Tutorials

By Dr Sharon Truter

To the Tutorials

By Dr Sharon Truter

What to expect from the Tutorials What to expect from these tutorials

Outlines, structure, guided reading, explanations, mnemonics

Begin with anatomy.

Final tutorial: Articles and aspects important for practicing as a neuropsychologist but not part of required learning for exam (court work & working with other disciplines)

Pathology covered with anatomy

Reading to be received after each tutorial

Additional Information What is SACNA? What is NeuropsychologySA? The SACNA exam

Cost Dates of exams Associate membership Contact Frances Hemp for more information:

franhemp@yebo.co.za

Additional information Linked-In group Study groups Contact me regarding questions

Study Tips ±15 Hours a week of study.

Start with Kolb.

Anatomy of Lezak: Use as revision.

Laminate pg. 53 of Kolb book.

Make use of Latin and Greek references on website Latin and Greek for Neuropsychologists: Part 1 Neuroanatomy

Latin and Greek for Neuropsychologists: Part 2 Neuroanatomy

Read: Sage advice from Successful SACNA Examinees

Summaries available: Didi at creativepromotions@webmail.co.za.

The Skull, Meninges and Blood Supply

By Dr Sharon Truter

By Dr Sharon Truter

Skull

Falx

Cribriform Plate

Pathology: Base of Skull/Basilar Fracture

Typically involving the temporal bone, occipital bone, sphenoid bone, and/or ethmoid bone.

Also anterior bones.

Such fractures can cause tears in the meninges, with resultant leakage of the cerebrospinal fluid (CSF).

CSF may dribble out through a perforated eardrum (CSF otorrhea), into the nasopharynx (causing a salty taste), or drip from the nose (CSF rhinorrhea)

Battles Sign

Bilateral Raccoon eyes

Base of Skull Fracture

Battle’s sign (William Henry Battle)

Bilateral raccoon eyes

CT Scan of Basilar Skull Fracture

By Dr Sharon Truter

Meninges

Meninges

Pathology: Meningitis Inflammation of meninges (-itis = inflammation) Caused by viruses, bacteria or other micro organisms. Common symptoms:

Headache Neck stiffness Fever Confusion or altered consciousness, Vomiting Photophobia and phonophobia

A lumbar puncture diagnoses. Meningitis can lead to serious long-term consequences such

as: deafness, epilepsy, hydrocephalus and cognitive deficits

Pathology: Epidural and Subdural Haematoma

Pathology: Subarachnoid haemorrhage

Scalp Haematoma

Scalp Haemtoma Occur on the outside of the skull between the bone and

the skin of the scalp.

There are numerous layers to the scalp and the hematoma may be located in any of those layers.

While a scalp hematoma cannot press on the brain and cause symptoms, it is a signal that a head injury has occurred and there may also be underlying brain injury. This is especially true for neonates and infants.

By Dr Sharon Truter

Arteries and Veins

Arteries Veins

Cerebral Arteries

Anterior Cerebral Artery Middle Cerebral Artery Posterior Cerebral Artery

Blood Flow ACA = Anterior cerebral artery

MCA = Middle Cerebral Artery

PCA = Posterior Cerebral Artery

Circle of Willis

Made up of: Anterior cerebral artery (left and right). Anterior communicating artery. Internal carotid artery (left and right). Posterior cerebral artery (left and right). Posterior communicating artery (left and

right).

Circle of Willis The basilar artery and middle cerebral

arteries, supplying the brain, are not considered part of the circle.

If one part of the circle becomes blocked or narrowed (stenosed) or one of the arteries supplying the circle is blocked or narrowed, blood flow from the other blood vessels can often preserve the cerebral perfusion well enough to avoid the symptoms of ischemia.

Pathology of the Arteries and Veins

Cerebral ischemia (stroke). Thrombosis: blood clot in vessel.

Embolism: blood clot from larger vessel forced into a smaller one.

Reduction in blood flow: cerebral arteriosclerosis.

Transient ischemia.

Cerebral haemorrhage (bleeding).

Angioma: Congenital collections of abnormal vessels that divert normal blood flow.

Aneurisms: Vascular dilations from localised defects in the elasticity of the vessels.

Pathology: Stroke

A sudden appearance of neurological symptoms as a result of severe interruption of blood flow.

Pathology: Aneurism

Angiography A substance that absorbs X-rays is injected into the blood stream.

Angiogram showing aneurism

Pathology: Headaches Headaches

Pain caused by pressure, displacement or inflammation. Pain sensitive structures: dura mater, large arteries of the brain,

branches of some of the cranial nerves (5th, 9th & 10th). Migraine (Greek: hemi = half; kranion = skull)

Aura: constriction of one or more cerebral arteries has produced ischemia of the occipital cortex.

Actual headache: begins as the vasoconstriction reverses and vasodilation takes place.

Types: Classic. Common. Cluster headache. Hemiplegic migraine (loss of movement of limbs). Opthalmologic migraine (loss of movement of eyes).

Reading for Tutorial 1:

Kolb & Wishaw (Kolb) Chapter 1 (The Development of Neuropsychology) & Chapter 2 (Origins of the Human Brain and Behaviour).

Kolb Chapter 3 (Organisation of the Nervous System) & Chapter 10 (Principles of Neocortical Function). Review Kolb pg. 57- 59, Review Kolb pg. 76 - 78 (Cellular Organisation of the Cortex), Kolb pg. 253 - 273 (The Structure of the Cortex), Kolb Chapter 4 (The Structure and Electrical Activity of Neurons) & Kolb Chapter 5 (Communication between Neurons).

Kolb pg. 55 (Support and protection) & Kolb pg. 764 (Meningitis).

Review Kolb pg. 56 - 57 (Blood Supply), Kolb pg. 147 (Angiography), Kolb pg. 51 (Stroke), Kolb pg. 749 - 751 (Vascular Disorders), Lezak pg. 229 - 242 (Cerebrovascular Disorders) & Kolb pg. 760 - 762 (Headaches). Kolb pg. 759 - 760 (Tumours). Lezak pg. 333 - 338 (Brain Tumours). Kolb pg. 107 (Snapshot of MS). Lezak pg. 290 - 303 (Multiple Sclerosis).

Nothing worth having

comes easy