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Flashcards in Bio Bases of Bx: Cognitive Disorders Deck (60):
1

Impact of stroke, trauma, tumor depends on 3 factors

1. Size
2. Specific location
3. Cerebral Hemisphere

2

Aphasia

Language disorder
Resulting from damage or lesion to LEFT Hem
Nature of lang impairment based on location of lesion

3

Common Aphasias (4)

Broca's
Wernicke's
Conduction
Global

4

Broca's Aphasia
*Hint: Broca=broken speech

Location: Left FRONTAL, motor strip
Impacts expression of speech
Dysarthia:Speech slow & effortful
Comprehension mostly intact

5

Wernicke's Aphasia
*Hint: Garbage in, garbage out

Location: Left TEMPORAL lobe
No lang comprehension
speak fluently, but nonsense
Often unaware they have a problem
Considered a receptive/sensory aphasia

6

Conduction Aphasia

Location: Connection between expressive & receptive speech areas (between broca & Wernicke)
Intact lang comprehension
Fluent speech, but unable to repeat, nonsensical speech
May resemble Wernickes but are able to follow commands b/c they understand

7

Global Aphasia

Damage to most left cortex
Impairment to fluency, comprehension, repetition, naming, reading & writing

8

One sided neglect

Damage to one side of brain impacts fx on opposite side of body
Loss of sensation or movement
Ex: forget to dress one side of body, eating food from one side of plate

9

Apraxia

Inability to carry out purposeful motor mvmts, though no deficit in motor or sensory skills
Muscles & limbs still move, but in wrong position or omit a step of a particular action

10

Agraphia

Impaired ability to write
Could include spelling, word selection, grammar, spatial arrangement
Left Hem damage to variety of areas

11

Alexia

Partial or complete inability to read
Most commonly due to stroke
Pure alexia is alexia without agraphia

12

Prosopagnosia

Inability to recognize familiar face
Typically retrograde & anterograde
Due to injury to the visual assoc cortex

13

Anosagnosia

Lack of awareness of disability
Ex: Wernickes where ppl don't recognize they are speaking gibberish

14

Hydrocephalus

Accumulation of cerebrospinal fluid in brain ventricles, causing increased intracranial pressure
Often caused by malabsorption of CSF
Can be caused by head injuries, tumors, meningitis, or encephalitis

15

Dementia is characterized by memory impairment + at least one of the following deficits

1. Aphasia (language probs)
2. Apraxia (motor probs)
3. Agnosia (difficulty recognizing objects)
4. Executive functioning deficits (planning, organizing, sequencing, abstracting)

16

True or false: overall rate of dementia is equal in men & women

True

17

What is the most common form of dementia?

Alzheimers disease; accounts for over 1/2 of cases

18

True of False: Alzheimers is more common in men

False- women

19

Alzheimers is a diagnosis of _____, where all other possible medical, neurological, and psychiatric causes are ruled out first

Exclusion- can only be confirmed upon autopsy

20

Alzheimers stages: Early Phase

Impaired recent memory (forgetting names of items, forget what one is doing, diff problem solving)
Irritability, frustration, anger

21

Alzheimers stages: Middle Stage

Further impaired memory
Cognitive deficits like aphasia, apraxia, agnosia
Confusion, wandering, socially undesirable bxs

22

Alzheimers stages: Late Stage

Gait & motor probs
Possibly mute

23

Alzheimers progresses most rapidly when ____________

onset is early, or before 65 years of age

24

Etiology of Alzheimers Disease

Genetic component: 1st degree relatives 6x more likely to develop
Brain changes: Senile Plaques & Neurofibrillary tangles especially in hippocampus & amygdala
Changes in neurotrans: Decrease in acetylcholine

25

Most common medication tx for Alzheimers

Aricept (donepezil)

26

True or False: Vascular dementia is twice as common in males as females

True

27

Vascular Dementia

Result of small cerebrovascular accidents, or strokes
Onset abrupt, marked by rapid changes described as step wise due to plateaus followed by further degeneration

28

Half of ppl dx w/vascular dementia die within __ years of dx

2-3

29

Tx of Vascular Dementia

Prevention efforts through lifestyle changes
No medications to reverse impact of stroke but aspirin, anticoagulants, antihypertensives frequently prescribed to reduce likelihood of future strokes

30

Parkinson's Disease

Movement disorder characterized by:
tremor
rigidity
bradykinesia (slowed initiation of movement)
shuffling gait
dementia (30 -50% of patients)
depression (50-90% of patients)

31

Etiology of Parkinson's Disease

Degeneration of neurons in substantia nigra (section of basal ganglia). decrease in dopamine

32

Tx of Parkinson's

L-Dopa (levodopa), a precursor to dopamine treats movement component
No tx to slow progression or decrease sxs of dementia
Antidepressants may help with emotional & cognitive fx

33

Neurotransmitters assoc with Eating Disorders

Serotonin & norepinephrine (implicated in appetite & mood)

34

Chemotherapy preferred tx for childhood tumors over radiation b/c radiation contributes to:

learning problems & growth deficiencies

35

Cerebral Palsy most commonly results from

trauma at birth

36

Dementia due to head trauma

non progressive if result of single head trauma

37

Huntington's Disease

Involves basal ganglia, result of autosomal dominant gene
Onset 35 to 45 years, Offspring have 50% chance of being affected
Sxs: personality change, progressive dementia, choreiform mvmts (brisk jerking mvmts of pelvis, trunk, limbs), athetotis (slow writhing mvmts), facial grimaces

38

Neurotransmitters implicated in Huntington's

acetylcholine & GABA
Destruction of caudate nuc & putamen results in dec level of GABA (which is produced in bas ganglia), GABA moderates/inhibits production of dopamine. Without it, there is too much dopamine which results in chorea (uncontrollable, irregular muscle mvmts of arms legs & face)

39

Pick's Disease

Rare disease, clinically indistinguishable from Alz Disease
Twice as common in women
Onset btwn 50s and 60s
Frontal & temporal lobes affected
Decreased initiative, inappropriate bx, euphoria, explosive temper, poor impulse control, probs w/memory & language
Apraxias & agnosias less common than Alz Dis

40

Aids Dementia

10-15% of ppl w/AIDS develop
Cognitive sxs-memory, language
Motor Sxs
Behavioral Symptoms-apathy, withdrawal, mood swings,

41

Dementia due to head trauma

Acute brain injury- delirium or amnestic disorder
Closed head (Concussions, Contusions)
Open Head

42

Concussions

most common, neural dysfunction but no cerebral contusion
Often causes anterograde amnesia & retrograde (events just before injury, incident itself but remote events remain intact)
Most common sx: irritability, fatigue, headache, dizziness

43

Contusions

brain bruises, coup-countercoup injuries (both sides of brain due to impact against skull and backlash)
Temp aphasia, slight hemiparesis, unilateral numbness

44

Pseudodementia

False dementia- due to depression
Subjective complaints of memory loss may be a sign, with rapid onset & progression

45

Delirium/Acute Confusional State

Syndrome resulting from disturbances to consciousness
Acetylcholine implicated
Reduced ability to focus, disoriented, memory deficit
Acute onset, fluctuating course, clouded sensorium, reversible if underlying condition treated

46

Common causes of delirium

infections, metabolic & endocrine disorders, postoperative states, substance intoxication, substance withdrawal

47

Amnestic Disorders (only memory impaired) most commonly caused by:

head trauma
alcohol abuse

48

Korsakoff's Syndrome

Amnestic disorder
caused by chronic thiamin deficiency assoc w/alcoholism
Anterograde amnesia
Retrograde for remote memory of adult life
Results in confabulation
Lack of insight
limited spontaneous conversation

49

2 Major phases of sleep:

non REM (stages 1 thru 4)
REM

50

When a person is alert & active, ___ waves predominate; during relaxation, ___ waves predominate

beta
alpha

51

Stages of sleep

Stage 1-brief transitional stage between wake & sleep, theta waves (4 to 8 Hz)
Stage 2- Greatest amt of time during sleep; charac by spindles or rhythmical responses of 12 to 16 Hz
Stages 3 & 4- slow delta waves of 1 to 2 Hz, hard to awaken
REM sleep-follows stage 4, EEG patterns of stage 1 with REM

52

Tonic Clonic Seizures

Tonic stage- continuous tension or contraction followed by clonic stage (rapid involuntary, alternating muscle contractions, relaxation)
Occur during grand mal seizure

53

Petit Mal Seizures

Absence seizures, most often in children
Change in level of consciousness, blinking/rolling of eyes, blank stare, slight mouth mvmts, posture retained

54

Simple Partial Seizures

electrical abnormalities in a focal area of the brain
can affect very small area of body vs half of the body
remain conscious, can recall details

55

Jacksonian Seizures

Initially localized motor seizure, with spread of abnormal activity to adjacent brain areas

56

Complex Partial Seizures

Preceded by an aura
Purposeless bx
lip smacking, unintelligible speech

57

Tests of brain fx & structure (3 types)

PET Scan- show fx capacity for a particular brain region
MRI- Visualization of brain structure
CAT scan- x ray like pics of internal organs of the brain, very clear & accurate

58

Synesthesia

2 or more senses are connected
seeing music, or smelling colors

59

General Adaptation Syndrome

Hans Selye's model of response to severe stress:
Stages
Alarm-sympathetic nervous system activated; lowered resistance to illness
Resistance-alarm reaction subsides, body adapts to stressor, resistance to illness above normal
Exhaustion-response to chronic unremitting stress, sign loss of health

60

Health Belief Model

Rosenstock
Ind who believe they can control their health are more likely to engage in healthy habits