Vision And Visual Perception Heirarchy and stroke

Question 1

What is addressed most often in assessments

Answer 1

Visual cognition

Question 2

What is visual cognition

Answer 2

complex visual analysis

highest lvl. very complex. ability to integrate and manipulate info wit other info to solve problems and make decisions

Question 3

What is visual memory

Answer 3

mental visual picture

retrieval

Question 4

What is pattern recognition

Answer 4

Used to identify salient features

general and specific features eliminate clutter visually

Question 5

What is scanning a product of

Answer 5

visual atention

Question 6

what are normal scanning functions

Answer 6

left to right
up & down
circular

Question 7

Scanning is what in nature

Answer 7

Reflexive (see something and scan)

Cortex (planned to look for something)

Question 8

What are the two kinds of visual attention

Answer 8

Focal attention- detail

Ambient attention- peripheral

Question 9

What does a right cva result in

Answer 9

inattention

Question 10

What happens to vision with a left hemisphere lesion

Answer 10

not significant inattention to L b/c R compensates

Question 11

What happens to vision if there is a lesion in the right hemisphere

Answer 11

significant inattention to he L

Question 12

Characteristics of VFD

Answer 12

Abbreviated search
attempts are slower
rescan for accuracy
appropriate time:slower but not abnormally slow 
organize and efficient

Question 13

Characteristics of inattention

Answer 13

Asymmetrical: make no attempt to start on the L
inefficient, random, disorganized
no rescan for accuracy
fast
task specific: doesn’t carry anything over to a specific task

Question 14

Assessments for attention/scanning

Answer 14

Clinical ops
Bivaba scanboard
BIT
Line discretion 
draw a flower test

Question 15

interventions for attention and scanning

Answer 15

functional tasks using search and scan
patching 1/2 of the R visual field to to facilitate attention to the L
Mirror therapy
videotape performance

Question 16

VFD’S cause what

Answer 16

narrow slower search patterns: dangerous for safety/mobility
problems with perceptual completion: brain fills in missing info

Question 17

assessments for VFD

Answer 17

Confrontation testing
campimeter
automated periphery testing

Question 18

Interventions for VFD

Answer 18

Functional reading and mobility will be impacted the most
teach to reorganize and scan 
broaden visual field 
reinforce w/ sensory
practice in context
emphasize conscious attention to detail

Question 19

How to teach effective search strategies

Answer 19

Education
Anchoring
adding color or contrast
encouraging self monitoring
placement of items 
(play gaes, do adls, use verbal cues)

Question 20

What is a stroke

Answer 20

a variety of disorders characterized by the sudden onset of neurological deficits caused by vascular injury to the brain
vascular damage to the brain disrupts blood flow and O2 supply to surrounding cells, leading to brain tissue or infarction

Question 21

What are symptoms and prognosis of the stoke determined by

Answer 21

Mechanism- type of stroke
location
extent of lesion- how much damage

Question 22

Kinds of stroke

Answer 22

Ischemic

Hemorrhagic

Question 23

What does an ischemic stroke result from

Answer 23

blockage of a blood vessel

Question 24

2 ways ischemic stroke can happen

Answer 24

Thrombosis- 2 ways stenosis (narrowing of blood vessel) or occlusion
Embolism- dislodged platelets, cholesterol, or other material that travels in bloodstream and blocks a vessel

Question 25

What dos a hemorrhagic stroke result from

Answer 25

rupture of blood vessels (hypertension, aneurysm, arteriovenous malformation- snarl tangle of arteries and veins)

Question 26

A hemorrhagic stroke can be either

Answer 26

Intracerebral | subarachnoid

Question 27

Which kind of stroke do you see less

Answer 27

Hemorrhagic

Question 28

What is the 3rd leading cause of death in the US

Answer 28

Stroke

Question 29

If the stroke occurs in the anterior circulation where will you see signs and symptoms

Answer 29

hemisphere

Question 30

If the location of the stroke is in the posterior circulation where will you see signs and symptoms

Answer 30

brainstem

Question 31

What will you see from a Left CVA

Answer 31

R hemiparesis Aphasia or other communication deficits Apraxia or motor planning deficits

Question 32

What will you see from a R CVA

Answer 32

L hemiparesis VFD or spatial neglect poor insight or judgement impulsive behavior

Question 33

What does recovery from stroke depend on

Answer 33

nature and severity neuroplasticity spontaneous recovery neurological and functional recovery

Question 34

What is functional recovery

Answer 34

amount of assistance required to carry out daily living tasks whether stroke survivor can resume function at home

Question 35

What is the course of recovery influenced by

Answer 35

``` Type Size Site Advanced Age Severity of coexsisting disease ```

Question 36

Wha are indicators of good functional outcomes

Answer 36

Family support independence in basic ADL's Access to cont. service

Question 37

What are poor functional outcomes influencing recovery

Answer 37

``` Severe initial motor deficits poor sitting balance dependence in ADL prior stroke (more likely to have another) Severe visuospatial deficits Severe cog. impairments Depression Severe aphasia poor social supports ```

Question 38

When does the largest % of motor and functional recovery occur

Answer 38

in the 1st month after stroke

Question 39

What are influences on the therapists selection of assessments

Answer 39

Stages of recovery setting for treatment extent of impairment

Question 40

What are the 3 stages of receovery

Answer 40

1. Acute 2. Rehabilitation 3. Community reintegration

Question 41

What forms of assessment is more critical in the acute phase

Answer 41

One assessing client factors and performance skills

Question 42

What to consider in rehabilitation and community reentry phases

Answer 42

Activity demands contexts patterns of performance integration of skills

Question 43

What are practice guidelines to assis in the selection of assessment tools

Answer 43

American Heart Association/American Stroke Association (AHA/ASA) Management of adult stroke rehab care National institutes of health stroke scale

Question 44

What are 3 assessments used too assess IADLS

Answer 44

COPM Assessment of motor and process skills Stroke impact scale

Question 45

What are assessments used to assess Self-care

Answer 45

Barthel index | Functional independence measure

Question 46

How to assess areas of occupation

Answer 46

observation both clinical context and in the home

Question 47

What kind of assessment would you not implement in the acute phase

Answer 47

Stroke impact scale

Question 48

What are natural reactions to stroke

Answer 48

``` Denial Anxiety Anger depression emotionalism emotional lability ```

Question 49

OT treatment in the acute phase

Answer 49

Perform diagnostic tests appropriate medical treatment make decisions for next phase of rehab early immobilization and return to self-care Lower risk for 2ndary complications (skin care, fall prevention etc)

Question 50

OT treatment in the Rehab phase

Answer 50

Focus on patient or family is more on getting better w/ recovery or lost function rather than adapting to life or chronic disability improve independence in adl

Question 51

Emerging OT treatments

Answer 51

Mirror therapy Virtual reality Robot assisted therapy Neuromuscular electrical stimulation (NMES)

Question 52

When does discharge planning take place

Answer 52

throughout the entire process

Question 53

What does discharge planning throughout the whole process result in for client and family

Answer 53

Comfortable in decisions made Capable of maintaining gains and continue progress Able to monitor changes

Question 54

What can ots help with in discharge planning

Answer 54

Identifying appropriate discharge settings train pt., family, caregiver arrange for continuity of care

Question 55

Things to do with patient, family, caregiver for education

Answer 55

Demonstration Written instructions experiential sessions

Question 56

What do most effective home programs do

Answer 56

incorporate treatment for component limitations into self care and leisure routines

Question 57

postdischarge continuity of care aspects

Answer 57

progress should be evaluated 1 month after return to community progress should be evaluated at regular intervals throughout the 1st year of recovery

Question 58

Visual processing intervention approaches

Answer 58

Adaptive- promotes adaptation of the environment. Used when restoration is unlikely Restorative-attempts to increase or improve abilities to process and use info Compensation- used if client isn't aware they have a problem