Final Flashcards
Functions of the right hemisphere: Language
- Prosody
- Emotional content
- Humor
- Figurative Language
Functions of the right hemisphere: construction (visuo spatial)
- External details
* General Orientation
Functions of the right hemisphere: Calculation
• Visuospatial organization of digits
Functions of the right hemisphere: Memory
• Non-verbal memory
Functions of the right hemisphere?
Processes holistic non-linear, spatially distributed arrays.
It is holistic and context-dependent, ex: Verbal jokes, Metaphors, Narratives, Indirect speech acts and Intonation
Recognition of facial expression
- How do you screen for visual neglect?
Cancelation
Line bisection
Scanning
Drawing
Cancellation
look at an array of stimuli (symbols, numbers, letters, etc.) on a page. Make a mark through all of target symbol. Can increase number of items or number of different stimuli to make more difficult. Total number missed is a measure of general attention abilities, and more missed on left side is related to left neglect.
Line bisection
bisect a horizontal line through it’s center
Scanning
scan rows of numbers, letters, or symbols for the target. Id all instances of target
Drawing
from memory or copy symmetrical objects (flower, man, cross, house, tree, square)
• Test for right hemisphere syndrome
RICE - Evaluation of Right Hemisphere
Burns, Halper, & Mogil 1985 (2nd Edition)
MIRBI - The Mini Inventory of Right Brain Injury, Pimental & Kingburg 1989
(2nd Edition)
Categories of dementia and examples
- Age: “presenile dementia” (before age 65) and “senile dementia” (after age 65)
- Cortical: Alzheimer’s dementia & Pick’s Disease
- Subcortical: Parkinson’s Disease, Huntington’s Chorea & Progressive Supranuclear Palsy
- Mixed: Vascular dementia, Lewy body dementia & Front temporal dementia
The early stages of Alzheimer’s disease: strengths
Language comprehension
Express needs independently
Conversations
Answers multiple choice and yes/no questions
The early stages of Alzheimer’s disease: deficits
Diminished reading comprehension Difficulty with written expression Word finding Paraphasia Reduced verbal output Pragmatic deficits Distractibility Difficulty concentrating Confusion Disorientation Problems maintaining ADLS
- How could you differentiate between primary progressive aphasia (PPA) and dementia?
• Cognition (idea/taught) is not impacted in PPA while it is in Dementia
• Patients with Dementia often encounter difficulties performing daily activities while patients with PPA do not.
• PPA occurs with apparent reason
- No identifiable stroke, tumor, infection, or metabolic disease.
• PPA is a clinical syndrome and not a reflection of a particular underlying brain pathology, while Dementia is a syndrome due to disease of the brain and it is characterized by diffuse impairments of memory, intellect and cognitions appearing later in life.
• PPA can announce the presence of degenerative neurologic disease
Dementia
is a syndrome due to disease of the brain, it characterized by diffuse impairment of memory, intellect and cognition appearing late in life, developing gradually and worsening over time.
PPA characteristics
characterized by gradual deterioration of language functions. Many patients develop impairments in memory, attention, reasoning and executive function 2 to 10 years after the appearance of aphasia.
- Symptoms of fronto-temporal dementia
- Early decline in personal & interpersonal conduct
- Emotional blunting
- Loss of insight
- Mental inflexibility
- Distractibility
- Impersistence
- Hyper orality & dietary changes
- Perseverative behavior
- Adequate goals for clients with dementia
Mobility, Communication, Socialization & Behavior
• Montessori based intervention
• R’ will consistently respond to cue to recall presence of food tray and initiate self‐feeding 80% of trials.
: Connects past interest and skills with present spared skills. Ex: recalling family member’s names to increase communication and socialization in visits
millieu therapy
To increase socially appropriate behaviors
• Client will correctly match names with peers on unit to promote socialization and interaction during meals 80% of trials.
Spaced-retrieval training
Pts recall important information over progressively longer intervals of time.
“Client will recall location of daily schedule to complete ADL’s independently & improve participation in meals and with peers 90% of trials.”
Reminiscence Activities:
Capitalize on person’s remote memory, is usually persevered until the late stages
• Client will utilize personal memory book to remain constructively engaged and promote conversation with others 90% of trials.
PPA
clinical syndrome and not reflection of a particular underlying brain pathology decline in linguistics abilities for no apparent reason (no identifiable stroke, tumor, infection, or metabolic disease)
Vascular dementia
an important cause of dementia in adults, second to Alzheimer’s with 15-20% of dementia cases. Diagnosed by the presence of dementia and evidence of cerebrovascular disease. Pure vascular is uncommon
Patients have a history of hypertension, heart disease or both and multiple strokes.
• Abrupt deteriorations & stair-step decline
