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NUR 111
Cognition lecture notes
| Question | Answer |
|---|---|
| What is cognition primarily controlled by? | The brain |
| What lobe is behind the forehead? | Frontal lobe |
| Where are the motor and sensory cortices found? | Between the frontal and parietal lobes |
| What does the motor cortex control? | Movement |
| What does the sensory cortex control? | Sensation |
| Where is the parietal love located? | Behind the frontal lobe, at the back of the brain, above the ears |
| What role does the parietal lobe play? | Our ability to understand spatial relationships (ex: the distance between 2 objects) |
| Importance of temporal lobes | Holds the bulk of our memories and contains Broca’s area and Wernicke’s area |
| Where is the occipital lobe located? | The very back of the head, behind the parietal lobes |
| What is the occipital lobe responsible for? | Vision |
| Damage/ injury to the occipital lobe can result in? | Partial or complete blindness |
| What does the cerebellum control? | Coordination of movement |
| Pts with damage to the cerebellum have… | Ataxia |
| What is ataxia? | Lack of muscle control or coordination of voluntary movements (walking, picking up objects, etc) |
| What does the pituitary gland do? | Regulates the body’s hormones |
| List 8 hormones the pituitary gland regulates | Adrenocorticotropic hormone (ACTH) Follicle-stimulating hormone (FSH) Luteinizing hormone (LH) Growth hormone (GH) Prolactin (PRL) Thyroid-stimulating hormone (TSH) Oxytocin Antidiuretic hormone (ADH) |
| Mnemonic for the 8 hormones the pituitary gland regulates | ACTing FSHy, Let’s Go Party, Take OXY & Diuretics |
| Adrenocorticotropic hormone | Stimulates the production of cortisol, a “stress hormone” that maintains B/P and blood sugar |
| Follicle-stimulating hormone | Promotes sperm production and stimulates the ovaries to produce estrogen |
| Luteinizing hormone | Stimulates ovulation in women and testosterone production in men |
| Growth hormone | Helps maintain healthy muscles and bones and manage fat distribution |
| Prolactin | Causes breast milk to be produced after childbirth. ALSO affects the hormones that control the ovaries and testes, which can affect menstrual periods, sexual functions, and fertility |
| Thyroid-stimulating hormone | Stimulates the thyroid gland, |
| What does the thyroid gland do? | Regulates metabolism, energy, and the nervous system |
| Oxytocin | Helps labor to progress, causes breast milk to flow, affects labor, breastfeeding, behavior, social interaction, and the bonding between a mother and her child |
| Antidiuretic hormone | Regulates water balance and sodium levels |
| Another name for Antidiuretic hormone (ADH) | Vasopressin |
| What does the brain stem control? | Controls breathing, heart rate, and conscious level |
| What is the function of cerebral spinal fluid? | Acts as a cushion Circulates nutrients and chemicals filtered from the blood Removes waste products from the brain |
| Where can CSF be found? | The ventricles of the brain (also in the central spinal canal and the subarachnoid space) |
| What is attention? | The ability to stay alert and aware to focus on a stimulation and prioritize it |
| What are some alterations in attention? | Cognitive disorders like Attention Deficit Disorder Stress and Anxiety Acute illness |
| What is a learning disability? | It impacts a person’s ability to meet their full potential, brain variations could be genetic or environmental |
| What is the IQ of someone with a learning disability? | Average IQ |
| What do people with learning disabilities also have issues with? | Social cognition, executive functioning, memory, processing speed, attention, and motor coordination |
| Examples of learning disabilities | Dyslexia, dyscalculia, dysgraphia |
| What is an intellectual disability? | Result from a prenatal error in the CNS development, or external factors that damage the CNS, or pre / postnatal changes in a person’s biological environment |
| What is the IQ of someone with an intellectual disability | Low = 70-75 or below |
| 3 examples of intellectual disabilities | Down syndrome, Fragile X syndrome, and fetal alcohol syndrome |
| What is Down syndrome? | Intellectual disability where there is an alteration to the individuals 21st chromosome |
| What will 50% of children born with Down syndrome have? | A congenital heart defect |
| What does Down syndrome increase your likely hood to have | Hearing loss, GI blockages, celiac disease, vision problems, thyroid disease, skeletal abnormalities, orthodontic problems, leukemia, and dementia |
| What is the expected life span of someone with Down syndrome? | About 60 years |
| What is Fragile X syndrome? | Results from a single recessive abnormality to the X chromosome, resulting in an intellectual disability and delayed development (late to sit, stand, walk, etc) |
| In fragile X syndrome, what is the intellectual disability typically accompanied by? | Attention Deficit Hyperactive Disorder (ADHD) |
| What is fetal alcohol syndrome? | Preventable condition caused by maternal alcohol consumption during pregnancy, manifests in growth defects, facial abnormalities, and CNS abnormalities |
| TRUE OR FALSE: A pregnant woman can have a drink every so often as long as it is only one drink | FALSE, it is not safe to drink any amount of alcohol during pregnancy |
| Pathophysiology of fetal alcohol syndrome | Alcohol crosses the placenta and the fetal liver cannot process it , so the fetus has the same blood alcohol content as the mother |
| Global rate of alcohol consumption in pregnant women | 1 in 67 women |
| What 3 populations are at greatest risk for cognitive impairment? | Older adults Women with poor health status, dependency, lack of social support, or insomnia Men with history of stroke or diabetes |
| Personal behaviors that increase risk for cognitive impairment | Substance abuse Participation in high risk activities Accidental injuries |
| Environmental exposures that increase risk for cognitive impairment | Lead, pesticides |
| Congenital conditions that increase risk for cognitive impairment | Maternal substance abuse, birth injuries (cerebral palsy), chromosomal abnormalities (Down syndrome, fragile X) |
| Genetic conditions that increase the risk for cognitive impairment? | Phenylketonuria, galactosemia, Huntington disease |
| What is phenylketonuria? | Rare inherited disorder that causes an amino acid (phenylalanine) to build up in the body Causes intellectual disability, seizures etc |
| What is galactosemia? | Occurs when an enzyme called galactose-1-phosphate uridyltransferase (GALT) is missing or not functional, GALT is the enzyme that breaks down galactose into glucose |
| What is Huntington disease? | An inherited disorder that causes nerve cells (neurons) in parts of the brain to gradually breakdown and die, can effect areas of the brain that control voluntary movement |
| Comatose on GCS scale | 8 or less |
| Totally unresponsive on the GCS scale | 3 |
| 5 words to describe level of consciousness | Alert, lethargic, obtunded, stuporous, comatose |
| What is lethargic? | Generally refers to a low amount of energy, sluggish and/or apathetic |
| What is obtunded? | Depressed level of consciousness and cannot be fully aroused; difficult to arouse |
| What is stuporous? | Unable to be aroused from a sleep-like state, may still mumble words or move when stimulated |
| What is comatose? | Unresponsive |
| how can a brain CT or MRI scan help us assess a patient for cognitive impairment? | Looks for structural or functional abnormalities (tumors, bleeds, ischemia, hydrocephalus) |
| How are IQ tests used to assess a pt for cognitive change? | Used to distinguish between learning disabilities and intellectual disabilities |
| What does the Confusion Assessment Model (CAM) scale assess? | Assesses for delirium |
| What is the Mini Mental State Exam (MMSE)? | A standard cognitive assessment tool that provided 11 cognitive tasks to assess attention, language, memory, orientation, and visuospatial proficiency |
| What does a low Mini Mental State Exam score mean? | The lower the score, the more severe the cognitive impairment is |
| Why is important to use the geriatric depression scale? | Depression can present as a cognitive impairment or cause cognitive impairment |
| List 6 consequences of cognitive impairment | -increased risk for injury -complicates disease management -decreases ability to perform ADLs -increases need for assistive services/devices -financial hardship -caregiver burden |
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