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Orientation,
Memory
Asking questions about month, date, day of week and place tests orientation,
which involves not only memory but also attention and language. Three-word
recall tests recent memory for which the temporal lobe is important. Remote
memory tasks such as naming Presidents, tests not only the temporal lobes
but also heteromodal association cortices.
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Attention-working
memory
Digit span, spelling backwards and naming months of the year backward test
attention and working memory which are frontal lobe functions.
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Judgement-abstract
reasoning
These frontal lobe functions can be tested by using problem solving, verbal
similarities and proverbs.
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Set
generation
This is a test of verbal fluency and the ability to generate a set of items
which are frontal lobe functions. Most individuals can give 10 or more words
in a minute.
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Receptive
language
Asking the patient to follow commands demonstrates that they understand
the meaning of what they have heard or read. It is important to test reception
of both spoken and written language.
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Expressive
language
In assessing expressive language it is important to note fluency and correctness
of content and grammar. This can be accomplished by tasks that require spontaneous
speech and writing, naming objects, repetition of sentences, and reading
comprehension.
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Praxis
The patient is asked to perform skilled motor tasks without any nonverbal
prompting. Skills tested for should involve the face then the limbs. In
order to test for praxis the patient must have normal comprehension and
intact voluntary movement. Apraxia is typically seen in lesions of the dominant
inferior parietal lobe.
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Gnosis
Gnosis is the ability to recognize objects perceived by the senses especially
somatosensory sensation. Having the patient (with their eyes closed) identify
objects placed in their hand (stereognosis) and numbers written on their
hand (graphesthesia) tests parietal lobe sensory perception.
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Dominant
parietal lobe function
Tests for dominant inferior parietal lobe function includes right-left orientation,
naming fingers, and calculations.
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Non-dominant
parietal lobe function
The non-dominant parietal lobe is important for visual spatial sensory tasks
such as attending to the contralateral side of the body and space as well
as constructional tasks such as drawing a face, clock or geometric figures.
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Visual
recognition
Recognition of colors and faces tests visual association cortex (inferior
occiptotemporal area). Achromatopsia (inability to distinguish colors),
visual agnosia (inability to name or point to a color) and prosopagnosia
(inability to identify a familiar faces) result from lesions in this area.
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