Left Hemiplegia Flashcards
What is perception and what does it allow?
perception is how we attach meaning to sensation and allows us to recognize objects
What is the difference between serial processing and parallel processing?
Serial processing comes from info from a single sensation from a single type of receptor (e.g proprioception)
Parallel processing is different types of sensory info being processed at the same time and results in perception
What does motor processing begin with?
an internal representation of the desired movement (sensory processing)
What gives rise to perceptions and helps focus attention in extra-personal pace?
Posterior parietal lobe, which integrates somatic sensory input with other sensory modalities
What is agnosia?
What happens if people have this deficit?
Loss of ability to identify things through touch or vision
lose the ability to interpret or have meaning of things
What is Figure Ground?
What happens if people have a deficit in this?
Property of perception in which there is a tendency to see parts of a visual field as solid, well-defined objects standing out against a less distinct background
have difficulty visually differentiating objects from the surroundings
What is Apraxia?
What happens if people have this deficit?
a disorder of the nervous system, characterized by an inability to perform purposeful movements, but not accompanied by a loss of sensory function or paralysis
difficulty coordinating highly skilled tasks with multiple steps. They may have difficulty recognizing the purpose of tools or gestures
What is neglect?
somatic sensations are intact but lose conscious awareness of the spatial aspects of all sensory input from the left side of the body and left external space
What is denial?
severe neglect where the patient deny a leg or an arm belongs to them, they also are unaware of anything being wrong with them
Deficit in what brain area will cause conditions such as aparaxia and agnosia?
Left posterior parietal lobe
What is stereognosis?
ability to utilize somatosensory info (proprioception and touch) to identify objects
What is astereognosis?
How common is astereognosis?
an inability to recognize the form of objects through somatosensation
34-64% of people post-stroke have proprioception loss and 31-89% stereognosis loss
What interventions can help with astereognosis?
- Practice differentiating different objects through tactile cues
- Practice shaping hand for different objects
A lesion to what area would cause loss of figure ground organization?
Left posterior parietal cortex
What interventions can help for figure ground issues? Is this usually an area treated by PTs?
Instruct the person to identify important aspects from visual environment
Generally more of an OT area of practice
What are the 3 types of apraxia?
- deficits in sequencing action steps (i. e make a sandwich)- accessing the motor plan is a problem
- conceptual errors-knowledge of tool purpose and gestures-not understanding tool or gesture use
- Spatial-temporal organization errors during movement- may have wrong movements in motor plan, or problems with orientation, speed or grip
How common is apraxia?
25-46% of people with left hemisphere stroke have apraxia
What should be recorded and evaluated when doing a task analysis for a pt you suspect has apraxia?
- ability to sequence (making coffee or wrapping a gift)
- use of ab object (using matches or a stapler)
- interpret and perform gestures (waving or thumbs up)
What intervention are appropriate for apraxia patients?
- errorless guidance of movement with many reps is specific to the task with limited generalization to other tasks
- teaching similar movements under different contextual situations can address problems of generalization
- strategy training may be most effective for overall treatment
- use of verbal cues improves apraxia when cures are faded, must use meaningful activities
Damage to what area of the brain can cause neglect?
Right posterior parietal cortex
What deficits can arise from damage to the right posterior parietal lobe?
Neglect Syndrome (memory, sensory, or spatial neglect)
Disturbance in Direct Attention (post. parietal cortex and frontal cortex-shifting attention from one sensory input to another)
What is an extinction test? What are typical and atypical responses?
Exam that tests attention by using light touch unilaterally and then bilaterally
Typical Response- person identifies both single touch and bilateral touch
Atypical Response-identifies deficits in attention=the person recognizes single touches on either side, but when both sides are touched-one side is ignored
What intervention can help address or reduce neglect?
Sustain attention-use auditory cues (like a knock) and saying “attend” when the person is not attending to that side. slowly transition to have the individual perform self-cueing
Provide Proprioception Input-sitting r standing with body rotation to the left in sitting (head straight)-there is a stretch in the left SCM; the stretch provides a proprioceptive cue to attend to the left side
Prisms-prisms glasses move the left visual field to the right by 10 deg, then direct the individual to point to objects
Patching-patch right eye for 3 months to reduce left neglect
Mirror Therapy-initially place the mirror on the right side of the individual, such that they can visualize the left side, then instruct the individual to reach for objects in the left hemi-field, slowly move the mirror to the left
Sensory Stimulation- Sensory input to left side during tasks, either electrical stim or proprioception
A lesion to the posterior lateral thalamus can cause what syndrome?
Pusher Syndrome
What is involved with Pusher Syndrome?
Visual and vestibular systems ONLY
What is mismatch? What causes mismatch?
Visual vertical or perception of tilted body orientation relative to vertical based on visual and vestibular inputs
caused by error in information processing of info from the body and is NOT from the vestibular gravireceptors
Which direction will patient lean to with Pusher Syndrome?
toward the affected side
How do you classify a patient with pusher syndrome?
severe tilt with fall
severe tilt without fall
mild tilt without fall
True or False: An individual can only be classified as pusher syndrome if they use the uninvolved limbs to the side to “push” toward the paretic side
True
What interventions help address pusher syndrome?
Teach patient to recognize that they are not upright
Use visual cues of the environment to recognize upright
Learn the movements that are associated with the upright position
Maintain upright while doing other tasks
True or False: Prognosis for post-stroke patients with Pusher’s Syndrome is poor due to the high risk fall
False, outcomes are about the same as those without pusher’s syndrome but it will take roughly 3 and a half weeks longer for rehabilitation stays
