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ECU Cognitive/Linguistic Impairment in Brain-Injured Adults > 8.1 - Right Hemisphere Syndrome > Flashcards

8.1 - Right Hemisphere Syndrome Flashcards

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1
Q

Every year, more than ________ people in the United States have a stroke.

A

795,000

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2
Q

About ________ of these are first or new strokes.

A

610,000

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3
Q

About ________ strokes—nearly one of four—are in people who have had a previous stroke.

A

185,000

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4
Q

What percentage of stokes are ischemic stokes?

What are ischemic strokes?

A

About 87%

When blood flow to the brain is blocked.

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5
Q

What is processed by the Right Hemisphere?

2

A

Gestault

Whole picture

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6
Q

What is processed by the Left Hemisphere?

2

A

Analytic

Linear processing

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7
Q

What percentage of the population is right handed?

A

> 90%

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8
Q

In what percentage of right handed people is the left hemisphere is dominant for language?

A

99%

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9
Q

In what percentage of left handed people is the left hemisphere is dominant for language?

Right hemisphere?

Bilateral dominance?

A

70%

15%

15%

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10
Q

In what percentage of the ENTIRE population is the left hemisphere is dominant for language?

A

97%

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11
Q

Those who have experienced a Right Hemisphere Stroke are a __________.

A

Heterogeneous group

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12
Q

Is the Location and Extent of Lesions the same in those who have experienced a Right Hemisphere Stroke?

A

No

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13
Q

Are the Presence and Severity of Difficulties caused by Right Hemisphere Stroke the same across patients?

A

No

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14
Q

What are 6 other factors that influence communication performance in those who have experienced a Right Hemisphere Stroke?

A

Age

Cognitive ability

Educational level

Time of lesion

Individual response

Handedness

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15
Q

What 3 categories of deficits are seen in Right Hemisphere Disorders?

A

Pragmatic Deficits

Cognitive-linguistic Deficits

Discourse Deficits

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16
Q

Which category of deficits seen in Right Hemisphere Disorders most often prevents a patient from returning to work?

A

Pragmatic deficits

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17
Q

___% of individuals experiencing a right hemisphere stroke will exhibit characteristics of right hemisphere disorders resulting in communication issues that lead to inadequate or
inappropriate social interactions

A

> 50%

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18
Q

What are the 13 characteristics of Right Hemisphere Syndrome?

A

Difficulty with facial recognition

Left visual neglect

Poor awareness of deficits

Poor self-monitoring

Impulsive behavior

Poor initiation and motivation

Disorientation

Impaired attention/memory

Difficulty with organization and reasoning/problem - solving

Difficulty with social aspects of language

Difficulty understanding humor

Difficulty with word retrieval

Monotone and flat affect

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19
Q

Patients with Right Hemisphere Syndrome appear ____________, who may take little account of social communication conventions, perhaps interrupting and failing to make eye contact, or alternatively as a verbose, rambling communicator whose discourse shows tangential associations.

A

Abrupt, disinterested and insensitive communication partners

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20
Q

Patients with Right Hemisphere Syndrome exhibit impairments in the ability to ______ and _______ incoming information may also be impaired, leading to difficulties with some aspects of comprehension

A

Integrate

Interpret

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21
Q

Prosodic, affective and cognitive impairments, including ______, ______, and ______ may accompany and contribute to the communication disorder.

A

Denial

Attention deficit

Neglect

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22
Q

What are 8 conditions commonly seen in Right Hemisphere Disorders?

A

Anosognosia

Left neglect

Agnosia

Prosopagnosia

Aprosodia

Initiation problems

Social judgment/pragmatics

Cognitive-communication problem

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23
Q

What is Anosognosia?

2

A

Denial of illness

Poor self awareness

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24
Q

What is Agnosia?

A

Inability to process sensory information

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25
What is Prosopagnosia?
Inability to recognize faces
26
What is Aprosodia?
Inability to communicate prosody
27
What are the three levels of denial seen in Anosognosia?
Mild Moderate Severe
28
What is MILD Anosognosia? | 2
Acknowledge disability but unconcerned about them Failure to notice and use
29
What is MODERATE Anosognosia?
Acknowledge disability but underestimate decficits and minimize the effects
30
What is SEVERE Anosognosia?
Reject the presence of major disabilities (paralysis, sensory loss, visual blindness, hemiplegia) or ownership of limbs
31
Is someone with SEVERE Anosognosia a good candidate for treatment?
No
32
What is Left Hemispatial Neglect? | 4
Failure to respond to information presented on the side opposite (contralateral) to their brain lesion Reduced attention to left-side input Reduced use of left limbs Reduced awareness of and recognition of left-sided body parts
33
What are the 2 Subtypes of Left Hemispatial Neglect?
Allocentric Egocentric
34
What is Left “Allocentric” Neglect?
Errors on the left sides of individual stimuli (picture), regardless of location in respect to the viewer
35
What neurological are is Left “Allocentric” Neglect most strongly associated with?
Right superior temporal gyrus
36
What is Left “Egocentric” Neglect?
Viewer does not see (errors) anything from the midline to the left (The "midline" may be skewed to the right or left of the viewer)
37
What neurological are is Left “ Egocentric” Neglect most strongly associated with?
Right angular gyrus
38
What 3 Modalities (other than vision) are neglected in Right Hemisphere Disorders?
Tactile Neglect Olfactory Neglect Auditory Neglect
39
What causes Neglect in Right Hemisphere Disorders? | 3
Lesions of the right hemisphere most common cause Damage involving the right inferior-parietal lobe or nearby temporo-parietal junction May be caused by lesions of inferior frontal lobe and lesions in the posterior cerebral artery
40
Does anatomy really matter if there is neglect?
No
41
Can PCA lesions result in ______ Neglect?
Visual
42
What types of PCA Lesions can cause Visual Neglect?
Large lesions extending beyond occipital cortex into medial temporal lobe and including hippocampus
43
What are the 2 Theories of Neglect?
Representational Theories Attentional Theories
44
What are Representational Theories? | 2
The representation of space and spatial relations is mapped topographically across hemispheres Contralateral half of these mental representations is under-represented in patients with neglect
45
What are Attentional Theories? | 3
Reduced ability of brain to attend to information in left space Neglect is the result of abnormalities in the distribution of attention When attention is cued to the contralesional side, neglect is almost reduced
46
What is Neglect seen primarily due to damage in the Right Hemisphere and not the Left Hemisphere?
Left Hemisphere is organized to only receive spatial information from the right hemifield Right hemisphere is organized to receive spatial information from both hemifields
47
What 4 Sensorimotor Deficits are seen in Right Hemisphere Syndrome?
Visuosensory Deficits (Hemianopia) Hemisensory Deficits Hemiplegia Hypokinesia
48
What is the difference between Deficit and Neglect?
Deficit = cannot process information from one side Neglect = cannot attend to information from one side
49
Who is aware of their lost visual field: those with visual deficits or those with visual neglect?
Those with visual deficits
50
What is Agnosia? | 2
Loss of ability to recognize objects, persons, sounds, shapes or smells The specific sense is not defective nor is there any significant memory loss
51
What senses may be affected in Agnosia? | 3
Auditory Visual Tactile
52
What is Prospagnosia? | 3
Disorder of Facial Recognition Inability to recognize a person simply by studying their face No loss of knowledge of the person
53
How common is Prospagnosia?
Rare
54
What is Misidentification Syndrome? | 3
Misidentification of place Misidentification of persons Misidentification limbs
55
What is an example of Misidentification of Place?
Reduplicative paramnesia
56
What is Reduplicative Paramnesia?
Believing that the place you are in has been duplicated and both places exist simultaneously
57
What is an example of Misidentification of Persons?
Capgras syndrome
58
What is Capgras Syndrome?
Believing that a known person has been replaced by an identical imposter
59
What is an example of Misidentification of Limbs?
Somatoparaphrenia
60
What is Somatoparaphrenia?
Elaborate explanations for lost limbs and/or hemiplegia
61
What kind of COMMUNICATION difficulties are seen following a right-hemisphere stroke? (2)
Cognitive-communicative disorder Not linguistic
62
What causes the COMPREHENSION difficulties are seen following a right-hemisphere stroke? (2)
Concreteness Inability to infer information
63
What is the most important speech domain to assess after a right hemisphere stroke?
Pragmatics
64
What is Aprosodia? | 2
Impairment of speech prosody Inability to either produce or comprehend the affective components of speech (emotional tone)
65
What kind of lesions can cause Aprosodia?
Lesions of the right perisylvian region
66
What are the 2 types of Aprosodia?
Expressive aprosodia Receptive aprosodia
67
What is Expressive Aprosodia characterized by?
“Flat speech”
68
What kinds of lesions can cause EXPRESSIVE Aprosodia?
Right anterior lesions
69
What kinds of lesions can cause RECEPTIVE Aprosodia?
Right posterior lesions
70
What 3 RH Impairments may cause Prosodic Deficits?
Aprosodia Auditory Affective Agnosia Dysprosody
71
What other 3 deficits may be cause perceived pragmatic deficits by RH Impairments?
Motor Speech Deficits Language Impairments Psychiatric Conditions
72
What are 5 Pragmatic Deficits that may be seen in RH Syndrome?
Turn-taking Topic maintenance Eye contact Interjection of irrelevant, tangential, or inappropriate comments Generally insensitive to rules of conversation
73
What 2 Linguistic Deficits may be seen in RH Syndrome?
Auditory Comprehension Deficits Word Retrieval Deficits
74
What 3 Auditory Comprehension Deficits may be seen in RH Syndrome?
Single Words Sentences Multi-Stage Commands
75
What might Word Retrieval affect in those with RH Syndrome?
Verbal Fluency
76
What Reduced Discourse Abilities may be seen in RH Syndrome? | 5
Reduced ability to generate inferences Reduced ability to comprehend and produce main concepts and central themes Reduced level of informative content Reduced ability to manage alternative meanings Reduced sensitivity to communicative content
77
What types of Discourse Deficits may be seen in RH Syndrome?
Expressive Comprehension
78
What types of Expressive Deficits may be seen in RH Syndrome? (8)
Poor macrostructure Reduced informative content Reduced flexibility Reduced specificity Reduced ability to generate alternatives Reduced conversation structure Excessive speech output Unelaborated speech output
79
What styles of discourse may those with RH Syndrome experience reduced sensitivity to? (7)
Gist of narratives (spoken & written) Intended/implied meaning New info. or revision of old info Emotional content Paralinguistic information Conversation rule and conventions Communicative setting; purpose, and role of the participants
80
What styles of language do those with RH Syndrome have difficulty with? (4)
Figurative Language Indirect Requests Humor Confabulation often seen
81
The brain's capacity to represent events is ______.
Limited
82
Attention protects the brains limited capacity through __________ and _______.
Attentional selection Habituation
83
Attention is a ______ resource.
Limited
84
Various forms of processing require __________ of attention.
Different degrees
85
Attention is ______ and ______.
Unitary Supervisory
86
What do we know about the predictors of Recovery in RHD? | 2
Little is known Recovery data is more available for deficits such as neglect than cognitive communicative disorders

ECU Cognitive/Linguistic Impairment in Brain-Injured Adults (23 decks)

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