Human Neuropsychology (486 / 686) Lecture Chapter 26 .

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Neurological Disorders

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The Neurological Examination

 Patient History Patient and family background and disease history Observation of behavior and state of awareness Simple tests of memory and speech  The Physical Examination Head and body size, Blood pressure Various reflexes Smell and taste, sensation and hearing Sensitivity to light Muscular strength Object recognition, speech repetition

Vascular Disorders

 Cerebral vascular accident (CVA) aka Stroke: sudden appearance of neurological symptoms resulting from disruption of blood flow to the brain Mild to severe

Vascular Disorders

 Ischemia – lack of blood supply Causes: Thrombosis, Embolism, Cerebral Arteriosclerosis, Cerebral Vascular Insufficiency (transient ischemia)  Migraine stroke - Appears as a transient ischemic attack Symptoms: Impaired sensory function, Numbness, Difficulty moving, Aphasia  Cerebral Hemorrhage – bleeding most common cause high blood pressure

Vascular Disorders

 Angiomas Collection of abnormal blood vessels  Angiomas -

Arteriovenous Malformation

 Aneurysms Vascular dilation

 Drug therapies Anticoagulants, blood pressure meds,steroids

Treatments

 Surgeries

Traumatic Brain Injuries

 Open Head Injury – penetrating wounds, deficits specific to injury site, greatest risk of infection  Closed Head Injury – forces that cause damage: coup, countercoup, twisting and shearing, bleeding and edema

Closed-Head Injuries

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Coma

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Behavioral effects

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General complaints

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Risk for future head injury

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Cumulative effects

Behavioral Assessment

 Glasgow Coma Scale

Behavioral Assessment

 Post-Traumatic Amnesia (PTA)

Epilepsy

 Three common symptoms  Diagnosed with EEG

Types of Seizures:

 Focal

Jacksonian, Complex partial

 Generalized

Grand Mal, Petit Mal

 Akinetic and Myoclonic

Treatment for Epilepsy:

 Anticonvulsant drugs  Surgery

Tumors

 Benign vs Malignant  Encapsulated vs Infiltrating  Types: Gliomas, Meningiomas, Metastatic  Treatment: Surgery, Radiation, Chemotherapy

Gliomas:

astrocytoma oligodendroglioma ependymoma

Menigiomas

Metastatic tumors

From Lung cancer From skin cancer

Headaches: Migraine

Classic migraine Common migraine Cluster headache Hemiplegic and ophthalmologic migraine Treatment: Specific drugs to prevent and control pain e.g. topamax, ergotamine

Other Headaches

 Neurological disease related Causes: tumor, head trauma,infections, vascular malformation, hypertension treatment: treat the cause  Muscle-contraction headaches ( tension) treatment: Analgesics, Muscle relaxants, tranquilizers, posture improvement, reduce stress  Nonmigrainous vascular headaches Causes: Fever, anoxia, anemia, high altitude, physical effort, hypoglycemia, food, or chemical agents

Infections

Interfere with blood supply, Disrupt glucose or oxygen metabolism, Alter cell membranes, Form pus, Edema Types:  Viruses – neurotropic, pantropic  treatment: Difficult to treat; no antidote Bacteria – Meningitis, Brain abscesses treatment: Antibiotics, Drainage   Mycotic Infections – fungus Parasitic Infections – Amebiasis,Malaria No satisfactory treatment, Antibiotics

Motor Neurons and the Spinal Cord

 Myasthenia Gravis  Poliomyelitis  Multiple Sclerosis  Paraplegia  Brown-S équard Syndrome  Hemiplegia

1. Moran and Desimone showed that monkey neurons responded selectively to specific stimuli in their visual fields: a. after reward training b. when the stimulus was presented to the right visual hemifield c. when the stimulus was presented to the left visual hemifield d. when the stimulus was a particular color

2. Which of the following processes are necessary prerequisites of consciousness?

a. attention and perception b. working memory c. arousal d. all of these processes are necessary

3. Dendrite growth differs from axonal growth in that: a. axons grow faster than dendrites in order to play a role in shaping dendritic growth b. axons grow faster than dendrites in order to reach a larger maximum size c. dendrite grow faster than axons in order to play a role in shaping axonal growth d. dendrite grow faster than axons in order to reach a larger maximum size

4. After a series of higher than normal stimulations followed by a rest period, a baseline stimulation to a neuron elicits a greater excitatory post synaptic potential from another neuron that receives it’s projections. This phenomenon is known as: a. kindling b. long-term potentiation c. ischemia d. synaptogenesis

5. Countercoup damage is the result of: a. aneurysm b. infection c. closed head injury d. open head injury

6. What are Piaget’s four stages of cognitive development? Briefly characterize each stage. 7. What evidence is there that motor maps can be modified by experience? 8. What is the difference between an angioma and an aneurysm?