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Neurophysiology > Cognitive, Sensory, and Perception > Flashcards

Cognitive, Sensory, and Perception Flashcards

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
Q

what are the afferent fiber characteristics in the spinothalamic tract?

A

small, thin, slow conducting

no myelination

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26
Q

where is the spinothalamic tract heading?

what are it’s major connections?

A
  1. lower brainstem
  2. thalamus
  3. limbic system
  4. diffuse cortical areas
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27
Q

what types of sensations are carried by the dorsal column/medial lemniscus tract?

A
  1. discriminative touch (tactile location)
  2. proprioception
  3. kinesthesia
  4. vibration
  5. 2-point discrimination
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28
Q

what types of receptors are utilized in the dorsal column/medial lemniscus tract?

A
  1. muscle spindle
  2. GTOs
  3. joint receptors
  4. some cutaneous receptors in the skin
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29
Q

what are the afferent fiber types of the dorsal column/medial lemniscus tract?

A

large, thick, rapidly conducting

well myelinated

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30
Q

where is the dorsal column/medial lemniscus tract headed?

A

sensory cortex

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31
Q

what types of sensations are carried in the spinocerebellar tract?

A

“unconscious”

proprioception and kinesthesia

32
Q

what types of receptors are utilized in the spinocerebellar tracts?

A
  1. muscle spindles
  2. GTOs
  3. joint receptors
  4. some cutaneous receptors in the skin
33
Q

what are the afferent fiber types of the spinocerebellar tract?

A

fast, direct, heavily myelinated

34
Q

where is the spinocerebellar tract headed?

A

cerebellum

35
Q

What are the 4 major subcategories/components of the perceptual exam?

A
  1. Body scheme and body image impairments
  2. spatial relationships
  3. agnosias
  4. apraxia
36
Q

what is the difference between body scheme and body image?

A

body image = visual/mental image of one’s body

body scheme = postural model of body (body awareness)

37
Q

Name a major impairment to body scheme/image

A

Unilateral Neglect

38
Q

what is unilateral neglect?

A

failure to orient toward, respond to, or report stimuli on the contralateral side to the lesion

*despite normal sensory, visual and motor systems

39
Q

Unilateral neglect occurs mostly with ________ lesions

A

R tempoparietal junction

posterior parietal

(**R side most often)

40
Q

what are the 2 classification systems for unilateral neglect?

A
  1. Modality
  2. Distribution
41
Q

what are the 3 types of modality neglect?

A
  1. sensory
  2. motor
  3. representational
42
Q

What is sensory neglect?

A

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
Q

what is motor neglect?

A

“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
Q

what is representational neglect?

A

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
Q

What are the two subcategories of distribution neglect?

A
  1. Personal
  2. Spatial
46
Q

what is personal neglect?

A

individual lacks awares of entire contralateral side of their body

47
Q

what is spatial neglect?

A

failure to acknowledge stimuli of the contralateral side of space

can be peripersonal (within reaching space)

extrapersonal (in far space)

48
Q

Other than unilateral neglect. What are 4 other types of body scheme/body image impairments?

A
  1. somatoagnosia
  2. R-L discrimination
  3. vertical disorientation/midline disorientation
  4. Pusher syndrome
49
Q

what is somatoagnosia?

A

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
Q

what portion of the brain is primarily/most often affected with somatoagnosia?

A

usually lesion to dominant parietal lobe

51
Q

what is R-L discrimination?

A

decreased R/L differentiation with body parts and following directions

52
Q

what portion of the brain is primarily/usually affected with R/L discrimination?

A

lesion to either parietal lobe

53
Q

what is vertical disorientation/midline disorientation?

A

cannot ID when their body is in the middle

54
Q

what is Pusher Syndrome?

A

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
Q

what portion of the brain is primarily affected with pusher syndrome?

A

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
Q

list the various spatial relationships impairments

A
  1. Figure ground
  2. spatial relations disorder
  3. position in space disorder
  4. topographical disorientation
  5. depth and distance perception
57
Q

what is Figure ground?

A

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
Q

what is spatial relations disorder?

A

the inability to percieve relationships of one object in space to another object, or to one’s self

59
Q

what primarily causes spatial relations disorder?

A

lesion in the R inferior parietal lobe

60
Q

what is position in space disorder?

A

decreased ability to perceive and interpret spatial concepts

can’t distinguis between opposite directional/spatial concepts

ex: confused up and down

61
Q

what is topographical disorientation?

A

difficulty perceiving relationships from one location to another in the environment

62
Q

what is depth and distance perception?

A

inaccurate judgement of directions, distance, and depth

more broad than spatial relationship disorders, and deals with environmental cues (like difficulty negotiating a curb)

63
Q

what is the primary cause of depth and distance perception issues?

A

lesion of R or bilateral visual assocaition cortex

64
Q

what does the general term agnosias mean?

A

decreased ability to recognize stimuli despite intact sensory function.

most commonly associated with damage to temporal lobe

65
Q

what are the different types of agnosias?

A
  1. Sensory
    1. visual
    2. auditory
    3. tactile (asterognosis)
  2. Body scheme
    1. anosognosia
    2. somatagonsia
66
Q

what is visual agnosia?

A

inability to recognize familiar objects despite normal eye function

67
Q

what type of lesion normally causes visual agnosia?

A

occipital and temporal lobe (R or L)

68
Q

what is auditory agnosia?

A

inability to recognize non-speech sounds and discriminate between them

69
Q

what type of lesion normally causes auditory agnosia?

A

left temporal lobe

70
Q

what is tactile agnosia (astereognosis)?

A

inabilty to recongize objects when handling them, despite normal tactile sensation

71
Q

what types of lesions normally causes tactile agnosia?

A

parietal/temporal/occipital association areas (R or L)

72
Q

what is anosognosia?

A

a severe condition in which an individual does not acknowledge, denies, or lacks awareness of presence/severity of one’s deficits

73
Q

define apraxia

A

impairment of voluntary, skilled, well-learned movement

w/o deficits in motor function, sensory function, or coordination

74
Q

what are the 2 types of apraxia?

A

ideomotor

ideational

75
Q

what is ideomotor apraxia?

A

breakdown between concept (idea) and performance (motor execution)

76
Q

what is ideational apraxia?

A

failure in the conceptualization of the task

77
Q

what type of lesion normally causes apraxia?

A

left frontal or parietal lobes

Neurophysiology (9 decks)

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