EXAM 3 RHD symptoms/deficits? Flashcards
Right Hemisphere Functions (non-verbal)
- Thought Organization (staying on topic)
- Mental Flexibility (following someone else’s topic change)
- Motivation
Right Hemisphere Functions (Communcation)
- Intonation (voice shows emotions)
- Non-literal language (idioms, metaphors, proverbs)
- Emotional Comprehension and Expression
- Facial Expression
Causes of RHD
STROKE, tumor, brain injury
Cognitive Domain: Affective (emotions) Deficits in RHD
-Difficulty expressing emotions
-Difficulty recognizing emotions of others
- Delusions and confused states
- Agitated delirium, confabulations, and disorientation
- May refuse to acknowledge family
- Depression
- Apparent lack of motivation
- Apathy
Characteristics of RHD (Communication)
- Prosody (aprosodia)
- Comprehension
- Production
- Pragmatics
- Complex linguistic material (humor/idioms)
- Discourse
Cognitive Domain: RHD Attention Deficits
Focused, selective, sustained, and alternating attention, unilateral neglect
Focused Attention
Response to a single, specific stimulus
Selective Attention
Focus on task/stimulus while ignoring distractors
Alternating Attention
Shifting between two or more things
Sustained Attention
Maintaining focus over time
Inattention
Visual Inattention is a lack of awareness. The patient is unable to perceive an object without a loss of vision.
Perceptual loss is NOT a loss of sight
Unilateral Neglect
Reduced attention to contralesional space is NOT a visual deficit
Hemispheric Visual Attention
Left hemisphere attends only to the right visual field
Right hemisphere can attend to both visual fields
Neglect syndrome
Big sign of RHD: patients do not respond to any information presented on the opposite side of the brain lesion:
- Visual Information
- Auditory Information
- Proprioceptive information
Neglect Types
Left Neglect: Due to RHD, it is more common, more severe, and lasts longer
Right neglect: Due to Bilateral, it is less common, may be masked by other deficits (e.g., aphasia) , less severe, and resolves more quickly
perceptual and Attentional Deficits in RHD
Impulsivity, distractibility, and poor attention to tasks.
Neglect may also occur across other modalities such as tactile, olfactory, sensory-motor, psychosocial, and emotional components
Cognitive Domain: Executive Function Deficits in RHD
- Reduced awareness of
deficits (anosognosia) - Disorientation
- Impaired attention: especially sustained and selective attention
- Difficulty with memory
- Poor integration of information
- Difficulty with logic, reasoning, planning, and problem solving
- Impaired comprehension of inferred meanings
- Difficulty understanding humor
- Lack of motivation (also from frontal lobe damage)
- Impulsivity
- Disorientation to time and direction
Anosognosia
Reduced awareness of deficits:
Hard to assess, can resolve during spontaneous recovery, awareness influenced by motivation, fatigue, complexity
Communication Domain: Apragmatism in RHD
trouble understanding or producing language in social situations through linguistic, paralinguistic, and/or extralinguistic modes
Communication Domain: Linguistic in RHD
Impairments seem related to putting information together both words and non-verbal cues (linguistic/nonlinguistic)
May struggle with:
Understanding complex stories
Following steps or instructions
Putting events in the right order
Theory of Mind and RHD
The ability to understand that others have ideas, thoughts, beliefs, feelings, and emotions that differ from one’s own can be affected by RHD
Discourse in RHD
Trouble making and understanding meaningful conversation
Thoughts may be disorganized or jump around
Hard to follow or use the “unspoken rules” of conversation (like turn-taking or staying on topic)
Struggles with understanding complex language
Communication Domain: Paralinguistic
Prosody: consists of pitch, stress, and duration and contributes to the meaning of language
RHD patients may experience aprosodia
Aprosodia in RHD
Expressive: Talks in a flat or monotone voice; doesn’t show feelings through tone
Receptive: Struggles to understand others’ emotions or tone of voice
Shows less facial expression or can’t read others’ expressions well
