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Neuro Cognitive Disorders > 4: Right Hemisphere Brain Dysfunction (RHD) > Flashcards

4: Right Hemisphere Brain Dysfunction (RHD) Flashcards

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1
Q

What is arousal?

A

readiness to respond to external stimuli

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2
Q

What is orienting?

A

directing attention to stimulus

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3
Q

What are two big types of attention?

A

1) sustained

2) selective

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4
Q

What does sustained attention do?

A

detect changes in stimuli

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5
Q

What does selective attention do?

A

Pays attention to specific stimuli and ignores others

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6
Q

What are 4 big functions of the right hemisphere?

A

1) attention
2) visual perception
3) emotional experience/expression
4) communciation/language

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7
Q

What are different types of visual perception?

A

1) holistic
2) spatial information
3) facial recognition
4) body image

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8
Q

What is body image?

A

can see the whole body and use accordingly for various tasks

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9
Q

What are the 3 big areas of communciation/lagnauge controlled by the right hemisphere?

A

1) discourse comprehension
2) discourse production
3) managing pragmatic skills

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10
Q

What is discourse comprehension?

A

understanding ambiguous meaning, understanding emotional tone/prosodic aspects of speech

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11
Q

What is discourse production?

A

communicative efficiecy and specificity, complex inferences in verbal exchanges, appropriate emotional expression throguh tone, approapriate prosdic aspects

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12
Q

What are 4 pragmatic skills?

A

1) turn taking
2) topic maintenance
3) social appropriateness
4) eye contact

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13
Q

What are 3 causes of RHBD?

A

1) stroke
2) tumors
3) TBI

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14
Q

Damage to what artery most common cause of RHBD?

A

right MCA

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15
Q

What are the 5 general characteristics of MCA RHBD?

A

1) visuospatial perceptual impairments
2) anosoagnosia
3) impaired pragmatics
4) impaired attention
5) changes in mood/personality

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16
Q

What are potential other characteristics of MCA RHBD?

A

1) upper extremity paralysis/paresis - contralateral limb (difficulty ambulating)
2) sensory impairment

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17
Q

What is the visuospatial perceptual impairment that occurs with MCA RHBD?

A

neglect

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18
Q

What is anosoagnosia?

A

impaired awareness of deficits

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19
Q

What are 3 effects MCA RHBD can have on language?

A

1) influence on auditory comprehension
2) verbal expression
3) reading/writing

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20
Q

Damage to PCA causing RHBD general characteristics: (4)

A

1) rare
2) chronic visual deficits
3) sensory abnormalities
4) motor weakness

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21
Q

What are other symptoms that can occur with PCA RHBD?

A

acute vision loss

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22
Q

What is the acute vision loss that might occur with PCA RHBD?

A

homonymous hemianopsia - loss of outer half of visual field in 1 eye and inner half in the other eye

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23
Q

What are the 2 processes of vision?

A

1) eyes move and take visual info to brain

2) process in interpretation of visual image

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24
Q

How is vision sent to brain?

A

each eye receives some info from right and left halves of environment, info is combined, corsses, and sent to occipital lobes

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25
what are 5 characteristics of ACA RHBD?
1) confabulation 2) disinhibition 3) unconcern 4) anterograde and retrograde amnesia 5) limited awareness
26
What are 2 challenges of RHBD?
1) differ in nature/severity depending on location/lesion | 2) limited pre-hospitalization info\
27
What are 2 large common impacted areas with RHD?
1) cognition | 2) communcation
28
What are 3 areas of cognition that can be impacted with RHD?
1) attention 2) executive function 3) deficit awareness
29
What are 3 areas of communication that can be impacted by RHD?
1) langauge 2) speech 3) pragmatics
30
What is the impact of visual neglect and anosognia on outcomes?
poor functional outcomes for return to independent living
31
What are attentional difficulties that can occur with RHBD?
1) focus/maintain/shift attention 2) determining overal situational meaning 3) importnat vs not 4) identifying relationships 5) contration
32
What is neglect?
impairment in ability to attend to stimuli on opposite side of brain lesion
33
RHBD attention/neglect issues can influence what motor and/or sensory systems (4)?
1) motor - not full use of left arm/leg 2) sensory tactile - difficulty processing left side info 3) auditory - sounds on left 4) visual (neglect)
34
What are types of visual neglect (5)?
1) visual (most common) 2) personal 3) peripersonal 4) extrapersonal 5) reading/writing
35
What is personal neglect
failure to attend to one side of your body
36
What is peripersonal neglect?
failure to attend to items within arms reach on one side
37
What is extrapersonal neglect
reduced attention to things on one side beyond extend of the arm
38
What is reading neglect?
only read info on one side and complain it doesnt make sense
39
What is writing neglect outcomes? (4)
1) leave large margins on the left 2) slants upward on the right 3) letter/word omission or perseveration 4) extra lines/strokes may be added to letters
40
Contralateral neglect and common spatial disorders are most often seen with lesions in the _________________ hemisphere, in the _________ lobe
non-dominant | parietal lobe
41
Why are contralateral neglect and other common spatial disorders most often seen in the non-dominant parietal lobe (2)?
1) lesions on dominant/left typically cause big lang issues that cover up spatial issues 2) non-dominant/right parietal seems to direct attention o both visual worlds (contra- and ipsi-laterla) but dominant parietal only does contralateral (aka rt side more sig loss when affected)
42
What are the 2 main cognitive areas affected with RHBD?
1) memory | 2) executive function
43
What are areas of executive function that can be impacted by RHBD?
1) organization and sequencing 2) goal directed behaviors 3) problem solving 4) reasoning 5) judgement 6) impulsivity
44
What are constructional impairments?
decreased performance in drawing/copying geometric figures, creating designs, etc.
45
What is construvctional impairment not caused by?
visual perceptual or motor imapirment
46
What are 4 causes of constructional impairments
1) impulsivity 2) awareness 3) decreased self correction 4) disorganized/crowded
47
What is topographic impairment?
difficulty relating to extrapersonal space
48
Difficulty with familiar routes, reading maps, and giving directions are examples of what impairment?
topographic
49
Topographic impairment is different than what 2 things?
1) disorientation | 2) confusion
50
What can help someone with topographic impairment?
talking through the sequence
51
What is geographic disorientation?
when you can recognize their general surroundings but are mistaken about geographic location (know person, time, reason, but not specific location)
52
What are visoperceptual impairments?
failure to identify objects, pictures, or drawings that are incomplete/distorted
53
What is prosopagnosia?
facial recognition deficits - failure to identify familiar people by facial features but can if they are described
54
What is anosognosia?
denial of illness
55
Damage to what lobe most often causes anosognosia?
parietal lobe
56
What is the lowest level of anosognosia?
acknowledge deficit but are indifferent
57
What is the moderate level of anosognosia?
acknowledge deficit but underestimate severity and minimize effect
58
What is the severe level of anosognosia?
deny existence of major disabilities (paralysis, sensory loss, visual deficits, etc) and deny ownership of hemiplegic limbs
59
What are reasons that anosognosia is challenging?
1) often ignore errors 2) confabulate 3) argue 4) justify performance errors 5) think they don't need therapy
60
What is the communiation impairement impact with RHDB? (3)
1) non-verbal 2) verbal 3) pragmatic
61
What is aprosodia?
difficulty expressing and interpreting emotion or intent conveyed through prosody
62
What are the 2 types of aprosodia?
1) linguistic | 2) emotional
63
What is linguistic prosody?
issues with word emphasis and rising/falling intonation
64
What is emotional prosody?
intonation that relays emotion
65
Which type of prosody is more likely to be affected with RHBD?
emotional
66
What is the communication impairment impact on verbal and written production? (2)
1) reducing efficiency/effectiveness - problems conveying intent 2) disorganized, tangential, overpersonalized (say a lot but with little content)
67
How might reading and aud comp be affected by RHBD communication impairements?
1) reduced efficiency and effectiveness comprehending message intent 2) misinterpretation of message intent 3) difficulty comprehending nonliteral language (metaphors, idioms, sarcasm)
68
What effect can RHBD communication impairment have on pragmatics? (5)
1) organization/efficiency 2) eye contact 3) personal space 4) turn taking 5) topic appropriateness
69
About what percent of individuals with RHBD have 1+ communication impairments?
50-78%
70
Bilateral lesions to both the right and left PCA can result in:
cortical blindness
71
Damage to what 3 areas can cause issues of attention/neglect with RHBD?
1) right parietal lobe (inferior parietal lobe/temporoparietal junction/supramarginal gyrus) 2) right inferior frontal lobe 3) subcortical structures (thalamus and basal ganglia)

Neuro Cognitive Disorders (13 decks)

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