Quiz #3 Flashcards

Question

Treatment (reading)

Answer 1

- Visual scanning therapy | - "Edgeness" for neglect

Answer 2

Teach overt rules of social interaction by watching others, then attempting to transfer

Answer 3

- Object sorting - Trail-making (#s, word-finding) - Listening for targets - Simple games (checkers, tic-tac-toe, Go Fish, poker, solitaire)

Answer 4

Stroop task - Say colors, ignore words - Say words, ignore colors Letter cancellation Distractors (radio, tv)

Answer 5

- Sorting | - 2 simultaneous games

Answer 6

Answering questions while completing a taks

Answer 7

- Impulsivity - Memory (metamemory) - Problem solving/reasoning - RC - Homonyms - Inferencing - Humor - Error recognition - Distractibility - Slower rate of learning - Motivation - Judgement

Answer 8

- Performance prediction/appraisal - Build/maintain rapport - Counsel pt/family - Practice patience - Generalization is key - Measure outcomes (functional, QOL, NOMS system) - Consider degree of neglect - "Sell" the rationale - Utilize pt's spontaneous productive strategies - Practice for generalization - Self reliance is the goal

Answer 9

Natural settings for tasks -Barrier tasks (e.g., PACE) Targets of opportunity -Teachable moments Incorporate self-monitoring/instruction

Answer 10

- Medical issues - Age - Education - Social involvement

Answer 11

FIMS - Asks about pt's competency - Multidisciplinary

Answer 12

- Maximum benefit - Decision will often be mutual - Special problem of college clinics

Answer 13

- There's nothing you can't count - Use probes for efficient documentation - Don't keep data in your head - Document generalization - Be creative

Answer 14

- Major cause of death in U.S. - High risk groups: racial & ethnic minorities, service members/veterans, homeless, those in correctional & detention facilities, survivors of intimate partner violence, those in rural areas

Answer 15

- Falls lead to nearly 1/2 of TBI related hospitalization - Firearm related suicide is most common cause of TBI related deaths - MVAs & assaults are also common - TBI can be overlooked among older adults - About 10% of TBIs are due to assaults - Men were nearly 3x as likely to die as women - Falls were leading cause among children ages 0-14 & adults 45 years + - MVAs were leading cause of hospitalizations for adolescents & young adults ages 15-44 years - 40-60% of pts are intoxicated when admitted

Answer 16

- School adjustment (poor academic performance) - SES - Divorce rates 4x likely - Type A > Type B - Homeless 3x greater than general public - High risk sports

Answer 17

- ~6 million survivors alive today - As many as 1/2 admitted to hospital w/ TBI are intoxicated (male drivers 16-44 2x as likely to be intoxicated) - 50% of young males have poor academic history; increased probability of 2nd TBI

Answer 18

Actual impact to brain

Answer 19

- Infection - Hypoxia - Edema - Increased intracranial pressure - Infarction - Hematoma

Answer 20

- Fatigue - Seizure activity - Spasticity - Changes in bowel/bladder - Dysphagia

Answer 21

Penetrating head injury

Answer 22

- Non-penetrating brain injury (no opening or breakage of skill) - More common thna open head injuries - Most often caused by MVAs

Answer 23

1 side of head is hit but impact causes opposite side of brain to be injured (whiplash)

Answer 24

When cell bodies on outside of brain are injured in 1 place but b/c brain is shaken around, fibers become twisted & ripped & can't send messages to other areas --> creates a lot of problems

Answer 25

- Struck by particles impelled w/ violent force from an explosion - Nothing hits head primarily - Levels of damage: primary (explosion itself), secondary (energized fragment move around), tertiary (thrown from blast into object), fourth (blood loss, amputation, inhalation of toxic gas)

Answer 26

Sudden acceleration or deceleration of the head, causing brain & brainstem to suffer diffuse damage caused by their movement inside skull

Answer 27

Caused by sudden acceleration of head by a force that moves through midline

Answer 28

Sudden deflection & rotation of head by a force that strikes head at an angle

Answer 29

Causes less severe brain damage than acceleration injuries. Deformation of skull by impact of object striking skull

Answer 30

Evident in ~25% of all TBI clients Most common problems: - Delayed triggering of swallow responses - Reduced tongue control - Reduced pharyngeal transit - Sensory problems Worsened by: - Cognitive impairments - Respiratory impairment - Inability to cough - Medications

Answer 31

- Focused attention - Sustained attention (vigilance) - Selective attention - Alternating attention - Divided attention

Answer 32

Pre-traumatic amnesia (retrograde) -Doesn't remember anything before incident Post-traumatic amnesia (anterograde) -Remember everything up to incidents, but difficulty forming new memories

Answer 33

"Cognitive-Communication Disorder" All of the above deficits impact language & communication - Bilateral & diffuse damage compound communication problems - Attention deficits interfere w/ comprehension - Aphasia may or may not be clearly present (usually fluent or anomic & deficits in all 4 modalities)

Answer 34

People with TBI generally experience: - Irritability - Aggression - Anxiety - Depression - Dis-inhibition (impulsiveness) - Social inappropriateness - Rage reaction - Pseudo-bulbar affect

Answer 35

- Slowed processing - Excessive cautiousness - Perseveration - Concreteness - Catastrophic reactions - Sexual frustation

Answer 36

Duration of coma (generally longer in coma, poorer prognosis) Duration of posttraumatic amnesia (longer is lasts, poorer prognosis) Patient related variables - Age - Substance abuse - Education - Intelligence - SES - Personality

Answer 37

Warnings: - Use caution when using existing standardized tests - Evaluate individual's pre-injury characteristics - Collaborate w/ other professionals in interpreting level of impairment

Answer 38

Coma (typically come out 3-4 wks after injury, but not always) Vegetative state -Persistent vegetative state lasts no longer than 1 month Minimally conscious state --> have to exhibit 1 or more of the following: - Follow simple commands - Intelligible verbalizations - Movements/emotional responses to environmental stimuli (purposeful reaching, frowning, crying, visual tracking)

Answer 39

1. Inform patient & caretaker(s) about nature & consequences of disorder 2. Provide appropriate treatment approaches & techniques

Answer 40

- Management of health & disability - Management of grief & coping - Acceptance of injury & redefinition of self - Development of social support networks - Empowerment

Answer 41

Neuronal growth through repetitive exercises & drills

Answer 42

Circumventing the impaired functions (component training)

Answer 43

Anything you do to environment to make person more aware of impairments

Answer 44

Train person to use compensatory strategies in certain situations

Answer 45

Training person to evoke strategy when they perceive that a problem is occurring

Answer 46

Teach person to use strategy at 1st sign of impending problem or maybe even before problem happens

Answer 47

- Sensory stimulation - Orientation - Behavior management - Pharmacologic intervention - "Component training" e.g., memory, attention, awareness, reasoning, problem solving, visual processing

Answer 48

Poor awareness: 1. Intellectual awareness: basic understanding that there's an impairment 2. Emergent awareness: how they are conducting themselves when engaged in task 3. Anticipatory awareness: reflective on future & consequences of their actions

Answer 49

- Scanning drills - Figure-ground discrimination - Mental manipulation of visual stimuli

Answer 50

Language & communication Time pressure management Compensatory memory strategies - Internal strategies: mnemonic devices, imagery, self-talk - External aids: checklists, calendars, phones - Environmental compensation - Setting these everyday routines - Group treatment