Cognition Flashcards
List the level of consciousness.
- Alertness
- Lethargy
- Obtundation
- Stupor
- Coma
- Unresponsive vigilance state
- Minimally conscious state
Describe a patient who would be considered alert.
- opens eyes and looks at therapist
- responds fully and appropriately to stimuli
Describe a patient who is considered at a lethargy conscious level.
- pt appears drowsy; FALLS asleep EASILY
- opens eyes and looks at examiner
- responds to questions
Describe a patient who is demonstrating obtundation?
- opens eyes and looks at therapist
- responds to questions, but responds SLOWLY and is confused
- decreased alertness and interest in environment
Describe a patient in a stupor.
- can only be aroused from sleep with PAINFUL stimuli
- verbal responses are slow or absent
- Pr returns to unresponsive state with stimuli is removed
- demonstrates minimal awareness of self and environment
Describe a patient in a coma
- state of consciousness from which pt CANNOT be aroused
- eyes remained close
- no response to external stimuli or environment
Describe a patient in Unresponsive vigilance state.
- a state characterized by the return of sleep/wake cycles, normalization of vegetative vitals
- lack of cognitive responsiveness (can be aroused but is unaware)
What is considered a persistent vegetative state?
a state lasting > 1 year for TBI and >3 mons for anoxic brain injury
Describe a patient in a minimally conscious state.
State characterized by severely altered consciousness with nominal but definite evidence of self or environment awareness
A score ranging from 1-8 is considered what on the glascoma scale (GCS)
Severe brain injury
A score ranking from 9-12 is considered what kind of brain injury on the Glasgow Coma Scale (GCS)?
Moderate brain injury
A score ranking from 13-15 is indicative of what kind of brain injury on the Glasgow Coma Scale (GCS)?
Minor brain injury (scores 13-15)
When going through the Glasgow Coma Scale a therapist is assessing response to what three elements?
- Eye opening
- Motor response
- Verbal response e
A therapist is wanting to test immediate recall (memory), how can she/he do this?
Name three items previous presented after a brief interval (i.e. 5 minutes)
A therapist is wanting to assess short-term memory of patient. How can he/she do this?
Recall recent events (i.e. What did you have for breakfast)
A therapist is wanting to assess remote (long-term) memory. How can he/she do this?
Recall of past events (i.e. where were you born? Where did you grow up)
A therapist asks a patient to recall seven numbers in the order they were presented. What is the therapist trying to assess?
Length of attention span and therapist is using a digit span retention test
A therapist wants to assess the patients ability to attend to task without redirection (sustained attention). How can he/she do this?
Determine time spent on task and frequency of redirection
Describe divided attention.
Ability to shift attention from one task to another
When assessing attention what else should a therapist assess?
Divided attention
Ability of dual task control
perseveration (mental inertia)
Describe perseveration.
Getting stuck on a task
Describe focused attention.
Ability to stay on task in presence of detractors
How would a therapist assess focused attention
Assess impact of environmental vs internal detractors
True or false: therapist should assess the ability of a patient to follow one- or two step, multilevel commands
True
List Emotional Responses/Behaviors that should be assessed.
- Safety, judgment: impulsivity and lack of inhibition
- Affect/mood: irritability, agitation, depression and withdrawal
- Frustration tolerance
- Self-centeredness
- Insight into disabilty
- Ability to follow rules of social conduct
- Ability to tolerate criticism
List Higher-level cognitive abilities that can be assessed.
- Judgement, problem-solving
- Abstract reasoning
- Fund of general knowledge: current events, ability to learn new information, generalize learning to new situations
- Calculation: Serial 7 test (count backwards from 7)
- Sequencing: ability to order components of cognitive or function task; assess if cueing is necessary, frequency of cues
The MMSE screening includes what items?
Orientation
Registration
Attention and calculation
Recall and language
A max score on the MMSE is ?
30
A score on the MMSE 21-24 indicates what?
Mild cognitive impairment
A score on the MMSE of 16-20 indicates ?
Moderate impairment
A score of <15 on MMSE indicates?
Severe cognitive impairment
Describe the 8 levels of the Rancho los amigos
No response (I)
Decrease response (II-III)
confused levels (IV, V, and VI)
Appropriate (automatic, purposeful) levels (VII and VIII)
