4.16 Stroke 4 Flashcards
Things to look for with attention deficits in stroke pts
- sustained attention
- selective attention
- alternating attention
- dividing attention
sustained attention
staying attentive to what’s going on in front of you at the moment
selective attention
can they stay focused on one thing with other distractions
alternating attention: what happens with stroke pts?
- may take them a lot of attention to perform a functional task
- adding another task negatively impacts their performance in the first
- doing one task AND do another task
alternating attention is important for
getting someone to do one thing and do it well (walk/stand)
dividing attention
ability to respond simultaneously to 2 or more tasks or stimuli where all are relevant
memory impairment categories
- immediate recall
- short term recall
- long term recall
Which is the most important type of recall for PT? Why?
short term
- making new memories
- carryover of treatments from one day to the next and week to the next
- long term has more of an effect on their job
What are the executive function impairment types?
- volition
- planning
- purposive action
- effective performance
volition
desire or force causes you to do something
planning
- Thinking about how to do the task
- skills, materials
purposive action
make actions toward the thing I’ve planned and desired
effective performance
- perform the action well
- awareness and intrinsic feedback
- think - appropriate force to open a refrigerator
What are some of the perceptual issues that stroke pts may deal with?
- body image
- body scheme
- unilateral neglect
- anosognosia
- somatoagnosia
- right/left discrimination
- finger agnosia
What is body image?
visual mental image of one’s body that includes feelings about the body, esp as it relates to health and disease
Important things to remember about pts with body image issues?
pts can have issues that are completely unrealistic to what you as a PT sees
- typically need counseling
- difficult to treat
- don’t tell someone they’re just wrong about their body image
What is body scheme?
- postural model of the body, including relationship of body parts to each other and relationship of body to the environment
- how they piece themselves together in their own heads
What is unilateral neglect?
- body doesn’t receive stimuli from one side
- no reception or integration of sensory information
- body just doesn’t think it’s there
What type of CVA often produces unilateral neglect?
right CVA
Vision issues with unilateral neglect
only see half of the information
“pusher”
don’t perceive that side to the extent that they will use all muscle on the normal side to push themselves toward the impaired side
- works against what you’re trying to do
- they’ll fall to the bad side
possible explanation for pushers
- they don’t have the same midline
- have to create a new one
anosognosia
- complete denial of their injury
- typically gets better once they figure it out, takes repeated reminders
A patient with anosognosia really needs to have these
safe fails
somatoagnosia
- body scheme issue
- lack of awareness of the body structure and the relationship of body parts to oneself or to others
right/left discrimination problems
- inability to identify the right and left sides of one’s own body or of that of PT
- can also go in other directions
- may not understand those words or have a completely inverted sense of what they shold be
finger agnosia
- inability to ID fingers of one’s own hands or hands of PT
- no coordinated articulation of fingers together
