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Neuromanagment > Influence and Effects of Perception Dysfunction > Flashcards

Influence and Effects of Perception Dysfunction Flashcards

1
Q

What is perception?

A

The process of using senses to acquire information about the surrounding environment or situation

  • Perceived information (input) further processed by cognitive functions
  • Our perception of the environment provides information so that we can respond accordingly
  • Finely honed perceptual skills gained through practice and experience
  • Develop expertise and efficiency in actions
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2
Q

What is the pathway of sensation to the CNS?

A

Stimulus energy (light, sound, etc) > Sensory receptors (eyes, ears, nose, etc) > Neural impulses > Brain (visual, auditory, olfactory areas)

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3
Q

What are perceptual impairments?

A

The loss of ability to correctly perceive. There is a distorted view of body and awareness of body in relation to the environment. Most commonly seen with lesion in right hemisphere

Causes:

  • CVA
  • TBI
  • Degenerative disorders: MS, Parkinson’s, Alzheimers
  • Acquired brain injury
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4
Q

What are effects of perceptual and cognitive impairments?

A
  • All occupational areas are affected (ADLs, IADLs, education, play, leisure, and social participation)
  • Serious safety concerns (walking, transferring, and everyday tasks)
  • OT’s role is to assess safe and independent functioning in valued occupations
  • Be aware and assess visual perception and cognitive understanding and awareness
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5
Q

What is gnosis and agnosia?

A

Gnosis is knowledge or knowing

Agnosia refers to loss of knowledge and inability to recognize sensory input

  • Loss of ability to recognize familiar objects, words, people, shapes, and forms perceived by senses
  • The specific sense/sensation (tactile, visual, auditory) is intact because the person has sensory reception
  • Sensory recognitions is a problem area
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6
Q

What are types of perceptual dysfunction?

A
  • Visual perception/agnosia
  • Visual spatial perception
  • Tactile perception/agnosia
  • Body scheme perception
  • Motor planning perception
  • Gustatory perception
  • Olfactory perception
  • Language perception
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7
Q

Vision Screening

A
  • Is always warranted when client has a neurological impairment
  • Vision is critical pathway for clients to gather information about their environment
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8
Q

What is form constancy?

A
  • The ability to visually discriminate and tell the difference between a boy wearing a yellow jacket and a large yellow duck
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9
Q

What is visual agnosia?

A
  • Inability to identify or recognize familiar objects and people
  • Visual system is intact
  • Neural connections are interrupted between cortical receptor region for visual stimulus and memory of image
  • Usually due to parietal lobe damage
  • Ex: Inability to recognize a coat, shoes in a closet, or car in a parking lot
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10
Q

What is prosopagnosia?

A
  • Inability to recognize familiar faces
  • Inability to perceive expressions of facial muscles that make every person unique
  • This can sometime misdiagnosed as dementia
  • Damage to left hemisphere
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11
Q

What is visual attention?

A

Attention that is influenced by general alertness, visual fixation and focused gaze of person
- Defined as person ability to determine: what (object identification) and where (orientation to space) of thing in the environment

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12
Q

What is visual spatial inattention?

A

Client has decreased awareness of body and spatial environments on side contralateral to cerebral lesion
- Can occur with or without visual field deficits

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13
Q

What happens when a person is unable to discriminate right from left?

A
  • Client doesn’t understand the concepts of right and left
  • Inability to know their left and right body parts
  • Inability to know left or right in relation to objects and directions in the environment
  • Occurs when there is damage to the left hemisphere
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14
Q

What is visual-spatial perceptual disorder?

A
  • Clients have difficulty following directions
  • Clients have difficulty getting from one place to another
  • New environments are difficult because they are unrecognizable

Problems with:

  • Topographical orientation
  • Position in space dysfunction: difficulty with directional concepts of up, down, left, right
  • Depth perception: misjudging distance of proximity of objects close or far away
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15
Q

How do OTs assess perception?

A
  • Interview client
  • Observe client in natural environment while doing ADLs
  • Test perception
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16
Q

What are visual perception agnosia assessments?

A
  • Ask client to identify common and familiar items

- Ask client to point or identify family members and friends in photos or from phone

17
Q

What are visual agnosia interventions?

A

Compensatory strategies include:

  • Use of other senses: tactile or olfactory to recognize object/item
  • Increase client awareness of limitation
  • Teach spatial and location cues to recognize objects and people
  • Organize space/environment for items, practice through repetition
  • Use color cues, labels, textures to hightlight items
  • Have client describe properties of objects
18
Q

What is tactile agnosia?

A
  • A perceptual disorder that commonly results from lesions to the secondary somatosensory area of the parietal lobes (touch, pain, temperature receptors remain intact)
  • Higher level of synthesis compared to basic tactile sensory functions for light touch and pressure
  • Client has difficulty attaching meaning to objects in environment by touch alone
  • Ex: reaching into pocket and discriminating between coins by touch alone
  • Difficulty typing
  • Difficulty with fasteners despite intact motor function
  • Client cannot distinguish objects without visual cues
19
Q

What is astereognosis?

A
  • The inability to identify common objects by touch alone
  • Clients still have motor function
  • Movement may be slow and purposeful and people with astereognosis may be less active
20
Q

What are principles of perception assessments?

A
  • Requires a verbal response from client (naming a picture)
  • Motor response (drawing or construction)
  • Flexible response
    1) Multiple choice indicated by vocalizing the number or letter or pointing to chosen item
    2) Allows for physical and/or communication limitations of client (adapt assessment)
21
Q

What is the purpose of assessing for tactile agnosia?

What are indications of tactile agnosia?

A
  • To test person’s ability to identify common objects and perceive their tactile properties
  • Occlude person’s vision
  • Common objects use: pencil, pen, key, nail, sunglasses, etc.
  • Client is unable to ID 35 objects presented
  • Client is able to identify objects in one hand but not the other hand - lesion is indicated on the contralateral hemisphere
22
Q

What is ahyognosia?

A
  • Inability to discriminate between different types of materials by touch alone
23
Q

What is amorphagnosia?

A
  • Inability to discriminate between different forms by touch alone (triangle, square, circle, rectangle)
24
Q

What is agraphesthesia?

A
  • Inability to recognize numbers, letters, forms written on skin’s surface
  • Agraphesthesia is indicated if clients ID 3/5 letters or person is able to identify letters on one hand but not the other
25
Q

What are compensatory interventions for tactile agnosia?

A
  • Increase the clients awareness of the problem, especially how it will affect function and personal safety (i.e. kitchen, ADL’s)
  • Utilize other senses - vision and use of “good hand” to teach tactics of perception
  • Use visual strategies to aid in recognition, “it is white and square. Is it a bar of soap?”
  • Choose sensory tasks of interest to client, they can start and finish allowing for success and failures to promote learning
  • Train the client to focus on specific properties of the object (i.e. contour, texture, or temperature)
  • Present the object within normal context and routine
26
Q

What are interventions for tactile perception/agnosia?

A
  • Allow patient to manipulate item while looking at it, making noise with objects such as tapping on a tabletop (use sound, tactile, and vision senses)
  • Client examines object visually as it is rotated by therapist
    1) Handle item in less affected hand while observing
    2) Handle with both hands while observing
    3) Place object in affected hand and observe
    4) Repeat with vision occluded, once ID of item is consistent, client retrieves item placed in sand or bag
27
Q

What is body scheme perceptual disorder?

A
  • Aka somatognosis
  • In early development, tactile, proprioceptive, vestibular, and visual perception provides internalized sense of body scheme - which is essential to all motor function
  • Body scheme is awareness of spatial characteristics of one’s body in space
  • Sensory perception resulting from synthesis of sensory systems
28
Q

What is unilateral neglect?

A
  • Likely to result from right hemisphere lesions in the posterior parietal multimodal associate area
  • Client presents inattention to left side of body and environment following a CVA or TBI
  • Person’s sense of body shape, position, and capacity is frequently distorted
29
Q

What is unilateral motor neglect?

A
  • Motor problems: sensory or motor neglect
  • Does client fail to respond because they don’t perceive (sensory neglect) or because they can’t initiate the movement (motor problem)?
  • Assessment and testing - observe how they use extremity (UE or LE or both)
  • Reluctance to move
  • Movement after a delay (hypokinesia)
  • Movement with strong encouragement (akinesia)
  • Tendency to undershoot target they are reaching for (hypometria)
  • Monitor direction of movements
    1) Movements in same “side” space (right or left side of body)
    2) Contralateral space movements (across midline of body)
30
Q

What are symptoms of unilateral/left neglect?

A
  • Inability to integrate and use perceptions from one side of the body or one side of the environment. The awareness of left side of body is lost temporarily
  • Clients often experience left neglect syndromes, although right neglect does occur
  • Clients can be trained to heighten their awareness of the neglected side of the body and environment

Neuromanagment (22 decks)

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