Module 5 RHD Flashcards by Sydney Klyczek

Principle of Lateralization:
the two cerebral hemispheres are structurally ? byt functionally?

LH -> ?
-verbal
-math
-verbal ?
all aspects of ?

RH ->?

similar / distinct

sequential processing:
verbal expression, WM
-mathematics
verbal logic, analysis of cause and effect

global processing

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Localization of Right Hemisphere:
no clear pattern of ?
don’t get ? from damage in the RH

some believe that the RH is less ? than the left

but it is clear

deficits from specific lesions

borcas or wernickes

less focally organized

RH has diff. functions than left

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RH functions:
non-verbal:
thought
mental
moti?

communication:
in..
non-literal
emotion ?
many …cues

organization
-mental flexibility (following someone else’s topic change)
-motivation

intonation
non-literal change
emotional comprehension and expression (intonation and facial expression)
-many nonverbal cues

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What is Split Brain Syndrome:
occurs after.. surgically severed in order to alleviate

have anomie when ? but ca ?

when stimuli presented on left they can?

corpus callosum

seizures

anomia. presented on left/ can draw it

say it

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causes of right hemisphere disorder:
..most common
–

stroke
tumor
brain injury

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Consequences of stroke:
RHD-CCD

linked to

poorer outcomes

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Characteristics of RHD-CCD:
cognitive deficits:
attention:
unilateral ?

executive function:

reduced awareness of ?

communication deficits:
prosody -

comprehension:
non-literal
ambig…
use of context to

production:

complex lingusitic material:
specificity of

discourse characterized by:

focused, sustained attention, alternating and divided attention
-unilateral neglect

organization, sequencing, problem solving, reasoning, judgment, insight

deficits

tone of voice and intonation to express meaning and emotion

non-literal language
-ambiguities
-use of context to determine intended meaning

efficiency and effectiveness

eye contact, facial expressions, turn taking

specificity of information, humor, morals and themes

overpersonalization, tnagential ideas, and poor organization

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Cognitive deficits: attention deficits:

focused attention

selective attention

sustained attention

alternating attention

divided attention

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hemispheric attention vs visual field deficits:

hemispheric attention:
this attention refers to the brain’s ability to ?
therefore inattention or neglect is a ?

inattention is NOT a loss of ?

perceive information on the contralateral side of each hemisphere

perceptual loss

loss of sight

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Visual field deficits: this refers to the loss of ?

visual field deficits often result from ?

sensory information received from your eyes and sent to your brain

damage to the visual tracts

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Hemispheric Visual Attention: the right hemisphere is more important than the ?

left hemisphere attends only to the ?

right hemisphere can attend to

left hemisphere for attention

right visual field

both visual fields

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Hemispheric asymmetry in attention:
right parietal lobe atttends to both

right hemisphere =

left hemisphere lesion= right neglect not as

right hemisphere intact and still ?

bilateral lesion= attention to both visual fields is ? only way you can get ?

left and right hemisphere

left neglect

not as severe

attends

impaired / right hemisphere neglect

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Neglect syndrome:
patients do not respond to any ?
-..info
-…info
-…info

more common with ? than ?
-hallmark for ?
-…/140 RH strokes had ?

information presented on opposite side of brain lesion
-visual info
-auditory info
-proprioceptive info

Right brain damage / left
-RHD
-78/140

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Forms of Neglect:
left neglect:
-more
-more
lasts

right neglect (due to LHD)
-less
-may be masked by other
-resolves more
-usually as a result of

common
severe
longer

common
-masked by other deficits
-severe
-more quickly
-bilateral damage

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Unilateral Neglect:
reduced attention to ?
NOT a ?
-but can co-occur with ?

not an ? disorder
various types of
varies by
varies over
varies depending on ?

motor neglect: reduced use of

tactile neglect: reduced ?

auditory neglect: reduced processing of ?
-poorer ?

contralesional space
-visual deficit
-hemianopsia (visual field cut)

all or none disorder
-neglect
-region of space
-over time
-stimuli, task, complexity, other attentional demands

one side of body

response/recognition of tactile stimulation

auditory stimuli from left side
-localization of sounds from left

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Neglect phenomena:
magnetic ?
neglect is worse with both ?
unable to disengage attention from ?

attentional imbalance: stronger

extinction: failure to resond to ?
respond to ? but not to left stimulation when ?

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attraction to right side
-R and L sided stimuli
-from right sided item to move attention to left

stronger pull to right than left

double simultaneous stimulation
-left stimulation alone/ right is also present

Types of unilateral neglect: region of space affected
personal space: one’s own ?
neglect to ?

peri-personal space: within ?
-most ?

extra-personal space: beyond?

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one’s own body
-shave, dress, comb left side

within reaching distance
-common

arm’s reahc

Types of unilateral Neglect: frames of reference

viewer centered: left defined by
-… neglect
…% of cases

stimulus/object centered: … defined for each object
…neglect
..% of cases
putting things on the … won’t help

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client’s view/visual field
-egocentric neglect
-28%

left defined for each object
-allocentric neglect
5% of cases
-right side

Functional problems with Left Hemispatial Neglect:
problems reading ?
-depends on
-problems with ?
need a ? like a red line across page

reduced (sometimes greatly( awareness of ?

reduced ability to complete ?
eating only what is on ?

localizing ?

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left half of reading materials
-severity
-margins and spacing when writing
-visual cue

left side of body

ADLS
-right side

sounds on left

Neglect and Language:
can affect ?
neglect ?

neglect ?
begin writing in ?
… perseverations

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reading and writing
-neglect alexia

dysgraphia
-middle or right side of page
letter and line

Other perceptual and attentional deficits:
… to tasks
excessive attention to ?
neglect may also occur across other ?

these pt’s have now lost their ?

prosopagnosia:
a problem of ?

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impulsivity, distractability, and poor attention to tasks

irrelevant information

modalities such as tactile, olfactory, and sensory motor

independence so also psychosocial and emotional components

visual pattern recgonition necessary to idneotfy a face

Cognitive deficits: executive function deficits

pevalence ?

anecdotal evidence that adults with RHD have ?

assessment and treatment based on research with other

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unknown

have exec. function deficits

other populations

Cog. deficits in RHD:
dis…
impaired ?
difficulty with ?
poor integration of ?
difficulty with ?
impaired comprehension of ?

difficulty understanding ?

lack of ?

decreased ?

disorientation to ?

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disorientation

impaired attention

memory

information

logic, reasoning, planning and problem solving

inferred meanings

understanding humor

motivation

impulsivity

alertness

time and direction

Affective deficits in RHD:
difficulty expressing:

difficulty recognizing:

delusions and ?

depres..

apparent lack of

…

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emotions

emotions of others
-facial expressions, gestures, postures

delusion and confused states
-agitated delirium, confabulations, disorientation

depression

apparent lack of motivation

apathy

Anosognosias: occurs in... % of those with RHD -hard to -can resolve during -awareness influenced by ? anosognosia: unilateral physical comm. ? consequences of ?

7-77% -assess -resolve during spontaneous recovery -motivation, fatigue, complexity unilateral neglect physical deficits comm. deficits consequences of deficits

anosognosia: reduced awareness of deficits impacts ? more intensive rehab recommended for ? impacts rehab and post-rehab: poorer longer treatment prior to lower ? poorer outcome with? impacts ? greater distress with greater ?

referrals -patients with greater unawareness compliance and participation -treatment prior to return to work -functional status upon discharge outcome with employment distress with unawareness

Right hemisphere disorder and langauge: overall impairments related to difficulty integrating ? linguistic AND? -complex ? sequencing? .. instructions difficulty picking out ? difficulty with ? oganization and complex ? -emotional components of -abstract -nonverbal ? -.. vs. ..langiage

information -linguistic and non-linguistic complex stories, sequencing information, verbal instructions important versus unimportant info thougth organization and complex linguistic forms: -emotional components of language -abstract forms -nonverbal comm. -literal versus fig. langauge

Comm. deficits: prosody comm. functions of prosody -pragmatic grammatical affective indexical aprosodia: inability to comprehend prevalence: impact -limited spouses cargeivers rate aprosodia as?>

draw attention to specific info -segmenting clauses, differentiate words and sentence types conveys emotion and mood idiosyncratic speech patterns or produce prosody 20-80% of people with RHD information -as important

Prosodic deficits: affect and comm. aprosodia after RHD -may affect more commonly affects ? resulting in attenuated variation in ? -expressive receptive: affect after RHD: reduced use of ? emotional processing after RHD: use fewer ? decreased ? and ? of emotions -patient may appear ?

linguistic -affective prosody / variation in stress, duration and funcamental frequency expressive: flat, monotone receptive: diff. interpreting others mood or emotion or intended meaning facial expression emotionally-laden words, decreased expression and comprheension of emotions -rude, odd, inattentive

Comprehension process: construction phase: activate ? -multiple meanings of ? RHD can cause deficits in this stage - integration phase: menaings integrated into less appropriate ? RHD can cause deficits at this stage which impact

construct meaning of words, phrases, sentences -ambiguous words this stage - activation of less-common meanings context -meanings suppressed/inhibited impact general comprehension

Comm. deficits: non-verbal flat affect (facial expression) can accompany difficulty interpreting ?

aprosodia body language and facial expression

Non-literal language and inferencing: deficits after RHD: generation of ? can make don't always use at ? revision of ? slow/inefficient revision of ? appreciation/use of ?

inferences -can make inferences -don't aleays use relevant cues so inferences aren't always correct interpretation -inference/interpretation humor

Comm. Deficits: discourse production and pragmatics discourse production: pragmatics: many studies of RHD and pragmatics: many facotrs no clear ? RHD most often results in: ... discourse production reduced reduced use of

organization, topic selection, coherence eye contact, turn taking, topic selection considered no clear patterns of deficits disorganized, tangential, overly-personalized discourse eye contact, turn taking emotionally-laden words

Comm. deficits: discourse verbal: poor ? and diff. with ? rules difficulty organizing and ? ideas may have diff. staying on tend to have excessive understanding speaker reduced ? may not understand ? reduced ?

turn taking/ conversational rules organizing and sequencing ideas topic speech output speaker intentions or internal motivations of others flexibility gist informative content

Non-verbal discourse deficit: impairment in ... recall of mental unusual

comprehending and using gestures appropriately prosopagnosia visual forms rotation views

Theory of Mind: the ability to understand that others have ? can be affected after might affect ? -diff. interpreting ? poor ?

ideas, thoughts, beliefs, feelings and emotions that differ from one's own RHD language and comm. jokes and sarcasm coherence

Module 5 RHD Flashcards

(36 cards)