CORTICAL FUNCTION

Anatomy and physiology

Cortical function:
Three

CNS:

major operation of neurons of the

Reception

and registration of sensory

stimuli from outside and from within.
Planning and execution of complex motor
act.
Intermediary processing.
.(thought,language,memory,self
awareness,mood and affect)

Cerebral hemisphere : right and left

connecting by corpus calosum

Cerebral hemisphere are divided

Primary

sensory cortex.
Primary motor cortex.
Association cortex.
Limbic-paralimbic cortex

Cortical function : specific location

Primary receptive area

Secondary receptive area

Association area

NEUROBEHAVIOR:

How environmental stimuli are processed within the

central nervous system (CNS) to effect behavioral
and emotional responses.
Processing of stimuli are recognition, interpretation,
storage and retrieval of information to which meaning
is attributed from the past and present experience.
Task performance in daily activities is a result of
behavioral responses.
The mechanism of nervous system processing and
neurobehavior is thus a complex interaction of
processing and responses

NEURO-BEHAVIOR

Mempelajari hubungan antara perilaku

dengan fungsi otak.

Behavior/perilaku:

Hasil aksi dan reaksi psikomotor yang secara

objektif dapat diamati dan diinterpretasikan dan
akan mempengaruhi lingkungan subyek tsb
Mencakup berbagai fungsi,aktifitas
motorik,komunikasi,aksi/tindakan sosial dan
ekspresi afektif.

Perilaku dapat dibedakan atas:

Goal oriented behavior:

Komponen sensorik ,psikomotor,emosi dan kognitif

bekerja harmonis sesuai dengan keinginan dan tujuan
individunya.

Specific oriented behavior:

Perilaku yang muncul pada situasi tertentu sebagai

suatu reaksi terhadap stimulus tertentu misalnya
impulsif,kecewa,kekerasan.
Perilaku ini patologis,mencerminkan kegagalan
kognitif,kepribadian yang abnormal atau disfungsi
neurobiologik.

Behavior Neurology:
Pengaruh

penyakit otak pada perilaku

manusia dan fungsi kortikal luhurnya.
Perilaku termasuk :
Perilaku

spesifik seperti
memori,komunikasi dan visuospatial.
Perilaku kompleks:Kualitas
intelegensia,emosi,suasana hati dan
kepribadian.

BEHAVIOR NEUROLOGY ;
Bertujuan

untuk membedakan perilaku

normal dan abnormal dalam kaitan
dengan fungsi otak yang normal atau
abnormal.

Neuropsikologi:
Bagian

dari psikologi yang berkaitan

dengan pemeriksaan fungsi otak
dengan menggunakan tes psikologi
yang baku.
Neuropsikologi membantu untuk
mendapatkan data kuantitatif
pemeriksaan neurobehavior yang
penting dalam penatalaksanaan pasien.

Neuropsikiatri:
Mempelajari

abnormalitas fisik atau

organik yang mendasari gejala psikiatri
dimana tidak dapat dibuktikan adanya
lesi primer diotak

HIGHER COGNITIVE
FUNCTION

HIGHER COGNITIVE
FUNCTION:
Manipulation

of well learned material,

abstract thinking, arithmetic
computations is the highest level of
human intellectual functioning.
Represent the most advanced stages of
intellectual development, often highly
susceptible to neurological diseases

Higher Cognitive Function

Coordination of external and internal factor

in human being
Study of the relation between brain and
behavior
Basic Processes :
1.
2.
3.
4.
5.
6.
7.

Attention and consentration

Language
Memory
Visual-spatial
Executive
Emotion
Praxis

1. Evaluation
The fund of acquired information or
the store of knowlegde

1.

Assessed by :
1.
2.
3.

Simple verbal test of vocabulary

General information
Comprehension

2. Manipulation of old
knowledge
Ability to apply information to new or
unfamiliar situations
Assessed by :

1.
2.

Calculation
Social comprehension

3. Social awareness and

Judgement

Evaluated by :
1.

2.

Knowledge of environmental or social

situation
Social appropriate responses in such
situations and the ability to personally
apply the correct response when faced
with a real situation

4. Abstract Thinking
Assessed by :
1. Use of proverbs
2. Conceptual series
3. Analogy interpretation

Memory

Involves :
1.
2.
3.

Recognition
Registration
Recall Retrieval

Anatomical basis of memory

Hippocampus

The Anatomical Basis of Memory

Test of Memory
Immediate memory
2. Recent memory
3. Remote memory
1.

Disorder of Memory
(Amnesia Syndrome)
1.

Retrograde amnesia

2.

Impairment of memory for events that

antedate illness or injury

Anterograde amnesia

Inability to learn new verbal or non-verbal

information from onset of illness or injury

Disorders of Memory Retrieval

Senescence

AAMI (Age Associated

Memory Impairment) Rapid retrieval
of stored memory become defective
Depression disorder in motivation and
concentration
Subcortical dementia Slowed (but
correct) response rate to questions of
memory function

Disorder of Language - Dysphasia

Language function of dominant
hemisphere
Emotional - Instinctive expression of
feelings
Symbolic or proportional thoughts,
opinions and concepts depend upon
culture, education, normal cerebral
development

Dysphasia
Acquired

loss of production or
comprehension of spoken and / or
written language secondary to brain
damage

Cortical Centers for Language

1. Brocas Area
Executive or motor for
production of
language
Brocas dysphasia
Motor dysphasia

Nonfluent / hesitant
speech
Telegraphic speech
Comprehension good
Handwriting - pure

Wernicks Area Receptive Area

Wernicks dysphasia :

Comprehension
Impaired
Speech fluent but
nonsensical
Neologism
Paraphasia half right
words
Patient unaware of
language problems
Hand writing poor

Global Dysphasia
Non-fluent

speech
Comprehension impaired

Receptive and expressive areas linked

by arcuate fasciculus in order to
integrate function
Conduction
Speech

Dysphasia

nonsensical but fluent

Comprehension - normal
Repetition - poor

Dysphasia may developed as

a result of :
1.
2.
3.
4.
5.

Vascular disorders
Space occupying lesion
Traumatic
Infection
Degenerative disorders

Mental State Examination

Mini

Mental State Examination.

Score 0-30
Orientation

(time.place)
Memory registration
Attention and Concentration
Memory Recall
Language
Visual-patial

0-10
0-3
0-5
0-3
0-8
0-1

Orientation
1.

Ask the patient : What is this year,

season, date, day, month?
Score 5

2.

Ask : Where are you?

State, country, town, place, floor (or
ward)
Score 5

Memory Registration
3.

Tell the patient that you want him /her

to remember something for you, then
name three unrelated objects (speak
clearly and slowly). Ask the patient to
repeat the three objects
Score 3 points; if correct first time,
Score 2 points; if correct second time
Score 1 point: if correct third time
Ask the patient to keep the three things in
mind

Score 3

Attention and Concentration

4.

Ask the patient to take seven from

100, then seven from the result, and
so on for five subtractions. Score 1
point for each correct answer
or
Ask the patient to spell world
backwards, and score 1 point for each
correct letter
Score 5

Memory Recall
5.

Ask the patient to recall the three

objects from test 3
Score 3

Language
6.

7.
8.

9.

Show the patient two familiar objects (e.g.

a pen, a watch) and ask him/her to name them
Score 2
Ask the patient to repeat a sentence after you:
No ifs, ands or buts
Score 1
Ask the patient to follow a three-stage
command: Please take this paper in your left
hand, fold it in half and put the paper on the
floor
Score 3
Ask the patient to read and follow a written
instruction, e.g: Close your eyes
Score 1

Language (cont)
Ask the patient to write a simple
sentence. The sentence should contain
a subject and a verb and should make
sense
Score 1
11. Ask the patient to copy a picture of
intersecting pentagons
Score 1
10.

Total Score
A score

30

below 24 indicates probable

cognitive impairment
A score below 17 indicates definite
cognitive impairment