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Neuroconditions 2022 > TBI and Concussion > Flashcards

TBI and Concussion Flashcards

1
Q

What is RLA level IV

A

Confused agitated

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2
Q

describe RLA IV

A

confused agitated
heightened state of activity
bizarre behavior
patient is unable ot cooperate directly with treatment efforts
confabulation may be present
brief attention to environ,emt
no short or long term recall

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3
Q

What are the PT roles for RLA IV

A

mobilize with consideration
low stimulation environment with structured times for therapy
assist with sleep wak cycle
short sessions

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4
Q

What is RLA Level V

A

Confused inappropriate

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5
Q

describe RLA V

A

confused inappropriate
follows simple commands
gross attenton to the environment but highly distractable
lacks ability to focus on specific task
verbalization is often inappropriate and confabulatory
memory is impaired
difficultly learning new information

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6
Q

What are the PT roles for RLA V

A

environemental modification
progress mobility
structured short sessions
directed tasks vs automatic tasks
consider implicit learning over explicit

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7
Q

What is focused attention

A

focus on and respond to a specific stimulus

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8
Q

What is sustained attention

A

sustain attention over a period of time

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9
Q

What is selective attention

A

focus attnetion in the presence of distracting stimuli

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10
Q

What is alternating attention

A

Shift focus of attention from one task to another

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11
Q

What is divided attention

A

respond simultaneously to multiple tasks

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12
Q

at is RLA Level VI

A

confused appropriate

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13
Q

Describe RLA Level VI

A

confused appropriate
goal directed behavior but is dependent on external input for direction
follows simple directions
shows carryover
errorless learning (mmultiple reps and guidance needed)
past memories show more depth

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14
Q

What are the PT roles for RLA VI

A

prevent learneed non-use
constraint induced therapy may be initiated
BWSTT
incorporate goal directed tasks, ADLs

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15
Q

What is errorless learning (ELL)

A

cognitive therapy technique for those with sever memory impaitments
use verbal and visual cues
hand over hand assistance
discouragement of guessing
gradual fading of prompts
part task practice of discrete portions of larger skill
immediate timing of FB for correction if an error does occur

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16
Q

What is RLA VII`

A

automatic
appropriate
MIN A needed
goes through daily routine automatically, but ffreqeuntly robot like with minimal to ansent confusion
has shallow recall of activities
shows carryover for new learning, decreased rate
with structure able to initiate social or recreational activities

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17
Q

What is RLA VIII

A

purposeful
appropriate
SBA
able to recall and integrate past and recent revents and is aware of and responsive to environment
shows carryover for new learning and needs no supervision once actiities are learned

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18
Q

What is RLA IX/X

A

purposefuul
appropriate
SBA upon request/ Mod I

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19
Q

What is occupational medicine

A

adresses the physial, cognitive, psychosocial, sensory, and other aspects of performance in a variety of contexts to support participation in everydat, meaningful life activities

20
Q

What do OTs focus on?

A

instumental activities of daily livining
cognition
rest and sleep
education
work
play
leisure
social participation

21
Q

What does speech language pathology practice include?

A

includes identification, prevention, assessment, and treatment of disorders of cognition communication, speech, language, voice, and swallowing

22
Q

what does SLP do for dysphagia?

A

dysphagia= disordered swallowing
bedside exam
barium swallow exam

fiberoptioc endoscopic evaluation of swallowing (FEES)
assess vocal cord function

23
Q

SLP also help with speech, language anc voice with…

A

aphasia
apraxia (oral and verbal planning)
dysarthria (motor function) speech produ tion

24
Q

What is consciousness?

A

a state of awareness of self and environment that requires alertness and arousal

25
Q

What is arousal

A

arousal is the level of consciousness

26
Q

What is awareness

A

awareness is the content of consciousness

27
Q

What is the goal of a consciousness assessment

A

goal is to provide accurate diagnosis
develop treatment plan
accurate prognosis

28
Q

What is the gold standard for consciousness assessment?

A

behaviorial assessment

29
Q

What is the coma recovery scaled revised (CSR_R)

A

standard adminstration and scoring
excellent content validitiy
susbstantial evidence of internal consistency and good inter-rater reliability
contains 23 items that comprise 6 subscales

30
Q

Who is appropriate for the CSR-R

A

patients who range from RLA II - V
lvel II= gneralized response
level III= localized response
level IV: confused and agitiated
level V- confused and inappropriate

31
Q

What are the CRS-R subscales

A

auditory function scale
vvisual function scale
motor funiton scale
oromotor/verba,, function scale
communication scale
arousal scale

32
Q

What defines a coma?

A

no eye opening
absence of sleep/wake cycle
unable to follow instructions
no speech or other forms of communication
no purposeful movement
behavior limited to reflexive activity

33
Q

What is RLA level I

A

no reponse– paitnet appears to be a deep sleep and is unresponsive to any stimuli

34
Q

What are the PT roles for RLA Level I

A

no response
consult
provide supportive care
bed and mattress
positioning in bed
pulmonary needs
contracture prevention
skin protection
ROM initiated with caregiver education

35
Q

What is vegetative state?

A

Return of sleep wake cycle with periodic eye opening and eye closing
may moan or make other sounds
may cry or smile or other facial expression
may briefly move eyes toward person or object
may react ot loud sounds with startle response
unable to follow instructions
no speech or other comunication
no evidence of sustained, reproducible. purposeful or voluntary behavioral responses to stimuli

36
Q

What is unresponsive wakefulness syndrome?

A

shift in language ti describe vegetative state
perceived as less lnegative connotation
demonstrates wakefulness (eye opening) but no voluntary motor responses
can be transitory or permanent

37
Q

what is primitive posturing?

A

de-corticate posturing== flexion
de-cerebrate posturing== dual extension

38
Q

What is RLA LEvel II

A

generalized response

39
Q

What is the description of RLA Level II

A

patient reacts inconsistently and non- purposefully to stimui in a nonspecific manner
responses are limited and are often the same regardless of stimulus presented
awake but not following commands
unable to localize voice (often presents with chewing motion, breather heavier, tenses in reposnes )

40
Q

what are the PT roles for RLA Level II (generalized response)1

A

consult
provide supportive care
bed and mattress
positioning
pulmonary needs
contracture prevention
skin protection
ROM initiation
coma stimulation

41
Q

What is a minimally conscious state?

A

sometimes follows simple instructions
may communicate yes or no by talking or gestures
may speak some understandable words or phrases
may response to people, things, events by
-crying, laughing, smiling
-makign sounds or gesturing
-reaching for or trying to hold/use
-keeping eyes focused on people or things for a sustained period of time

do things inconsistently, which makes it difficult to distiniguish between vegetative state and minimally conscious state

42
Q

What is RLA LEvel III

A

localized repsonsed = Level III

43
Q

Describe RLA Level III

A

localized response
paitent reacts specifically but inconsistently to stimuli
responses are directly related to the type of stimulus presented
may follow simple commands in an inconsistenct, delayed manner, such as closing eyes or squeezing hand
responses delayed or inconsistent

44
Q

What are the PT roles for localized response (RLA Level III)

A

provide an enriched envornment
positioning, ROM, sensory stimulation
mobilization
combine positioning with exercise

45
Q

What classifies emergence from minimally conscious state

A

communication
followig instructions consistently
demonstrating functional use of an object
almost always experience confusion

Neuroconditions 2022 (14 decks)

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