Final Flashcards
What percentage of people are left hemisphere dominant for language?
98%
What percent of left-handed people are left hemisphere dominant for language?
60% (the other 40% will be dominant for language in their right hemisphere)
What does a lesion to the non-dominant hemisphere cause?
cognitive-linguistic deficits
Which hemisphere has a higher ratio of white matter?
right (means there is more diffuse connection in the right hemisphere)
What would a lesion to the right temporal lobe result in?
- poor processing of nonverbal stimuli
- prosopagnosia
- difficulty interpreting facial expressions
- poor interpretation of emotional intonation
- poor voice recognition
What would a lesion to the right parietal lone cause?
- visuospatial deficits
- topographical disability
- attention problems
- anosagnosia
- constructional apraxia
what would a lesion to the frontal lobe cause?
- decreased inhibition
- distractibility
- problems with higher level thinking
- problems with executive functions
- decreased ability to profit from cues
What are some characteristics patients with NDHD may have?
- aprosodia
- hypermelodia
- problems with emotions
- problems understanding humor
- problems with discourse
what are the types of attention?
- sustained
- spatial selective
- alternating attention
- divided attention
What are things to work on for NDHD?
- comprehension and production of humor
- problem solving
- orientation
- neglect
- impulsiveness
- memory
- prosody
- inferences
- planning and organizing
Do people with right or left hemisphere strokes tend to experience more euphoria?
right hemisphere strokes
what things should you assess with NDHD?
- neglect
- attention
- discourse analysis
What are some assessments that can be used with NDHD?
- SLUMS
- Mini Mental
- MOCA
What kind of deficits result from a traumatic brain injury?
mostly cognitive-linguistic deficits
What is a closed head injury?
nothing penetrates the brain
What is an open head injury?
something has penetrated the skull
What is post concussion syndrome?
when the patients has dizziness, headaches, and problems with concentration and short term memory.
When can post concussion syndrome happen?
immediately or a few days later
Why do post concussion symptoms happen?
because there is damage to the reticular activating system
What is second impact syndrome?
when the brain hasn’t healed from the first concussion and then gets a second one
What is a coma?
a possible consequence of a TBI. A loss of consciousness for more than a concussion
Explain the alexander 6 point scale of recovery levels
1: coma
2: unresponsive vigilance
3: mute responsiveness
4: confusional state
5: independent self care
6: intellectual indepence
Explain the Ranchos levels
1: unresponsive
2: generalized response, inconsistent reaction (often stereotypic)
3: localized response
4: confused and agitated, possible confabulation
5. confused, inappropriate, non-agitated
6. confused, appropriate, comprehension is coming along
7. automatic, appropriate, patient is becoming more independent in self care
8. purposeful, appropriate
explain the Glasgow outcome scale
1=death 2= persistent vegetative state 3=severe disability 4=moderate disability 5=good recovery
How is a number given on the Glasgow coma scale?
based on patient’s eye movement, best motor response, and best verbal response
What score on the Rapport Coma/Near Coma scale means a vegetative state?
21 or more
Explain coma stimulation
stimulate different senses to stimulate the RAS, thalamus, and brainstem
What are some scales you can use to assess TBI?
- SCATBI
- RIPA
- Assessment of cognitive abilities
- COAT (after amnesia)
- GOAT (after amnesia)
What kind of approach can you use with TBI patients
Top down or bottom up approach (top down has the best results)
What is something you can do to help a patient in early stages of recovery?
coma stimulation
What is something you can do to help patients in the middle stages of recovery
focus on compensations and training
What is something you can do to help patients in the end stages of recovery
withdrawing some of the compensations that were put in place
Areas of treatment for TBI
- orientation
- attention/concentration
- memory
- organization
- problem solving
- social skills
- judgment
- safety with objects
- decreasing impulsivity
- behavior management
When does Alzheimers tend to present?
around a person’s 60s. chances grow by ten times by the person’s 80s
What are symptoms of dementia?
- recent memory loss
- emotional disturbances
- increased language problems
- intact motor skills
- steady pattern of decline
What are the language characteristics of dementia?
- receptive language will decline over time
- reading is a strength, but it isn’t comprehended
- visuospatial deficits
- word fluency is reduced
- patients are verbose without saying a lot
- may circumlocute
- grammar tends to stay intact
What is multi-infarct dementia?
happens when the patient has numerous strokes that are in location to cause cognitive decline
What kind of decline is MID?
stair step decline
What is Pick’s disease?
type of dementia where the patient can be very inhibited and make sexual advances towards people
What is frontotemporal dementia?
related to primary progressive aphasia
-language goes first, then cognition
What is the Hachinski Ischemic scale used for?
to differentiate between Alzheimer’s from MID
Things to consider during dementia treatment
- use of environmental aids
- help keep structure and routine
- initiation of activities
- be calm
What can you use to assess dementia
- MOCA
- Mini mental
- SLUMS
- Global deterioration scale
What should dementia treatment focus on?
- reality orientation
- compensation strategies
- procedural memory
What is Validation therapy?
-communicate about whatever reality the patient is in
What are the benefits of Validation therapy?
reduce anxiety and problem behaviors
-will also increase initiation, improve mood, and reduce agression
What is Reminiscence therapy?
using a lot of pictures and memorabilia to get the patient talking about things from his/her era
What is sensory stimulation?
-putting things near the patient that will be tangible cue from the client. Can use memory wallets or cards that contain relevant information
What is Spaced Retrieval therapy?
involves asking the patient to recall relevant information with systematically longer delays
What is the focused program?
F: face to face communication O: orient patient to topic C: continuity of topic U: unsticking any blocks (repairing breakdown) S: structured questions E: exchanging turns D: direct short sentences
What is the Montessori Method?
involves a lot of concrete materials that help enhance safety and decrease anxiety
What are some linguistic modifications that caregivers should make?
- stay pleasant
- ask yes/no questions
- keep language simple
- repeat yourself
- use concrete language
- use high frequency
- personally relevant topics
- converse about events that are in view
