

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13
Q

Global aphasia

A
  • poor: non-fluent, comprehension, repetition, naming

lesion: frontal, tempral, parietal, broca’s Wernicke’s

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14
Q

transcortical sensory aphasia

A

-poor: comprehension, naming

good fluency, repetitin

lesion: posterior temporo-parieto-occipial
spare Wernicke’s

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15
Q

Transcortical motor aphasia

A
  • poor: non-fluency, poor naming
  • good: comprehsion, repeition

lesion: frontal but spare Broca’s

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16
Q

Mixed Transcortical Aphasia

A
  • Poor: nonfluency, poor comp, naming
    good: repetition

lesion asscoation cortex, spare perisylcian language region

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17
Q

Anomic Aphasia

A

-poor naming only

lesion temporal, temporo-parietal

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18
Q

Alexia without agraphia

A
  • can’t read but can write

- lesion at midline affecting info from going to Left angular guys = NO reading

19
Q

Frontal lobe defecits

A

issues with initiation, attention, set shift, pull to perceptul features, abstraction, plnning, selfmonitoring, selfawareness, personality changes, theory of mind

20
Q

Fluency tests

A
  • name animals/minute

- fluency F

21
Q

Attention tests

A
  • serial 7s, 3s, months backward

- stroop: word, colour saying sheet

22
Q

Shift set tests

A
  • drawing loops
  • Wisconsin card sorting test
  • teach and do…change process - they will fixate on old instrauctions
23
Q

Pull to perceptual features

A
  • clock drawing

- misperception of visual stimuli

24
Q

Reduplicative paramnesia

A

-delusion that person/place is duplicated

25
Q

Capgras syndrome

A

-family are imposters

26
Q

Theory of mind

A
  • orbitofrontal lesion

- not aware of content in other’s minds, cn’t understand aother’s perspective

27
Q

Ideomotor apraxia

A
  • know what to do but can’t do
  • can’t flip coin, wave, kick ball, use scissors
  • top cause: non-fluent primary progressive aphasia/coricobasal syndrome
  • Alz D, dementia, stroke, PD
28
Q

Limb apraxia

A

-can do but clumsy, slow, awkward

29
Q

Apraxia

A
  • lack of motor prorams to do things
  • can’t perform movements to commands
  • due to loss of dominant association areas
  • NOT aphasia, hemipresis, hemisensory, cerebellar issues
30
Q

Gerstmann’s syndrome

A
  • left parietal lesion > hemineglect
  • idetional apraxia

FADA:

  • alcalculi
  • agraphia without alexia
  • finger agnosia (can’t name, dont knwo which)
  • impaired L/Rt discriminiation
31
Q

Ideational apraxia

A
  • can’t sequence events

- ok with single step commands

32
Q

Aphasia

A

language issues

-fluency, comprehension, repetition, naming

33
Q

Memory testing

A
  • 10 items
  • 2 words
  • 3 words
  • read story
  • draw image
34
Q

Dementia

A

progressive deterioration of cognitive fnc impacting daily life
-Ask about: attn, memory, language, visuospatial, executive fns, social, personlity, mood, praxis, adls

-must rule out:
metabolic, infections, tumours, alcohol, benzos, sleep apnea, psych, vascular, epilepsy

35
Q

Dementia with Lewy bodies

A
  • vivid hallucinations
  • motor signs
  • orthostatic htn
36
Q

Dx of MCI

A
  • memory complaint, impairment
  • not demented, fnc intact, activities ok

-prodrome for dementia

37
Q

Alzheimer’s Disease

A

-memory impairment + 1:
aphasia, apraxia, agnosia, executive fnc issus
-fnc impaired
-most common dengen dementia

Risk factors: genetic (amyloid gene - APoE), age, cvd, htm, dm, obesity, smoking

  • oxidative stress > toxic to cells > cell death due to deposis of tau tangles and amyloid plaques
  • temporal lobe atrophy
38
Q

Tx for AD

A

Cholinesterase inhibitors: donepezil, rivastigmine, galantamine
Memantine: NMDA glutamate antag to prevent glutamate mediated cell death. preserve NMDA receptors

39
Q

Long term potentiation

A
  • glutamate bind membrane > Mg removed from NMDA receptors > Ca2+ influx
    1. phosphorylation of NMDA receptors to open longer
    2. recruit more NMDA receptors
    3. transcription to form more synapses by sprouting more dendrites
40
Q

Addiction pathway

A
  • maladaptive plasticity
  • disinhibit the prefrontal cortex signal to block nucleus accumbens > prolonged reward pathway
  • stimulus > venral tegmental area > DOPAMINE > nucleus accumbens…wants more
  • depress the signal from VTA to PFC to suppress NAc
41
Q

TMS use

A
  • high f use to activate
  • low f use to depress
  • used in depression, migraines
42
Q

Memory

A

Stores: sensory, short, long
Systems: working, episodic (personal), semantic, procedural
Processes:

  • medial-temporal: hippocampus - lay down, consolidate, and associate
  • frontal: L - encoding; Rt - retrieval

-decreses gray matter with time

43
Q

Hm and KC, memory

A

HM: surgery to remove bilatearl temporal lobe for epilepsy
-lost episodic memory but has working and procedural

KC: accident and damage bilateral hippocampus: no episodic but have semantic