Final Flashcards
The general term that reflects the mental enterprises related to absorbing information, thinking, and goal-direction action
Cognition
A systematic functionally oriented service of therapeutic cognitive activities based on an assessment and understanding of the person’s brain-behavior deficits for the overall goals of generalizing to promote improvement in daily life
Cognitive rehabilitation
Knowledge about one’s own cognitive processes, has been described as cognition about cognition and knowing about knowing, self-awareness of one’s own strengths and weaknesses
Metacognition
Being awake, not in a stuporous state, refers to readiness of the CNS to receive information
Alertness
Information entering the system by one or more primary systems
Sensory register
The mental process by which information is recognized, labeled, and understood by means of intact visual and language systems, required fir LTM and STM
Encoding
The mental process of recall or “pulling” information from memory either by recognition or independently recalling from storage or long-term memory
Retrieval
Maintenance of information presented a brief period prior to recall or recognition; usually with no intervening distractors
STM
Storage and retrieval through recall/recognition of information “some time” after initial presentation
LTM
The ability to understand self and the relationship to the past and present environment. Traditionally involves awareness in 4 spheres: person, place, time, and circumstance. May be negatively affected by disturbances in attention and/or memory
Orientation
A pervasive attentional deficit leading to disorientation
Confusion
The period following the comatype stage that is characterized by the inability to store/recall information on a day to day or minute to minute basis
Post-traumatic amnesia (PTA)
In the period of PTA, refers ro the loss of information or recall of experiences acquired after the injury
Anterograde memory loss
Inability to recall information stored prior to the injury, including orientation to person and other autobiographical information, considered a sign of diffuse and/or severe involvement
Retrograde amnesia
Incorrect verbal responses to orientation questions, may be bizarre or plausible but incorrect
Confabulation
Top 5 causes of TBI in order
Falls, other/unknown, struck by/against, motor vehicle, assaults
TBI peak ages
Very young children (0-4), adolescents and young adults (15-19), older adults (75+)
Frontal lobe functions
Executive functioning, initiation, termination, motor and visual involvement
TBI that occurs when an object, such as a bullet, backed by a strong force fractures the sill and meninges, damaging brain tissue and surrounding membranes
Meninges and skull fracture
Open TBI
TBI that occurs when brain tissue impacts the inside of the skull
Closed TBI
TBI symptoms resulting immediately from initial trauma
Primary TBI
TBI symptoms that are changes evolving over a period of time (hours to days) after the initial injury
Secondary TBI
Mild jostling of the brain, results in headaches, fatigues, and trouble with attention
Most common TBI, caused when the brain receives trauma from an impact or sudden momentum or movement change
Concussion
A region of injured brain tissue or skin in which blood capillaries have been ruptured, causing a bruise and increase in intracranial pressure
Contussion
2 types of contussion
Coup, contrecoup
Type of contussion that occurs under the site of impact with an object, associated with cerebral contusions
Coup
Type of contussion that occurs on the opposite side of the brain that was hit
Contracoup
Twisting motion of the brain, axonal pathways disturbed, occurs over a widespread area
Diffuse axonal injury
Mild TBI
GCS: 13-15, PTA greater than 1 hour
Moderate TBI
GCS: 9-12, PTA 1-24 hours
Severe TBI
GCS: 9 and below, PTA greater than 24 hours
Intervention for Rancho levels 1-3
Environment, positioning, PROM, sensory stimulation, communication, family involvement
Subtype of delirium in the coma-emerging patient that is associated with frontotemporal injury, disorientation, comorbid medical complications, and/or use of anticonvulsant medication. Causes excesses of behavior that include some combination of aggression, akathisia, disinhibition, and emotional lability
Agitation
ABCs of behavior management also called
Positive behavior supports/management and proactive behavior management
What do the ABCs stand for in behavior management?
Antecedent, behavior, consequence`
Rancho levels for high cognitive impairment
4-6
Rancho levels for moderate cognitive impairment
6-7
Rancho level for low cognitive impairment
8-10
Behavioral interventions for high cognitive impairment
restraints, prevention, positive approach and antecedents, environmental considerations for safety, extinctions, calm approach, redirect, do not over-explain, avoid questioning strategies, distraction
Behavioral interventions for moderate cognitive impairment
Positive reinforcements/antecedents, reward systems, time out, redirect or substitute, explain, structure, repetition
Behavioral interventions for low cognitive impairment
Explanations of long-term consequences, oral agreements, contracts, corrective feedback, consider safe natural consequences allowed, consider group intervention and peer feedback, teach compensatory strategies, consider use of AT, teach self-management strategies
Hierarchy for process specific approach to cognitive rehab
Reasoning and concept formation, memory, visual-spatial processing, motor planning, orientation, attention/concentration, cognitive rehabilitation
Systematic intervention that is directed to achieve functional changes by reinforcing, strengthening, or re-establishing previously learned patterns of behavior or establishing new patterns of cognitive activity or mechanisms to compensate for impaired neurological systems
Multidisciplinary field and broad category of intervention methods aimed at improving cognitive functioning
Cognitive rehabilitation
Rancho scale progresses from ________ to _______
No response, purposeful & appropriate
Coma occurs at what level
1
Unarousablility with absence of sleep wake cycles and inability to interact with the environment
Coma
What level is associated with vegetative state?
Level 2
Capacity for spontaneous arousal, but still a complete inability to interact with environment, follows initial coma period and behavior is reflexive only
Vegetative state
At what stage does minimally conscious state occur?
Level 3
Have some conscious awareness, only some awareness of self or environment, follow simple commands, but inconsistent responses and require relevance and structure
Minimally conscious state
Abnormal extensor tone in UEs and LEs, wrist flexion and internal rotation
Decerebrate rigidity
Decerebrate rigidity indicates damage where?
Upper midbrain and lower pons
Abnormal flexion in UEs and extension in LEs, indicates internal capsule or other cortical disruption of the corticospinal pathways
Decorticate Rigidity
Level with no response
1
Level with generalized response
2
Nonspecific, inconsistent and non-purposeful reaction, not necessarily related to environmental stimuli
Generalized response
Level with localized response
3
Response is directly related to type of environmental stimulus but is inconsistent and/or delayed
Localized response
The ability to respond discretely to specific visual, auditory, or tactile stimuli
Focused attention
The ability to maintain a consistent behavioral response during continuous or repetitive activity
Sustained attention
Maintaining a behavioral or cognitive set in the face or competing or distracting stimuli, requires activation and inhibition of responses
Selective attention
The mental flexibility which allows an individual to shift focus of attention and move between tasks having different cognitive requirements, requires rapid switching from one response to another
Alternating attention
The ability to respond simultaneously to multiple tasks or multiple task demands, most difficult level of attention/concentration
Divided attention
The ability to recall such information as name, age, birthplace, marital status, and family members
Orientation to personal information
Identifying by name or role, familiar family members, friends, staff, or other patients in environment
Orientation to persons in immediate environment
Identifying one’s own hospital room, OT room, the building one is in, community, state, and country
Identifying immediate environmental factors
Includes the ability to state time, date, season, facts about daily scheduled events
Recall or independently locate information regarding time
Includes information about the events occurring in one’s community, state, or country, sports or political events, current president
Recall current events
Visual, auditory, and tactile stimulation facilitates a selective sensorimotor response
Generalized movement is possible in response to sensory stimulation
Specific, discrete motor responses either toward or away from a stimuli; these may be reflexive/spontaneous volitional (body turning, limb withdrawal, eye blink, vocalization)
Localized body movement occurs in response to discrete stimuli
The achievement and maintenance of a posture may be facilitated by external cues (visual, verbal, tactile)
Ability to achieve and maintain limn or body posture
The ability to reliably and volitionally produce hand or limb movements either of a familiar or unpracticed/novel nature
Ability to achieve hand and limb postures or movements
Involves re-establishing of transitional body motion, or limb and hand motions of either a familiar or unfamiliar nature
Ability to produce sequenced movements