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Neuro anatomy Exam 1 > Phys Cognition/sensation/perception > Flashcards

Phys Cognition/sensation/perception Flashcards

1
Q

Levels of consciousness:
Full consciousness
Lethargy -

A

Lethargy - general slowing of cognitive & motor processes
- Interactions can easily get diverted, need frequent redirection

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2
Q

Levels of consciousness:

Obtundation -

A
  • Dulled or blunted sensitivity, difficult to arouse

- Respond slowly when awake, frequently confused when awake

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3
Q

Levels of consciousness:

Stupor -

A

State of semi-consciousness, only arouses with intense stimulation (deep pressure pain)

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4
Q

Levels of consciousness:

Coma -

A

Unconsciousness

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5
Q

What system is interrupted when consciousness goes wrong?

A

Ascending reticular activating systems - functions to arouse and awake the brain and control sleep/wake cycles

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6
Q 
How do we measure level of consciousness? (WHAT SCALE?)
What three areas of consciousness do we measure?
What scores (3-15) mean?
A 
Glasgow Coma scale:
1. Eye opening
2. Motor response
3. Verbal response
<8: severe
9-12: moderate
13-15: mild
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7
Q

What three measures for orientation?

A
  1. Person (What is your name, how old are you, where are you from?)
  2. Place (Where are you right now? What city/state? What is the name of this place?)
  3. Time (What day, month, year, season?)
  4. Situation (What happened? Why are you here?)
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8
Q

Sustained attention -

How test for it?

A

Sustained attention - sustain and focus attention over duration of time
Test: Cancellation test - template with different pictures, have patient circle all birds and can they do it without losing attention?

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9
Q

Selective Attention -

How test for it?

A

Selective attention - ability to screen and process relevant sensory info about the task and environment while screening out irrelevant information
Test: Stroop test - say out loud the color of the word, not what color the word reads

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10
Q

Divided attention -

How test for it?

A

Divided attention - ability to perform 2 task simultaneously
Test: Walkie-talkie test - can walk alongside me with a conversation without either degenerating

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11
Q

Alternating Attention -

How to test for it?

A

Alternating attention - Attention flexibility

Test: Supine to sit to immediate sit to stand

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12
Q

Declarative (explicit) memory -

A

conscious recollection of facts and events

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13
Q

Non-declarative (procedural, implicit)

A

recall of movements/movement schema without conscious recollections

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14
Q

Immediate recall -

A

After short interval of time (sec-min)

Ex: repeat after me…

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15
Q

Short-term memory -

A

Recent or working memory (min-hours/day)

EX: day to day events/learning new material

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16
Q

Long-term memory -

A 
Remote memory (months-years)
EX: birthdays, historical events
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17
Q

Executive function -
What part of brain?
Any specific tests?

A
  • Capacity to engage successfully in independent, purposeful, self-directed behavior
  • Prefontal cortex
  • No specific tests
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18
Q

Executive function:

1. Volition/Planning -

A

Goal planning and task initiation

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19
Q

Executive function:

2. Problem solving/reasoning -

A

Abstract thinking, flexibility

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20
Q

Executive function:

3. Insight/awareness -

A

Poor judgment

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21
Q

Executive function:

4. social pragmatics -

A

Inappropriate behavior

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22
Q

Executive function:

5. Self-regulation/purposeful action -

A

initiate, maintain, switch, and stop tasks

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23
Q

What is the difference between sensation and perception?

A

Sensation - raw data

perception - interpretation of data

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24
Q

Spinothalamic sensation:
What type of receptors?
Fiber characteristics? (Conduction velocity/myelination)

A
  • Free nerve endings

- Small, thin, slow conducting, no myelination

25
Q

Dorsal column sensation:
What type of receptors?
Fiber characteristics? (Conduction velocity/myelination)

A
  • Muscle spindle, GTO, joint receptors

- Large, thick, rapidly conducting, well myelinated

26
Q

Spinocerebellar sensation:
What type of receptors?
Fiber characteristics? (Conduction velocity/myelination)

A
  • Muscle spindle, GTO, joint receptors

- Fast, direct, heavily myelinated

27
Q

Sensory Exam Components: (9)

A
  1. Light touch
  2. Tactile location (discriminatory touch)
  3. Pain
  4. Bilateral touch (sensory extinction)
  5. Proprioception
  6. Kinesthesia
  7. Stereognosis
  8. 2-pt discrimination
  9. Vibration
28
Q

Perceptual Exam Components: (4)

A
  1. Body scheme and body image impairments
  2. Spatial relationships
  3. Agnosias
  4. Apraxia
29
Q

Perceptual deficits usually injury to what lobe/side of brain?

A

Parietal

R>L

30
Q

Body image -

A

Visual and mental image of one’s body (in relation to health/disease)

31
Q

Body scheme -

A
  • Postural model of body
  • Includes relationship of body parts to each other and their relationships of the body to the environment (body awareness/purposeful movements)
32
Q

T/F: With neglect, a patient will also experience sensory, motor and visual deficits

A

False: failure to orient toward, respond to, or report stimuli despite normal sensory, motor and visual systems

33
Q

Patients with neglect usually have damage to with side of brain/lobe?
Why?

A
  • Mostly R temporoparietal junction, posterior parietal lesions
  • Why Right? right side does more in regard to vision
  • Right hemi lesions = entire left side of perception gone
  • Left hemi lesions = right side does bulk of work and makes up for it
34
Q

Representational neglect -

How test for it?

A

-Loss of internally generated images (memories)

Test ex: draw clock from memory

35
Q

Visual neglect -

How test for it?

A

Test ex: cancellation test, have patient draw a house from a copy (will only draw half)

36
Q

Auditory neglect -

How test for it?

A

Test ex: give a command to patient on right (uninvolved side) and give command again on left (involved side)

37
Q

Motor neglect -

How test for it?

A

-“Output neglect”
-Failure to generate movement response to stimuli even though patient is aware of stimuli
Test ex:
1. Patient produce movement (bicep curl) on Right side (uninvolved)
2. While patient visually attends to left side limb (involved side) repeat curl
3. Have perform both at same time (bimanual) - usually only 1 will curl (uninvolved side)

38
Q

Personal neglect -

How test for it?

A

-Lack of exploration or awareness of contralateral side of body (total loss of perception of one side)
Test ex: Pick up affected arm and ask patient to identify ownership of arm
-Ask patient how many arms/legs they have (cross arm into other side to eliminate visual neglect)

39
Q

Peripersonal (spatial) neglect -

A

-failure to acknowledge stimuli of contralateral side within reaching space (one side of desk)

40
Q

Extrapersonal (spatial) neglect -

A

-failure to acknowledge stimuli of contralateral side in far space

41
Q

How to test for peri vs extra personal vs visual neglect?

A
  1. Place object within arms reach of patient
  2. Then further away
    If visual - Won’t see either
    If peripersonal - Won’t see it up close but will see it far away
    If extrapersonal - Will see it up close but won’t see it far away
42
Q

Somatoagnosia -
Where is lesion?
How to test for it?

A

-(impairment of body scheme) lack of awareness of relationship of body parts (how each part of body relates to next)
-Lesion: dominant parietal lobe
Test ex: Ask patient to point out body parts on a picture, then on therapist, then on themselves - if +, will not be unable to do on themselves

43
Q

R/L discrimination -
Where is lesion?
How to test for it?

A

-Decreased R/L differentiation with body parts and with following directions
-Lesion: Either parietal lobe
Test ex: Have patient respond to cues to raise R/L arm/leg or have patient walk and cues to turn head/body R/L (if +, may pause or go other way than cued)

44
Q

Difference between visual neglect and R/L discrimination when told to turn R/L -

A

Visual - will have difficulties only turning Left

R/L - difficult turning both ways, turn opposite way than told

45
Q

Vertical/midline orientation -

How to test for it?

A

-Can’t identify when body is in midline (standing up straight)
Test ex: easily identified via observation - if not sitting/standing midline ask patient if they think they are straight (will answer yes)

46
Q

Pusher syndrome -

Where is lesion?

A

-Leaning and active pushing toward hemiplegic side w/o compensation for instability and with resistance to passive correction toward midline (high fall risk)
Lesion: R posterolateral thalamus

47
Q

Figure Ground -

How to test for it?

A

-Inability to distinguish a figure from the background in which it is embedded
Test ex: Place handful of distinctly different objects on table and ask patient to pick up specific object

48
Q

Spatial relations disorder -
Where is lesion?
How to test for it?

A

-Inability to perceive relationship of one object in space to another object or to one’s self
-Lesion: right inferior parietal lobe
Text ex: place 3-4 cones on ground, each varying in distance from patient and instruct patient to walk up to cones until they are about 2 ft away (will end at different distance each time)

49
Q

Position in space disorder -

How to test for it?

A

-decreased ability to perceive and interpret spatial concepts
Test ex:
1. Ask patient to position arm “above” their head
2. Instruct patient to stand behind the table
3. Tell patient to go up stairs

50
Q

Topographical disorientation -

How to test for it?

A

-Difficulty perceiving relationship from one location to another in environment
Test ex: Take patient to familiar place (nursing station) and instruct them to find way back to room

51
Q

Depth and distance perception -
Where is lesion?
How to test for it?

A

-Inaccurate judgement of direction, distance and depth (height of object based on our distance to it)
Lesion: right or bilateral visual association cortex
Test ex: Obstacle course - space out 3 steps of variable heights down the hallway and have patient negotiate them

52
Q

Visual Agnosia -
Where is lesion?
How to test for it?

A

-Inability to recognize familiar objects despite normal eye function
Lesion: occipital and temporal (L or R)
Test ex: Ask patient to name objects, places, and faces (family members) by name

53
Q

Auditory Agnosia -
Where is lesion?
How to test for it?

A

-Inability to recognize familiar sounds or to discriminate between them
Lesion: Left temporal lobe
Test ex: Play familiar sounds and have patient identify them

54
Q

Tactile Agnosia -
Where is lesion?
How to test for it?

A

-Inability to recognize objects when handling them
Lesion: parietal/temporal/occipital association area (L or R)
Test ex: reach into bag and grab certain object (3 distinct objects inside)

55
Q

Anosognosia -

A

Denial or lack of awareness of presence or severity of one’s deficits
-May deny ownership of limbs

56
Q

Apraxia -

Lesion:

A

-Impairment of voluntary, skilled, well-learned movement

Lesion: left frontal or parietal lobes

57
Q

Ideomotor apraxia -

Test for it:

A

-breakdown between concept (idea) and performance (motor)
-Lose ability to carry out task on command but can do it on their own
Test ex: they can tell you what a comb is used for but will try and brush teeth

58
Q

Ideational apraxia -

Test for it:

A

-Failure to conceptualize task
-Can’t do it on own or on command
Test ex: give patient a brush, they can’t describe what to do with it or do it

Neuro anatomy Exam 1 (13 decks)

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