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62 Cards in this Set

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Def: The faculty of knowing
Recognition and Perception: objects, faces, spatial representations
Attention and Consciousness
Language: lexical, semantic, syntactic systems
Memory
Judgment and reasoning (problem solving)
Executive functioning
Cognition
“ability to maintain a coherent line of thought or action.”
Attention
degree of wakefulness or level of consciousness
Arousal
Unresponsiveness/Arousal
Damage to the ascending reticular activating system (ARAS) within the brain stem terminating in the thalamus
From the thalamus, have projections to cerebral cortex via the white matter fibers.
3 mental operations involved in moving attention from one location to another
Disengagement of attention from its current focus (parietal lobe engagement)
Moving attention to another location (midbrain engagement)
Engaging attention at that location (frontal-diencephalon system
: a localized behavioral response to internal sensations (pain, temperature, thirst, hunger, discomfort) and/or external sensations (visual, auditory, kinesthetic, gustatory, olfactory)
Focused Attention
The ability to maintain a consistent behavioral response during a continuous activity that is specifically related to that activity. Events occur slowly and vigilance is required.
Sustained Attention
The ability to respond simultaneously to multiple tasks or single tasks with multiple task demands.
Associated with frontal lobes
Divided Attention
The ability to maintain a behavioral response to an activity in the face of distracting internal (irrelevant thoughts) or external stimuli. One has to selectively attend to relevant information and inhibit irrelevant information. Right frontal lobe particularly involved
Selective Attention
The ability to shift one’s attention back and forth between tasks or from one task to the next.
Associated with dorsolateral prefrontal cortex (bilaterally)

Ridley Stroop in 1935 published a paper in Journal of Experimental Psychology
When you have two dimensions of stimuli and you are paying attention to one, you can’t ignore the other.
Alternating Attention
Fatiguing elements (extended vigilance)
Increasing memory demands
Task complexity
Time pressure
Not personally relevant
Areas of attention decline in > 80
Stored knowledge and the processes of manipulating and retrieving knowledge.
A relatively enduring change in behavior as a result of experience
Memory
Reconceptualization of short-term memory
Active role in concurrent information processing and storage activities
Involves large bilateral portions of the dorsolateral frontal cortex
Working memory
responsible for the selection & execution of strategies for maintaining & shifting attention, coordinating & manipulating information.
Central executive system
1. phonological loop that acts as a brief acoustic store with an articulatory rehearsal mechanism.
2. stores and manipulates nonverbal spatial representations
Verbal system

Spatial sketchpad
There is only a limited amount of processing capability available (number of ‘slots’ in the system) not time per se.
Decays rapidly
Needs frequent updating
Prob. w/ working memory
Ability to consciously recollect facts, names or events when needed
Includes episodic memory, concepts (semantic) memory and word (lexical) memory
Declarative memory
Factual knowledge of events or episodes
Recollection of conscious experiences from personal past
Involves both recall and recognition
Hippocampus and projections to temporal and frontal lobes
Episodic memory
Sum total of our knowledge. Facts about the world, meanings of words and concepts
Structures surrounding the hippocampus are critical for new semantic memory
Storage appears to involve the lateral temporal lobes in the form of a distributed network. Strength of connections
Concepts memory
Memory that is contained within learned skills or modifiable cognitive operations. (Squire 1987)
Knowledge of “how to” with an implied understanding of “when”, but no readily available explanation of “what”
Series of condition-action relationships
Procdural memory
There is only a limited amount of processing capability available (number of ‘slots’ in the system) not time per se.
Decays rapidly
Needs frequent updating
Prob. w/ working memory
Ability to consciously recollect facts, names or events when needed
Includes episodic memory, concepts (semantic) memory and word (lexical) memory
Declarative memory
Factual knowledge of events or episodes
Recollection of conscious experiences from personal past
Involves both recall and recognition
Hippocampus and projections to temporal and frontal lobes
Episodic memory
Sum total of our knowledge. Facts about the world, meanings of words and concepts
Structures surrounding the hippocampus are critical for new semantic memory
Storage appears to involve the lateral temporal lobes in the form of a distributed network. Strength of connections
Concepts memory
Memory that is contained within learned skills or modifiable cognitive operations. (Squire 1987)
Knowledge of “how to” with an implied understanding of “when”, but no readily available explanation of “what”
Series of condition-action relationships
Procdural memory
Ability to process and perform, without the perceiver’s conscious recollection of the stimulus.
Also includes priming (prior exposure improves recall)
Includes associative learning (classical and operant conditioning-pairing of a neutral stimulus to a learned response)
Builds with repetitions
Involves the basal ganglia
Implicit memory
Memory of our distant past
Reminiscence bump:memories of our teen years and early adult years seem to be most resilient to decay
Remote memory
1. memory trace fades with passage of time; details lost
Interference_original learning is disrupted by subsequent learning
2.-what you learned before interferes with what you're trying to remember now
3.-information you’ve just learned interferes with ability to remember previous information
Passive decay

proactive interferance

Retroactive interferance
short-term (tested with span tasks) appears to remain relatively intact as one ages.
Primary memory
Ability to recognize and monitor one’s own memory capabilities and effectiveness.
Frequently impaired with frontal lobe injury
May be affected with age.
May help explain the poor generalization of procedures form training tasks to other tasks and ability to maintain them over time.

Retrospective memory refers to the ability to remember past events
Prospective memory refers to the ability to remember for upcoming events.
Persons with prospective memory impairment commonly rely on prosthetic systems like appointment books, reminders from others, or electronic reminder systems.
Metamemory
1. refers to the ability to remember past events
2. refers to the ability to remember for upcoming events
Retrospective memory

Prospective memory
which is the active organization or manipulation of incoming information
Encoding
Allows one to operate in a regulated fashion beyond that of instinct, habit or impulse.
The ability to project action into internal or external environments
Executive functioning
The ability to plan and follow through with the steps necessary to achieve a desired goal.
Motivation
Anticipation
Organization
Sequencing
Modifications of plan
Selection and execution
The ability to utilize internal and external feedback to control accuracy and appropriateness of ones behavior when executing a plan.
Awareness
Insight
Judgment
Self regulation
Ability to know self strengths & limitations
Ability to set realistic goals
Ability to plan and organize behavior designed to achieve the goals
Ability to initiate behavior toward achieving goals and inhibit behavior incompatible with achieving goals.
Ability to monitor and evaluate performance
Ability to flexibly revise plans and strategically solve problems in the event of difficulty or failure
Effects of thoughtful behavior
Cancellation tasks, repeating graphomotor patterns, trail making
Vigilance: sustained attention
Selection:disengaging and engaging in tasks
Attention and concentration skills
Visual matching, “odd-man-out” with abstract designs, clock drawing, geographic locations
Visual perception: scanning, discriminating, analyzing, interpreting visual information
Visual construction: ability to create visual stimuli using perceptual skills and motor responses
Visuospatial skills
Slow or rapid force applied to stationary head so it is crushed.
Impression trauma-meninges and cortex at site of impact are damaged
Static loading
Results from head motion generated by either impact or impulsive forces. Results in
Translational (Linear) acceleration: all parts of the body are similarly accelerated & there is no resultant relative movement among parts of the brain but there is differential movement between the brain and the skull. This results in contusions which occur directly opposite the the point of impact. This is called contrecoup contusions
Inertial or accelerated loading
consists of the area of brain tissue characterized by multifocal capillary hemorrhages, vascular engorgement and edema
Contusion or bruise
when the head receives a force that does not pass through its center of gravity resulting in a twisting motion between the brain and the skull and causes shear-strain or distortion of the brain tissue. This causes permanent stretching or rupturing of neuronal fibers that interconnect different brain regions. Referred to as diffuse axonal injury (DAI). Most lesions occur in the deep white matter.
Rotational (angular)acceleration
Brain is 15% of body weight; brain is 3% of adult’s body weight
More pliable because of unfused sutures and open fontanelles
Greater elasticity and may absorb energy of physical impact better
However, > pliability may result in > risk of hemorrhages.
In child, floors of the the middle cranial fossa and orbital roofs are smooth and offer little resistance
Infant vs. adult head
Cerebral Edema
Intracranial Pressure
Hypoxic-Ischemic Damage- decrease in O2
Hemorrhages
Seizures
Secondary damage after TBI
Cerebral edema is an increase in brain volume due to an accumulation of excess water in the brain tissue. Most common secondary effect of brain injury
Cerebral Edema
Hypoxic-Ischemic Injury
Blood that does reach the brain may be poorly oxygenated because
Respiratory distress,
Slowed heart rate resulting in poor supply of blood to brain,
Constricted cerebral blood vessels
Cerebral vasoplasm (constriction of muscular layer surrounding blood vessels)

Along with ICP, most severe CHI have hypoxic injury
Areas which are most susceptible are hippocampi (80%) which will cause damage to memory capabilities
Hypoxic-ischemic attack
Result from laceration of the middle meningeal artery by fx bone. Involves bleeding between the skull bones and the dura mater. Typical pt recovers from unconsciousness & then 1-2 hrs later develops paralysis as a result of compression of the ipsilateral cerebral hemisphere’s expanding hematoma.
Extradural (epidural) hematoma:
Rupture of the small blood vessels within the subdural space leading to bleeding between the dura mater and arachnoid.
Develops slowly: some cases days or weeks after TBI
High mortality rate
Automobile accidents are frequent cause
subdural hemmorhage
Rupture of the blood vessels that cross the subarachnoid space between the arachnoid and pia mater.
Common after TBI
Detected in blood in the cerebrospinal fluid (CSF)
Spontaneous recovery
subarachnoid hemmorhage
Consists of progressive gait disturbance
Urinary incontinence
Frontal lobe dysfunction
May occur years, months or weeks after a subarachnoid hemorrhage
Normal pressure hydrocephalus
Sudden, transient alteration of neurologic function often with modification of consciousness due to an abnormal discharge of neurons
Epilepsy: a neurologic disorder manifested by recurrent seizures.
seizures
Occurs during childhood and can persist into teens
An abrupt loss of awareness which may last only a few seconds
Patient has a bewildered look but no abnormal movements
Abnormal EEG waves
If adult onset, usually related to lesion in temporal lobe
Petit Mal epilepsy
Also known as tonic-clonic seizures or primary generalized seizures
Episodes of sudden loss of consciousness with associated motor activity such as collapsing to the ground and shaking
Abnormal EEG
As many as 25% or persons with CVA may develop seizure disorder usually from 6-9 months post CVA
Grand Mal epilepsy
Caused by highly localized focal lesions.
May start in a distal limb and spread over the course of time to involve the rest of a limb or one side of the body.
Usually from lesions in the temporal lobe
Tempo-limbic epilepsy (TLE): recurrent episodes of involuntary, apparently purposeful, complex motor activity carried out in a repetitive manner. Estabrooks p. 38
Focal epilepsy
tumors of the nervous system that arise from within the brain
Gliomas
most malignant tumor of the brain
Glioblastoma
New memory complaint
Objective evidence of impairment of STM for age (short-term memory)
Normal general cognitive functions
No substantial interference with work, social activities or ADLs
No dementia according to criteria
Mild Cognitive impariment
One of the following: impaired handling of complex tasks, impaired reasoning ability, impaired spatial ability and orientation, impaired language
On basis of patient’s history and mental status examination, patient has difficulty learning and retaining new information
Alzheimers Disease
Also known as Dementia and Cerebrovascular Disease (DCVD)
One of the following: impaired handling of complex tasks, impaired reasoning ability, impaired spatial ability and orientation, impaired language
On basis of patient’s history and mental status examination, patient has difficulty learning and retaining new information
Vascular dementia
Also known as Dementia and Cerebrovascular Disease (DCVD)
One of the following: impaired handling of complex tasks, impaired reasoning ability, impaired spatial ability and orientation, impaired language
On basis of patient’s history and mental status examination, patient has difficulty learning and retaining new information
Subcortical dementias
do need to know- initial diagnosis is Aphasia but it gets worse and worse
Primary Progressive Aphasia
Testing for Aphasia
Language Processes
Cognitive Processes
Repetition
Oromotor Functioning
Intelligibility of Speech
Their perceived handicap