11 “neurological disorders” human neuropsychology (486 / 686) lecture chapter 26
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““Neurological DisordersNeurological Disorders””
Human Neuropsychology (486 / 686)Human Neuropsychology (486 / 686)
Lecture Chapter 26Lecture Chapter 26
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The Neurological ExaminationThe Neurological ExaminationPatient HistoryPatient History
Patient and family background and disease historyPatient and family background and disease historyObservation of behavior and state of awarenessObservation of behavior and state of awarenessSimple tests of memory and speechSimple tests of memory and speech
The Physical ExaminationThe Physical ExaminationHead and body size, Blood pressureHead and body size, Blood pressureVarious reflexesVarious reflexesSmell and taste, sensation and hearingSmell and taste, sensation and hearingSensitivity to lightSensitivity to lightMuscular strengthMuscular strengthObject recognition, speech repetitionObject recognition, speech repetition
Vascular DisordersVascular Disorders
Cerebral vascular accident (CVA) aka Cerebral vascular accident (CVA) aka Stroke: Stroke: sudden appearance of neurological sudden appearance of neurological symptoms resulting from disruption of blood flow symptoms resulting from disruption of blood flow to the brainto the brain
Mild to severeMild to severe
Ischemia – lack of blood supplyIschemia – lack of blood supply
Causes: Thrombosis, Embolism, Cerebral Arteriosclerosis, Cerebral Vascular Causes: Thrombosis, Embolism, Cerebral Arteriosclerosis, Cerebral Vascular Insufficiency (transient ischemia)Insufficiency (transient ischemia)
Migraine stroke - Appears as a transient ischemic attackMigraine stroke - Appears as a transient ischemic attackSymptoms: Symptoms: Impaired sensory function, Numbness, Difficulty moving, AphasiaImpaired sensory function, Numbness, Difficulty moving, Aphasia
Cerebral Hemorrhage – bleedingCerebral Hemorrhage – bleeding
most common cause high blood pressuremost common cause high blood pressure
Vascular DisordersVascular Disorders
Angiomas - Angiomas - Collection of Collection of abnormal blood abnormal blood vessels vessels
Vascular DisordersVascular Disorders
Aneurysms - Aneurysms - Vascular dilationVascular dilation
Angiomas -Angiomas -Arteriovenous Arteriovenous
MalformationMalformation
TreatmentsTreatmentsDrug therapiesDrug therapiesAnticoagulants, blood Anticoagulants, blood
pressure pressure meds,steroids meds,steroids
SurgeriesSurgeries
Traumatic Brain InjuriesTraumatic Brain Injuries
Open Head Injury – penetrating wounds,Open Head Injury – penetrating wounds,
deficits specific to injury site, greatest risk of deficits specific to injury site, greatest risk of infectioninfection
Closed Head Injury – Closed Head Injury –
forces that cause damage: coup, forces that cause damage: coup, countercoup, twisting and shearing, countercoup, twisting and shearing, bleeding and edemableeding and edema
Closed-Head InjuriesClosed-Head Injuries
ComaComa
Behavioral effectsBehavioral effects
General complaintsGeneral complaints
Risk for future head injuryRisk for future head injury
Cumulative effects Cumulative effects
Behavioral AssessmentBehavioral Assessment
Glasgow Coma Glasgow Coma ScaleScale
Behavioral AssessmentBehavioral Assessment
Post-Traumatic Post-Traumatic Amnesia (PTA)Amnesia (PTA)
EpilepsyEpilepsy
Three common Three common symptomssymptoms
Diagnosed with Diagnosed with EEGEEG
Types of Seizures:Types of Seizures: Focal Focal
Jacksonian, Complex partialJacksonian, Complex partial GeneralizedGeneralized
Grand Mal, Petit MalGrand Mal, Petit Mal Akinetic and MyoclonicAkinetic and Myoclonic
Anticonvulsant drugsAnticonvulsant drugs SurgerySurgery
Treatment for Epilepsy:Treatment for Epilepsy:
TumorsTumors
Benign vs MalignantBenign vs Malignant Encapsulated vs InfiltratingEncapsulated vs Infiltrating
Types:Types:
Gliomas, Meningiomas, MetastaticGliomas, Meningiomas, Metastatic
Treatment:Treatment:
Surgery, Radiation, ChemotherapySurgery, Radiation, Chemotherapy
Gliomas:Gliomas:
oligodendrogliomaoligodendroglioma
astrocytomaastrocytoma
ependymomaependymoma
MenigiomasMenigiomas
Metastatic Metastatic tumorstumors
From Lung cancer
From skin cancer
Headaches: MigraineHeadaches: MigraineClassic migraineClassic migraine
Common migraineCommon migraineCluster headacheCluster headacheHemiplegic and ophthalmologic migraineHemiplegic and ophthalmologic migraineTreatment: Specific drugs to prevent and Treatment: Specific drugs to prevent and
control pain e.g. topamax, ergotaminecontrol pain e.g. topamax, ergotamine
Other HeadachesOther Headaches
Neurological disease relatedNeurological disease relatedCauses: tumor, head trauma,infections, vascular malformation, Causes: tumor, head trauma,infections, vascular malformation, hypertensionhypertensiontreatment: treat the causetreatment: treat the cause
Muscle-contraction headaches (Muscle-contraction headaches (tension)tension)
treatment: Analgesics, treatment: Analgesics, Muscle relaxants, tranquilizers, Muscle relaxants, tranquilizers, posture improvement, reduce stressposture improvement, reduce stress
Nonmigrainous vascular headachesNonmigrainous vascular headachesCauses: Fever, anoxia, anemia, high altitude, physical effort, Causes: Fever, anoxia, anemia, high altitude, physical effort, hypoglycemia, food, or chemical agentshypoglycemia, food, or chemical agents
InfectionsInfectionsInterfere with blood supply, Interfere with blood supply, Disrupt glucose or Disrupt glucose or oxygen metabolism, Alter cell membranes, Form oxygen metabolism, Alter cell membranes, Form pus, Edemapus, Edema
Types:Types: Viruses – neurotropic, pantropicViruses – neurotropic, pantropic
treatment: Difficult to treat; no antidotetreatment: Difficult to treat; no antidote Bacteria – Meningitis, Brain abscessesBacteria – Meningitis, Brain abscesses
treatment: Antibiotics, Drainage treatment: Antibiotics, Drainage
Mycotic Infections – fungusMycotic Infections – fungus Parasitic InfectionsParasitic Infections – Amebiasis,Malaria – Amebiasis,Malaria
No satisfactory treatment, AntibioticsNo satisfactory treatment, Antibiotics
Motor Neurons and the Spinal CordMotor Neurons and the Spinal Cord Myasthenia GravisMyasthenia Gravis
PoliomyelitisPoliomyelitis
Multiple SclerosisMultiple Sclerosis
ParaplegiaParaplegia
Brown-SBrown-Sééquard Syndromequard Syndrome
HemiplegiaHemiplegia
1. Moran and Desimone showed that monkey 1. Moran and Desimone showed that monkey neurons responded selectively to specific neurons responded selectively to specific stimuli in their visual fields:stimuli in their visual fields:
a. after reward traininga. after reward training
b. when the stimulus was presented to the right b. when the stimulus was presented to the right visual hemifieldvisual hemifield
c. when the stimulus was presented to the left c. when the stimulus was presented to the left visual hemifieldvisual hemifield
d. when the stimulus was a particular colord. when the stimulus was a particular color
2. Which of the following processes are 2. Which of the following processes are necessary prerequisites of consciousness?necessary prerequisites of consciousness?
a. attention and perceptiona. attention and perception
b. working memoryb. working memory
c. arousal c. arousal
d. all of these processes are necessaryd. all of these processes are necessary
3. Dendrite growth differs from axonal 3. Dendrite growth differs from axonal growth in that:growth in that:
a. axons grow faster than dendrites in order a. axons grow faster than dendrites in order to play a role in shaping dendritic growthto play a role in shaping dendritic growth
b. axons grow faster than dendrites in order b. axons grow faster than dendrites in order to reach a larger maximum sizeto reach a larger maximum size
c. dendrite grow faster than axons in order to c. dendrite grow faster than axons in order to play a role in shaping axonal growthplay a role in shaping axonal growth
d. dendrite grow faster than axons in order to d. dendrite grow faster than axons in order to reach a larger maximum sizereach a larger maximum size
4. After a series of higher than normal 4. After a series of higher than normal stimulations followed by a rest period, a stimulations followed by a rest period, a baseline stimulation to a neuron elicits a baseline stimulation to a neuron elicits a greater excitatory post synaptic potential greater excitatory post synaptic potential from another neuron that receives it’s from another neuron that receives it’s projections. This phenomenon is known as: projections. This phenomenon is known as:
a. kindlinga. kindling
b. long-term potentiationb. long-term potentiation
c. ischemiac. ischemia
d. synaptogenesisd. synaptogenesis
5. Countercoup damage is the result of:5. Countercoup damage is the result of:
a. aneurysma. aneurysm
b. infectionb. infection
c. closed head injuryc. closed head injury
d. open head injuryd. open head injury
6. What are Piaget’s four stages of 6. What are Piaget’s four stages of cognitive development? Briefly cognitive development? Briefly characterize each stage. characterize each stage.
7. What evidence is there that motor 7. What evidence is there that motor maps can be modified by experience? maps can be modified by experience?
8. What is the difference between an 8. What is the difference between an angioma and an aneurysm? angioma and an aneurysm?