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Year 2: Neuromuscular > Test 2: Perceptual Deficits > Flashcards

Test 2: Perceptual Deficits Flashcards

1
Q

what is perception

A

ability to select those stimuli that require attention to action and to integrate those stimuli with each other and prior info to finally interpret them

this awareness enables the individual to make sense of complex/dynamic sensory environment

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2
Q

what are perceptual deficit

A

complex and intimately linked to the sensorimotor deficit associated (hemiplegia)

innappropriate interpretation of appropriate sensation

inability to perceive stimuli due to underlying sensorimotor deficit

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3
Q

2 largest populations with perceptual deficits

A

stroke and TBI

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4
Q

perception vs sensation

A

stimuli input required for sensation and perception; perception is not independent of sensation

sensation = cognitive appreciation/awareness of stimuli through organs of special sense, peripheral receptors, etc

perception = more complex than just appreciation; ability to interpret sensation accurately and resond appropriately

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5
Q

pathophysiology of perceptual deficits

A

neuro injury to parietal lobe

MCA stroke, TBI, vascular disease

more common with injury to non-dominant R parietal lobe

examples: R MCA stroke can cause L unilateral neglect or left spatial relation disorders, L MCA CVA causes body agnosia

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6
Q

what is agnosia

A

simple perception deficits

inability to recognize anything familiar or make sense of incoming information despite intact sensory capacities

visual, auditory, and tactile (astereognosis) types

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7
Q

what is visual agnosia

A

inability to recognize familiar objects despine normal function of eyes

prosopagnosia is inability to recognize familiar faces

color agnosia is inability to recognize colors; NOT color blindness

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8
Q

what is auditory agnosia

A

inability to recognize familiar non-speech sounds or discriminate between them

rarely occurs in absence of other communication disorders

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9
Q

what is tactile or astereognosis agnosia

A

inability to recognize forms by handling them through tactile, proprioceptive, and thermal sensations may be intact

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10
Q

what is body schema/body image

A

individuals perception of postural model of body including the relationship of body parts to each other and relationship of the body to the environment

more complex combo of multiple agnosias

“body awareness”/”body orientation”

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11
Q

deficits of body schema include

A

unilateral neglect
ipsilateral pushing
anosognosia
somatoagnosia
R-L discrimination
finger agnosia

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12
Q

what often accompanies unilateral neglect that relates to vision but is not due to visual dysfunction

A

homonymous hemianopsia

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13
Q

unilateral neglect is caused by

A

posterior/inferior parietal lobe injury

R MCA most common resulting in L neglect

20% of stroke pts

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14
Q

what is personal unilateral neglect

A

decreased self awareness

doesnt recognize own arm, remains half dressed

clinical presentation:
- half face of makeup
- half face shaved
- leaves arm behind

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15
Q

what is spatial unilateral neglect

A

decreased environmental awareness

i.e. runs into doroways, only makes R turns

Peripersonal
- only eats half of the food in front of them; locks one side of WC

extrapersonal
- runs into doorways/people on neglected side

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16
Q

what is anosognosia

A

denial of symptoms
safety awareness deficits

lack of awareness/denial of paretic limb as belonging to person; pt can recognize when other people with similar deficits have unsafe behaviors but could not recognize their own

severe form of unilateral neglect

often resolves spontaneously in first 3 months following stroke

important to maintain safety of neglected limb while performing rehab

17
Q

what is somatoagnosia (body agnosia or autotopagnosia)

A

lack of awareness of body structure and relationship of body parts to oneself or others

i.e. pt has trouble with transfers b/c he doesnt perceive the meaning of terms related to body parts such as “reach back with your arm and grab the armrest”

18
Q

how to test for somatoagnosia

A

have pt point to parts of body

“show me your hand and now the other hand”

“point to your elbow” and pt points to knee

19
Q

how to manage somatoagnosia

A

sensory stimulation to the body part affected

20
Q

what is R-L discrimination disorder

A

inability to identify R or L of ones own body or someone elses body

cant execute movements in response to verbal commands that include the terms R and L

close association with aphasia

as PT can cue “use arm with watch” or point directly to arm you want pt to use

21
Q

what are spatial relation disorders

A

difficulty in perceiving the relationship between self and two or more objects

most frequently happens with R sided lesions affecting parietal lobe (i.e. R MCA)

22
Q

examples of spatial relation deficits

A

figure ground discrimination

form discrimination

spatial relations

position in space

topographical disorientation

depth perception

vertical/”midline” orientation

23
Q

what is figure ground discrimination

A

cant visually distinguish a figure from the background

cant pick an object our of an array of other objects

cant locate important objects that aren’t prominent = frustration

increase of fall risk i.e. descending stairs and not seeing where one starts and another stops

24
Q

what is form discrimination

A

ability to perceive subtle differences in form and shape

pt is likely to confuse objects of similar shape or not to recognize an object placed in an unusual position

i.e. confuse pen with toothbrush or cant distinguish or set the place of utensils

25
Q

what is spatial (relations) disorientations

A

inability to perceive the relationship of one object in space to another object or to oneself

spatial relation skills required to manage most ADLs

can become a safety issue:
- walking into doors
- distance between sitting target
- trouble reading analog clock, distance between hands

26
Q

what are position in space deficits

A

inability to perceive and interpret spatial concepts such as up, down, under, over, in, out, in front of, behind

differs from proprioception alone

i.e. if pt asked to lift arm over head that are confused or lift arm incorrectly

27
Q

how to test for deficits with position in space

A

pt is presented with 2 objects and asked to describe their relationship with one another

i.e. toothbrush in cup and asked to describe this

28
Q

what is topographical disorientation

A

difficulty understanding and remembering relationship of one location to another

pt unable to get from one place to another without cues/map

29
Q

how to test topographical disorientation

A

pt asked to describe or draw a familiar route such as the block on which they live or the layout of their house

pt unable to do so

pt asked to walk back to your room from therapy gym

30
Q

describe depth/distance perception

A

judgement of direction, distance, and depth

pt may have difficulty navigating stairs, may miss chair when attempting to sit

can be a contributing factor in faulty distance perception

31
Q

what is vertical orientation

A

difficulty finding midline/upright position

distorted perception of true vertical

can contribute to appearance of postural stability deficits or gait disturbance

can be in presence or absence of homonymous hemianopia

common presentation = most pts post R CVA in early phase

32
Q

what is pusher syndrome

A

active pushing toward neglected side

feel like you are pushing them over if you try to correct

severe vertical orientation deficit

active resistance to passive correction

can visually see they are vertical but perception of upright is skewed

33
Q

what is apraxia

A

inability to perform voluntary learned movement

inability to perfom purposeful movements not related to:
- inadequate strength
- coordination loss
- impaired sensation
- poor comprehension
- uncooperative
- etc

34
Q

2 types of apraxia

A

ideomotor = cant perform on command but can do it automatically, unconscious muscle memory (i.e. cant go to the door if asked but may automatically if doorbell rings)

ideational = cant perform task at all; hard to differentiate between aphasia and other disorders; no IDEA

35
Q

what is diplopia

A

double vision

pt sees 2 of environment

defective function of extraocular muscles in which both eyes are used but not in conjunction with the other

treatment = exercise for eye muscles; eye patch on alternating eyes until condition clears

36
Q

what is homonymous hemianopia

A

“visual field cut”

loss of vision from half (R or L) visual field of both eyes

most common visual deficit with hemiplegia; MCA damage near internal capsule affecting optic tract; presents similar to PCA damage to visual cortex

17% of R MCA

37
Q

homonymous hemianopia vs unilateral neglect

A

HH = aware of problem and compensate automatically or learn to compensate by head turn; injury occurs along visual projectsions

unilateral = may have intact vision but seems unaware of the problem and doesnt attempt to compensate spontaneously by turning head; possibly no injury to visual projections

Year 2: Neuromuscular (20 decks)

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