CR: MidTerm Review

Question 1

Diffuse axonal injury is most often an effect of which type of injury?

Answer 1

closed head injury

Question 2

The Glascow Coma Scale does not assesses

Answer 2

emotional response

Question 3

Coma following brain injury is most often due to damage to what area of the brain?

Answer 3

brainstem

Question 4

The return of function to swollen but undamaged areas of the brain refer to which process of recovery?

Answer 4

diaschisis

Question 5

The ultimate goal of cognitive rehabilitation is

Answer 5

to make the client as self-sufficient as possible

Question 6

Considering hte Kennard principle as well as Donal Hebb’s theory, who is most likely to recover from brain injury?

Answer 6

young adults

Question 7

Which of the following types of assessment can be used to evaluate functional skill as well as track progress over the course of rehabilitation?

Answer 7

tracking evaluation

Question 8

The inability to recall memories from on’es past is

Answer 8

retrograde amnesia

Question 9

Which of the following is considered the best indicator of brain injury serverity

Answer 9

length of post-traumatic amnesia

Question 10

Which approach fro treating attention deficits entails utilizing pacing strategies, orienting procedures, and the use of a “key ideas log”?

Answer 10

self-management strategies

Question 11

In which stage of memory is information transferred from short-term to long-term memory?

Answer 11

storage

Question 12

Which of the following types of memory is most likely to be spared following brain injury?

Answer 12

procedural memory

Question 13

When providing treatment for memory loss, do not

Answer 13

increase the amt of information to be remembered

Question 14

Expanded Rehearsal (Space Retrieval) ER is not used to learn a large amount of

Answer 14

generalized information

Question 15

Which memory treatment strategey is generally considered to be the most successful and functional?

Answer 15

use of external aids

Question 16

Which external memory aid would be most appropriate for a person with impaired reading/and or writing skills?

Answer 16

auditory visual aids

Question 17

The ability to maintain response to a stimulus during continuous activity

Answer 17

sustained attention

Question 18

The most basic ability to respond to external sensory stimuli.

Answer 18

focused attention

Question 19

The ability to maintain response to stimuli in the presence of competintg competing stimuli

Answer 19

selective attention

Question 20

The ability to respond to several stimuli or task demands at once

Answer 20

divided attention

Question 21

The ability to shift attention between two or more stimuli

Answer 21

alternating attention

Question 22

How does self sufficiency apply to the Principles of Cognitive Reorganization discussed in the first half of the course?

Answer 22

Self sufficiency is the ultimate goal of cognitive rehabilitation. To make the client as self-sufficient and safe in his enviroment as possible sue thate he can return to living as independently as possible.

Question 23

How does family involvement apply to the Principles of Cognitive Reorganization discussed in the first half of the course?

Answer 23

The family can provide information about premorbid interests and abilities for better therapy planning. They may also have to take over therapy activities when the insurance money runs out, and can provide motivation and better follow-through at home if thy are invested and involved in therapy.

Question 24

How does premorbid interests apply to the Principles of Cognitive Reorganization discussed in the first half of the course?

Answer 24

These interests should be incorporated into therapy activities so that the patient has increased motivation to participate. They can also be used to help the patient retrain to do things they will have to do upon discharge and and will allow the SLP to create individualized goals for the patient following treatment.

Question 25

How does intervention efficacy apply to the Principles of Cognitive Reorganization discussed in the first half of the course?

Answer 25

Speaks to the importance of SLPs proving that what we are doing is effective to third party payers. There is a big need for more scientific evidence behind what we are doing if we are to be a respected, trusted profession, and if we are to be able to charge for services. Also, on an individual leverl, if what we are doing with the patient is not working, therapy must be adapted and changed to meet the clients’ individual needs.

Question 26

How does awareness of deficits apply to the Principles of Cognitive Reorganization discussed in the first half of the course?

Answer 26

Many patients following brain injury are unaware of their cognitive and physical deficits. It is important to educate these patients about their limitations for safety’s sake, but also to increase their motivation to improve and the likelihood of their participation.

Question 27

It has been strongly emphasized that cognition cannot be isolated during cognitive rehabilitation. Name three factors (other than cognitive deficits) that can impact the success of your rehabilitation program and briefly explain how they can increase or decrease the likelihood of success.

Answer 27

Any number of factors are possibilities for this answer, including:
family involvement, gender, age, cultural background, drug and alcohol abuse, premorbid intelligence and education. Must include a brief description of HOW these factors can affect rehabilitation outcomes.

Question 28

Describe the three potential levels of damage following a brain injury.

Answer 28

1. Primary damage: caused by direct contact (cerebral contusions)
2. Secondary damage: damage to area surrounding impact (intracranial pressure, hemorrhage, swelling, infection, hematomas (bloodclots), infarction, anoxia
3. Non-neurological alteration: physiological effects that can impact brain function, hyperthermia (excessive fever), electrolyte imbalance (dehydration, starvation), hyperventilation, damage to hypothalamus/pituitary gland

Question 29

The importance working as a part of a comprehensive rehabilitation team cannot be stressed enough. Name four of the six team members discussed in class and list the types of information that each team member can provide.

Answer 29

physician- location and severity of injury, other medical problems that may impact therapy, prognosis
nurse- best times of alertness & arousal, medicines & medicine schedule (when to best see client)
physical therapist-stamina, how long the client can engage in therapy, how to best position them during therapy
occupational therapist= ADLs, what skills to work on, strengths and weaknesses

Question 30

Suppose that a patient comes to your clinic for cognitive rehabilitation. Medical records state that the patient was involved in a motor vehicle accident in which his head hit the windshield. Which lobe(s) of the brain would you expect to be most affected? Name three deficits you may expect to see as a result of this damage.

Answer 30

The Front lobe (coup injury) is definitely the most likely point of impact in this type of incident, as well as one of the other three lobes (temporal, occipital, parietal ) as a point of impact for the contracoup injury. Any of the functions of the frontal lobe can be listed and/or functions of the other lobe listed. All four lobes should not be listed.

Question 31

When considering what type of external aid is most appropriate for a client, it is important to conduct a thorough needs assessment. Name the three factors to be considered in this process and give an example of how each factor can impact your choice of an external aid.

Answer 31

Correct Answer:
Organic factors - can the person read, write, does s/he have impaired vision, hearing, manual dexterity?
Personal factors - Can the patient afford the device, what have they used before, do they have family support for compliance?
Situational factors - Is the patient going to be using this device at work, school, does it need to be small and mobile, etc.?

Question 32

Contrast the effects of an open head injuy VS a closed head injury

Answer 32

Open Head Injury - focal lesion, fewer cognitive deficits, increased risk of infection, lesser risk of coma
Closed Head Injury - usually more diffuse lesion, coup/contracoup, more deficits, diffuse axonal injury, increased risk of coma. reduced incidence of infection.