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47 Cards in this Set
- Front
- Back
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What is perception?
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The interpretation of sensory stimuli. What do our senses tell us about our body? What do our senses tell us about how to interact with the environment?
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Visual-Receptive components occur on what pathway?
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anterior visual pathway
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Lesions occurring anywhere from the retina, optic nerve, optic chiasm to the lateral geniculate of the thalamus affect reception in what ways?
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sensory or motor based primary skills
Ability to receive, detect orient, and locate Acuity, field, oculomotor control, accomodation, fixation, tracking, saccades, stereopsis, binocular fusion, pursuit, & scanning |
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Visual cognitive components occur on what pathway?
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posterior visual pathway
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Lesions occuring anywhere from the thalamus to the primary visual cortex in the occipital lobe, to the parietal, temporal, and frontal lobes result in problems with what?
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Perception
visual attention & memory, recognition of form color and spatial relations (depth perception, figure ground, etc.) |
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What are the foundations for visual perception? What are the next skills that develop in hierarchy? What are the last skills to develop?
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Visual acuity, visual field, & oculomotor control
Visual attention, scanning, & pattern recognition Visual memory & visuocognition |
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A visual field cut can occur with lesions where?
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To either side of the brain in either the temporal field or nasal field & upper and lower quadrants
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People with visual field deficits may have some inattention depending on severity. Can they learn to compensate?
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yes, they can quickly learn to compensate after inital training and minimal cues.
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What are some common visual field cuts?
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Hemianopia or loss of vision in one half (temporal or nasal) in one eye
Homonymous or loss of field (right or left) that is the same in both eyes Bilateral hemianopia is the loss of the same half of the vision in both eyes Homonymous hemianopia or loss of nasal field in one eye and temporal field in the other resulting in the loss of an entire visual field. |
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The lack of visual spatial attention (spatial neglect) in those who have right hemisphere lesions indicates what?
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unilateral neglect syndrome
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In regards to visual spatial attention (spatial neglect), where do lesions occur more often?
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in the right brain (inferior parietal lobe)
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Can a patient with visual spatial neglect compensate?
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no, this may affect body and illness awareness as well
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What is hemineglect?
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the impaired or lost ability to react to or process sensory stimuli (visual/auditory/tactile/olfactory) presented in the hemispace contralateral to a lesion of the right (or left) hemisphere
is accompanied by losses in visual field, body awareness, hemiparesis, somatosension, spatial awareness |
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What is somatagnosia?
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inability to recognize body parts
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What is anosognosia?
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denial or lack of awareness of paralysis; particularly hemiparetic arm
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What is R/L discrimination?
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difficulty determining left from right or discriminating left vs. right side of body
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What is unilateral body neglect?
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failure to orient to stimulus to involved side
(usually occurs w/ right parietal lobe lesions & so is coupled w/ issues of unilateral spatial neglect) |
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Spatial relations (relationship of space between objects, and space between self and objects) most frequently occurs in people who have what kind of lesion?
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right inferior parietal hemisphere lesions
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What are some examples of Spatial Relations?
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Depth perception, figure ground (differentiating foreground from background), Position in Space (are objects above or below, inside or outside, behind or in front, etc.), Form constancy (objects are recognized as the same despite size, location or position), Topographical orientation (knowing ones location in a larger space), Spatial Attention (lack of attention to stimulus in the visual environment is unilateral spatial neglect)
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What are some characteristics of hemineglect?
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Asymmetry of attention & shift away from left events in favor of right
Rightward shift of the frame of reference with respect to self Distortion of mental representation in space Contralesional hemianesthesia (impaired position and pain sense) Deviation of body posture in stance Contralesional gaze avoidance Visual-spatial disorders and visual sensory deficit |
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Contralesional neglect arising from ____ hemisphere lesions is more frequent, more severe, and more permanent
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right
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The right parietal lobe attends to what visual field?
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both the left and right visual field
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The left parietal lobe attends to what visual field?
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only the right
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Right hemisphere damage not only results in neglect, but aslo in what?
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decreased arousal & attention due to decreased dopamine, difficulty shifting attention, & deficits in the internal spatial representation of the contralesional side of space resulting in a rightward error in the body's spatial orientation
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What is cognition?
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the interpretation of perceptions; How do we use the info that we gather from our senses abour our body & about our environemnt to perform functional tasks?
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Cognitive deficits are most associated with lesions where?
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in the frontal lobe
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What are executive functions?
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problem solving/sequencing problem recognition, judgment, and planning, organization initiation etc. are indicative of the individuals ability to be employ new strategies to old tasks and be safe and independent
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What are tests of basic cognitive impairments?
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Orientation, attention, short-term memory, and following verbal commands are often used predictively as precursors for executive functions and for determining D/C environment.
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A top-down evaluation of cognitive & perceptual deficits may include...
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interview, observation, standardized & non-standardized assessments
(occupations & their desire to perform these occupations) |
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A bottom-up evaluation of cognitive & perceptual deficits may include...
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observation & standardized and non-standardized assessments
(ability to perform occupations by understanding the strengths & limitations of the individual) |
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What observation assessments should you make?
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Observe person’s behavior during the interview
Informal/Formal observation of task to determine occupational performance and strengths & limitations Observing dressing FIM |
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What clues in respect to the person can help you determine what assessment to use?
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Can they participate (necessary skills, amount of time)? Is it relevant to them (age/diagnosis)? What additional info do I want to know about the person (will it provide more info than I already have)?
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What clues in respect to the assessment can help you determine what assessment to use?
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Does it cover areas of cognition & perception that I want? Is it in line with the model/frame of reference guiding my intervention (bottom-up, top-down, etc.)? Do I need a sensitive assessment that can measure small changes over time for outcomes? Am I qualified to perform the assessment?
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What are some pros & cons to medical & psychology test? Give some examples.
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Pro - more easily recognized by other team members, frequently more significant research
Con - relationship to function/occupation may not be apparent Examples - Trail Making Test, The Scan Chart Test, MVPT, LOTCA, Letter Cancellation Task, Line Bisection |
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Remedial/restorative intervention for perception & cognition include...
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Practice and repetition of underlying processing skills
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Functional/adaptive intervention for perception & cognition include...
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Compensatory strategies to improve the dysfunction through repetitive practice & feedback
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What approach combines remedial/restorative & function/adaptive intervention techniques when it comes to perception & cognition?
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task oriented/ occupation-based approach to challenge the development of the underlying process skills
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Studies suggest that Remedial Approaches can be used with patients at what stages?
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early in cognitive/perceptual rehab when they are unable to participate in occupationally driven intervention OR later in rehab when the person understands the relevance of the intervention with no context
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How can computer programs be used in restorative intervention for perceptual deficits?
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Hierarchial cognitive retraining programs (including topographical orientation) & Useful field of view/ visual attention (discriminate a peripheral stimulus against a cluttered background)
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What are some examples of drill & practice?
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saccades, visual search & scan, pen & paper exercises (trail making, letter/number cancellation, line bi-section, hidden pictures, etc.)
[these are particularly designed for remediation of visual spatial neglect] |
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What are some examples of table-top restorative intervention activities?
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Constructional Praxis (DLM 3-D block designs, parquetry) & Body Scheme (puzzles, DLM- L&R hand cards)
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Evidence Based Intervention targeting Spatial Representation is favorable, but limited in results. What are some possible interventions?
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Contralateral limb activation
Constraint Induced Movement Therapy Mental imagery Prism glasses Eye patching and hemispatial glasses Caloric Stimulation Optokinetic Stimulation Neck Vibration Trunk Rotation |
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What are some limitations to remedial intervention?
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Based on the concept of neuroplasticity & the ability of the brain to reorganize itself to use intact areas of the brain to perform skills. But does this actually occur?
Most effective when patient can understand the connection between working on underlying process skills & functional tasks By using this approach we assume if the person improves in the deficit area, generalization of learning or transfer of training to functional tasks will occur. Evidence suggest that results do not generalize or endure |
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What is Luminosity?
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A computer-based cognitive rehab website that offers courses that are individually tailored to maximize the benefits of cognitive training through careful selection of the mix & length of training activities.
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Does computer intervention have a significant affect on performance of functional tasks?
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nope!
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What intervention approach includes both remedial/restorative and function/adaptive ideas?
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Easy Street! (simulated "real life" environments/modules for practice real life tasks
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The Task Oriented Intervention involves what?
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Activity Processing (discuss the purpose & results of the activity with the patient)
Behavior Modification (use of prompts & cues to shape & reinforce to support independence) Group Treatment (feedback, shared experiences) Multicontextual Approach (uses patients’ ability to process & self monitor for the transfer of skills) Affolter Approach (use tactile & kinesthetic [hand over hand] input to create the connection between movement & its affect on objects) |
