Traumatic brain injury Flashcards
(37 cards)
1
Q
Define TBI
A
- results from an impact to the head, e.g. from a car accident or a fall
- results from an outside force and subsequent complications which can follow and further damage the brain - include a lack of oxygen, rising pressure, and swelling
2
Q
What is the incidence of TBI
A
- estimated 69 million globally a year
- 1110 sheffield in one year
3
Q
Who is most at risk for TBI?
A
- children (esp newborn - 4)
- young adults, esp 15-24
- adults 60+
- males in any age group
4
Q
What are the main causes of TBI?
A
- road traffic collision
- falls
- assault
- GSW and blast injuries
5
Q
Define closed head injury
A
- caused by a blow to the head with no penetration
6
Q
Define open head injury
A
when a penetrating injury occurs
7
Q
What is TBI severity determined by?
A
- length of time person experienced loss of consciousness (LOC)
- GCS score
- length of time in post traumatic amnesia
8
Q
What is GCS?
A
a reliable, objective way to record conscious state of a person
9
Q
What is PTA
A
- post traumatic amnesia
- a state where a person seems to be aware of the things around them but is confused/disoriented
10
Q
Where does damage commonly occur in TBI?
A
- frontal lobe injury
- orbitofrontal and ventromedial prefrontal cortex
11
Q
What is ‘frontal lobe syndrome’
A
- injury to frontal lobes can result in deficits in executive function, memory and attention – and cause impulsivity, reduced cognitive function, lack of insight
- link with personality disturbances
- damage to the orbitofrontal cortex during TBI is a major contributor to acquired social disinhibition
12
Q
Define executive functions
A
- mediate and regulate other cognitive activities and behaviour in a purposeful and goal-directed fashion
- doing what must be done to solve a problem or achieve goals
- incorporates aspects of attention, memory, planning, reasoning, and problem solving to organise and regulate purposeful behaviour
- behavioural routines to accomplish intentions
- Maintaining and regulating goal-directed behaviour
- Monitoring and modifying behaviour in response to situational variables
13
Q
What are some functional assessments for EF?
A
- multiple errands test (MET)
- behavioural assessment of dysexecutive syndrome (BADS)
- Functional Assessment of Verbal Reasoning and Executive Strategies (FAVRES)
- wisconsin card sorting task
- clinical obs
14
Q
What is dysexecutive syndrome?
A
- impairment of cognitive processes and behaviours that enable a person to direct and control their behaviour in a purposeful and adequate way
15
Q
How might dysexecutive syndrome present?
A
- impaired inhibition
- impaired ability to formulate goals
- impaired planning
- difficulty carrying out activities
- reduced ability to regulate performance
16
Q
What processes are involved in memory?
A
- taking in info
- storing info adequately
- retreiving info when needed
17
Q
What is anterograde amnesia?
A
difficulty laying down new info
18
Q
What is retrograde amnesia?
A
loss of memory from before the injury
19
Q
Describe the MT Wilga Ax
A
- get them to repeat sentences after you
- content units credited as well as vertabrim repitition
20
Q
What are the different types of attention?
A
- selective
- divided
- sustained
- visual
- auditory
21
Q
How might you assess attention in TBI?
A
- test of everyday attention (TEA)
- CLQT
- clinical obs
22
Q
What are the challenges of insight deficits?
A
- distressing for survivors because they may struggle to understand why people are restricting them from doing certain things
- distressing for family because TBI may behave inappropriately without being aware that there is anything wrong with their action
23
Q
How is fatigue related to TBI?
A
- most common reported effect
- intense and can have sig impact on QOL
24
Q
How is reduced processing speed related to TBI?
A
- consistently documented after TBI
- sig related to measured of EF
25
How might processing speed be assessed?
- Speed and capacity of language processing (SCOLP)
- clinical obs
26
How might personality change following TBI?
- aggression
- disinhibition
- confabulations
- impulsivity
- irritability
- perserveration
27
How might personality changes following TBI be assessed?
patient and SO interviews and reports
28
What cognitive skills may be affected in cognitive-communication disorder?
- attention
- memory
- problem solving
- speed of info processing
- insight
29
How might attention affect communication?
- Misses important info in conversation, leading them to say inappropriate things
- Appears rude when loses focus on speaker
30
How might memory affect communication?
- Struggles to remember past events in discussions
- Difficulty remembering people’s names
31
How might problem solving affect communication?
- May be inflexible in their own opinions
- struggle to come to an agreement
32
How might speed of info processing affect communication?
- Difficulty keeping up with fast-flowing conversations
- Extended pauses in conversation
33
How might insight impact communication?
- person believes they are acting ‘normally’
- Feeling that others are treating them ‘like a child’
34
What are the Axs for cog com disorder
- Cognitive-Communication Checklist for Acquired Brain injury (CCABI)
- Cognitive Linguistic Quick Test (CLQT)
- Montreal Evaluation of Communication (MEC) (conversational discourse subtest)
- Measure of Cognitive-Linguistic Abilities (MCLA)
- Mt Wilga
- La Trobe Communication Questionnaire
- Clinical obs
- Functional assessments e.g. MET
35
Describe the Montreal Evaluation of coms
- short spontaneous conversation with the patient on two different topics
- Rated using a discourse checklist comprised of 17 different communication behaviours, including items that reflect the difficulties often encountered in cog com impairment
- can be done in 10 mins
36
What social skill difficulties might someone experience after TBI?
- not recognise everyday social cues, both verbal and non-verbal
- may struggle to read emotions (Martins et al, 2011)
37
How might social skills be assessed?
- the awareness of social infrence test _TASIT)
- pragmatic profile questionnaire
