Sensory perception & vascular review

Question 1

body scheme/image disorders

Answer 1

parietal lesions in right on non-dominant side

unilateral neglect, R/L discrimination, anosognosia

Question 2

unilateral neglect

Answer 2

A deficit affecting the individual’s awareness of the body half and the extra personal space contralateral to the lesion
True unilateral neglect occurs even with intact vision but may be exacerbated by hemianopsias;
right (non-dominant) hemispheric lesion

Question 3

R/L discrimination

Answer 3

Inability to discriminate between left and right

Question 4

anosognosia

Answer 4

Patients deny the existence of their affected extremities and or deny their deficits completely

Question 5

visuospatial disorders

Answer 5

right parietal and occipital association areas

figure-ground discrimination, spatial relations, position in space, topographic disorientation, form and space constancy

Question 6

figure-ground discrimination

Answer 6

Inability to perceive the foreground separate from the background

Question 7

spatial relations

Answer 7

The recall of location and relationships of objects and places

Question 8

topographic disorientation

Answer 8

Inability to negotiate a building such as the hospital without getting lost

Question 9

form and space constancy

Answer 9

Ability of patient to perceive variations in the form of objects and their arrangement in space
2 people in hall – would know there are 2 different people, but one person could appear very small when they are right in front of you
Difficulty reaching for objects, navigation with walking

Question 10

position in space

Answer 10

Correct use and understanding of words such as up, down, underneath
Understanding where limbs are in space
Difficulties eating, dressing, etc.

Question 11

Agnosias

Answer 11

visual
auditory
tactile

Question 12

visual agnosias

Answer 12

(Occipital Cortex)
Visual Object Agnosia: inability to recognize an object by visual inspection
Prospagnosia: inability to recognize familiar faces but able to recognize their voice or mannerisms
Color agnosia: inability to discriminate between colors

Question 13

auditory agnosias

Answer 13

(Temporal Cortex)
Unable to recognize sounds
Lesion in dominant hemisphere (usually left) in Wernicke’s area: unable to understand speech and language
Lesion in non-dominant hemisphere: unable to interpret noises such as doorbells and alarm clocks

Question 14

tactile agnosias/astereognosis

Answer 14

(Parietal Cortex):

inability to identify objects by touch and manipulation

Question 15

ideomotor apraxia

Answer 15

Breakdown between concept and performance
Unable to perform task on command even though patient can describe how to perform the task and sometimes perform it automatically
Evaluated by asking patient to perform tasks to command and observation of task when not requested
Lesion to left side of pre-motor and supplementary cortex

Question 16

ideational apraxia

Answer 16

Failure of conceptualization of task
Cannot perform task automatically or on command
Cannot explain how to accomplish a purposeful activity
Often attempts to use objects for the wrong purpose (ex) use toothbrush to wash face)
Lesion to left side of parietal association cortex

Question 17

constructional apraxia

Answer 17

Inability to produce two or three dimensional forms by drawing or construction
Unable to manipulate environment effectively due to inability to construct things from component parts; can’t take spatial information and draw properly
Assessed by asking patient to draw, copy, match building blocks, pegboard, configurations, etc.
Lesion to right side of parietal association cortex

Question 18

dressing apraxia

Answer 18

nability to dress oneself properly owing to combination of body scheme and motor planning deficits
Due to combination of body scheme disorders and constructional apraxia; can’t plan, can’t manipulate body
Assessed through clinical observation and treated through functional approach of changing sequence pattern for dressing and repetition
Lesion to right parietal association cortex

Question 19

middle cerebral artery (MCA) supplies/lesion

Answer 19

Supplies lateral cortex

Lesion or Stroke = affectation of UE, upper trunk, face

Question 20

anterior cerebral artery (ACA) supplies/lesion

Answer 20

Supplies medial cortex

Lesion or Stroke = affectation of LE, lower trunk, genitalia

Question 21

posterior cerebral artery (PCA) supplies/lesion

Answer 21

Supplies portions of parietal and occipital lobes

Lesion or Stroke = affectation of vision

Question 22

3 levels of perception

Answer 22

1. Primary Cortex - concerned with direct processing of sensory and motor functions - see, feel, or hear the stimulus.
2. Secondary Association Cortex - first level of processing - name the stimulus by sight, sound, or touch.
3. Tertiary Association Cortex - more complex integration - attach memories and/or emotions to the object.