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138 Cards in this Set
- Front
- Back
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functions of frontal lobe?
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goal directed behavior, planning, sequencing, inhibiting, shifting
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Gerstmann's syndrome
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damage to parietal lobe- right/left confusion, difficulty with writing, math, making things, language, perception, contralateral neglect and denial of defects
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Anton's syndrome
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are blind but lack awareness of it, think you can see- due to stroke in occipital lobe
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functions temporal lobe?
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hearing, memory, categorization and language
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left side temporal lobe lesions?
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impaired verbal memory, poor comprehension of words
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right side temporal lobe lesions?
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impaired recall of non-verbal material(music, drawing), loss of talking inhibition, no recognition of tone, can't recognize faces, poor categorization
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functions of cerebellum?
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coordination of movement, balance, muscle tone and coordinated speech
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cerebellar lesions?
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loss of coordinated movement, poor distance judgement, inability to perform rapid alternating movements, movement tremors, staggering, explosive speech, abnormal eye movements
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define language?
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attachment of meaning to otherwise arbitrary sounds, gestures or written symbols
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define aphasia?
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acquired disorder of language secondary to brain disease or injury
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fluent aphasia?
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many word output but omit the meaningful ones(empty speech)
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paraphasia
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substitution of phonemes or words
table-trable table-chair linked to Fissure of Rolando-posterior tocentral sulcus |
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nonfluent aphasia?
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sparse output with much effort, poorly articulated,
dysprosody-abnormal rhythm agrammatism-only nouns and verbs linked to anterior central sulcus |
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anomia?
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difficulty with word finding
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Broca's aphasia?
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damage to left frontal lobe
meaningful speech without linking words(agramatism)-telegraphic comprehension in tact speech nonfluent |
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transcortical motor aphasia?
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usually left frontal lobe damage
fluency impaired comprehension, repetition and naming intact nonfluent |
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global aphasia?
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MCA infarction
hemiparesis impaired comprehension, fluency, repetition and naming may resolve into Broca's nonfluent |
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mixed transcortical aphasia?
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lesions along sylvian fissure
isolation syndrome of language zones comprehension, fluency and naming are impaired but repetition is intact nonfluent |
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Wernicke's aphasia?
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damage to left temporal lobe
poor comprehension but good fluency word salad-confused string neologisms-made up words fluent |
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transcortical sensory aphasia?
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fluent
lesions in temporoparieto-occitital region behind Wernicke's area comprehension and naming impaired but fluency and repetition intact |
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anomic aphasia?
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fluent
lesions outside language zones moderate aphasias of many types naming impaired but comprehension, repetition and fluency intact |
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conduction aphasia?
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fluent
in arcuate fasciculus repetition and naming impaired but comprehension and fluency intact |
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apraxia of speech?
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disturbance of motor programming for articulators of speech
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dysarthria?
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group of disorders resulting from weak, slow or incoordinated speech musculature
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mutism?
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inability to produce speech due to neuro and non-neuro disorders
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agraphia?
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inability to produce written language
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alexia?
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inability to comprehend written language
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define intelligence?
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the ability to use one's experiences and adapt to demands of one's life and environment
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old way to IQ test?
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(mental age/chronological age) X 100
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which Wechsler tests are used for which age group?
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WAIS-III-adults
WISC-IV-6-16 WPPSI-III-3-6 |
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is intelligence stable across time?
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yes, but only compared with peers
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what does IQ best predict?
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school performance and number of school years finished along with occupational attainment
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define learning disability
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one SD between measure of ability(IQ) and measure of achievement
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what is the MMPI-2?
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objective personality test that determines validity and clinical problems
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what do objective tests correlate with?
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clinical diagnoses, treatment plans and outcomes
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when is GH released in sleep?
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first third of the night, given to elders to stim. slow wave sleep
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what is polysomnography?
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measurements of local graded potential
EEG measures amp. and speed of pyramidal cells EOG measures slow and rapid eye movements EMG measures REM and phasic switches |
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NREM 1 sleep
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EEG is less than 8 Hz
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NREM 2 sleep
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K-complexes and sleep spindles
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NREM 3 sleep
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greather than 20% slow waves
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what does a sleep spindle indicate?
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the brain blocking sensory input
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what does the K-complex indicate?
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the brain responding to stimulus
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stage R sleep?
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EEG-tonic-like stage 1, phasic-sawtooth waves
EOG- tonic-no eye movements, phasic- rapid eye movements EMG-tonic-atonic, phasic- muscle twitches |
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who enters straight into REM sleep?
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infants, narcoleptics
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how much REM sleep do we get?
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from age 2 till death it is about 20%
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physiological sleepiness?
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brain's propensity to fall asleep or unable to resist sleepiness under minimal influence of masking effects
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manifest sleepiness?
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outward appearance of sleepiness,
affected by transient factors like physical activity, external demands and lighting |
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what is the multiple sleep latency test?
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4-6 naps under ideal conditions after full night sleep, asks the question what is your worst sleepiness
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what is the maintenance of wakefulness test?
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4-6 tests after full sleep, optimal conditions, asks the question how well can you avoid falling asleep
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how much recovery sleep do you need?
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half of what you missed plus normal
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what is the record for staying awake?
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264 hours
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what happened to the sleep deprived rats?
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lesions, inability to regulate body temp, weight loss despite increased food intake, altered thyroid function
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what does sleep duration correlate with?
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BMI
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what does sleep deprivation correlate with?
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increased errors during surgery, poor immune response to vaccine
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what turns REM on?
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ACh from giganto cell
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what turns REM off?
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NE from locus coeruleus and 5-HT from Raphe Nucleus
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what is the sleep switch?
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VLPO
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what is the awake promoting region?
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MCH, missing in narcoleptics
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what controls the circadian rhythm?
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SCN
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what effect does melatonin have?
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shuts off wake promoting drive
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what effect does adenosine have on sleep?
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builds up the longer you are awake, sleep drive
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what effect does caffeine have?
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blocks adenosine receptors, loss of sleep drive
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what is the S process?
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sleep drive decreases exponentially during sleep, due to adenosine,
prevalent in the 1st half of the day and night |
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what is the C process?
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wake promoting, prevalent during 1st part of day and end of night
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define social networks
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the links between people-potential
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define social support
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what passes through the social network, good or bad
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are social support and networks correlated?
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nope
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what is the relationship between social ties and mortality?
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the more diverse connections the lower the mortality
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what makes a person less likely to seek health care or follow doctor's instructions?
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a tight family network or social isolation
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what makes a person more likely to seek health care and follow doctor's instructions?
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a sparse friend network
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what is the basis of a PPO?
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the provider and insurance have a pre-arranged agreement for payment-fee for service
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what is the basis of an HMO?
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the provider and insurer are the same entity
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what is the incentive for an HMO doctor?
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do less and keep patients healthy, patients are cost
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what is the most common type of HMO?
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Individual practice association-the HMO pays for a certain amount of appointments per month, more expensive for patients
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what type of care is covered out of network in a PPO?
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emergency and urgent care
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where do resident salaries come from?
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medicaid
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what is a DRG?
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diagnostic related group-controls what government pays for health care and based on: principal and secondary diagnoses, principal procedures, age, gender and discharge status
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what behaviors do DRG's effect?
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quick discharge, serial admission, outpatient care, diagnoses inflation, diagnoses and procedure preferences
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what is the RBRVS?
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resource based relative value system-payment based on: amount of work, cost of practice, cost of training, office overhead
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effects of RBRVS?
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higher pay for cognitive over procedures, providers don't determine payment
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what is an APC?
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ambulatory procedure classification-payment based on labor costs, resources required for service, number of procedures performed
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who is medicare for?
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elderly, disabled(out of work for 2 years), dependents of disabled
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what are the parts of medicare?
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A-hospital care
B-physician care C-choice(like HMO) D-prescription drugs and screening, premium, deductible, |
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what are most elderly in nursing homes covered by?
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medicaid
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what is TRICARE?
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for military personnel and dependents
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what is Tricare Prime?
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HMO
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what is Tricare Extra?
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deductible and co-pay
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what is Tricare Standard?
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only necessary medical care
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what are the benefits of an HSA?
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lower premiums, tax savings, portable, rollover, enduring, investment growth but combined with high-deductible health plan
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reasons for rising cost of health care?
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obesity, *aging society, drugs, induced demand, innovation, malpractice, screening, *third party payers, *administrative cost
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biopsychosocial model
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emphasis on feedback can be used empirically
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what is the first line of mental health services?
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primary care-60-70% of visits
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which is more detrimental, daily stress or major life events?
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daily stress
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what is PMR?
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progressing muscle relaxation-both action and visualization
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what is mindfulness based stress reduction?
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awareness without judgement
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what are the big four mental health diseases?
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depression, anxiety, substance abuse and adjustment disorder
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what is the diagnoses of depression?
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depressed mood or loss of interest for more than two weeks that interferes with daily life and four of the following SIGECAPS: suicidal ideation, loss of interest, guilt, loss of energy, concentration difficulty, appetite change, psychomotor agitation/retardation, sleep problems
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define dysthymia
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mild depression through life-responsive to cognitive restructuring
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what is the diagnoses of anxiety?
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3 or more symptoms for 6+months with significant impairment, not substance related CRIMES: concentration problems, restlessness, irritability, muscle tension, easily fatigued, sleep disturbance
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what is the diagnoses of substance abuse?
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maladaptive use leading to significant impairment with 1 or more symptom: failure to fulfill major role obligations, use in hazardous situations, legal problems, continued use despite social problems
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diagnoses of substance dependence?
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not one of big 4
use with impairment or distress in 3+ symptoms: tolerance, withdrawl, larger intake over time, desire but inability to quit, much time spent using or obtaining, activities limited by use, continued use despite related illness |
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correlation between abuse and dependence?
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you can have abuse without dependence, but not dependence without abuse
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diagnoses of adjustment disorder?
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emotional or behavioral symptoms in response to a stressor within three months: significant if there is excess distress or social and functional impairment
symptoms can't be part of another disorder, a result of bereavement or dissolve less than 6 months after stressor termination |
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diabetes facts
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6% prevalence
6th leading cause of death 2x risk of early death and depression linked with depression as most disabling comorbidity 60-80% do not adhere to regimens 65% risk of alzheimers 11% have depression, 82% have anxiety |
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what are the risk factors for diabetes and depression?
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low socioeconomic status, less education, minority, female, poor social support, unmarried, younger adult
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what is the best treatment for depression with diabetes?
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cognitive-behavioral therapy with antidepressants
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difference between self and body image?
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self-how you actually look
body-how you feel you look |
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definition of chronic pain
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unrelieved, in excess of damage, longer than 6 months, rest assoc. with worse symptoms, activity gives relief, long term med use
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what is a TIA?
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transient ischemic attack-resolves itself within 24 hours
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what is a RIND?
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reversible ischemic neurological deficit-a TIA lasting a week
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what is a CVA?
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cerebral vascular accident-does not resolve itself
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stroke facts
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3rd leading cause of death
2/3 left with disability #1 cause of paralysis 80% are ischemic-lower death rate but worse recovery 20% are hemorrhagic-high death rate but better recovery |
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define dysphagia
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eating problems
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amputation facts
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75% on adults over 55
90% removal of lower extremity 1/3 are depressed 85% experience phantom limbs feel more vulnerable, but are more victimized children respond the best, adolescents the worst |
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parts of adaptive coping
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redefine optimal function
humor shift in values downward social comparison spirituality |
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coping styles
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avoidant-not denial
anticipatory-emotional, practical planning emotion-focused problem-focused-practical sequencing |
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define learning
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the process by which experience or practice results in a relatively permanent change in behavior or potential behavior
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how many times must you present the CS with the UCS to get a CR?
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about 10
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what effect does fear have on conditioning?
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CS and CR are associated faster and it is harder to extinguish because you avoid it
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who is the father of operant conditioning?
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E.L. Thorndike
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what is the difference between classical and operant conditioning?
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the individual is in control in operant
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what is shaping?
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reinforcing a behavior step by step
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what is the best reinforcement for quick learning?
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fixed ratio, but not for maintenance
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what is the best reinforcement for maintenance of behavior?
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variable ratio, also the most resistant to extinction
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what is stimulus generalization?
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when similar stimuli elicit the same response
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what is response generalization?
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new behaviors established by reinforcement to one response
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what is the extinction burst?
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an increase in responses soon after removing reinforcement-if you reinforce at that time it makes the behavior harder to extinguish
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what is biofeedback?
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treatment where people are trained to improve their health by using bodily signals-must be able to measure and provide positive feedback
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what is biofeedback used to treat?
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migraines, Raynaud's(numb hands and feet), tension headaches and bruxism(teeth clenching)
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what is the SUD scale?
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subjective units of discomfort-used in systematic desensitization
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what are the ABC's of behavior?
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antecedent, behavior, consequence
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difference between shaping and chaining?
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in chaining the order matters, in shaping the end matters
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what is the transtheoretical model?
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the stages of change
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what are the stages of change?
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precontemplation
contemplation preparation action maintenance |
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what should you do to help a patient in the pre-contemplation/contemplation stages?
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social support, emotional arousal, self-evaluation and consciousness raising
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what to do to help a pt. in preparation?
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discussion, gathering materials, logistics, confidence
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what to do to help a pt. in action/maintenance?
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reinforcement, counter negative behavior, environmental control
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basis of cognitive-behavioral model
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thoughts precede feelings and behaviors and we can control them
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