Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Cognitive Communication Disorders > Cognitive Lecture 2 Sequelae TBI > Flashcards

Cognitive Lecture 2 Sequelae TBI Flashcards

1
Q

Coma

A

Altered state of consciousness; a deep state of unconsciousness where a person does not consciously respond to external stimuli; can be brief or last for weeks at a time; occurs secondary to underlying neurological condition or TBI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Coma Characteristics

A

No eye opening, no communication, no following directions, no purposeful movement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Vegetative State:

A

Patient has lost cognitive ability & awareness of surroundings; will maintain normal sleep-wake cycles; spontaneous movement may occur & include crying, laughing, grimacing; may open eyes to external stimuli

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Persistent Vegetative State

A

once it has persisted past 1 month

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Characteristics of Vegetative State

A

unconsciousness, no communication, no following directions, no purposeful movement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Minimally Conscious State (MCS)

A

pts. that exhibit a slow recovery of consciousness; continue to have poor self-awareness as well as awareness of world around them; very inconsistent; may intermittently follow directions, communicate y/n via gestures/ vocalizations, use some recognizable words+phrases, reach for objects or try to hold onto objects, focus on items or people for longer periods of time

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

TBI Severity Ratings

A

Pts. may be classified as having a mild, moderate, or severe TBI based on level of consciousness
3 Main rating scales: Glasgow Coma Scale, Post-Traumatic Amnesia, Ranchos Los Amigos Scale of Cognitive Functioning

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Glasgow Coma Scale

A

Teasdale & Jennette, 1974,76
Estimation of the depth of coma as a measure of severity w/in the 1st 24hours of the trauma
Pt. assigned a score of 3-15; points are assigned per BEST eye opening (1-4), BEST motor response (1-6), BEST verbal response (1-5); greater the score, more conscious the person

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Cell phone, pen GCS

A

3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Versions of GCS

A

Adult version

Modified pediatric version

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

GCS Coma Severity Ratings:

A

13-15 Mild TBI
9-12 Moderate TBI
Less than 8 Severe TBI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Decorticate Flexion (Posturing)

A

Results from damage to 1 or both CSTs; Arms adducted & flexed, wrists & fingers flexed on chest; legs stiffly extended & internally rotated, plantar flexion of feet (toes pointed); “mummy pose”

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Decerebrate Flexion (Posturing)

A

Results from damage to upper brainstem; arms are adducted & extended, wrists pronated & fingers flexed; legs stiffly extended, plantar flexion of feet (toes pointed)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

PTA

A

Duration focus; may be used as an alternative to GCS; references period of time where pt. has regained consciousness but is still in a disoriented & confused state & until time pt.’s memory for ongoing events become reliable & accurate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

PTA levels

A

Mild TBI: Period of coma+PTA less than 1 hr.
Moderate TBI: Pd. of coma+PTA is 1-24 hrs.
Severe TBI: Pd. of coma+PTA is 1-7 days
Profound TBI: Pd. of coma+PTA is 7+ days
Some MDs don’t use profound

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Response progression

A

Pts. may progress thru several types of responses during recovery from a state of altered consciousness; deepest stage-> reflexive behaviors->generalized responses ->localized responses->physiological responses

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Deepest Stage

A

pt. is totally unresponsive to any stimuli including painful or aversive types

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Reflexive Behaviors Stage

A

pts. exhibit production of unconscious, subcortical reflexive behaviors; may return to primitive behaviors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Generalized Response Stage

A

stimulation triggers movement of a body part not associated w/ actual stimulus; noise in the room may trigger chewing response

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Localized Response Stage

A

noise occurs in the room and pt. turns toward stimulus; fixating on where stimulus came from

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Physiological Response Stage

A

Stimulus triggers change in BP, RR, O2, Temp, Pupils

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Ranchos Scale (RLAS)

A

way to describe cognitive functioning from early stages of injury to later stages of recovery; pt. assigned level based on presentation using #s 1-10 (Can change; be able to back up findings)
Levels 1-3: severe deficits/vegetative state
Levels 4-6: moderate deficits
Levels 8-10: milder deficits

23
Q

Ranchos Scales Levels I-III

A

Pt. presents as comatose or emerging from coma; may be persistent vegetative state or minimally conscious state

24
Q

Ranchos Scales Levels IV-VI

A

Pts. present as beginning process or regaining orientation & memory skills necessary for full consciousness; getting better

25
Q

Ranchos Scales Levels VII-X

A

Pts. present with persistent cognitive, social, & emotional challenges

26
Q

Ranchos I

A

No response; unresponsive to any stimuli

27
Q

Ranchos II

A

Generalized response; non-purposeful responses; usually to pain only

28
Q

Ranchos III

A

Localized response; purposeful; may follow simple commands

29
Q

Ranchos IV

A

Agitated/Confused; confused, disoriented, agitated, aggressive, combative, unable to perform self-care

30
Q

Ranchos V

A

Confused/Inappropriate; non-agitated, appears alert, responds to commands, does not learn, verbally inappropriate

31
Q

Ranchos VI

A

Confused/Appropriate; can relearn old skills; serious memory deficits; some awareness of others and self

32
Q

Ranchos VII

A

Automatic/Appropriate; oriented, robot-like ADLs; minimal confusion, lacks insight into planning ability

33
Q

Ranchos VIII

A

Purposeful/Appropriate; A&O, independent in living skills, capable of driving, deficits may persist for judgment, skills not premorbid

34
Q

Ranchos IX

A

Purposeful/Appropriate; stand-by on request, (l)ly shifts back and forth between tasks with good accuracy for at least 2 hours

35
Q

Ranchos X

A

Purposeful/Appropriate; Modified independent, handles multiple tasks simultaneously in all settings, may need rest breaks

36
Q

Coma/Sensory Stimulation

A

involves use of multi-sensory presentation to medically stable individuals who are comatose or in vegetative states
Controversial/not a ton of research
Western Neuro-Sensory Stimulation Profile

37
Q

Goal of Coma/Sensory Stimulation

A

with intense and repetitive stimulation, the multi-sensory applications will stimulate and “awaken” the reticular formation, responsible for consciousness)

38
Q

Coma/Sensory Stimulation Principles

A

suggested as soon as pt. is medically stable; range from 1-8hours daily with 15-30 minute sessions
Collaborate with/Educate family; insurance may not cover it
Auditory, tactile, proprioceptive, gustatory, visual, olfactory
Never overstimulate pt.
Document
Do not harm

39
Q

Signs of overstimulation

A

HR up or down, respiration changes, flushing/perspiration, increased muscle tone, agitation, prolonged respiration, decreased arousal, hiccuping/yawning

40
Q

Auditory Stimulation

A

small bell, favorite type of music playing softly, tv shows always watched; something that meant something to pt.

41
Q

Gustatory Stimulation

A

tastes, flavored toothettes, etc.

42
Q

Tactile Stimulation

A

touch, deep pressure, warm washcloth and cool washcloth, different textures (rough, smooth, etc.)

43
Q

Proprioceptive Stimulation

A

Be careful!
changing body positions (leg lifts, etc.)
Passive range of motion

44
Q

Visual Stimulation

A

Pictures of loved ones, family, friends, pets, maybe open blinds/colored lights

45
Q

Olfactory Stimulation

A

cinnamon, coffee, scented packs, q-tip dipped in scented thing, perfume/cologne sprayed on index card

46
Q

Cognitive-Communication Impairment

A

Decreased ability to perform language-based activities b/c of a deficit in 1 or more of the cognitive functions that underly communication
Communication challenges for the pt. w/ TBI are different from those for pts. with CVA

47
Q

5 Domains of Cognition

A 
EMAPS
Executive functioning
Memory
Attention
Problem-solving
Sequencing
48
Q

Cognition vs. Language

A

TBI can cause communication disorders without disrupting language
TBI can cause language disorders without disrupting communication
Type of comm. deficit depends upon location & severity of brain damage
Often a mismatch between surface structure of language (actual words) & deep surface structure of language (meaning)

49
Q

Verbal & Gestural Output in TBI

A

may use incorrect words (wrong word choice), exhibit poor sentence structure, be paraphasic, neologistic, or perseverate

50
Q

Coprolalia

A

obscene use of words, swearing, cursing

51
Q

Copropraxia

A

obscene use of gestures

52
Q

Coprographica

A

Obscene pictures via drawings, illustrations (words?)

53
Q

Palilalia

A

Abnormal speech fluency; Abnormal repetition of syllables, words, phrases with increasing rapidity & decreasing intelligibility (sounds like stuttering/ cluttering to a degree but it’s not

Cognitive Communication Disorders (5 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions