Perceptual Dysfunction Flashcards
What is perception?
Perception: Integration of sensory impressions into information that is psychologically meaningful.
What is the difference between sensation and perception?
- Sensation is the appreciation of senses through special sense organs.
- Perception is the ability to interpret these sensations accurately.
What are clinical indicators of perceptual dysfunction?
- difficulty participating in PT
- inability to do simple tasks
- difficulty switching tasks
- inability to identify objects
- unable to follow step commands
- activity taking a long time to complete
- denial of disability
Why is it important to conduct a sensory examination before perceptual testing?
To ensure poor performance is not incorrectly attributed to perceptual problems rather than sensory issues.
What is unilateral neglect?
- Inability to register and integrate stimuli and perceptions from one side of the body or environment
- Not due to sensory loss
What are the subtypes of unilateral neglect?
- contralesional personal space = pertaining to the body
- contralesional peripersonal space = space within arms distance
- contralesional extrapersonal space = space beyond arms distance
What is anosognosia?
Anosognosia: Denial or lack of awareness of the paretic extremity as belonging to the person, or denial of the presence/severity of paralysis.
How does anosognosia affect rehabilitation?
Patients may not accept their disability, compromising safety and rehabilitation until it resolves.
What is somatoagnosia?
Somatoagnosia: Impairment in body scheme, lack of awareness of body structure, and relationship of body parts to oneself or others.
- Lesion of dominant parietal lobe, commonly seen with R hemiplegia
How is right-left discrimination tested?
Patients are asked to point to body parts on command, (e.g., ‘right hand,’ ‘left foot.’)
What are spatial relations disorders?
- impairments in figure-ground discrimination
- spatial relations
- position in space
- topographical disorientation
- depth and distance perception
- vertical orientation
Describe treatment approaches for unilateral neglect.
- cueing
- using a mirror to draw attention to the neglected side
- prism glasses
- eye patching
- virtual reality/computer training
What is the remedial approach to treating perceptual dysfunction?
Focuses on patient’s deficits and attempts to retrain the impaired skills.
What is the compensatory approach to treating perceptual dysfunction?
- uses intact behaviors to compensate for the impaired ones, and changes the environment to ensure patient safety and independence.
Describe treatment strategies for right-left discrimination.
- avoid using ‘right’ and ‘left’
- use labels like ‘arm with watch’
- use red tape on right side of objects
Describe treatment strategies for somatoagnosia.
Sensory stimulation of the affected body part, patient verbally identifies body parts.
What is agnosia?
Inability to recognize or make sense of incoming information despite intact sensory capacities.
What are the different types of agnosias?
Visual, auditory, and tactile agnosia.
What is visual agnosia?
Inability to recognize familiar objects despite normal eye and optic tract function.
What is prosopagnosia?
Inability to recognize familiar faces.
What is color agnosia?
Inability to identify or name colors on command.
Describe treatment for visual agnosia.
Practice discrimination between colors, faces, and objects; use intact sensory modalities.
What is auditory agnosia?
Inability to recognize non-speech sounds or discriminate between them.
How is auditory agnosia tested?
By a speech-language pathologist; patient closes eyes and identifies the source of various sounds.
What is tactile agnosia (astereognosis)?
Inability to recognize forms by handling them.
How is tactile agnosia tested?
Patient identifies objects placed in hand without visual cues.
Describe treatment for tactile agnosia.
Patient practices feeling various objects, noting their special characteristics, and using visual compensation.
What is apraxia?
Inability to perform purposeful movements not due to strength, coordination, sensation, attention, or comprehension deficits.
What are the types of apraxia?
- ideomotor apraxia
- ideational apraxia
Describe ideomotor apraxia.
Difficulty executing motor tasks despite understanding the concept.
Describe ideational apraxia.
Inability to conceptualize tasks and perform them in the correct sequence.
What is figure-ground discrimination?
Inability to visually distinguish a figure from its background.
How is figure-ground discrimination tested?
Ayres figure-ground test, functional tests like picking out a spoon from an unsorted array of eating utensils.
Describe treatment for figure-ground discrimination.
Practice visually locating objects, use other intact senses, use markers like red tape on edges of stairs.
What is depth and distance perception impairment?
Inaccurate judgment of distance, direction, and depth.
Describe treatment for depth and distance perception impairments.
Education, careful walking on uneven surfaces and stairs, training for depth and distance.
What is topographical disorientation?
Difficulty understanding and remembering the relationship of one location to another.
How is topographical disorientation tested?
Ask patient to draw or describe familiar routes or layout of their house.
Describe treatment suggestions for topographical disorientation.
Practice going from one place to another, starting with simple routes then progressing to more complex ones.
What is vertical disorientation?
Distorted perception of what is vertical.
How is vertical disorientation tested?
Holding a cane vertically and horizontally.
Describe treatment for vertical disorientation.
Education and compensating by using tactile cues when moving through doorways and elevators.
What is the lesion site commonly associated with unilateral neglect?
Inferior posterior regions of the right parietal lobe.
What is the lesion site commonly associated with right-left discrimination impairment?
Parietal lobe of either side.
What is the lesion site commonly associated with figure-ground discrimination impairment?
Parieto-occipital region, commonly of the right hemisphere.
What is the lesion site commonly associated with spatial relations impairment?
- Inferior parietal lobe, or
- Parieto-occipital-temporal junction, mostly of the right side.
What is the lesion site commonly associated with vertical disorientation?
Non-dominant parietal lobe.
What is the lesion site commonly associated with auditory agnosia?
Dominant temporal lobe.
What is the lesion site commonly associated with tactile agnosia?
Parieto-temporo-occipital lobe of either hemisphere.
