Chapter 11: non-motor impairments Flashcards
how can vision be affected in stroke patients
diplopia blurred vision vision loss nystagmus impaired ocular convergence impaired saccadic movement dry eyes
what assessments can be done for visual loss?
NIHSS item 1
types of somatosensory deficits
exteroception - loss of superficial tactile stimulus perception (vibration, touch, hot-cold discrimination, sharp blunt) via mechanoreceptors
proprioception - deep sensory inputs from muscles and joints
types of speech and language impairments
Dysarthria - loss of the ability to generate speech due to impaired function of the lips, tongue, larynx etc
dysphasia - loss of ability to interpret language
wernicke’s receptive, Broca’s expressive
Dyspraxia - loss of ability to organise, plan, process and/or execute skilled speech (unable to pronounce words properly, correctly and consistently)
types of speech and language impairments
Dysarthria - loss of the ability to generate speech due to impaired function of the lips, tongue, larynx etc
dysphasia - loss of ability to interpret language
wernicke’s receptive, Broca’s expressive
Dyspraxia - loss of ability to organise, plan, process and/or execute skilled speech (unable to pronounce words properly, correctly and consistently)
how can impaired perceptual-cognitive ability present in stroke patients?
agnosia neglect reduced attention and memory dyspraxia (of the limbs) pusher's syndrome
how is Neglect classified
by senses
- tactile, visual, auditory
by spatial distribution
- personal, peripersonal, extrapersonal
failure to respond to stimuli on one side of the body/space
what is agnosia
loss of ability to recognise sounds, people, faces, objects etc, despite intact sensory system
what types of agnosia are there?
astereoagnosia - inability to recognise symbols or objects by touch
autotopagnosia - inability recognise body/perceive own body parts, cannot distinguish left and right
Anosognosia - inability to recognise presence or severity of paralysis due to an underlying neurological condition
what is limb dyspraxia?
the loss of ability to organise, plan, process and/or execute skilled movements (fine motor)
what are the types of limb dyspraxia?
Ideational dyspraxia - characterised by absent-mindedness and lack of purpose in performing actions,
ideamotor dyspraxia - characterised by inability to select, sequence and use objects
what is pusher syndrome?
patients actively push away from the non-affected side of the body, leading to loss of balance
have an impaired perception of the body’s orientation in relation to gravity
What are the characteristics of pusher syndrome?
spontaneous body posture (lean towards paretic side)
abduction and extension of the intact arm/leg (pushing toward paretic side)
resistance to passive correction of posture (resisting attempt to upright posture)
what assessments can be done for neglect
NIHSS item 11 – neglect
Line bisection test
Cancellation test (bells or star cancellation test)
Copying and drawing test
- Figure copying
- Clock drawing
- Reading and writing
Catherine Bergego Scale (CBS)
General observation:
- Preferential gaze/attention to one side
- May slump to one side
- May leave hemiplegic arm behind when rolling or hanging when sitting
- May comb only one side of head, eat only one side of plate
What assessments can be done to assess somatosensory deficits
sensation - sharp blunt test, light touch test
proprioception - joint position and movement test
