Normal Cognition and Assessment (COG) Flashcards
(177 cards)
1
Q
Cognition is an umbrella term for all
A
higher mental processing
2
Q
Higher mental processes include
A
LAME = language, attention, memory, executive-functions
3
Q
Cognition and language were historically believed to be____ but are ________
A
related but are two different things
4
Q
Language comprehension and formulation are NOW considered
A
part of the cognitive system
5
Q
T/F Language comprehension may not be as distinct from cognition as previously thought
A
True
6
Q
What might the impact of medications be on a client’s cognitive functioning?
A
may variously affect the capacity for behavioral change, confusion, and memory loss in individual client
7
Q
You should become familar with ____ ___ , their uses and ____ _____
A
common medications; side-effects
8
Q
T/F: Cognitive change as a normal process of aging has been well documented in scientific literature
A
True
9
Q
Some ____ abilities may improve with age (i.e. vocabulary). Other abilities decrease with time
A
Cognitive
10
Q
________ _______ Refers to the speed with which cognitive activities are performed
A
Processing speed
11
Q
Cognitive speed begins to decline in the ____ decade of life and continues throughout life
A
Third
12
Q
Sustained attention shows little _____ with age
A
Decline
13
Q
______ Control (i.e. selective and alternating attention) shows a more noticeable decline
A
Memory
14
Q
What type of memory is explicit?
A
Declarative
15
Q
_____ memory shows decline throughout life
A
Episodic
16
Q
T/F: Semantic memory shows decline in later life
A
True
17
Q
Nondeclarative (implicit memory) is what?
A
Unconscious
18
Q
T/F: Concept formation, abstraction, inhibition and mental flexibility decline with age, especially after age 70
A
True
19
Q
Verbal and mathematic reasoning _____ beginning around age 45
A
Declines
20
Q
T/F: Ability to appreciate similarities and reason about familiar material remain stable throughout life
A
True
21
Q
_____ lobe and hippocampus important for storage of new memories and retrieval of existing memories.
A
Temporal
22
Q
Temporal lobe and _______ important for storage of new memories and retrieval of existing memories.
A
Hippocampus
23
Q
_____ lobe and subcortical structures important for encoding information and retrieving through their role in “executive” or “supervisory” functions (e.g., attention, organization; temporal memory).
A
Frontal
24
Q
There are multiple ___-____ memory sites, especially in integration areas of temporo-parietal lobes that are implicated in verbal and visual memory.
A
long-term
25
_______ ______ is mediated by the frontal lobe and associations with other cortical and subcortical areas that trigger the retrieval of memories.
Retrieval process
26
Modality specificity: verbal vs. visual memory -
Left hemisphere: ______ memory and lexical information
Right hemisphere: _____ memory, topographical memory and non-verbal information
verbal ; visual
27
Definition of memory: The function of the brain to _____ and ______ information
store and recall
28
Theoretical Models of Human Memory
____ model
____ models
Stages; System
29
______ Model
| Intended to describe various stages of information processing: Encoding, Storage, Retrieval
Stages
30
Stages Model - _____ : Early processing of material to be learned.
Involves strategies such as rehearsal and organization.
Quality determines how well info is stored and later retrieved (e.g., depth of encoding, organization of material).
Encoding
31
Stages Model - Storage:
Holding of information in the ____ system for future use
_____-term store temporary unless transferred to long- term store
Encoding processes occur during short-term storage
_____-term store considered to be permanent unless disrupted by pathological process
memory; Short; Long
32
Stages Model - Retrieval:
Pulling information from _____ (long-term store) in order to use it.
Delayed recall on memory tests
May be facilitated by presentation of information in ______ formats (e.g., multiple choice, yes/no)
storage; recognition
33
Interaction Between Encoding, Storage, Retrieval:
| T/F: Quality of encoding impacts storage and retrieval
True
34
Information encoded ____ and associated with pre-existing knowledge is more likely to be encoded more effectively and efficiently
Deeply
35
Information is better recalled under conditions ____ to when it was learned (context-dependent memory or domain specific memory)
Similar
36
Repeated retrieval of information can _______ probability of being retrieved at a later time
Increase
37
______ Models of Memory evolved from concerns that stage models were _____ and could not explain complexities of memory process
System; simplistic
38
Systems Models of Memory: Breakdowns occur in ___ component of system, while others are preserved
e.g., patients with severe amnesia can have preserved digit span and recall of recent items, with inability to learn new material
one
39
Memory is comprised of sets of _____ systems and subsystems
interrelated
40
Types of System Models:
____ Memory
____-term Memory
Model of _____ Memory (previously short-term; Baddeley & Hitch, 1974)
Model of Long-Term Memory (Squire, 1992; Tulving, 1985)
working; long; working
41
Model of Working Memory: When information arrives via the ____ organs (perceptually encoded), it goes to working memory
sense
42
Some information is consolidated into ____-term (pick one: long or short) memory
long
43
Test of Everyday Attention (TEA)
| Dedicated to _______ and is Normed
attention
44
Attention Process Training Test (APT- Test):
Dedicated
NOT normed
Sustained, selective, alternating and divided attention
Can be followed by APT-I and APT-II _____ treatment programs
attention
45
Wechsler Adult Intelligence Scale (WAIS-IV):
Normed
Includes subtests:
Digit Span ______ (sustained attention)
Digit Span Backward (sustained attention, _______ memory)
Digit _____ (sustained attention, working memory)
Forward; working; Sequencing
46
Attention:
Remember to pay attention to ______ (e.g. auditory, visual)
Remember to consider ____ (attention normally decreases over time)
Modality; time
47
What types of attention might you test?
| all is not an option...
Sustained, executive control (selective, alternating, suppression, working memory)
48
If there is an impairment in memory, what areas of the patient's brain are most likely to be impacted?
Frontal lobe, temporal lobe, parietal lobe, amygdala, hippocampus, basal ganglia, prefrontal cortex, cerebrum...
49
What types of executive function might you test?
Initiation, problem-solving, mental flexibility, planning, judgement, inhibition, reasoning, self-regulation, meta-cognition
50
If there is an impairment in executive function, what areas of the patient's brain are most likely to be impacted?
Frontal lobe ; connections
51
The MD requests a cog eval for a patient that demonstrates changes since having a UTI (urinary tract infection). Would you consider treating?
No correct answer *insert eye roll* She said no in lecture
52
What is 1 memory test??
Communication Activities of Daily Living
CLQT (Cognitive Linguistic Quick Test)
RIPA (Ross Information Processing Assessment)
SCCAN (Scales of Cognition of Communication for Neuro Rehabilitation
SCATBT (Scales of Cognitive Ability in Traumatic Brain Injury
MoCA (Montreal Cognitive Assessment)
53
T/F: Etiologic categories are exhaustive.
False, not exhaustive.
54
Name the etiologic categories (diseases)
Degenerative diseases, inflammatory diseases, toxic-metabolic diseases, neoplastic diseases, vascular diseases, trauma, Iatrogenic, idiopathic
55
Which etiologic category is related to declining neuronal function?
Degenerative diseases
56
COVID-19 and Meningitis are a type of what etiologic category?
Inflammatory disease
57
The inflammatory response to bacteria, immunologic reactions, and viruses is relating to what etiologic category?
Inflammatory diseases
58
Examples of toxic-metabolic diseases include what?
Vitamin deficiencies, complications of kidney and liver disease, hypoxia, hyponatremia, drug toxicity
59
T/F: Cancer is an inflammatory disease.
False; neoplastic disease
60
T/F: Vascular diseases are the most common cause of neurologic deficits
True
61
An example of a vascular disease is what?
Cerebrovascular disease (stroke)
62
MVA, falls, gunshot wounds, blast injury, sport related are potential precipitating events for which etiologic category?
Trauma
63
Which etiologic category is caused by medical examination or treatment?
Iatrogenic
64
T/F: Nerve damage from surgery is an Iatrogenic etiologic category.
True
65
T/F: Idiopathic etiologic categories are known.
False; unknown
66
Name the 3 parts of a Cognitive Evaluation.
Case History/Background
Physical Examination
Assessments
67
What does the Case History/Background include?
Personal Information, Medical/Social/Surgical & Treatment History, Chief Complaint, History of present illness, Current Medications, Test Results/Imaging
68
You would use the Case History/Background for what 3 reasons?
To determine their cognitive function pre-injury
To confirm assessment choice
To determine their current function
69
T/F: SLPs do not need to be aware of the more global elements of a patient's condition. If it is available, it doesn't have to be integrated into the clinical picture.
False
70
A physical examination includes what? (5 things)
General observations, vitals, oral mech, cranial nerve exam, vision/hearing
71
A case history or background is used to determine what?
Which assessments will be used
72
T/F: We shouldn't make a hypothesis about what we'll see during the assessment.
False
73
What should we look for as far as the general observations?
Behavior, gait/posture, alertness
74
What can abnormal vital ranges tell us?
They can indicate a more acute problem/need
75
What is the purpose of the oral mech exam?
Can give a general idea of motor function for the speech mechanism
76
T/F: Symmetry, coordination and involuntary movements are things we need to look at for a cranial nerve exam.
False; oral mech exam
77
What is the purpose of the cranial nerve exam?
Can provide information relating to the site of the lesion, neurologic conditions, etc.
78
T/F: The oral mech exam can provide information relating to the site of the lesion, neurologic conditions, etc.
False; cranial nerve exam
79
T/F: There are many imaging results if in the early disease process (acute care).
False
80
T/F: Cranial nerves can help you consider where the issue is in the brain.
True
81
T/F: Assessment completion & results and treatment may have an impact based on vision/hearing
True
82
Synthesizing the results of the physical exam into the overall clinical picture of the patient can have an impact on what?
evaluation results or diagnosis
| and treatment
83
T/F: The presence or absence of an impairment should be based on the results of a single measure
False, should not.
84
Family and friends can be helpful in providing information. List at least 3 examples of questions to ask (in regards to their Personal Info, Medical, Social, Surgical & treatment history, Chief Complaint)?
(all are listed)
- What is their native language?
- What was their pre-morbid cognitive functional skills?
- Besides their new acquire injury, any other reasons you might see changes in their cognition?
- What were their premorbid responsibilities to work and family?
- What will their post-injury responsibilities be?
- Their chief complaint: What is their awareness of what is happening?
85
Define etiology.
Cause, set of courses, or manner of causation of a disease or condition
86
Name the executive function related to Luria's theoretical model
Anticipation
Planning
Execution
Self-Monitoring
87
Name the executive functions related to Stuss and Benson's theoretical model
Initiation
Planning
Sequencing
Organization
88
Define pathophysiology and provide an example.
Definition: the disordered physiological processes associated with disease or injury
For example, a demyelinating disease can make neural communication slowed or stopped.
89
Development of disease/injury symptoms can be:
| __________ (within ______); ____________ (within _______); ___________ (within ________)
* Acute: within minutes
* Subacute: within days
* Chronic: within months
90
The course of a disease/injury can be described using 5 terms.
transient, improving, progressive, exacerbating-remitting, stationary (chronic)
91
Name the terms for the extent of disease/injury in the brain (3 types)
focal, multifocal, diffuse
92
Define Executive Function.
Set of cognitive processes important in goal-directed and purposeful behavior
93
What does executive function assist with?
Planning, organizing, initiating, and adapting in a flexible manner, as the situation demands
94
Name the theoretical models of Executive Function.
1. Luria (1966)
2. Stuss and Benson (1986)
3. Lezak (1995)
4. Sohlberg and Mateer (2001)
5. Keil and Kaszniak (2002)
95
Name the executive function related to Luria's theoretical model
Anticipation
Planning
Execution
Self-Monitoring
APES or LAPES to include Luria in the acronym
96
MEMORY assessments can be organized by:
```
Memory Systems
Types of memory
Immediate recall
Delayed recall (retrieval)
Recognition
Forced choice
```
97
Memory Systems assessment assesses:
• working vs long-term
98
Types of memory assessment assesses:
* Verbal (e.g. words, numbers, names) vs. nonverbal (e.g. figures, faces, spatial arrangements)
* Declarative vs. nondeclarative
99
Immediate recall MEMORY assessment assesses:
• Recall of stimuli immediately following presentation
100
Delayed recall (retrieval) MEMORY assessment assesses:
• Recall of stimuli following a time interval
101
Recognition MEMORY assessment assesses:
• Recognize target stimuli from distractor materials
102
Forced choice MEMORY assessment assesses:
• Choose the word from a pair that was from a previous list
103
Commonly administered assessments for MEMORY
* Montreal Cognitive Assessment (MOCA), FYI: this is a screen, not eval
* Dedicated: Wechsler Memory Scale – Fourth UK Edition (WMS–IVUK)
Other assessments with memory subtests:
• Arizona Battery for Communication Disorders of Dementia (ABCD)
• Brief Cognitive Status Exam
• Brief Test of Head Injury
• Burns Brief Inventory of Communication and Cognition
• Communication Activities of Daily Living
• Cognitive Linguistic Quick Test (CLQT)
• Ross Information Processing Assessment (RIPA)
• Scales of Cognition and Communication for Neuro Rehabilitation (SCCAN)
• Scales of Cognitive Ability in Traumatic Brain Injury (SCATBT)
104
The regulation of one's thoughts, emotional responses, actions, and motivation in order to behave in an expected way for a given situation is meta-cognition
False; it is self-regulation
105
Name the executive functions related to Sohlberg and Mateer's theoretical model
```
Initiation and drive
Response inhibition
Task persistance
Organization
Generative thinking
Awareness
```
106
Name the executive functions related to Keil and Kaszniak's theoretical model
Planning, scheduling, strategy use, rule adherence
Generation, fluency, initiation
Shifting and suppression
Concept formation and abstract reasoning
107
T/F: Components of executive function are NOT mutually exclusive
True
108
T/F: Components of executive function do not interact or overlap
False: Components of executive function interact and overlap
109
T/F: There is general agreement about the primary cognitive processes compromising executive function
True
110
Define Initiation
The action of beginning a goal-directed task
111
Define Problem-solving
Identifying the problem, generating potential solutions, choosing a solution, and evaluating the outcome
112
What is mental flexibility
The ability to change a course of action or thought based on the shifting demands of a situation
113
Define Planning
Setting objectives and determining a course of action for achieving those actions
114
Define Judgement
Being able to discern the potentially good and harmful aspects of a situation, and act in a way that makes sense
115
Define Inhibition
The ability to select appropriate responses and suppress unwanted actions
116
T/F: The ability to select appropriate responses and suppress unwanted actions is inhibition
True
117
Define Reasoning
The process of forming conclusions, judgments, or inferences from facts or premises
118
Define Self-regulation
The regulation of one's thoughts, emotional responses, actions, and motivation in order to behave in an expected way for a given situation
119
Define Meta-cognition
Awareness and understanding of one's own thoughts and skills and how you learn information
120
T/F The regulation of one's thoughts, emotional responses, actions, and motivation in order to behave in an expected way for a given situation is meta-cognition
False; it is self-regulation
121
Every task we perform requires activation a number of cognitive processes defines ______ ______.
cognitive processing
122
Name the two types of cognitive processing
Automatic processing and controlled processing
123
What cognitive processing is effortless, rapid, unconscious, and uses fewer resources?
Automatic processing
124
What cognitive processing is slow, effortful, conscious, and uses more resources?
Controlled processing
125
What is regulation of cognitive resources?
Each cognitive process takes up some of the resources
126
What are executive functions associated with?
frontal lobes and their connections
127
What is divided into subsections? (neuroanatomy of executive function)
The prefrontal area
128
List the divisions of the prefrontal area
```
Dorsolateral
Ventrolateral
Orbitofrontal
Dorsomedial
Ventromedial
```
129
T/F: Cognitive abilities cannot improve with age.
False: Some cognitive abilities may improve with age (e.g., vocabulary)
130
T/F: Abilities other than vocabulary decrease with time
True
131
T/F: Cognitive change as a normal process of aging has not been well documented in scientific literature
False
132
What does processing speed refer to?
Processing speed refers to the speed with which cognitive activities are performed
133
When does processing speed begin to decline?
In the third decade of life and continues to decline throughout life
134
What is the cause of the cognitive changes reported in healthy older adults?
slowed processing
135
Related to attention, what shows little decline with age?
sustained attention
136
T/F: Executive control shows less noticeable decline than sustained attention.
False; Executive control shows a more noticeable decline
137
Executing control includes _____ and ____ _____
selective; alternating attention
138
What is the most common complaint with aging?
memory
139
Organizational Framework for EXECUTIVE FUNCTION Assessment (Keil & Kazniak, 2002)
* Tests of planning, scheduling, strategy use, and rule adherence:
* Tests of generation, fluency, initiation:
* Tests of shifting and suppression:
* Tests of concept formation and abstract reasoning:
140
EXECUTIVE FUNCTION Tests of planning, scheduling, strategy use, and rule adherence: Includes tests that what?
• Includes tests that require creation of subgoals, temporal sequencing, strategy generation and application, using environmental feedback to guide behavior, and self-monitoring.
141
EXECUTIVE FUNCTION Tests of generation, fluency, initiation: : Includes tests that what?
• Includes tests that require generation of concepts and compliance with environmental constraints, and measure lack of monitoring, i.e., through perseverative errors.
142
EXECUTIVE FUNCTION Tests of shifting and suppression: : Includes tests that what?
• Includes tests that require shifting between tasks (i.e., set) and inhibition of external or internal/overlearned responses.
143
EXECUTIVE FUNCTION Tests of concept formation and abstract reasoning: Includes tests that what?
• Includes tests that require formation of concepts and conceptualization of abstract relationships.
144
Observation/Performance-Based Measure
* Behavior Rating Inventory of Executive Functions- Adult (BRIEF-A)
* The Dysexecutive Questionnaire (DEX) (Burgess, Alderman, Wilson, Evans, & Emslie, 1996)
* Frontal Systems Behavior Scale (FrsBe)
* Profile of Executive Control System (PRO-EX)
* Executive Function Route Finding Task
* Cognitive Estimation Task
* American Multiple Errands Test
145
Cognitive-Communication Measures
* LaTrobe Communication Questionnaire (LCQ)
* Pragmatic Profile of Impairments in Communication (PPIC)
* The Adapted Kagan Scales
* Discourse Analysis Measures
* Narrative
* Macrolinguistic
* Micorstructural
* Macrostructural
* Story Grammar
* Conversation
* Obliges, comments, clarification
* Exchange Structure Analysis
146
Impairment-based Assessments
```
DKEFS
WCS
COWAT
PORTEUS
MAZES
CLQT
Generate naming
Design generation
Symbol trails
Mazes
```
147
Activity/Participation Assessments
SAVRES
| BADS
148
What are the functions of the dorsolateral?
Monitors and adjusts behavior using working memory and executive functions
149
What are the functions of the ventrolateral?
Response inhibition Goal appropriate response selection selection attentional control vigilance
150
What are the functions of the orbitofrontal?
Personality, emotional input, social behavior, suppression of distracting signals
151
What are the functions of the dorsomedial?
Arousal, motivation, and initiation of activity
152
What are the functions of the ventromedial?
Emotional control and empathy
153
What are the consequences of lesions in the dorsolateral?
Executive function deficit
Disinterest/emotional reactivity
Decreased attention to relevant stimuli
154
What are the consequences of lesions in the ventrolateral?
Emotional dysregulation
| Poor attention and vigilance
155
What are the consequences of lesions in the orbitofrontal?
Emotional lability
Disinhibition
Distractibility
Social inappropriateness
156
What are the consequences of lesions in the dorsomedial?
Apathy
Decreased drive/awareness
Akinetic-abulic syndrome
Mutism
157
What are the consequences of lesions in the Ventromedial?
Impaired judgment
| Inappropriate social behavior
158
```
To which subsection do these connections belong to? (listed superior to inferior)
Parietal cortex
Caudate nucleus
Global pallidus
Substantia nigra
Thalamus
```
dorsolateral
159
```
To which subsection do these connections belong to? (listed superior to inferior)
Parietal cortex
Caudate nucleus
Global pallidus
Substantia nigra
Thalamus
```
ventrolateral
160
```
To which subsection do these connections belong to? (listed superior to inferior)
Temporal, parietal
Insula
Globus pallidus
Caudate nucleus
Substantia nigra
Amygdala
Thalamus
Cerebrocerebellar circuit
```
orbitofrontal
161
```
To which subsection do these connections belong to? (listed superior to inferior)
Temporal, parietal
Caudate nucleus
Global pallidus
Substantia nigra
Cingulate
Thalamus
```
dorsomedial
162
To which subsection do these connections belong to? (listed superior to inferior)
Amygdala
Temporal lobe
Prelimbic cortex
ventromedial
163
Types of Long Term Memory:
| Declarative / _____ memory (conscious)
explicit
164
Types of Long Term Memory:
| _____: knowledge of facts (e.g. multiplication tables)
Semantic
165
Types of Long Term Memory:
| Episodic: knowledge of _____ experience (e.g. what you had for breakfast)
personal
166
Types of Long Term Memory:
| ___-______ / implicit memory (unconscious)
Non-Declarative
167
Types of Long Term Memory:
| _______ memory: preserved learning even when you don’t recall learning it
Procedural
168
Semantic and episodic are part of ____/____ memory in the model of long term memory.
declarative/explicit
169
Procedural memory is part of _____/____ in the model of long term memory.
Non-declarative/implicit memory
170
When symptoms resolve completely after onset, that is known as what type of course?
Transient
171
Describe an improving type of course.
severity is reduced but symptoms are not resolved
172
T/F: When symptoms continue to progress or when new symptoms appear, that is known as an exacerbating-remitting course.
False; progressive.
173
When symptoms develop, resolve or improve, then recur and worsen, that is known as what type of course?
Exacerbating-remitting
174
Describe a stationary (or chronic) type of course.
symptoms remain unchanged for an extended period of time
175
The extent of a disease/injury that involves a single circumscribed area or contiguous group of structures (e.g., left frontal lobe) is what?
Focal
176
T/F: Diffuse is described as involving more than one area or more than one group of contiguous structures (e.g., cerebellar and cerebral hemisphere plaques associated with MS)
False; multifocal
177
The extent of a disease/injury that involves roughly symmetric portions of the nervous system bilaterally (e.g., generalized cerebral atrophy associated with dementia) is known as what?
Diffuse
