Engelse samenvatting van 3.6. Neuropsychology aan de Erasmus Universiteit Rotterdam. Een uitgebreide samenvatting van de boekhoofdstukken 26, 14, 9, en 13 van Kolb en de artikelen Cantagallo et al. (2012) en Karnath et al. (2012).
Kolb et al. (2015) – Chapter 14, Kolb et al. (2015) – Chapter 9, Cantagallo et al.
(2012)
Agnosia
Kolb et al. (2015) – Chapter 13
Ignored
Karnath et al. (2012)
Stroke
Cantallago et al. (2012)
General
Kolb et al. (2015) – Chapter 26. Neurological disorders
- Responses to stressful events were once considered mainly psychological, but the medical
and psychological communities now recognize that responses characteristic of PTSD can also
trigger physical changes in the brain (e.g., the frontal lobe and hippocampus).
The neurological examination
- People suspected of sustaining a nervous system disorder are examined by a neurologist, a
physician specializing in the treatment of brain injury or dysfunction.
- Takes patient’s history, makes general assessment of patient’s physical condition,
recommends additional tests (EEG or brain scan), compile a case summary.
• The patient’s history
- Ask the patient about the problem; the patient’s background, such as previous diseases,
accidents, and symptoms such as headache, loss of consciousness and sleep disturbances.
- Family background is reviewed, because many diseases (epilepsy) have high familial
incidence.
- While asking about the history, the neurologist observes the mental status evaluation,
behavior, abnormalities or asymmetries, speech abnormalities, and posture.
- Testing of aspects of memory by citing a number of digits and asking the patient to repeat it.
- Ask about handedness, because handedness can be a clue to which hemisphere controls
speech.
2
, 3.6. Neuropsychology
- Additional tests for speech can be given, such as asking the meaning of words or having
words repeated.
• The physical examination
- Using many tools to assess the patient’s nervous system functioning, from basic (e.g., blood-
pressure cuff) to sophisticated imaging technologies.
- Measuring tape: Records head and body size and size of skin lesions.
- Stethoscope: Reveals sounds of the heart and blood vessels.
- Otoscope: Examine the auditory canal and eardrum.
- Flashlight: Elicits pupillary reflexes.
- Tongue depressors: Elicit gag reflex and abdominal and plantar (sole of the foot)
reflexes.
- Vials of coffee (for smell) and salt and sugar (for taste).
- Tuning fork: Tests vibratory sensation and hearing.
- Cotton wisp: Elicit the corneal reflex and test sensitivity to light touch.
- Plastic tubes: Test temperature sensations.
- Pins: Pain sensations.
- Rubber-headed hammer: Elicits muscle stretch reflexes (e.g., knee-jerk reflex).
- Critical part is the examination of the
head (e.g., size, shape, sensory and
motor functioning of its 12 sets of
cranial nerves).
- Motor system is examined and
coordination is tested.
- Generally, all of the muscles are
tested in head-to-foot order.
- Sensory examination includes
investigating sensitivity to painful
stimulation, touch, and temperature,
as well as vibration sense, joint-
position sense, two-point
discrimination, tactile localization,
object identification, and ability to
identify numbers or letters traced on
the skin with a blunt object.
- Suspected nervous system problems
are further investigated with tests of the blood, saliva, and stool, and neural assessment with
EEG, CT scans, and MRI.
- Examining PTSD this way, showed reduced cortical thickness in the hippocampus and
amygdala within the temporal lobes and frontal cortex.
Cerebral vascular diseases
- Vascular problems can affect healthy central nervous system functioning, because blood-
vessel disease or damage can greatly reduce the flow of oxygen and glucose to a brain
region (longer than 10 minutes means dying of that region).
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