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Clinical Neuropsychology Literature Summary

Name: Clinical Neuropsychology Literature Summary
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Author: charlykeen

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Clinical Neuropsychology

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Universiteit Leiden (UL)

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CLINICAL NEUROPSYCHOLOGY
SPECIALISATION SUMMARY
Fundamentals of Human Neuropsychology, 7th Edition

2017/2018
INTERNATIONAL BACHELOR IN PSYCHOLOGY (IBP)

,Nervous System Organization

Stroke: interruption of blood flow to the brain, kills brain cells
Ischemia: deficient blood flow to the brain (functional constriction of a blood vessel by a clot)
Third-leading cause of death in U.S., leading cause of long-term disability
Haemorrhagic stroke: burst vessel bleeding into brain – administer drug t-PA (tissue plasmogen
activator) within three hours
Brain is plastic – can undergo enormous changes during a person’s life span
Ipsilateral: lie on same side,
Contraleral: opposite sides, bilateral: one in each hemisphere
Proximal/distal
Afferent: movement toward a brain structure
Efferent: movement away
Precentral gyrus/ motor-/ Jackson’s strip = primary motor cortex/ M1
Nervous system: Central NS (brain and spinal cord) and peripheral NS (autonomic NS –
sympathetic/parasympathetic)
CNS lies within bony encasements, PNS more vulnerable to injury but can renew itself
Meninges: triple-layered set of membranes (dura mater, arachnoid membrane, pia mater)
Cushioned from shock and sudden pressure changes by cerebrospinal fluid (CSF)
Hydrocephalus (‘water brain’): blocked channel outflow, congenital condition
Blood-brain barrier: protects from toxic substances and infection
Four arteries connect at the base of the brain, where they enter the skull
Brain originates in single, undifferentiated neural stem cell (germinal cell), extensive capacity for self-
renewal
In developing embryo: stem cell -> progenitor cells (migrate and act as precursor cells) -> nondividing
primitive nervous system cell types (blasts)
• Sensory neurons: simplest sensory receptor = bipolar neuron (retina)
o Somatosensory neuron: sensory receptor to spinal cord
• Interneurons: link up sensory and motor-neuron activity in CNS
• Motor neurons: ‘final common path’ – all behaviour produced by brain is produced through
them
Glial cells:
• Ependymal: line brain’s ventricles and make CSF
• Astroglia (star-shaped): structural support and nutrition to neurons
• Microglia (tiny glia): fight infection and remove debris
• Oligodendroglia (few branches): insulate neurons in the CNS
• Schwann cells: insulate sensory and motor neurons in the PNS (myelin)
Grey matter: capillaries and neuronal cell bodies (cortex)
White matter: axons, myelin composed of same fatty substance (lipid) that gives milk its white
appearance
Reticular matter (rete = net): mixture of cell bodies and axons
Groups of cell bodies in CNS: layers or nuclei (clusters), in PNS clusters are called ganglia
Fibers and fiber pathways that enter and leave the CNS = nerves, once they enter the CNS = tracts
Developing brain originates as a three-part structure:
• Prosencephalon (front brain): olfaction
Anterior -> cerebral hemispheres (telencephalon – endbrain)
Posterior -> Thalamus (diencephalon – between brain)
• Mesencephalon (middle brain): vision and hearing
• Rhombencephalon (hindbrain): movement and balance
-> Metencephalon (across brain) cerebellum and myencephalon (spinal brain)
Ventricles (‘bladders’) 1-4: lateral = C-shaped lakes (1,2)
Cerebral aqueduct: connects third and fourth ventricles
Each body segment forms a ring (dermatome – skin cut)
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,Outer cord consists of white matter tracts, interior = grey matter, shape of a butterfly
Bell-Magendie law: Ventral anterior portion of each spinal segment = motor, dorsal posterior =
sensory
Afferent spinal nerve fibre converges -> posterior root
Efferent -> anterior root
Cutting dorsal roots: loss of sensation, cutting ventral roots: loss of movement
Paraplegic: cut below cervical segments, no longer have control over their legs, if cut is higher, unable
to use arms as well (quadriplegic)
Spinal cord injury: sever connections between the cord and the brain. Damage in the cord takes hours
to days to develop. Spinal cord’s neural circuits produce reflexes (specific forms of movement elicited
by specific forms of sensory stimulation) – stepping, postural support, bladder control.
Pain and temperature fibers are smaller, touch and muscle sense larger
Flexion reflexes: away from injury, extension reflex: maintains contact
Twelve pairs of cranial nerves: signals to and from the head
ANS regulates internal organs and glands without our conscious awareness
Sympathetic nervous system arouses body for action, parasympathetic calms the body down
Spinal cord connected to a chain of autonomic control centres (sympathetic ganglia) – primitive brain
Sacral region: parasympathetic connects directly to spinal cord
Vagus nerve calms most internal organs, facial nerve controls salivation, oculomotor nerve controls
pupil dilation and eye movements (three cranial nerves)
Parasympathetic ganglia near target organs
Referred pain: pain in inner organs perceived as coming from outer parts of dermatome

Brainstem
• Hindbrain:
o Cerebellum: surface gathered into narrow folds/ folia, contains about four times more
neurons than the cerebral cortex, motor coordination and motor learning. Damage:
equilibrium problems, postural defects, impairments of skilled motor activity
o Reticular formation: maintains general arousal/ consciousness -> reticular activating
system. Damage: permanent unconsciousness
o Nuclei within the pons bridge inputs from the cerebellum to the rest of the brain.
Tip of spinal cord: medulla: vital functions (breathing, functioning of the cardiovascular
system
• Midbrain: posterior sensory component = tectum (roof): superior colliculi (receive projections
from retina), inferior colliculi (receive projections from the ear) -> locating objects in
surrounding space and anterior motor structure = tegmentum (floor): red nucleus controls
limb movements, substantia nigra connects to forebrain – rewarding behaviours (approaching
desired objects), periaqueductal grey matter (PAG): controls species-typical behaviours and
modulates pain responses
• Diencephalon:
o Hypothalamus: (lower room): interacts with pituitary gland – endocrine functions,
take part in nearly all aspects of motivated behaviour
o Thalamus (chamber): 20 nuclei, each projecting to a specific area of the cerebral
cortex, serves a hub
o Epithalamus (upper room): pineal gland (secretes melatonin during the dark – feeling
of tiredness, daily and seasonal body rhythms) & habenula (regulates hunger and thirst)
Forebrain
• Basal ganglia (knots below the cortex): collection of nuclei that form a circuit with the cortex:
putamen – shell, globus pallidus – pale globe, caudate nucleus – tailed nucleus
Play a role in controlling and coordinating movement patterns, not in activating the nucleus
Excessive movement – Huntington’s: basal ganglia cells die progressively – chorea, Tourette’s
Loss of movement – Parkinson’s: loss of connections in and out of the basal ganglia
Supports associative learning (stimulus-response/ habit learning)
2

, • Limbic system: older cortical structures – limbic lobe/ reptilian brain
Self-regulating behaviours
o amygdala (almond): emotion
o hippocampus (seahorse): personal memory
o cingulate (girdle) cortex: social interactions
Receives projections from the olfactory bulbs – rhinencephalon/ smell-brain, hippocampus
contains many receptors for stress hormone corticosterone
• Neocortex: cortex = any outer layer of cells, 2500 square centimetres, 1.5-3mm thick, six
layers (grey matter), heavily wrinkled
Cerebral hemispheres separated by longitudinal fissure and cingulate sulcus
A cleft is called a fissure if it extends deeply enough into the brain to indent the ventricles, sulcus if
shallower. A ridge is called a gyrus.
Occipital – vision, temporal – audition, parietal – body senses, frontal – motor functions
Primary areas: receive projections from the major sensory systems/ send motor projections to the
muscles, small relative to neocortex’s size
Secondary areas: adjacent to primary areas, elaborating info
Tertiary areas/ association cortex: all cortex not specialized for sensory/ motor function – mediate
complex activities, re-entrant connections
Neurons in neocortex arranges in six layers
• V & VI send axons to other brain areas – large size typical of cells that send info over long
distances
• IV receive input from sensory systems and other cortical areas, stellate neurons – granular
cortex (grainy appearance)
• I, II, III receive input from layer IV
Cytoarchitectonic (cell) maps – Korbinian Brodman (1909), the numbers of Brodman’s map have no
special meaning
Homotopic paints: correspond to each other in the brain’s mirror image structure, commissures act
as zipper, linking together the representations of the world formed in each hemisphere
Brainbow & Clarity – brain structure
For humans, 50% of optic fibres from each eye project to the opposite hemisphere
Crossings (decussations) – damage to a hemisphere produces symptoms related to perception and
movement on the opposite side of the body

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