Neuro Exam 3: Attention, Memory, Executive Function, & Language

Dorsal Attention Network (DAN)

Controls top-down, voluntary sustained attention and filters out distractions.

Ventral Attention Network (VAN)

Detects unexpected/salient stimuli and interrupts the DAN (bottom-up/automatic).

Default Mode Network (DMN)

Active at rest; involved in mind-wandering and thinking about past/future.

DAN Disruption

Causes hemispatial neglect, difficulty sustaining focus, and poor topic maintenance.

VAN Disruption

Failure to orient to new stimuli, missed topic shifts, and reduced prosody.

DMN Disruption

Associated with Alzheimer's, Schizophrenia, and ADHD.

Hippocampus (memory)

Supports declarative memory (facts/events) and transfers short-term to long-term storage.

Hippocampus damage (memory)

Alzheimers (new memory affected before old)

Dorsolateral Prefrontal Cortex (memory)

Supports working memory, planning, cognitive flexibility, and monitoring.

Dorsolateral PFC Damage (memory)

Frontotemporal Dementia

Basal Ganglia and Cerebellum (memory)

Procedural memory, implicit, unconscious memory for motor skills and habits.

Basal Ganglia and Cerebellum damage (memory)

Parkinsons and Huntingtons

Anterograde Amnesia

Difficulty making new memories post-injury; often caused by hippocampal damage.

Frontotemporal Dementia (FTD)

Condition where executive function/social cognition are affected before memory.

Executive Function

Manage and direct thoughts

Dorsolateral PFC (EF)

Planning, working memory, cognitive flexibility, and self-monitoring

Orbitofrontal PFC (EF)

Inhibitory control, impulse regulation, and social judgement.

Ventromedial PFC (EF)

Emotional responses, value-based decision-making, and interoception.

Dorsomedial PFC (EF)

Regulates motivation, initiation, self-awareness, and emotional regulation.

Dorsolateral PFC Disruption

Disorganized tangential discourse; perseveration; poor self-monitoring; discourse breakdown with disorganized communication and difficulty following directions

Orbitofrontal PFC Disruption

Causes disinhibition, socially inappropriate comments, and poor judgement.

Ventromedial PFC Disruption

Leads to emotional dysregulation and depression-like symptoms.

Dorsomedial PFC Disruption

Causes reduced verbal output, flat affect, and anosognosia.

Dual Stream Model

Maps sound to meaning (Ventral) and speech sound to movement (Dorsal).

Ventral Stream Model

Maps sounds onto meaning, supports auditory comprehension, and semantic processing.

Ventral Stream Model Organization

Bilateral

Dorsal Stream Model

Maps sound onto motoric production/articulation; fluent speech.

Dorsal Stream Model Organization

Left hemisphere dominant

IFG: Pars Triangularis/Orbitalis

Ventral stream structures where semantic information combines with syntax/working memory.

IFG: Pars Opercularis

Dorsal stream structure for articulatory planning and motor organization.

Ventral Stream Disruption

Results in Wernicke's aphasia and semantic impairments.

Dorsal Stream Disruption

Results in nonfluent aphasia, Broca's aphasia, and apraxia of speech.

Parietotemporal Reading System

Decoding system for word analysis (grapheme to phoneme conversion).

Occipitotemporal Reading System

Word recognition system located in the fusiform gyrus and inferior-posterior temporal areas.

Anterior Reading System

Links reading to speech production/silent reading; located in Broca's area.

Circle of Willis

Safety valve connecting brain blood supplies to ensure continuous flow.

Internal Carotid Arteries

Anterior cerebral and middle cerebral arteries

Basilar Artery

Posterior cerebral arteries

Posterior Communicating Arteries

Connects the Internal Carotid Artery and the Posterior Cerebral Artery.

Anterior Cerebral Artery (ACA) Stroke

Causes contralateral leg weakness, executive impairment, and flat affect.

Middle Cerebral Artery (MCA) Stroke

Causes contralateral face/arm weakness, aphasia (left), and neglect (right).

Posterior Cerebral Artery (PCA) Stroke

Causes contralateral vision loss, agnosia, and memory impairment.

Watershed Zones

Overlap areas (e.g., ACA-MCA) vulnerable to ischemia during blood pressure drops.

Blood Brain Barrier

Mechanism regulating arterial permeability in the Central Nervous System.

Cerebrovascular Accident Stroke

Occurs when the disease process intensifies to an occlusion or hemorrhage (blockage or bleeding of an artery)

Occlusive (blockage) CVA

Embolic is a traveling clot; Thrombotic is local plaque build-up.

Hemorrhage (bleed) CVA

Aneurysm (ballooning of the arterial wall/burst)) or AVM (arteriovenous malformation) (tangle of abnormal blood vessels)

External pressure CVA

Tumor or Intracranial Pressure

Wallerian Degeneration

Degeneration of an axon when it is severed from the cell body.

Glial Scar

Formed by glial cells in the CNS after injury; prevents axon regeneration.

Early LTP

Short-term strengthening; postsynaptic neuron creates more receptors.

Late LTP

Permanent genetic change and growth of new connections via repeated activation.

Neurogenesis

Creation of new neurons; occurs in the olfactory bulb and hippocampus.

Diaschisis

Functional depression of intact brain areas distant from the primary injury.

Neuroplasticity: Salience

Principle stating the training experience must be meaningful to the client.

Neuroplasticity: Transference

Gains in one task influence or support learning in similar tasks.

Neuroplasticity: Interference

Learning a new task can obstruct previously learned behaviors.

Synaptogenesis

Creation of new neural connections

Functional Recovery

Other body parts compensate for damage, not neurological

ACA-MCA watershed

Bilateral shoulder and arm weakness (not face or legs)

MCA-PCA watershed 

Visual processing, language comprehension, sensory processing