Neuroanatomy
Major damage to the temporal lobes would result in problems with which of the following senses most:
Vision or Touch or Hearing?
Hearing.
The temporal lobes house the auditory cortex.
Describe at least 3 domains that the RCFT measures?
VISUAL: immediate memory, delayed memory, attention, executive functions, construction...
Listening and reading are forms of which of the following? Expressive language or receptive language?
Receptive language
Bonus: Give an example of expressive language
True or false: WAIS-IV Similarities subtest measures verbal executive functioning
True
It measures verbal abstract reasoning (among other things)
Is your Pt "fails" validity testing, what does that mean?
They likely did not try their best or put forth good effort
True or False? Since concussions diffusely affect the brain, then executive functioning is more vulnerable to become impaired compared to a patient with a focal stroke.
True
Describe working memory and 1 test that measures it.
Working memory is the ability to recall something WHILE processing something else. One example is digit span backward + sequencing (not forward).
Define verbal fluency and name a disorder that has impaired verbal fluency
Broca's aphasia (other non-fluent aphasias), possibly TBI, stroke, pseudodementia, nonfluent primary progressive aphasias...
Name some behavioral observations to look for that signal the executive functioning in your pt?
(i.e., not test results)
Time of arrival, impulsivity, volition, verbal fluency, strategy when doing tests, social skills, tracking the rules of the tests, frustration tolerance ....
Describe the difference between "symptom" validity and "performance" validity
"Symptom" validity measures self-report testing patterns, such as SX magnification. "Performance" measures mental effort on cognitive testing
A Pt's scores are high on verbal memory but impaired on visual memory. Which brain lobe + hemisphere may be damaged to cause the impairment?
Right temporal lobe
Name a diagnosis that may be applicable if BOTH visual memory and verbal memory scores are impaired?
TBI, dementia, developmental disorders, hypoxic injury .... stroke is less likely
You ask a pt to "stand up," "point to the ceiling," or "pick up the ball". What are you trying to measure?
Receptive language or comprehension ability
Why would it be important to include EF tests in a battery?
Many reasons.. One is EFs are required to do activities of daily living, and problems with EF are very destructive in life; knowing whether EF is intact can inform the diagnosis.
Describe 1 benefit and 1 limitation to using "embedded" validity tests
Benefits: do not add time, resistant to coaching..
Limits: Weaker specificity..
A patient has a left hemisphere stroke which affected Broca's area, the arcuate fasciculus AND Wernicke's areas. Which aphasia would they likely be suffering?
Global aphasia
On the CVLT, there is a 20 min delay before the delayed recall tasks. Describe the kinds of tests you would NOT want to give during that 20 min interference period?
Avoid giving other tests of verbal list learning (or other verbal memory tests) to minimize extra interference effects
Describe the difference between a semantic and a phonemic paraphasic error.
Bonus: Name a test that could reveal these types of errors in a patient's speech
Semantic: Pt says an incorrect word that is semantically related to the target word ("pencil" instead of "pen").
Phonemic: Pt incorrectly pronounces a word by changing a phoneme ("perencil")
A Pt presents with low scores on EF tests. What could you do to determine whether this was due to true executive dysfunction, versus from underlying problems with attention/memory/etc.?
Give tests that specifically only measure attention, memory, etc and not EF. This would help differentiate the source of impairment.
Your dementia patient failed a few effort tests. How would you describe their results in terms of whether they tried their best or not?
Lots of options! A key point would be their presenting disorder has impaired their cognition enough to invalidate the use of the validity testing..