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Neuropsychology Midterm


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What are the main approaches to neuropsychological testing?
1. Halstead-Reitan
2. Luria Nebraska
3. Process
Advantages and Disadvantages of the Halstead Reitan?
1. tests specific parts of the brain
2. tests higher cognitive functioning
3. straight forward- tells you where the damage is
4. for higher functioning adults

1. doesn't look at hierarchy, prob could be in other places
2. all items at same difficulty level
3. very long
4. many of the tests are complex, requiring multiple skill sets
Advantages and Disadvantages of the Luria Nebraska?
1. Good for stroke victims
2. much shorter
3. items increase in difficulty, which allows you to identify the extent of the problem
4. allows for functional recommendations

1. doesn't test higher cog. functioning skills
2. not as integrated
Advantages and Disadvantages of the Process Approach?
(Most common approach)
1. Pick and choose your own battery
2. tailor it to what is most useful to your client
1. You might miss something
2. You need experience, this approach depends ont he skill level of the examiner
What are 5 specific Halstead Tests?
1. Finger tapping - motor strip
2. category - frontal lobes
3. Tactual Performance Test (TPT)- R. hemi
4. Aphasia Screen - L. hemi
5. Trails A & B - Frontal lobes
Name 6 discrete areas assessed by neuropsych tests?
1. attention/concentration
2. motor
3. sensory perception
4. language
5. memory
6. higher lvl functioning- executive functioning and IQ
Name 3 types of scans used by neurologists to diagnose brain dysfunction?
1. Catscan
2. EEG
3. MRI
3 ways to estimate premorbid functioning level?
1. occupation
2. educational level/grades in school client having difficulty at work with things they used to do well?
Name 2 situations when a MSE is preferable to a full battery?
When a person is changing rapidly, out of a coma, etc.

When a person needs to be tested multiple times? (???)
4 areas to be discussed with a patient in a preparatory interview?
1. purpose of testing
2. how the info. will be used
3. feedback to pt.
4. brief explanation of process
A neuropsychologist can test hypotheses by varying what 3 areas?
1. length of stimuli (one letter, then two, then three)
2. modality (auditory, or visual, which is the pt. better at?)
3. format (how the info was presented, list, paired association, etc)
What 3 types of impairment would significantly affect all types of cognitive testing?
1. vision
2. motor abilities
3. hearing
What is an extremely important history question to be asked prior to neuropsych interpretation?
Developmental history/milestones
What area of cognition must be intact prior to neuropsych testing?
What are the 3 areas assesseed by the Glasgow Coma Scale?
1. eye open
2. verbal
3. motor response
What are 2 tests of concentration?
1. WAIS- arithmetic
2. Serial 7s
What are the 5 stages of coma?
1. alertness
2. lethargy/somnolescence
3. obtundation/obtunded
4. semi-coma/stupor
5. coma
1. not fully alert
2. go to sleep if not stimulated
3. spontaneous movements down
4. awareness limited
5. can't play close attention
6. thoughts wander from topic to topic
1. very difficult to arouse
2. confused when aroused
3. need constant stimulation in order to provide marginal cooperation
4. acute confusional state, or quiet delirium
1. respond only to delirium
2. persistent and vigorous stimulation
3. when stimulated groan and mumble and move restlessly
1. completely unarousable
2. don't respond to internal or external stimuli
3. no evidence of response or stimulation
name and describe briefly 3 types of attention and how you would assess each?
1. immediate attention: digit span, say numbers and they are repeated back immediately
2. sustained/vigilance: focused on a specific task, TOVA
3. length/overtime: how long are you able to maintain attention over a time period, (behavioral observation)
Name 3 different drawing tests that would assess constructional difficulties?
1. bender-gestalt
2. Rey O (or complex figure)
3. free drawing task
How would you assess motor perseveration? (3 ways)
1. M & N test
2. square/triangle test
3. bender gestalt
over or undershooting the distance to an object
lack of voluntary movmement coordination (lack smooth cordination in eating and walking)
movements of your mouth uncoordinated
The motor effects of Parkinsons's
1. increased muscle tone
2. person's face loses it's expression
3. slow, shuffling gait
4. a resting tremor
The motor effects of Huntington's Chorea
1. rapid jerking non-rhythmic momement of extremities, trunk and/or face
2. dementia
slow, bizarre twisting movement of the arms and fingers
a violent swinging motion of the arms or legs
3 ways to assess visual neglect?
1. reading
2. line by section
3. cookie theft story
4 types of aphasia?
1. broca's
2. wernicke's
3. conduction/repetition
4. global
Broca's aphasia?
1. Nonfluent- little output (think: closer to mouth)
2. effort to verbalize
3. use lots of substantiative words & less connecting words
Wernicke's aphasia?
1. Fluent- difficulty with comprehension (think: closer to ear)
2. plentiful output of words
3. tendency to omit meaningful words
4. very difficult to understand and excessive paraphasias
Repetition (conduction) aphasia?
1. Problem with the fibers connecting Broca's and Wernicke's (arcuate fasciculus)
2. unable to repeat things
Global aphasia
the whole left hemisphere is affected and they have all these different kind of aphasias. Phrase of curse words they repeat a lot.
inability to name common items
had ability to read and loses it.
difficulty w/ writing
loss of math ability
an inability to recognise something by one sensory modality, but you can recognie it by the other sensory modality
persons closes eyes and can tell what an object is by feeling it in their hands
Finger nosis
fingers are number, when fingers are touched they tell you what number it is.
Word substition (2 types)
1. semantic: substitute word different in meaning (pen/pencil)
2. phonemic: substitute word close in sound but not in meaning (pen/pin)
What 4 functional activities are affected when a person has an aphasia?
1. spontaneous speech
2. comprehension
3. reading
4. spelling
2 types of dyslexia?
1. phoneme-grapheme
2. ideographic repesentation
phoneme-grapheme dyslexia?
(aka sound-letter) difficulty knowing sounds that go with the letter
ideographic representation?
specific letter groups go w/ specific sounds (ph) (tion) (sound symbols) unable to sound out words. Spells phonetically.
immediate memory
something beyond attention but less than 3 minutes
delayed memory
1/2 hour
remote memory
(sometimes called long term) personal facts, stuff on info. subtest
4 processes involved in memory?
1. registration
2. encoding
3. storage
4. retrieval
What are 3 common error made by individuals with neurological problems that are seen very infrequently in a normal population during a memory assessment?
1. repetition: a repetition of a word they've already given
2. intrusion: come up w/ an item not on the original list
3. confabulation: ome up w/ own story instead of actual facts
2 measure of incidental nonverbal memory?
1. bender-gestalt
2. Rey O
The conceptual functions of the frontal lobes
1. looks at acquired knowledge, such as subjects
2. prob. solving on old knowledge
3. abstract thinking (similarities)
4. social judgement
5. comprehension
6. forming a concept
7. categorizing
8. generalization
9. distinguishing relevant from irrelevant
10. where do you focus your attention
What are the executive functions of the frontal lobes?
1. organize your perceptions
2. integrates cortical and subcortical functions
3. heps retrieve stored material
4. helps you process 2 or more types of events simultaneously
5. helps you to tranform experience into behavior
6. helps to know when you should generalize or not
7. provides a feedback system for monitoring your behavior
How would you distinguish between someone with schizophrenia from someone with frontal lobe impairment?
1. hallucinations
2. paranoid ideation
3. history
4. bizarre behavior
5. flat affect
What types of unusual behaviors would you expect to see in someone with a frontal lobe injury?
1. impulse prolems
2. disinhibition
3. planning
4. organization
5. tangential
What are some tests specifically designed to measure frontal lobe injury, not intelligence?
1. WISC card sort
2. trails a & b
3. CAT test

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