Week 11 Flashcards
Warrens Visual Hierarchy
1 - Oculomotor control / Visual Fields / Visual Acuity 2 - Attention = alert and attending 3 - scanning 4 - pattern recognition 5 - visual memory 6 - visual cognition 7 - adaptation through vision
1 - oculomotor control
CONTROL - effective coordination of eye movement
fixation/tracking/saccades/smooth pursuits
1 - visual fields
Fields - amount of the visual scene you take in without movement
homonymous hemianopsia - loss of the right or left half of the field in both eyes
Teach Scanning
Visual Field Test
confrontation test - assesses all 4 quads, pt should be able to count fingers held in each quad
1 - Visual acuity
allows for sharp, clear, accurate pictures
myopia - near sightedness
hyperopia - far sightedness
presbyopia - farsightedness assoc with aging
2 - Visual Attention
focusing on visual information
selective / focal
ambient / peripheral
visual attention deficits
- left neglect - disregard for the left side of body after right sided brain injury
- right inattention - after left sided brain injury
3 - visual scanning
allows you to shift and focus selected areas / information on the macula
typical scanning - left to right, top to bottom, and clockwise. Lighthouse pattern.
4 - Pattern recognition
identify the most important features of an object and use that to distinguish an object from its surroundings
pt with right sided brain injuries will fail - due to “not seeing”
pt with left sided brain injuries may be aware of the objects but have trouble identifying them
5 - visual memory
retaining a two dimensional mental pic of a 3 dimensional object
ROCF - rey-osterrieth complex figure test
6 - visual cognition
ability to manipulate visual information
allows us to understand the mental image and to integrate it with other sensory information
6 - visual cognition deficits
spatial agnosia (spatial relation)
somatognosis (poor body scheme)
alexia - difficulty reading
Agraphesthesia - inability to recoginze numbers/letters, on the skin
tactile agnosia - can’t identify through touch
apraxia - inability to plan or perform purposeful movement
types of apraxia
Ideomotor:inability to perform motor action at will, but can perform spontaneously.
ideational - inability to form the concept of the movement, unable to perform by command
constructional - inability to copy, draw or construct
Dressing - inability to plan and perform motor actions to dress oneself & linked w/ deficits in body scheme, orientation, and constructional
4 cranial nerves involved with vision
Optic CNII-damage anterior to optic nerve results in loss of vision on same side; damage to optic nerve itself results in loss laterally in both visual fields; damage posterior to optic nerve causes loss in visual field on side opposite to damage.
Oculomotor CNIII-results in drooping eyelid, difficulty focusing on near items.
Trochlear CN IV-causes decreased ability to look down and out
Abducens CN VI- causes decreased ability to move eyes laterally, crossed eyes. Damage to CNIII, CN IV , and CN vi causes double vision
ideomotor
- inability to perform on command/ spontaneously can do
treatment - use short, clear, concise, concrete and repetitive instructions, try simply putting pt in front of a bathroom mirror and handing them a comb to see if they spontaneously perform hair combing task.
ideational
- inability to form the concept of the movement, unable to perform by command
treatment - use short, clear, concise, concrete and repetitive instructions, can break it down and use hand over hand guidance. Use verbal and demonstrated instructions. After each step is completed, clinician can combine steps
constructional
- inability to copy, draw or construct
treatment - functional retraining: practice in natural context, perform at appropriate times of day, encourage an organized system of gathering items, establish regular sequence & gradually provide fewer cues over time, use colored tabs sewn into clothing to provide cues
Perceptual deficits & treatment
- body scheme, apraxia, alexia, graphesthsia, impaired visual closure and figure/ground, agnosia ( cannot identify object by touch)
- perceptual treatments: functional retraining, practice in natural context at appropriate times of day, use color tab cues, tactile stim to affected area, use a mirror, avoid using words right & left, use visual cues, practice identifying objects by sight and touch, label & organize items, position garments in same position each time, use hand over hand, attempt to have client perform entire task in typical context,
