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ecu cognition Flashcards

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1
Q

what is a grade 1 concussion

A

person is confused but conscious

symptoms clear within 15 minutes

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2
Q

what is a grade 2 concussion

A

person remains conscious
develops amnesia
symptoms last longer than 15 minutes

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3
Q

what is a grade 3 concussion

A

overlaps with TBI
loss of consciousness
disruption of brain function
unconscious for seconds or minutes

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4
Q

what is post concussive syndrome

A 
history of head trauma that causes concussion 
greater than 3 occur
1. becomes fatigues easily
2. disordered sleep
3. headache
4. vertigo
5. irritability
6. anxiety
7. change in personality
8. apathy
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5
Q

what are the levels of assessment for TBI

A
  1. severity: Glascow Coma Scale
  2. level of cognitive-behavioral function: Ranchos
  3. cognitive-communicative function
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6
Q

what does the glascow coma scale measure

A
  1. best eye response
  2. vest verbal response
  3. best motor response
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7
Q

what is the severity scale for the glascow

A

3-8 severe
9-12 moderate
13-15 mild
greater than or equal to 9 are not in a coma

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8
Q

what are symptoms of a mild TBI

A
  1. GCS 13-15
  2. brief post traumatic amnesia
  3. alteration in mental state (dazed, confused)
  4. focal neurological deficit
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9
Q

what is post traumatic amnesia

A
  1. retrograde: loss of memory before the injury. Prognostic predictor
  2. anterograde: loss of memory just before and following accident
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10
Q

what are the levels of severity for PTA

A 
less than 5 minutes: very mild
 5-60 minutes: mild
1-24 hour: moderate
1-7 days: severe
1-4 weeks: very severe
more than 4 weeks: extremely severe
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11
Q

how would you assess patients in RLA level 1-111

A
  1. arousal/attention 6. tactile response
  2. auditory response 7. object manipulation
  3. ausitory comprehension 8. visual tracing
  4. visual comprehension 9. olfactory response
  5. expressive communication
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12
Q

which standardized assessments would you use for low level patients levels 1-3

A
  1. Western Neuro Sensory Stimulation Profile
  2. Coma Recovery Scale
  3. Agitated Behavior Scale
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13
Q

which cognitive domains would you assess

A
  1. alertness/attention
  2. perception
  3. orientation
  4. memory
  5. organization
  6. reasoning
  7. problem solving and judgment
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14
Q

what are the types of alertness

A
  1. tonic: intrinsic arousal that fluctuates from minutes to hours. Important for sustaining attention and for working memory and executive control
  2. phasic: rapid change in attention due to a brief event
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15
Q

what are the types of attention

A
  1. focused: on an object or person
  2. sustained: attend to a task from start to finish
  3. selective: ignore distractions
  4. alternating: switch attention from one task to next
  5. divided attention: multitask
  6. directed attention: executive functioning. Highest level
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16
Q

how do you assess orientation

A

non standardized: assess person, place, time, and situation

standardized measures : orientation section of the GOAT, and the Orientation Log

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17
Q

what is prospective memory

A

remembering to do things at certain times

18
Q

what is retrospective memory

A 
memory of past events
includes declarative (what we know about things) and procedural (how to do things)
19
Q

what are the types of decarative memory

A
  1. episodic: memory for personally experienced events

2. semantic: our organized knowledge of the world

20
Q

what is affected by impaired abstract thinking

A

proverb interpretation
similarities and differences
categorization and sorting tasks

21
Q

what affects the prognosis of recovery for TBI

A
  1. severity of TBI
  2. level of post traumatic amnesia
  3. severity of cognitive domains
  4. co-existing motor speech and language deficits
  5. co-existing medical issues
  6. pre-morbid level of functioning
  7. pre-morbid sociodemographic characteristics
22
Q

what considerations should be made for treatment of TBI

A
  1. level of alertness
  2. attention span
  3. agitation
  4. level of memory impairment
  5. premorbid level of functioning/lifestyle
  6. functional goals
23
Q

what are the general principles of TBI treatment

A
  1. remediation: retraining specific cognitive domains with that expectation that function will improve. Based on neuroplasticity
  2. Compensation: strategies which may be temporary or permanent
  3. modify the environment to maximize abilities
24
Q

what are methods of cognitive-communication treatment

A
  1. drill and practice to stimulate damaged neural networks to restore specific skills
  2. dual task training: improves task complexity by targeting the ability to carry out 2 competing tasks. (divided attention). Can be a cognitive paired with a motor task
  3. errorless learning
  4. metacognitive skills training
  5. sensory stimulation
25
Q

what is errorless learning

A

SLP prevents the patient from making errors during the learning phase by
1. breaking task down into small steps
2. provide several models before the patient is asked to perform
3. avoid guessing
4. immediately correct errors
5. fade prompts
best for patients with intact procedural memory

26
Q

what is metacognitive skills training

A
  1. focuses on improved awareness, self monitoring, and self regulaton
  2. helps client recognize problem situations
  3. helps client identify strategies that will assist in daily living
27
Q

what is sensory stimulation treatment

A

also known as coma stimulation.
systematic exposure of a comatose, vegetative, or minimally conscious patient, to environmental stimuli
includes visual, tactile, olfactory, auditory, and kinesthetic senses

28
Q

when is sensory stimulation treatment used

A

ranchos level 1=3.

ICU or Coma Unit

29
Q

when is Cognitive Communication Rehab used

A

inpatient rehab

Ranchos levels 4-8

30
Q

when is reintegration, modified environments used

A

Inpatient
outpatient
day therapy
Ranchos 7-10

31
Q

when is reintegration done in a natural environment

A

ranchos 8-10

32
Q

how do you treat focused attention

A 
focused attention: low level patients: 
1. localize to a sound
2. localize to touch
3. find an object in the environment
4. track a person or object across the midline
high level patients
1. tap the table every time you hear me say the letter A
2. word generation task
3. letter/number/symbol cancellation
4. dot to dot
33
Q

how do you treat sustained attention

A

increase the amount of time a person is able to consistently sustain their attention on a task (eating a meal, flipping through a magazine)

34
Q

how do you treat selective attention

A

can they attend to the task with distractions or background noise

  1. in therapy use any sustained attention task and add distraction
  2. gradually increase the level of distractions by increasing noise or moving to a busy place to complete treatment
35
Q

how do you treat alternating attention

A
  1. can a person continue a task with high level of accuracy when you change the rules (sorting cards by number for a minute then change to sorting by shape)
  2. can a person shift their attention between two things
    (coding activity: assign each letter a number and decode the secret message
36
Q

how do you treat divided attention

A
  1. assign a patient 2 equally important tasks to complete simultaneously (symbol cancellation where they must locate at least 2 symbols; hold a conversation while playing a game)
37
Q

how do you treat memory

A
  1. have client restate in own words
  2. rehearse info
  3. complete real life tasks for practice
  4. compensatory strategies
    Write
    Repeat
    Associate
    Picture
38
Q

what do you treat at Ranchos levels I. II. III

A

level of alertness

response to stimuli

39
Q

what do you treat at Ranchose levels IV, V, VI

A 
environmental management
1. stimulation management
2. freedom of movement
3. avoid unstructured time
4. fit schedule to client
physical management
1. physical management of aggressive behaviors
medication management
40
Q

what do you treat at Ranchos level VII-X

A 
high level cognitive rehab
1. attention concentration
2. working memory
3. executive functins
behavior impairments
family rehab
community reintegration

Praxis (20 decks)

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