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Unit 17 > Apraxia & Neglect > Flashcards

Apraxia & Neglect Flashcards

1
Q

Define apraxia

A

inability to carry out a learned skilled movement that cannot be attributed to sensorimotor dysfunction or comprehension deficits

They understand what has to be done, they have the capacity to do it but performance fails

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2
Q

is apraxia a motor deficit or a higher order deficit?

A

higher order deficit: their gross motor movement can be completely fine yet still they cannot complete tasks

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3
Q

Can someone with apraxia tell you the steps to do a transfer?

A

yes! but they will not be able to perform it

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4
Q

Hippocampus is in what lobe

what does the hippocampus tell you?

A

temporal lobe: WHAT - facts, explicit steps

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5
Q

what lobe is the “how” pathway in

A

parietal lobe: HOW - implicit and procedural

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6
Q

what lobe

why lobe

A

what = temporal and hippocampus

how = parietal (L lobe)

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7
Q

is L or R parietal lobe involved more in praxis?

A

LEFT

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8
Q

the angular and supramarginal gyrus function is what?

A

they store the learned motor plans for functional actions

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9
Q

from angular and supramarginal gyri follow the path of action to the control of the R side of the body

A

angular and supramarginal gyri (which are in the L inferior parietal lobe) –>L premotor cortex –> L primary motor cortex –> control of the R side of the body

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10
Q

from angular and supramarginal gyri follow the path of action to the control of the L side of the body

A

angular and supramarginal gyri (which are in the L inferior parietal lobe) –> L premotor cortex –> corpus collosum –> R premotor cortex –> R primary motor cortex –> control of the L side

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11
Q

where is the angular and supramarginal gyri located

A

inferior potion of the L parietal lobe

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12
Q

true or false: both angular and supramarginal gyri work to control both L and R primary motor cortex’s?

A

true!

If you have a lesion in the L gyris, deficits that are not motor in nature and are apraxic in nature will be bilateral!

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13
Q

define ideational apraxia

A

affects OBJECT USE

inappropriate or incorrect sequencing

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14
Q

define ideomotor apraxia

A

inability to pantomime or imitate

actual tool use is fine

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15
Q

if someone can use an object two different ways and struggles to do so, is that ideational or ideomotor apraxia?

A

ideational

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16
Q

Not remembering to lock the WC before transferring would be a ideational or ideomotor apraxia?

A

ideational

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17
Q

object misuse would be ideational or ideomotor?

A

ideational

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18
Q

no response/initiation would be ideational or ideomotor?

A

ideational

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19
Q

omission of steps or sequencing errors would be ideational or ideomotor?

A

ideation

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20
Q

Doesn’t use an object even when available would be ideational or ideomotor?

A

ideational

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21
Q

Perseveration would be ideational or ideomotor?

A

ideational

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22
Q

awkward, clumsy movements or imprecise would be ideational or ideomotor?

A

ideomotor

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23
Q

crossing midline becomes difficult would be ideational or ideomotor?

A

ideomotor

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24
Q

difficulty sequencing movements alone would be ideational or ideomotor?

A

ideomotor

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25
Q

Spatial orientation erros would be would be ideational or ideomotor?

A

ideomotor

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26
Q

difficulty coupling joints would be ideational or ideomotor?

A

ideomotor

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27
Q

Difficulty timing movement would be would be ideational or ideomotor?

A

ideomotor

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28
Q

which is more subtle ideational or ideomotor?

A

ideomotor

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29
Q

uses a straw as a spoon would be ideational or ideomotor?

A

ideational

IA

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30
Q

Doesn’t “know how” to turn on a water faucet would be ideational or ideomotor?

A

ideomotor

IM

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31
Q

Attempts to propel w/c by pushing on breaks would be ideational or ideomotor?

A

ideational

IA

32
Q

Cannot plan movement for supine to sit

A

IM

ideomotor

33
Q

true or false: there are a lot of standardized measures at our disposal for looking at apraxia?

A

False! there is a lack that actually correlate with real life performance

34
Q

what makes it difficult to diagnose apraxia?

A

other co-morbidities after stroke, like aphasia

35
Q

true or false: there are clear definitions of different types of apraxia

A

nope, they’re not clear, there is limited research

36
Q

what does a bottom up assessment of apraxia begin with?

what is the problem with this

A

non-functional, out of context tasks

The problem is this doesn’t tell you how it relates to occupational or motor performance

37
Q

what does top down assessment of apraxia begin with?

provides information on what?

what is the caveot

A

functional occupation and motor performance

provides information on real life HOWEVER it doesn’t tell you if the issue is comprehension or otherwise related

38
Q

true or false: there is normally a strong correlation btwn formal testing results and actual performance in ADL’s for apraxia assessment

A

false! you have to observe them in daily routine to really detect influence of apraxic disturbance

39
Q

TULIA is an example of a top down or bottom up assessment for apraxia?

A

bottom up: they are looking at discrete non functional tasks

40
Q

Observational assessment is top down or bottom up assessment of apraxia?

A

Top down: more like movement analysis

41
Q

JUST READ IT: for PT observation method there is value in structuring your observation, you want to identify error types and phases where error occurs

A

JUST READ IT: for PT observation method there is value in structuring your observation, you want to identify error types and phases where error occurs

42
Q

what is the goal of observational assessment of apraxia for PT

A

understand error types

think about cues you may provide during task

determine if there are any sensory, motor or cognitive issues interfering w/activity performance (diagnosis by exclusion)

43
Q

what are the three types of errors observed during phases of an activity

A

content

temporal

spatial

44
Q

is the strategy training approach recovery or compensatory based?

A

compensatory

45
Q

explain strategy training approach.

A

use this to figure out how you’re going to formalize your training, then combine it with either direct or exploration training.

COMPENSATORY:
internal or external strategies to improve independence ADL

pts chose which activities to address

there was a transfer or training to non-trained tasks

46
Q

name 2 characteristics of direct training

A

WHOLE task specific

errorless learning: there is no choice of error you are telling them what to do without giving them options

47
Q

name characteristics of exploratory training

A

have the pt perform and think about the task

highlight difficulty steps

guide exploration to fix errors

practice

48
Q

Gesture production exercises is training of transitive and intransitive gestures, there are three sections that need to be _____% accurate before moving onto a different phase

A

85: if you got it wrong its cool all the information is on the last slide its very slim he will ask a question on it.

49
Q

true or false: emphasizing the importance of habits and routines to caregivers is important?

A

true

50
Q

true or false: encourage caregivers to support partial engagement in a task and not to over assist

A

true!

51
Q

unilateral spatial neglect is defined as what?

A

Absence of awareness or failure of attention to stimuli contralateral to the side of the brain lesion, which cannot be attributed to primary sensory or motor dysfunction

52
Q

is neglect more common in L or R hemisphere stroke?

what % have it after that side stroke

A

R

80% of individuals w/R hemisphere stroke show neglect

53
Q

what is anosognosia?

what is its relevance

A

denial that anything is wrong

you will commonly see this post R hemisphere stroke

54
Q

name all the places neglect normally effects

A

TPO junction: temporo-parietal-occipital junction

parietal lobe

frontal lobe

thalamus

BG

55
Q

define allocentric

A

object based neglect

56
Q

define egocentric

A

ignore their own body as well as everything to that side of their body in the environment

57
Q

perceptual vs. representational vs. motor neglect

A

perceptual: person does not respond to contralateral stimuli
representational: mental representation of an image
motor: underuse of the contralateralesional limb that is not due to sensory or motor deficits

58
Q

what is peripersonal neglect

A

Within reaching space: they will only eat off one side of the plate

59
Q

what is extra personal neglect

A

they never see one whole side of objects that are away from them in the room. Like a clock

60
Q

USN is what

A

unilateral spatial neglect

61
Q

is USN (unilateral spatial neglect) hetero or homogeneous?

A

hetero

so theres no standard method to determine neglect

62
Q

true or false: you should consider using various assessments for USN?

A

yes! because there are different varieties of USN and you want to get as good of an overall picture as you can get

63
Q

true or false: apples test tests only allocentric neglect?

A

false it tests both!

Egocentric: they only cross out the completed apples on one side of the page

Allocentric: they cross out apples that have one side taken out of them because they don’t “see” the gap

64
Q

What intervention causes a shift in the sensorimotor coordinates?

How?

A

prism adaptation

optically displace the visual field by 10 degrees, UE trajectory is occluded during motor task

65
Q

is the prism adaptation perminant?

A

nope its transient!

66
Q

does the prism adaptation help with allocentric or egocentric neglect?

A

egocentric

67
Q

eyepatching occludes what

A

hemifields on the neglected side to increase search to the neglected side

68
Q

what intervention technique re-establishes balance btwn both hemispheres?

A

eye patching

69
Q

how long are eye patches worn for.

hours
days

A

8 hours for 15 days

70
Q

mirror therapy to get cortical reorganization and neuroplasticity is performed daily for how long

A

30 minutes

71
Q

what two things does mirror therapy change physiologically?

A

cortical reorganizaiton and neuroplasticity

72
Q

what intervention activates proprioceptive map in the parietal lobe?

A

ESTIM

73
Q

If you do FES just to get wrist and digit extension how long are you doing it

how many min
how many days a week
how many Hz

A

2x20 min
5 days a week
40Hz

If you’re dong FES and visual scanning do it for 45 minutes at less Hz

74
Q

Match the following pharmacological tx that benefit mostly egocentric neglect

alerting
orienting
executive

ACH
dopamine
noradrenaline

A

alerting: noradrenaline
orienting: ACH
executive: dopamine

75
Q

are we the primary care givers for these cognitive perceptive disorders?

A

no, but it obviously impacts our treatment greatly

76
Q

L hemisphere
R hemisphere

Neglect
Apraxia

A

neglect: R
apraxia: L

Unit 17 (9 decks)

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