Flashcards in Apraxia and neglect Deck (68):
premotor cortex is associated with what area of brain?
supplemental motor cortex is associated with what area of brain?
With simple finger movements, what areas of brain are active?
primary motor and sensory
With complex finger movements, which area of the brain is acitve?
Bilateral suplemental motor area and primary motor and sensory
With mental rehearsal of complex finger movements, what area of the brain is active?
only supplemental area
Supplemental motor area is associated with what type of movements?
Internally generated movements
Supplemental motor area associated with movements that have or have not been prelearned?
SMA associated with movements that HAVE been previously learned (think BG and parkinsons, motor patterns)
During what type of practice is the supplemental motor area active?
during mental practice
With what type of cue is the premotor cortex active?
When movement initiation is dependent on an external cue
What type of sensory input is the premotor cortex most active with and why?
most active when movement is visually guided b/c it interacts with the parietal cortex
Premotor cortex is most active in which phase of learning?
early phase of learning
What type of neurons are associated with the premotor cortex?
mirror neurons which fire when movement is watched
What phase of movement is the primary motor cortex associated with?
What type of movements are associated with the Primary motor cortex?
Fine motor control
Highly fractionated movements
What visual pathway is the inferior parietal lobule associated with?
"Where" visual pathway
What type of map does the Inferior parietal lobule generate?
Spatial map of body and environment
What do you get with a lesion of the Inferior parietal lobule?
Optical ataxia, apraxia
What is apraxia?
Difficulty or inability in executing appropriate and purposeful movements despite absence of paresis, ataxia or sensory loss, comprehension, attention or willingness to perform the movement
What three things does apraxia affect?
Affects previously learned movements
affects ability to learn new tasks
Affects non-paretic side
What type of damage does Apraxia usually result from?
Parietal lobe damage-esp. inf. parietal
Sometimes frontal motor association area damage
What hemisphere is usually damaged with apraxia?
Usually left hemisphere (dominant)
What type of damage can cause ideomotor apraxia?
Dominant parietal, sometimes Primary Motor cortex
What is the most common form of apraxia?
What type of deficits do you see with ideomotor apraxia?
Motor planning deficits
Breakdown betwen concept and performance
Between what two structures is there a lack of communication in ideomotor apraxia?
Inferior parietal lobule does not communicate movement parameters with the Primary motor cotex
Pts with ideomotor apraxia have difficulty performing spontaneous mvmts or mvmts on command?
Movements on command OR initiating gestures
What is the movement quality of someone with ideomotor apraxia?
Awkward and clumsy
What muscles will be overused in ideomotor apraxia and why?
Proximal muscles will be overused to compensate for impairment of distal musculature control
What is it called when someone with ideomotor apraxia gets stuck on a movement?
What type of understanging about an object do pts with ideomotor apraxia have?
Usually can describe the use of an object but cannot sequence movements to use it correctly (due to motor planning deficits)
What is oral motor apraxia?
Same disorder as ideomotor apraxia except it affects the lips and face, including purposeful movements associated with speaking and facial expression
Is ideational apraxia more or less severe than ideomotor apraxia?
A more severe form of motor planning defecit than ideomotor apraxia
What is the main difference between ideomotor apraxia and ideational apraxia?
With ideomotor apraxia you can still conceptualize the task, you just cannot correctly sequence the motor plan. With ideational apraxia you cannot conceptualize the motor task
With ideational apraxia, how well do pts perform a series of tasks
What types of errors do those with ideational apraxia make?
misuse/mislocation of objects
What do more severe cases of ideational apraxia look like?
cannot describe the motor task or the use of the object
have no spontaneous movement
What is Constructional apraxia?
The inability to construct or copy simple designs or models
What area of the brain is affected with constructional apraxia?
Visual association cortex of NONDOMINANT parietal lobe
Are patients with constructional apraxia aware of their mistakes?
What is dressing apraxia?
inability to dress oneself properly due to a disorder in body schema or spatial relationships
What area of the brain is affected with dressing apraxia?
NONDOMINANT occipital or parietal lobe
go review assessment and treatment principals
What is Agnosia?
Inability to recognize
What is tactile agnosia?
cannot recognize objects by touch
What area of the brain is affected with tactile agnosia?
areas 5,7 of the non dominant parietal lobe
what is visual agnosia?
cannot recognize by wight
With visual agnosia, what area of the brain is affected?
-vis. association areas 18, 19 for nonsymbolic objects
-nondominant inferior parietal lobule for symbols like words/signs
What is auditory agnosia?
cannot recognize by sound (e.g. moo for cow)
What part of the brain is affected with auditory agnosia?
Superior part of temporal lobe, bilateral damage
What is autotopagnosia?
Inability to identify the body or its parts or to orient them correctly
What area of the brain is affected with autotopagnosia?
nondominant inferior parietal lbule (area 39, 40)
What is anosognisa?
unaware or denial of illness
What area is affected with anosognisa?
Nondominant inferior parietal lobule (area 39,40)
What is prosopagnosia?
Inability to recognize faces
What area of the brain is damaged with prosopagnosia?
Damage to nondominant occipto-temporal area ("what pathway")
What is neglect?
Failure to report, orient toward, or respond to stimuli on the contralateral side of space that cannot be attributed to sensory or motor dysfunction
What is personal space?
area pertaining directly to the body
What is peripersonal space?
space within reacing distance
What is extrapersonal space?
area beyond reach
What area of the brain is usually lesioned in pts with neglect?
Usually nondominant inferior parietal lobe (39,40)
-occasionally nondominant frontal, thalamus or basal ganglia
What is the incidence of neglect with a RCVA?
13-81%. real specific...
What effect does neglect have on patient outcomes?
poorer outcomes than pts without neglect
What does neglect often occur with?
What are the two proposed mechanisms of neglect?
disorder of attention
Disorder of coding visual information
review testing and intervention for neglect
What is right parietal syndrome?
damage to the non-dominant (right) hemisphere, esp. parietal lobe, often resulting in severe perceptual defecits that often occur in combination
What are symptoms of an internal capsule stroke?
Pure motor hemiplegia and/or pure sensory hemianesthesia