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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
Spatial orientation erros would be would be ideational or ideomotor?
ideomotor
26
difficulty coupling joints would be ideational or ideomotor?
ideomotor
27
Difficulty timing movement would be would be ideational or ideomotor?
ideomotor
28
which is more subtle ideational or ideomotor?
ideomotor
29
uses a straw as a spoon would be ideational or ideomotor?
ideational IA
30
Doesn't "know how" to turn on a water faucet would be ideational or ideomotor?
ideomotor IM
31
Attempts to propel w/c by pushing on breaks would be ideational or ideomotor?
ideational IA
32
Cannot plan movement for supine to sit
IM ideomotor
33
true or false: there are a lot of standardized measures at our disposal for looking at apraxia?
False! there is a lack that actually correlate with real life performance
34
what makes it difficult to diagnose apraxia?
other co-morbidities after stroke, like aphasia
35
true or false: there are clear definitions of different types of apraxia
nope, they're not clear, there is limited research
36
what does a bottom up assessment of apraxia begin with? what is the problem with this
non-functional, out of context tasks The problem is this doesn't tell you how it relates to occupational or motor performance
37
what does top down assessment of apraxia begin with? provides information on what? what is the caveot
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
true or false: there is normally a strong correlation btwn formal testing results and actual performance in ADL's for apraxia assessment
false! you have to observe them in daily routine to really detect influence of apraxic disturbance
39
TULIA is an example of a top down or bottom up assessment for apraxia?
bottom up: they are looking at discrete non functional tasks
40
Observational assessment is top down or bottom up assessment of apraxia?
Top down: more like movement analysis
41
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
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
what is the goal of observational assessment of apraxia for PT
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
what are the three types of errors observed during phases of an activity
content temporal spatial
44
is the strategy training approach recovery or compensatory based?
compensatory
45
explain strategy training approach.
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
name 2 characteristics of direct training
WHOLE task specific errorless learning: there is no choice of error you are telling them what to do without giving them options
47
name characteristics of exploratory training
have the pt perform and think about the task highlight difficulty steps guide exploration to fix errors practice
48
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
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
true or false: emphasizing the importance of habits and routines to caregivers is important?
true
50
true or false: encourage caregivers to support partial engagement in a task and not to over assist
true!
51
unilateral spatial neglect is defined as what?
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
is neglect more common in L or R hemisphere stroke? what % have it after that side stroke
R 80% of individuals w/R hemisphere stroke show neglect
53
what is anosognosia? what is its relevance
denial that anything is wrong you will commonly see this post R hemisphere stroke
54
name all the places neglect normally effects
TPO junction: temporo-parietal-occipital junction parietal lobe frontal lobe thalamus BG
55
define allocentric
object based neglect
56
define egocentric
ignore their own body as well as everything to that side of their body in the environment
57
perceptual vs. representational vs. motor neglect
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
what is peripersonal neglect
Within reaching space: they will only eat off one side of the plate
59
what is extra personal neglect
they never see one whole side of objects that are away from them in the room. Like a clock
60
USN is what
unilateral spatial neglect
61
is USN (unilateral spatial neglect) hetero or homogeneous?
hetero so theres no standard method to determine neglect
62
true or false: you should consider using various assessments for USN?
yes! because there are different varieties of USN and you want to get as good of an overall picture as you can get
63
true or false: apples test tests only allocentric neglect?
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
What intervention causes a shift in the sensorimotor coordinates? How?
prism adaptation optically displace the visual field by 10 degrees, UE trajectory is occluded during motor task
65
is the prism adaptation perminant?
nope its transient!
66
does the prism adaptation help with allocentric or egocentric neglect?
egocentric
67
eyepatching occludes what
hemifields on the neglected side to increase search to the neglected side
68
what intervention technique re-establishes balance btwn both hemispheres?
eye patching
69
how long are eye patches worn for. hours days
8 hours for 15 days
70
mirror therapy to get cortical reorganization and neuroplasticity is performed daily for how long
30 minutes
71
what two things does mirror therapy change physiologically?
cortical reorganizaiton and neuroplasticity
72
what intervention activates proprioceptive map in the parietal lobe?
ESTIM
73
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
2x20 min 5 days a week 40Hz If you're dong FES and visual scanning do it for 45 minutes at less Hz
74
Match the following pharmacological tx that benefit mostly egocentric neglect alerting orienting executive ACH dopamine noradrenaline
alerting: noradrenaline orienting: ACH executive: dopamine
75
are we the primary care givers for these cognitive perceptive disorders?
no, but it obviously impacts our treatment greatly
76
L hemisphere R hemisphere Neglect Apraxia
neglect: R apraxia: L

Unit 17 (9 decks)

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