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Cog and Comm > Module 5 RHD > Flashcards

Module 5 RHD Flashcards

1
Q

Principle of Lateralization:
the two cerebral hemispheres are structurally ? byt functionally?

LH -> ?
-verbal
-math
-verbal ?
all aspects of ?

RH ->?

A

similar / distinct

sequential processing:
verbal expression, WM
-mathematics
verbal logic, analysis of cause and effect

global processing

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2
Q

Localization of Right Hemisphere:
no clear pattern of ?
don’t get ? from damage in the RH

some believe that the RH is less ? than the left

but it is clear

A

deficits from specific lesions

borcas or wernickes

less focally organized

RH has diff. functions than left

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3
Q

RH functions:
non-verbal:
thought
mental
moti?

communication:
in..
non-literal
emotion ?
many …cues

A

organization
-mental flexibility (following someone else’s topic change)
-motivation

intonation
non-literal change
emotional comprehension and expression (intonation and facial expression)
-many nonverbal cues

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4
Q

What is Split Brain Syndrome:
occurs after.. surgically severed in order to alleviate

have anomie when ? but ca ?

when stimuli presented on left they can?

A

corpus callosum

seizures

anomia. presented on left/ can draw it

say it

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5
Q

causes of right hemisphere disorder:
..most common
–

A

stroke
tumor
brain injury

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6
Q

Consequences of stroke:
RHD-CCD

linked to

A

poorer outcomes

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7
Q

Characteristics of RHD-CCD:
cognitive deficits:
attention:
unilateral ?

executive function:

reduced awareness of ?

communication deficits:
prosody -

comprehension:
non-literal
ambig…
use of context to

production:

complex lingusitic material:
specificity of

discourse characterized by:

A

focused, sustained attention, alternating and divided attention
-unilateral neglect

organization, sequencing, problem solving, reasoning, judgment, insight

deficits

tone of voice and intonation to express meaning and emotion

non-literal language
-ambiguities
-use of context to determine intended meaning

efficiency and effectiveness

eye contact, facial expressions, turn taking

specificity of information, humor, morals and themes

overpersonalization, tnagential ideas, and poor organization

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8
Q

Cognitive deficits: attention deficits:

A

focused attention

selective attention

sustained attention

alternating attention

divided attention

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9
Q

hemispheric attention vs visual field deficits:

hemispheric attention:
this attention refers to the brain’s ability to ?
therefore inattention or neglect is a ?

inattention is NOT a loss of ?

A

perceive information on the contralateral side of each hemisphere

perceptual loss

loss of sight

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10
Q

Visual field deficits: this refers to the loss of ?

visual field deficits often result from ?

A

sensory information received from your eyes and sent to your brain

damage to the visual tracts

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11
Q

Hemispheric Visual Attention: the right hemisphere is more important than the ?

left hemisphere attends only to the ?

right hemisphere can attend to

A

left hemisphere for attention

right visual field

both visual fields

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12
Q

Hemispheric asymmetry in attention:
right parietal lobe atttends to both

right hemisphere =

left hemisphere lesion= right neglect not as

right hemisphere intact and still ?

bilateral lesion= attention to both visual fields is ? only way you can get ?

A

left and right hemisphere

left neglect

not as severe

attends

impaired / right hemisphere neglect

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13
Q

Neglect syndrome:
patients do not respond to any ?
-..info
-…info
-…info

more common with ? than ?
-hallmark for ?
-…/140 RH strokes had ?

A

information presented on opposite side of brain lesion
-visual info
-auditory info
-proprioceptive info

Right brain damage / left
-RHD
-78/140

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14
Q

Forms of Neglect:
left neglect:
-more
-more
lasts

right neglect (due to LHD)
-less
-may be masked by other
-resolves more
-usually as a result of

A

common
severe
longer

common
-masked by other deficits
-severe
-more quickly
-bilateral damage

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15
Q

Unilateral Neglect:
reduced attention to ?
NOT a ?
-but can co-occur with ?

not an ? disorder
various types of
varies by
varies over
varies depending on ?

motor neglect: reduced use of

tactile neglect: reduced ?

auditory neglect: reduced processing of ?
-poorer ?

A

contralesional space
-visual deficit
-hemianopsia (visual field cut)

all or none disorder
-neglect
-region of space
-over time
-stimuli, task, complexity, other attentional demands

one side of body

response/recognition of tactile stimulation

auditory stimuli from left side
-localization of sounds from left

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16
Q

Neglect phenomena:
magnetic ?
neglect is worse with both ?
unable to disengage attention from ?

attentional imbalance: stronger

extinction: failure to resond to ?
respond to ? but not to left stimulation when ?

A

attraction to right side
-R and L sided stimuli
-from right sided item to move attention to left

stronger pull to right than left

double simultaneous stimulation
-left stimulation alone/ right is also present

17
Q

Types of unilateral neglect: region of space affected
personal space: one’s own ?
neglect to ?

peri-personal space: within ?
-most ?

extra-personal space: beyond?

A

one’s own body
-shave, dress, comb left side

within reaching distance
-common

arm’s reahc

18
Q

Types of unilateral Neglect: frames of reference

viewer centered: left defined by
-… neglect
…% of cases

stimulus/object centered: … defined for each object
…neglect
..% of cases
putting things on the … won’t help

A

client’s view/visual field
-egocentric neglect
-28%

left defined for each object
-allocentric neglect
5% of cases
-right side

19
Q

Functional problems with Left Hemispatial Neglect:
problems reading ?
-depends on
-problems with ?
need a ? like a red line across page

reduced (sometimes greatly( awareness of ?

reduced ability to complete ?
eating only what is on ?

localizing ?

A

left half of reading materials
-severity
-margins and spacing when writing
-visual cue

left side of body

ADLS
-right side

sounds on left

20
Q

Neglect and Language:
can affect ?
neglect ?

neglect ?
begin writing in ?
… perseverations

A

reading and writing
-neglect alexia

dysgraphia
-middle or right side of page
letter and line

21
Q

Other perceptual and attentional deficits:
… to tasks
excessive attention to ?
neglect may also occur across other ?

these pt’s have now lost their ?

prosopagnosia:
a problem of ?

A

impulsivity, distractability, and poor attention to tasks

irrelevant information

modalities such as tactile, olfactory, and sensory motor

independence so also psychosocial and emotional components

visual pattern recgonition necessary to idneotfy a face

22
Q

Cognitive deficits: executive function deficits

pevalence ?

anecdotal evidence that adults with RHD have ?

assessment and treatment based on research with other

A

unknown

have exec. function deficits

other populations

23
Q

Cog. deficits in RHD:
dis…
impaired ?
difficulty with ?
poor integration of ?
difficulty with ?
impaired comprehension of ?

difficulty understanding ?

lack of ?

-

decreased ?

disorientation to ?

A

disorientation

impaired attention

memory

information

logic, reasoning, planning and problem solving

inferred meanings

understanding humor

motivation

impulsivity

alertness

time and direction

24
Q

Affective deficits in RHD:
difficulty expressing:

difficulty recognizing:

delusions and ?

depres..

apparent lack of

…

A

emotions

emotions of others
-facial expressions, gestures, postures

delusion and confused states
-agitated delirium, confabulations, disorientation

depression

apparent lack of motivation

apathy

25
Q

Anosognosias:

occurs in… % of those with RHD
-hard to
-can resolve during
-awareness influenced by ?

anosognosia:
unilateral
physical
comm. ?
consequences of ?

A

7-77%
-assess
-resolve during spontaneous recovery
-motivation, fatigue, complexity

unilateral neglect
physical deficits
comm. deficits
consequences of deficits

26
Q

anosognosia: reduced awareness of deficits

impacts ?
more intensive rehab recommended for ?

impacts rehab and post-rehab:
poorer
longer treatment prior to
lower ?
poorer outcome with?

impacts ?
greater distress with greater ?

A

referrals
-patients with greater unawareness

compliance and participation
-treatment prior to return to work
-functional status upon discharge
outcome with employment

distress with unawareness

27
Q

Right hemisphere disorder and langauge:
overall impairments related to difficulty integrating ?
linguistic AND?
-complex ? sequencing? .. instructions

difficulty picking out ?

difficulty with ? oganization and complex ?
-emotional components of
-abstract
-nonverbal ?
-.. vs. ..langiage

A

information
-linguistic and non-linguistic
complex stories, sequencing information, verbal instructions

important versus unimportant info

thougth organization and complex linguistic forms:
-emotional components of language
-abstract forms
-nonverbal comm.
-literal versus fig. langauge

28
Q

Comm. deficits: prosody
comm. functions of prosody
-pragmatic
grammatical
affective
indexical

aprosodia: inability to comprehend

prevalence:

impact
-limited
spouses cargeivers rate aprosodia as?>

A

draw attention to specific info
-segmenting clauses, differentiate words and sentence types

conveys emotion and mood

idiosyncratic speech patterns

or produce prosody

20-80% of people with RHD

information
-as important

29
Q

Prosodic deficits: affect and comm.
aprosodia after RHD
-may affect
more commonly affects ? resulting in attenuated variation in ?
-expressive
receptive:

affect after RHD: reduced use of ?

emotional processing after RHD:
use fewer ? decreased ? and ? of emotions
-patient may appear ?

A

linguistic
-affective prosody / variation in stress, duration and funcamental frequency
expressive: flat, monotone
receptive: diff. interpreting others mood or emotion or intended meaning

facial expression

emotionally-laden words, decreased expression and comprheension of emotions
-rude, odd, inattentive

30
Q

Comprehension process:
construction phase:
activate ?
-multiple meanings of ?

RHD can cause deficits in this stage -

integration phase:
menaings integrated into

less appropriate ?

RHD can cause deficits at this stage which impact

A

construct meaning of words, phrases, sentences
-ambiguous words

this stage - activation of less-common meanings

context
-meanings suppressed/inhibited

impact general comprehension

31
Q

Comm. deficits: non-verbal

flat affect (facial expression)
can accompany

difficulty interpreting ?

A

aprosodia

body language and facial expression

32
Q

Non-literal language and inferencing:
deficits after RHD:
generation of ?
can make
don’t always use at ?

revision of ?
slow/inefficient revision of ?

appreciation/use of ?

A

inferences
-can make inferences
-don’t aleays use relevant cues so inferences aren’t always correct

interpretation
-inference/interpretation

humor

33
Q

Comm. Deficits: discourse production and pragmatics

discourse production:
pragmatics:

many studies of RHD and pragmatics:
many facotrs
no clear ?

RHD most often results in:
… discourse production

reduced

reduced use of

A

organization, topic selection, coherence

eye contact, turn taking, topic selection

considered
no clear patterns of deficits

disorganized, tangential, overly-personalized discourse

eye contact, turn taking

emotionally-laden words

34
Q

Comm. deficits: discourse

verbal:
poor ? and diff. with ? rules

difficulty organizing and ? ideas

may have diff. staying on

tend to have excessive

understanding speaker

reduced ?
may not understand ?

reduced ?

A

turn taking/ conversational rules

organizing and sequencing ideas

topic

speech output

speaker intentions or internal motivations of others

flexibility

gist

informative content

35
Q

Non-verbal discourse deficit:

impairment in
…
recall of
mental
unusual

A

comprehending and using gestures appropriately

prosopagnosia

visual forms

rotation

views

36
Q

Theory of Mind:
the ability to understand that others have ?
can be affected after

might affect ?
-diff. interpreting ?
poor ?

A

ideas, thoughts, beliefs, feelings and emotions that differ from one’s own

RHD

language and comm.

jokes and sarcasm

coherence

Cog and Comm (8 decks)

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