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נארו > Agnosia And Apraxia > Flashcards

Agnosia And Apraxia Flashcards

1
Q

agnosia/apraxia

what is it

A

altered perception occurs, difficulty making sense of information coming in

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2
Q

perception

what is it an ability of

what does it require

A
  • ability to interpret sensory input or to process visual, somesthetic, auditory input
  • requires cortical association areas interacting with primary sensory cortex
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3
Q

Cortical Association Areas (4)

A
  1. prefrontal cortex
  2. temporal lobe
  3. occipital lobe
  4. parietal lobe
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4
Q

Prefrontal cortex

5 things it does

A
  1. goal directed behavior
  2. understanding outcomes of behavior
  3. determining goal achievement
  4. Short Term Memory
  5. Emotional Responsiveness
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5
Q

Temporal Lobe

5 things it does

A
  1. memory processing: make sense of the memory
  2. auditory association–makes sense of sounds (area 22, superior temporal gyrus)
  3. Language comprehension–makes sense of spoken language and written language (Wernickes area)
  4. Visual Task Memory: make sense of visual input
  5. Visual Recognition: complex patterns
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6
Q

Occipital Lobe (3)

A
  1. visual association area : make sense of visual input
  2. identify visual input (area 18)
  3. how to use visual input (area 19)
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7
Q

Parietal lobe (4)

A

makes sense of sensory input

  1. somatosensory association area: i am holding a key
  2. interface sensory and motor cortices
  3. process spatial aspects of environment
  4. right hemisphere: body image, tactile discrimination
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8
Q

Parieto Temporal Spatial Occipital Junction

what it does
what a lesion will do

A

overlapping association area, a polymodal sensory area

ability to make multimodal sense of LANGUAGE as simultaneously written and spoken

there is a dense overlapping association cortex that allows us to make sense of association

lesions result in AGNOSIA or APRAXIA

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9
Q

AGNOSIA

  1. what causes it
  2. what is it
A

“lack of knowledge”

  1. lesion in association cortex causes inability to interpret sensory input
  2. agnosia is an acquired condition characterized by an inability to recognize stimuli when transduction, transmission, and perception of stimuli are intact
    - -lack of perceptual ability to recognize stimuli (ie stereognosia, graphesthesia)

–cannot interpret, perceive or recognize

–occurs in the presence of normal sensation

–can be agnostic for a specific modality (more common: visual, auditory, tactile) or a subcatogory (facial)

–can touch, feel, and describe it, but cannot recognize or make sense of it

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10
Q

Is sensation intact in agnosia

A

yes

–can touch, feel, and describe it, but cannot recognize or make sense of it

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11
Q

Body Image

  1. what is it, how is it formed
  2. is it acquired
  3. what lobe
  4. what happens if difficulties here
A

1) body acquired mental image about the body formed by synthesis of sensory stimuli
2) acquired through memory of previous body position, movements, relationship to objects
3) nondominant parietal lobe
4) difficulties here result in intact movement skills but difficulty performing functional tasks due to inability to recognize the “meaning” of the task

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12
Q

body image issue

how does it affect movement

A

difficulties here result in intact movement skills but difficulty performing functional tasks due to inability to recognize the “meaning” of the task

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13
Q

Body Image Agnosis (2)

A
  1. somatopagnosia: loss of ability to identify body as a whole or recognize relationship of body parts (not mine)
  2. hemisomatotopagnosia: impaired ability to recognize 1/2 of body –can feel and use it, but do not recognize it (not mine)
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14
Q

somatopagnosia:

A

loss of ability to identify body as a whole or recognize relationship of body parts (not mine)

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15
Q

hemisomatotopagnosia:

A

impaired ability to recognize 1/2 of body –can feel and use it, but do not recognize it (not mine)

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16
Q

Unilateral Neglect (2)

A
  1. Hemispatial Neglect: a spatial neglect and do not pay attention to that part of the body.
    –impaired attention to 1/2 of body
    –NOT agnosia
    –complete lack of sensation or awareness of 1/2 of body but not a denial, an IGNORAL
    –unaware that the hand is hanging off the w/C
    do a clock test
  2. Hemisensory Neglect: loss of sensation of hemi side, they can see it, may be able to use it, but do not feel it
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17
Q

Hemispatial Neglect:

what is it

is it agnosia

what test can we do

A

a spatial neglect and do not pay attention to that part of the body.

  • -impaired attention to 1/2 of body
  • -complete lack of sensation or awareness of 1/2 of body but not a denial, an IGNORAL
  • -unaware that the hand is hanging off the w/C

–NOT agnosia (can be cued to see it and would know it is their own body) [like when on autopilot]

do a clock test

18
Q

Hemisensory Neglect:

A

loss of sensation of hemi side, they can see it, may be able to use it, but do not feel it

19
Q

hononymous hemianopsia

A

loss of 1/2 of visual feild

cannot see that side

it is a visual feild cut

in L sided hononymous hemianopsia, one can only see the right visual field

injury to R brain will effect L visual feild

20
Q

side note: tranndelenburg

A

When standing on the right leg, if the left hip drops, it’s a positive right Trendelenburg sign (the contralateral side drops because the ipsilateral hip abductors do not stabilize the pelvis to prevent the droop).

21
Q

finger agnosia

A

inability to recognize one owns finger from those of the examiner

22
Q

tactile agnosia

what is it

what causes it

how to test

A

inability to recognize object by touch in the presence of intact cutaneous and proprioceptive hand sensation

  • -inability to synthesize tactile and proprioceptive information (texture, size, weight)
  • -difficulty with using scissors, putting on gloves, R and L discrimination

caused by lesion in the CONTRALATERAL PARIETAL LOBE

test with graphesthesia or stereognosis

23
Q

Visual Agnosia

what is it

what makes us suspect it

common characteristic

A

inability to interpret visual stimuli despite intact visual sensory apparatus

individual can perceive a visual stimuli, describe its specific characteristics, but is not able to “recognize” its function, structure, or purpose

suspect if :
RO visual acuity
EOM
Visual Fields

CIRCUMLOCATION: talk around it, cannot determine it is a pen, can describe it, do not know what it is for, ask if they know what it is and if they can demonstrate a use for it

24
Q

CIRCUMLOCATION:

A

in visual agnosia

talk around it, cannot determine it is a pen, can describe it, do not know what it is for, ask if they know what it is and if they can demonstrate a use for it

25
Q

Visual Object Agnosia

what is it

how to test it

what causes it

A

inability to name or demonstrate use of a familiar object

test by giving pt familiar object and asking them to demonstrate its use

indicates lesion in the visual association cortex of the occipital lobe

26
Q

visual spatial agnosia

what is it

examples

what causes it

how is it tested

A

inability to perceive spatial relationships between objects or between the object and self

  • unable to follow familiar paths
  • unable to orient objects in space
  • impaired ability to judge distance
  • poor depth perception

ie sit down and miss chair
make the bed with everything in the wronge place

RIGHT PARIETAL LOBE

Tests:
figure ground
design extraction test
ask person to touch body parts
design copying
27
Q

Prosopagnosia

what is it

what causes it

how is it tested

A

facial agnosia

inability to recognize familiar faces, either famous people or close relationships

bilateral medial TEMPORAL-OCCIPITAL LOBE

famous people test

28
Q

How to test visual-spatial agnosia

A

figure ground

  1. design extraction test: find design in the design and perceive 2 identical objects in different positions
  2. separating objects from two identical ones
  3. ask person to touch body parts ie left shoulder and right eye etc.
  4. design copying: draw a design and they have to copy it
29
Q

Apraxia

what is it

what causes it

A

praxis = movement organization

loss of movement organization
not caused by incoordination, sensory loss, or failure to follow simple commands

in absence of sensory, motor or language problem

PREMOTOR LESION

30
Q

What is lost in apraxia, what isnt lost in apraxia

A

praxis = movement organization

loss of movement organization
not caused by incoordination, sensory loss, or failure to follow simple commands

in absence of sensory, motor or language problem

31
Q

Types of Apraxia (3)

A
  1. ideational
  2. ideomotor
  3. special apraxia
32
Q

Ideational Apraxia

  • -what is it
  • -what can they not do/what is preserved?
  • -give an example
  • -what causes it
A
  • cannot form the concept of an action
  • inability to form a plan or idea for a specific movement

-ability to DESCRIBE ACTION is preserved
see inability to complete a typical multistep command

ie pick up a pen, write name, put paper into envelope
–>spatial and temporal errors (cannot do multistep command)–incorrect sequencing or may not be able to figure out how to put the paper into the envelope

see diffuse bilateral brain damage AD
dominant lobe lesions

movement looks smooth, NOT like cerebellar overshoot

33
Q

Ideomotor Apraxia

what is it
what can work
what causes it

A
  • inability to follow commands
  • spontaneous movement is intact and can do the movement on their own

-gestural commands may do better than spoken commands

DOMINANT PARIETAL LOBE LESION

[we also see movement to command impaired in PD but different cause]

34
Q

constructural apraxia

what is it
what can work
what causes it

A

–unable to use visual information to complete a motor task

  • inability to draw or construct a simple figure (lego)
  • copying may be ok (draw)
  • OCCIPITAL LOBE LESION
35
Q

dressing apraxia

A

specific form of apraxia with difficulty sequencing motor actions needed for dressing

36
Q 
IMPAIRMENTS BY LOBE
Temporal Lobe (4)
A

1) memory loss [hippocampus]
2) auditory processing
3) language: WERNICKE’s APHASIA
4) visual : UPPER QUADRANTANOPSIA

37
Q 
IMPAIRMENTS BY LOBE
Frontal Lobe (6)
A

1) apathy (lose will)
2) disinhibition (any urge is acted on)
3) preservation (task, ideal movement, speech repeated over and over)
4) loss of executive function (pay attention to disinhibition)
5) BROCA’s APHASIA
6) contralateral hemiplegia

38
Q 
IMPAIRMENTS BY LOBE
Parietal Lobe (5)
A
  1. mental status: calculation, perceptual/spatial orientation
  2. apraxias
  3. neglect
  4. VISUAL: homonymous hemianopsia
  5. sensory: hemisensory deficit
39
Q 
IMPAIRMENTS BY LOBE
Occipital Lobe (4)
A
  1. visuospatial deficits
  2. central blindness
  3. visual hallucinations
  4. Hemianopsia (lose 1/2 of visual field)
40
Q

Note to self: determine difference in visual in parietal and temporal and occipital

A

Note to self: determine difference in visual in parietal and temporal and occipital

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