Parietal lobe examination (Cognitive Assessment)

Cognitive Examination/Test

1. Parietal Lobe Examination Task: You are asked to review Miss Jenny Anderson, an 85-year-old woman who has had a recent diagnosis of vascular dementia. Please perform a parietal lobe examination. STEPS: Introduction & Build rapport I’m here to conduct an assessment that will help us understand how a specific part of your brain is functioning.  This will involve some simple tasks to check things like your ability to recognize objects , drawing and writing. It shouldn’t take too long. During the examination I might touch you, is that okay? Do you want anyone with you? Before we begin, I just want to check if you have any difficulties with your hearing or vision that might make it harder for you to answer the questions or do the tasks. Note : Wash your hands before and after the examination.

2. Parietal Lobe Examination Dominant Lobe Finger agnosia – Ask the patient to show you their right index finger and left little finger. Right–left disorientation – Ask the patient to touch their left ear with their right hand and vise versa. Dyscalculia – Ask the patient to take seven away from 100 and continue for 5 times (serial 7s). e.g . (I’d like you to do a simple math exercise for me. Could you start with the number 100 and then subtract 7? After you get that number, subtract 7 again, and keep doing this five times in total. Take your time.) Dysgraphia : "Can you write the name of this object for me? Now, can you say and then copy this word: 'apple'? Finally, can you repeat and then write this phrase: 'The sun is shining’?” I deomotor apraxia : "Can you show me how you would wave goodbye? Now, can you act as if you're brushing your hair? Lastly, could you copy how I’m holding my hand?“ I deational apraxia : “Can you please take this pen in your right hand, remove the cap and write a short sentence” A utotopagnosia (Extra test): "Can you point to your elbow? Now, can you touch your nose?"

3. Parietal Lobe Examination Non-dominant lobe Dressing apraxia – Turn a jacket inside out and ask the patient to turn it the right way around and put it on. E.g. ("I’m going to give you a jacket that’s inside out. Could you please turn it the right way around and then put it on?") It depends on whether there is a jacket or not!! Neglect – Ask the patient to draw a clock face with numbers then the time to show ten past five or ten past eleven Anosognosia – If there are known physical health problems, ask the patient if they are aware of them. (for example, paralysis in the arm!!) Constructional apraxia – Ask the patient to copy interlocking pentagons and a cube. (drawing a clock face might be sufficient if there is no time). Topographical disorientation – Ask the patient whether they often get lost or confused in new places.

4. Parietal Lobe Examination Bilateral Function Astereognosis – Ask the patient to identify an object (key/coin) in their hand with their eyes closed. (if they want you to do it, there will be coins on a table, don't use your own coins!!) A graphognosia – Trace two letters on the patient’s palm and ask the patient to identify which letters they were. “I’m going to lightly trace two letters on the palm of your hand with my finger. Can you tell me which letters I drew?” Proprioception : "Please close your eyes. I’ll move your index finger on your right hand, then your left, either up or down. Let me know which direction it moves.“ T wo-point discrimination: "Please close your eyes. First, I’ll check if you can feel me touching the back of each of your hands, is that okay? Now, I’m going to touch the back of your hands again, and I’d like you to tell me if you feel one or two points."

5. Parietal Lobe Examination Visual Prosopagnosia – Ask the patient to identify whose face (i.e., the Queen’s) is on a bank note.(if they want you to do it, there will be coins on a table, don't use your own coins!!) Visual fields – Test for lower-quadrant homonymous hemianopia (indicating damage to the optic radiation). Watch this video: https://www.youtube.com/watch?v=OodMJMPcITQ A ssess for unilateral neglect: "Please look at my nose and keep focusing on it. I'll move my fingers in your side vision, and you just let me know when you see them move.“ A ssess for optic ataxia: "Keep looking at my face. I’ll hold out my hand in your side vision, and I’d like you to reach for it when you see it, first on your right, then on your left.“ A ssess for oculomotor apraxia: "Please look at my face, then move your eyes to the right and then to the left, keeping your head still."