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Neuro Eval > Session 16 - TBI, Rancho Los Amigos Levels, Cognitive Rehabilitation FOR > Flashcards

Session 16 - TBI, Rancho Los Amigos Levels, Cognitive Rehabilitation FOR Flashcards

1
Q

injury caused by a direct or indirect force with no resultant penetration into the skull (Ex: external force, rotational or deceleration injuries)

A

closed head injury

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2
Q

injury caused by an external force with resultant penetration of the skull (Ex: skull fracture)

A

open head injury

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3
Q
  • most common TBI
  • Wide range of severity
  • direct blow
  • whiplash
A

concussion

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4
Q
  • direct blow

- bruise to the brain or bleeding into brain tissue

A

contusion

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5
Q

bruising at initial site of force or impact and then at back of head

A

coup-contrecoup injury

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6
Q
  • gun shot wound
  • Knife wound
  • other sharp object
A

penetrating injury

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7
Q

name 6 secondary health complications of TBI.

A
  • seizures
  • hydrocephalus
  • infection
  • polytrauma
  • vascular injuries or internal bleeding
  • deep vein thrombosis
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8
Q

a condition resulting in extensive lesions in white matter (Sheering forces) and a major cause of coma or vegetative state

A

diffuse axonal injury

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9
Q

name the 5 most vulnerable areas for diffuse axonal injury.

A
  • cerebral cortex
  • corpus callosum
  • cerebral peduncles
  • basal ganglia
  • thalamus
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10
Q

name 4 common types of occurrences of diffuse axonal injuries.

A
  • MVA, fall or other accident
  • strong rotation of head or blow to the head
  • shaken baby syndrome
  • blast injury (military-related TBI)
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11
Q
  • Specific and localized

- Usually more manageable and less impairment level seen

A

focal injuries

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12
Q

name the 4 anatomical substrates that are important for attention functions.

A
  • brainstem
  • thalamus
  • limbic system connections
  • neurotransmitters
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13
Q

ascending reticular activating system (ARAS) in the reticular formation

A

brainstem

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14
Q

attends to right and left sides

A

right hemisphere

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15
Q

mainly attends to right side

A

left hemisphere

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16
Q
  • strong reciprocal connections btwn frontal and parietal lobes for processing of multi-modal stimuli
  • connected with heteromodal association cortex (lateral parietal cortex, temporal association cortex, and occipital association cortex)
A

frontal and parietal association cortex

17
Q
  • role: coordination with parietal, occipital and temporal cortex, and brainstem for processing attention
  • role: frontal eye fields direct and initiate eye movements toward target of interest for sustained or directed visual attention
A

frontal heteromodal association area aka anterior multimodal association area (found in prefrontal cortex)

18
Q

Degree of generalized readiness to receive information

A

alertness

19
Q

Ability to choose specific stimuli while suppressing irrelevant stimuli

A

attention

20
Q

Highest level of attention processing used to direct all actions

A

awareness

21
Q

Parietal Lesion with resultant Hemi-spatial Neglect Syndrome

A

right hemisphere stroke

22
Q

no response

A

Level 1 - Ranchos Los Amigos Levels of Cognitive Function

23
Q

generalized response

A

Level 2 - Ranchos Los Amigos Levels of Cognitive Function

24
Q

localized response

A

Level 3 - Ranchos Los Amigos Levels of Cognitive Function

25
Q

confused - agitated

A

Level 4 - Ranchos Los Amigos Levels of Cognitive Function

26
Q

confused - inappropriate

A

Level 5 - Ranchos Los Amigos Levels of Cognitive Function

27
Q

confused - appropriate

A

Level 6 - Ranchos Los Amigos Levels of Cognitive Function

28
Q

automatic - inappropriate

A

Level 7 - Ranchos Los Amigos Levels of Cognitive Function

29
Q

purposeful - appropriate

A

Level 8, 9, 10 - Ranchos Los Amigos Levels of Cognitive Function

30
Q
  • disorders of consciousness
  • coma
  • vegetative state
  • minimally conscious state
  • responses: eye opening, sleep-wake cycles, visual tracking, object recognition, command following, communication
  • coma – none
  • vegetative state – eye opening, sleep-wake cycles
  • minimally conscious state – eye opening, sleep-wake cycles, others inconsistently
  • concern with responses to stimuli
  • ranges from initially none to inconsistent to non-purposeful
  • assessed in highly controlled fashion
  • addressing initial sensory inputs: tactile, visual, olfactory, auditory, gustatory, and pain
A

levels 1 - 4 - Ranchos Los Amigos Levels of Cognitive Function

31
Q

name 2 general OT interventions for ranchos los amigos levels 1-4.

A
  • introduction to environmental stimuli in a controlled manner
  • beginning motor control and address motor impairments - ROM, positioning, muscle tone, mobility in and out of bed
32
Q
  • concern with agitation and aggression as RAS is easily over stimulated and unrelated
  • focus on basic attention and vision/perception
  • addressing increase in skill with increased normal sensory modulation
A

rancho los amigos - levels 5-8

33
Q

name 6 general OT interventions for levels 5-8 of ranchos los amigos.

A
  • introduction to environmental stimuli in a controlled manner
  • work on addressing neurobehavioral issues and cognitive deficits
  • beginning motor control and address motor impairments
  • cognition
  • basic ADL functioning
  • family and caregiver education and training
34
Q
  • attention, concentration, memory/recall
  • awareness, judgment/safety
  • organization, problem-solving
  • flexibility, self-monitoring
  • higher order cognitive skills
  • executive functions
  • grade skills with demands of task and environment based on individual’s ability
  • still needs highly structured tasks (may decrease over time)
  • may be independent and functional with structure
A

levels 8-10 - ranchos los amigos

35
Q

name 4 aspects of OT interventions for levels 8-10 of ranchos los amigos.

A
  • grade skills with demands of task and environment based on individual’s ability
  • still needs highly structured tasks (may decrease over time)
  • May be independent and functional with structure
  • family and caregiver education and training

Neuro Eval (20 decks)

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