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PPO II > Neuro-Opt Tech for ABI > Flashcards

Neuro-Opt Tech for ABI Flashcards

1
Q

Define: ABI + Examples

A

Any condition/event resulting in a sudden, non-progressive, or non-degenderative change in neurological processing; TBI, Stroke or Cerebral Vascular Accident, Post-Surgical Neuro Complications, Vestibular Dysfxns

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2
Q

Define: TBI + Examples

A

Occurrence of injury to the head that is documented in a med record with one or more of the following conditions as contributors: decreased level of consciousness, amnesia, skull fracture, neuro/neuropsych abnormality, intracranial lesion; mild/mod/severe

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3
Q

Open vs Closed TBI – diagnostic question

A

Did the skull remain intact

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4
Q

What is an MTBI and what are its consequences?

A

Mild TBI;
Post-Concussion Syndrome (lingering symptoms after injury - headache, fatigue, poor memory, insomnia, impaired gait, noise intolerance, etc.)
Post-Trauma Vision Syndrome (CI, high exophoria/tropia, accommodative dysfxn, oculomotor deficits, vis-spatial distortions, etc.)

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5
Q

Define CVA

A

Cerebral Vascular Accident
rapidly dev’d symptoms/signs of focal loss of cerebral fxn with no apparent cause other than of vascular origin
Loss of fxn can be global; recovery is full to severe disability
Strokes may be due to arterosclerosis, cerebral embolism, TIA (80% are ischemic)

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6
Q

What % of our environmentally received info is visual?

A

80%

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7
Q

How many areas of the brain are involved with visual processing?

A

35

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8
Q

T/F: More areas of the brain are dedicated to vision than any other sensory system?

A

True

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9
Q

Visual Processing fxn of Occipital Lobe

A

contour, contrast, depth

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10
Q

Visual Processing fxn of Frontal Lobe

A

Motor planning, self-directed eye movement

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11
Q

Visual Processing fxn of Temporal Lobe

A

recog people, places, things; object identification, motion processing

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12
Q

Visual Processing fxn of Parietal Lobe

A

spatial org of obj, vis attention

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13
Q

Describe: Parvocellular pathway

A

80% fibers, Ventral Stream, Central Processing/Focal Vision, representation/recog (what is it?), accommodation involved to tell details of obj (shape, colour)
LGN –> Occipital –> Temporal

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14
Q

Describe: Magnocellular pathway

A

20% fibers, Dorsal Stream, Peripheral Processing/Ambient Vision; visual-spatial, sensory modality of space (Where is it?), Pursuits, Saccades, Vergence for spatial relationships (where we are, where it is)
LGN –> Occipital –> Parietal

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15
Q

Describe: Central/Focal Processing

A

Parvocellular; detail, what is it?, high res, colour vis, conscious, central 2˚, static, innate

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16
Q

Describe: Peripheral/Ambient Processing

A

Gestalt, Where am I? Where is it?, Low res, non-conscious, non-colour, entire vis field, dynamic (integrates with other sensory systems), learned

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17
Q

What is Ambient Vision?

A

A constant stream of data about the location of your body in space, the location of other people and objs, and info about how quickly and in what direction those people/objects are moving

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18
Q

What does Ambient Vision lead to?

A

Binocularity, accurate judgement of distance and movement, defining our self image/view of our world

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19
Q

Interference with Central/Focal processing

A

Refractive, Accommodative Dysfxn

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20
Q

Interference with Peripheral/Ambient processing

A

Gaze palsy, fixation dysfxn, pursuit/saccadic dysfxn, binocular dysfxn, eye muscle paresis/paralysis

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21
Q

Q that Central/Focal processing answers

A

What is it?

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22
Q

Q that Peripheral/Ambient processing answers

A

Where is it?

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23
Q

Interference with Central and Peripheral Processing

A

altered vision: trouble with balance, moving with coordination, walking correctly, knowing where body ends and outside world begins; inability to correctly perceive space and time;
a receptive problem not an expressive problem

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24
Q

Oculomotor Dysfunction deficits

A

Limitations of gaze, nystagmus, speed and quality of pursuits and saccades

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25
Q

Oculomotor Dysfunction potential symptoms:

A

Inability to follow objects smoothly, Reading problems, skipping words, re-reading words, word/letter reversals

26
Q

Accommodative Dysfunction deficits

A

accommodative insufficiency, pseudo-myopia, speed and quality of accommodative response

27
Q

Accommodative dysfunction potential symptoms

A

blur, headache, pain, double vision, squinting, closing an eye, reading problems, ocular discomfort, tired eyes, watery eyes, falling asleep when reading, task avoidance

28
Q

Binocular Dysfunction deficits

A

Strabismus, muscle paresis/paralysis, convergence insufficiency, reduced or slow fusional ability

29
Q

Binocular Dysfunction potential symptoms

A

Head turn/tilt, diplopia, poor depth/spatial judgements, closing an eye, headaches, asthenopia, reading difficulty, tired eyes, watery eyes, fall asleep with reading, task avoidance

30
Q

Visual-Spatial/Visual Information Processing Dysfunctions: Deficits

A

Visual-vestibular integration problems, visual-motor integration problems, difficulty understanding spatial coordinates, disturbances in body image, disturbance in spatial relationships, difficulty sustaining visual attention

31
Q

Visual-spatial/visual information processing dysfunctions: Potential Symtoms

A

Balance issues, poor distance judgment, motor coordination problems, eye-hand coordination issues, left-right confusion, objects appear to move, agnosia=difficulty in object recognition, apraxia=difficulty in manipulation of objects, difficulty with differentiation, analyzing categorizing, sequencing, etc., inattentive, difficulty with visual closure/recognizing faces, difficulty with visual memory, difficulty with figure-ground analysis, difficulty with writing

32
Q

Visual Field Loss/Visual-Spatial Neglect Deficits

A

Visual Field Cut (ex: homonymous hemianopsia), visual-spatial attention/neglect

33
Q

Visual Field Loss/Visual-Spatial Neglect Potential Symptoms

A

Oculomotor related symptoms, difficulty locating objects, difficulty with gait, dificulty with alance, bumps into chairs, objects, etc., difficulty seeing at night, spatial insecurity(holds onto walls, etc.), unable to drive, disturbances in spatial relations

34
Q

Other (Acquired Injury) Deficit

A

Low blink rate, staring

35
Q

Other (acquired injury) potential symptoms

A

dry eyes, red eyes

36
Q

Why have an ABI patient close eyes in-between tests?

A

Patient might have a peripheral processing issue, so things like the flickering of fluorescent lights can provoke symptoms

37
Q

How to give an exam to an ABI patient

A

minimize movements in front/around patient, keep room illumination del dim (incandescent rather than fluorescent), speak clearly and more slowly, provide lens choices slowing in refraction, slowly change prism magnitudes in vergence tests, have patient close eyes in-between tests

38
Q

Management of ABI patient

A

Optical correction of ametropia, added lens power for near, horizontal or vertical prism, segmental occlusion, yoked prism, vision therapy, surgery

39
Q

Visual field loss is typically measured by

A

confrontational visual fields, tangent screen, automated perimetry

40
Q

Two types of visual field loss due to retrochiasmal lesion

A

homonymous hemianopsia (incl. macular sparing), quadrantopsia

41
Q

What happens the more posterior a retrochiasmal lesion is?

A

the more congruent the hemianopsia

42
Q

What are treatment options for visual field expansion

A

Fresnel prisms, Gottlieb and Peli lenses

43
Q

What is visual neglect

A

cognitive deficit that refers to thr unawareness of obj, people, and visual stimuli presented in a visual space contralateral to the cerebral lesion

44
Q

What will patients with visual spatial neglect also likely have?

A

visual field loss

45
Q

Asking a patient to draw a face of a clock or to bisect lines - used to evaluate what?

A

Visual neglect

46
Q

Define: Visual Midline Shift Syndrome

A

Mismatch of information and distorting of space due to disruption of ambient system

47
Q

What can Visual Midline Shift Syndrome lead to?

A

alteration of posture, difficulty with balance

48
Q

What is visual midline shift syndrome associated with?

A

hemiplegia, hemiparesis, flexion/extension, neglect

49
Q

What can be used to shift the midline in visual midline shift syndrome?

A

yoked prisms

50
Q

What treatment may be recommended to photophobic patients.

A

Outdoor tint (brown or gray), indoor tint (blue or gray; blue for fluoresecent lighting)

51
Q

In what directions can diplopia be?

A

horizontal, vertical, or cyclotorsional

52
Q

Diplopia due to what can resolve on its own over a period of months?

A

ABI

53
Q

What are treatment options for diplopia

A

grint in prisms, fresnel prisms

54
Q

What visual deficits are amenable to vision rehab?

A

oculormotor deficits, vergence deficits, accommodative deficits, visual-vestibular disturbances, photodensitivity due to deficits in bunocularity, impared visual field integrity

55
Q

Vision rehab for oculomotor deficits

A

basic scanning and searching exercises

56
Q

Visual rehab for oculomotor deficits

A

create an aperture/window highlighting text of regard while obscuring non-pertinent text

57
Q

Visual rehab for vergence deficits

A

stabilize vergence in primary gaze (far and near), facility and sustainability of fusional vergence (far and near)

58
Q

Visual rehab for accommodative deficits

A

build up and equalize accommodative amplitudes, work on improving weaker aspect of focusing, work on maintaining the ability to rapidly change focus and sustain focus; use loose lenses and flip lenses, in free space using targets at different viewing distances

59
Q

Visual rehab for visual-spatial function

A

work on central-peripheral integration

60
Q

Visual rehab for visual field loss

A

practice scanning into blind field, borderzone stimulation (new therapy system to map blind field and increase visual field over time)

PPO II (1 decks)

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