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325 Cards in this Set

  • Front
  • Back

Model of intelligence which states all abilities share a factor and a global IQ can summarize all abilities

Spearman's general factor theory

Described the Cattell-Horn-Carroll theory of intelligence

derived via factor analysis and posits multiple distinct intelligences, eight relatively broad intelligences, and many relatively narrow or specific abilities

Describe emotional intelligence

ability to perceive, process, understand, and control emotion in oneself and others

Define intellectual disability

developmental disorder with onset before age 18 with IQ >/= to 2 SD below mean and significant deficits in 2+ adaptive skills

Definition of dementia

syndrome involving decline in or loss of general cognitive ability or multiple areas of impairment stemming from a disease or medical condition and resulting in social or occupational impairment

Does IQ decline with dementia

yes as it advances into moderate stages

The syndrome in which a persona has an intellectual disability or autism specturm disorder and one or more specific or remarkable talent that is in stark contrast to intellectual disability

savantism

What disorders is Savantism associated with

autism spectrum disorders; psych disorders; CNS injuries/disease

Is Savantism more likely in males or females

males (6X)

the process whereby an individual receives and subsequently processes incoming information

attention

Attention is closely related with what other cognitive processes

executive functioning and working memory

form of processed information before it is sent to short term memory whereby information is being actively maintained or rehearsed can be retained for up to several minutes

working memory

simple, passive attention to information that is lost if not rehearsed

attention span

ability to allocate and direct attenton that is dependent on capacity

focused attenton

process by which one chooses soem information from other surrounding information or distractors

selective attention

maintaining attention over a period of time

sustained attention

shifting one's attention back and forth between tasks

alternating attention

concentrating one more than one task at a time or multiple aspects within a task, referred to as multitasking by some in the lay public

divided attention

Digit span and corsi blocks assess what type of attention

attention span

digit symbol coding assesses what type of attention

focused attention

cancellation assesses what type of attention

selective

continuous performance tests assess what type of attention

sustained

Trails B assesses what type of attention

alternating attention

Paced Auditory Serial Addition Test assesses what type of attention

divided attention

Define concentration

ability to sustain attention over time or to mentally manipulate information

speed at which mental activities are performed

processing speed


Factors affecting attention (3)

processing speed, arousal level, motivation/effort

Describe the model of attention by Posner and Petersen

There are anterior and posterior attention networks with posterior network focused on orientation and shifting attention andanterior system serving as the detection subsystem and detects stimuli from sensory events and memory. These two systems interconnect allowing for multitasking. An alerting network subserved by ascending reticular activating system and operates at high and low arousal

a disorder marked by waxing and waning deficits in attention with increased distractibility, poor awareness, and persistent confusion

delirium

Primary attentional processes affected by delirium

attention span and arousal

developmental disorder characterized by inattention, impulsivity, and at times hyperactivity

ADHD

attention primarily affected by ADHD

Executive aspects

Ascending Reticular Activating System (ARAS) is relevant to what aspect of attention

arousal and attention

anterior cingulate and limbic system is relevant to what aspect of attention

determining saliency of stimuli and associated emotion/motivation

Brain structure relevant to response selection, control, sustained attention, focus, switching, searching, and alternating attention

prefrontal cortex

Orbitofrontal area of the brain is relevant to which aspect of attention

inhibition or responses

initiation of responses is relevant to which brain structure

dorsolateral frontal area

Superior colliculus is relevant to which aspect of attention

shifting attention; eye movements

Extracting information from the target location and filtering distractors is relevant to which brain structure

lateral pulvinar

Inferior and posterior parietal are relevant to which aspect of attention

disengagment from a stimulus and representation of space; hemispatial inattention/neglect

spatial attention associated with hemispatial inattention/neglect is relevant to which part of the brain

right hemisphere

Hemispatial inattention

impairment in awareness of visual or other stimuli on side contralateral to brain lesion that is not result of sensory deficit

Associated features of hemispatial inattention (3)

anosognosia, asomatognosia; extinction of stimuli

anosognosia

denial of illness

asomatognosia

denial of body part

Region of brain most often associated with hemispatial inattention

temporal-parietal region

Most often hemispatial inattention affects the ______side due to _____side lesion but can be vice versa

left; right

two types of attention affected by hemispatial inattention

spatial focused attention, selective attention

an acquired inattention or unawareness to part of space as in hemineglect contralateral to the lesion

sensory neglect

Motor neglect

failure to respond or initiate movement to stimuli in contralateral space

types of attention often affected in moderate to severe TBI

executive aspects, reduced information processing speed, reduced arousal, poor attentional capacity, increased distractibility


Nonneurological factors that can negatively influence attention (4)

depression and anxiety; fatigue and lack of sleep; environmental factors; medications

Define language

system of communication involving formal symbolic scheme reliant on phonology and rules of syntax to express lexical or semantic meaning

4 areas comprising language competence

phonology, syntax, semantics, and pragmatics

Which hemisphere mediates or performs most language function related to semantics and syntactics

left

an acquired loss or impairment of language following brain damage or disease

aphasia

Lichtheim localiationist model of language

five interrelated cortical and subcortical areas proposed to underlie language processing involving a center for movement patterns of oral speech, word sounds, movement patterns of writing, written words, andforming concepts and ideas to be expressed

Theory suggesting disorders of aphasia, apraxia, and agnosia were really disconnexion syndromes or disorder resulting from lesions interrupting the transfer of information from one neural region to another

Geschwind

Neuropathology of aphasia

structural alterations in the language cortex with type of syndrome determined by brain part affected not by etiology

Primary etiology of aphasia

stroke

how to assess spontaneous speech

elicit through simple conversation, medical history, or ask for description of a picture

2 areas addressed with spontaneous speech

form and content

refers to whether speech is fluency to nonfluent

form of speech

How to assess form of speech

assess effort, rate, melody, and length of phrases

Syndrome with normal verbal output, normal phrase length (5-6 words), normal articulation, normal melody with nonmeaningful paraphasic errors (word or sound substitution)

fluent aphasic speech (Wernicke's, transcortical sensory)

Name the syndrome with nonfluent spontaneous speech, intact comprehension impaired repetition, limited reading and naming, and impaired writing

Brocas

Syndrome with fluent speech, impaired comprehension, repetition, naming, reading, and writing

Wernicke's

Syndrome with fluent speech, intact comprehension and reading, and impaired repetition, naming, and writing

Conduction aphasia

Syndrome with nonfluent speech and impaired comprehension, repetition, naming, reading, and writing

Global aphasia

Syndrome with fluent, empty speech with intact comprehenson repeition, and reading and impaired naming and impoverished content on writing

Anomic aphasia

Syndrome with fluent or nonfluent speech, intact comprehension and repetition and impaired naming as well as impaired OR intact reading and writing

Subcortical aphasia

Syndrome involving nonfluent speech and intact comprehension, repetition, and reading as well as limited naming and impaired writing

transcortical aphasia

Syndrome involving fluent and echolalic speech, intact repetition and impaired comprehension, naming reading and writing

Transcortical sensory aphasia

Syndrome involving nonfluent echolalic speech, with intact repetition and impaired comprehension, naming, reading, and writing

transcortical mixed aphasia

Speech with diminished verbal output and decreased phrase length (<3-4 words), laborious articulation, and poor rhythm with possible speech initiation and impaired production of grammatical sequences

nonfluent aphasic speech

Define content of speech

word choice and syntax and the presence or absence of paraphasic errors in spontaneous speech

Syndromes in which word output itself is likely to be normal but content may not be informative or convey meaning

fluent aphasic syndroes

Syndromes in which the critical words or words needed to convey meaning can be present but may not be in the correct order and with correct grammar....speech may appear telegraphic

nonfluent aphasic syndromes

How do you assess comprehension?

questions and commands that increase in complexity and evaluated words, categorical info, and meaning imparted from syntax and word order

Two types of comprehension difficulties

syntactic; lexical/semantic

Lesions involving what speech areas may result in comprehension of syntactic information used to construct word names

anterior speech areas

lesions involving what speech areas often results in disturbed comprehension of sequencing of meaningful word sounds to convey meaning

posterior

How do you test repetition

begin with simple words and the multisyllabic words followed by short and longer sentences increasing in complexity

If repetition is intact the _______ is likely intact

perisylvian language centers

How do measure word finding difficulty

spontaneous speech through pausing to search for word or using too many words to describe something, or presenting a stimulus and asking patient to name it

How do we use naming difficulty differentially

nonfluent syndromes have difficulty with naming due to initiation or production problems: fluent syndromes difficulty as result of selection problems or inability to find right word

How to we assess reading

assess both reading aloud and silently; start with single letters and digits, then words and sentences of increasing length and complexity

If patient does not have expressive language available, how can we test eading

allow patient to match words to pictures

severe impairment in auditory language except pure word deafness is almost always associated with what

reading impairment or alexia

Is alexia good for localization and is so where does it localize?

No because it is seen in all kinds of aphasias

How do we assess writing?

ask to write single letters and digits and then words and multidigit numbers and then sentences of increasing length and complexity for both writing to dictation or based on visual input

Agraphia

inability to write

Agraphia is usually seen in combination with

alexia or aphasia

nonfluent aphasias are associated with dysfunction within the _________language centers

anterior

fluent aphasias are associated with dysfunction within _________language areas

posterior

if aphasia without repetition, what area localizes

borderzone language areas

Hallmark symptoms of perisylvian aphasia syndrome

impaired repetition

Name the nonfluent aphasias of the perisylvian fissure (1)

brocas

Name the fluent aphasias of the perisylvian fissure

Wernicke's aphasia and conduction aphasia

syndrome with strikingly nonfluent verbal output that is sparse, effortful, dysarthric, dysprosodic, of short phrase length, and agrammatic with poor repetition in the context of relatively spared auditory comprehension for content, usually impaired writing, often impaired naming with aid from contextual and phonemic cues

Broca's aphasia

What is prognosis of Broca's aphasia

good if involves only cortex or no associated right hemiparesis; permanent if extends into basal ganglia and internal capsule

Syndrome with fluent verbal output with normal word count and phrase length and difficulty in word finding, along with signiicantly impaired auditory comprehension and poor repetition with often empty speech

Wernicke's aphasia

Syndrome with impaired repetition in the context of relatively fluent speech and well preserved auditory comprehension with literal paraphasias, word finding difficulties, and commonly severely impaired writing and naming ability impaired by paraphasias with reading out loud severely disturbed and possibly normal reading comprehension

Conduction aphasia

These neuroanatomical findings are suggestive of what syndrome

frontal opercular area in dominant hemisphere or posterior portion of inferior frontal gyrus of the L hemisphere, including the 3rd frontal convolution of the L hemi and subcortical white matter extending posteriorly to the inferior portion of the motor strip

Possible associated features associated with Brocas

common right hemiparesis

These neuroanatomical findings are consistent with what aphasic syndrome.....posterior superior portion of the L temporal lobe or the auditory association cortex adjacent to the Heschl's gyrus of the primary cortical auditory center

Wernicke's aphasia

Possible features associated with Wernicke's

Occasional superior quadrantanopia

These neuroanatomical findings are consistent with what aphasic syndrome......damage to the arcuate fasciculus thus disconnecting Brocas and Wernicke's area , but the syndrome also appears to involve the posterior superior aspect of the left temporal lobe, supramarginal gyrus, or deep parietal matter

Conduction aphasia

Possible features associated with conduction aphasia

common hemisensory defect and cortical sensory loss

These neuroanatomical findings are consistent with what aphasia syndrome .....entire perisylvian region

Global aphasia

The neuroanatomical findings are consistent with what type of aphasia.....no specific location but often involves angular gyrus in teh dominant hemi and disconnection between WErnicke's and intrasensory input areas in teh parietal, temporal and occipital lobes

anomic aphasia

These neuroanatomical findings are consistent with what type of aphasia......usually anterior Broca's area, often in the supplementary motor area of the dominant hemi or in the frontal tissues between that region and dominant hemisphere opercular area

transcortical motor

Occasional right hemiparesis is often an associated feature of what aphasic syndrome?

transcortical motor

These neuroanatomical findings are associated with what type of aphasia......usually the junction of parietal, temporal, and occipital regions in the angular gyrus in the dominant parietal regions, sparing Wernicke's

Transcortical sensory aphasia

Occasional right hemiparesis, and common hemisensory defect are possible associated features of what type of aphasia

transcortical sensory aphasia

These neuroanatomical findings are associated with what type of aphasia......isolation of disconnection of speech area and pathology involving entire vascular borderzone area in both the frontal and parietal zones

Transcortical mixed aphasia

Common right hemiparesis and hemisensory defect are associated with what type of aphasia

transcortical mixed

This is considered a disconnection syndrome isolating the higher order visual systems from language systems and involves the left occipital area and corresponding inferior portion of the left side of the splenium of the corpus callosum

alexia without agraphia

This type of aphasia involves lesions in the posterior margin of the parietal lobe

alexia with agraphia

Color anomia, trouble spelling and comprehending spelling, bilateral right visual field hemianopsia are possible features associated with this type of aphasic syndrome

alexia without agraphia

Common right hemiparesis and hemisensory defect are possible associated features of what aphasic syndromes

alexia with agraphia

These neuroanatomical findings are associated with what aphasic syndrome.....damage to both temporal lobes with destruction of Heschl's gyrus on the left and the white matter tract connecting it to the auditory association area on the right

word deafness

Aphasic syndromes involving the borderzone region are known as

transcortical aphasia syndromes

Describe transcortical aphasia syndromes

ability to repeat spoken language is preserved in face of distinct language impairment

Name the two nonfluent extrasylvian apahsia syndromes

transcortical motor aphasia; mixed transcortical aphasia

Describe transcortical motor aphasia

repetition intact with impoverished speech and writing, intact comprehension, and nonfluent verbal output

Describe mixed transcortical aphasia

Repetition intact, typically nonfluent adn otherwise resembles global aphasia

Likely causes of mixed transcortical aphasia

hypoxic brain injury due to decreased cerebral circulation, as with cardiac arrest, carbon monoxide poisoning, or occlusion/stenosis of the carotid artery

Name the fluent extrasylvian aphasia syndromoe

Transcortical sensory aphasia

Describe transcortical sensory aphasia

preserved repetition, absent auditory comprehension or meaningful expresssion, and possible echolalia, fluent and paraphasic output (heard language is processed, but not interpreted)

Name the two nonlocalizing aphasia syndromes

anomic aphasia and global aphasia

Describe anomic aphasia

difficulty with word finding with multiple pauses, frequent circumlocution, and stumbling verbal output with intact repetition and comprehension; disturbed reading and writing often (often residual disorder)

Describe global aphasia

severe disturbance in all major language functions

Global aphasia is often result of occlusion where

early in MCA vascular tree affecting large section of language dominant hemisphere

Describe subcortical motor aphasia syndrome (aphemia)

period of mutism followed by motor amnormalities in speech such as hypophonia or articulation issues and fluent or nonfluent verbal output with many paraphasias; near normal repetition; possible impairment in repetition, comprehension, naming, reading, and writing

Prognosis of aphasia

if entirely subcortical-good with some residual speech impairment; if cortical, likely more persistent

Describe alexia without agraphia (pure word blindness)

selective loss of ability to read configurations of letters without a comparable loss in writing or other language disturbance; can write but not read own writing

Describe alexia with agraphia

loss of ability to read with specific loss of writing in spite of intact motor abilities; intact speech and comprehension; possible anomia

Describe pure word deafness

loss of auditory comprehension and react to speech sounds as if deaf; can speak, read, write but not repeat

localizaton of auditory agnosia

auditory cortex of right temporal or bilateral temporal lobes

Describe agnosia for sounds

inability to recognize meaning of nonverbal environment sounds (barking, train)

Agnosia for sounds is often associated with what other disorder

pure word deafness

Describe agnosia for music

inability to recognize meaning of musical sounds (ex. inability to appreciate rhythm or only hear noise versus music)

Two types of aprosodia

expressive; repetitive

Describe expressive aprosodia

robotic quality of speech

Where does expressive aprosodia localize

area contralateral to Brocas area

Describe receptive aprosodia

difficulty interpreting emotional prosody, rhythm, pitch, stress, intonation, etc. can't understnad sarcasm, jokes, etc.

Localization of receptive aprosodia

dysfunction in regions contralateral Wernicke's area

Describe agnosia

inability to recognize formerly familiar objects

Describe visual agnosia

disturbed visual perceptual function concerning identification and recognition of objects, faces, or their representation and meaningful or meaningless forms, colors, and spatial information not due to vision, inattention, or naming

Describe the function of the ventral stream of visual processing

"what"-idenitfies form of stimuli (color, object, face, letter)

Describe the function of the dorsal stream of visual processing

Where-spatial relationships, locating and analysis of objects in space

Neuroanatomy of ventral stream of visual processing

projects to occipital temporal association cortex connecting striate, prestriate, and inferior temporal regions

Neuroanatomy of dorsal stream of visual processing

projects to parietal-occipital association cortex, connecting striate, prestriate, and inferior parietal regions

Disorder associated with ventral stream of visual processing

visual agnosias

Disorder associated with dorsal stream of visual processing

spatial analysis/processing impairment

Would the Hooper and Picture Completion tests be used to assess the ventral or dorsal stream of visual processing

Ventral

Would the JLO test and Block Design tests be used to assess the ventral or dorsal stream of visual processing

Dorsal

Describe visual object agnosia

inability recognize and appreciate meaning of object, may be able to describe, but don't know what it is

Two types of visual object agnosias

apperceptive and aassociative

Describe apperceptive agnosia

disruption in object recognition during visual perception

Describe associative agnosia

disruption in object recognition because of inability to access stored info regarding meaning of object

Describe prosopagnosia

inability to recognize, id, or revisualize faces ; must use other details such as speech or mannerisms to recognize others

Is prosopagnosia an apperceptive or associative agnosia

associative

Inability to recognize colors even though the ability to discriminate between colors is intact

color agnosia

These neuroanatomical findings are consistent with what disorder.......left occipital lesions with extension to subcortical white matter but also bilateral lesions involving peristriate angular gyrus and lingual and fusiform lobules

visual object agnosia

A disconnect between area important in visual perception and areas important in language function is associated with what type of agnosia

associative visual agnosia

These findings are associated with what visual agnosia.....bilateral and involves the inferior occipital temporal junction or inferior parietal-occipital area, but when unilateral, typically in right hemi involving inferior longitudinal fasciculus and splenium of the corpus callosum

prosopagnosia

What area of the brain is usually involved in color agnosia

left or bilateral occipital-temporal areas

What area of the brain is associated with location of objects in space

unilateral or bilateral occipital parietal junction

What area of the brain is associated with spatial analysis

posterior right hemisphere

The involvement of both frontal and parietal systems in either the right or left hemi but most likely with parietal and bilateral parietal lobe lesions is associated with what type of apraxia

Constructional apraxia

Dressing apraxia usually involves lesions of the what region

right parietal-occipital region

Unilateral and bilateral involvement of the posterior medial regions and the calcarine cortex surrounding the calcarine fissure more on the left than right is generally associated with what disorder

achromatopsia

Spatial acalculia is considered to be generally localized in the

right parietal lobe

Describe constructional apraxia

loss of impariment of ability to carry out purposeful movement that is a visualspatia disorder resulting in inability to construct or draw

Describe dressing apraxia

isolated disturbance in dressing, but may be part of neglect

impariment in color perception is called

achromatopsia

When an acquired deficit in calculation results from spatial confusion it is called

spatial acalculia

4 stages of the infomration processing model of memory

encoding; storage; consolidation; retrieval

the active organization or manipulation of incoming stimuli such as through rehearsal and repetition

Encoding

the transfer or transient memory to where it can be made more permanent

storage

the process by which encoded info undergoes a series of processes that render memory representations progressively more stable and permanent

consolidation

ability to access previously stored information; by way of cues

retrieval

Types of memory in 3 stage model of memory

sensory; STM; LTM; and remote memory

Type of memory that holds info for only 1-2 seconds

sensory memory

iconic memory

visual sensory memory

auditory sensory memory

echoic sensory memory

Type of memory with limited capacity of 7 + 2 items; temporary store whereby information can be held up for several minutes and often equated with working memory and attention

Short Term Memory

Type of memory that is more permanent where info is stored by way of consolidation or learning requiring the hippocampus where structural change takes place due to long term potentiation

Long term memory

Old memories, though to be more stable or resilient to damage and disease

Remote memory

Describe declarative memory

memory of conscious retrieveal or recognition of contextually related information or episodes

memory of facts that is not time dependent

semantic memory

memory of temporal events; autobiographical

episodic memory

Describe prospective memory

memory to do something at a particular time in the future and also involves executive functioning

memory system responsible for skills, procedures, habits, and classically conditioned responses and takes place largely without awareness

non-declarative (implicit) (procedural)

remembering info without cues

free recall

remembering info with aid of stimuli

Recognition

Process by which recently learned info interferes with the ability to remember previously learned info

retroactive interferene

process by which previously learned information interferes with new or current learning

proactive inference

Described amnesia

isolated loss of memory with no other loss of cognitive function with declarative memory affected and procedural memory not affected

amnesia for events prior to accident that is typically temporally graded

retrograde amnesia

Ribot's law

oldest memories are most resistant to amnesia

Severity of retrograde amnesia is related to severity of what

hippocampal pathology

inability to learn or encode new information or form new memories

anterograde amnesia

neuroanatomy of transient global amnesia

hypoperfusion of medical temporal or diencephalic regions OR result of ECT

acute onset memory loss for hours or days resulting in profound anterograde amnesia and variable retrograde amnesia

Transient Global Amnesia

Anoxic injury may result in damage to what area of the brain

medial temporal lobe, particularly area CA1

Describe memory impairment as a result of anoxic injury

dense amnesia typically pronounced anterograde amnesia that is profound in some cases and in others improves with retrieval; often preserved insight and no confabulation

Anterior communicating artery aneurysm often result in damage to what areas of the brain

basal forebrain, striatal, and frontal system

Describe frontal amnesia characteristic of ACoA aneurysm

confabulation, attention problems, disorientation, apathy, lack of insight, and variable retrograde amnesia

This disorder occurs as a result of chronic alcohol use and thiamine deficiency

Wernicke-Korsakoff's Syndrome

Memory characteristics of Korsakoff's syndrome

anterograde and retrograde amnesia, confabulation, and poor insight with associated features of gait ataxia, oculomotor palsy, and encephalopathy

Herpes encephalopathy often affects what areas of the brain

medial and inferior temporal lobes and the amygdala

Symptoms of herpes encephalopathy

amnesia, aphasia, and agnosia

Memory impairment subsequent to extensive bilateral medial temporal resection for intractible epilepsy

severe anterograde amnesia with preserved insight and not prone to confabulation

pathology involved with posterior cerebral artery stroke

medial temporal and posterior occipital lobes

Other cognitive deficits associated with PCA stroke in addition to amnesia

visual deficits, heminopic alexia, color agnosia, and 0bject agnosia

Name the brain region; amnesia type; insight; and confabulation in TGA

medial temporal/diencephalic; profound atnerorgrade and variable retrograde; present insight; rare confabulation

Name the brain region; amnesia type; insight; and confabulation in anoxia

medial temporal; anterograde; present; rare

Name the brain region; amnesia type; insight; and confabulation in ACoA

frontal and basal forebrain; frontal, maybe; often

Name the brain region; amnesia type; insight; and confabulation in Wernicke-Korsakoff's

diencephalic; retrograde; no; often

Name the brain region; amnesia type; insight; and confabulation in Herpes encephalopathy

medial temporal; severe retrograde; present; rare

Name the brain region; amnesia type; insight; and confabulation in PCA infarct

medial temporal; depends on laterality; present; rare

Name brain structures in hippocampal pathway

entorhinal cortex, fornix, mammilary bodies, mammillothalamic tract, cingulate cortex

Disroders assocaited with damage to hippocampal pathway

hypoxia and anoxia

Name 3 brain structures in amygdaloid pathway

amygdala; dorsal medial thalamus; dorsomedial cortex

Name disorders assocaited with amygdaloid pathway

Herpes encephalitis; PTSD

Naem 4 structures in diencephalon associated with memory

anterior nucleus of thalamus; dorsomedial nucleus of thalamus; fornix; mammillary bodies

Memory disorders associated with diencephalon

Korsakoffs

Name three memory related structures of basal forbrain

medial septal nucleus; diagonal band of Broca; and nucleus basalis of Meynert

Disorders associated with basal forebrain

Alzheimer's disease; ACoA aneurysm

Parts of cortex asscoatied with memory

medial and anterior temporal lobe and frontal lobe

Memory disorders associated with cortex

surgical ablation, TBI, herpes, anoxia, PCA infarct

Describe the Dorsolateral Prefrontal Syndrome (dysexecutive syndrome)

poor problem solving, word list generation, organization, sequencing, abulia/amotivation, and sometimes perseveration

Describe the orbitofrontal syndrome (inferior/frontal)

emotional lability, impulsivity, disinhibition, childishness, personality change, and distractibility

Describe the medial frontal/cingulate syndrome

decreased initiation and indifference, but can also have amnesia, incontinence, and leg weakness and also involves supplementary motor area and oculomotor circuit

Do subcortical or cortical dementias often present with reduplicative paramnesia or Capgras syndrome

cortical

Do subcortical or cortical dementias often involve personality changes and depression

subcortical

Where does damage in TBI occur to result in confabulation and decreased awareness

diffuse frontal system and diencephalon

Common executive dysfunction in TBI

confabulation, decreased awarenesss, dysexecutive, or personality symptoms

Damage to what two areas of the brain results in poor motor sequencing

prefrontal and dorsolateral prefrontal area

Damage to what two areas of the brain results in poor directed attention

prefrontal and frontal eye fields

Damage to what area of the brain results in poor working memory

dorsolateral prefrontal area

information that is actively maintained or rehearsed that can be retained for up to several minutes

working memory

damage to what area results in perseveration

dorsolateral prefrontal

uncontrolled repeating of a response

perseveration

damage to what area results in poor reasoning

dorsolateral prefrontal area

lacking in initiation/motivation/concern

abulia

Damage to what part of brain results in abulia

dorsolateral prefrontal area, as well as basal ganglia and anterior cingulate (medial frontal)

Damage to these two parts of the brain result in poor planning/organization

dorsolateral prefrontal area; orbitofrontal area

Damage to this area results in impulsivity

orbitofrontal area

Damage to this area results in emotional lability

orbitofrontal area

inability to control emotions

emotional lability

damage to this part of the brain results in utilization behavior or environmental dependency

orbitofrontal area

When patients respond to whatever stimuli is at hand even when inappropriate

utilization behavior/emotional dependency

inappropriate jocularity

Witzelsucht

Damage to this area of the brain results in Witzelsucht

orbitofrontal

damage to what area of the brain may result in disinhibition (2)

orbitofrontal and anterior cingulate

inability to speak or move

apathy/akinetic mutism

damage to this area may result in apathy/akinetic mutism

anterior cingulate

Damage to which side of the frontal lobe is thought to lead to depression

LEFT

feeling that a place has been duplicated

reduplicative amnesia

damage to these two areas may result in reduplicative amnesia

right posterior parietal and frontal

feeling that a person has been duplicated or is an imposter

Capgras syndrome

damage to these two areas may result in Capgras syndrome

right temporal; Bilateral frontal

damage to what areas may result in anosognosia

frontal, posterior parietal, bilateral, and right hemisphere regions

unawareness of deficit that is that is different than denial due to limited defensiveness and lack of awareness not due to psychological denial or avoidance

Anosognosia

Loss of ability to name or identify fingers of one's own hand or fingers of the hands of another person

finger agnosia

4 characteristics of Gertsmann syndrome

finger recognition, acalculia, right left disorientation, and agraphia

autotopagnosia

loss of ability to id parts of one's body to command or imitation

inability to id left and righ side of one's own body or another person's body

right-left disorientation

somatagnosia

disturbance in general feeling perstaining to existence of one's body or body schema

Somatagnosia is result of dysfunction of what lobe?

parietal

Two types of somatagnosias

asterogosia; asomatognosia

astereognosia

loss of ability to recognize the nature of object by tactual ability or physical features (shape, size)

asomatognosia

disturbance in knowlede of ones own body and bodily condition (e.g. hemispatial inattention)

Lesion location in finger agnosia

left inferior parietal lobe particularly angular gyrus

lesion location in right left disorientation

left inferior parietal lobe esp angular gyrus

lesion location in asterognosia

unilateral posterior parietal region and rolandic gyri

lesion assocaited with asomatognosia

bilateral parietal lobes , unilateral right inferior parietal bordering interparietal sulcus, supramarginal gyrus and angular gyrus, or unilateral dominant parietal lobe, especially angular gyrus

impairment in ability to carry out purposeful, skilled movement despite normal primary motor skills and normal comprehension of act not explained by weakness, incoordination, sensory loss, concentration, inattention, or Intellectual impairment

apraxia

Common etiology of apraxia

focal lesions, progressive dementia, stroke

Apraxia is frequently associated with what other disorders that make differential diagnosis more confusing

aphasia and anosognosia or right hemiparesis

Examination for apraxia should include:

pantomime; evaluation of transitive movements; intransitive movements; and ability to carry out serial acts

impairment in planning the movements necessary for speech production manifested in inconsistent articulation errors and difficulty with correct articulatory placement

apraxia of speech

disorder of motor coordination

dysarthria

difficulty performing voluntary skilled motor movements of face, tongue, lips, and cheeks on command

buccofacial apraxia

How to assess intransitive buccofacial gestures

puff out cheeks, stick out tongue

How to assess transitive buccofacial gestures

pretend to suck on straw or sniff a flower

loss of normal capacity to use legs appropriately for act of walking even though can demonstrate when laying down

gait apraxia

localization of speech apraxia

uncertain

locations of ideational apraxia

bilateral nonfocal lesions and with left hemi lesions esp posterior temporal-parietal junction

localization of ideomotor apraxia

lesions in left inferior parietal lobe or supplementary motor area or lesion in corpus callosum

localization of limb-kinetic apraxia

pyramidal motor system

loss of ability to plan and execute complex gestures as if lost idea behind it or use tool despite knowledge of it resulting in difficulty motor planning adn errors in sequencing actions to complete task

ideational apraxia

how to assess for ideational apraxia

request completion of serial acts

loss of ability to perform or pantomime transitive or intransitive gestures on command and to imitate, although spontaneous production of the gesture may remain intact resulting in using body part as if it were an object

ideomotor apraxia

how to assess intransitive ideomotor apraxia

ask to wave or salute

how to assess transitive limb gestures

ask to pretend to use comb or scissors

inability to precisely move hands or legs not related to skilled movement present with pantomime, imitation, and use of objects affecting goal directed transitive movement more than simple intransitive movement, is more often asymmetric, and affects distal more than proximal movement

limb-kinetic apraxia

language disorder associated with aphasia and alexia or to primarily motoric and spatial deficits

agraphia

Part of brain often implicated in emotional regulation

frontal lobe particularly orbitofrontal and left frontal, right hemi and limbic areas such as amygdala and septum

Disoreder where patients are aware they have impairments but have no emotional distress or concern often presenting with neglect

anosodiaphoria

localization of anosdiaphoria

right parietal or frontal

inability to understand, process or describe emotions

alexithymia

localizationof alexithymia

right hemi

fluctuations of emotion and or increased emotional reactivity

emotional lability

localization of emotional lability

orbitofrontal area, limbic system

type of emotional lability, extreme involuntary emotional responses to mild stimulation

psuedobulbar affect

localization of pseudobulbar affect

pseudobulbar palsy or damage to upper motor neuron corticobulbar tract

passive behavior with little spontaneous activity and markedly delayed response or speak brief and soft

abulia

purposeful substitution of many words for a word or other words unable to find that manifests as talking around word finding difficulties

circumlocution

breadth and depth of knowlege adn understanding acquired through learning, education, and acculturation often resistant to aging and injury/illness

crystallized intelligence

difficulty in articulation typically able to read and write

dysarthria

difficulty in vocaliation

dysphonia

intelligence referring to ability to reason, adapt, solve problems, form concepts, and undestand relationships

fluid intelligence

substitution or rearrangement of sounds or syllables in otherwise correct words

literal or phonemic paraphasias

underlying speech sounds in a language and rules governing production of speech sounds

phonology

context in which words are used

pragmatics

element of speech that contributes to conveance of meaning through rhythm, stress, pitch, loudness, tempo, and intonation

prosody

meanings of words and rules governing the use of words...sequencing of meaningful words and sounds to convey meaning

semantics

substitution of a correct words or phrase for another semanticaly related word or phrase different than Wernicke's due to multiword paraphasic errors or paragrammatism

semantic paraphasia

rules governing structure of phrases and sentences

syntax

substitution of one correct word for another

verbal paraphasias