ecu cognition Flashcards
what is a grade 1 concussion
person is confused but conscious
symptoms clear within 15 minutes
what is a grade 2 concussion
person remains conscious
develops amnesia
symptoms last longer than 15 minutes
what is a grade 3 concussion
overlaps with TBI
loss of consciousness
disruption of brain function
unconscious for seconds or minutes
what is post concussive syndrome
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
what are the levels of assessment for TBI
- severity: Glascow Coma Scale
- level of cognitive-behavioral function: Ranchos
- cognitive-communicative function
what does the glascow coma scale measure
- best eye response
- vest verbal response
- best motor response
what is the severity scale for the glascow
3-8 severe
9-12 moderate
13-15 mild
greater than or equal to 9 are not in a coma
what are symptoms of a mild TBI
- GCS 13-15
- brief post traumatic amnesia
- alteration in mental state (dazed, confused)
- focal neurological deficit
what is post traumatic amnesia
- retrograde: loss of memory before the injury. Prognostic predictor
- anterograde: loss of memory just before and following accident
what are the levels of severity for PTA
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
how would you assess patients in RLA level 1-111
- arousal/attention 6. tactile response
- auditory response 7. object manipulation
- ausitory comprehension 8. visual tracing
- visual comprehension 9. olfactory response
- expressive communication
which standardized assessments would you use for low level patients levels 1-3
- Western Neuro Sensory Stimulation Profile
- Coma Recovery Scale
- Agitated Behavior Scale
which cognitive domains would you assess
- alertness/attention
- perception
- orientation
- memory
- organization
- reasoning
- problem solving and judgment
what are the types of alertness
- tonic: intrinsic arousal that fluctuates from minutes to hours. Important for sustaining attention and for working memory and executive control
- phasic: rapid change in attention due to a brief event
what are the types of attention
- focused: on an object or person
- sustained: attend to a task from start to finish
- selective: ignore distractions
- alternating: switch attention from one task to next
- divided attention: multitask
- directed attention: executive functioning. Highest level
how do you assess orientation
non standardized: assess person, place, time, and situation
standardized measures : orientation section of the GOAT, and the Orientation Log
what is prospective memory
remembering to do things at certain times
what is retrospective memory
memory of past events includes declarative (what we know about things) and procedural (how to do things)
what are the types of decarative memory
- episodic: memory for personally experienced events
2. semantic: our organized knowledge of the world
what is affected by impaired abstract thinking
proverb interpretation
similarities and differences
categorization and sorting tasks
what affects the prognosis of recovery for TBI
- severity of TBI
- level of post traumatic amnesia
- severity of cognitive domains
- co-existing motor speech and language deficits
- co-existing medical issues
- pre-morbid level of functioning
- pre-morbid sociodemographic characteristics
what considerations should be made for treatment of TBI
- level of alertness
- attention span
- agitation
- level of memory impairment
- premorbid level of functioning/lifestyle
- functional goals
what are the general principles of TBI treatment
- remediation: retraining specific cognitive domains with that expectation that function will improve. Based on neuroplasticity
- Compensation: strategies which may be temporary or permanent
- modify the environment to maximize abilities
what are methods of cognitive-communication treatment
- drill and practice to stimulate damaged neural networks to restore specific skills
- 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
- errorless learning
- metacognitive skills training
- sensory stimulation