Acquired Brain Injury - Perceptual Disorders and Disorders of Consciousness Flashcards

1
Q

Aphasia - Definition and Divisions

A

Impairment of language, affecting verbal communication, due to impairment in production or understanding of speech, writing and reading.
100% cognitive deficit.
- Aphasia with impaired production (Borca, difficulty finding words)
- Aphasia with impaired comprehension (Wernicke, difficulty understanding)
- Global and transcranial aphasia with global impairment

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2
Q

Aphasia Symptoms Related to Language Production (4)

A

Word substitution
Sound switch (not realizing you are not making the correct sound)
Sentence coherence
Neologism (using a word that doesn’t exist and substituting it for another)

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3
Q

Aphasia Symptoms Related to Language Comprehension

A

Misinterpretation of figurative and literal expression.
Logorrhea (vomiting words that don’t make sense, can’t stop talking)

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4
Q

Aphasia Symptoms Related to Writing and Reading

A

Spelling difficulties
Dyscalculia (difficulty doing math)

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5
Q

Unilateral Spatial Neglect (UNS) - Definition, Most commonly seen in?

A

Behavioral disorder where sensory input from the compromised body region cannot be transmitted to S1, due to thalamic and parieto-temporal lesion. To the patient, the compromised body area does not exist!
Mostly after ischemic stroke of MCA on the right side.

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6
Q

Unilateral Spatial Neglect (UNS) - Symptoms

A

Anosognosia (self awareness deficit)
Spatial reasoning deficit
Time reasoning deficit (do not understand that 5 minutes are 5 minutes, think its enough time to shower, eat and get across town)

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7
Q

Pusher Syndrome - Definition

A

Sub symptom of a neglect patient.
Actively pushes the whole body with non-compromised side in all directions. Increasing the strength when stopped and not realizing it affects balance.

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8
Q

Extinction Phenomena - Definition

A

Sub symptom of neglect patients.
Unable to perceive inputs coming from the former affected side, when both sides are simultaneously stimulated. Affected side erased.

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9
Q

Precautions and Red Flags: Perceptual Disorders (5)

A

Loss of balance in neglect.
Injuries on affected side related to WCh-positioning.
Loss of mobility on affected upper limb related to positioning and non-use.
Use of equipment that could lead to harm.
Confronting patient with a traumatic situation and/or symptomology, that they are not aware of.

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10
Q

Consciousness - Definition and Divisions (5)

A

Interaction between awareness of environment and wakefulness, the reaction of sensory inputs from this environment.
- Brain death
- Coma
- Unresponsive wakefulness syndrome
- Minimal Consciousness State
- Awake and aware

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11
Q

Brain Death - Definition (3)

A

Irreversible loss of all brainstem reflexes combined with progressive loss of cortical and respiratory functions in a patient in a persistent state of DOC.
- Known reason for DOC
- Repeated evaluation, every 6h
- No electrical activity in areas associated with internal thought and diminished cortical irrigation.

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12
Q

Coma - Definition and characteristics (4)

A

Between 1h - 5 weeks, before it develops to another state of DOC.
Non-reactive state where patient can’t be woken up.
- Absence of sleep wake cycle
- Absence of verbal communication
- Absence of reaction on command
- Diminished respiratory and thermo-regulatory functions (not able to maintain)

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13
Q

Unresponsive Wakefulness Syndrome - Characteristics (6)

A

As soon as eye opening is observed.
Vegetative state.
Thalamus and cortex still damaged.
Have sleep-wake cycles!
No awareness of environment.
Autonomic functions and brainstem reflexes mostly present.

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14
Q

Unresponsive Wakefulness Syndrome - Divisions (2)

A

Persistent state: over 1 month. Little likelihood of recovery.
Permanent state: over 3 months. Minimal likelihood of recovery.

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15
Q

Minimal Consciousness Sate - Characteristics (4)

A

Inconsistent signs of awareness.
Might sometimes be able to communicate.
Emotional state observed (smiling, crying)
Temporary or permanent.

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16
Q

Locked-in Syndrome - Definition

A

Complete plegia, without sensory deficit, following brainstem lesion.
Verbal communication not possible, some have eye movement, fewer dominant index finger.

17
Q

Relevant Network in DOC - Default Mode Network (DMN)

A

Internal thought, perspective taking of desires, beliefs, intentions to others, memory and planning.
HPC, AM, aCC, vmPFC, dlPFC, left temporal cortex, anterior cingulate gyrus, left parietal cortex.

18
Q

Relevant Network in DOC - Salience Network (SN)

A

Conscious perception of stimuli, creating a context to be interpreted as a base for decision making processes.
Frontoinsular cortex, aINS, dorso-anterior cingulate cortex, dorsomedial thalamus, VTA, temporal pole.

19
Q

At which stage of DOC is the most increase in SN and DMN activity?

A

Minimum consciousness state