Basics

Question 1

domain-general vs. localization theories of neuropsych

Answer 1

domain general: whole brain is involved in higher order thinking. (behaviorists like watson, Gestalt psychology,

localization: different parts of the brain are responsible for different tasks (Broca, Wernicke)

Question 2

prosopagnosia is related to damage in the

Answer 2

inferior temporal lobe (fusiform gyrus)

Question 3

what is the cerebral laterality theory?

Answer 3

it’s an in-between of domain-generalist and localization theories that claims there are 2 separate “processors” in each hemisphere

Question 4

which hemisphere is responsibel for positive vs. negative valence interpretations?

Answer 4

right: negative
left: positive (lesion could cause dysphoria)

Question 5

dorsal/ventral stream theory

Answer 5

dorsal: above sylvian fissure, responsible for processing, storage of spatial info “where system”

ventral: below sylvian fissure, responsible for shape, color, identity “what”

proposes this top-down approach carries forward to the frontal lobes as well

Question 6

Balint syndrome: localization and symptoms

Answer 6

bilateral superior occipital-parietal lesion

can recognize objects but not reach for them (Optic ataxia)

think about visual dorsal/ventral pathways!

Question 7

what is executive function theory?

Answer 7

the proposal that one or more general processors controls domain-specific processors

kind of a combination of domain general and localization theories

like “central executive” theory from Baddeley

Question 8

posner and petersen’s neurobiological model of attention

Answer 8

posterior network: orienting and shifting attention

anterior network: detection and executive attention subsystems

alerting network: ascending reticular activating system can influence both anterior and posterior networks

Question 9

role of superior and inferior colliculi related to attention

Answer 9

superior colliculus: shifting attention, eye movements
inferior colliculus: orientation to auditory stimuli

Question 10

sensory neglect

Answer 10

inattention/unawareness to half of space (contralateral to lesion)

Question 11

motor neglect

Answer 11

failure to respond or initate movemetn to stimuli in contralateral space

Question 12

combined sensory-motor neglect

Answer 12

ignoring stimuli an dfewer motor mvmts in contralateral space

Question 13

disorders resulting in poor attention

Answer 13

TBI, incl concussion
depression and anxiety
fatigue, lack of sleep
enviro factors
medications
reduced motivation
dx impacting white matter: MS, TBI, vascular cog impcirment, parkinsons

Question 14

role of orbitofrontal cortex in attention

Answer 14

inhibition of responses, sustained attention

Question 15

role of dorsolateral PFC in attention

Answer 15

inhibition of responses, sustained attention, shifting attention

Question 16

role of medial frontal PFC in attention

Answer 16

motivation
consistency of responding
focused attention

Question 17

syntactic comprehension impairment

Answer 17

related to lesion in anterior speech area

problems with understanding the phonological information used to construct word names

Question 18

lexical/semantic comprehension ipmairment

Answer 18

related to lesion in posterior language areas

impaired comprehension of sequencing of meaningful word sounds to convey meaning

Question 19

how are aphasic syndromes related to reading problems

Answer 19

all aphasic syndromes with impairment of auditory language (except pure word deafness) are associated with impaired reading (alexia)

Question 20

what is characteristic of a perisylvian aphasic sydnrome?

These include Broca’s, Wernickes, global, conduction

Answer 20

impaired repetition

Question 21

what is the prognosis for Broca’s aphasia as it relates to damage of specific brain regions

Answer 21

if only cortex is damaged then prognosis is good if there’s no R hemiparesis

if lesion extends from cortex deep into basal ganglia and internal capsule, then aphasia is likely permanent

Question 22

what is mixed transcortical aphasia and what are some common causes?

Answer 22

sensory and motor aphasia with intact repetition

extensive border zone (extra-sylvian) damage

usually caused by hypoxia (cardiac arrest), CO poisoning, or temporary occlusion of the Carotid artery

Question 23

common cause of global aphasia

Answer 23

Occlusion early in the MCA vascular tree

Question 24

semantic anomia: what is it and what brain region

Answer 24

impaired meaning of words

angular gyrus

Question 25

what is a subcortical aphasia syndrome

Answer 25

related to lesions in the striatum, internal capsule, or thalamus when lesion is entirely subcortical, prognosis is okay but may continue to have speech impairment poorer outcomes if both cortical and subcortical regions are involved

Question 26

pure word deafness

Answer 26

loss of auditory comprehension of speech : react to speech sounds as though they were deaf biltaeral temporal lesions that disconnect Wernicke's from both auditory cortices

Question 27

alexia with and without agraphia

Answer 27

with: angular gyrus damage without: involves damage to left occipital cortex and splenium of the corpus callosum, can co-occur with color anomia, trouble spelling, and bilateral right visual field hemianopsia

Question 28

Heschl's gyrus: where is it and what does it do

Answer 28

buried within lateral sulcus primary auditory cortex

Question 29

what are some tests assessing visual what pathway

Answer 29

hooper visual organization test picture completion

Question 30

what are some tests assessing where visual pathway

Answer 30

JOLO Block Design

Question 31

apperceptive agnosia

Answer 31

inability to perceive visual objects. unable to copy or draw objects, match objects, sort object categories disrupted object recognition usually diffuse lesion of posterior cerebral hemispheres (occipital, parietal, posterior temporal) bilaterally *think posterior cortical atrophy

Question 32

associative agnosia

Answer 32

inability to recognize visual objects unable to name or demonstrate how to use, but can match and draw related to disconnect between areas important in visual perception and areas important in language functioning

Question 33

prosopagnosia Where is lesion

Answer 33

lesion is usually bilateral and in inferior occipital-temporal junction or inferior parietal-occipital. when unilateral, is usually in R hem and involving inferior longitudinal fasciculus and splenium of corpus callosum

Question 34

constructional apraxis (and neuroanatomical region responsible)

Answer 34

impairment of the ability to carry out purposeful movements: due to a visual-spatial problem indicating an inability to construct shapes and geometric designs. usually damage to frontal and parietal systems can be R or L but is usually RIGHT pareital lesion and bilateral parietal

Question 35

dressing apraxia

Answer 35

a form of constructional apraxia: difficulties locating objects in space

Question 36

achromatopsia

Answer 36

impaired color perception - see world in black and white occipital-temporal lesions and usually restricted to a hemifield or quadrant

Question 37

spatial acalculia

Answer 37

deficit in calculation due to spatial confusion right hemisphere lesions

Question 38

transient global amnesia

Answer 38

due to hypoperfusion of medial temporal or diencephalic regions and the resulting disconnection of lateral and medial limbic circuits causes: Electroconvulsive therapy infarction of perirhinal/parahippocampal cortex migraine profound anterograde amnesia, variable retrograde confabulation is common

Question 39

anoxia or hypoxia affecting medial temporal lobe

Answer 39

can cause memory loss worse if there is also involvement of the lateral limbic circuit insight may be preserved, confabulation is rare

Question 40

Anterior communicating artery aneurysm

Answer 40

results in basal forebrain, striatal, and frontal system damage, and disruption of cholinergic neurons projecting to medial and lateral limbic circuits "frontal amnesia" with confabulation, attention problems, disorientation, apathy/lack of insight, variable retrograde amnesia

Question 41

Wernicke-Korsakoff's

Answer 41

due to chronic alcohol use and thiamine deficiency diencephalic amnesia with anterograde and retrograde amnesia, proactive interference, temporal order impairment, confabulation, and poor insight also comes with gait ataxia, oculomotor palsy, and encephalopathy

Question 42

herpes encephalopathy

Answer 42

infection that affects medial and inferior temporal lobes and the amygdala amnesia, aphasia, agnosia

Question 43

PCA stroke

Answer 43

specific lesion depends on laterality, but pathology involves medial temporal and posterior occipital lobes results in memory impairment. confabulation rare, usually pt is aware of impairment co-occurs with visual deficits, hemianopic alexia, color agnosia, and object agnosia

Question 44

cortical vs subcortical dementias and EF/other sxs

Answer 44

cortical: often present with EdF, sometimes with reduplicative paramnesia or Capgras subcortical: often present with EdF, and with personality change and depression

Question 45

medial frontal/cingulate dysexecutive syndrome

Answer 45

decreased initiation indifference amnesia, incontinence, leg weakness circuit is involved in motivation and saliency

Question 46

what is a risk for parkinson's patients taking dopaminergic tx?

Answer 46

40% show impulse ctrl disorders like binge eating, gambling due to impaired fronto-striatal (subthalamic nucleus) and cingulo-frontal connections

Question 47

Gerstmann syndrome

Answer 47

finger agnosia R-L disorientation agraphia acalculia damage to posterior lobule of parietal lobe in dominant hemisphere - including angular gyrus

Question 48

astereognosia

Answer 48

loss or acquired impairment in ability to recognize the nature of an object by tactual ability or its physical features usualy posterior parietal and rolandic gyri lesion

Question 49

asomatognosia

Answer 49

disturbance in knowledge of one's own body or body condition usually a parietal lesion

Question 50

ideational vs ideomotor apraxia

Answer 50

ideational: loss of ability to plan & execute complex gestures (incl serial gestures) ideomotor: loss of ability to perform or pantomime transitive or intransitive gestures and to imitate

Question 51

what is brain region involved in apraxia

Answer 51

usually associated with lesions NEAR language zone or bilateral lesions left inferior parietal lobule and frontal lobe (premotor cortex, supplementary motor area, frontal convexity)

Question 52

dysarthria vs. apraxia of speech

Answer 52

dysarthria: poor motor coordination apraxia: poor PLANNING of speech movements

Question 53

anosodiaphoria

Answer 53

pt is aware they have impairments but no emotional concern/distress neglect is common R parietal or frontal systems

Question 54

brain regions involved in alexithymia

Answer 54

R hemisphere, esp amgydala, insula, anterior cingulate, fusiform gyrus

Question 55

psuedobulbar affect

Answer 55

extreme involuntary emotional responses to mild stimulation due to psuedobulbar palsy: damage to the upper motor neuron corticobulbar tract and its connections to the cerebellum

Question 56

cranial nerve 1

Answer 56

olfactory nerve projects from olfactory regions to the midbrain can see olfactory loss if there's an injury to subfrontal region (due to tumor, abscess) or trauma to orbitofrontal region, or viral infections damaging olfactory neuroepithelium

Question 57

cranial nerve 2

Answer 57

optic nerve

Question 58

akinesia - what is it?

Answer 58

lack of movement

Question 59

athetosis

Answer 59

slow writhing like mvmt

Question 60

chorea

Answer 60

irregularly timed excessive jerky mvmt

Question 61

ballismus - what is it?

Answer 61

extreme choreiform mvmts

Question 62

what are sxs associated with upper motor neuron lesions where is damage?

Answer 62

hyperreflexia, increased tone pronator drift (when hand/arm extended with palms upwards rotates into pronation when standing w feet together) projections from cortex to spinal cord (incl decussation in the medulla)

Question 63

what are sxs associated with lower motor neuron lesions where is damage?

Answer 63

atrophy fasciculations hyporeflexia projections from brainstem and spinal cord, via motor nerves - go to skeletal muscle

Question 64

what is stereognosis

Answer 64

inability to identify 2 objects at the same time by touch

Question 65

what is a spastic gait?

Answer 65

when affected leg swings in an arc motion (circumducts) indicates spastic (upper motor neuron) hemiparesis

Question 66

what is scissored gait

Answer 66

gait is stiff, thigh crosses over in front of the other thigh indicates corticospinal dysfunction

Question 67

steppage gait

Answer 67

foot drop

Question 68

how to test for cerebellar dysfunction

Answer 68

finger to nose: dysmetria alternating between palm up and palm down: dysdiadochokinesia heel-shin test: lay on back, lift heel of foot and move it in a straight line along opposite shin

Question 69

what is the romberg sign?

Answer 69

unsteadiness when standing and closing eyes (within a few seconds) indicates problems with proprioception: posterior column dysfunctionhow

Question 70

how to test corticospinal dysfunction

Answer 70

Babinski sign: scrape handle of reflex hammer along lateral surface of foot from hel upward and across ball of foot. if + see fanning of toes and upward flexion of big toe. Presence of Babinksi sign would indicate UMN dysfunction normal in kids up to 1y

Question 71

what is CT good for?

Answer 71

identifying gross abnormalities: skull fractures, hemorrhage, mass effect can use contrast to enhance ability to see tumors, AVMs, abcesses, subdural hematomas

Question 72

T1 vs T2 MRI

Answer 72

T1 better anatomical T2 better contrast, more sensitive to identifying damaged vs healthy tissue * intact WM is grey, damaged is Bright *CSF also very bright so easier to see cavities FLAIR shows even better contrast between normal and pathological tissue

Question 73

diffusion weighted imaging

Answer 73

variant of MRI that uses diffusion of water molecules to generate contrast collects info about molecular activity an dfunction used in stroke, white matter diseases, oncology

Question 74

perfusion weighted MRI

Answer 74

allows inference of how blood travels thru the brain's vasculature in stroke or TIA allows better understanding of cerebral vasculature's response to changes in perfusion pressure

Question 75

susceptibility weighted imaging

Answer 75

can detect unique magnetic susceptibility differences between various tissues/background sensitive at detecting small amounts of blood products or calcium useful for small lesions, subtle TBIs, microhemorrhages

Question 76

magnetic resonance spectroscopy

Answer 76

uses MRI tech to image endogenous biological markers like creatinine and n-acetyl aspartate (in neurons and glia). Can detect glutamate and choline used in detecting brain-cell loss in degenetative conditions like Alz and MS.a

Question 77

alpha waves - EEG

Answer 77

8-12 Hz relaxed, eyes closed on EEG, occurs bilaterally in posterior regions and has higher amplitude on dominant side frontal alpha activity related to drugs, anesthesia, or following sleep

Question 78

beta waves - EEG

Answer 78

12-30 Hz alert, anxious, eyes open usually symmetrical, frontal beta activity enhanced by sedating drugs like benzos

Question 79

theta waves - EEG

Answer 79

4-7 Hz observed in children and during sleep (at any age) most prominent during drowsiness

Question 80

delta waves - EEG

Answer 80

<4 Hz observed during sleep in all age groups normally the dominant rhythym in infants in adults seen more frontally seen together with theta activity with diffuse disorders or metabolic encephalopathy

Question 81

what is an evoked potential and what is most commonly examined?

Answer 81

measuring brain's electrical response to a stimuli P100 response: prolongation can indicate optic nerve dysfunction, ischemic disturbance, or demyelinating disease most commonly used in MS, AIDS, neurosyphilis cerebr