Parietal _ Occipital Lobe.ppt

Parietal and occipital lobe

1. Name of Institution
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Amity Institute of Psychology &
Allied Sciences
MA, Clinical Psychology Semester 3
Subject-Basics of Neuropsychology
Faculty-Dr. Anganabha Baruah

2. Name of Institution
TheParietalLobe

3. Name of InstitutionSomatosensory Cortex
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4. Name of InstitutionSomatosensory
Association
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5. Name of Institution
Posterior Association Area
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BOUNDARIES OFPARIETALLOBE
–Anteriorborder-CentralFissure
–Ventralborder-SylvanFissure
–Posteriorborder -Parieto-occipitalsulcus

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Subdivisionsof theParietalLobes

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Structures in Parietal Lobe
•Postcentralgyrus:Thisregionisthebrain's
primarysomatosensory cortex,andmaps
sensoryinformationontowhatisknownasa
sensoryhomonculus.Someresearchersalsorefer
tothisregionasBrodmannarea3.
•Posteriorparietal(Association)cortex:This
regionisthoughttoplayavitalroleincoordinating
movementandspatialreasoning.Italsoplaysarole
inattention,particularlyattentiondrivenbynew
stimuli,suchaswhenananimaljumpsintotheroad
whileyouaredriving.

10. Name of Institution
•Superiorparietallobule:Thisregionhelpsyou
determineyourownorientationinspace,aswellas
theorientationofotherobjects.Italsoreceives
significantinputfromthehand,suggestingthatithelps
coordinatefinemotorskillsandsensoryinputfromthe
hands.
•Inferiorparietallobule:Sometimes called
Gerschwind'sterritory,thisregionaidsinassessing
facialexpressionsforemotionalcontent.Some
researchsuggestsitplaysaroleinotherfunctions,
includinglanguageprocessing,basicmathematical
operations,andevenbodyimage.Itcontainsa
numberofsub-regions,includingtheangularand
supramarginalgyrus.

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SUPERIOR PARIETAL LOBULE
Thesuperior parietal lobuleforms the association cortex of the
parietal lobe, and plays an important role in planned
movements, spatial reasoning and attention. The intraparietal
sulcus can be further divided into a lateral, medial, ventral and
anterior area. Thelateral areais responsible for oureye
movements in response to a stimulus in space. Themedial
areahelps us to determine how far and where we need to reach
in relation to our nose. Theventral areais an area that
receives a number of sensory modalities; these include
auditory, visual, vestibular and somatosensory information.
Finally, theanterior areaenables us to interpret the size, shape
and position of objects we are about to grasp. The anterior and
ventral areas work together to enable visual motor coordination
of hand movements.

12. Name of InstitutionInferior Parietal Lobule
•Most neuroscientists also include
regions of the inferior parietal lobule,
particularly thesupramarginal
gyrus(Brodmann area 40) and
theangular gyrus(Brodmann area 39) in
Wernicke’s area.The supramarginal
gyrus forms the auditory area of speech,
while the angular gyrus, the visual area
of speech.
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13. Name of Institution
•The Parietal lobes
controlcalculationandlanguageon
thedominantside,andthesensory
visuospatialprocessingonthenon-
dominanthemisphereside.
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Functions of Parietal Lobes
•Distinguishingbetweentwopoints,evenwithoutvisualinput.
•Localizingtouch:Whenyoutouchanyobjectwithanypartof
yourbody,yourparietallobeenablesyoutofeelthesensation
atthesiteofthetouchandnot,say,inyourbrainorallover
yourbody.
•Integratingsensoryinformationfrommostregionsofthebody.
•Visuospatialnavigationandreasoning:Whenyoureadamap,
followdirections,orpreventyourselffromtrippingoveran
unexpectedobstacle,yourparietallobeisinvolved.Theparietal
lobeisalsovitalforproprioception—theabilitytodetermine
whereyourbodyisinspace,includinginrelationshiptoitself.
Forinstance,touchingyourfingertoyournosewithoutthe
assistanceofamirrorisafunctionoftheparietallobe.

15. Name of Institution
•Somevisualfunctions,inconjunctionwiththeoccipitallobe.
•Assessingnumericalrelationships,includingthenumberof
objectsyousee.
•Assessingsize,shape,andorientationinspaceofbothvisible
stimuliandobjectsyourememberencountering.
•Mappingthevisualworld:anumberofrecentstudiessuggest
thatspecificregionsintheparietallobeserveasmapstothe
visualworld.
•Coordinatinghand,arm,andeyemotions.
•Processinglanguage.
•Coordinatingattention.

16. Name of InstitutionDamage
•Difficultywithdrawingobjects
•Difficultyindistinguishingleftfromright
•Spatialdisorientationandnavigationdifficulties
•Problemswithreading(Alexia)
•Inabilitytolocatethewordsforwriting(Agraphia)
•Difficultywithdoingmathematics(Dyscalculia)
•Lackofawarenessofcertainbodypartsand/or
surroundingspace(Neglect)
•Inabilitytofocusvisualattention
•Difficultywithmotorplanningandcomplex
movements(Apraxia)
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17. Name of InstitutionAnatomy Of Occipital
Lobes
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OCCIPITAL
LOBE

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•Boundaries
Parieto-Occipital Sulcus
PreoccipitalNotch
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19. Name of InstitutionPrimary Visual Cortex
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20. Name of InstitutionVisual Association Cortex
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Theoccipitallobe
•isthevisualprocessingcenterofthemammalianbraincontaining
mostoftheanatomicalregionofthevisualcortex.
• TheprimaryvisualcortexisBrodmannarea17,commonly
calledV1(visualone).
• HumanV1islocatedonthemedialsideoftheoccipitallobe
withinthecalcarinesulcus;
•thefullextentofV1oftencontinuesontotheposteriorpoleof
theoccipitallobe.V1isoftenalsocalledstriatecortexbecauseit
canbeidentifiedbyalargestripeofmyelin,theStriaofGennari.

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Extrastriateregions
•VisuallydrivenregionsoutsideV1arecalled
extrastriatecortex.
•Therearemanyextrastriateregions,andtheseare
specializedfordifferentvisualtasks,suchas
visuospatialprocessing,colordiscrimination,and
motionperception.

23. Name of InstitutionPrimary Visual Cortex (V1)
•The primary visual cortex also known as
V1,Brodmann area 17, or thestriate
cortex, is located on either side of the
calcarine sulcus on the medial surface of
the occipital lobe and extends into both
the cuneus and the lingual gyrus. It
functions to receive special sensory
input from the eyes via the optic
radiations, and is, therefore, responsible
for integration and perception of visual
information.
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24. Name of Institution
•Visual association cortex
•Thevisualassociationcortexconstitutesthe
remainingregionsoftheoccipitallobeandis
alsoknownastheextrastriatevisualcortex.
Thisregionfunctionstointerpretvisual
images.Locatedwithinthevisualassociation
cortexoftheoccipitallobearethesecond,
thirdandfourthvisualareas.
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25. Name of Institution
•Second visual area
•Thesecondvisualarea,alsoknownas
thesecondaryvisualcortex,V2,orthe
prestriatecortex,occupiesmuchofBrodmann
area18andinsomecases19.Thesecondary
visualcortexsurroundstheprimaryvisual
cortexandreceivesinformationfromit.The
informationfromtheprimaryvisualcortexis
senttothesecondaryvisualcortex,before
beingpassedtothethirdandfourthvisual
areastofinallyreachtheinferiortemporal
cortex.Thesecondaryvisualareaisimportant
forcolor,motion,anddepthperception.
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26. Name of Institution
•Thirdvisualarea
•Thethirdvisualarea,orV3,liesadjacenttothe
anterioraspectofV2andisalsolocatedwithin
Brodmannarea18.Thisvisualareacommunicates
directlywiththesecondaryvisualcortexandis
functionallyimportantinthevisualprocessingof
motion.
•Fourthvisualarea
•Visualareafour,V4,islocatedanteriortoV3within
Brodmannarea19.Itcommunicatesandreceives
informationfromthesecondaryvisualcortex.The
functionofvisualareafouristointerpretcolors,
orientation,formandmovement. 26

27. Name of Institution
ConnectionsoftheVisualCortex
Connections
-Primary Visual Cortex (V1)
-Input from LGN
-Output to all other levels
-Secondary Visual Cortex (V2)
Output to all other levels
-After V2
•Output to the parietal
lobe -Dorsal Stream
•Output to the inferior temporal
lobe -Ventral
Stream
•Output to the superior
temporal sulcus (STS) -STS
Stream
•DorsalStream
–VisualGuidance ofMovements
•VentralStream
–ObjectPerception
•STS
–Visuospatialfunctions (biomovement

28. Name of Institution
Functions
•Asignificantfunctionalaspectoftheoccipitallobeisthatit
containstheprimaryvisualcortex.
•Retinalsensorsconveystimulithroughtheoptictractstothe
lateralgeniculatebodies,whereopticradiationscontinuetothe
visualcortex.
• Eachvisualcortexreceivesrawsensoryinformationfrom
theoutsidehalfoftheretinaonthesamesideoftheheadand
fromtheinsidehalfoftheretinaontheothersideofthehead.

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Function
V1 -function like mailboxes: segregating info to other areas.,
receives primary visual impressions Color/Form/Motion/Size and
illumination.
V2, V3, V3A, V4, V5-Visual association areas-Recognition and
identification of objects, storage of visual memories, it functions
in more complex visual recognition and perception,
revisualization, visual association and spatial orientation.

30. Name of Institution
•Contouranalysis and binocular vision
are two functions of the visual cortex, and such processing is a
function of both its horizontal and its vertical organization.
•The cells within the striate cortex are activated only by input
from the LGN, although other cortical areas have input into the
striate cortex.
•The striate cortex communicates with the superior colliculus
and the frontal eye fields.

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ClinicalEffectsofOccipitalLobe Lesions
•VisualFieldDefects
•Corticalblindness
•VisualAnosognosia
•VisualIllusions
•Visualhallucinations
•VisualAgnosias

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Visualfielddefects
•The most familiar clinical abnormality resulting from a lesion of one
occipital lobe, is a contralateral homonymous hemianopia,.
• Extensive destruction abolishes all vision in the corresponding half
of each visual field.
•With a neoplastic lesion that eventually involves the entire striate region,
the field defect may extend from the periphery toward the center, and
loss of color vision (hemiachromatopsia) often precedes loss of black and
white.
• Destructionofonlypartofthestriatecortexononesideyields
characteristicfielddefectsthataccuratelyindicatethelociofthelesion.

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CorticalBlindness
•With bilateral lesions of the occipital lobes (destruction of area 17 of
both hemispheres), there is a loss of sight that can be conceptualized
as bilateral hemianopia.
• The degree of blindness may be equivalent to that which follows
severing of the optic nerves.
• The pupillary light reflexes are preserved because they depend
upon visual fibers that terminate in the midbrain, but reflex closure of
the eyelids to threat or bright light may be preserved

34. Name of Institution
•No changes are detectable in the retinas.
• The eyes are still able to move through a full range and, if there is
macular sparing as there usually is with vascular lesions, optokinetic
nystagmus can be elicited
•Visual imagination and visual imagery in dreams are preserved.
• With rare exceptions, no cortical potentials can be evoked in the
occipital lobes by light flashes or pattern changes (visual evoked
response), and the alpha rhythm is lost in the electroencephalogram

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The usual cause of
corticalblindness
•is occlusion of the posterior cerebral arteries (most often embolic) or the
equivalent, occlusion of the distal basilar artery.
•Macular sparing may leave the patient with an island of barely serviceable
central vision.
•The infarct may also involve the mediotemporal regions or thalami, which share
the posterior cerebral artery supply, with a resulting Korsakoff amnesic defect
and a variety of other neurologic deficits referable to the high midbrain and
diencephalon (drowsiness, akinetic mutismetc… )

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VisualAnosognosia(Anton
Syndrome)
•The main characteristic of this disorder is the denial of blindness by a
patient who obviously cannot see.
•The patient acts as though he could see, and in attempting to walk,
collides with objects, even to the point of injury.
• The lesions in cases of negation of blindness extend beyond the
striate cortex to involve the visual association areas.

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VisualIllusions
(Metamorphopsias)
•These may present as distortions of form, size, movement, or color like deformation
of the image, change in size, illusion of movement, or a combination of all three.
• Illusions of these types have been reported with lesions confined to the
occipital lobes but are more frequently caused by shared occipitoparietal or
occipitotemporal lesions;
• The right hemisphere appears to be involved more often than the left.

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Visual
Hallucinations
•These phenomena may be elementary or complex, and both
types have sensory as well as cognitive aspects.
• Elementary (or unformed) hallucinations include flashes of
light, colors, luminous points, stars, multiple lights (like candles),
and geometric forms (circles, squares, and hexagons).
•They may be stationary or moving (zigzag, oscillations,
vibrations, or pulsations).
•Complex hallucinations include objects, persons, or animals and
infrequently, more complete scenes that are indicative of lesions
in the visual association areas or their connections with the
temporal lobes.

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Colorvisiondefects
•Two types of color vision deficit are associated with
occipital lesions.
• First, a complete loss of color vision, or
achromatopsia, may occur either ipsilaterally or in
one visual hemifield with lesions that involve
portions of the visual association cortex (Brodmann
areas 18 and 19).
•Second, patients withpure alexia and lesions of
the left occipital lobe fail to name colors, although
their color matching and other aspects of color
perception are normal.

40. Name of Institution
•Patientsoftenconfabulateanincorrectcolornamewhenasked
whatcoloranobjectis.
•Thisdeficitcanbecalledcoloragnosia,inthesensethata
normallyperceivedcolorcannotbeproperlyrecognized.
• Although this deficit has been termed color anomia, these
patients can usually name the colors of familiar objects such as
a school bus or the inside of a watermelon.

41. Name of InstitutionVisualObject
Agnosia
•Visual object agnosia is the quintessential visual agnosia: the patient
fails to recognize objects by sight, with preserved ability to recognize
them through touch or hearing in the absence of impaired primary
visual perception or dementia
•In 1890, Lissauer distinguished two subtypes of visual object agnosia:
apperceptive visual object agnosia, referring to the synthesis of
elementary perceptual elements into a unified image, and
associative visual object agnosia, in which the meaning of a perceived
stimulus is
appreciated by recall of previous visual experiences.

42. Name of InstitutionApperceptive
VisualAgnosia
•The first type, apperceptive visual agnosia, is difficult to separate from
impaired perception or partial cortical blindness.
•Any failure of object recognition in which relatively basic visual functions
(acuity, color, motion) are preserved is apperceptive.
•Patients with apperceptive visual agnosia can pick out features of an object
correctly (e.g., lines, angles, colors, movement), but they fail to appreciate the
whole object
•Warrington and Rudge (1995) pointed to the right parietoccipital cortex for its
importance in visual processing of objects, and they found this area critical to
apperceptive visual agnosia.

43. Name of Institution
•Apperceptivevisualagnosiarelatedtobilateraloccipitallesionsa
“pseudoagnosicsyndrome”associatedwithvisualprocessingdefects,as
comparedtotruevisualagnosias,in
whichtherightparietalcortexisdeficientinidentifyingandrecognizingvisual
objects.
•Recent evidence of the functions of specific cortical areas has included the
specialization of the medial occipital cortex for appreciation of color and
texture,whereas the lateral occipital cortex is more involved with shape
perception.
•Deficits in these specific visual functions can be seen in patients with visual
object agnosia

44. Name of Institution
•apperceptive visual agnosia usually occurs in patients with bilateral
occipital lesions.
•It may represent a stage in recovery from complete cortical blindness.
•Deficits in recognition of visual objects may be especially apparent with
recognition of degraded
images, such as drawings rather than actual objects.
•Apperceptive visual agnosia can also be part of dementing syndromes

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Associativevisualagnosia
•It is defect in the association of the object with past experience and memory .
The inability to recognize an object despite an apparent perception of the
object
is associative agnosia.
• Somepatientscancopyormatchdrawingsofobjectstheycannotname,
thusexcludingaprimarydefectofvisualperception.
•Aphasiaisexcludedbecausethepatientcanidentifythesameobjectpresented
inthetactileorauditorymodality
• occurswithbilateraloccopitotemoraljunctionlessions.

46. Name of Institution
prosopagnosia
•Patients with facial agnosia cannot recognize any
previously known faces, including their own as seen in a mirror or
photograph.
•First, patients who cannot match pictures of faces must have defective
face processing,or apperceptive prosopagnosia, whereas those who can
match faces but simply fail to recognize familiar examples(either friends
and relatives or famous personages) have associative prosopagnosia

47. Name of Institution
BentonFaceRecognition
•History: “facial agnosia”/ prosopagnosia
•Purpose: Measures visualoperceptual discrimination of unfamiliar faces
(not recognition/memory)
•Associated with right hemisphere: parietal, occipitoparietal and occipitotemporal
•3 parts:
–Match identical front view
–Match front view with ¾ view
–Match front view with various lighting conditions

48. Name of Institution
Inclinicalstudies
•prosopagnosia may occur either as an isolated deficit or as
part of a more general visual agnosia for objects and colors.
Faces are likely the most complex and individualized visual
displays to recognize, but some patients with visual object
agnosia can recognize faces, suggesting that there may be a
specific brain area devoted to facial recognition.

49. Name of Institution
OpticAphasia
•The syndrome of optic aphasia, or optic anomia, is intermediate
•between agnosias and aphasias.
• The patient with optic aphasia cannot name objects presented visually
but can demonstrate recognition of the objects by pantomiming or describing
their use.
• The preserved recognition of the objects distinguishes optic aphasia from
associative visual agnosia.
•Like visual agnosics, patients with optic aphasia can name objects presented in
the auditory or tactile modalities, distinguishingthem from anomic aphasics.

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Inopticaphasia
•information about the object must reach parts of the cortex involved in
recognition, perhaps in the right hemisphere, but the information is not
available to the language cortex for naming.
•Patients with optic aphasia may confabulate incorrect names when
asked to name an object they clearly recognize,just as the patient with
color agnosia confabulates incorrect color names.

51. Name of Institution
Visuospatial Agnosia
•Amongthisvarietyofdisordersofspatialperceptionandorientation,
onedisruptiveformistopographicaldisorientation—theinabilitytofind
one’swayaroundfamiliarenvironmentssuchasone’sneighborhood.
•People with thisdeficit seem unable to recognize landmarks that
would indicate the appropriate direction in which to travel
•Most people with topographical disorientation have other visual deficits,
especially defects in facial recognition.
• Criticalareaforthisdisorderliesintherightmedial
occipitotemporalregion,includingthefusiformandlingualgyri.

52. Name of Institution
Epilepsyandoccipitallobes
•Occipital lobe seizures are triggered by a flash, or a visual image that
contains multiple colors. These are called flicker stimulation (usually
through TV) these seizures are referred to as photo-sensitivity
seizures. Patients having experienced occipital seizures described their
seizure as seeing bright colors, and having severe blurred vision
(vomiting was also apparent in some patients).

53. Name of Institution
Occipitalseizures
•are triggered mainly during the day, through television, video games or any
flicker stimulatory system.
• Occipital seizures originate from an epileptic focus confined within the
occipital lobes. They may be spontaneous or triggered by external visual stimuli.
Occipital lobe epilepsies are etiologically idiopathic, symptomatic, or
cryptogenic.
•Symptomatic occipital seizures can start at any age, as well as any stage after or
during the course of the underlying causative disorder.
•Idiopathic occipital epilepsy usually starts in childhood.
• Occipital epilepsies account for approximately 5% to 10% of all epilepsies.

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CLINICAL EFFECTS OF
PARIETAL LOBE LESIONS

55. Name of Institution
•Receptiveaphasia
•Wernicke’sarea(Brodmannarea22)liesinthesuperior
temporalgyrusandoverlapstheparieto-temporaljunction.
Thisregionisresponsibleforourunderstandingofspeech.
Damagetothisregionwillresultinareceptiveaphasia,
whichisafluentformofaphasia.Thepatientwillpresent
with‘wordsalad’i.e.theywillbeabletoformwords,butthe
wordswillnotbeinanycomprehensibleorderorsyntax.The
homologousareaoftherightcortex,isresponsibleforour
interpretationofbodylanguage,andmakingsenseof
ambiguouswords.DamagetoWernicke’sareamaynot
alwaysresultinareceptiveaphasia.Ifthesurrounding
cortexisintact,andtherightcorrespondingareaisintact,
theresymptomsmaybeminimal.
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56. Name of Institution
•Bálint’ssyndrome
•Thissyndromeisusuallyassociatedwithlargebilaterallesions,
resultingindeficitsinvisualattention,aswellasmotorfunction.
Symptomsinclude:
•simultanagnosia(thepatientisn’tabletointerprettoseethe
wholevisualfield)
•opticataxia(thepatientisn’tabletomovetheirhandsin
relationtotheirvisualinput)
•opticapraxia(aninabilitytofixatetheeyes).
•AsBálint’ssyndromeisararedisease.Suddensevere
hypotension,whichimpactsthewatershedareasbetweenthe
parietalandoccipitallobes,ismostcommoncauseofthe
bilateralischaemia.Duetotherangeofsymptomsand
manifestations,theconditionisoftenmistakenforblindness
relatedtootherdisorders.
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57. Name of Institution
•Parietallobestroke
•Ischaemicstrokesarecommonlytheresultofatheroschlerotic
emboli.Themiddlecerebralarteryisthelargestbranchofthe
internalcarotidartery,andadirectcontinuationoftheartery.It
isthereforethecommonestlocationofischaemicstrokes.The
middlecerebralarterysuppliesthelateralsurfaceofthe
parietallobe(aswellasthesuperiortemporallobe),whichis
thelocationoftheupperlimbandfaceontheprimary
somatosensorycortex.Therefore,strokesimpactingthe
middlecerebralarteryresultinsensorylossoftheseareas,
withsparingofthelowerlimbs.Motorfunctionofthesame
areasmayalsoresult,astheprimarymotorcortexisjust
anteriortotheprimarysomatosensorycortex,andisalso
suppliedinpartbythemiddlecerebralartery.
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58. Name of Institution
•Hemi spatial neglect is a phenomenon that usually follows
damage to the non-dominant parietal lobes (usually the right),
usually following a stroke. The patient is still able to see both
sides of their visual fields in both eyes, but is not able to
interpret the sensory information sent to the brain from one
half of the visual field. If a stroke occurs in the right parietal
lobe, the patient will ignore the left visual field. If a stroke
occurs in the left parietal lobe, the ability of the patient to
solve mathematical problems, as well as reading and writing
would be impaired.
•The symptom of optic ataxia results in issues with the
patient reaching for objects in the contralateral visual field to
the affected parietal lobe. Amorphosynthesis is a condition
where the patient is unaware of somatic sensations from one
side of the body, and is a possible result of parietal lobe
stroke.
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59. Name of Institution
•Iftheleftlobeisaffected,agnosia(alossofgeneral
perception)results.Alesionoftherightparietallobe
causesissueswiththeperson’sinterpretationofthe
leftsideoftheirvisualfield,aswellastheirpersonal
space.
•Apraxiaisadisorderofmotorcontrol,thatusually
resultsfromdamagetotheleftparietallobe.
•DamagetoBaum’sloopresultsinacontralateral
lowerquadrantanopia,ora‘pieinthefloor’visual
deficit.AlesionofMeyer’sloopresultsina
contralateralupperquadrantanopia,or‘pieinthesky’
visualdeficit.
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60. Name of Institution
•Gerstmann’s syndrome
•This syndrome is related to damage to the inferior parietal
lobule in the dominant hemisphere of the brain (usually the
left), and is associated with right-left confusion and presents
characteristic symptoms, including:
•agraphia (difficulty in writing)
•acalculia (difficulty with math)
•aphasia (language disorders)
•agnosia (difficulty to perceive objects
•These symptoms vary in severity between patients. When
the supramarginal and/or angular gyri (parts of the inferior
parietal lobule) are impacted, the patient’s ability to interpret
written or oral language may be impacted.
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61. Name of Institution
Testsfor
calculations
Components –Rote tables (add, multiply, etc)
Recognition of signs (+ , -, * )
Basic arithmetic(carrying, borrowing) Spatial
alignment of written calculations
•Verbal rote examples: what is 4 plus 6 ?
•Verbal complex examples :what is 21 * 5 ?

62. Name of Institution
Testsforright–
left confusion
Identificationonself
ex:showyourleftfoot.
Crossedcommandsonself
ex:withyourrighthandtouchyourleftear
Identificationonexaminer
ex:pointmyrightelbow
Crossedcommandsonexaminer
ex:withyourlefthandpointmyrightfoot.

63. Name of Institution
Testsfor fingeragnosia
•Inability to name , point or recognize fingers on
oneself or others.
1.Non verbal finger recognition :
with pt eyes closed, touch one of his fingers.
Ask him to touch the same finger of examiner, with
eyes open.
2.Identifying named fingers on examiner’s hand :
examiner places hand in some irregular
position and asks pt –“ point to my middle finger”

64. Name of Institution
IDEOMOTOR APRAXIA(“how to do”)
•Most common type of apraxia
i.Buccofacial apraxia ( blowing a match )
ii.Limb apraxia ( flip a coin , comb hair )
iii.Whole body apraxia ( stand like boxer )
•Commands to be alternated b/w right and left
limbs

65. Name of Institution
IDEATIONALAPRAXIA(“whattodo”)
•Disturbance of complex motor planning of a higher
order .
•Pt able to do individual tasks, but cannot integrate
them as a whole.
•‘Conceptual apraxia’ –there is apparent inability to
recognise the use of objects (object agnosia).
ex: pt attempts to light a candle by striking it on matchbox

66. Name of Institution
Praxistesting(doneinanorder)
1.Observe the actions –shaving ,dressing,eating.
2.Carry out familiar acts –blow a kiss, wave gudbye.
3.Imitate the examiner (‘do this after me’)
4.How to use objects (pantomime)
simple acts –hammer nail, comb hair .
complex acts –light and smoke cigar; open soda
bottle, pour in glass and drink.
5.Demonstrate use of actual items
(both limbs and orofacial commands to be asked)

67. Name of Institution
Drawings to command :
1.draw a clock with 10:20 time
2.draw a 2D figure-daisy in a pot
3.draw a house –in way you can see two sides
and the roof.
Block designs
Lt.sidedlesions–simplificationofcomplexdiagrams
Rt.sided lesions–rotationofdiagrams.

68. Name of Institution
DRESSING APRAXIA
•Not a true apraxia.
•Combination of spatial disorientation and
visuospatial inattention.

69. Name of Institution
Testsforvisualdisorders
•Visualfieldtesting
•Visualneglect:
-casualobservationofpt’sbehaviour.
-drawingsmadebythept.

70. Name of Institution
Testsforgeographic
disorientation
•Geographic orientation is function of parietal lobe and its
multimodal association area.
•Combination of processes –spatial
orientation, right-left orientation ,visual perception and its
memory.
1.History from relatives :
Does he become lost in work?
Does he have difficulty in orienting to new environment?

71. Name of Institution
2.Localizing places in maps :
Adequate literacy level and historical knowledge is necessary.
ex :to locate cities or states on maps.
3.Ability to orient self in hospital :
By observing the pt’s capacity to find their bed, ward and
bathroom.