Cognitive Deficits (Perceptual)

Question 1

What is unilateral neglect?

Answer 1

Inability to register and integrate stimuli and perceptions from one side of the body (body neglect) or the environment (spatial neglect)

Aka: Hemineglect

Question 2

Which side of the body is usually affected by hemineglect?

Answer 2

Left side of the body; Right sided lesion (parietal lobe)

Question 3

What is Anosognosia?

Answer 3

Lack of awareness, denial or lack of insight to their deficits.

Question 4

What is Right-Left Discrimination?

Answer 4

Inability to identify the right and left sides of one’s own body or that of the examiner

• Patient cannot tell the PT which is the right arm or the left arm.
• Not able to understand the command “turn right at the corner”

Question 5

With a patient with Right-Left Discrimination Disorder what verbal cues/command do we need to avoid?

Answer 5

Avoid using commands that include terms “right and left”

Question 6

What is Finger Agnosia?

Answer 6

Inability to identify the fingers of one’s own hands or that of the examiners.

• Difficulty naming fingers on command
• Difficulty naming what finger was touched

Question 7

What movements/tasks deficits are Finger Agnosia highly correlated with?

Answer 7

Poor dexterity; Fine Motor Skills

• Buttoning a shirt
• Typing
• Tying shoes

Question 8

Which lobe has the biggest role in spatial perception?

Answer 8

Right Parietal Lobe

Question 9

What is Figure-Ground Discrimination?

Answer 9

Inability to visually distinguish a figure from the background in which it is embedded

• Patient cannot located items in a drawer, buttons on a shirts.

Question 10

What is Form Discrimination?

Answer 10

Inability to perceive or attend to subtle differences in form and shape.

• Patient confuses objects of similar shape
• Confusing a pen with a toothbrush

Question 11

What is a spatial relations disorder?

Answer 11

Inability to perceive the relationship of one object in space to another object or to oneself

Question 12

What is a Position in Space Impairment?

Answer 12

Inability to perceive and interpret spatial concepts such as up, down, under, over, in, out, in front of, and behind.

• Not understand if we say put your hands “above” your head
• Put your feet “on” the footrests.

Question 13

What is Topographical Disorientation?

Answer 13

Difficulty in understanding and remembering the relationship of one location to another. (Trouble navigating their familiar environment)

• Patient unable to get from one place or another, such as going from their room to the PT clinic despite being shown repeatedly.
• Unable to describe the layout of their bedroom at home.

Question 14

What is Depth and Distance Perception Disorder?

Answer 14

Inaccurate judgement of direction, distance and depth.

• Difficulty navigating stairs
• Miss a chair when attempting sit
• Pouring water in a glass that is already full

Question 15

What is Vertical Disorientation?

Answer 15

Distorted perception of what is vertical

• May view the world differently, thus affecting posture

Question 16

What is Visual Agnosia?

Answer 16

Inability to recognize familiar objects_despite normal function of the eyes and optic tracts.

Question 17

What is Prosopagnosia?

Answer 17

Inability to recognize familiar faces

Question 18

What is Astereognosis?

Answer 18

Inability to recognize forms by handling them despite having all necessary sensations intact.

• Causes ADL difficulties

Question 19

What is Apraxia?

Answer 19

Impairment of voluntary skilled learned movement

• Inability to perform purposeful movements

Question 20

What is Ideomotor Apraxia?

Answer 20

Disconnect between the idea of a movement and its motor execution.

• May carry out habitual tasks automatically
• Not able to complete/imitate tasks on command

When asked to comb their hair, may not use the comb appropriately. Patient may even tell you what the object is for. Patient will be to do it spontaneously.

Question 21

which hemisphere are apraxias typically a result of?

Answer 21

Left hemisphere damage

Question 22

With patients with ideomotor apraxia, how should verbal commands be altered?

Answer 22

• One command given at a time, second command should not be given until the first task is completed
• Talk slowly, shorter sentences

Question 23

What is Ideational Apraxia?

Answer 23

Inability to perform a purposeful motor act either automatically or on command. Patient does not understand the overall concept/idea of the task.

• May be able to perform isolated components, but cannot combine them to complete the task.
• Cannot describe the use of an object.

e.g:

• Trying to put toothpaste on a toothbrush without moving the cap, or putting the entire tube of toothpaste in the mouth

Question 24

What is Homonymous Hemianopia?

Answer 24

Loss of half of visual field in each eye, contralateral to the side of the cerebral hemisphere lesion

Question 25

What is Somatognosia?

Answer 25

Body scheme disorder; personal awareness of one’s own body.

Question 26

How to test joint position sense;proprioception?

Answer 26

Perceive joint position at rest, in response to your position of the patient’s limb

Question 27

How to test kinesthesia?

Answer 27

Perceive movement in response to moving the patient’s limb, patient can duplicate movement on opposite side or give verbal report.

Question 28

Difference between Rigidity and Spasticity?

Answer 28

Both are increase resistance to PROM

Rigidity - Not Velocity Dependent
Spasticity - Velocity Dependent; increased speed = increased resistance