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Neurophysiology > Cognitive, Sensory, and Perception > Flashcards

Cognitive, Sensory, and Perception Flashcards

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1
Q

what are the 5 primary categories of tests for cognitive status?

A
  1. consciousness
  2. orientation
  3. attention/concentration
  4. memory
  5. executive function
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2
Q

what are the levels of consciousness?

A
  1. alert/fully conscious
  2. lethargy = general slowing of cognitive and motor processes
  3. obtundation = dulled/blunted sensitivity, difficult to arouse
  4. stupor = semi-conscious state, aroused only w/deep pressure pain
  5. coma
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3
Q

what is the gold-standard test for levels of consciousness?

A

Glascow Coma Scale (GCS)

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4
Q

what are the 3 areas of consciousness measured in the GCS?

A
  1. eye opening
  2. motor response
  3. verbal response

*graded 3-15 (<8 = severe; 9-12 moderate; 13-15 mild)

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5
Q

What are the 3-4 primary areas of examination for orientation?

A
  1. Person
  2. Place
  3. Time
  4. Situation
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6
Q

what are the 4 different aspects of attention/concentration?

A
  1. sustained attention
  2. selective attention
  3. divided attention
  4. alternating attention
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7
Q

what is sustained attention?

How can we test it?

A

ability to sustain and focus attention over a duration of time

tested via the Cancellation Test

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8
Q

what is the Cancellation test?

A

a method of testing sustained attention

instruct pt to inspect an image and circle all of the ______ in the image. Will take a lot of time and require a lot of attention

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9
Q

what is selective attention?

How can we test it?

A

ability to screen and process relevant sensory info about the task and environment while screening out irrelevant info

Test = Stroop Test

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10
Q

what is the Stroop Test?

A

used to test selective attention

look at a letter outloud and say the color of the word rather than the word itself

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11
Q

what is divided attention?

How can we test it?

A

ability to perform 2 tasks simultaneously

Walkie-Talkie Test

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12
Q

what is alternating attention?

How can we test it?

A

attention flexibility

shifting your attention back and forth between 2 different things

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13
Q

What is memory?

A

the capacity to store knowledge, experiences, and perceptions for recall and recognition

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14
Q

what are the 2 types of memory?

A

Declarative (Explict)

Non-declarative (Procedural/Implict)

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15
Q

what is declarative memory?

A

conscious recollection of facts and events

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16
Q

what is non-declarative memory?

A

recall movements/movement schema without conscious recollections

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17
Q

what is another 3 part classification of memory?

A
  1. immediate recall
    • “repeat after me” (seconds to minutes)
  2. short-term memory
    • recent or working memory (minutes to hours/days)
  3. long-term memory
    • remote memory (months to years)
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18
Q

What is executive function?

A

capacity to engage successfully in independent, purposeful, self-directed behavior

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19
Q

what are the different aspects of executive function?

A
  1. volition/planning
  2. problem solving/reasoning
  3. insight/awareness
    • poor judgement
  4. social pragmatics
    • inappropriate behaviors
  5. self-regulation/purposeful action
    • initiate, maintain, switch, and stop tasks
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20
Q

what is difference between sensation and perception?

A

sensation = raw data

perception = interpretation of data

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21
Q

what are 2 critera for sensation to occur?

A

adequate arousal and selective attention

adequate stimulus level to activate sensory receptor

*entire pathway must work!

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22
Q

Give a working definition of perception

A

capacity to transform info from the senses and use it to interact appropriately with the environment

selective, integrative, dynamic process that includes problem solving and memory

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23
Q

what type of sensations are carried in the spinothalamic tract?

A
  1. pain
  2. temperature
  3. crude touch
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24
Q

what types of receptors are utilized in the spinothalamic tract?

A
  1. free nerve endings
  2. cutaneous receptors in the skin
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25
what are the afferent fiber characteristics in the spinothalamic tract?
small, thin, slow conducting no myelination
26
where is the spinothalamic tract heading? what are it's major connections?
1. lower brainstem 2. thalamus 3. limbic system 4. diffuse cortical areas
27
what types of sensations are carried by the dorsal column/medial lemniscus tract?
1. discriminative touch (tactile location) 2. proprioception 3. kinesthesia 4. vibration 5. 2-point discrimination
28
what types of receptors are utilized in the dorsal column/medial lemniscus tract?
1. muscle spindle 2. GTOs 3. joint receptors 4. some cutaneous receptors in the skin
29
what are the afferent fiber types of the dorsal column/medial lemniscus tract?
large, thick, rapidly conducting well myelinated
30
where is the dorsal column/medial lemniscus tract headed?
sensory cortex
31
what types of sensations are carried in the spinocerebellar tract?
"unconscious" proprioception and kinesthesia
32
what types of receptors are utilized in the spinocerebellar tracts?
1. muscle spindles 2. GTOs 3. joint receptors 4. some cutaneous receptors in the skin
33
what are the afferent fiber types of the spinocerebellar tract?
fast, direct, heavily myelinated
34
where is the spinocerebellar tract headed?
cerebellum
35
What are the 4 major subcategories/components of the perceptual exam?
1. Body scheme and body image impairments 2. spatial relationships 3. agnosias 4. apraxia
36
what is the difference between body scheme and body image?
body image = visual/mental image of one's body body scheme = postural model of body (body awareness)
37
Name a major impairment to body scheme/image
Unilateral Neglect
38
what is unilateral neglect?
failure to orient toward, respond to, or report stimuli on the contralateral side to the lesion \*despite normal sensory, visual and motor systems
39
Unilateral neglect occurs mostly with ________ lesions
R tempoparietal junction posterior parietal (\*\*R side most often)
40
what are the 2 classification systems for unilateral neglect?
1. Modality 2. Distribution
41
what are the 3 types of modality neglect?
1. sensory 2. motor 3. representational
42
What is sensory neglect?
brain loses ability to maintain awareness of a specific sense as it comes in (can be visual, auditory, or tactile) the sensation is fine but the perception is off
43
what is motor neglect?
"output neglect" failure to generate a movement response to a specific stimuli even if the pt. is aware of the stimuli ex: ball is thrown at you, you only raise 1 arm to catch it even though both arms have 5/5 strength
44
what is representational neglect?
loss of internally generated images ex: pt asked to recall and draw a clock. They draw a clock with all the numbers on 1 side of a circle
45
What are the two subcategories of distribution neglect?
1. Personal 2. Spatial
46
what is personal neglect?
individual lacks awares of entire contralateral side of their body
47
what is spatial neglect?
failure to acknowledge stimuli of the contralateral side of space can be peripersonal (within reaching space) extrapersonal (in far space)
48
Other than unilateral neglect. What are 4 other types of body scheme/body image impairments?
1. somatoagnosia 2. R-L discrimination 3. vertical disorientation/midline disorientation 4. Pusher syndrome
49
what is somatoagnosia?
an impairment of body scheme Lack of awareness of relationship of body parts (how your shoulder relates to your elbow, difficult to differentiate from proprioception)
50
what portion of the brain is primarily/most often affected with somatoagnosia?
usually lesion to dominant parietal lobe
51
what is R-L discrimination?
decreased R/L differentiation with body parts and following directions
52
what portion of the brain is primarily/usually affected with R/L discrimination?
lesion to either parietal lobe
53
what is vertical disorientation/midline disorientation?
cannot ID when their body is in the middle
54
what is Pusher Syndrome?
a subtype of vertical/midline disorientation characterized by leaning and active pushing towards hemiplegic side w/o compensation for instability and with resistance to passive correction towards midline
55
what portion of the brain is primarily affected with pusher syndrome?
lesion to R hemisphere centered in area of posterolateral thalamus tends to be more common when L hemiplegia is present alongside L spatial and sensory neglect
56
list the various spatial relationships impairments
1. Figure ground 2. spatial relations disorder 3. position in space disorder 4. topographical disorientation 5. depth and distance perception
57
what is Figure ground?
the inability to distinguish a figure from the background in which it is embedded ex: pick a screwdriver out of a toolbox full of tools
58
what is spatial relations disorder?
the inability to percieve relationships of one object in space to another object, or to one's self
59
what primarily causes spatial relations disorder?
lesion in the R inferior parietal lobe
60
what is position in space disorder?
decreased ability to perceive and interpret spatial concepts can't distinguis between opposite directional/spatial concepts ex: confused up and down
61
what is topographical disorientation?
difficulty perceiving relationships from one location to another in the environment
62
what is depth and distance perception?
inaccurate judgement of directions, distance, and depth more broad than spatial relationship disorders, and deals with environmental cues (like difficulty negotiating a curb)
63
what is the primary cause of depth and distance perception issues?
lesion of R or bilateral visual assocaition cortex
64
what does the general term agnosias mean?
decreased ability to recognize stimuli despite intact sensory function. most commonly associated with damage to temporal lobe
65
what are the different types of agnosias?
1. Sensory 1. visual 2. auditory 3. tactile (asterognosis) 2. Body scheme 1. anosognosia 2. somatagonsia
66
what is visual agnosia?
inability to recognize familiar objects despite normal eye function
67
what type of lesion normally causes visual agnosia?
occipital and temporal lobe (R or L)
68
what is auditory agnosia?
inability to recognize non-speech sounds and discriminate between them
69
what type of lesion normally causes auditory agnosia?
left temporal lobe
70
what is tactile agnosia (astereognosis)?
inabilty to recongize objects when handling them, despite normal tactile sensation
71
what types of lesions normally causes tactile agnosia?
parietal/temporal/occipital association areas (R or L)
72
what is anosognosia?
a severe condition in which an individual does not acknowledge, denies, or lacks awareness of presence/severity of one's deficits
73
define apraxia
impairment of voluntary, skilled, well-learned movement w/o deficits in motor function, sensory function, or coordination
74
what are the 2 types of apraxia?
ideomotor ideational
75
what is ideomotor apraxia?
breakdown between concept (idea) and performance (motor execution)
76
what is ideational apraxia?
failure in the conceptualization of the task
77
what type of lesion normally causes apraxia?
left frontal or parietal lobes

Neurophysiology (9 decks)

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