4.16 Stroke 4

Question 1

Things to look for with attention deficits in stroke pts

Answer 1

• sustained attention
• selective attention
• alternating attention
• dividing attention

Question 2

sustained attention

Answer 2

staying attentive to what’s going on in front of you at the moment

Question 3

selective attention

Answer 3

can they stay focused on one thing with other distractions

Question 4

alternating attention: what happens with stroke pts?

Answer 4

• 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

Question 5

alternating attention is important for

Answer 5

getting someone to do one thing and do it well (walk/stand)

Question 6

dividing attention

Answer 6

ability to respond simultaneously to 2 or more tasks or stimuli where all are relevant

Question 7

memory impairment categories

Answer 7

• immediate recall
• short term recall
• long term recall

Question 8

Which is the most important type of recall for PT? Why?

Answer 8

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

Question 9

What are the executive function impairment types?

Answer 9

• volition
• planning
• purposive action
• effective performance

Question 10

volition

Answer 10

desire or force causes you to do something

Question 11

planning

Answer 11

• Thinking about how to do the task

- skills, materials

Question 12

purposive action

Answer 12

make actions toward the thing I’ve planned and desired

Question 13

effective performance

Answer 13

• perform the action well
• awareness and intrinsic feedback
• think - appropriate force to open a refrigerator

Question 14

What are some of the perceptual issues that stroke pts may deal with?

Answer 14

• body image
• body scheme
• unilateral neglect
• anosognosia
• somatoagnosia
• right/left discrimination
• finger agnosia

Question 15

What is body image?

Answer 15

visual mental image of one’s body that includes feelings about the body, esp as it relates to health and disease

Question 16

Important things to remember about pts with body image issues?

Answer 16

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

Question 17

What is body scheme?

Answer 17

• 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

Question 18

What is unilateral neglect?

Answer 18

• body doesn’t receive stimuli from one side
• no reception or integration of sensory information
• body just doesn’t think it’s there

Question 19

What type of CVA often produces unilateral neglect?

Answer 19

right CVA

Question 20

Vision issues with unilateral neglect

Answer 20

only see half of the information

Question 21

“pusher”

Answer 21

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

Question 22

possible explanation for pushers

Answer 22

• they don’t have the same midline

- have to create a new one

Question 23

anosognosia

Answer 23

• complete denial of their injury

- typically gets better once they figure it out, takes repeated reminders

Question 24

A patient with anosognosia really needs to have these

Answer 24

safe fails

Question 25

somatoagnosia

Answer 25

• body scheme issue

- lack of awareness of the body structure and the relationship of body parts to oneself or to others

Question 26

right/left discrimination problems

Answer 26

• 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

Question 27

finger agnosia

Answer 27

• inability to ID fingers of one’s own hands or hands of PT

- no coordinated articulation of fingers together