Cognitive Lecture 3 Sequelae TBI 2 Flashcards

(63 cards)

1
Q

Attention

A

The allocation of processing resources
Forms the foundation for which all other cognitive skills are based
Difficulties may be more pronounced in less structured environments

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2
Q

5 Types of Attention

A
Focused
Sustained
Selective
Alternating
Divided
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3
Q

Focused/Sustained Attention

A

The state of focusing on 1 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 2 tasks that require thought & 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 2 tasks at once but 1 of the tasks requires little to no thought
“I can’t brush my daughter’s hair while talking on the phone; can’t do 2 things at once anymore”

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7
Q

Frontal Lobe

A

Frontal lobes responsible for higher-order functions; executive functions; emotional-behavioral-social control regulation, motor functioning, appropriate use of language, social pragmatics, subtleties of communication (innuendos, humor)

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8
Q

Damage/Disorders Related to the Frontal Lobe

A

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

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9
Q

Executive Functions

A

Relate to one’s ability to use cognitive skills efficiently in a complex env’t
Help us regulate our abilities so we can achieve goals
Often performed without thinking & may be age-related in terms of development
umbrella term that encompasses many skills
Goal is to help regulate to achieve things
Something we just do; but we can think about them, especially in competing stimuli
Allow us to have morals
Ability to attend & focus underlies all of them

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10
Q

“Some” Executive Functions…

A

Planning and organizing; multi-tasking; learning rules; motivation; generalization; flexible thinking; problem solving; social behavior; initiating/inhibiting behavior; controlling emotions; monitoring performance; self-awareness; making decisions; goal setting; insight

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11
Q

Commonalities of Executive Dysfunction

A

Pts may begin a task prior to thinking through all the steps
Repetition of a thought, behavior, action, or verbal utterance that continues even though it is no longer appropriate
Tend to think about features in lieu of groups or categories
Inability to focus on more than 1 thing at a time
Easily distracted

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12
Q

Premorbid Psychosocial Responses

A

Inhibition and Emotional Stability

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13
Q

Post-Morbid Psychosocial Responses

A

Cognitive-communication deficits, disinhibition, emotional instability

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14
Q

Orientation

A

Person, place, time, purpose

A&Ox4: they know who they are, where they are, what month &/or year, why they’re there

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15
Q

Procedural memory

A

Implicit
Ability to perform skills in the absence of conscious awareness
• Like riding a bicycle and can remember the procedure; doing a lay-up in basketball; serving in tennis (start out really thinking about it & use declarative memory, but eventually it will become a procedure & you don’t have to think about it—becomes implicit)
Recognition of patterns, etc.

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16
Q

Declarative memory

A

Explicit
Factual memory; all about the facts; ability to do algebra, do well on GRE, etc.
Remembering to recall and not forget

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17
Q

6 Types of Memory

A

Long-term, recall, episodic, prospective, short-term, procedural

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18
Q

Problem Solving

A

Identifying problems, generating solutions, organizing, sequencing, implementing solutions, managing time, self-monitoring, safety

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19
Q

Critical Thinking

A

Drawing inferences, deductive reasoning, inductive reasoning, abstract reasoning, flexibility of thought

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20
Q

Drawing Inferences

A

Making a connection between 2 otherwise unrelated facts

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21
Q

Deductive Reasoning

A

Drawing a specific conclusion from given info

getting/making spaghetti: we know we can’t make spaghetti because we don’t have all the ingredients

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22
Q

Inductive Reasoning

A

Drawing a general conclusion from inferred info
Relies on inferencing
a process of inferring info to arrive at a conclusion
Higher level thinking

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23
Q

Abstract Reasoning

A

Drawing conclusions based on notions, ideas, concepts that are not tangible

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24
Q

Flexibility of Thought

A

Shifting from 1 idea to another with relative ease

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25
Cognitive Communication Challenges
Impact the social, academic, behavioral, vocational lives of survivors
26
Typically, survivors of TBI have intact...
grammar & semantic knowledge; language appears fluent
27
Deficits in Cognitive-Communication Challenges Tend to be in...
Meta-semantics & pragmatics (both verbal & non-verbal types)
28
Meta-Semantic Deficits
Word-retrieval deficits (anomia) Difficulty understanding words w/ multiple meanings Lack of cohesive speech w/ poor knowledge of figurative language; language can be very concrete-centered Difficulty integrating & synthesizing info (parts=whole) & figuring out salient from relevant info Slower processing speed Confabulation (lack of truthfulness)
29
Pragmatics Definition
Social use of language, generally | Specifically, the functional use of verbal & nonverbal modes of communication to convey & interpret intended msgs.
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Verbal Pragmatic Deficits
Tangential speech Limited comm. initiation or maintenance per interactions w/ others Decreased topic maintenance Inappropriate topic selection & inadequate topic relevance Poor presupposition skills
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Tangential Speech
Conversation topics shift without listener notification
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Nonverbal Pragmatic Deficits
Poor eye contact, both too much & too little Flat affect; poor use of facial expressions to convey emotion Lability; emotional excess Inappropriate proxemics & physical contact Decreased understanding of other's nonverbal cues
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Amnesia
TBI can leave old memories intact but hinder ability to store &/or retrieve new memories; also includes learning new info Impaired attention can also make learning new info difficult
34
2 Types of Amnesia:
Anterograde | Retrograde
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Anterograde Amnesia
Loss of ability to learn & recall new info after the trauma key word: after; loss of ability to learn and recall new info after trauma; more challenging to learn to play piano after head injury
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Retrograde Amnesia
Loss of memories stored before an injury | loss of memory stored before injury; after head injury, lost ability to play piano or play as well as before
37
Seizures
Change in behavioral state as a result of abnormal electrical activity within the brain
38
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
39
When seizures occur without any obvious precipitant or cause...
the person may be considered to have a form of epilepsy
40
Types of Seizures
Generalized Partial Nonepileptic Status Epilepticus
41
Generalized Seizures
Increased electrical impulses occur throughout the brain
42
Partial Seizures
Relatively small electrical impulses in more focal parts of the brain
43
Nonepileptic Seizures
Not caused by abnormal electrical activity in the brain
44
Status Epilepticus
Prolonged seizures; continuous state of seizure
45
Post-Traumatic Seizure Disorder
Seizures common after TBI & are broken down into 2 categories: 1. Seizures that occur w/in a 7-day post-injury window; pt is still ICU or in acute stage 2. Late-onset seizures that occur more as focal issues
46
Seizure Incidence is Higher in ____
Children than adults
47
Late seizures more likely to occur ____
In adults or when head injury was a penetrating type
48
Anti-epileptic Medications
No medications can protect against post-traumatic epilepsy
49
Types of Injuries that Predispose Pts to Seizure Disorders
Depressed skull fractures & hemorrhagic contusions
50
TBI Concomitant Issues
``` Post-traumatic headaches & fatigue Somnolence Balance disorders Sexual disorders Depression Mania Anxiety Disorders PTSD Personality Changes Aggression, etc. ```
51
Depression Following TBI
Level of brain injury severity poorly predicts pt's level of depression/ susceptibility to depressed state Pre-injury depression common Increased anxiety levels + depression often coincide
52
Brain Structure and Depression Correlations
Decreased left prefrontal gray matter correlated w/ depression
53
Features Predicting Suicidal Behavior
Pre-injury aggression & hostile features
54
Short-Term Memory (STM)
immediate recall of new visual or verbal info
55
Recent Memory
delayed recall of new info up to 30 minutes
56
Long-Term Memory (LTM)
recall of previously known information; may also be called remote memory
57
Prospective Memory
ability to recall information needed in the future; what can I anticipate might happen?; remember to make dr. appt. or remember when you scheduled a dr. appt.
58
Episodic Memory
recall of temporally dated events; use to go back and think about 1st day as grad student at UofL; tied to an event in time; wedding day, birth of child, etc.
59
Broad-Based Tests
related to language, it will look at all 5 domains of language; Boston Test of Aphasia
60
Specific Tests
expressive one word and receptive one word tests: semantic test: targets vocabulary only; Reading Comprehension Battery for Adults; Behavioral Test of Inattention Look only at 1 aspect
61
Meta-Semantics
thinking about how semantics plays into everyday life
62
Latency Period
period of time when you ask pt to respond and then you wait for the answer
63
Part of Therapist Job is to Shed Light on Deficits Because...
Deficit awareness is part of executive function, etc.