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Cognitive > Lecture 3 > Flashcards

Lecture 3 Flashcards

1
Q

Attention

A
  • Attention is the allocation of processing resources
  • Attention forms the foundation for which all other cognitive skills are based
  • Attention difficulties may be more pronounced in less structured environments
  • Attention is the foundation for all cognitive processes are built upon.
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2
Q

Types of Attention

A
  1. Focused/Sustained
  2. Selective
  3. Alternating
  4. Divided
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3
Q

Focused/Sustained Attention

A

The state of focusing on one stimulus to the exclusion of all other competing stimuli

-“I try to watch TV but I just drift off.”

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4
Q

Selective Attention

A
  • The ability to focus on the important/relevant stimuli in the presence of distracting stimuli
  • “I can’t cook while there is noisy construction work happening next door; I get too distracted.”
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5
Q

Alternating Attention

A
  • An individual is asked to focus on any two tasks that require thought and are completed at the same time
  • “I can’t listen to a lecture and take notes at the same time.”
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6
Q

DIvided Attention

A
  • An individual is asked to complete two tasks at once but one of the tasks requires little to no thought
  • “I can’t brush my daughter’s hair while talking on the telephone; can’t do two things at once anymore.”
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7
Q

Frontal Lobe Disorders

A

The frontal lobes are responsible for higher-order functions; executive functions, emotional-behavioral-social control regulation, motor functioning, and the appropriate use of language, social pragmatics, and the subtleties of communication (innuendoes, humor)

  • Think of EMAPS
  • Houses intellect, cognitive processes, and regulates emotions
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8
Q

Frontal Lobe Damage

A

Motor impairment; halting/disorganized speech; personality changes; aphasia; apraxia; difficulty with emotional/behavioral control; Patients may exhibit passivity, apathy, or lack of internal drive/motivation

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9
Q

Executive Functions

A
  • The executive functions relate to one’s ability to use cognitive skills efficiently in a complex environment
  • EFs help us regulate our abilities so we can achieve goals
  • EFs are often performed without thinking and may be age-related in terms of development
  • EFs are an umbrella term that encompass many different skills
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10
Q

List of Executive Functions

A
  1. Planning and organization
  2. Multi-Tasking
  3. Learning Rules
  4. Motivation
  5. Generalization
  6. Flexible Thinking
  7. Problem Solving
  8. Social Behavior
  9. Initiating/Inhibiting Behavior
  10. Controlling emotions
  11. Monitoring Performance
  12. Self- Awareness
  13. Making decisions
  14. Goal setting
  15. Insight
    - do not need to think about performing these tasks (very little thought involved)
    EF’s allow you to have morals- determine right from wrong
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11
Q

Commonalities: Executive Function

A
  • Patients may begin a task prior to thinking through all of the steps
  • Repetition of a thought, behavior, action, or verbal utterance that continues even though it is no longer appropriate
  • Patients tend to think about features in lieu of groups or categories

-Inability to focus on more than one thing at a time
Patients are easily distracted

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12
Q

Pre-morbid responses

A
  • Prior to injury
  • inhibition
  • emotional stability
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13
Q

Post-Injury

A
  • Cognitive-Communication Deficits
  • Disinhibition
  • Emotional instability
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14
Q

Orientation

A
  1. Person
  2. Place
  3. Time
  4. Purpose
    - A patient is orientated times 4
    - Could be person, place, month, and year.
    - Use a calendar to reorient the patient about time
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15
Q

Types of Memory

A
  1. Procedural (implicit)
  2. Declarative (Explicit)
  3. Long term
  4. Recall
  5. Short term
  6. Episodic
  7. Prospective
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16
Q

Procedural (implicit)

A

Ability to perform skills in the absence of conscious awareness (motor memory). Remember the procedure for riding a bike.

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17
Q

Declarative (explicit)

A

-Factual memory, ability to do algebra, do well on tests, ability to recall so you don’t forget. Declarative memories can become procedural memories.

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18
Q

Long-term memory

A
  • (LTM)- recall of previously known information (remote memory) The ability to remember information we have stored. Challenge yourself-crossword puzzles and brain teasers
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19
Q

Short-term memory

A
  • (STM)- immediate recall of new visual or verbal information. Can recall 7 items, plus or minus 2
  • can use chunking to remember (don’t do this or add intonation to the list that a patient needs to remember)
20
Q

Recent memory

A

Delayed recall of information up to 30 minutes

21
Q

Prospective memory

A

The ability to recall information needed in the future

22
Q

Episodic memory

A

-Recall of temporarily dated events. Tied to a date in time or an episode

23
Q

Problem Solving

A
  1. Identifying Problems
  2. Generating Solutions
  3. Organizing
  4. Sequencing
  5. Implementing Solutions
  6. Managing Time
  7. Self-Monitoring
  8. Safety

o Needs to use attention skills as well as executive functioning

o Organize- make lists

o Sequencing- steps in order of importance

24
Q

Broad based test

A
  • nonspecific tests, test all aspects of language or cognition- CASL or CELF
25
Q

Specific tests

A

o Specific tests- EOWPVT (semantic test) and ROWPVT (receptive semantic test)
• Behavioral test of inattention- targets attention

26
Q

Critical thinking

A
  1. Drawing inferences
  2. Deductive reasoning
  3. Inductive reasoning
  4. Abstract reasoning
  5. Flexibility of thought
27
Q

Drawing inferences

A
  • Making a connection between two otherwise unrelated facts
28
Q

Deductive reasoning

A
  • Arrive at a conclusion based on known facts
29
Q

Inductive reasoning

A
  • The process of determining how to achieve a goal or solve a problem (involves inference)
30
Q

Abstract reasoning

A
  • Drawing conclusions based on notions, ideas, concepts that are not tangible
31
Q

Flexibility of thought

A

-Shifting from one idea to another with relative ease

32
Q

Behavior

A
  • Aspects of behavior associated with cognitive communication disorders
  • metacognition
  • communication problems
33
Q

Communication Challenges

A
  • Cognitive-Communication challenges impact the social, academic, behavioral, and vocational lives of survivors
  • Typically, survivors of TBI have intact grammar and semantic knowledge; language appears fluent
  • Deficits tend to lie in the areas of meta-semantics and pragmatics (both verbal and nonverbal types)
34
Q

Meta-Semantic Deficits

A
  1. Word-retrieval deficits (anomia)
    - —–Shed light on deficits- create deficit awareness for patients
    - —–Give patients time to process information
    - —-Patients can have poor deficit awareness
    - —-Latency period- period of time when you ask patient to respond and their response. In assessment you can note that a patient has an increased latency period.
  2. Lack of cohesive speech with poor knowledge of figurative language; their language can be very concrete centered
  3. Difficulty understanding words with multiple meanings
  4. Difficulty integrating and synthesizing information (parts = whole); figuring out salient from irrelevant information
  5. Slower processing speed
  6. Confabulation (lack of truthfulness)
35
Q

Pragmatics

A
  • Pragmatics is generically defined as the social use of language
  • Pragmatics is specifically defined as functional use of verbal and nonverbal modes of communication to convey and interpret intended messages
36
Q

Verbal pragmatic deficits

A
  • Tangential Speech: Conversation topics shift without listener notification
  • Limited communication initiation or maintenance per interaction with others
  • Decreased topic maintenance
  • Inappropriate topic selection
  • Inadequate topic relevance
  • Poor presupposition skills
  • –implicit assumption about the world or background belief relating to an utterance whose truth is taken for granted in discourse.

Example:
Jane no longer writes fiction.
Presupposition: Jane once wrote fiction.

37
Q

Nonverbal pragmatic deficits

A
  • Poor eye contact; includes both too much and insufficient amounts
  • Flat affect; Poor use of facial expressions to convey emotions
  • Lability; emotional excess
  • Inappropriate proxemics
  • Inappropriate physical contact
  • Decreased understanding of other’s nonverbal cues
38
Q

Amnesia

A
  • Traumatic brain injury can leave old memories intact but hinder the ability to store and/or retrieve new memories; also includes learning new information
  • Impaired attention can also make learning new information difficult
39
Q

2 types of Amnesia

A
  1. Anterograde amnesia

2. Retrograde amnesia

40
Q

Anterograde Amnesia

A

-Loss of the ability to learn and recall new information after the trauma

41
Q

Retrograde Amnesia

A

-Loss of memories stored before an injury

42
Q

Seizures

A
  • Change in behavioral state as a result of abnormal electrical activity within the brain
  • The occurrence of a seizure in the presence of some acute precipitating physiological disturbance does not mean that it will ever happen after the cause has been resolved
  • When seizures occur without any obvious precipitant or cause, then a person may be considered to have a form of epilepsy

o Know the different types of seizures in case you see them in a chart
o No medicine can prevent TBI seizures
o Place patient on the floor, move everything out of the way

43
Q

Seizure Types

A
  1. Generalized Seizures:
    Increased electrical impulses occur throughout the brain
  2. Partial Seizures:
    References relatively small electrical impulses in more focal parts of the brain
  3. Nonepileptic Seizures:
    Not caused by abnormal electrical activity in the brain
  4. Status Epilepticus:
    Prolonged seizures; continuous state of seizure
44
Q

Post-traumatic seizure disorder

A
  • Seizures are common following TBI and are broken down into two separate categories:
  • Seizures that occur within a seven day post-injury window; Patient is still in ICU or in the acute stage
  • Late onset seizures that occur more as focal issues
45
Q

General seizure information

A
  • Seizure incidence is higher in children than in adults
  • Late seizures are more likely to occur in adults or when the head injury was of the penetrating type
  • There are no anti-epileptic medications that will protect against post traumatic epilepsy
  • Depressed skull fractures and hemorrhagic contusions tend to predispose patients to seizure disorders
46
Q

Concomitant Issues (TBI)

A
  1. Post-traumatic headaches
  2. Post-traumatic fatigue
  3. Somnolence (sleepy)
  4. Balance disorders
  5. Sexual disorders
  6. Depression
  7. Mania
  8. Anxiety Disorders
  9. PTSD
  10. Personality Changes
  11. Aggression
    - etc
47
Q

Depression following TBI

A
  • The level of brain injury severity poorly predicts a patient’s level of depression or susceptibility to a depressed state
  • Pre-injury depression is common
  • Increased anxiety levels + depression often coinside
  • Decreased left prefrontal gray matter volume often correlates with depression
  • Pre-injury aggression and hostile features may predict suicidal behavior

Cognitive (14 decks)

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