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LM Neuropsyc
Methods Lecture Two
| Question | Answer |
|---|---|
| Bedside Assessments can test what four things? | Vision, Attention, Eye movement and Memory |
| Bedside tests for vision test your visual field. In the video the patient us unable to see/respond to stimuli in his right hemifield (wiggling finger). What is the patient diagnosed with? | Blindness for half of his visual field = hemianopia |
| What is the problem with the bedside test for vision? | The doctor may accidently look at what finger he is wiggling so is bias as can give the patient a clue. |
| What is the difficulty with bedside assessments for attention? | It can be hard to distinguish between attention and visual problems |
| How can one determine whether the patient has an attentional problem or a visual problem using a bedside test? | Use the extinction method: give both unilateral stimuli and bilateral stimuli. Patient will get both correct if vision is normal with unilateral. Then wiggle both at the same time and patient will only get one correct if has problem with attention |
| In bedside assessment for eye movements, the patient has trouble following a pen with their eyes. What is the problem with this test? | Hard to know if it is an attention problem or an oculomotor problem. |
| Short term memory example is name 3 cities and then asked to repeat. This is an easy bedside test for memory | .... |
| Long term memory can be bedside tested but what is a problem with this? | It is harder to know what they did last week for example without the assistance from family members |
| Structural Imaging is looking at ONE structure - not __________ | function |
| CT stands for what? | Computer Tomography scan |
| CT scan is an old technology based on what type of technology? | Xray |
| What are the advantages of CT scans? | It is inexpensive and can be used with patients who have metal stuff. |
| With CT scans you end up with ____ images and you put them closer together to look for smaller areas of damage | 2D |
| In CT scans higher density parts (bone) turn out what colour? and lower density parts (ventricles filled with CSF) turn out what colour? | White, darker |
| Stroke is not immediately apparent. First you pick up on behavioural symptoms and then you do brain scan. The first scan does not show damage but 5 days later it does.There is change in ventricles (swelling,pushing into the ventricles)& you end up with... | ....eventually you end up with CSF filled holes |
| 3 days is long enough to see the damage after a stroke | ... |
| When the damage from the stroke has been cleared away, it is filled with _____ so left with a _____ filled hole | CSF, CSF |
| Magnetic Resonance Imaging (MRI) are used when you need to see ________ as it provides better ___________ (fine detail) | detail, resoluation |
| With MRI the magnetic properties indicate different tissue types. | ... |
| You get a 3D concept of the brain by bringing the images together but you cannot have metal devices in the brain such as shrapnel. | .... |
| What are the pros and cons of MRI? | Gives more detail, better resolution, 3D image, but cant have metal in the brain |
| With MRI what can you clearly differentiate between? | Grey and white matter and can pick out small details of structures of the brain such as the genu of the CC, splenium etc. |
| DTI stands for what? | Diffusion Tensor Imaging |
| What does DTI provide a view/image of? and what machine does it use? | The white matter tracts such as axons using a MRI scanner |
| Angiography is a form of what? | Vascular radiology |
| Angiography provides an image of what? | The vascular structure of the brain |
| Angiograms allow the size and location of what? to be evaluated? and are especially valuable in diagnosing abnormalities in ______ ________ | blockages, blood vessels |
| Angiography can be based on different methods such as? | x-ray, computed tomography, magnetic resonance |
| Normally your blood vessels cannot be seen with an x-ray so how do they do we get an angiogram using an xray? | By adding into the blood stream a contrast agent that the x-ray cannot pass through which makes your blood vessels show up on the film |
| What are examples of problems with blood vessels that Angiograms pick up on? | Aneurysm, arteriovenous malformation, narrowing of the arteries, blood clot |
| Functional Assessment of the brain looks at the FUNCTION of the brain | .... |
| Electroencephalography is also called? | EEG |
| EEG provides a recording of the brains.... | electrical activity |
| What picks up on clogged vessels or abnormal vessels causing bleeding? | Angiography/angiogram |
| With EEG electrodes are attached to the surface of the scalp and is used medically to detect abnormal _____ ______ | brain activity |
| What is done to the signal detected by each electrode using EEG? | It is amplified and recorded |
| There are predictable patterns associated with different behavioural states. How is this information used by EEG method? | Can detect when it is an abnormal activity patterns by comparing with the normal activity for that state. Abnormalities could be caused by seizure activities |
| What does TMS stand for? | Transcranial Magnetic Stimulation |
| What does TMS assess? | The integrity of motor pathways |
| With TMS the patient not being able to move left arm may be caused by what? and where do you put the TMS to check this? | Disconnection between hemispheres so put the stimulation in the right hemisphere on the motor cortex where the hand area is to move the left hand. |
| The TMS is a powerful magnetic pulse (really brief output) and is used to check that it is not the motor pathways that are causing the lack of hand movements. So if patient moves hand with the TMS the motor pathways must still be intact. | ..... |
| Electromyography (EMG) records what? | muscle activity/activation of muscles |
| What does PET stand for? | Positron Emission Tomography |
| What does a PET scanner detect? | Radioactive material |
| Participants either inhale or are injected with radioactive material. When this radioactive material enters the bloodstream, it goes to areas of the brain that are....? | metabolically active |
| PET provides a functional view of the brain by measuring regional _________ ________ ________ and can be used to test the integrity of neurotransmitter system such as Parkinsons Disease with dopamine changes | cerebral blood flow |
| You can see age-related changes in domaminergic (dopamine) activity using a __________ method with young and old people. You have the PET data overlaid on _______ _______ such as MRI | DEDUCTION, functional data |
| fMRI is an adaptation of what method? | MRI |
| fMRI records changes related to metabolic activity in successive images in order to produce a functional view of the brain. | .... |
| What is the advantage of fMRI? | It has better spatial resolution than PET and everything else |
| fMRI can be used to look at functional recovery after someone has had a stroke | ... |
| Studies based on lesion locations can have what three types of control groups? | Completely healthy people matched for gender and age, the patients themselves by comparing damaged and nondamaged hemisphere, patients with damage near to ROI but not ROI to show influence of ROI |
| Lesion location studies can be single case studies or group studies. Why do we tend to use single case studies more? (3 reasons) | Patient has a rare lesion site - uncommon ROI is damaged so have one set of data and cant test what was like beforehand (bad as might have been abnormal already. May be rare syndrome so cant get more than one patients. May be post-tremor surgery patients |
| What are the two problems with studies that are based on lesion locations? | Brain vary (e.g. left versus right handers) and the lesion locations vary |
| You can also do studies based on symptoms. Here participants are selected based on whether they exhibit specific symptoms (parkinsons or hemispatial neglect) and the brain areas damaged may vary. So only interested in _______ and not ______ the damage is | symptoms, where |
| What can be used for control group for symptoms based studies? | Age-matched neurologically healthy participants and/or a group with brain damage but without the symptoms of interest. |
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alicemcc33
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