| Term | Definition |
|---|
| Attention disorders | sustained, focused/selective, divided, alternating |
| sustained attention | attending to relevant information for a period of time |
| Focused/selective attention | the ability to disregard unimportant stimuli |
| Divided attention | the ability to respond to simultaneous stimuli |
| Alternating attention | the ability to move back and forth between tasks |
| Assessment of attention disorders | attempt to distract patient in the designated manner |
| Effects on function with attention disorders | unable to complete multi-step tasks or follow multi step directions, unable to disregard irrelevant environmental distractiors, unable to complete tasks in a timely fashion |
| Treatment and or management strategies of attention disorders | single step directions, one task at a time, decrease enviornmental distractors while learning new skills (closed environment), talk through tasks, set time limits |
| Areas of the brain involved in attention disorders | reticular formation, sensory systems, limbic and frontal lobes |
| Memory disorders | emotional, procedural, declarative, immediate recall, short term memory, and long term memory |
| Emotional memory disorder | memory of feelings |
| Procedural memory disorder | memory of how to do something |
| Declarative memory disorder | memory of facts and concepts |
| Immediate recall | a few seconds |
| short term memory | a few minutes, hours or days |
| long term memory | years |
| Assessment of memory disorders | Pt. is asked to recall events of past per the type of memory being assessed |
| Effects on function with memory disorders | inability to remember directions, unable to recall past events and the effect they had on the pt. unlikely to correctly complete HEP, safety concerns |
| Treatment/management strategies of memory disorders | Written directions and HEP, verbal reminders, pictures and videos, involve family |
| Areas of the brain involved in memory disorders | a whole lot of them, parietal lobe has short term memory and temporal has long term |
| Executive function (4 components) | Volition, planning, purposeful action, effective performance |
| Volition | determining what one needs or wants to do |
| Planning | identifying and organizing the steps needed to perform a task |
| Purposeful action | the ability to initiate, maintain, switch and stop action |
| Effective performance | the ability to monitor and correct one's behavior |
| Assessment of Executive functions | ask family member about pt. ability to complete tasks necessary for indep living, provide a task that requires pt to utilize one of the components (planning task, selecting items needed for task.) |
| Effects on function with executive function | unable to live independently, difficulty maintaining a schedule |
| Treatment /management strategies for executive function | provide feedback on appropriate and inappropriate behaviors, written directions for planning, lists, minimize distractions, alarm clock, watching video of appropriate/inapprorpiate behaviors |
| Areas of brain involved with executive function | frontal lobe and prefrontal cortex |
| Body Scheme | a mental map involving relationships between body parts and between the body and the environment |
| Body image | a visual and mental image of one's body, includes feelings about one's body |
| Unilateral neglect | pt. ignores one side of the body. In severe cases, pt. may deny extremites are part of their body, unable to perceive stimuli from one half of the body (body neglect) or the environment (spatial neglect), not due to visual field loss |
| Assessment of Body scheme/body image disorders | observation during completion of functional skills, have pat. copy drawings, place objects on left side |
| Effects on function with body scheme/image disorders | dressing one side of body, shaving one side of face, put makeup on one side of face, bum into objects on left side |
| Treatment /management strategies of body scheme/image disorders | stimulate the right side of the brain (shapes/blocks), encourage looking to left, use left UE and LE to complete activities, place ribbion on affected extremity, mirror, draw lines on paper |
| Areas of the brain involved with body scheme/image disorders | right parietal lobe |
| Anosognosia | denial or lack of awareness of one's paralysis |
| Assessment of Anosognosia | talk with patient about what happened, if they are paralyzed, why they can't move the extremity |
| Effects on Function with Anosognosia | difficult to get to use affected limb during rehab, safety concerns |
| Treatment/management Strategies | usually resolves spontaneously, tactile stimulation to affected limb, visual attention drawn to limit |
| Areas of the brain involved with Anosognosia | supramarginal gyrus |
| Somatoagnosia (aka body agnosia) | impairment of body scheme that may be due to lack of proprioceptiion (seen with right hemiplegia) |
| Assessment of Somatoagnosia | paint to body parts named, imitate PTA movements, discuss relationship of body parts, DO NOT use terms right and left |
| Effects on function with Somatoagnosia | difficulty with transfers, completing exercises |
| Treatment/management strategies with Somatoagnosia | sensory stimulation of named body parts , visual reminders of pars needed to complete activites (ribbon on R arm to complete R exercises) |
| Areas of the brain involved with Somatoagnosia | dominant parietal lobe (usually left side lesions) |
| Right-Left discrimination disorder | inability to discriminate between right and left sides of body |
| Assessment of right-left discrimination disorder | point to body parts named, first without use of R and L to rule out somatoagnosia |
| Effects on function with right-left discrimination disorder | dressing is difficult, following directions, topographical disorientation |
| Treatment/management strategies of right-left disorder | visual markers on right shoe or hand, pint out rings and watches worn on a certain hand and use these as commands rather than right and left (hand with wedding ring) |
| Areas of the brain involved with right-left disorders | parietal lobe (usually left hemisphere) |
| Finger Agnosia | Difficulty identifying and naming fingers and mimicking finger movements |
| Assessments of finger agnosia | name fingers touched, point to named fingers, imitate finger movements |
| Effects on functions with finger agnosia | poor finger dexterity when completing fine motor tasks |
| Treatment/management strategies with finger agnosia | sensory input to fingers, visual markers of certain fingers |
| Areas of the brain involved with finger agnosia | either parietal lobe |
| Spatial relations disorder-Figure-ground discrimination | inability to visually distinguish a figure from the background difficulty ignoring irrelevant visual stimuli |
| Assessment of Spatial relations disorder | find white towel on white sheet, pick out spoon from unsorted silverware drawer |
| Effects of Spatial relations disorder | cannot locate items in purse or drawers, unable to discern where stairs/cubs begin or end (safety) |
| Treatment/management strategies with spatial relations disorder | practice with smaller number of objects and work up to larger group, use other senses (touch and sound), keep drawers uncluttered |
| Areas of the brain involved with Spatial relations disorders | right parieto-occipital lesion |
| Form discrimination | inability to use subtle difference in shape to distinguish between 2 different objects |
| Assessment of Form discrimination | similar shape and size objects are placed together and pt is asked to select a certain one |
| Effects on function with form discrimination | Confuse objects that are similar |
| Treatment/management strategies with form discrimination | practice identifying objects, talk through subtle differences label objects |
| Areas of the brain involved with Form discrimination | parieto-temporo-occipital region of non-dominant lobe |
| Spatial relations deficit | inablity to judge positional relationships between objects or an object and the body |
| Assessment of Spatial relations deficit | ask pt. to put himself in certain portions tin relationship to therapist |
| Effects on functions with Spatial relations deficit | difficulty putting things together, dressingc crossing midline, telling time, setting table |
| Treatment/management strategies with Spatial relations deficit | use visual and tactile cues along with verbal directions, copy block patterns, acttivites that cross midline |
| Ares of the brain involved with Spatial relations deficit | right inferior parietal lobe |
| Position of Space | inability to understand positional terms such as up, down, under, over, in, out |
| Assessment of Position of Space | ask, pt. to place objects in certain positions to one another (on, above, besides, below) |
| Effects of function of Position of Space | unable to perform ADL, exercises will be difficult with verbal instructions, following written directions will be difficult |
| Treatment/management strategies with Position of Space | practice placing objects in the desired positions, match verbal commands with visual cues |
| Areas of brain involved with Potions of Space | non-dominant parietal lobe |
| Topographic Disorientation | Inability to remember how to get form point A to point B |
| Assessment of Topographic Disorientation | have pt describe or draw a familiar route or room outline |
| Effects of function with Topographic disorientation | unable to get from one place to another or describe spatial relationships of familiar locatiosn |
| Treatment/management strategies of Topographic disorientation | practice routes, take easiest routes, mark with visual cues, remind pt. not to leave home/clinic without assistance (usually recovers within 8 weeks) |
| Areas of the brain involved with Topographic disorientation | bilateral parietal lobe |
| Assessment of Depth and distance perception | pt. asked to grasp object held in mid-air (will overshoot target) or fill glass with water |
| Effects on function with depth and distance perception | trouble with stairs, sitting in chair, pouring liquids dumping objects |
| Treatment/management strategies with depth and perceptions | discuss safety issues, use intac senses, retrain sense of depth perceptions |
| Areas of the brain involved with depth and perception | posterior right hemisphere |
| Vertical disorientation | distorted perception of what is vertical |
| Assessment of Vertical disorientation | hold cane in vertical, turn horizontal and ask pt. to return it to vertical |
| Effects of function with Vertical disorientation | walking into doorways, setting objects down (spilling water) |
| Treatment/management strategies of Vertical disorientation | use touch to orient self |
| Areas of the brain involved with Vertical disorientation | non-dominant parietal lobe |
| Agnosias | Disorders of sensory perception |
| Visual object Agnosia | inability to recognize familiar objects despite normal vision |
| Simultanagnosia | inability to perceive whole objects |
| Prosopagnosia | inability to recognize people |
| Color agnosia | inability to recognize color |
| Assessment of Visual object agnosia | place common objects or pictures of familiar people in front of pt. and ask him to identify them |
| Effects on function with Visual object agnosia | must feel objects to identify them, social implications (prosopagnosia) |
| Treatment /management strategies for Visual object agnosia | practice discriminating object and people by distinguishable features |
| Areas of the brain involved with Visual object agnosia | occipito-temporo-parietal association area |
| Assessment of Auditory Agnosia | pt. closes eyes and attempts to identify common sounds played by the therapist |
| Effects of Auditory Agnosia | unable to tell difference in doorbell and telephone, car horn and train horn |
| Treatment/management strategies for Auditory Agnosia | repetition (no research to support its benefits) |
| Areas of brain involved for auditory agnosia | dominant temporal lobe |
| Tactile Agnosia/Asterognosia | inablity to recognize objects through touch |
| Assessment of Tactile Agnosia /Asterognosia | place objects in pt.'s hand and ask him to identify them without looking |
| Effects of function with Tactile Agnosia / Asterognosia | difficulty with ADL's, unable to complete tasks with hands and no vision (in dark) |
| Treatment/management stategies with Tactile Agnosia/ Asterognosia | practice feeling various object and identifying their distinguishing characteristics feel objects then look at them to make mental connections |
| Areas of the brain involved with Tactile Agnosia/ Asterognosia | parieto-temporo-occiptial lobe |
| Apraxia | inability to perform purposeful, skilled movement despite intact strength, coordination, sensation attention and comprehension |
| Ideomotor Apraxia | Disconnect between the idea of moving and performing the movement, able to perform automatic tasks, know how to do it but can't translate that into performing the skill |
| Assessment of Ideomotor Apraxia | ask pt. to complete tasks which pt. has been observed to complete automatically |
| Effects on Function with Ideomotor Apraxia | perseverate on tasks they can complete, difficulty finishing one task and moving on, difficulty with ADL's and morning routine |
| Treatment /management strategies with Ideomotor Apraxia | give single-step directions, breakdown tasks, incorporate multiple sensory systems |
| Areas of the brain involved with Ideomotor Apraxia | frontal or posterior parietal lobes of left hemisphere |
| Ideational Aproxia | inablity to conceptualize a task, even automatic ones, can't comprehend how a task can be completed so unable to do it on command or spontaneously |
| Assessment of Ideational Apraxia | Combine observation of requested tasks with family report of task performance |
| Effects on function with Ideational Apraxia | unable to put parts of task toghether to complete entire skill, cannot explain how to complete the tasks, ADL's virtually impossible |
| Treatment/management strategies with Ideational Apraxia | give single-step directions, breakdown tasks, incorporate multiple sensory systems |
| Areas of the brain involved with Ideational Apraxia | dominant parietal lobe |
| Constructional Apraxia | inability to conceptualize how parts can be put together to make a whole object |
| Assessment of Constructional Apraxia | ask pt. to put puzzle together, put wedge pieces into a circular form (pizza slices) |
| Effects on function with Constructional Apraxia | unable to move from pieces to a whole object, can't place letters in envelope, make a sandwich |
| Treatment/management stategies of Constructional Apraxia | Demonstrate putting pieces together, draw diagrams of how to constuct objects, use verbal cues |
| Areas of the brain involved with Contructional Apraxia | parietal lobe |
Combine with other sets
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