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Cognitive Retraining > CR: Lesson 1 > Flashcards

CR: Lesson 1 Flashcards

1
Q

A complex collection of mental skills

A

cognition

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2
Q

What skills are included in cognition

A 
attention/perception
comprehension
learning/memory
problem-solving/reasoning
organization
orientation
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3
Q

Rehabiliation of a cognitive impairment by improving/compensationg for cognitive deficits to allow increased daily function is

A

cognitive rehabilitation

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4
Q

Therapy tasks may try to do the following:

A

imporve actual brain function OR

provide improved environment or cues to compensate for loss.

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5
Q

Cognitive rehab objectives must balance _______ and ___________for daily tasks

A

independence

safety

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6
Q

What are essential considerations for treatment plans

A

social/emotional impact
general health
family support
behavioral characteristics

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7
Q

3 Basic types of damage following brain injury

A

primary damage, secondary damage, nonneurological alterations

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8
Q

structural leasions caused directly by the impact

A

primary damage (cerebral contusions)

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9
Q

damage to the area surrounding the impact…

A

secondary damage

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10
Q

secondary damage can be caused by

A 
increased intracranial pressure
intracranial hemorrhage
brain swelling
infection
hematomas (bloodclots)
infarction (strok-like effects due to impaired blood supply)
oxygen deprivation (anoxia)
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11
Q

examples of nonneurologic alterations

A

hyperthermia (excessive fever)
electrolyte imbalance (dehydrations, starvation, etc)
hyperventilation
damage to the hypothalamus or pituitary gland

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12
Q

which usually has a larger area of damage? Primary or secondary damage

A

secondary damage

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13
Q

2 Major Types of Brain Injury

A

open head

closed head

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14
Q

Closed Head Injury

A

occurs when head is struck by a blunt object

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15
Q

closed head injury tend to be more diffuse due to

A

direct contact & inertial forces

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16
Q

The area of direct injury is called

A

coup injury

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17
Q

The cerebral area opposite the impact is called

A

contracoup injury

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18
Q

diffuse axonal injury (DAI)

A

the twisting and shearing of axons in the brain due to the rotational forces of impact

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19
Q

Comas is much more common following…

A

closed head injury

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20
Q

twisting the brainstem may result in damage to axons in the reticular formation, which =

A

coma

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21
Q

an injury in which the scalp and skull are penetrated

A

open head injury

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22
Q

secondary damage can occur due to increased ________ and their is less likelihood of ________than with OHI

A

cranial pressure

infection

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23
Q

Coma is NOT common with _________

A

open head injury (OHI)

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24
Q

Most common areas of damage in close head injuries are

A

inferior and lateral surface of the frontal & parietal lobes with contracoup to the parietal and occipital lobes

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25
Q

Common impairments seen in closed head injury

A

executive function
personality functions
memory

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26
Q

An example of executive function impairment commonly seen in closed head injury

A

initiation and planning

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27
Q

An example of personality function impairment commonly seen in closed head injury

A

self-regulation & control

social behavior

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28
Q

An example of memory impairment commonly seein in a closed head injury

A

sequencing & organization

awarness of impairments

29
Q

CVA brain injury

A

cerebrovascular acciden/stroke

  1. cerebral hemorrhage
  2. cerebral infarction
30
Q

Brain bleed aka “wet stroke”

A

cerebral hemorrhage

31
Q

Cerebral infarchtion aka “brain attach”

A

ischemic stroke

32
Q

Which CVA injury produces diffuse damage

A

cerebral hemorrhage

33
Q

Which CVA injury generally produces a focal lesion

A

cerebral infarction (ischemic stroke)

34
Q

Brain Tumors

A

abnormal cell growth…usually a focal lesion

35
Q

Other types of brain injuries that usually result in multifocal or diffuse brain injury

A

enephalitis
meningitis
hypoxia
hypotensive injury

36
Q

infectious disorder of the brain tissue and meniges, usually viral

A

menigitis

37
Q

lack of oxygen

A

hypoxia

38
Q

decreased perfusion of blood throughout the brain

A

hypotensive injury

39
Q

Severe damage and post injury coma more than _____ to ______hours= _________mortality rate and ____________recovery levels in survivors.

A

24-48
high
low

40
Q

inflammation of the brain

A

encephalitis

41
Q

the neural and behavior resilience that provides the brain’s ability to reorganize after injury

A

plasticity of the brain

42
Q

spontaneous recovery

A

due to resolution of hematoma, decrease in edema, normalization of blood flow, and neurochemical balance

43
Q

diaschisis

A

occurs in unharmed areas adjacent to the lesion immediately following the injury. surrounding areas may exhibit temporary loss of function due to edema, increased pressure, or delpletion of blood flow.

44
Q

axonal growth

A

refers to axonal sprouting from damaged neurons as well as intact axons

45
Q

denervation supersensitivity

A

the dendrites that previously received innervation from damaged axons become more sensitive to the remaining neurotransmitter inputss as they sprout more receptor sites to compensate for lost innervation.

46
Q

substitution

A

suggests that intact brain structures assume the functions previously held by the lesioned areas.

47
Q

Some people believe substitution is due to ________in the brain

A

redundancy

48
Q

_______will grow to establish new connections

A

axons

can be as long as the entire length of your body

49
Q

3 Major Influences in the field of Cognitive Rehabilitation

A

advances in technology
health care
accountability for treatment efficacy

50
Q

Russian neuropsychologist that described the brain in terms of a body of 3 functional units that worked together to provide function for the higher level processes of cognition

A

Alexander Luria (1980)

51
Q

The arousal unit

A

treated with coma stim and attention/concentration training

52
Q

the sensory input unit

A

receives information from outside of the nervous system, analyzing and storing it—treated with attention and memory training

53
Q

the organizational & planning unit

A

deals with programming, planning, and implementation of volitional actions–treated with executive function, reasoning, & problem-solving training

54
Q

Principles of Neural Plasticity

A
  1. The brain is dynamic, capable of reorganization
  2. motor/sensory/cognitive abilities can improve, but over time and usually with persisitng deficit
  3. Neural structural changes (dendritic branching, new synapses, etc) underlie behavioral changes
  4. Neurobehavioral recovery based on environmental stimulation
  5. Restitutive and compensatory approaches have role in rehabilitation.
55
Q

Principles of Cognitive Reorganization

A
  1. Consider multiple patient perspectives
  2. Client and family involvment
  3. Build on client’s strengths
  4. The goal is self-sufficiency
  5. Incorporate assessment data
  6. 3 Pronged approach
  7. Increase client awareness of deficits
  8. Variety of techniques for variety of goals
  9. consider client’s premorbid interests, careers, values
  10. Utilize new scientific theory & technology
  11. Assess efficacy of intervention methods
  12. Team-based intervention
56
Q

Patient perspectives

A

physical (tolerance)
emotional (motiviation)
cognitive (awareness)
social (caregiver support)

57
Q

3 Pronged approach

A

rehabilitation
compensation
emotional managment

58
Q

Stages of Cognitive Reorganization

A 
emergency care
coma care
inpatient rehab
outpatient rehab
community reintergration
59
Q

Goals of CR

A

foster natural recovery
discourage maladaptive coping patterns
implement proper interventions

60
Q

2 Conflicting Theories concerning age

A

The Kennard Principle & Donald Hebb

61
Q

Kennard Principle

A

recovery more complete when sustained while young

62
Q

Donal Hebb

A

early injuries can cause more disturbances than those later in life

63
Q

TRUTH about age & recovery…

A

young adults recover best

64
Q

Variables contributing to neurological recovery

A
  1. premorbid intelligence/education
  2. Gender (effects of progesterone=beneficial)
  3. Cultural background (multicultural likely to end therapy sooner)
  4. Drug & alcohol abuse
  5. psychological factors
  6. depression/anxiety
65
Q

Injury related variables

A

time since injury
injury extent & severity
recovery of diff functions

66
Q

recovery of simple, _____tasks occur more quickly thatn recovery of higher level activities.

A

overlearned

67
Q

Mild injuries recover ______quickly than people with more severe injuries

A

more

68
Q

recovery is most rapid in the first____ months.

A

6

Cognitive Retraining (6 decks)

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