Mindstorms Flashcards
(120 cards)
1
Q
When brain cells receive INADEQUATE oxygen.
A
Hypoxemia
2
Q
When brain cells do not receive ANY oxygen.
A
Anoxia
3
Q
What are the 4 major types of brain injury?
A
*Focal Contusional *Focal Hemorrhagic (or Ischemic Injury) *Diffuse Axonal Injury *Diffuse Hypoxemic or Anoxic Injury
4
Q
Focal Contusional Injury
A
Bruising of specific areas of the brain
5
Q
Focal Ischemic or hemorrhagic injury
A
caused by blockage or rupture of specific blood vessels that supply certain areas of the brain with oxygen - Stroke
6
Q
injuries affecting the entire brain are termed ______
A
Diffuse
7
Q
How long can brain cells survive without oxygenated blood?
A
Not more than 6 or 7 minutes
8
Q
“Method is much, ____________________, ________________.” - Benjamin Cardozo
A
technique is much, but inspiration is even more.
9
Q
Why shouldn’t you let someone with a possible head injury go to sleep?
A
You wouldn’t be able to tell if they fell into a coma.
10
Q
Happiness is something no doctor can order up: It comes from _________________________________________________________.
A
doing things in your life that produce a sense of well-being.
11
Q
What do you do if someone is having a seizure?
A
* Put them on their side (protects from aspirating) * Protect their head (put in lap or on pillow) * Call 911 for immediate medical attention * Never put anything in the mouth of someone who is in the midst of a seizure. * Many seizures end just minutes after they begin. * Risk of subsequent seizures.
12
Q
Hypopituitarism
A
* Underactive pituitary glad. * Caused by injury to hypothalamus * Often overlooked in TBI diagnostic * Doesn’t appear until 3 months after TBI * Results in: weight gain, confusion, dry skin, stunted growth (in youths), amenorrhea (absent menstruation), infertility in women, and impotence in men. * Diagnosed with blood tests.
13
Q
Hemiplegia:
A
Weakness or paralysis on one side of the body, most commonly seen following strokes.
14
Q
Dysarthria:
A
A loss of oral muscle function that results in the inability to articulate words clearly, even though a patient’s knowledge of language is intact.
15
Q
Dysphagia:
A
An inability to swallow caused by damage to the neurons that control the coordinated movement of the muscles in the back of the throat.
16
Q
Ataxia:
A
An inability to coordinate muscle movements leading to awkward gait and imbalance.
17
Q
What are the 2 subdivisions of long term memory?
A
Explicit (or declarative) and implicit.
18
Q
What are the 2 subdivisions of explicit memory?
A
Episodic and semantic
19
Q
Episodic memory
A
account of what occurs in our lives (what you had for breakfast, or who visited)
20
Q
Semantic memory
A
* Facts * Learned from others * “textbook learning” * sometimes called “crystallized memory”
21
Q
Implicit memory
A
* muscle memory or procedural memory
* doesn’t require conscious thought
* uses different parts of brain than other memory
22
Q
retrograde amnesia:
A
loss of pre injury memories
23
Q
postraumatic amnesia
A
unable to lay down new memories
24
Q
Aphasia:
A
loss of speech and language
25
fluent aphasia
problems understanding spoken and written language (also known as sensory aphasia or Wernicke's aphasia)
26
nonfluent aphasia
difficulty communicating both orally and in writing (also called motor aphasia or Broca's aphasia)
27
global aphasia
can't speak or comprehend language usually resolves into fluent or nonfluent aphasia
28
Episodic dyscontrol syndrome (EDS)
primitive emotion unchecked by higher executive functioning of frontal lobes (often leading to inappropriate expressions) If damage is restricted to outer areas of frontal lobes (dorsal lateral areas), the person may just not care about anything. This is often confused with depression as symptoms are similar. Both expressions called frontal lobe syndromes
29
Percentage of prisoners in our jails with TBI?
82% 65% had lost consciousness more than once due to head injury
30
Anosognosia
Brain-based disorder resulting with compromised frontal function, in which subject stubbornly refuses, and truly lacks the ability to understand, that they have problems.
31
Loss of sexual restraint caused by damage to which lobes?
Frontal and temporal
32
Abnormally high or low sex drive caused by damage to the \_\_\_\_\_\_\_\_\_\_
hypothalamus
33
Time is \_\_\_\_\_. - Anonymous
Brain
34
Hobbies can provide \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
Real life therapy
35
The medical director
\*team leader (symphony conductor) \* drives treatment planing and therapeutic strategies \* oversees and supervises entire staff \* specialty may be in neurology, neuropsychiatry, or physical medicine and rehabilitation.
36
Complete TBI team usually has staff members from 3 disciplines
Neurology Neuropsychiatry Physical medicine and rehabilitation
37
Neuropsychologists perform:
\*psychological, behavioral, and neuropsychological testing \* cognitive therapies (to strengthen and compensate)
38
Clinical Psychologists
Provide counseling for patients and families (usually through teaching, cognitive behavioral manner, not "talk therapy").
39
6 supporting members of a good TBI team
\* Physical therapists \* Occupational therapists \* Speech and language pathologists \* Rehabilitation nurses \* Recreational therapists \* Vocational therapists
40
Case managers
Supportive liaisons between patients and their funding sources. Ideally remains involved after patient discharge.
41
Factors in depression
\* genetic predisposition \* environmental stressors \* hormonal imbalances \* abnormal brain chemisty
42
SSRI's
selective serotonin reuptake inhibitors
43
A person with severe TBI will rarely say that she is depressed - she will more likely demonstrate it by exhibiting the following symptoms:
\* fatigue \* inability to pay attention \* obsessive thinking
44
SSNRI's
Selective serotonin and norepinephrine reuptake inhibitors
45
Alternative to SSRI's and SSNRI's
inhibit reuptake of norepinephrine and dopamine (doesn't produce weight gain or sexual dysfunction common in SSRI's) bupropion (Wellbutrin)
46
Tricyclics
\* Older class of antidepressants \* impact whole array of neurotransmitters \* may provide releif from pain \* side effects: dry mouth, blurry vision, and constipation
47
emotional incontinence
\* loss of control of emotions \* can go from laughing to crying in minutes
48
What are Benzodiazepines (BDZ) used for?
\* short term management of debilitating anxiety or insomnia
49
Alprazolam (Xanax)
Benzodiazepine
Xanax
50
Exelon
\* Rivastigmine \* Works by increasing acetylcholine
51
What natural salt can help balance mood?
Lithium carbonate \* Can stabilize lives of TBI survivors \* Can be toxic to cardiac and central nervous system if levels get too high
52
Why are stimulants used for TBI's?
\* reduce distraction and impulsivity \* wake sleepy and lethargic patients \* increase processing and ability to pay attention
53
Many stimulants increase what neurotransmitter?
dopamine
54
Common stimulants for TBI's
\* methlphenidate (Ritalin) \* amphetamine (Dexedrine) \* pemoline (Cylert)
55
Common SSNRI's
\* venlafaxine (Effexor) \* mirtazapine (Remeron)
56
Common tricyclics
\* impipramine (Tofranil) \* amitriptyline (Elavil) \* nortriptyline (Pamelar)
57
What non stimulant induces wakefulness, and what are it's advantages over stimulants?
modifinil (Provigil) \* non habit-forming \* doesn't increase heart rate and blood pressure
58
Key points to managing frustrated patients
\* back off for a few minutes \* after they cool down ask if they want help \* ask if anger helped them accomplish their goal \* see if they can "express rationale for the breakdown" \* never assume you understand the patients rationale or problem
59
Why is routine easier on a brain injured individual?
Short-term memory can be so impaired by deficits in attention and concentration that new learning cannot take place. Routine impresses unconscious (procedural) learning stored in implicit memory. It doesn't require the conscious thought involved in explicit memory and uses completely different neuronal pathways.
60
Repetition is key
break down tasks into simple steps and practice the important ones with added repetition Ex: practice putting shoes on more than once a morning
61
People cannot learn without
awareness
62
Ultimately, therapies directed at improving cognition are also designed to impact a persons \_\_\_\_\_\_\_\_\_, \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_.
behavior, the observable manifestations of thought.
63
Reorganize bedroom to minimize _________ and establish _________ that will not require him to \_\_\_\_\_\_\_.
distractions routines think
64
Behavioral therapy works on the basis of what two simple strategies?
Reward the good and ignore the bad
65
Why try and ignore bad behavior?
humans are wired to crave attention, even if it's negative attention. We'd rather argue and fight than be ignored.
66
"Many patients complain that they are "just too tired" to do these exercises, but if the family caregivers permit these activities to be set aside, \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_.
the fatigue will only get worse.
67
When adults with moderately severe brain injuries are trying to return to work or school, the author thinks it is time for what?
Neuropsychological testing and structured vocational evaluation
68
How did Sigmund Freud define the good life?
As having the ability to both love and work.
69
Today, there is practically an epidemic of traumatic brain injury - a staggaring ___________ Americans disabled by TBI.
6.3 million
70
"If the human brain were so simple that we could understand it, we would be so simple that we couldn't"
Emerson M. Pugh (research scientist for IBM)`
71
Peripheral nervous system (PNS)
all the nerves outside of the spinal cord and brain (usually run parallel with our blood vessels)
72
Central nervous system (CNS)
brain and spinal cord
73
Four major structures of brain stem:
\* midbrain \* reticular activating system \* pons \* medulla oblongata
74
Function of brain stem:
most basic functions \* regulation of heart \* breathing rates \* blood pressure \* general arousal
75
Function of limbic system
memories and emotional responses
76
2 other names for the cerebral cortex are:
\* neocortex ("new brain") \* also called gray matter
77
Why is grey matter grey?
Nerves in this area lack the insulating myelin
78
Bulges on brain are called?
Gyri
79
Fissures on brain are called?
Sulci
80
largest opening at the bottom of the skull
foramen magnum
81
3 membranes covering the brain
dura, pia, arachnoid
82
dura
\*first membrane under the skull \*toughest layer covering the brain
83
pia
thin lining that hugs the brain
84
arachnoid
web-like lining between dura and pia
85
brain incased in what fluid
cerebrospinal fluid (CSF)
86
medulla oblongata
\* lowest part of the brain stem \* takes care of automatic responses like: - breathing - swallowing - blood pressure - body temperature - pupils
87
reticular activating system
\* within the brain stem, adjacent to and above the medulla \* reponsible for: - producing arousal - controlling sleep-wake cycles
88
pons
\* "bridge" from lower brain stem to midbrain and cerebellum
\* coordinates motor movements
\* helps maintain balance
89
midbrain
\*reflexive control of visual and auditory information and orientation \* dorsal part connects RAS and cerebellum
90
cerebellum
\* "little brain" attached to back of brain stem \* 3 lobes \* coordinates all our movements \* including regulating fluid speech \* remembers learned motor responses like riding a bike
91
thalamus
\* the brain's relay center to the cerebral cortex \* "every bit of information, every message... goes through the thalamus ... look like testicles in the middle of your brain
92
The thalamus and hypothalamus are the two all-important gateways to \_\_\_\_\_\_\_\_\_\_\_, \_\_\_\_\_\_\_\_\_, and \_\_\_\_\_\_\_\_\_.
higher thought, emotion, mental health
93
Hypothalamus
\* right below thalamus \* one of the brains control towers \* "Although no bigger than a pea, it's a dynamo of function". \* controls eating patterns \* sleeping and waking cycles \* body temperature \* blood sugar levels \* emotional tone \* sex drive \* hormonal balances via pituitary gland
94
pituitary gland
regulates hormonal production and secretion
95
cortisol
\* a steroid that promotes healing \* produced by adrenal gland \* controlled by hypothalamus \* can create chronic stress response if constantly produced
96
Limbic system
\* network of nerve cells that providing the "biological basis of our emotional lives" \* right below higher functioning cerebral parts of the brain \* "ensures that emotions reach our conscious thoughts - and our thoughts affect our emotions." \* limbic system and cerebral cortex actively influence each other (why emotional events are well remembered) \* damage to limbic system can leave patient distant and disconnected from others
97
Hippocampus and amygdala are responsible for \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_.
much of what we remember and the tone of our emotions. (Triggers limbic system)
98
Hippocampus is directly connected to what functions.
the senses.
- touch
- sight
- hearing
- smell
99
Neocortex
Uniquely human additions to the cerebral cortex that all mammals share. "new brain"
100
prefrontal cortices are responsible for:
executive functions (reasoning and judgment)
101
The frontal lobes are where your....
personality anatomically exists. Where it is created, honed, and refined. Where the ego is housed.
102
"If someone suffers damage to his frontal lobes, ..."
"... he will not be himself - literally."
103
What is the general function of the parietal lobes?
Sensation and perception
104
The frontal and parietal lobes meet where there are strong connections for what?
Muscle movement and sensation.
105
The main function of temporal lobes
\* make sense of what we hear (via the auditory cortex) \* perceptions and memories (via limbic system and it's connections)
106
What is the primary function of the occipital lobes?
analyze what we are seeing
107
In general the left hemisphere controls:
\* details \* logical thinking \* language skills \* numerical calculations \* and movement on the right side of the body
108
In general the right hemisphere controls:
\* big picture concepts \* visual memories \* artistic talents \* and movements of the left side of the body
109
Brain hemispheres. The right side sees "\_\_\_\_\_\_\_\_\_", the left side sees "\_\_\_\_\_\_\_\_\_\_'.
the forest the trees
110
What chemicals carry messages between neurons?
Neurotransmitters
111
Prozac
flouxetine SSRI
112
Paxil
paroxetine SSRI
113
Zoloft
sertraline SSRI
114
Lexapro
excitalopram SSRI
115
Celexa
citalopram SSRI
116
What might help TBI Patients with memory loss
Exelon (Rivastigmine) \* Already used in treating Alzheimer's \* Because TBI's increase the likelihood of Alzheimer's, it might be reason to use these medications earlier in management.
117
Chlordiazepoxide
Benzodiazepine
(Librium)
118
Clonazepam
Benzodiazepine
(Klonopin)
119
Diazepam
Benzodiazepine
(Valium)
120
Lorazepam
Benzodiazepine
| (Ativan)
