Exam 3 Cognition Flashcards
Cognition and Perceptual Impairments categories (3-7)
- ~cognition
- ~higher order/ executive function
- ~Perception
- body scheme/body image disorders
- spatial relation disorders
- ~Agnosias
- ~apraxia
Cognition and perceptual impairments: cognition categories (2)
- ~attention deficits
- ~memory impairments
Cognition and perceptual impairments: cognition categories- attention deficits (4)
- ~Sustained attention
- ~Selective attention
- ~Divided attention
- ~Alternative attention
Cognition and perceptual impairments: cognition categories- memory impairments (3)
- ~immediate recall
- ~short- term
- ~long- term
Cognition and perceptual impairments: Higher-order/ executive function (4)
- ~Volition
- ~Planning
- ~Purposive action
- ~Effective performance
define Volition
Ability to move
define Planning
Want to do something so you plan your movement
define: Purposive action
When you are able to do an action that has a pursue
Cognition and perceptual impairments: perception (4)
- ~body scheme/ body image
- ~spatial relation disorders
- agnosia
- apraxia
Cognition and perceptual impairments: 5 body scheme/ body image disorders
- ~Unilateral neglect
- ~Anosognosia
- ~Somatoagnosia
- ~Right-left discrimination
- ~Finger agnosia
Cognition and perceptual impairments: 7 spatial relations impairments
- ~Figure-ground discrimination
- ~Form discrimination
- ~Spatial relations
- ~Position in space
- ~Topographical disorientation
- ~Depth and distance perception
- ~Vertical disorientation
Unilateral neglect (4 things about it)
- ~inability to recognize half of your sensory form ½ your body that is not due to a sensory loss
- ~Usually left side
- ~pusher- push towards their affected side/ involved side
- ~The person will not know/ think about the involved side; the body wants to compensate and will push towards the involved side to try and make a new midline
Anosognosia
what is it?
when does it occur?
when is it most prominent?
- ~No insight or awareness of their injury; their brain does not know that they has had the injury
- ~Usually resolved in the first few months
- ~Usually more prominent right CVA
Define Somatoagnosia
- ~“body agnosia”
- ~Difficulty with body structure and the relationship with one body part to another; where is my elbow in relationship to my hand
define Right-left discrimination impairment
- ~No clue on R/L
- ~Have to put some other input besides r/l; tapping, colors, etc
Define Finger agnosia
- ~Cant figure out how to use the fingers in a helpful fashion; any fine motor skill is not easy
- ~Opposition, tying shoes, buttoning, etc
define Figure-ground discrimination impairment
- ~You wont be able to discriminate between lines to find a figure; will just random line and not image
- ~Cant see where things are because they are all just in the background
- ~Cant figure out where to grab on a wheelchair
describe Form discrimination impariment
- ~Small difference are hard for the pt to discriminate/ separate
- ~If you open up a drawer- there are lots of long skinny object (pencils, pens, tooth brush, etc) but they all look the same to the stroke pt
define “Position in space” impairment
- ~Up, down, in, out, below, above- all a jumbled mess to them
- ~Get on top of the table? Put you hand on top of your knee? Etc
- ~They cannot understand what that means
describe “Topographical disorientation” impariment
- ~Map- if you want them to gym from their room, they wont remember how they got there (the twists and turns)
- ~They wont remember how to get to the restroom
- ~Very common in TBI and stroke; good reason to keep them in therapy
describe “Depth and distance perception” impairment
- ~Can be visual
- ~Do you where glasses? Near or far sighted?
- ~Stairs- can look like a slide or a wall; pouring into a glass; curves; potholes/ bumps in the ground
describe “Vertical disorientation”
- ~Everyone is off by 10-15*at first after stroke; not standing straight because they think the world is off tilted
- ~The world is off to them, so they walk funny/ at an angle
- ~*like you are walking through the crazy house
- ~Typically gets better; can occur in either type of stroke (right or left)
what are three Agnoias?
- ~visual agnosia
- ~auditory agnosia
- ~tactile/ asterognosis
describe Visual agnosia
- ~Has normal eye function/ their eyes work
- ~They have problems naming the object when they just looking at it
- ~If they can hold it, they can name it right away
- ~Just can’t process the visual pathways to say what it is
describe Auditory agnosia
- ~They can still hear, but is a sound has a similar sound, it sound the same
- ~Inability to recognize/ decipher the sounds
- ~Bark and lightening; cell phone and an ambulance going down the street, voices will probably sounds similar
- ~Typically have other processing issues
describe Tactile/ astereognosis
Cant tell you what it is when it is in your hand without looking at it
list four Apraxias
- ~ideomotor
- ~ideational
- ~constructional
- ~dressing
describe Ideomotor apraxia
- ~Breakdown btw concept and performance
- ~They can do the task but they cannot do the task when asked~Can brush their teeth without thinking, but if you ask them to do it, they cant
- ~Can get it form an idea to a motor
- ~You can sometimes trick them into doing it (if you tell them to stand, they cant, but if you try and get them to get a drink of water, they will easily stand up)
- ~Also tend to perseverate (motor or verbal)- yes, yes, yes, yes or they keep doing the same action over and over again
describe Ideational apraxia
- ~A complete failure of the conceptionalization of the task
- ~Cant even do the task~Have no idea on how to put the tasks together to walk, stand up, roll over, etc
describe Constructional apraxia
The ability to put parts together to make a whole (in the correct way)
describe Dressing apraxia
- ~Are you able to dress properly
- ~Putting underwear on the outside, etc
what do we need to know about Non equilibrium tests?
Does someone have coordination outside of balance; don’t have to know all these, but should know at least one for UE and LE for exams
what are some Non equilibrium tests? (16)
- 1) Finger-to-nose
- 2) Finger-to therapist’s finger
- 3) Finger-to-finger
- 4) Alternate nose-to-finger
- 5) Finger opposition
- 6) Mass grasp
- 7) Pronation/supination
- 8) Rebound test
- 9) Tapping (hand)
- 10) Tapping (foot)
- 11) Pointing and past pointing
- 12) Alternate heel-to-knee; heel-to-toe
- 13) Toe to examiner’s finger
- 14) Heel on shin (common)
- 15) Drawing a circle
- 16) Fixation or position holding
what are some Equilibrium tests?
Testing balance- berg’s, etc
COM- stands for
Center of mass
COM- male vs female (locations)
Men COM is around the navel, but females are lower because of hips
describe: Cone of stability
- ~if you take your COM to the limits of the BOSs without falling (leading forwards/ backwards/ side to side)
- ~After you fall, the person has a very small cone when standing
what is Retropulsion?
- ~after the fall, fight standing up
- ~will push back so they will move backwards
- ~rigid extension
BOS- stand for
Base of support
what are some things that can make a BOS?
- ~Feet: different when they are shoulder width, staggered, narrow, etc
- ~can be your butt when sitting- want 90/90/90 (hip, knee, ankles); moving forward and backwards will change BOS bc it changes where the feet are
As you get older, your BOS will..
get more narrow
what is Balance?
Maintaining your COM over your BOS
6 things that can Influence COM
- ~Large boobs
- ~Larger belly/ pregnancy
- ~Backpacks
- ~HALOs
- ~Amputees
- ~Injuries on LE- will stand on the uninvolved side
If you start to fall to try and keep from fall, what are the 3 stragegies?
- ~Bend at the ankle
- ~Bend at the hip
- ~Take a step
If pt has fallen…
Do fall prevention training
- ~You want to work on putting them right to the point of them falling without making them fall
- ~Don’t let them fall!
- ~Strengthen muscles and neuro system to work faster
- ~Will find out where they are weak and work on that part
- ~You want to perturb them, unstable surfaces, etc
- ~Want to do a lot of single leg stuff (walking involves single leg stance)
Standing with assistive devices- cane
what happens to COM?
Com is in the center, but if you have a cane, the cane will move the COM towards the cane side
Standing with assistive devices- crutches
What happens to COM?
Crutches are like a double cane (one on each side) people need to be really good with their BOS with the feet are off the ground
Standing with assistive devices-walker
what happens to COM?
- ~Walkers- make sure that the pt is within the walk’s base
- ~if the walker is in front of the pt, the COM is way in front of the feet
- ~Different walkers: Standard walker, rolling walker, posterior walker, hemiplegic walker
Standing with assistive devices- roller
issues
Roller- will not let you get within the walking space
Standing with assistive devices- cane
COM is normally in the center, but if you have a cane, the cane will move the COM towards the cane side
