Cognition Flashcards
What is perseveration?
Perseveration: repetition of the same story
What is confabulation?
False answers to Q’s
Why do we examine cognition?
Mental Status/cognitive examination often occurs during or right after history.
Impact on rehabilitation
Responsibility for screening/referral
Cognition includes:
Awareness Reasoning Judgement Memory Executive Functions
How does CVA vs. TBI influence cognition?
CVA: usually localized pattern of cognitive loss
TBI: usually more global pattern of cognitive loss
Describe arousal:
slow fluctuations in alertness that relate to circadian rhythm, food intake, drug effects; ability to respond consistently to sensory input by eye opening, localizing, or tracking with head or eye movement to stimulation.
Define obtunded:
Very low arousal/alertness
A&O x 3-4 includes:
Alert and orientated to person, place, time, situation/circumstance
Glascow coma scale items:
- eye opening
- verbal response
- motor response (normal, pain local/general, posturing)
JFK Coma Recovery:
used most often in minimally conscious inpatients
Rancho Los Amigos Cognitive Scale:
Descriptive scale that may help teach families learn expected stages and level of assistance for TBI pts
Define alternating attention:
Ability to move flexibility between tasks and respond to demands of both tasks
Define divided attention:
Respond simultaneously to two or more tasks when all stimuli are relevant
Define sustained attention:
Ability to sustain attention over time
Define selective or focused attention:
Process relevant information about task and environment while screening out irrelevant information
… remember that gorilla in the ball toss video?!
Define attention:
Ability to select and attend to specific stimulus while suppressing extraneous stimuli
Describe Disinhibition and examples:
Distraction by internal factors
ex: pt. has to pee and is distracted but doesn’t tell you
ex: making inappropriate comments
Describe Hyperactivity:
Excessive motor activity
Describe Distractability:
Attention to irrelevant factors within the environment
A severe disturbance in motivation can be described as:
Apathy: absence of response to stimuli
Abulia: extreme version of apathy
Describe neuro motivation:
the degree of cooperation
the ability to sustain effort
the amount of encouragement required to complete a task.
Motivation requires initiative and refers to:
the extent to which an individual desires to reach a goal and demonstrate actual follow through.
Describe a flat affect:
no external expression or emotional feeling, tone or mood
Describe emotional lability in a neurological pt:
inappropriate laughter or crying
sometimes aware, sometimes not aware
Describe executive fxns:
Capacity to plan, manipulate information, initiate and terminate activities, recognize errors, problem solve and think abstractly
Capabilities that allow a person to engage in independent, purposive and self serving behavior
Describe insight:
Capacity to discern the true nature of a situation
Describe judgment:
ability to objectively make a decision after deliberation
Describe reasoning:
includes problem solving, organization, sequencing, generalization, levels of abstraction
Define dysarthria:
motor problem
Define dysphonia:
production of sounds
Hypophonic: soft
Hyperphonic: loud
Fluent aphasia / wenickes:
normal rate and melody of speech with some inappropriate words/sounds but no perception of problem
Non-fluent aphasia / broca’s:
expressive problem with preserved auditory perception
Describe perception:
Integration of sensory impressions into information that is meaningful
- Select meaningful stimuli
- Integrate those stimuli
- Interpret meaningful stimuli
anosognosia:
unawareness or denial of deficits/ severity
Spatial relation disorders:
Difficulty in perceiving oneself in relation to other objects in relation to oneself
Topographic orientation
Figure ground perception
Body image/scheme disorders:
Difficulties with awareness of body parts and their relationship to one another and the environment
Right/left discrimination
Unilateral neglect
Apraxia:
Inability to carry out pruposeful movement in presence of intact sensation, movement and coordination
What are the 5 types of apraxia?
Verbal
Buccofacial
Constructional
Dressing
What are 2 types of limb apraxia?
Ideomotor
Ideational
Define ideomotor apraxia:
imitate gestures spontaneously but can’t perform voluntarily
Define ideational apraxia:
Ability to conceptualize complex motor activities that involve tools or objects
ie: putting toothpaste on a toothbrush
Memory includes:
Immediate recall
Retention of information stored for a few seconds
Short term memory
Retention of events within a few minutes, hours or days
Long term memory
Early experiences and information acquired over a period of years
The MMSE = mini mental status exam screens to ID:
unrecognized cognitive disorders in community dwelling elders
