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Neurologic PT > Visual and Perceptual Impairments > Flashcards

Visual and Perceptual Impairments Flashcards

1
Q

Dysfunction in visual functional skills is associated with _______.

A

Cranial nerve palsy

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2
Q

What is visual acuity? Function?

A

Visual Acuity: Ability to produce a focused image on retina

Function: Collecting detailed visual information allowing for interpretation

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3
Q

List and describe 3 acuity dysfunctions.

A
  1. Astigmatism cause of blurred vision: an unequal curving of one or more of the refractive surfaces of the eye, usually the cornea.
  2. Myopia light entering the eye is focused in front of the retina and distant objects cannot be seen sharply.
  3. Hyperopia focused behind the retina, distant objects being seen more distinctly than near ones
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4
Q

Describe the examination, treatment and prognosis for visual acuity.

A
  1. Examination: Near and Distant Acuity Charts (Snellen)
  2. Treatment: Corrective Lenses
  3. Prognosis: Good with Correction
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5
Q

What is ocular movement? Function? Examination? Prognosis?

A
  1. Ocular Movement: Ability to move eyes
  2. Function: eye alignment, binocular vision
  3. Examination: Visual screen
  4. Prognosis: Fair to good
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6
Q

List 3 remediation and 2 compensation treatments for problems with ocular movement.

A
  1. Remediation: Eye Exercises & Patching, Surgery

2. Compensation: Prisms and Patching

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7
Q

What is accommodation? Function? What 2 conditions occur as a result of dysfunctional accommodation?

A
  1. Accommodation: Ability to bring near objects into focus quickly
  2. Function: note-taking
  3. Dysfunction: blurry vision, diplopia (double vision)
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8
Q

What is convergence? 3 Functions? What 2 conditions occur as a result of dysfunctional convergence?

A
  1. Convergence: ability to move eyes inward in a coordinated fashion
  2. Function: Near vision, tracking approaching objects, hand-eye coordination
  3. Dysfunction: decreased hand-eye coordination, blurry vision
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9
Q

What is divergence? 3 Functions? What 2 conditions occur as a result of dysfunctional divergence?

A
  1. Divergence: ability to move eyes away from midline
  2. Function: Maintaining a single image as objects move away from you, depth perception, orientation in space
  3. Dysfunction: diplopia, disorientation
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10
Q

What are pursuits? Function? What 2 conditions occur as a result of dysfunctional pursuits?

A
  1. Pursuits : ability to visually track objects moving through space
  2. Function: Hand eye coordination
  3. Dysfunction: clumsiness, dizziness
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11
Q

What are saccades? Function? What 2 conditions occur as a result of dysfunctional saccades?

A
  1. Saccades: ability to shift focus from one object to another rapidly without head movement.
  2. Function: Driving
  3. Dysfunction: clumsiness, dizziness
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12
Q

Visual functional skills involve acquiring visual information at the _____.

A

RETINA

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13
Q

Where does visual perception begin and end?

A
  1. Brain begins to interpret and attach meaning to visual information in the hypothalamus.
  2. Process is completed in the occipital, parietal and temporal lobes.
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14
Q

Visual gnosia is the ability to attach ____ to visual ____.

A

Meaning to visual stimuli

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15
Q

What is the difference between visual and facial agnosia?

A

Visual agnosia: inability to attach meaning to visual stimuli despite normal functional vision and expressive language

Facial agnosia: inability to recognize faces

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16
Q

Visual field loss is an impairment of visual ____.

A

Perception

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17
Q

List 2 examples of spatial perception deficits.

A 
Sensory neglect (inattention)
Motor neglect
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18
Q

Visual field loss is caused by ____ anywhere along the visual pathway.

A

LESIONS

19
Q

VISUAL FIELD LOSS

A

REFER TO DIAGRAM ON SLIDE 31 (IMPORTANT)

20
Q

What is the cause of homonymous hemianopsia? List 2 characteristics associated with this condition.

A
  1. Caused by lesion along the optic tract as it passes through the Parietal and Temporal Lobes

Characterized by:

  1. Loss of vision in the nasal field ipsilesional eye
  2. Loss of vision in peripheral field of the contralesional eye.
21
Q

How is homonymous hemianopsia diagnosed? List 3 characteristics that make up the clinical presentation of this condition.

A

Diagnosis: Visual Field Testing

Clinical Presentation
1. Bumps into objects
Hugs one side of hallway
Stares to one side or at floor

22
Q

List 2 examinations that can be done to identify homonymous hemianopsia.

A
  1. Line bisection

2. Cancellation test

23
Q

List 1 thing a patient with homonymous hemianopsia will NOT be able to do. List 3 things a patient with homonymous hemianopsia WILL be able to do.

A

Patient will not be able to:
1. Attend to visual stimuli in the contralesional space

Patient will be able to:

  1. Move into contralesional hemispace
  2. Direct gaze into contralesional hemispace
  3. Attend to sound and somatosensory input in the contralesional hemispace
24
Q

Describe the prognosis of patients with homonymous hemianopsia.

A

Lower FIM scores at admission and discharge from rehabilitation

25
Q

List 1 remediation and 3 compensation treatments for homonymous hemianopsia.

A

Remediation: Scanning activities

Compensation

  1. Prisms
  2. Anchoring
  3. Encourage patient to outline workspace
26
Q

Hemispatial inattention is also known as _____. What is hemi spatial inattention?

A

Sensory neglect

A disorder of attention and perception where all sensory pathways are intact but information is not being used functionally.

27
Q

List 5 areas where a lesion could cause hemi spatial inattention.

A
  1. Posterior parietal cortex
  2. Frontal eye fields
  3. Cingulate gyrus
  4. Striatum
  5. Thalamus
28
Q

List 2 characteristics of the clinical presentation for patients with hemi spatial inattention.

A
  1. Bumps into obstacles in new environments

2. Scans right side to middle

29
Q

List 1 thing a patient with hemispatial inattention will NOT be able to do. List 3 things a patient with hemispatial inattention MAY be able to do

A

Will not be able to:
1. Attend to sound and somatosensory input in the contralesional hemispace

Patient may be able to:

  1. Move into contralesional hemispace
  2. Direct gaze into contralesional hemispace
  3. Attend to visual stimuli in contralesional space
30
Q

List 4 treatment interventions used for REMEDIATION of hemispatial inattention.

A
  1. Scanning emphasizing head movement & COG displacement
  2. Eye patching and occluders
  3. Tracking and pursuit activities – from area of function to dysfunction and back
  4. Limb Activation Strategies
31
Q

List 3 treatment interventions used for COMPENSATION of hemispatial inattention.

A
  1. Outlining
  2. Anchors
  3. Prisms
32
Q

Patients with motor neglect will be unable to move into a _____ despite being aware of sensory info in that space.

A

Hemi space

33
Q

List 3 characteristics of the clinical presentation for patients with motor neglect.

A
  1. Intact or non-intact visual fields
  2. Will not cross midline when cued
  3. Won’t wash or dress hemiplegic side of body
34
Q

List 2 things a patient with motor neglect will NOT be able to do. List 2 things a patient with motor neglect MAY be able to do.

A

Will not be able to

  1. Move into contralesional hemispace
  2. Move eyes into contralesional hemispace

Patient may be able to:

  1. Attend to visual stimuli in contralesional space (peripheral vision)
  2. Attend to sound and somatosensory input in the contralesional hemispace (passive)
35
Q

List 4 treatment interventions used to treat motor neglect.

A
  1. Turn trunk to left
  2. Patching an eye
  3. Occluding right fields
  4. Arranging room or workspace
36
Q

Pusher Syndrome is a ____ response to a perceptual impairment that predominantly occurs with ____, with a lesion at the _____.

A

MOTOR
Right CVA
Lesion: Posterior-lateral thalamus

37
Q

List 3 characteristics of Pusher Syndrome.

A
  1. Characterized by patient actively pushing toward paretic side with non-paretic extremities
  2. Visual vertical perception is intact
  3. Graviceptive orientation is 18 degrees toward paretic side
38
Q

What is the prognosis of Pusher Syndrome? When is the majority of the improvement seen?

A

Prognosis: Lower FIM scores and slower improvement

Majority of improvement in pushing behavior in the first month

39
Q

List 5 interventions used to treat Pusher Syndrome.

A
  1. NDT: Lean against walls
  2. Utilize intact visual vertical
  3. Work in gravity reduced postures
  4. Consider involved side transfers
  5. Tens on contra lesional side of neck
40
Q

What is coordination? What 3 things must be intact to ensure proper coordination?

A
  1. Ability to execute smooth movement

2. Dependent on intact: somatosensory, visual and vestibular input

41
Q

What is ataxia?

A

Lack of voluntary control over movement

42
Q

List 5 interventions used to treat ataxia.

A
  1. Damping (weighting to reduce oscillation in movement)
  2. Tracking resistance (ie. weighted walker to provide resistance in opposition direction of pt.’s motion)
  3. Control degrees of freedom (distal splinting/ sliding)
  4. Enhancing proprioceptive input
  5. Core and proximal UE/LE strengthening
43
Q

What is the difference between dysmetria and dysdiadokinesia?

A
  1. Dysmetria: Over and undershooting

2. Dysdiadokinesia: Trouble with rapidly alternating movements

Neurologic PT (11 decks)

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