ms 8 Flashcards
1
Q
Inattention/Extinction
A
– DIFFERENT TO NEGLECT
- The failure to recognise or respond to a stimulus on the affected side only when the unaffected side is also being stimulated – DON’T TOUCH UNAFFECTED LIMB
- IF IMPAIRMENTS OF INTENSITY 4 OR < ARE FOUND, IT is INAPPROPRIATE TO TEST FOR INATTENTION.
- If you can’t feel light or deep touch greater than 4, can’t test for bilateral inattention
2
Q
Agnosias
A
- The inability to recognise objects or symbols in the absence of impairments of the primary senses
- Vis., auditory, tactile or prop.
- People with agnosiad tend to be very unrealistic about it, can’t trust them. Can deny what has happened and fail to recognise the presence or severity of the paralysis.
3
Q
Asterognosis
tactile
A
Asterognosis (tactile) The inability to recognise objects by touch even though tactile, thermal and proprioceptive functions are intact. Eg. Give them a box of stuff and ask find me the peg, if have tactile agnosia can't recognise
4
Q
Autotopagnosia
A
Disturbed perception of the patient’s own body parts • may be unaware of existence of one side of body • may be unable to distinguish right from left (laterality) • Assessment: draw a man test
5
Q
OTHER IMPAIRMENTS OF VISUOSPATIAL AWARENESS
A
- Essential to rule out or be aware of impairment of primary visual skills:
- Eye movements: visual scanning and saccadic eye mvmts. Can do one but not the other
- Visual fields
- Disturbance of distance perception eg struggles with stairs and curbs – PENCIL TEST
- Disturbance of size, colour or shape perception
- Disturbance of figure-ground perception – can’t distinguish a specific stimulus from background plus can be auditory as well. Trying to get attention, but so much stimulus going on can’t separate stimulus
- Disturbance of direction sense
- Difficulty with route finding/poor topographic memory eg find way in familiar surorundings or learn way in new situation
- Disturbance of vertical perception – fall/lean to one side
- Subjective Visual Vertical – vestibular cortex (part of the thalmus) – determining whether an object is lying vertical or horizontal when rotating against a blank background
6
Q
PUSHING: MOST PUSHERS ARE LEFT HEMIS *
A
- an asymmetrical trunk posture towards the hemiplegic side: Loss of midline orientation of head and trunk
- active pushing towards the hemiplegic side: Overactivity of the nonparetic ipsilesional arm and leg > extend the unaffected arm and leg and actively push away from the nonparetic side
- Can be associated with left or right hemi’s – postero-lateral thalmus
- Can be resistant to passive correction due to fear of falling
- More apparent when BOS is reduced or when task increases complexity
7
Q
Pushing Behaviour severity
A
- Most severe when there is an inability to transfer weight to unaffected side in any position
- Last severe when typicall post stroke asymmetry in less challenging situations or PB only evident when walking or more challenging environment
8
Q
PB facts
A
- Hard to separate a true pusher from other impairments (incidence of 10 -55%)
- Poor prognosis however two groups: 1. Transient behavior or 2. Persistent problems
- PB clients require longer LOS to reach similar functional level and discharge status
- Greater sensory loss = Greater pushing behaviour
9
Q
Apraxia
A
Goodglass and Kaplan Test for Apraxia
- Tend to be right hemis – 1/3 left CVA
- The inability to carry out skilled purposeful movements
- Not due to motor weakness, sensory loss, incoordination or receptive aphasia
- Difficulty in transforming an idea into a movement plan
10
Q
types of apraxia
A
Ideational: Trouble putting the bigger picture together = instead use simpler, smaller commands
Ideomotor: The inability to perform purposeful movement on external command even though the concept of the task is fully understood
- While not able to perform on command – eg can’t do extend arm but can do reaching for the remote
Exactly the same activity may be executed perfectly in a natural setting
11
Q
Constructional
A
Constructional:
- Impairments in producing designs in 2 (clock, man, house drawings) or 3 (build tower, puzzles, block designs) dimensions by copying, drawing or constructing on command or spontaneously
- Functionally difficult to perform purposeful acts while using objects in environment eg making bed, setting the table
- Right hemisphere damage: Felt to be due to visual or spatial disorders
- Left hemisphere damage: Felt to be due to conceptual
12
Q
Dressing
A
- Unable to relate spatial forms of clothes to that of the body
Due to disorder of recognition of body parts or visuospatial neglect
