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Neuro Cognitive Disorders > 4: Right Hemisphere Brain Dysfunction (RHD) > Flashcards

4: Right Hemisphere Brain Dysfunction (RHD) Flashcards

1
Q

What is arousal?

A

readiness to respond to external stimuli

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2
Q

What is orienting?

A

directing attention to stimulus

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3
Q

What are two big types of attention?

A

1) sustained

2) selective

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4
Q

What does sustained attention do?

A

detect changes in stimuli

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5
Q

What does selective attention do?

A

Pays attention to specific stimuli and ignores others

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6
Q

What are 4 big functions of the right hemisphere?

A

1) attention
2) visual perception
3) emotional experience/expression
4) communciation/language

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7
Q

What are different types of visual perception?

A

1) holistic
2) spatial information
3) facial recognition
4) body image

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8
Q

What is body image?

A

can see the whole body and use accordingly for various tasks

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9
Q

What are the 3 big areas of communciation/lagnauge controlled by the right hemisphere?

A

1) discourse comprehension
2) discourse production
3) managing pragmatic skills

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10
Q

What is discourse comprehension?

A

understanding ambiguous meaning, understanding emotional tone/prosodic aspects of speech

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11
Q

What is discourse production?

A

communicative efficiecy and specificity, complex inferences in verbal exchanges, appropriate emotional expression throguh tone, approapriate prosdic aspects

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12
Q

What are 4 pragmatic skills?

A

1) turn taking
2) topic maintenance
3) social appropriateness
4) eye contact

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13
Q

What are 3 causes of RHBD?

A

1) stroke
2) tumors
3) TBI

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14
Q

Damage to what artery most common cause of RHBD?

A

right MCA

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15
Q

What are the 5 general characteristics of MCA RHBD?

A

1) visuospatial perceptual impairments
2) anosoagnosia
3) impaired pragmatics
4) impaired attention
5) changes in mood/personality

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16
Q

What are potential other characteristics of MCA RHBD?

A

1) upper extremity paralysis/paresis - contralateral limb (difficulty ambulating)
2) sensory impairment

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17
Q

What is the visuospatial perceptual impairment that occurs with MCA RHBD?

A

neglect

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18
Q

What is anosoagnosia?

A

impaired awareness of deficits

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19
Q

What are 3 effects MCA RHBD can have on language?

A

1) influence on auditory comprehension
2) verbal expression
3) reading/writing

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20
Q

Damage to PCA causing RHBD general characteristics: (4)

A

1) rare
2) chronic visual deficits
3) sensory abnormalities
4) motor weakness

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21
Q

What are other symptoms that can occur with PCA RHBD?

A

acute vision loss

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22
Q

What is the acute vision loss that might occur with PCA RHBD?

A

homonymous hemianopsia - loss of outer half of visual field in 1 eye and inner half in the other eye

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23
Q

What are the 2 processes of vision?

A

1) eyes move and take visual info to brain

2) process in interpretation of visual image

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24
Q

How is vision sent to brain?

A

each eye receives some info from right and left halves of environment, info is combined, corsses, and sent to occipital lobes

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25
Q

what are 5 characteristics of ACA RHBD?

A

1) confabulation
2) disinhibition
3) unconcern
4) anterograde and retrograde amnesia
5) limited awareness

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26
Q

What are 2 challenges of RHBD?

A

1) differ in nature/severity depending on location/lesion

2) limited pre-hospitalization info\

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27
Q

What are 2 large common impacted areas with RHD?

A

1) cognition

2) communcation

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28
Q

What are 3 areas of cognition that can be impacted with RHD?

A

1) attention
2) executive function
3) deficit awareness

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29
Q

What are 3 areas of communication that can be impacted by RHD?

A

1) langauge
2) speech
3) pragmatics

30
Q

What is the impact of visual neglect and anosognia on outcomes?

A

poor functional outcomes for return to independent living

31
Q

What are attentional difficulties that can occur with RHBD?

A

1) focus/maintain/shift attention
2) determining overal situational meaning
3) importnat vs not
4) identifying relationships
5) contration

32
Q

What is neglect?

A

impairment in ability to attend to stimuli on opposite side of brain lesion

33
Q

RHBD attention/neglect issues can influence what motor and/or sensory systems (4)?

A

1) motor - not full use of left arm/leg
2) sensory tactile - difficulty processing left side info
3) auditory - sounds on left
4) visual (neglect)

34
Q

What are types of visual neglect (5)?

A

1) visual (most common)
2) personal
3) peripersonal
4) extrapersonal
5) reading/writing

35
Q

What is personal neglect

A

failure to attend to one side of your body

36
Q

What is peripersonal neglect?

A

failure to attend to items within arms reach on one side

37
Q

What is extrapersonal neglect

A

reduced attention to things on one side beyond extend of the arm

38
Q

What is reading neglect?

A

only read info on one side and complain it doesnt make sense

39
Q

What is writing neglect outcomes? (4)

A

1) leave large margins on the left
2) slants upward on the right
3) letter/word omission or perseveration
4) extra lines/strokes may be added to letters

40
Q

Contralateral neglect and common spatial disorders are most often seen with lesions in the _________________ hemisphere, in the _________ lobe

A

non-dominant

parietal lobe

41
Q

Why are contralateral neglect and other common spatial disorders most often seen in the non-dominant parietal lobe (2)?

A

1) lesions on dominant/left typically cause big lang issues that cover up spatial issues
2) non-dominant/right parietal seems to direct attention o both visual worlds (contra- and ipsi-laterla) but dominant parietal only does contralateral (aka rt side more sig loss when affected)

42
Q

What are the 2 main cognitive areas affected with RHBD?

A

1) memory

2) executive function

43
Q

What are areas of executive function that can be impacted by RHBD?

A

1) organization and sequencing
2) goal directed behaviors
3) problem solving
4) reasoning
5) judgement
6) impulsivity

44
Q

What are constructional impairments?

A

decreased performance in drawing/copying geometric figures, creating designs, etc.

45
Q

What is construvctional impairment not caused by?

A

visual perceptual or motor imapirment

46
Q

What are 4 causes of constructional impairments

A

1) impulsivity
2) awareness
3) decreased self correction
4) disorganized/crowded

47
Q

What is topographic impairment?

A

difficulty relating to extrapersonal space

48
Q

Difficulty with familiar routes, reading maps, and giving directions are examples of what impairment?

A

topographic

49
Q

Topographic impairment is different than what 2 things?

A

1) disorientation

2) confusion

50
Q

What can help someone with topographic impairment?

A

talking through the sequence

51
Q

What is geographic disorientation?

A

when you can recognize their general surroundings but are mistaken about geographic location (know person, time, reason, but not specific location)

52
Q

What are visoperceptual impairments?

A

failure to identify objects, pictures, or drawings that are incomplete/distorted

53
Q

What is prosopagnosia?

A

facial recognition deficits - failure to identify familiar people by facial features but can if they are described

54
Q

What is anosognosia?

A

denial of illness

55
Q

Damage to what lobe most often causes anosognosia?

A

parietal lobe

56
Q

What is the lowest level of anosognosia?

A

acknowledge deficit but are indifferent

57
Q

What is the moderate level of anosognosia?

A

acknowledge deficit but underestimate severity and minimize effect

58
Q

What is the severe level of anosognosia?

A

deny existence of major disabilities (paralysis, sensory loss, visual deficits, etc) and deny ownership of hemiplegic limbs

59
Q

What are reasons that anosognosia is challenging?

A

1) often ignore errors
2) confabulate
3) argue
4) justify performance errors
5) think they don’t need therapy

60
Q

What is the communiation impairement impact with RHDB? (3)

A

1) non-verbal
2) verbal
3) pragmatic

61
Q

What is aprosodia?

A

difficulty expressing and interpreting emotion or intent conveyed through prosody

62
Q

What are the 2 types of aprosodia?

A

1) linguistic

2) emotional

63
Q

What is linguistic prosody?

A

issues with word emphasis and rising/falling intonation

64
Q

What is emotional prosody?

A

intonation that relays emotion

65
Q

Which type of prosody is more likely to be affected with RHBD?

A

emotional

66
Q

What is the communication impairment impact on verbal and written production? (2)

A

1) reducing efficiency/effectiveness - problems conveying intent
2) disorganized, tangential, overpersonalized (say a lot but with little content)

67
Q

How might reading and aud comp be affected by RHBD communication impairements?

A

1) reduced efficiency and effectiveness comprehending message intent
2) misinterpretation of message intent
3) difficulty comprehending nonliteral language (metaphors, idioms, sarcasm)

68
Q

What effect can RHBD communication impairment have on pragmatics? (5)

A

1) organization/efficiency
2) eye contact
3) personal space
4) turn taking
5) topic appropriateness

69
Q

About what percent of individuals with RHBD have 1+ communication impairments?

A

50-78%

70
Q

Bilateral lesions to both the right and left PCA can result in:

A

cortical blindness

71
Q

Damage to what 3 areas can cause issues of attention/neglect with RHBD?

A

1) right parietal lobe (inferior parietal lobe/temporoparietal junction/supramarginal gyrus)
2) right inferior frontal lobe
3) subcortical structures (thalamus and basal ganglia)

Neuro Cognitive Disorders (13 decks)

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