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Cognitive Retraining > CR: Lesson 1 > Flashcards

CR: Lesson 1 Flashcards

1
Q

A complex collection of mental skills

A

cognition

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2
Q

What skills are included in cognition

A 
attention/perception
comprehension
learning/memory
problem-solving/reasoning
organization
orientation
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3
Q

Rehabiliation of a cognitive impairment by improving/compensationg for cognitive deficits to allow increased daily function is

A

cognitive rehabilitation

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4
Q

Therapy tasks may try to do the following:

A

imporve actual brain function OR

provide improved environment or cues to compensate for loss.

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5
Q

Cognitive rehab objectives must balance _______ and ___________for daily tasks

A

independence

safety

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6
Q

What are essential considerations for treatment plans

A

social/emotional impact
general health
family support
behavioral characteristics

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7
Q

3 Basic types of damage following brain injury

A

primary damage, secondary damage, nonneurological alterations

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8
Q

structural leasions caused directly by the impact

A

primary damage (cerebral contusions)

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9
Q

damage to the area surrounding the impact…

A

secondary damage

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10
Q

secondary damage can be caused by

A 
increased intracranial pressure
intracranial hemorrhage
brain swelling
infection
hematomas (bloodclots)
infarction (strok-like effects due to impaired blood supply)
oxygen deprivation (anoxia)
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11
Q

examples of nonneurologic alterations

A

hyperthermia (excessive fever)
electrolyte imbalance (dehydrations, starvation, etc)
hyperventilation
damage to the hypothalamus or pituitary gland

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12
Q

which usually has a larger area of damage? Primary or secondary damage

A

secondary damage

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13
Q

2 Major Types of Brain Injury

A

open head

closed head

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14
Q

Closed Head Injury

A

occurs when head is struck by a blunt object

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15
Q

closed head injury tend to be more diffuse due to

A

direct contact & inertial forces

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16
Q

The area of direct injury is called

A

coup injury

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17
Q

The cerebral area opposite the impact is called

A

contracoup injury

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18
Q

diffuse axonal injury (DAI)

A

the twisting and shearing of axons in the brain due to the rotational forces of impact

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19
Q

Comas is much more common following…

A

closed head injury

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20
Q

twisting the brainstem may result in damage to axons in the reticular formation, which =

A

coma

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21
Q

an injury in which the scalp and skull are penetrated

A

open head injury

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22
Q

secondary damage can occur due to increased ________ and their is less likelihood of ________than with OHI

A

cranial pressure

infection

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23
Q

Coma is NOT common with _________

A

open head injury (OHI)

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24
Q

Most common areas of damage in close head injuries are

A

inferior and lateral surface of the frontal & parietal lobes with contracoup to the parietal and occipital lobes

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25
Common impairments seen in closed head injury
executive function personality functions memory
26
An example of executive function impairment commonly seen in closed head injury
initiation and planning
27
An example of personality function impairment commonly seen in closed head injury
self-regulation & control | social behavior
28
An example of memory impairment commonly seein in a closed head injury
sequencing & organization | awarness of impairments
29
CVA brain injury
cerebrovascular acciden/stroke 1. cerebral hemorrhage 2. cerebral infarction
30
Brain bleed aka "wet stroke"
cerebral hemorrhage
31
Cerebral infarchtion aka "brain attach"
ischemic stroke
32
Which CVA injury produces diffuse damage
cerebral hemorrhage
33
Which CVA injury generally produces a focal lesion
cerebral infarction (ischemic stroke)
34
Brain Tumors
abnormal cell growth...usually a focal lesion
35
Other types of brain injuries that usually result in multifocal or diffuse brain injury
enephalitis meningitis hypoxia hypotensive injury
36
infectious disorder of the brain tissue and meniges, usually viral
menigitis
37
lack of oxygen
hypoxia
38
decreased perfusion of blood throughout the brain
hypotensive injury
39
Severe damage and post injury coma more than _____ to ______hours= _________mortality rate and ____________recovery levels in survivors.
24-48 high low
40
inflammation of the brain
encephalitis
41
the neural and behavior resilience that provides the brain's ability to reorganize after injury
plasticity of the brain
42
spontaneous recovery
due to resolution of hematoma, decrease in edema, normalization of blood flow, and neurochemical balance
43
diaschisis
occurs in unharmed areas adjacent to the lesion immediately following the injury. surrounding areas may exhibit temporary loss of function due to edema, increased pressure, or delpletion of blood flow.
44
axonal growth
refers to axonal sprouting from damaged neurons as well as intact axons
45
denervation supersensitivity
the dendrites that previously received innervation from damaged axons become more sensitive to the remaining neurotransmitter inputss as they sprout more receptor sites to compensate for lost innervation.
46
substitution
suggests that intact brain structures assume the functions previously held by the lesioned areas.
47
Some people believe substitution is due to ________in the brain
redundancy
48
_______will grow to establish new connections
axons | can be as long as the entire length of your body
49
3 Major Influences in the field of Cognitive Rehabilitation
advances in technology health care accountability for treatment efficacy
50
Russian neuropsychologist that described the brain in terms of a body of 3 functional units that worked together to provide function for the higher level processes of cognition
Alexander Luria (1980)
51
The arousal unit
treated with coma stim and attention/concentration training
52
the sensory input unit
receives information from outside of the nervous system, analyzing and storing it---treated with attention and memory training
53
the organizational & planning unit
deals with programming, planning, and implementation of volitional actions--treated with executive function, reasoning, & problem-solving training
54
Principles of Neural Plasticity
1. The brain is dynamic, capable of reorganization 2. motor/sensory/cognitive abilities can improve, but over time and usually with persisitng deficit 3. Neural structural changes (dendritic branching, new synapses, etc) underlie behavioral changes 4. Neurobehavioral recovery based on environmental stimulation 5. Restitutive and compensatory approaches have role in rehabilitation.
55
Principles of Cognitive Reorganization
1. Consider multiple patient perspectives 2. Client and family involvment 3. Build on client's strengths 4. The goal is self-sufficiency 5. Incorporate assessment data 6. 3 Pronged approach 7. Increase client awareness of deficits 8. Variety of techniques for variety of goals 9. consider client's premorbid interests, careers, values 10. Utilize new scientific theory & technology 11. Assess efficacy of intervention methods 12. Team-based intervention
56
Patient perspectives
physical (tolerance) emotional (motiviation) cognitive (awareness) social (caregiver support)
57
3 Pronged approach
rehabilitation compensation emotional managment
58
Stages of Cognitive Reorganization
``` emergency care coma care inpatient rehab outpatient rehab community reintergration ```
59
Goals of CR
foster natural recovery discourage maladaptive coping patterns implement proper interventions
60
2 Conflicting Theories concerning age
The Kennard Principle & Donald Hebb
61
Kennard Principle
recovery more complete when sustained while young
62
Donal Hebb
early injuries can cause more disturbances than those later in life
63
TRUTH about age & recovery...
young adults recover best
64
Variables contributing to neurological recovery
1. premorbid intelligence/education 2. Gender (effects of progesterone=beneficial) 3. Cultural background (multicultural likely to end therapy sooner) 4. Drug & alcohol abuse 5. psychological factors 6. depression/anxiety
65
Injury related variables
time since injury injury extent & severity recovery of diff functions
66
recovery of simple, _____tasks occur more quickly thatn recovery of higher level activities.
overlearned
67
Mild injuries recover ______quickly than people with more severe injuries
more
68
recovery is most rapid in the first____ months.
6

Cognitive Retraining (6 decks)

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