Term
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Definition
| On one end are emotions that are repelling or “bad.” The emotions on the other end are considered attractive or “good.” |
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Term
| intensity or arousal continuum |
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Definition
| Emotions can be classified on both of these continua. For example, rage would be classified as repelling on the valence scale and higher on the intensity/arousal scale. Contentment would be more toward the attractive end of valence and lower on intensity/arousal. |
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Term
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Definition
Anger
fear
disgust
happiness
sadness |
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Term
| Neurological basis of emotion |
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Definition
• Various structures of the limbic system
• Various areas of the cortex, ESPECIALLY the rostral portion |
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Term
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Definition
Emotion and Memory
• There isn’t agreement on the structures that make up the limbic system. But most include:
• Hippocampus
• Hypothalamus
• Amygdala
• Septal nuclei
• Cinglulate gyrus
• (Thalamus) |
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Term
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Definition
• Essential for memory formation and assisting with moving short-term memories into long-term storage
• The hippocampus is physically close to the thalamus and to the olfactory nuclei. Which is why different senses can trigger memories.
- This close association is the physiological basis for easier storage and retrieval of emotionally charged events (positive or negative). Amygdala appears important for this. |
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Term
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Definition
• Remember that this does a lot of things.
• In emotions, one of its big jobs is in the regulation of the
autonomic nervous system.
• The ANS is important for regulating the intensity of experienced emotions. |
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Term
|
Definition
• The lateral nucleus
• It receives information from cortical and subcortical (including the thalamus) structures.
• A lot of the input is sensory from primary and association sensory cortices
• The central nucleus (hormones and modulation)
• It will help trigger hormonal (including that which is involved
with the ANS) and behavioral responses.
• It also helps to modulate cortical processing of information.
• For example, it has projections to the part of the brain that is important for recognizing faces so that the emotional response to that person can be experienced (e.g. differential emotional response to seeing your significant other than a bank teller) |
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Term
| Functioning of the amygdala |
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Definition
Produces fear and anger
• Fear conditioning enables people (and other animals) to associate negative/dangerous stimuli with fear. That is what enables us to avoid dangerous situations and keep ourselves safe.
• It is very involved with emotional generation and processing.
• The emotions that the amygdala is best at generating are fear and anger. When the amygdala is stimulated, it produces these feelings very strongly.
• When it is destroyed, especially bilaterally, the person will become more mellow, though also demonstrate disinhibition, which will include hypersexuality (called Kluver-Bucy syndrome) |
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Term
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Definition
bilateral amygdalae are important for teaching us to fear something with which we have direct negative experience
• Bilateral amygdalae are also involved when watching someone else interact with something dangerous or fear provoking
• People can also learn to fear something by being TOLD it is dangerous/unpleasant (LEFT AMYGDALA) |
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Term
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Definition
• Important for experiencing pleasurable emotions
• An important structure for reward and reinforcement |
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Term
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Definition
• Helps to regulate pain and emotion
• This helps to drive the conscious response to emotion
• It contributes to helping the person (or animal) avoid negative consequences due to emotion/behavior |
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Term
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Definition
• The limbic system needs a lot of sensory input to help with generating emotion
• There are a lot of connections between the thalamus and limbic system structures.
• The close proximity helps as well. |
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Term
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Definition
• Contains several areas, including the ventromedial, dorsolateral, and orbitofrontal cortices.
• The prefrontal cortex is essential for emotional regulation and empathy.
- emotional empathy (“feeling” others’ feelings)
• The orbitofrontal cortex evaluates context surrounding an emotional situation |
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Term
| Damage to the orbitofrontal cortex |
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Definition
acting without thinking
insensitive, inappropriate, and impulsive
they will often perform dangerous or unnecessary risks |
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Term
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Definition
PREFRONTAL CORTEX
• For truly effective emotional regulation, the person needs to be able to down-regulate negative emotion, inhibit responses, and understand social situations (including the consequences of taking action – positive or negative) |
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Term
|
Definition
EMOTIONAL REGULATION AND EMPATHY
• People with damage to the ventromedial prefrontal cortex lack cognitive empathy (conscious understanding of another’s emotional state)
• People with damage to the dorsolateral prefrontal cortex (an area that has been implicated in mirror neurons) lack emotional empathy (“feeling” others’ feelings)
• Orbitofrontal cortex damage results in damage to emotional regulation. |
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Term
| Prefrontal cortex: Damage to Orbitofrontal cortex |
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Definition
|
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Term
| Prefrontal Cortex: Damage to Dorsolateral Prefrontal Cortex |
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Definition
|
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Term
| Prefrontal Cortex: Damage to Ventromedial Prefrontal Cortex |
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Definition
|
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Term
| Emotional Regulation: Adolescence |
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Definition
PREFRONTAL CORTEX NOT FULLY DEVELOPED
• During this time, the prefrontal cortex undergoes change, including pruning
• Other changes in the limbic system, including the amygdala increasing in volume and forming more connections to cortical regions. |
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Term
| Hemispheric differences in emotional processing |
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Definition
RIGHT --> negative emotions/isolative
LEFT --> positive emotions /sociable
• People with right hemisphere lesions (which means that the left hemisphere is intact) may experience more feelings of euphoria
• People with left hemisphere lesions (which means that the right hemisphere is intact) may experience more feelings of depression. |
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Term
| Neurotransmitters and emotion |
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Definition
- work in conjunction with other neurotransmitters
- dopamine, beta- endorphins, norepinephrine/epinephrine, and serotonin |
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Term
| Neurotransmitters and emotion: Dopamine |
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Definition
• Associated with pleasurable feelings and reward • Reward:
• When a person (or other animal) is taught that a stimulus will be associated with a reward, the dopamine neurons will fire in anticipation of the reward.
• They will also fire if a reward is expected and not given
• In this way, dopamine neurons firing appears related to “want” |
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Term
| Neurotransmitters and emotion: Beta-endorphins |
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Definition
|
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Term
| Neurotransmitters and emotion: Norepinephrine and Epinephrine |
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Definition
SYMPATHETIC
• Important for the stress response
• Causes rise in BP, increased heart rate, extreme emotions |
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Term
| Neurotransmitters and emotion: Serotonin |
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Definition
• Important for mood regulation, especially for helping with energy levels and calmness
• This is one of the major neurotransmitters targeted in the treatment of depression.
• Selective Serotonin Reuptake Inhibitors [SSRI] |
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Term
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Definition
• Reticular formation – mediates alertness and arousal
• Superior parietal lobe, temporoparietal junction, frontal eye fields help select relevant information by directing attention toward the stimulus.
• Anterior cingulate, lateral prefrontal cortex, basal ganglia help with divided attention, selective attention
• Frontoparietal regions – important for sustained attention. |
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Term
|
Definition
• Arousal /Alerting
• Focused attention
• Physical
• Mental
• Sustained attention
• Selective attention
• Attentional switching/alternating attention/attentional flexibility
• Divided attention |
|
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Term
| Types of attention: Arousal/Alerting |
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Definition
Awake, alert
- Reticular formation |
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Term
| Types of attention: Focused Attention |
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Definition
Physical: orientating self towards stimulus
Mental: mind on stimulus
- superior parietal lobe, temporoparietal junction, frontal eye fields |
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Term
| Types of attention: sustained attention |
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Definition
How long a person can attend to a task
maintaining attention for an extended period
• Frontoparietal regions |
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Term
| Types of attention: selective |
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Definition
- selecting attention to what is relevant
- being able to identify relevant vs. irrelevant information
• Anterior cingulate, lateral prefrontal cortex, basal ganglia |
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Term
| Types of attention: Attentional switching/alternating attention/attentional flexibility |
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Definition
Change gears and return
(can stop a task, do something else, and return to the task, picking up where left off) |
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Term
| Types of attention: divided attention |
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Definition
- ability to attend to two things at once (multitasking)
ex. driving
• Anterior cingulate, lateral prefrontal cortex, basal ganglia |
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Term
| Types of memory: Short-term |
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Definition
• Recently processed sensory input
• Items retrieved from long-term memory
• Result of working memory processes |
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Term
| Types of memory: Long term Declarative or explicit |
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Definition
CONSCIOUS
• Semantic (facts – e.g. What was the year of the last presidential election?)
• Episodic (events – e.g. Tell me about your first day being an OT student) |
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Term
| Types of memory: Working memory |
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Definition
• “Mental workspace”
• Allows manipulation of information (e.g. serial 7’s) • Conscious mental effort |
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Term
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Definition
• Attention: to information from the (internal and external) environment
• Encoding. Starts with analysis of material in order to form memory. This process can take minutes to hours.
• Storage. Transfer of short term memory to long term storage unit for retention. When a memory is stored, it causes a permanent change in cellular structure in brain. Storage can change with age of memory
• Retrieval. Through recall or recognition. |
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Term
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Definition
• A process by which people encode, store, and retrieve information.
• Impairment very common after brain injury. Type of memory affected depends on where brain damage occurs, though there are a lot of interconnections. |
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Term
| Types of memory: Long term Nondeclarative or implicit |
|
Definition
NOT CONSCIOUS
• Procedural learning!
• Priming (better performance when exposed to information previously)
• Classical conditioning
• Non-associative learning (e.g. habituation) |
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Term
| Types of memory: Prospective |
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Definition
• Remembering to perform a task in the future
• Important for independent living
• Can be time based (e.g. call sister at 8:00) or event based (turn in your homework when class begins) or activity based (after hit the ball with the bat, run to first base) |
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Term
| Steps in prospective memory |
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Definition
• Form intention
• Remember the intention
• Remember when to complete the action
• Completing the action at the appropriate time and place and in the correct way
• Remembering that action completed and what the results were |
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Term
| Types of memory: Metamemory |
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Definition
• Awareness of own abilities related to memory
• What are the limits of your memory?
• What do you do to help yourself out? |
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Term
|
Definition
medial temporal lobe
• Hippocampus – includes dentate nucleus
• Parahippocampal gyrus – includes entorhinal (one of first places impacted by Alzheimer’s)
• Diencephalon also important for memory.
• Especially important are the mediolateral and anterior nuclei.
• Korsakoff’s syndrome (dementia due to alcohol abuse) damages the mediolateral nucleus |
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Term
|
Definition
• Awareness of self in relationship to person, place, time, and circumstances (if know all of these, will see reported as “oriented X 4”)
• Time seems to be most vulnerable to getting lost
• Order of recovery is typically person, place, time. |
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Term
| Orientation and the brain |
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Definition
MEMORY AND ABILITY TO LEARN
• Orientation is actually a fairly complex skill. It is dependent upon a number of other cognitive skills, especially memory. Also requires the ability to learn. |
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Term
| Executive Functions: Orientation |
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Definition
• Initiation – starting task at right time without a lot of external cueing
• Organization – efficient completion of task
• Planning
• Sequencing
• Cognitive flexibility
• Decision making
• Problem solving
• Reasoning, including abstract thought (Drawing inferences or conclusions from known or assumed facts)
• Concept formation (Ability to analyze relationships between objects and their properties) |
|
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Term
|
Definition
• Easy to miss as an occupational therapist, especially if issues are more mild/subtle
- completed tasks unlikely to be performed in acute care setting
- tasks: complicated IADL, budgeting, work/school |
|
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Term
|
Definition
MONITOR AND ASSESS MY OWN COG. FUNCTIONING
• Allows monitoring and assessment of cognitive functioning. Also enables person to use strategies regarding cognitive functioning in multiple environments.
• Crucial component of everyday competence in: • IADL
• Work
• Interpersonalrelationships
• Motivation to change or grow |
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Term
| Executive Function and the Brain |
|
Definition
integrates information from multiple parts of the brain
• Some problems seen with executive function may be the result of problems with other cognitive skills (e.g. attention or memory)
• Imaging studies have indicated that executive functions rely more upon distributed cortical (and subcortical) circuits rather than discrete areas of the brain. |
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Term
|
Definition
• Realistic knowledge about abilities and limitations and how those impact function
• Allows monitoring of behavior and performance and allows for adjustment during activity |
|
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Term
|
Definition
• Understand that function is impaired in some way
• May improve over time, especially as person tries to function in the “real
world” |
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Term
|
Definition
| • Recognizes problem when it is actually happening |
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Term
|
Definition
| • Person can predict when problem is likely to occur before it happens |
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Term
|
Definition
• Strategy taught to person which enables monitoring of performance before and during activities
• Requires emergent and anticipatory awareness |
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Term
|
Definition
The process by which sensory information is analyzed and interpreted by the brain
Influenced by numerous factors, including cognition, motor ability (which affects the way the person is able to gather and act upon sensory input), and information from other sensory systems
Those with intact perception are able to analyze, interpret, and use sensory information to inform decision making and interactions with the world around them |
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Term
Neural basis of both perception and
cognition – start with sensation |
|
Definition
Information travels from the primary sensory areas to association cortices. The farther away from the primary sensory cortices, the more integrated the information
Information travels from the primary sensory areas to association cortices. The farther away from the primary sensory cortices, the more integrated the information
There are two types of association cortices:
◦ Unimodal
◦ Multimodal |
|
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Term
| Unimodal association cortices |
|
Definition
One single sense
Responsible for further processing of information from the sensory cortices. Still pretty much focused on a single sense. |
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Term
| Multimodal association cortices |
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Definition
Allow integration of information from different modalities (including motor)
Highly interconnected to multiple areas of the brain, including the unimodal association cortices and the thalamus
Three areas:
◦ Limbic association area
◦ Posterior association area
◦ Anterior association area |
|
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Term
|
Definition
Located in the anterior-ventral part of the temporal lobe at the parahippocampal gyrus
The purpose of this area is to link emotion with sensory input This is essential for learning and memory
Damage here will limit the ability to make new explicit memories (due to damage to the hippocampus) |
|
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Term
| Posterior association area |
|
Definition
LATERALITY, VISUAL, SPTIAL, OF RIGHT HEMISPHERE PERCEPTION
VISUAL MOTOR ARE SAME ON BOTH HEMISPHERES
Located at the junction of the occipital, temporal, and parietal lobes
Links information from primary sensory cortices and unimodal sensory areas
Important for sensory perception and language
Examples of visual perception skills include: visual analysis, visual spatial, and visual motor integration. |
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Term
|
Definition
Skills that are needed to visually identify objects, including:
◦ Object constancy (recognition that objects are the same when viewed from multiple angles)
◦ Visual discrimination (ability to identify different features of objects) ◦ Figure ground (distinguishing an object from its background)
◦ Form closure (identification of an object when partially obscured) |
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Term
|
Definition
Impairment in ability to recognize sensory input Rare compared to other perceptual deficits
May be present in visual, auditory or tactile systems |
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Term
|
Definition
◦ Prosopagnosia is a subset of this with person unable to recognize faces
Visuospatial agnosia – difficulty with spatial distance between self and objects in environment |
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Term
|
Definition
Enable a person to judge position in space
Includes the position of objects in relation to oneself and the position of objects in relation to other objects.
The ability to identify directions (right, left, up, down) is also a component of these skills
A part of body map |
|
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Term
|
Definition
Eye-hand coordination
The ability to construct models (through drawing and through building in three dimensions) is also a skill that stems partly from this area. |
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Term
| Anterior association area |
|
Definition
Located in the prefrontal cortex
Links information from other association areas
Important in memory, planning, abstract thought
Damage here can cause deficits such as executive dysfunction, difficulties with abstract thinking
With TBI, there are two different syndromes that have been described, one from damage to the dorsolateral prefrontal area. The other from damage to the orbitofrontal cortex. |
|
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Term
| Lesion to dorsolateral prefrontal cortex |
|
Definition
Flat affect
Impairments in cognition
Impairments in motor activity |
|
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Term
| Lesion to orbitofrontal cortex |
|
Definition
Disinhibition, including socially Poor judgment
Emotionally labile |
|
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Term
|
Definition
COGNITIVE ISSUE - RIGHT SIDE OF BRAIN
Client does not respond to input from contralesional side Is not due to sensory or motor deficit
May be perceptual, representational, motoric, motivational, or any combination of these |
|
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Term
|
Definition
| What we see depends on several factors, including alertness (brainstem and thalamus), motivation (cingulate gyrus), the ability to move eyes in the direction desired (frontal eye fields), and an intact visual perceptual system (numerous areas, most notably the postcentral gyrus in the parietal lobe) |
|
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Term
|
Definition
Postcentral gyrus in the parietal lobe
◦ Contributes to PERCEPTION of sensory information. Input comes from
numerous areas of the brain, and all sensory information has started to be
processed
◦ Also REPRESENTATIONAL - CaN PICTURE THINGS NOT IN FRONT OF ME |
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Term
| Postcentral gyrus in the parietal lobe |
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Definition
◦ Contributes to PERCEPTION of sensory information. Input comes from
numerous areas of the brain, and all sensory information has started to be
processed
◦ Also REPRESENTATIONAL |
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Term
| Premotor-prefrontal cortex including frontal eye fields |
|
Definition
◦ DIRECTS VOLUNTARY MOVEMENT toward the contralesional space, including
eye and head movement, in addition to reaching with EITHER UPPER EXTREMITY |
|
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Term
| Cingulate Gyrus (Limbic System) |
|
Definition
MEANING AND MOTIVATION (SEARCH AND SEEK)
◦ Attaches emotions to what see and creates motivation for searching for information contralesionally ◦ Damage leads to indifference |
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Term
| Superior Colliculi (midbrain) |
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Definition
◦ Involved in drawing attention to stimuli in periphery (WARNING system)
◦ When motion is detected, eyes move in that direction
◦ When lesion occurs, person does not respond to movement in periphery –
looks straight ahead |
|
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Term
|
Definition
Right hemisphere directs attention to both left and right fields (and is generally responsible for global attention – the big picture)
LEFT IS DETAIL, attending to information for the right |
|
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Term
|
Definition
LEFT HEMISPHERE
The ability to produce planned, skilled and coordinated movement in order to interact with the environment – requires intact sensory and motor systems |
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Term
| Praxis: Conception/ideation |
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Definition
planning stage in which WHAT to do is processed,
including what actions will be needed, how they will be sequenced, and how
to use the necessary tools. Plan is CREATED. |
|
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Term
|
Definition
knowledge of HOW to move and interact appropriately with the
environment. Plan is IMPLEMENTED. |
|
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Term
|
Definition
| Disruption in the praxis system. Causes problems with planning or implementation of movement in approximately 1/3 of those with L hemisphere damage. |
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Term
| Areas of cortical involvement |
|
Definition
Apraxia more likely if these areas involved:
◦ Left inferior parietal lobe (where “praxicons” located)
◦ Arcuate fasciculus, which connects left parietal lobe to premotor area in frontal lobe
◦ Anterior fibers of corpus callosum which communicate with right hemisphere to coordinate both sides of body (unilateral apraxia on left)
◦ Primary motor cortex (unilateral apraxia on left if damage on right)
◦ Basal ganglia or thalamus – ideomotor apraxia |
|
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Term
|
Definition
DEFICIT IN CREATION
Observations may include:
◦ Inappropriate tool/object use
◦ Performance latency (very slow with tasks)
◦ Does not initiate task
◦ Sequencing errors during task
◦ Perseveration |
|
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Term
| Ideomotor Apraxia (AKA Motor Apraxia) |
|
Definition
DEFICIT IN CARRY OUT THE PLAN
Observations:
◦ Awkward and clumsy movements
◦ Difficulty crossing midline
◦ Difficulty adjusting body (e.g. grasp) to complete task (at start of or during the task – e.g. tooth brushing)
◦ Sequencing errors during movement ◦ Spatial movement errors |
|
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Term
|
Definition
• Propositional/symbolic language consists of the words we use and the way we link them together (written and verbal)
• Emotional language – communication through vocalization and behavioral displays. Present in more than just humans. |
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Term
| Wernicke-Geschwind model of speech |
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Definition
| • States that speech is received in primary auditory cortex and travels to Wenicke’s ares to be processed (reading starts in the visual cortex but then follows a similar path). Communication with Broca’s area then happens through the arcuate fasciculus. Broca’s area converts the input into speech motor commands. |
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Term
| Mesulam model of language |
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Definition
• This model uses a hierarchy of networks in which language is processed differently depending upon complexity.
• Though he still hypothesized that there are two major areas for language processing – Broca’s area and Wernicke’s area |
|
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Term
|
Definition
• Right (nondominant) part of brain important for this aspect of speech.
• The “melodious” part of speech.
• Includes inflection, pitch, timbre, rhythm |
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Term
|
Definition
• Remember that for most people, the ability to understand and produce language resides in the left hemisphere. (Per your textbook, about 95%)
• Right hemisphere has rudimentary language skills. Also important for the emotional/nonverbal part of language (including prosody), music, jokes, “nonliteral” part of language. |
|
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Term
|
Definition
• It is important for production of language.
• More recently, language production has been ascribed to a larger area, often called “Broca’s territory” – includes Brodmann’s areas 44 and 45 along with posterior part of the middle frontal gyrus. |
|
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Term
|
Definition
• It is positioned close to the motor centers for the mouth, tongue, soft palate, pharynx, larynx
• Interconnections between area 44 and primary motor cortex |
|
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Term
|
Definition
| • Appears to be more involved in the semantic aspects of language (i.e. word choice), including contributing to verbal memory |
|
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Term
| Wernicke’s area/territory |
|
Definition
• Important for language comprehension
• Appears to encompass a larger area than previously thought (including superior and middle temporal gyrus, part of the inferior parietal lobe, etc.) with three subareas |
|
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Term
| Wernicke’s area/territory: subareas |
|
Definition
• One responds to spoken words (including those that are self-generated) and
other sounds
• Second responds to words spoken by another and is activated with word
recall (e.g. how many words can you name in one minute that begin with the letter “s”)
• Third closer to Broca’s territory and may contribute to producing speech. |
|
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Term
|
Definition
• Appears to be involved in phonological and articulatory processing of words (i.e. breaking down sounds)
• Together, these areas receive multimodal information from auditory, visual, and somatosensory systems |
|
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Term
|
Definition
• Contributes to semantic processing
• Together, these areas receive multimodal information from auditory, visual, and somatosensory systems |
|
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Term
| Limbic system and language |
|
Definition
INITIATION
• Damage to the limbic system can lead to mutism
• Also seems to contribute to emotionally charged language. As a result, some people with aphasia may see improvement in speech when they are emotionally upset. Can also see preservation of emotionally charged speech (such as swear words) |
|
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Term
| Definition of neuroplasticity |
|
Definition
• The ability of the nervous system to make changes
• Happens on a neuronal level. Neurons are able to change their function, chemical profile, or structure
• Happens throughout the lifespan |
|
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Term
|
Definition
Nonassociative learning
Results in a decrease in neural activity in response to a repeated, benign stimulus. This is what allows you to “tune out” irrelevant information
• With habituation, there is a decrease in excitatory neurotransmitters which then results in fewer action potentials being sent.
• This is “reset” after the stimulus is removed so that the person is ready to attend to it again.
• There can be more permanent change over time (e.g. treatment for tactile defensiveness or some vestibular disorders) |
|
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Term
| Learning/memory formation |
|
Definition
• The changes to the brain in learning are experience-dependent
• These changes can happen through different mechanisms:
• Adjustment of neurotransmitters
• Structural changes in the neurons themselves (up- or down-regulation of receptors; changes in the number and size of dendritic spines; increase in axonal branching)
• Changes in the connections: creation of new synapses or pruning of unnecessary synapses (AKA long-term potentiation or depression) |
|
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Term
|
Definition
• When the brain experiences damage, neurons are deprived of oxygen
• They then release a large amount of glutamate, which acts as an excitatory neurotransmitter.
• This excessive glutamate causes a cascade of reactions that ultimately leads to death of postsynaptic neurons |
|
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Term
| Principles of neuroplasticity and rehabilitation |
|
Definition
1. Use it or lose it – it’s essential to use the skills want to develop. If they are not used, they will not develop
2. Use it and improve it – training can lead to enhancement of that skill. THAT INCLUDES MALADAPTIVE SKILLS
3. Specificity of training matters – it is important to train for skill acquisition, not just use.
4. Repetition matters – MUST practice if you want true neural change (and therefore skill acquisition)
5. Intensity matters – need to find a balance between too much (which can cause further damage, especially early) and late
6. Timing matters – it is important to start rehabilitation early
(remembering principle 5 about too much intensity having the potential for damage)
7. Meaning matters – Using activities that are meaningful to clients increase the likelihood of positive neural change. YAY!
8. Age matters – MUCH more plasticity when people are young than when they are older. That said, neuroplasticity is a possibility throughout the lifespan
9. Transference – Changes in one area of the CNS promotes changes in areas that are focused on similar skills.
10. Interference – On the other hand, changes in one area can prevent plasticity within the same circuitry (e.g. back to those maladaptive compensatory strategies – can be VERY hard to “unlearn” these strategies/skills) |
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