Chapter 8-9 Flashcards
(122 cards)
1
Q
Describes serious or potentially life-threatening levels of physical injury
A
Trauma
2
Q
Describes serious or potentially life-threatening levels of physical injury
A
Trauma
3
Q
Damage that results from an external and usually forceful event.
A
TBI
4
Q
TBI Damage that results from an ____ and usually ____ event.
A
TBI
5
Q
Damage that results from an external and usually forceful event, not stroke or surgery
A
TBI
6
Q
Caused by falls, motor vehicle and traffic accidents, incidents of a person being struck by an object, sports accidents, and violent assaults
A
TBI
7
Q
Most at risk populations for TBI include:
A
Younger than 4 years of age
Older than 75 years
Adolescent males
Users of alcohol or recreational drugs
Of lower socioeconomic status
Previous sufferers of TBI
Law enforcement or military personnel
8
Q
When a person’s body (and brain) is moving very fast (accelerating) through space and then comes to an abrupt stop (decelerating).
A
Acceleration- deceleration closes head injury
9
Q
Brain slams around with damaging level of force inside the skull.
A
Acceleration- deceleration closed head injury
10
Q
Damage from acceleration-deceleration closed head injury
A
Coup-contrecoup
11
Q
_____- brain hits the front of the skull
A
Coup injury- brain hits the front of the skull
12
Q
______ injury- brain hits the back of the skull
A
Contrecoup injury- brain hits the back of the skull
13
Q
Contrecoup injury- brain hits the ____ of the skull
A
Contrecoup injury- brain hits the back of the skull
14
Q
Coup injury- brain hits the ___ of the skull
A
Coup injury- brain hits the front of the skull
15
Q
The amount of pressure being applied to a body by acceleration forces
A
G force
16
Q
Neuronal connections are pulled apart and create microlesions across large areas of the brain
A
Diffuse axonal shearing
17
Q
Injury to the brain that occurs as a result of stationary head being impacted by a moving object
A
Impact-based TBI
18
Q
Skull is forced inwards at the sight of impact, which exerts compressive forces to the area of the brain under impact
A
Impact based TBI
19
Q
Injury that penetrates the skull into the brain
A
Open head injury
20
Q
when a projectile (bullet or piece of sharp shrapnel) passes through the skull and into the brain.
A
Ballistic trauma
21
Q
Most common cause of TBI and death in children
A
Shaken baby syndrome
22
Q
Due to physical violence of shaking of the child by a caregiver, usually due to the infant’s crying
A
Shaken baby syndrome
23
Q
Penetrating or open head wound resulting from gunshot to the head was the most common form of TBI in WW1 & WW2
A
True
24
Q
Following trauma or admittance to the hospital TBI patients may be:
A
1.Unconscious, minimally conscious, or at best very confused and disoriented.
2. May have undergone tracheotomy to help them breathe.
3. May have undergone brain surgery to repair a hemorrhage or intracranial pressure.
4. May have a NG tube or PEG tube to deliver hydration or nutrition.
5.May have undergone a craniotomy
25
Surgery to remove part of the skull to allow the brain to swell without incurring damage from being crushed by pressure within the skull.
Craniotomy
26
As TBI patients recover they may:
1. Have severe cognitive and language deficits, which can lead to confusion, disorientation, and aggression.
2. Spend a great amount of their day sleeping.
3. May display photophobia.
4. May display phonophobia
5. Demonstrate fatigue.
27
TBI May affect any level of:
Orientation, attention, memory, problem solving, inferencing, personality changes
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Period of unconsciousness lasting more than 6 hours with individual unable to be awakened and is unresponsive to sensory stimuli
Coma
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Person is minimally responsive to stimuli, but lacking consciousness and cognition
Vegetative stage
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Vegetative state continues longer than 4 weeks
Persistent vegetative state
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Combination of retrograde and anterograde memory loss that present in those who recover from comas and vegetative states
Post-traumatic amnesia
32
Damage to the ____ lobe plays a role in personality and personal preferences.
Damage to the frontal lobe plays a role in personality and personal preferences.
33
Assessment of memory in TBI
Long term memory
Visual memory
Immediate recall
Short-term recall
34
Categorical scales in which individual is assigned a number that indicates their level of arousal based on the presence or absence of certain behaviors or response to stimuli
Coma scales
35
Orientation to person, place, and time is assessed by asking simple questions regarding orientation
Assessment of orientation
Ask patients simple questions such as:
What is your name?
What is your age?
Where are you?
36
Determines the level and tracks changes of agitation over time
Agitated behavior scale
37
Asses the presence of verbal or psychical aggression against others, oneself, or objects
Overt aggression scale
38
Formal tests for TBI include
Burns Brief Inventory of Communication and Cognition
Cognitive-Linguistic Quick Test
Ross Information Processing Assessment
39
Therapy for TBI targets the following
Decreased arousal
Attention deficits
Problem solving deficits
Working memory deficits
40
Targeted similar to attention therapy for right hemisphere and left hemisphere disorders
Attention deficits
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Targeted through simple paper and pencil tasks
Functional tasks such as balancing a checkbook
Problem solving deficits
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Use instructions and utterances that are short
Use functional tasks in context of ADLs
Avoid speaking fast, emphasize important words/phrases
Increase automaticity of responses
Break down complex tasks into individual components
Working memory deficits
43
Targeted through sensory stimulation therapy, which may or may not be efficacious
Visual stimulation, oral stimulation, and cutaneous stimulation
Decreased arousal
44
To rehabilitate lost abilities
Restorative memory approach
45
Presentation of information for recall over increasingly greater intervals of time
Spaced retrieval training
46
Cognitive acts that increase the likelihood of retaining information over short term and long term to compensate for memory deficits
Internal memory strategies
47
Training the individual to repeat information to themselves to increase the likelihood of retaining the information
Rehearsal training
48
Training the individual to create a visual image in their mind of the information to be recalled
Imaging and visual association
49
Internal memory strategies include
Rehearsal training & imaging and visual association
50
Material devices used to allow compensation for memory deficits
External memory strategies
51
Checklists, alarm clocks, memory pads, calendars, schedules, memory books, diaries
Low tech devices
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Smartphones and computers
High tech devices
53
External memory strategies include
Low tech and high tech devices
54
Repetitively exposing the patient to relevant facts
Orientation deficits
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Compensatory strategies of orientation deficits:
1. posting a calendar or clock in the patient’s room
2. assist the patient in being oriented to date or time
3. posting family photos around the room can help facilitate orientation to self and stimulate long-term memories
56
Most common etiology of dementia is Alzheimer’s disease, which accounts for 60-80% of all cases.
57
Is an acquired global loss of brain function with slow insidious onset caused by a variety of diseases.
Dementia
58
DSM IV defines dementia as memory loss plus one additional deficit in an area that affects ADLs:
Verbal/written expressive and receptive language
Recognition/identification of objects
Inability to execute motor activities
Abstract thinking, judgment, and execution of complex tasks
59
Sudden disturbance in consciousness or change in cognitive ability that fluctuates throughout the course of the day
Delirium
60
Onset of ___ is result of general medical condition (such as UTI).
Delirium
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-Begins suddenly and develops quickly
-Cognitive ability fluctuates throughout the course of the day.
Delirium
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-Begins gradually and progresses
-Cognitive changes do not vary much throughout the course of a day.
Dementia
63
SLP Must recognize, diagnose, and provide treatment for ___ and ___ deficits, as well as the training and counseling of caregivers.
Must recognize, diagnose, and provide treatment for cognitive and communicative deficits, as well as the training and counseling of caregivers.
64
Normal aging
Language remains intact
Sustained attention remains mostly intact
Slight decline in selective attention skills
Divided attention skills intact during simple tasks
Divided attention begins to break down in complex tasks
Reaction time is slowed
Long-term memory and procedural memory remain intact
Episodic and short-term memories are reduced
65
Progressive diseases nad terminal illnesses are the most etiologies of dementia a
True
66
Primarily by degeneration of the cerebral cortex.
Cortical dementia
67
Cerebral cortex is the ____ layer of your brain.
Cerebral cortex is the outermost layer of your brain.
68
The most common etiology of dementia is ____
The most common etiology of dementia is Alzheimer’s Disease.
69
Alzheimer’s is a progressive and fatal disease with no known treatments to stop or slow progression.
70
Alzheimer’s Onset usually after age ___
Onset usually after age 65
71
1906 autopsied the brain of former patient who displayed odd behaviors and a profound short term memory loss.
Alois Alzheimer’s
72
Samples of brain tissue under the microscope revealed pathologic anomalies, which would be called neurofibriallary tangels, amyloid plaques and granulovascular degeneration.
73
Alzheimer’s Neuropathology includes presence of:
Neuropathology includes presence of:
Neurofibrillary tangles
Amyloid plaques
Granulovacuolar degeneration
General neuronal atrophy-shrinkage of cortex and widening of ventricles
74
These clumps begin to occupy large amounts of space within the neuron
Causing cellular dysfunction and cell death
Nerofibtilllary tangles
75
Abnormal intracellular clumps of misfolded and insoluble tau protein in the cell bodies of neurons that the cell cannot dispose of properly
Nerofibrillary tangles
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Abnormal extracellular deposits of the protein amyloid beta.
Amyloid plaques
77
Reduce the ability of neurons to function eventually leading to cell death.
Amyloid plaques
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Formation of abnormal membranous sacks of fluid containing granules within the cytoplasm of certain neurons
Granulovacuolar degeneration
79
Pathologic changes in brain tissue either contribute to or are concomitant with the progressive disease in amount of brain tissue.
Alzheimer’s diseases
80
Diagnostic test uses a compound, known as Pitssburg B compound (PiB).
PiB test
81
Inject the compound into the bloodstream.
Once it travels to the brain it binds with amyloid deposits in the brain. When the brain is scanned using positron emission tomography, it makes visible to reseachers whether the amyloid plaques are present and where they are located.
View the pattern of amyloid buildup in the brains of individuals.
PiB test
82
Risk factors of Alzheimer’s disease
Women are more likely than man to delveiop
A family history of individuals who developed Alzheimer’s
A history of depression increases the risk of Alzheimer’s
Past head trauma
Individuals with less education are at a higher risk than those with higher levels of education
83
Early stage of Alzheimer’s
-Motor function retained
-Short-term memory loss
-word-finding difficulties
-comprehension of verbal language deficits
-personality changes
-Early stage lasts 2 years on average
84
Mid stage of Alzheimer’s
-Negative impact on ADLs and reliance on others
-More severe memory loss, attention deficits, dramatic personality changes, visuospatial and visuoconstructive deficits, and expressive language deficits
-May experience wanderlust, sundowner’s syndrome, disorientation, and confusion
-Mid stage lasts from 4 to 10 years
85
Late stage of Alzheimer’s
-Loss of motor function
-May become nonambulatory, bedridden, incontinent, and unresponsive
-Memory, cognition, and expressive language deficits are profound
-May cause muteness and dysphagia
86
Degeneration of frontal and temporal lobes
Frontotemporal dementia
87
Cortical Dementia: Frontotemporal Dementia includes
Pick’s disease
Progressive nonfluent aphasia
Semantic dementia
88
Arnold Pick identified the clinical syndrome.
Picks disease
89
Characterized by personality changes, antisocial and inappropriate behavior, and memory loss in absence of language deficits
Picks disease
90
Dementia resulting from progressive degeneration of the frontal and temporal lobes.
Picks disease
91
Neuropathology includes Pick bodies and ballooned neurons
Results in shrinkage of frontal and temporal lobes
No amyloid plaques or neurofibrillary tangles
Picks disease
92
Huntingtons disease falls under ___ dementia
Subcortical dementia
93
___ & __ fall under cortical dementia
Alzheimer’s and picks disease
94
Neuropathology includes production of mutant Huntingtin protein that creates degeneration of basal ganglia, hippocampus, substantia nigra, and Purkinje cells of pons
Huntington’s disease
95
Hereditary disorder, which makes identification easier.
Huntingtons
96
Typical life span is 20 years after diagnosis.
Huntingtons
97
Characterized by motor symptoms of chorea, emotional problems, difficulty concentrating, memory problems, difficulties with executive functioning, sleeping and swallowing difficulties
Stage 1 &2 of Huntingtons
98
Characterized by chorea and hyperkinesias that interfere with speech production
Training on AAC for future loss of verbal and written expression
Stages 2 3 and 4 of Huntingtons
99
Characterized by nonambulatory, rigidity, bradykinesia, incoordination, full dependence on others, high risk of aspiration, and use of AAC devices to communicate
Stage 5 of Huntingtons
100
Presence of abnormal spherical deposits of the protein alpha-synuclein in the cell bodies of neurons.
Levy body disease
101
2 Primary Variants of Lewy Body Disease:
Parkinson’s disease
Dementia with Lewy bodies
102
Characterized by motor abnormalities such as rigidity, tremor, slowness of volitional movement, and cognitive deficits
Parkinson’s disease
103
No known treatment to slow or stop disease process
Parkinson’s diseases
104
Neuropathology includes loss of dopamine producing cells in substantia nigra as a result of Lewy bodies.
Parkinson’s disease
105
Medical treatment for Parkinsonian symptoms
Levodopa/ l-dopa
106
Levodopa is converted into ___ within the brain.
Medical treatment for Parkinsonian symptoms
Dopamine
107
Progressive supranuclear palsy (PSP) is a rare neurodegenerative disorder with an average onset of around age ___ that affects ___ more than ___
Progressive supranuclear palsy (PSP) is a rare neurodegenerative disorder with an average onset of around age 60 that affects men more than women
108
Ocular motor problems characterized by difficulty looking down and an upward gaze
Early-onset frontal lobe syndrome characterized by cognitive symptoms of personality changes, loss of executive functioning, memory and attention deficits, apathy
Individuals with PSP also display balance difficulties and an exceedingly straight posture known as axial rigidity.
Progressive supranuclear palsy
109
Two commonly used medications:
For dementia
Donepezil (Aricept)
Memantine (Namenda)
110
Therapy for dementia
Should improve _____and ensure individual is operating at the ___level possible despite deficits
Strengthen abilities that can improve
___ demands on impaired abilities
Should improve quality of life and ensure individual is operating at the highest level possible despite deficits
Reduce demands on impaired abilities
111
Therapy for dementia
Increase use of intact cognitive abilities
Provide stimuli that evoke positive emotion and memories
112
Semi-cued conversation about past events, experiences, and activities to increase orientation and recall of pleasant long-term and episodic memory
Reminiscent therapy
113
Difficulty level of task is set within the ability of the patient to maximize patient success and minimize patient failure
Errorless learning
114
Presentation of new or previously known information that must be recalled over increasingly greater intervals of time
Spaced retrieval training
115
External memory aids such as memory books/wallets, calendars, smart phones, or personal digital assistance to augment memory
Memory prostheses
116
Breaking down complex tasks into individual parts into hierarchy of difficulty and from concrete to abstract
Montessori approach
117
Direct therapy strategies include
Reminiscence therapy
Errorless learning
Spaced retrieval training
Memory prostheses
Montessori approach
118
Custom-made videos that provide audiovisual presentation of personal facts and past events to increase orientation and decrease confusion
Life history videos
119
Keep individual with dementia safe, calm, and minimize disorientation
Environmental manipulators
120
Indirect therapy strategies include
Life history videos
Enviorenmntal manipulators
121
Strategies that focus on modifying or manipulating the physical or communicative environment
Indirect therapy strategies
122
Individual or group therapy sessions that target deficits
Direct therapy strategies
