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Cognitive Eval > Week 8 (after midterm) > Flashcards

Week 8 (after midterm) Flashcards

1
Q

majority of our sensory input is through our sense of ____.

A

vision

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2
Q

up to what % of visual and visual-cognitive disorders are found in neurologically impaired patients?

A

60%

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3
Q

up to what % of individuals with CVA have increased length of rehab. stay due to perceptual and visual spatial deficits?

A

20%

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4
Q

___ ___ ___ have been shown to be associated with poor performance in reading, accident proneness, and dependence in self-care activities after CVA.

A

visual processing problems

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5
Q

the pathology of visual or VP impairments is found to be similar in people with which 2 neuro conditions?

A

TBI and stroke

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6
Q

name 4 different types of visual impairment after stroke.

A
  • eye alignment and movement impairment
  • visual field impairment
  • low vision
  • perceptual difficulties
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7
Q

as high as what % of individuals with TBI can have visual changes?

A

90%

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8
Q

name 4 common symptoms/visual impairments following a TBI.

A
  • diplopia
  • photophobia
  • eye strain
  • reading complaints-blurriness,
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9
Q

what percent of people of several TBIs were found to have VP impairments 1 year post injury?

A

31%

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10
Q

name 8 complications related to visual impairments.

A
  • reading deficits
  • decreased speed
  • increased risk of falls - twice the risk
  • over 4x risk of hip fractures
  • increased social isolation
  • decreased confidence
  • higher level of depression
  • impact potential for cognitive improvements
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11
Q

visual impairments lead to how much of a greater risk of hip fractures?

A

4x

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12
Q

describe Mary Warren’s Hierarchical Model of Visual Processing.

A
  • vp is viewed holistically and as a unified process
  • hierarchy of skills rather than a series of independent skills
  • skills at the bottom of the hierarchy form the foundation for each level above it
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13
Q

the sharpness of eyesight. ensures that visual info sent to CNS is accurate; quality of information.

A

visual acuity

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14
Q

the area the eyes can see at any one time; register the visual scene; quantity of information

A

visual field

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15
Q

efficient conjugate eye movements

A

oculomotor control

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16
Q

___ ___ is the quality of information, while ___ ___ is the quantity of information.

A

visual acuity, visual field

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17
Q

visual acuity is the ___ of information, while visual field is the ___ of information.

A

quality, quantity

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18
Q

name the 3 components on the first (bottom) level of Mary Warren’s Hierarchy of Visual Processing.

A
  • visual acuity
  • visual field
  • oculomotor control
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19
Q

the ability to view all details of a scene systematically in an organized and thorough manner; critical to making a correct identification while ignoring unessential elements.

A

scanning

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20
Q

the ability to attend to stimuli and shift attention between stimuli. triggered by events in the environment - such as flash of light, busy interactions

A

attention

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21
Q

name the 2 components in the 2nd level of Mary Warren’s Hierarchy of Visual Processing.

A
  • visual scanning

- visual attention

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22
Q

requires ability to create a picture of object in the mind’s eye while visual analysis is completed; to store image and retrieve upon command.

A

visual memory

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23
Q

the ability to identify salient features of an object such as shape, contour, and specific features (ex: color, details, shading, and texture); essential for object recognition.

A

pattern recognition

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24
Q

name the 2 components in the 3 level of Mary Warren’s Hierarchy of Visual Processing.

A
  • visual memory

- pattern recognition

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25
Q
  • highest order VP skills
  • the ability to mentally manipulate visual information and integrate it with other sensory information to problem solve, and plan
  • visually analyze the environment - reading, writing, solving math problems, certain professions rely heavily: architect, surgeon, artist
A

visual cognition

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26
Q

name 3 components within visual cognition.

A
  • visual spatial
  • figure ground
  • visual closure
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27
Q

name the 1 component in the 4th level of Mary Warren’s Hierarchy of Visual Processing.

A

visual cognition

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28
Q
  • the ability to make decisions, interpret and adapt to the environment through information gathered visually
  • learning and adaptation tasks take place at this higher level but won’t occur if there is a disruption of vision at one of the foundation levels
A

adaptation through vision

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29
Q

name the 1 component in the 5th and final level of Mary Warren’s Hierarchy of Visual Processing.

A

adaptation through vision

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30
Q

each skill level depends on the ___ of those before it.

A

integration

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31
Q

skill level disrupted at one level can have adverse effect on the ___ ___.

A

total structure

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32
Q

a deficit at a ___ ___ may actually be caused by an impairment in the ___ ___ of the hierarchy.

A

higher level, lower level

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33
Q

provides the initial evaluation of the foundation skills that then form the bases for higher level visual-perceptual skills and cognition.

A

basic vision screen

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34
Q

name 3 general ways in which eye ROM and strength is tested.

A
  • visual fixation
  • visual saccades
  • visual scanning
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35
Q

the ability to hold a stationary gaze

A

visual fixation

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36
Q

the ability to track a target in unpredictable areas of the visual field

A

visual saccades

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37
Q

the ability to follow an object a smooth and continuous path, which allows for skills such as reading

A

visual scanning

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38
Q
  • comprised of battery of subtest
  • clinical observation checklist
  • assessments of visual acuity (distance and reading)
  • contrast sensitivity function
  • visual field
  • oculomotor function
  • visual attention and scanning
  • developed by Mary Warren
A

brain injury visual assessment battery for adults (biVABA)

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39
Q

the acuteness or clearness of vision; both near and distant acuity; quality of information entering the CNS

A

visual acuity

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40
Q

____ can cause shearing or tearing of the optic nerve or corneal scarring from direct trauma to the eye.

A

TBI

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41
Q

name 2 symptoms of visual acuity.

A
  • client complains of fuzzy or blurry print

- print too small; glasses don’t work as well as before injury

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42
Q

name 2 ways to assess visual acuity.

A
  • snellen eye chart

- lea symbol test

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43
Q

name 3 effects of visual acuity on function.

A
  • difficulty with reading/writing tasks
  • trouble with driving
  • inability to recognize faces
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44
Q

what is the criteria for referral for visual acuity?

A

20/40 or poorer, or if there is greater than a two line difference between the 2 eyes

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45
Q

what does the NJ DMV require for visual acuity?

A

20/50 binocularly

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46
Q

name 3 interventions for visual acuity.

A
  • refer to eye doctor - to get evaluated for appropriate prescription
  • may been referral to low vision specialist
  • educate on proper use of glasses
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47
Q

name 5 compensatory strategies for visual acuity.

A
  • increased illumination
  • increased contrast
  • increased size (enlarge or magnify)
  • decreased background pattern or clutter
  • organize the environment
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48
Q
  • field of view of the external world by both eyes without headturning
  • quantity of information entering the CNS
A

visual field

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49
Q

describe the two components of a person’s full field of vision.

A
  • peripheral vision

- central vision

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50
Q

visual field loss will depend on the __ __.

A

lesion site

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51
Q

inferior field loss has been linked to which 3 impairments?

A
  • decreased balance
  • decreased mobility
  • decreased seeing steps or curbs
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52
Q

superior field loss has been linked to problems with which 3 things?

A
  • problems with seeing signs
  • decreased reading abilities
  • decreased writing abilities
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53
Q

field loss to the entire right field of both eyes, caused by a lesion to the left optic radiation

A

right homonymous hemianopia

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54
Q

what is the name of the test that assesses one’s visual fields?

A

confrontation testing

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55
Q
  • gross assessment, client to detect a moving target
  • may miss mild/subtle field cuts
  • observe the client during function tasks
A

confrontation testing (visual field)

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56
Q

name 7 intervention techniques to teach if a patient has a visual field deficit.

A
  • visual search strategies (left to right for reading, scanning)
  • lighthouse technique
  • large scale eye movements for environment
  • small scale eye movements for reading and near tasks
  • increased head turns
  • use of anchors or rulers to keep track of lines, edge of text
  • grading treatment tasks - start with organized move to random, start with slow work toward increasing speed, large and small area tasks
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57
Q

allows for efficient conjugate movements (eyes moving together in the same direction)

A

ocular-motor control

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58
Q

___ ___ are common after brain damage and can vary depending on the size and location of the lesion or injury.

A

oculomotor deficits

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59
Q

name 2 common impairments associated with ocular-motor control.

A
  • slower speed, control, and coordination of eye movements

- disruption of visual scanning and attention

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60
Q

name 8 “symptoms” associated with deficits in ocular-motor control.

A
  • excessive head movement
  • decreased attention to details
  • line skipping
  • headaches
  • fatigue
  • squinting
  • head tilt
  • shutting one eye
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61
Q

name the 3 areas/components of ocular-motor control.

A
  • fixation stability
  • saccadic function
  • pursuit function
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62
Q

the ability to visually attend by extra-ocular muscles maintaining an eye position.

A

visual fixation

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63
Q

name 3 interventions for visual fixation.

A
  • select activities that will require client to focus attention to a target or time
  • functional activities - pouring and filling, threading beads, using tweezers or tongs to sort items
  • remedial tasks: HART charts, computer-based programs
64
Q
  • quick eye movements that occur when the eyes fix on various targets in the visual field
  • essential for reading and scanning the environment
A

saccades

65
Q

name 3 deficits associated with saccades.

A
  • undershooting or overshooting targets
  • difficulty shifting gaze
  • inability to isolate head and eye movement
66
Q

what is the name of the screening for saccades?

A

developmental eye movement test

67
Q

name 7 interventions for saccades.

A
  • treatment tasks: copying tasks, card games, sudoko, writing checks, puzzles
  • provide education such as giving examples of how this will impact daily life - reading, searching for objects, etc.
  • use line guide such as a finger or ruler
  • increase print size
  • decrease clutter
  • saccadic exercise - one eye at a time, start with large movements then to smaller movements
  • have patient keep head still and focus on moving eyes not head
68
Q
  • eye movements that maintain continued fixation; allows us to follow a moving image or object across the visual field without head movement
  • ex: following a ball with your eyes, watching people or animals run or walk, watching pen or pencil while writing, etc.
A

pursuits

69
Q

name 3 deficits associated with pursuits.

A
  • difficulty crossing midline
  • overshoot/undershoot, jumpiness
  • client will have problems with mobility esp. through moving crowd, driving, navigating a store aisle, etc.
70
Q

name 5 interventions for pursuits.

A
  • start with one eye at a time
  • pt. should keep head still
  • start with small movements progressing to large movements
  • teach compensatory techniques such as increased illumination, enlarge print, reduce clutter, visual markers
  • treatment tasks - mazes, following remote control car, shape tracing, ball games, pen light on wall, ball games
71
Q
  • adjusting and sustaining focus from one distance to another
  • decreases with age
A

accommodation insufficiency

72
Q

name 5 symptoms of accommodation insufficiency

A
  • excessive blinking
  • headaches
  • eye strain
  • blurred vision during self care (make up, buttoning)
  • driving difficulties
73
Q

name 9 strategies for OT generalist to reinforce for accommodation.

A
  • pt. to wear prescription glasses, if bifocals make sure they are using bottom during close work
  • large print may relieve symptoms
  • take frequent rest breaks
  • increase illumination
  • decrease clutter
  • use line guide
  • avoid glare
  • limit time doing visual tasks
  • take frequent rest breaks
74
Q

when the brain perceives an object at near to be farther away than it is, which results in the need for extra effort to be used as the eyes and brain must work harder in order to point accurately at the object. therefore, the eyes have a tendency to turn slightly outward when viewing close objects due to this problem with localization.

A

convergence insufficiency

75
Q

name 4 deficits associated with convergence insufficiency.

A
  • difficulties with close up tasks
  • difficulties with reading and writing
  • complaints of blurred vision
  • eye strain or fatigue when reading
76
Q

what is the screening for convergence called?

A

break point recovery test

77
Q

___ or ___ treatment activities to be performed by OT specialized in vision and under direction of neuro-optometrist.

A

accommodative or convergent

78
Q

name 5 strategies for convergence insufficiency that an OT generalist can recommend.

A
  • illumination
  • decrease clutter
  • visual markers
  • avoid glare
  • time limit
79
Q

-ocular alignment, coordinated function of both eyes

A

binocular vision

80
Q

how many muscles and cranial nerves are there for both eyes?

A

12 muscles, 6 cranial nerves

81
Q

eye misalignments

A

strabismus

82
Q

name the 3 most common strabismus.

A
  • esotropia
  • exotropia
  • hypertropia
83
Q

eye turning in

A

esotropia

84
Q

eyes turn out

A

exotropia

85
Q

one eye turns up

A

hypertropia

86
Q

name 3 strategies/treatments if both eyes are not aligned.

A
  • client may close one eye
  • use a patch
  • develop an awkward head turn (compensate for paralyzed muscle)
87
Q

proper eye alignment is key to what?

A

depth perception

88
Q

which technique is used for binocular vision testing?

A

hirschberg technique

89
Q

name the screening used for binocular vision.

A

Maddox Rod screening tool

90
Q

when would you refer someone for strabismus (deficits in binocular vision)?

A

-if esophoria is 5 or more, if exophoria is 10 or more, if hypo or hyperphoria is 2 or more

91
Q
  • double vision, blurriness, difficulty with near task, words moving when reading, headaches with near tasks, eye strain, squinting with one eye
  • double vision can occur when looking into different fields - side to side, up down
A

diplopia

92
Q

if screening indicates double vision, what is necessary?

A

referral to neuro-opt.

93
Q

regarding binocular vision, if the neuro-opt determines that the problem is a muscle imbalance, what is initiated?

A

eye exercises

94
Q

if the client has double vision, provide which 2 things?

A
  • occlusion (as directed by eye MD)

- activities to obtain fusion (ex: maintain focus on a clock, menu)

95
Q

what is a short-term method for diplopia?

A

patching - determine dominant eye and alternate eye patch daily.

96
Q

name 5 compensatory strategies for diplopia.

A
  • increase illumination, contrast, or print size
  • decrease clutter
  • line guide, anchor, markers
  • avoid glare
  • limit time doing visual tasks and take frequent rest breaks
97
Q

awareness of the body and spatial environment

A

visual attention

98
Q

a deficit in visual attention is most often a result of what kind of damage?

A

right brain damage

99
Q

visual attention deficits do not always but may co-exist with what other kind of deficits?

A

visual field deficits

100
Q

name 3 types of visual inattention deficits.

A
  • personal - on body
  • peri personal - near body
  • extra personal - in environment
101
Q

__ __ needs to be addressed with visual inattention deficits.

A

self-awareness

102
Q

name 3 assessments for visual attention.

A
  • kessler foundation neglect assessment
  • behavioral inattention test
  • bells assessment
103
Q

name 8 treatment interventions for visual inattention.

A
  • increase client’s awareness of inattention
  • place items in neglected space for remediation
  • work with neuro-opt for prism use
  • use of visual imagery (eyes like a lighthouse)
  • reading left to right, circular pattern for large scan
  • use line guide - ruler, anchoring
  • brightly colored line at edge of text
  • adjust density, structure of task, speed
104
Q

name 3 components of selecting the best environment for vision treatment.

A
  • well lit, no glare
  • clutter free and quiet (unless working on more complex tasks)
  • determine patient’s position - seated, standing, or walking
105
Q

the ability to distinguish foreground from background

A

figure-ground discrimination

106
Q

the ability to identify forms or objects from an incomplete array of features or stimuli

A

visual closure

107
Q

the ability to coordinate info from the visual system with body movements during an activity or task

A

visual-motor integration

108
Q

involves the ability to organize and interpret visual info to give it meaning

A

visual processing skills

109
Q

name 5 components of visual processing skills.

A
  • figure-ground discrimination
  • visual closure
  • visual-motor integration
  • visual discrimination
  • visual memory
110
Q
  • no motor involvement needed to make a response
  • can be used for screening overall visual perceptual ability in children and adults (ages 4-70)
  • visual multiple choice - individual is shown a line drawing and is then asked to choose the matching drawing from a set of four one the following plate
A

motor-free visual perceptual test (MVPT)

111
Q

name 5 categories of visual perception measured in the MVPT.

A
  • spatial relationship
  • visual closure
  • visual discrimination
  • visual memory
  • figure ground
112
Q
  • battery of 6 subtests that measure different but interrelated visual-perceptual and visual-motor abilities; normed to age 75
  • pediatric and adult versions available
A

development test of visual perception (DTVP)

113
Q

name the 6 subtests within the DTVP.

A
  • copying
  • figure-ground
  • visual-motor search
  • visual closure
  • visual-motor speed
  • form constancy
114
Q

individuals are shown a simple figure and asked to draw it on a piece of paper. the figure serves as a model for the drawing.

A

copying

115
Q

individuals are shown stimulus figures and asked to find as many of the figures as they can on a page where the figures are hidden in a complex, confusing background.

A

figure-ground

116
Q

the individual is shown a page covered in numbered circles, randomly arranged on the page. the individual connects the circles with a line, in numerical sequence as quickly as possible.

A

visual-motor search

117
Q

individuals are shown a stimulus figure and asked to select the exact figure from a series of figures that have been completely drawn.

A

visual closure

118
Q

individuals are shown four different geometric designs, two or which have special marks in them, and a page filled completely with the four designs, none of which have marks in them.

A

visual-motor speed

119
Q

individuals are shown a stimulus figure and asked to find it in a series of figures. in the series, the targeted figure will have a different size, position, and/or shade, and it may be hidden in a distracting background.

A

form constancy

120
Q

the ability to recognize and distinguish the distinctive features of a form or object (ex: shape, size, and color)

A

visual discrimination

121
Q

deficits in visual discrimination will cause which 4 issues?

A
  • difficulty reading
  • difficulty recognizing signs
  • difficulty recognizing faces
  • decreased attention to details
122
Q

name 4 strategies for visual discrimination.

A
  • blocking
  • chunking
  • verbalization
  • organized scan
123
Q

name 2 activities for visual discrimination.

A
  • matching

- spot the difference

124
Q

the visual skill that allows us to record, store, and retrieve info. allows us to learn and later recall what is learned.

A

visual memory

125
Q

similar to visual memory in that it allows us to store and retrieve info when necessary or useful.

A

visual sequential memory

126
Q

involves the ability to distinguish the foreground from the background

A

figure-ground

127
Q

name 2 deficits associated with figure ground.

A
  • problems distinguishing a figure with competing background

- problem locating objects that are not well defined.

128
Q

name 5 strategies for figure-ground.

A
  • reduce clutter
  • organize items
  • color contrast
  • labeling
  • locate key salient features easier to find
129
Q

the ability to know that a form or shape is the same even if it has been rotated, made smaller/larger or observed from up close or far away

A

visual form constancy

130
Q

being able to see only parts of an object and mentally complete the object. often objects are partially occluded by other objects in the environment and our visual system fills in the missing info.

A

visual closure

131
Q

deficits in visual closure will cause significant problems in which 3 areas?

A

-reading, spelling, writing

132
Q

name 1 strategy for visual closure.

A

visual imagery

133
Q
  • effective communication btwn the eyes and hands

- can lead to difficulty with writing and poor coordination

A

visual motor integration

134
Q

VMI involves ___ ___ ___.

A

visual perceptual skills

135
Q

the ability to correctly perceive a form in order to correctly replicate it.

A

visual perceptual skills

136
Q

name 2 examples of visual motor integration.

A
  • correctly perceiving and copying shapes

- correctly perceiving and copying letters and numbers

137
Q
  • understanding the relationships of objects within the environment compared to other objects or oneself
  • above or below
  • right and left side
  • under and over
A

visual spatial relations

138
Q

name 3 examples of visual processing activities.

A
  • hidden pictures games
  • picture drawing
  • dot-to-dot
139
Q

initial evaluation/screenings

A

treatment stage 1

140
Q

minimize sensory deficit by introducing assistive devices (ex: eyeglasses, prisms, patching, large print, etc.) or corrective surgery

A

treatment stage 2

141
Q

education provided to client on visual processing areas, providing feedback and teaching self-monitoring techniques

A

treatment stage 3

142
Q

exercise and retraining activities to improve function; utilize training exercises, daily living tasks, and strategy training; address basic visual deficits first before proceeding to higher level visual processing deficits.

A

treatment stage 4

143
Q

promote compensation and self-management; practice generalization to various daily life situations

A

treatment stage 5

144
Q

provide recommendations for general adaptations (increased lighting, increased contrast, line guides)

A

OT generalists

145
Q

provide advanced training during ADLs, environmental adaptation, compensatory techniques, community reintegration, caregiver training and training with optical (prisms, magnifiers) and non-optical devices (assistive tech)

A

OT specialists

146
Q

name 4 types of deficits that generalist OTs can directly treat.

A
  • visual scanning
  • visual inattention
  • oculomotor deficits
  • VP disorders
147
Q

recognizing what something is going to be like from far away

A

pattern recognition

148
Q

when is the Lea Symbol Test used?

A

for children or patients with a language barrier or patients with aphasia

149
Q

highlighting one side of the page in a bright color

A

anchoring

150
Q

blocking device used to keep track of lines, edge of text

A

rulers

151
Q

focusing attention from one object to another or one letter on one page to a letter on the next page

A

HART charts (visual fixation)

152
Q

sharpness and actual viewing of something

A

visual acuity

153
Q

actually understanding what you are seeing

A

visual cognition

154
Q

which strategies would you use for a patient with right temporal hemianopsia who has trouble navigating their environment?

A
  • practice head turning and scanning the environment

- lighthouse technique

155
Q

how can you distinguish hemianopsia from unilateral neglect?

A

once you start to diagnose and note the level of awareness, it is easier to teach strategies - pt. with hemianopsia may begin to compensate and use strategies on their own if they have hemianopsia

156
Q

what type of cognitive rehab approach is used when practicing figure ground pictures?

A

remedial approach

Cognitive Eval (13 decks)

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