Vision And Visual Perception Heirarchy and stroke Flashcards
What is addressed most often in assessments
Visual cognition
What is visual cognition
complex visual analysis
highest lvl. very complex. ability to integrate and manipulate info wit other info to solve problems and make decisions
What is visual memory
mental visual picture
retrieval
What is pattern recognition
Used to identify salient features
general and specific features eliminate clutter visually
What is scanning a product of
visual atention
what are normal scanning functions
left to right
up & down
circular
Scanning is what in nature
Reflexive (see something and scan)
Cortex (planned to look for something)
What are the two kinds of visual attention
Focal attention- detail
Ambient attention- peripheral
What does a right cva result in
inattention
What happens to vision with a left hemisphere lesion
not significant inattention to L b/c R compensates
What happens to vision if there is a lesion in the right hemisphere
significant inattention to he L
Characteristics of VFD
Abbreviated search attempts are slower rescan for accuracy appropriate time:slower but not abnormally slow organize and efficient
Characteristics of inattention
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
Assessments for attention/scanning
Clinical ops Bivaba scanboard BIT Line discretion draw a flower test
interventions for attention and scanning
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
VFD’S cause what
narrow slower search patterns: dangerous for safety/mobility
problems with perceptual completion: brain fills in missing info
assessments for VFD
Confrontation testing
campimeter
automated periphery testing
Interventions for VFD
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
How to teach effective search strategies
Education Anchoring adding color or contrast encouraging self monitoring placement of items (play gaes, do adls, use verbal cues)
What is a stroke
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
What are symptoms and prognosis of the stoke determined by
Mechanism- type of stroke
location
extent of lesion- how much damage
Kinds of stroke
Ischemic
Hemorrhagic
What does an ischemic stroke result from
blockage of a blood vessel
2 ways ischemic stroke can happen
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
What dos a hemorrhagic stroke result from
rupture of blood vessels (hypertension, aneurysm, arteriovenous malformation- snarl tangle of arteries and veins)
A hemorrhagic stroke can be either
Intracerebral
subarachnoid
Which kind of stroke do you see less
Hemorrhagic
What is the 3rd leading cause of death in the US
Stroke
If the stroke occurs in the anterior circulation where will you see signs and symptoms
hemisphere
If the location of the stroke is in the posterior circulation where will you see signs and symptoms
brainstem
What will you see from a Left CVA
R hemiparesis
Aphasia or other communication deficits
Apraxia or motor planning deficits
What will you see from a R CVA
L hemiparesis
VFD or spatial neglect
poor insight or judgement
impulsive behavior
What does recovery from stroke depend on
nature and severity
neuroplasticity
spontaneous recovery
neurological and functional recovery
What is functional recovery
amount of assistance required to carry out daily living tasks
whether stroke survivor can resume function at home
What is the course of recovery influenced by
Type Size Site Advanced Age Severity of coexsisting disease
Wha are indicators of good functional outcomes
Family support
independence in basic ADL’s
Access to cont. service
What are poor functional outcomes influencing recovery
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
When does the largest % of motor and functional recovery occur
in the 1st month after stroke
What are influences on the therapists selection of assessments
Stages of recovery
setting for treatment
extent of impairment
What are the 3 stages of receovery
- Acute
- Rehabilitation
- Community reintegration
What forms of assessment is more critical in the acute phase
One assessing client factors and performance skills
What to consider in rehabilitation and community reentry phases
Activity demands
contexts
patterns of performance
integration of skills
What are practice guidelines to assis in the selection of assessment tools
American Heart Association/American Stroke Association (AHA/ASA)
Management of adult stroke rehab care
National institutes of health stroke scale
What are 3 assessments used too assess IADLS
COPM
Assessment of motor and process skills
Stroke impact scale
What are assessments used to assess Self-care
Barthel index
Functional independence measure
How to assess areas of occupation
observation both clinical context and in the home
What kind of assessment would you not implement in the acute phase
Stroke impact scale
What are natural reactions to stroke
Denial Anxiety Anger depression emotionalism emotional lability
OT treatment in the acute phase
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)
OT treatment in the Rehab phase
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
Emerging OT treatments
Mirror therapy
Virtual reality
Robot assisted therapy
Neuromuscular electrical stimulation (NMES)
When does discharge planning take place
throughout the entire process
What does discharge planning throughout the whole process result in for client and family
Comfortable in decisions made
Capable of maintaining gains and continue progress
Able to monitor changes
What can ots help with in discharge planning
Identifying appropriate discharge settings
train pt., family, caregiver
arrange for continuity of care
Things to do with patient, family, caregiver for education
Demonstration
Written instructions
experiential sessions
What do most effective home programs do
incorporate treatment for component limitations into self care and leisure routines
postdischarge continuity of care aspects
progress should be evaluated 1 month after return to community
progress should be evaluated at regular intervals throughout the 1st year of recovery
Visual processing intervention approaches
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
