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| Definition and goal of Neuropsychology |
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| The study of brain-behavior relationships-goal is to relate the pt's behavior to brain function |
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| involves the use of psychological/neurological/behavioral tests and techniques to make inferences about the pt's brain function, behavior and plan treatment. |
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| First to believe the brain was the center of thought (not the heart) |
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| in the 1700s created Phrenology-used the shape of the skull to indicate strengths and weaknesses in the brain. First to try to map the brain (although he was way off). Initiated localization theory. |
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| lesioned parts of animal brains to study effect of surgery on behavior. Thought that all behavior was alike regardless of what was removed. Asserted equipotentialist theory. |
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| Different brain areas are responsible for different functions |
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| Areas in the brain are not specific to certain functions |
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| described brain function as a hierarchy made of three levels:spinal cord, brain stem, frontal cortex. established first hierarchical models |
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| Russian neurologist who studied war veterans and peasants and started pathognomonic testing (all normals can pass), establishing behavioral neurology (as opposed to psychometrics) and a hierarchical model and introducing the idea that rehab for brain damage was possible. |
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| Developed psychological tests to distinguish normals from brain damaged later known as the Halstead-Reitan Test Battery, establishing a psychometric camp (opposed to behavioral neurology) |
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| opposite side of the body |
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| forebrain-contains cerebral cortex,basal ganglia and limbic system |
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| contains thalamus and hypothalamus |
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| midbrain-contains tectum and tegmentum |
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| hindbrain-contains pons, cerebellum |
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| outside layer of brain made up of gray matter. performs higher level cognitive functions. divided into lobes |
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| planning, motor output, attention, inhibition |
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| grey matter-subcortical nuclei that control movement and are implicated in Parkinson's disease. responsible for procedural memory. |
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| cortical and subcortical nuclei located in the frontal lobe (and some temporal) that control and affect behavior |
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| relay station which connects motor, sensory, limbic system, and reticular activating system RAS (arousal). |
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| maintains homeostasis and (body temp, circulation) involved with basic survival (food, sleep, sex, self defense) |
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| contains the superior and inferior colliculi, responsible for reflexes |
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| involved with reticular activating system (RAS) for arousal, controls eye movements and motor functions |
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| arousal (RAS), sleep/wake |
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| movement, balance, learning/memory |
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| arousal (RAS), cardiovascular, muscle tone, respiration |
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| brings sensations in from body to brain and brings motor commands from brain to muscles |
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| bring sensations from body to brain; dorsal (in the back of the spinal cord) |
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| bring motor commands from brain to muscles; ventral roots (in the front of the spinal cord) |
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| Four sections of spinal cord |
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| cervical, thoracic, lumbar, sacral |
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| protective sheaths of connective tissue which cover the brain, spinal cord, cranial and spinal nerves |
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| dura matter, arachnoid, subarachnoid space, pia matter |
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| layer of meninges next to skull. thick tough and flexible. has drainage pathways for blood to return through veins to heart and arteries to supply tissue. |
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| layer of meninges below dura. soft and spongy |
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| area between arachnoid and pia. filled with cerebrospinal fluid |
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| inner most layer of meninges. soft tissue, tightly attached to the brain. |
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| spaces within the brain which hold the cerebrospinal fluid. Made up of four ventricals (two lateral, 3rd and fourth). reduces shock to the brain and pressure on the brain. |
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| blocking of CSF in ventricular suystem |
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| vertebral artieries supply the posterior; internal carotid supply the anterior. brain needs constant supply of blood (20%) because it can't store glucose. |
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| cicular arterial srtucture in the pons where blood supplies from both arteries come together. Allows one set of arteries to make up for the other if one of the two is blocked. |
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| serve the sensory and motor functions of the head and neck. they are always evaluated by neurologists and assess intactness of the brain (esp. brain stem) |
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| oculomotor (moves eyes, constricts pupils) |
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| trigeminal (chews, feels front of head) |
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| facial (moves face, tastes, salivates) |
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| vestibulocochlear (hearing, balance) |
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| glossopharyngeal (tastes, salivates, swallows) |
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| vagus (tastes, swallow, heart) |
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| accessory (turns head, lift's shoulders) |
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| hypoglossal (moves toungue) |
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| responsible for the primary sensory reception (or primary motor movements). all of the cells in this cortex are devoted to one specific function |
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| cells are still devoted to the specific function but serve to further elaborate the primary cortex work (turns a group of lines into a specific object, sounds into words etc.) |
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| cells are not specific to one function and they integrate functions (visual objects can be named with words) |
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| collective name for secondary and tertiary cortices (because distinctions can be arbitrary) |
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| Main functions of temporal lobe |
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| audition, olfaction, language, memory, emotions/behavior |
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| Neuropsych tests of temporal lobe |
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| auditory confrontation (which ear am I snapping in?), smell test, receptive language/expressive language, visual and verbal memory retention, emotional/behavioral measures |
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| primary projection area for audition (all sound processed must pass through this area). Tonotopically localized (processing organized from high to low frequency along the gyrus) If both Heschl's gyri are destroyed you are cerebrally deaf. |
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| Lateral processing of audition |
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| most audition is processed contralaterally (right brain/left ear), but about 20% is ipsalateral. |
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| Type of sound processed in each hemisphere |
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left-language
right-nonlanguage sounds (music, speech prosody)
(specialization more pronounced in right handers). hemisphere that controls language is referred to as dominant. |
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| Hierarchy of language functions |
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| receptive-->expressive-->reading-->writing |
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| Classical model of language processing |
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ears-->Heschl's gyrus-->Wernicke's area for comprehension-->arcuate fasiculus (neuronal track)-->Broca's area for speech production
(this is not a hard rule as demonstrated by neuroimaging studies) |
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| language comprehension occurs. people can't understand speech or written language. People with Wernicke's aphasia speak in normal rate and tone but in neologisms and word salad. |
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| Related to speech production. People with Broca's aphasia understand but can't produce speech fluently and are aware of errors. |
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| unexpected difficulty in learning to read. In normal readers planum temporale is larger on left side of the brain. Not so in dyslexic people. |
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| acquired loss of reading skill (through injury/stroke etc.) |
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| difficulty in naming objects; usually in left posterior temporal-occipital areas (where language is meeting vision) |
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| Nondominant temporal lobe lesion problems |
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| acoustic anomia, amusia, nonverbal learning disability |
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| Dominant temporal lobe lesion problems |
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| aphasia, dyslexia, anomia, difficulty with repitition (when arcuate fasiculus is damaged) |
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| inability to recognize sounds (hear cow moo and pick up phone) |
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| difficulty recognizing rythms |
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| Nonverbal learning disability |
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| can't comprehend prosody of words, inflection, context |
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| Lateral processing of memory |
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left temporal-verbal
right temporal-visual |
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| processes memory for long term storage. Impacting in Alzheimer's, TBI, anoxic encephalopothy |
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| Model of memory processing |
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| acquistion-->encoding-->learning-->processing-->storage-->retrieval |
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| coordinates emotional processing and is connected to hippocampus (accounts for relationship of emotions to memory). also connected to olfactory system. |
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| Interventions with patient's with temporal lobe damage |
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-negotiate contract about how to help them understand you and express themselves (writing, gesturing, drawing, yes/no)
-act as auxilary memory (tape sessions, session reviews, write stuff down)
-consider language dysfunction can look like psychosis |
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-somatosensory
-visual-spatial
-reading/spelling
-association cortex (integration) |
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| Neuropsych tests for parietal functions |
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-tactile stimulation
-finger gnosis (which finger did I touch?)
-stereognosis (what is the object I put in your hand?)
-matching of line angles
-reading/spelling-iconic/graphic errors |
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| postcentral gyrus/somatosensory strip/homunculus |
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| topography associated with sensory areas. the more sensitive, the more area a body part makes up on the homunculus. |
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inability to appreciate sensory information that has reached the brain (right parietal). types include:
-finger agnosia-don't know where fingers are in space
-astereognosis-cant identify items by touch
-anosagnosia-neurological lack of awareness of illness |
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| Syndromes associated with parietal damage |
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-agnosia
-right-left disorientation
-geographical disorders
apraxia
-visual-spatial neglect |
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| inability to carry out purposeful movements even though person has basic motor ability (can't imitate gestures or use common objects even when they know what they are for) (usually left parietal) |
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| tendency to neglect half of extrapersonal space (sometimes intrapersonal space) (right parietal) |
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Tectum
(superior and inferior colliculi) |
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| name for the frontal lobes to allude to the idea that all of the other lobes deal with bringing information into the brain, but the frontal lobes are responsible for producing output. |
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| motor output, inhibition, organization and planning, |
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| failing to complete behaviors. You test this by giving someone a behavior to repeat until you say stop |
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| test of competing programs OR go/no-go tests |
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| test inhibition by giving one set of directions and then changing them (other hand or backward or something) |
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| contains the motor strip (primary motor cortex) |
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| coordinates order of gross motor movements that allow for complicated movement |
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| organizes information and weighs options to decide if motor movements are appropriate in a situation |
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| order of processing in motor movements |
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| Posterior of brain-->prefrontal-->premotor--> motor-->thalamus-->brainstem-->spinal cord-->peripheral nerves-->muscles |
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| pseudodepression, flat affect, lack of initiation, perseveration, limited verball output, indifference |
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| vascular disease affects white matter connections to frontal lobes and can result to dorsolateral damage |
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| pseudopsychopathy; failures to inhibit behavoir, aggressive behavior, often sexual |
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| arousal generally comes up through the brainstem through the RAS and info travels to the frontal lobe for inhibition. ADHD children fail to inhibit responses tostimuli |
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| they stimulate inhibition by acting as a dopamine agonist |
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| problems with language function (stammering, halting speech), behavior problems (lability agitation, aggression), apathetic (some think thismight be another syndrome |
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| losing gross motor function on half of the body |
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| frontal lobe impact on memory |
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| the frontal lobe is responsible for retrieval, so frontal lobe damage will result in poor retrieval, but the memories are there. Things can be remembered after a delay, but they will be more sensitive to interference and better with recognition than recall (unlike temporal patients who can't encode anything). |
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| primary role is in vision |
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| The most posterior part of the brain's occipital lobe, where visual information at the center of the visual field is processed. Strokes affecting the occipital pole cause a visual deficit called a central visual defect. |
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| primary visual cortex in the medial aspect of the posterior region; flips information right side up. contains cells that respond better to different line angles |
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| travels throughout the whole brain from eyes to calcarine cortex, which can serve as a good measure of brain's integrity because it is easily localizable |
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| light sensitive tissue in the back of the eyes. produce upside down images of the world |
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| pathway directly behind the eyes through which both hemiretinas send their information |
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| where information from the temporal visual field (medial hemiretina) crosses to the other side |
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| white matter track leading to the thalamus |
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| lateral geniculate nucleus |
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| located in the thalamus; serves as a relay station for visualinformation |
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| part of the pathway where the lower visual field is located in the parietal lobe and the upper visual field islocated in the temporal lobe |
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| occurs with bilateral damage to the occipital region. can physically see, but you can't process any of the visual info so you are blind for all intents and purposes |
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| visual system that controls movement and depth;controlled by superior colliculi in the tectum |
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| visual system that controls form and color |
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| when people with cerebral blindness have some sense of movement because they have parvocellular damage in the occipital lobe but not damage to the magnocelluar system |
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| denial of blindness related to right occipital lesions along with bilateral occipital lesions (right hemisphere deals with appreciation of limitations, occipital lobe deals with vision) |
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| relatedto right parietal and occipital lesions (visual-spatial functioning+vision) |
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| acquired difficulty with color perception (occipital-temporal lesions) |
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| failure to recognize objects through vision (occipital lobe lesions). can't recognize objects by vision but can by touch even though they can copy pictures. |
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| unable to recognize familiar faces (sometimes even one's own face); result of bilateral occipital lesions |
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