Cognition, Arousal, Attention Flashcards
Define cognition
Act or process of knowing, including awareness, reasoning, judgement, intuition and memory
Define arousal
Phsyiological readiness of the body for activity
Define alert
awake and attentive to stimuli
Define lethargic
Drowsy; may fall asleep if not stimulated
Define obtunded
Difficult to arouse; frequently confused when awake
Define Stupor
Responds to strong, noxious stimuli only; once stimulus stops pt returns to stupor
Define coma
State of arousal where pt is unable to be aroused
What are some ways you can try to wake a lethargic patient?
- sternal rub
- temperature difference
- raise head of bed
- auditory
- touch
Define attention
Ability to select and attend to a specific stimulus while AT THE SAME TIME ignoring extraneous stimuli
What are the brain areas respoinsible for attention?
- Reticular formation
- Various sensory systems
- Limbic system and frontal lobe
Define alternating attention
AKA Cognitive flexibility, the ability to move flexibly b/t tasks and respond appropriately to the demands of each
What are formal tests for cognition?
- Mini-Cog
- Mini-mental state exam (MMSE)
- Montreal Cognitive Assessment
- Trail Making Test A & B
What is a cognitive screen?
Asking orientation questions: name, date, where you are, situation
What is the Mini-Cog?
A screening tool for cognition that includes 3 word registration, clock drawing, and word recall w/score of 5 with <3 = dementia and <4 indicative of need for further testing
MMSE Scoring
Normal: 24-30
Mild impairment: 18-24
Severe impairment: 0-17
What are MMSE Correlated with? Why is this important?
Highly correlated w/baseline education scores and less correlated to actual mental capacities
Which cognitive test is better to use: MMSE or MoCA and why?
Montreal Cognitive Assessment because it is not based on prior level of education and has more emphasis on attention and executive function
Trail Making Test A & B
Test for cognition that tests visual attention and task switching
Define dysarthria
disorder of speech production
What are some ways to analyze communication
Dysarthria, aphasia, speech intelligibility, articulation
What muscles are responsible for speech production?
Lungs
Trachea
Larynx
Pharynx
Nose
Mouth
What do they mm of speech production also play a role in?
Swallowing
Difference b/t mild and severe dysarthria?
Mild: imprecise
Severe: totally unintelligible
What is the goal of treatment of dysarthria?
Improve communication and intelligibility
What is fluent aphasia
Speech produced at normal rate and flow (receptive aphasia: can not understand language, but language expression is “intact”)
What is on-fluent aphasia
Increased effort to produce speech; hesitant or awkward (Expressive: Can understand language but cannot express language)
What is global aphasia
features of both receptive and expressive aphasia
Would Broca’s aphasia be classified as nonfluent or fluent aphasia?
Nonfluent aphasia where language comprehension is still intact
Which type of aphasia is global aphasia?
A nonfluent aphasia where language comprehension is also impaired
Which type of aphasia is conduction aphasia?
Fluent aphasia where language comprehension is relatively intact
Which type of aphasia is wernicke’s aphasia?
Fluent aphasia where language comprehension is impaired
What is transcortical motor aphasia?
Nonfluent aphasia where language comprehension is relatively intact characterized by: Strong repetition skills; may have difficulty spontaneously answering questions
What is anomic aphasia?
Fluent aphasia where language comprehension is relatively intact characterized by: repetition of words/phrases good, but word finding is hard and uses generic titles or circumlocution
What is transcortical sensory aphasia?
A fluent aphasia where language comprehension is impaired characterized by repetition of words/phrases good, but may just repeat questions rather than answering them
List the components of an aphasia assessment
Auditory comprehension
Verbal expression
Social communication
Reading comprehension
Written expression
Multimodal communication
What is the impact of mild aphasia?
- trouble understanding long messages
- need extra time to understand and respond to spoken messages
- difficulty finding words
- putting words in wrong order/use wrong word
- difficulty responding to questions on the spot
What is the impact of severe aphasia?
Trouble understanding spoken messages
- may be unreliable in responding to “yes”/”no” Ws
- may not be aware of their own errors
- may use a combo of words and jargon that is not understood by others
What can I do to communicate effectively with someone that has aphasia?
- maintain eye contact
- use shorter, less complex sentences
- dec. distractions
- use gestures to assist in comm
- repeat when necessary
- don’t assume person understands you
- don’t guess at content too soon
How to assess dysphagia?
Bedside swallow exam
Modified barium swallowing study
What does the SLP do for language?
- naming and improving fluency
- strategies to compensate
- articulations; HEP for tongue and facial mm
What does an SLP do for cognition?
- recognize safety concerns
- training attn and other executive function sklls
What does an SLP do for dysphagia?
Strategies to improve swallowing
What does an OT do to help Neuro Deficits?
- helps cognition as it pertains to function
- Sequencing of ADLs
- Help w/IADLs
- role in perception and visual-perceptual deficits
What is the role of neuropsych with these patients
- Indepth testing of cognitive functions
- role in adjustment to illness/disability
