MindMap Gallery 5. Cognitive impairment
Summary of the knowledge framework of the chapter on cognitive impairment in neurology: Cognitive impairment refers to the loss of the ability to complete purposeful complex activities when consciousness, language understanding and motor functions are normal.
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This is a mind map about bacteria, and its main contents include: overview, morphology, types, structure, reproduction, distribution, application, and expansion. The summary is comprehensive and meticulous, suitable as review materials.
This is a mind map about plant asexual reproduction, and its main contents include: concept, spore reproduction, vegetative reproduction, tissue culture, and buds. The summary is comprehensive and meticulous, suitable as review materials.
This is a mind map about the reproductive development of animals, and its main contents include: insects, frogs, birds, sexual reproduction, and asexual reproduction. The summary is comprehensive and meticulous, suitable as review materials.
Cognitive impairment
memory impairment
forget
Unable to recognize and recall the materials and plots that have been recorded, or appear to be erroneous recognition or recall
Anterograde amnesia
Events experienced within a period of time after the onset of the disease cannot be recalled, memory of recent events is poor, new memories cannot be formed, and long-term memories are still preserved.
retrograde amnesia
Inability to recall events at a certain stage before the onset of the disease, loss of past information related to time gradients
memory loss
Memory loss refers to the general decline in memory, retention, recognition and recall. The early manifestations are weakened recall, and later the manifestations are loss of both recent and long-term memory. It is common in Alzheimer's disease, vascular dementia, etc.
memory enhancement
Memory enhancement refers to an abnormal increase in memory for remote events. Patients show that they can recall time and experiences that happened long ago, which is more common in mania, delusions, or overdose of stimulants.
memory errors
memory blurred
Including déjà vu, old things seeming new again, and repetitive memory errors, which are related to the process of memory loss.
hamartia
There are chronological errors in memory, and the events experienced in the past life are attributed to another unrelated period. The patient is not aware of it and firmly believes that what he said is completely correct.
Fiction
Recalling events or experiences that have never happened in the past as real, and being unable to correct errors on your own
visuospatial impairment
Functional impairment caused by the patient's inability to accurately judge the position of himself and objects
executive dysfunction
Inability to establish goals, formulate plans, revise plans, and implement plans to carry out purposeful activities
dyscalculia
Decreased numeracy ability. Simple calculations that were previously possible cannot be made correctly.
Aphasia
It refers to the impairment of speech communication ability caused by lesions in the language functional areas of the cerebral cortex when the mind is clear, the consciousness is normal, and there are no obstacles in pronunciation and articulation.
Classification
(1) Perisylvian aphasia syndrome
1.Broca’s aphasia
Motor aphasia, lesions in the posterior inferior frontal gyrus on the dominant side,
Performance:
The question is hard to answer. Non-fluent aphasia, telegraphic speech, relatively preserved oral comprehension
Common: cerebral infarction, cerebral hemorrhage, etc.
2.Wernicke’s aphasia
Sensory aphasia, posterior superior temporal gyrus on dominant side
Performance:
Severe hearing and understanding impairment, unable to answer questions. Fluent aphasia.
3.Conduction aphasia
Damage to arcuate fasciculus around Sylvian fissure
Fluent aphasia. The hearing and comprehension disorder is milder, and the retelling disorder is more serious than the listening and comprehension disorder, and the two are disproportionate.
(2) Transcortical aphasia syndrome
1. Transcortical motor aphasia
Non-fluent aphasia and complete rehearsal function. Cerebral infarction in the watershed area of the frontal lobe on the dominant side is more common
2. Transcortical sensory aphasia
Fluent aphasia, complete retelling function, but unable to understand the meaning of retelling. Cerebral infarction is more common in the watershed area of the temporal and parietal lobes on the dominant side
3. Transcortical mixed aphasia
Good at retelling, other severe impairments in language function
(3) Complete aphasia
(4) Naming aphasia
Fluent aphasia. Posterior middle temporal gyrus lesions on the dominant side.
(5) Subcortical aphasia
Thalamic aphasia:
Damage to the thalamus and its connecting fibers results in varying degrees of mutism and silence in the acute phase. Later, speech communication and reading comprehension will be impaired, and speech fluency will be impaired. Retelling function may be preserved.
Aphasia caused by damage to the internal capsule and basal ganglia:
Reduced verbal fluency, slow speech rate, difficulty in understanding, and impairment in reading and retelling
Mental status and advanced cortical function examination P103
memory
①Instant memory check method
The Anterograde Digit Span Test is used to measure attention and transient memory.
The retrograde digit span test asks the patient to speak a given sequence of digits backwards. This is a more complex test that requires the ability to store and process digits.
②Short-term memory check method
Patients who recall with the help of reminders or vocabulary lists may be able to retain information but have retrieval difficulties; patients who recall information with the help of reminders or vocabulary lists may have storage impairments. Patients with early-stage dementia may only exhibit retrieval impairment.
③Long-term memory check method
Including basic knowledge learned in school, such as the country's capital and famous figures; current information such as the current president, prime minister and related public figures; one's own related information, such as home address and phone number, etc.
computing power
Orientation
It is divided into time orientation (day of the week, year, month, day, season), location orientation (the location of the hospital or home) and person orientation (whether family members and familiar people can be recognized). This test requires the patient to concentrate.
Aphasia
①Oral expression
(1) Speech fluency:
Fluent speech and non-fluent speech.
(2) Speech disorder:
Whether the speech is slurred without any obstacles in pronunciation and vocal organs, and whether it affects the pitch and rhythm.
(3) Difficulty finding words:
Do you have difficulty recalling appropriate words when speaking, or do you take longer to find words?
(4) Paraphrases, new words, meaningless gibberish and stereotyped speech:
① Words with phonetic or semantic errors;
②Meaningless newly coined words;
③A string of sounds or words whose meaning is completely unclear;
④ Stereotyped and continuous repetition of the same, meaningless words, phrases or sentences.
(5) Grammatical barriers:
①Aphasia: often manifested by the lack of grammatical function words in the sentences expressed, typically in telegraphic language;
② Grammatical confusion: manifested in the misuse of particles or the order of word positions that does not conform to grammatical rules.
②Difficulties in listening and understanding
③Retell
④Naming
⑤Reading
⑥Writing
apraxia
agnosia
visual agnosia
auditory agnosia
tactile agnosia
Body image agnosia is also a type of agnosia
Skills and executive functions
Draw a clock
dementia
Acquired and persistent mental impairment syndrome due to brain dysfunction
1. Impairment in two or more cognitive domains 2. Daily or social abilities are significantly reduced 3. May be accompanied by mental and behavioral abnormalities
mild cognitive impairment
An intermediate state between normal aging and dementia, a cognitive impairment syndrome
amnestic mild cognitive impairment
Simple memory impairment type
Impairment in multiple cognitive domains
non-amnestic
Memory function retained
1. Decline in cognitive function 2. Retention of basic daily abilities
agnosia
The patient has no visual, auditory or somatosensory impairments and cannot recognize familiar things in the past when his consciousness is normal.
Classification
Visual agnosia: lesions located in the occipital lobe
Auditory agnosia: The lesion is located in the middle part of the bilateral superior temporal gyrus and its auditory connection fibers
Tactile agnosia: lesions are located in the angular and supramarginal gyrus of the parietal lobe
Body image disorder: lesions located in the parietal lobe of the non-dominant hemisphere
The patient's basic perceptual function is normal, but he loses the ability to distinguish the existence, spatial position and relationship between parts of his own body.
clinically possible
①Hemi-neglect:
②Insufficiency of illness
③Finger agnosia
④Inability to recognize oneself
⑤Phantom limb phenomenon
apraxia
It refers to the patient’s loss of the ability to complete purposeful complex activities under conditions of clear consciousness, normal language understanding and motor functions.
Classification p68
➢Ideational apraxia
➢Ideomotor apraxia
➢Apraxia of limb movement
➢Structural apraxia
➢Apraxia of dressing