NEUROPSYCHOLOGY DR.SCULLY FALL 2025 - MIDTERM 1

neuroanatomy

anatomy of nervous system

nuclei

groups of neurons in the CNS

tracts

groups of axons (long cable that sends signals away from cell body) within the CNS

rostral- caudal

• nose to tail axis of body— cut along the hairline, only see one hemisphere at a time

dorsal-ventral

• back to front axis of the body (top of head to neck)— see both hemisppheres at the same time

medial-lateral

• middle to edge (ear to ear)— cut perpendicular to hairline

ipsilateral

structures on the same side of the body

contralateral

structures on opposite sides of the body

proximal

structures that are close together

distal

structures that are far apart

afferent

movement toward the CNS

efferent

movement away from the CNS

CNS

spinal cord and brain

• protected by bone

PNS

projects out of the body

• somatic nervous system (voluntary actions)

• autonomic nervous system (non-voluntary)

  • sympathetic and parasympathetic

How is the CNS protected

• through bone —> skull, vertebral column

• meninges (3 layers)

meninges

• dura mater

• arachnoid mater

• pia mater

dura mater

tough outer covering

arachnoid mater

• weblike structure that connects inner and outer layers

  • spongy layer—> blood vessels, CSF

pia mater

tough inner layer that adheres to the surface of the brain

• tough thin layer, saran wraps around brain and spinal cord

• helps brain hold shape

CSF

• fills the spaces in and around the meninges to absorb shocks and carry away waste

blood-brain barrier

• provide chemical protection

• formed by astroglia holding the cells of the blood vessels tightly together

• regulates what molecules can exit the blood supply to enter the brain

blood supply

• Arteries branch to form smaller arteries, delivering blood to specific parts of the brain

• ensures that damage to a single blood vessel would not interrupt flow to the brain

stroke

interruption of blood supply, through a blocked or burst artery

how are glia cells formed

start as neural stem cells which then divide, give rise to neuroblast cells, that turn into neurons, then glioblasts which then differentiate to form ___

sensory neurons

• transduce info from the enviornment

• has one dendrite and one axon

• sends to motor neuron

interneuron

• connects snsory and motor neurons within CNS

• extensive branching of dendrites to gather info

motor neuron

• found in brainstem and spinal cord

• project to muscles to carry out movement

ependymal cell

secretes CSFa

astrocyte

star-shaped, symmetrical; nutritve and support function

oligodendroglial cell

asymmetrical; forms insulating myelin around axons in brain and spinal cord

• many branches

• CNS

Schwann cell

asymmetrical; wraps around periphral nerves to form insualting myelin

• flat blanket

• PNS

grey matter

• outer part of cortex

• contains cell bodies and capillaries that supply them with blood

• where information is processed (ex. perception, sensation, movement control, memory and leanring, deision making and emotions)

(NOT ON TEST)

white matter

• underneath the cortex

• the myelinated axons that connect with other parts of the brain

• function is to connect different brain rgions so they can communicate quickly and efficiently

(NOT ON TEST)

reticular formation

• found in the brainstem

• netlike appearnce that is a mix of grey and white matter

• role in consciousness, attntion, and arousal (alertness and arousal)

(NOT ON TEST)

Prosencephalon

creates forebrain

• divides to form telencephalon (cerbral cortex, basal ganglia, and limbic system) and the diencephalon (thalamus and hypothalamus)

mesencephalon

becomes midbrain

• connects higher brain areas (forebrain) with lower (hindbrain and spinal cord)

Rhombencephalon

creates hindbrain

• divides to form metencephalon (pons and cerebellum) and the myelencephalon (medulla oblongata)

ventricle

fluid-filled cavity (CSF) that helps protect and support the brain

Spinal Cord

• surrounded by white matter

• nerve roots branch out from to carry motor commands to body and conduct sensory info to CNS

what are the segments of spinal cord

cervical, thoracic, lumbar, sacral

spinal nerves

wiring that connects spinal cord to rest of body

• allows communication between brain/ spinal cord and your body

• carry sensory info up and motor commands down

• dorsal (sensory) root and ventral (motor) root

spinal reflexes

• generated in the spinal cord based on posterior sensory input making a direct connection onto the anterior motor output pathways

• can make decisions that affect other things connected to spinal cord

cranial nerves

nerve branches from brain and brainstem to provide snesory and motor innervation (supply of nerves) to head

• talk directly to brainstem rather than spinal cord

• some afferent (sensory), some efferent (motor)

autonomic nervous sytem

involved with involuntary actions, interacts with internal organs and glands

• 2 divisions sympathetic and parasympathetic

sympathetic branch

• fight or flight response

• ______ ganglia are close to the spinal cord (act quick)

(NOT ON TEST)

parasympathetic branch

• calms body down (rest and digest)

• ______ ganglia near target organ (takes longer)

(NOT ON TEST)

brainstem

extends from where spinal cord enters the skull to forebrain

• includes cerebellum, pons, medulla

cerebellum

important for motor control and sensory integration (mini brain)

pons

connects cerebellum with the rest of the brain

medulla

regulates functions such as breathing and heart rate

midbrain

contains tectum and tegmentum and surrounding cerebral aqueduct

tectum

within midbrain

• posterior aspect of midbrain

• superior colliculi relay visual info

• inferior colliculi relay auditory info

tegmentum

within midbrain

• anterior aspct of the midbrian

• nuclei are involved in motor control, including substantia nigra and red nucleus

diencephalon

connects brainstem to the brain

• includes thalamus, hypothalamus, and epithalamus

thalamus

infromation relay station

• nuclei relay sensorty info ro cortex, others relay info between cortical regions, others relay info form cortex to brainstem

hypothalamus

• many nuclei influences a wide rnage of behaviours (influence behvaiours through hormones)

• produces and releases many hormones that influence the entire body

telencephalon

comprised of neocortexx, basal ganglia, and limbic systemba

basal ganglia

important for motor control and learning

• incudes putamen, causate nucleus, and globus pallidus

• integrates sensory and motor info to produce fluid

• associative learning (stimulus-response pairing)

limbic system

important for spatial and emotional functions

• amygdala, hippocampus, cingulate cortex

amygdala

• in limbic system

• small nuclei in medial temporal lobes

• important in emotion and understanding emotion in others

hippocampus

• in the limbic system

• seahorse-shaped structure in the medial temporal lobe

• important for personal memories and navigation

cigulate cortex

• in limbic system

• arcs over latral venticles

• involved in decision making and executive functions

neocortex

• Outer layer of the forebrain

• Only 1.5–3 mm thick and includes six layers of cells

• Divided into two hemispheres by the longitudinal fissure

• Four lobes have different functions

primary areas

recieve projections directly from sensory systems or project directly to muscles

secondary areas

located near primary areas and do more elaborate processing of the info

• interpret inputs or organize movements

• intermediate between primary and tertiary

tertiary areas

integrate info across senses to coordinate cognitive functions and behvaiours

• accessory areas

cortical connections

Long-range connections between cortical areas enable the coordination of high-level behaviors (not all are myelinated)

• between differnet lobes, 2 hemispheres, through thalamus

clinical role of neuropsychology

not just diagnose the disorder bur also rehabilitation of patient

Houston Guidelines

1. assessment

2. treatments and interventions

3. consultation (patients, family, medical colleagues, etc.)

4. research

5. teaching and supervision

explain the steps of the houston guidelines

1. informtion gatherinf, history taking, treatment planning

2. implementation of the plan, specification of intervention targets, assessment of outcome

3. Effective basic ommunication, comuniction of evlaution results and recommendations, education patients and families regarding services snd disorders

4. Review of relevant literature, design of research, monitoring of progress, communication of results

5. Methods of effective teaching, plans and design of courses and curriculums, use of effective educational technologies

standardized tests

assess organicity, typical behaviour that has a biological basis

• quantitative

• figures out which part of the brain is repsonsible

individualized test

requires knowledge of the underlying theory

• qualitative

• understand patients’ strengths and weaknesses to administer

Boston Approach Battery

1. intellectual and Conceptual functions

2. memory functions

3. language functions

4. academic skills

5. self control and motor functions

explain 3 of the aspects of the noston approach battery

• Intellectual and conceptual functions

  • Weschlers Adult intelligence scale IV

  • ravens standardizes progressive matrices

  • proverbs test

• memory functions

  • weschler memory scale IV

  • rey auditory verbal learning test

  • rey complex figure test

• language function 

  • narrative writing sample

  • tests of verbal fluency

  • automobile puzzle

Commonly Assessed Categories

1. abstract reasoning and conceptualization

2. attention

3. daily activities

4. emotional or psychological sistress

5. language

6. memory

7. motor

8. orientation

9. sensation and perception

10. visuospatial

explain 3 of the most commonly assesd categories

• attention

  • selective, sustained, shifting, neglect

• language

  • receptive or expressive speech, aphasia 

• memory

  • verbal, visual, working 

Core Features of Assessment

1. collaborative

2. assess early

3. developmetal history

4. comorbidities

5. subjective complaints

6. maximize potentials

7. not for everyone

8. limitations

9. adequate intervals

10. transpaarency

explain 3 of the core features of assessment 

Laterality

the 2 hemispheres have seperate functions

• relative not absolute

• affected by environment and genetics

left hemisphere is specialized for…

language and controls right side of body

right hemisphere is specialized for…

nonverbal communication and controls left side of tth ebody

double dissociation

double casse study is when they take 2 individuals that injure the same area but on different hemispheres and compare functionality before and after

commissurotomy

cuts the corpus callosum and the anterior commissure to prevent the spread of the seizure activity

in split brain patients what happens when info is presented to the LEFT hemisphere (right visual field)

• the patient can name and describe it

• intepretes the respsonse of the left hand and makes up a reason

in split brain patients what happens when info is presented t the RIGHT hemisphere (left visual field)

they can verbally report seeing nothing, but can idneify the object with left hand

what happes wit facial recognition in split brain patients

The person identified in the left visual field was more often processed correctly

- face recognition more prominent in right hemisphere

- Language mainly on left hemisphere

(NOT ON TEST)

Wada Test

Injecting sodium amobarbital into the carotid artery will briefly anesthetize the ipsilateral hemisphere, and clinicians can check for impairments of speech and language, along with other cognitive functions

• confirms which hemispher language is located

(NOT ON TEST)

kimura dichotic listenigng model

Each hemisphere gets an auditory stimulus, then it is switched

• Found that in the left ear music, environment noises and emotion is easier to process and identify. In the right ear tone and language

• No difference for vowels or none melodic tones

(NOT ON TEST)

asymmetry in somatosensory system

• almost cpmpletely contralateral

• right-hand advantage for recognizing letters and a left-hand advantage for recognizing other shapes

apraxia

loss of skilled fine movements

when showing emotions…

left is more expressive, emotions are shown more strongly on the left but faster on the right side

what does laterality studies tell us

• Many of these studies are indirect measures of brain function

• Results are subject to interpretation

• Some laterality effects, such as dichotic listening, can be negated by telling the subject to focus on verbal information presented to the left ear

• Many researchers encourage skepticism when looking at the field of laterality research

specialized theory of lateralization

• suggest that differnt hemisheres have unique functions

• left hemisphere is specialized for fine motor control, and speech requires very detailed motor control

• speech is localized to the left hemisphere because of the need for motor control

interaction theory of lateralization

• sugget that one hemisphere may be better ata task, but the two cooperate in performing the task

• Two hemispheres both work on different parts of processing at the same time

• Both hemispheres may have the ability to perform the task, but one inhibits or suppresses the activity of the other

preferred cognitive mde

• Individual differences will cause people to use one type of thought process instead of another

• Some people prefer logic and math, others prefer looking at the big picture

• biases in how individuals approach problems,

difference of sylvian fissure on left vs. right handed indiviudals

the differnce is greater in individuals with language on the left side of the brain

(NOT ON TEST)

in right-handed people why does the pyramidal tract contain more fibres than the tract to left hand

need for specific fie motor movement, less connection needed for non dominant hand

who is more likely to be bilateral

left handed individuals

anatomical theories of hand preference

• left hemisohere shows enhanced maturation and greater development

  • left hemsphere controls right hand

hormonal theories of hand prefernce

• exposure to different levels of testosterone early in life could impact cerebral organization nd asymmetry 

• testosterone is typically inhibitory on development 

  • Geschwind and Galaburda proposed that testosterone acts on the left hemisphere, leading to greater development of the right hemisphere and left-handedness in some individuals