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quiz 2 611 > cognition/ perception > Flashcards

cognition/ perception Flashcards

1
Q

Ideational apraxia

A

inappropriate tool use, sequences activity incorrectly, overall loss of conceptual task, uses familiar objects incorrectly, ie.. can’t put toothpaste on toothbrush, eat soap, toothbrush used as hairbrush, can’t understand what to do with cane or walker, eats with fingers, task perseveration and multistep tasks requiring multiple objects AM and PM activitys are difficult.
Perseverates: ie.. is to repeat motion of washing area of face, must have to do hand over hand for them to wash other side.

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2
Q

Ideomotor/conceptual apraxia

A

A disorder of the Production Praxis System. A loss of kinesthetic memory patterns so that purposeful movement can’t be produced or achieved due to defective planning and sequencing of movements even though idea/purpose of task is understood.
A. clinical manifestations: the symptoms that appear
B. Awkward or clumsy movements
C. difficulty crossing midline, .
D. Trouble orienting the hand to objects, ie… hold in primitive way, “ lateral grasp” ie…pick up wrong side of fork or pencil to use
E.spatial errors such as moving scissors laterally
F. Difficulty coordinating 2 or more joint tasks: they breakdown 1 joint movement at time.
G. Difficulty with timing of movement
H. Imprecise movements
I. poor gesture ability

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3
Q

Global aphasia

A

expressively and effectively can’t produce speech “ can’t 1.understand understand or produce speech

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4
Q

Apraxia Prevalence

A

can’t do tasks on command but can do it when want.
Occurs with acquired brain injury, CVA, Parkinsons and Alzheimers , Suprnuclear palsy and Huntingston disease.
Strong association b/t expressive aphasia and ideomtor apraxia

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5
Q

Apraxia and ADL

A

Those with ideomotor apraxia have greater 1.dependence in toileting, dressing and bathing 2.compared to age matched controls.

  1. Start with familiar ADL for TX, kitchen assessments
  2. Learning new skills and relearning old skills in those with apraxia requires more repetition.
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6
Q

Assessments for Apraxia

A
  1. Structured Observation of functional Tasks
    a. content: “ Can they actually handle the basic tools?”
    b. temporal: figure out use of tool for functional task
    c. spatial: overshooting, under shooting, depth perception problems.
  2. MMT
  3. Dynatometer
  4. finger to nose coordination
  5. upper quarter screen
  6. clinical visual screen:
  7. Motor free vision perceptual test:
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7
Q

Intervention for Apraxia

A

focus was error specific and determined by the problems observed during the standardized ADL observations. Every two weeks new task were chosen.

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8
Q

Errorless learning

A

sit next to the pt. DO NOT let them make mistakes. Use hand over hand to model ADLs through whole routine.
Same way every time!

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9
Q

Apraxia

A

Absence of motor planning ability. ( frontal and parietal lobe dysfunction) . Consists of two steps: A. conceptual/ideation
B. production planning
DO NOT let them problem solve. To much frustration

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10
Q

Errorless learning

A

preventing mistakes through verbal and physical support verses trail and error.

a. initiation: develop necessary plan of action and SelectinG objects.
b. Execution: performing the plan ( hand over hand initiation only) usually no hand over hand!.
c. control: detect and correcting errors to ensure desired end result.

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11
Q

Chaining

A

start part of task for pt. and then pt. finishes task.

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12
Q

Hemianopsia ( Hemianomous hemianopsia) usually left side sensory and blindness

A

Blindness in 1/2 of the visual field and sensory loss within visual field.
compensation: by turning their head, prism glasses . Gets better as swelling of brain goes down.

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13
Q

intervention hemianopsia

A
  1. stimulate head turning toward left side (sensory and environmental )
  2. Pair movement with head turning toward left. ie visual exercise head turning throwing bean bags in cans by side.
  3. Prisims( binasal taping) “ behavioral optometrist ie Dr. Fox
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14
Q

Depth Perception

A

3-D understanding of objects ie night vision or glare

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15
Q

Figure ground

A

foreground from background distinction (white wash cloth on top white towel)

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16
Q

Spatial relations

A

relationship of objects to each other and self

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17
Q

Intervention for Visual deficits

A

Best to do functional everyday activities safely.
Task specific training, combine movement with visuospatiial demands, combine compensatory strategies with appropriate sensory cues

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18
Q

Agnosia

A
  1. inability to recognize incoming sensory information, sensory reception is intact.
  2. Loss of ability to recognize objects, people, sounds and shapes.
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19
Q

Visual Agnosias

A

inability to recognize incoming visual info despite intact primary visual skills.1. Object agnosia: can’t recognize objects in environment

  1. Prosopagnosia: poor face recognition, but will recognize voice.
  2. Simultanagosia: inability to recognize whole visual scenes. ie..beach, hosp, home setting
  3. Alexia: inability to recognize letters or words.
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20
Q

Tactile Agnosia: Astereognosis

A

inability to recognize tactually presented objects to despite adequate sensory , language and intellectual abilities.

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21
Q

Agnosia assessments

A

rule out sensory and memory loss, inattention, language deficit or dementia.
If more than one sensory modality is involved or cannot identify it by sound then it is most likely NOT agnosia.

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22
Q

Cognition

A

The brains ability to process, store, retrieve, and manipulate information.

23
Q

Attention

A

right prefrontal cortex function, able to follow directions, eye contact.

24
Q

Selective Attention

A

filtering critical from irrelevant stimuli while ignoring distractors. ( driving)

25
Q

Sustained Attention

A

vigilance to maintain attention over a period of time and to hold and manipulate information. ( vocation)

26
Q

Alternating Attention

A

flexibility to switch attention from one stimulus to another and return to original stimulus if needed. ( higher level executive functioning scale).

27
Q

Divided Attention

A

Multitasking b/t 2 or more competing tasks simultaneously.( cooking tasks, time management).

28
Q

Assessment of Attention

A

PASS and Test of Everyday Attention. Moss Attention Rating Scale , Trail Making Test Part A.( need visual scanning skills for this one). All Observation based

29
Q

Intervention for Attention

A
  1. Specific skills training: strategy development

2. time pressure management strategies for slow information processing. (TPM)

30
Q

Executive function Processes

A

Memory, Orientation, Judgment, Problem solving, Sequencing

31
Q

Memory Impairment

A
  1. attention
  2. encoding: register information storage
  3. storage: memories used and access and retention ( hippocampus and temporal lobes)
  4. retrieval: search for strategy and how to use info and how to recognize it.
32
Q

Anterograde Amnesia

A

Difficulty with recall of info AFTER acquired brain injury.

33
Q

Retrograde Amnesia

A

Difficulty with recall PRIOR to disease or injury.

34
Q

Short Term Memory

A

Stores chunks of info for a limited time.

35
Q

Working Memory

A
  1. Related to STM and deals with the active manipulation or rehearsal of information.
  2. conscious mental effort. ie..calculating change.
36
Q

Long Term Memory

A

relatively permanent storage expressed in skills, routines and habits.

37
Q

Explicit Memory/declarative (LTM)

A

Knowing something was LEARNED, facts, everyday events, knowledge of general world. ( dates, holidays, name of president, world events).

38
Q

Implicit Memory( LTM)

A

Knowing HOW to perform a skill, retaining previously learned skills ( driving, using AE, card game)

39
Q

Episodic Memory

A

1.Form of explicit LTM
2. Autobiographical memory for personally experienced events within context. ie..Remembering sequence in events , job, meal, days
TBI have issue’s with this

40
Q

Prospective memory

A
  1. Remembering to carry out FUTURE intentions. ( frontal lobe)
  2. requires working memory to be functional
  3. Critical for independent living
  4. planning phase: time-based ie meds on time, activity based ie turn lights out, event based, an action when external cue appears.
41
Q

Metamemory

A

Awareness of ones own memory abilities and knowledge of when compensating is needed via lists, writing down information, recognizing errors.

42
Q

Memory assessments

A

Rivermead Behavioral Memory test ( RBMT) a
Global memory test. Predicts everyday memory problems, 20-30 minutes to administer.
ie..what kind of things do you need to get together to get ready in the morning?
Weather outside and what to wear?

43
Q

Contextual Memory test (Memory assessments)

A

Awareness of memory, predicting memory prior to test, estimating capacity following test.
Immediate recall of 20 drawings
strategy use.

44
Q

Everyday memory Questionnaire ( Memory assessments)

A
  1. 35 items in original, now has 28 items
  2. TBI, CVA, MS, Elderly
  3. Speech- keeping track of conversation
  4. reading and writing- recall of spelling word, writing a sentence.
  5. Faces and places- recall of where object was put recognition of faces and locations!!6. actions - routines
  6. New learning- new skill, recall a NEW name, recall an appt.
45
Q

memory Interventions

A

Compensatory is best option, memory notebooks

46
Q

Errorless Learning techniques for memory

A
  1. Provide correct answer immediately.
  2. Backward Chaining: all steps of task are shown/ prompted by OT; next trial all but last step is shown/prompted and pt. must demonstrate it; 3rd trial all but the last 2 steps are shown/prompted and pt. must demo those and so on.
  3. Forward chaining: OT shows/prompts first step on the first trial , the first 2 steps on the second trial, and continues until whole sequence is remembered.
47
Q

Pre setting (Errorless Learning techniques for memory)

A

Put most important information at beginning of sentence.

environmental organization: simplify

48
Q

Executive functions

A

complex cognitive skills that require the coordination of several sub- skills to achieve a purposeful, goal directed behavior.
Mainly frontal lobe awareness and functioning

49
Q

Assessment of Executive Function

A

Executive Function Performance Test follow up with KTA

  1. uses structured cue/scoring system less than 25 = more deficit
  2. Light meal prep, medication management, phone use and paying bills
50
Q

Behavioral Assessment of the Dysexecutive System ( BADS) (Executive functions)

A
  1. Problem solving, planning and organizing behavior
  2. 6 subtests
  3. Good for assessing those from hospital more than home environments
  4. Flexibility, novel problem solving, judgment and estimation, behavioral regulation, and planning.
51
Q

Multiple Errands Test (MET)( Executive functions)

A

pt. is given 3 sets of tasks to perform with 8 instructions each with different requirements. Multitasking is required and pt. must structure , plan and execute tasks efficiently. ( Novel for pts) good to check

52
Q

Cognitive Failures questionnaire (Executive functions)

A
  1. self report for patient or others
  2. Attention lapses, memory, attention and cognition
  3. 25 items scored based on frequency of mistakes 0=never, 4= very often.
53
Q

Executive Function Route Finding Task (EFRT)

A
  1. Pt. must find an UNFAMILIAR office within their facility
  2. Rates aspects of route finding using Likert scale.
    a. understanding task
    b. retaining directions
    c. detecting
    d. correcting errors
    e. remaining on task
54
Q

Interventions for executive Skills

A
  1. problem solving and planning training
  2. Compensatory strategies ( development)
  3. environmental modifications
  4. task specific training
  5. Metacognitive strategies to promote self awareness.

quiz 2 611 (4 decks)

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