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256 Cards in this Set
- Front
- Back
Medical Model |
In the united states for many years understanding of chronic illness and disability was delineated by this which focused on specific medical conditions that were viewed as "problems" and were intrinsic to the individuals experiencing them. |
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Social Model |
Was in reaction to the medical model, emphasized societal and environmental barriers as primary contributors to disability. key component was equality. Paralleled civil rights and human rights movement |
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The Biopsychosocial Model |
Alternative to medical and social models. complex interaction of biological psychological, and social factors in combination that play role in individuals ability to function social refers to environment |
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The Experience of Disability |
Result of personal factors and circumstances individuals encounters within his or her own social and physical environment. Dynamic interaction between individuals experience with disability and functional capacity within a given text. EXAMPLE:person first language: you don’t talk about the stroke guy. you talk about the guy that had the stroke. don’t let the diagnosis define them. avoid terms like bedridden wheelchair bound. |
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impairment |
abnormality in body structure or appearance, one foot shorter than the other |
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disability |
consequence of impairment in terms of performance |
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Handicap: |
disadvantage individual experienced as a result of impairment or disability |
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ICF |
International classifications of functioning |
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What is the ICF |
Positive focus on function and health, Emphasizes integration of health and conditions (disease, injury, biological factors) and personal, societal, environmental factors. Disability not a problem: rather result of assets or barriers within social or physical environment. (disability is to ones owns interpretation) |
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Left brain |
logic and facts side of the brain |
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right brain |
more creative side of brain |
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Congenital: |
born with a disability |
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coping skills |
ways to manage,tolerate, reduce stress and restore psychological equilibrium |
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Adventitious: |
means acquired
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Uses of ICF |
Structure to facilitate communication within a between multidisciplinary groups |
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ICF is divided into two parts |
Part 1: Function and disability-body function and structure and activity and participation. ( how well their parts are working how well there minds are working) Part 2: Contextual factors- components: environmental factors and personal factors (what type of environment are they living in)
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Maximum Function |
greatest degree of functions possible; objective viewpoint |
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Optimal functioning |
subjective viewpoint of individual; derived from his or her own goals and experience. (what the person wants) |
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disease |
derived from medical model; changes in structure or function of body systems; focus on treatment; elimination of symptoms |
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illness |
individuals perception of their condition |
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health conditions |
how biological, psychological, social factors interact to determine functional capacity. |
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acute |
sudden onset of symptoms short term in nature; affect functional capacity on temporary basis |
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chronic |
symptoms last indefinitely; attributed to cause that may or may not be able to be identified |
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trajectory |
course of health condition over time |
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course |
nature or stages of condition: stable, progressive, episodic, degenerative, exacerbations, remissions |
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idiopathic |
do not know the cause of the disease |
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etiology |
the cause |
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remission |
goes away, period of time when symptoms go away remain stable and do not progress. |
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stable |
condition is being managed manifestations of the condition are not progressing and the heath status of the individual is not deteriorating |
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progressive |
manifestations of the condition continue to progress while health and functional capacity continue to decline |
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degenerative |
refers to conditions characterized by continuing breakdown of structure or function |
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exacerbations |
periods of time when manifestations become worse |
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stress in health conditions... Degree of stress |
relates to the degree of threat |
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Coping strategies |
denial; regression; compensation; rationalization; diversion of feelings. Learned and developed overtime as a way to manage tolerate or reduce stress associated with significant life events |
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coping is ______and ________ when it helps individuals reduce stress |
effective and adaptive |
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denial |
negate the reality of the situation |
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regression |
individuals subconciously revert to an earlier stage in development |
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compensation |
learn to counteract functional incapacitation in one area by becoming stronger or more efficient in another |
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rationalization |
enables an individual to find socially exceptable reasons for their behavior or to excuse themselves for not reaching their goals or not accomplishing tasks |
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diversion of feelings |
one of the most positive and constructive of all coping strategies can be the diversion of unacceptable feelings or ideas into socially acceptable behaviors |
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Guilt |
self critiscm or blame |
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grief |
natural reaction to loss |
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fear and anxiety |
threat due to loss of function, love, independence, financial, security |
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developmental stages |
continual process from infancy to old age and death |
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depression |
feelings of helplessness and hopelessness, apathy, or feelings of dejection and discouragement |
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self concept |
tied to self esteem and personal identity and included individuals perceptions and beliefs about their own strengths and weaknesses as well as others perceptions of them |
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self-esteem |
the evaluative component of an individuals self-concept. often thought as individuals assessment of their own self-worth with regard to attained qualities and performance |
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social identity |
individuals self-concept derived from perceived membership in social group |
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body image |
mental view of their body with regard to appearance, sexuality, ability to perform various physical tasks |
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Stigma |
feelings of shame due to disapproval of others and guilt resulting from being discredited or devalued by others (on the outside) |
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uncertainty |
concerns about unknown future |
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visibility of a condition |
associated with stigmatization and marginality. conditions you can see and some you can not detect |
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invisibility of condition |
no outward or physical signs or other cues to indicate limitations associated with conditons |
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sexuality |
ever changing, lived experience, affecting the way individuals view themselves and their bodies |
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family |
social network from which individuals derive identity and strong psychological bonds |
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Quality of Life |
subjective in nature wit uno universal meaning |
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adjustment |
search for meaning in experience; regain control and self-determination over events in ones life |
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acceptance |
reaching optimal functional capacity |
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nonacceptance |
immobility, dependency, anger and hostility, prolonged mourning, detrimental or self destructive activities. |
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Cultural aspects |
race/ethnicity |
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Functional Aspects |
determined by interaction of factors related to personal and his./her environment |
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structure and function of the nervous system |
Nervous system along with the endocrine system controls and coordinates the activities and functions throughout the body internally and externally, by sending, receiving, and sorting electrical impulse
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afferent |
sensory which carries messages from other parts of the body to the central nervous system |
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efferent |
motor system which carries messages from the central nervous system to other parts of the body |
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central nervous system consists of |
brain and spinal cord |
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peripheral nervous system includes |
nerve fibers extending form the brain and spina lcord that carry info between the central nervous system and the rest of the body |
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peripheral nervous system is divided into two parts : |
afferent and efferent |
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nerve cells are |
neurons, which are functional units of the nervous system. neurons transmit messages to and from the brain |
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axon |
conducts nerve impulses |
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Dura Mater |
a membrane between bony coverings, outermost membrane, lying closest to the bony coverings of the brain and spinal cord (underneath the skull) |
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arachnoid membrane |
middle membrane looks like a cobweb (where the cerebral spinal fluid regulates) |
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pia mater |
inner membrane lies closest to the brain and spinal cord. (touches the brain and cannot be penetrated) |
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epidural surface |
space between the dura mater and the inner surface of the bony covering |
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subdural space |
space between the dura mater and arachnoid membrane |
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subarachnoid space |
space between the arachnoid membrane and the pia mater |
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CSF |
cerebral spinal fluid |
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what does the csf do? |
cushions and protects the central nervous system |
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CSF formed by ?
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special capillaries called the choroids plexus in inner chambers within the brain called ventricles |
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ventricles |
inner chambers within the brain |
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blood brain barrier |
protective device structural arrangement of capillaries that determines which substances can be moved from blue into the brain. |
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white matter |
makes up inner part of the brain and the outer portion of the spinal cord and consists of mylinated covered axons that conduct nerve impulses. |
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gray mater |
makes up the thin outer layer of the brain and inner portion of the spinal cord. consists of neuron cell bodies |
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sympathetic nervous |
becomes active during periods of stress and in emergencies |
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autonomic nervous system divided into two part |
part of the peripheral nervous system sympathetic and parasympathetic |
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dendrites |
smaller nerve fibers conduct nerve impulses towards the cell body after recieving information from other neurons |
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afferent neurons |
(sensory neurons) fibers that carry info from parts of the body to the brain |
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efferent neurons |
(motor neurons) from brain to other parts of the body |
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myelin sheath |
covers the neurons, fatty, provides insulation |
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neurotransmitters |
at the tip of the axon is a tiny process |
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synapse |
space between two neurons where the neurotransmitters are released |
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cerebral spinal fluid |
central nervous system is protected by this and it cushions it |
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cranium |
bony coverings of the skull |
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cortex |
cerebrum is covered with a think outer layer of grey matter called this |
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cerebrum |
largest part of the brain |
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temporal lobe |
located under the the frontal and parietal lobes and is primarily responsible for the interpretation of and distinction between auditory stimuli |
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occipital lobe |
located at the back or posterior portion of each hemisphere. primary area for reception and interprtation of visual stimuli |
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wernikes area |
major area responsible for receptive function (speech understanding) |
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brocas area |
responsible for speaking ability and is closely associated with motor areas that control the muscles need for articulation |
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thalamus: |
acts as relay station that sorts, interprets, directs sensory information. involved incensory gathering and organizing |
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limbic system |
expression of instincts drives emotion formation of memories (the cause of all my issues) |
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cerebellum: |
coordination and integration of voluntary movement and for equilibrium, posture, balance of body. |
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Brain stem |
acts as relay station; center of involuntary function |
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reticular formation |
located within the brain stem, scattered groups of cells which are involved in the initiation and maintenance of wakefulness and alertness |
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cranial nerves |
12 peripheral nerves that connect and transmit messages dirrectly to the brain |
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spinal nerves |
the 31 pairs of peripheral nerves that connect and transmit messages directly to the spinal cord and are called spinal nerves |
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peripheral nervous system |
nerves lying on the outside of the central nervous system |
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somatic nervous system |
nerves that control voluntary functioning such as movement of the muscles or extremities |
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autonomic nervous system |
integrates the work of vital organs such as the heart and lungs, job is to keep homeostasis |
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parasympathetic nervous system |
dominates boyd when at rest, activates mechanisms that focus on body conservation such as decreasing the heart rate and constricting pupils of the eye |
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sympathetic nervous system |
becomes active in emergencies and stress, prepares body for action. deepening respiration making heart beat faster dilating pupils |
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TBI |
Traumatic Brain Injury |
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what is the leading cause of incapacitation due to injury |
TBI |
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Is TBI degenerative? |
no |
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what are TBI mainly caused by? |
vehicle accidents, assaults, violence, shaking |
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finklestein signs |
sign of de quervain synovitis |
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categories of TBI |
closed head injury, open or penetrating injury, blast injury |
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closed head injury |
could occur with a blow to the head or shaking or concussion. bleeding (hematoma) in intracranial cavity: which does more damage to the brain |
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craniotomy- |
-remove a flap of the skull so that there is no pressure on the brain |
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open head injury- |
skull fractured or foreign object penetrates skull. |
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edema |
swelling of the brain |
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intracranial hemorrhage |
bleeding within the cranial vault |
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hematoma |
sac filled with blood |
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what does swelling or bleeding do to the brain |
compresses the brain and causes cranial pressure which can interfere with brain function |
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epideral hematoma |
occurs in the space between the outer membrane and the skull. Carry a high mortality rate because they may not be recognized immediately |
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subdural hematoma |
space beneath the dura mater |
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meninges |
the lining surrounding the brain |
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blast injuries |
relates to initial shock wave blast from a war |
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glasgow coma scale |
classification system for rating seriousness of brain injury |
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Ranchos Los Amigos cognitive scale |
another scale to measure brain injury levels of arousal and cognitive functioning |
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disability rating scale |
was developed to quantify functional capacity patients with TBi and their progress form the time of injury through rehab into the time they reenter the community |
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Level 1 associated wit TBI |
no response to sounds light or touch |
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level 2 associated with TBI |
generalized response to stimuli such as responding to a loud noise but not turning toward the noise, not consistent and does not have purpose |
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level 3 with TBI |
localized response open eyes and look at specific objects head turns in direction of sound "squeeze my hand |
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level 4 with TBI |
confusion and agitation. restless regardless of circumstance. may become verbally abusive |
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level 5 TbI |
confused with conversation making no sense may be able to follow simple instructions less agitated may become frustrated |
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level 6 tbi |
confused by verbal responses are appropriate, some memory problems. capable of activites some judgment and problem solving difficulties |
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level 7 tbi |
puposeful and independent can process new information |
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concussion |
momentary loss of consciousness or breif period of feeling stunned after blow to head, considered mild brain injury |
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moderate brain injury |
brain injury that is associated with confusion or disorientation may experience cognitive, physical and psychological deficiets which may last weeks to months or may be permanent. (behavior has changed, argumentative resistant, finding fault, missing things and blaming other people) |
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severe brain injury |
brain injury coma for an extended period of time, unresponsive |
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when TBI occur and people get better they still may suffer from these conditions : |
post-traumatic epilepsy- brain doesn’t have control |
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post-traumatic hydrocephalus |
characterized by overproduction of cerebral spinal fluid or interference with reabsorption of cerebral spinal fluid |
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ataxia |
experiencing problems with muscle coordination which affects balance, causing them to walk with unsteady gait or to lurch from side to side. With upper extremity may have difficulty grasping items |
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dyskinesia |
characterized by abnormal movements |
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dystonia |
abnormal muscle tone |
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flaccidyity |
decreases the ability to move (too little tone) |
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spacticity |
too much muscle tone that heightens reflexes or exacerbates abnormal movement |
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apraxia |
loss in ability to organize and sequence specific muscle movements to perform a task. they are aware of what they want to do and how to do it but are unable to organize their muscle movements despite physical ability to do so |
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agnosia |
loss of comprehension of sensations, lose the ability to recognize familiar things such as words faces or objects. ex: coffee mug, coffee, feet |
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agnosignosia |
one-sided or unilateral neglect, in which body parts or objects on one side the body are ignored ( shave one side of face or put on one shoe) |
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diplopia |
double vision |
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hemianopsia |
loss in vision in half the visual field may have trouble seeing the other half of the dinner table |
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sensorineural hearing loss |
as with vision even though ear has been injured directly hearing deficits may be present if the area of the brain responsible for receiving, perceiving, or interpreting sound has been injured |
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paresthesia |
abnormal sensations, such as tingling or burning in various locations of the body |
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anosmia |
no sense of smell |
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dysphagia |
difficulty swallowing, and difficulty chewing |
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speech |
physical ability to produce sounds or movement of the lips |
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articulation |
position and placement of the tongue and muscles of the palate necessary to enunciate words and sentences |
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apraxia of speech |
loss in ability to plan organize and execute learned movement smoothly that is necessary for speech thereby affecting clarity of speech even though there is no muscle weakness or paralysis |
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language |
words gestures and other symbols put together to convey and understand concepts |
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aphasia |
inability or decreased ability to communicate through speech |
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paraphrasia |
difficulty finding words they want to say |
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paraphasia |
spoken words or written words that are jumbled because of brain damage |
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confabulation |
may make up answers to questions or make up situations or events |
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subluxation |
separation of the arm from the shoulder joint |
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hemiplegia |
paralysis on one side of the body |
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anoxia |
When there is no oxygen averrable for the brain. Brain tissue can be permanently damaged, resulting in neurological manifestations. |
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non traumatic brain injuries |
conditions that restrict blood flow and oxygen flow to the brain causing damage to brain tissue. (choking, near-drowning, carbon monoxide poisoning, infections such as meningitis, encephalitis, ruptured of weakened blood vessels, congenital structural aberrations, most common, : stroke |
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stroke CVA cerebral vascular accident |
caused by an insufficient flow of oxygen to the brain and blood. related to other diseases such as cardiac disease and arteriosclerosis and hypertension |
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risk factors for stroke are: |
obesity. smoking, physical inactivity, heavy alcohol use, and use of illicit drugs, especially cocaine, and amphetamines |
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ischemic stroke |
occasion of blood vessels that diminishes blood flow to the brain tissue |
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hemorrhagic stroke |
occurs because of rupture of blood vessel in brain |
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arteriosclerosis |
ischemic vascular disease hardening of the arteries |
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hypertension |
high blood pressure |
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infarction |
death of brain tissue |
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causes of infarction |
thrombus, cerebral thrombosis, embolism |
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thrombus |
blood clott |
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cerebral thrombosis |
blocks blood flow to an area of the brain preventing brain tissue from obtaining needed oxygen. |
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embolism |
clot has formed in another part of the body breaks free and travels through the blood vessels to the brain lodging in one of the cerebral arteries (can be a globule) |
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hypoxia |
too little oxygen in blood supply for brain to function |
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transient ischemic attacks |
mild stroke |
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subarachnoid space |
space fileld with cerebral spoinal fluid |
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aneurysm |
thin walled outpouching protrudes from blood vessel, cause no manifestations until they burst |
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edematous |
swelling of the brain |
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leading cause of incapacitation |
stroke |
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two chronic conditions that lead to stroke |
hypertension and diabetes |
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causes of hemorrhagic stroke |
uncontrolled hypertension, aneurysm, alterovenous malformation, aortic stroke. |
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alexia |
difficulty reading |
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agraphia |
difficulty writing |
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most common place to have a stroke |
middle cerebral artery |
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least common place to have a stroke |
anterior cerebral artery |
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atherosclerosis- |
blockages, created by lipids and cholesterol build up on arteries- called atheroma- soft on the inside hard on the outside. blood hits the atheroma and it gets bigger and the artery becomes more narrow. Aspirin breaks down atheroma and makes the artery wider |
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global aphasia |
difficulty to severe communicating and understanding language written or spoken |
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dysarthria |
coordination and accuracy of movement of the muscles, lips, tongue, or other parts of speech mechanisms may be impaired secondary to weakness or paralysis of muscles needed to speak |
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aphasia- |
the inability to transmit / to understand verbal or written language. Two categories: (expressive or motor) fluent (receptive or sensory) |
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broca’s aphasia- |
type of confluent aphasia characterized by articulation problems, hesitancy, and reduced vocabulary and grammar |
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issues associated with left brain damage |
right sided and sensory paralysis, may interfere with ability to comprehend and use language, problems with both understanding and speaking |
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issues associated with right side brain damages |
left sided motor and sensory paralysis |
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contracture |
soft tissue fusion, resulting in loss of range of motion or fixed deformity of the joint |
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lability |
emotional instability, loss of emotional control. part of the hypothalamus that was injured issued. crying when things are funny, laughing when serious |
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ADL |
activites of daily living (feeding yourself, personal care |
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iADL |
instrumental activities of daily living (driving a car) |
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epilepsy |
not a single condition, but rather a term used to describe a group of conditions that occur in conjunction with disruption of electrical activity in the brain which intern affects consciousness movement or actions through a seizure. |
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seizure |
temporary loss of control over certain functions. sign you have epilepsy. lose temporary or complete consciousness |
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Intrinsic factors relating to seizure |
recurrent, unprovoked seizures. |
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extrinsic factors relating to seizure |
happens outside the brain |
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aura |
warning sign before a seizure |
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two classifications of seizures |
generalized, partial |
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manifestations of generalized seizures |
tonic phase- body rigidity, then muscles enter clonic state where the body undergoes rapid jerky movements |
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absence seizures |
most commonly experienced by children |
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simple partial seizures |
nerve cells discharge in an isolated part of the brain, partial seizures occur. |
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focal seizures |
no loss of consciousness and manifestations are very localized depending on part of brain affected : jacksonian seizure starts with convulsions on one or part of the body |
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complex partial seizures |
loss of awareness in surroundings |
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status epilepticus |
seizures prolonged or in rapid succession without fill recovery of consciousness between seizures medical emergency that can be life threatening. grand mal seizures do not end, oxygen stops theoccurrence of seizures |
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detecting seizures |
extensive physical examination
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titrate- |
to get the right amount of certain drugs, the doctor has to titrate them. specific to each person |
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Meningitis |
inflammation of the meninges ( membranes surrounding brain and spinal cord) |
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Encephalitis |
inflammation of brain due to direct invasion of organism |
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Sleep apnea- |
disturbed sleep resulting in significant daytime sleepiness |
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two types of sleep apnea |
obstructive and central |
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Narcolepsy |
neurological sleep disorder involving central nervous system linked to disruption of sleep control mechanisms |
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paraparesis |
partial paralysis and indicates that some function remains below the level of injury |
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Spinal Cord transmits |
electrical messages to and from the brain that facilitate motor, sensory, or autonomic function |
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Most common cause of altered function of the spinal cord: |
direct injury from motor vehicle accidents most common (young men) |
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complete spinal cord injury |
total severance of spinal cord |
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incomplete spinal cord injury |
severence not complete |
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General function implications of traumatic spinal cord injury |
pulmonary function- (phrenic nerve) |
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spinal cord injury dealing with Cervical level (c1_c8) |
results in quadriplegia (paralysis of both upper and lower extremities) |
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spinal cord injuries with c1-c4 |
respiratory assistance with mechanical respiratory device or ventilator |
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spinal cord injuries with c5 |
some gross movement of upper extremities |
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spinal cord injury with c-6 |
gross motor movement of upper extremities; independence in self-care |
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spinal cord injury c-7 |
almsot total independence with some adaptations in environment |
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spinal cord injury with c8 |
some sensation in hands; may become totally independent |
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T-1 or lower injury |
result in paraplegia (paralysis of lower extremities), upper extremities for most part unimpaired |
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injury with Lumbar Level (L1_L15) |
Many muscles of mobility intact |
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Sacral Level (S1-S4) |
in most instances, individuals able to recover most perjury function |
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define ambulation |
walking |
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paraplegia |
paralysis of lower extremities |
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osteoporosis |
becomes spongelike calcium leaves bones |
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quadrapelegia |
involvement in lower extremeties |
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what are decubitus ulcers |
bed sores, pressure sores |
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autonomic dysreflexia |
medical emergency, produces a change in heart rate. laying down causes hypertension sitting up drains the brain. can lead to stroke |
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necrosis |
skin tissue death |
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thrombophlebitis |
formation of blood clots in the legs |
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pulmonary embolism |
a blood clot that travels to the lungs |
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orthostatic hypotension |
a condition in which the blood pressure becomes significantly lower with the individual moves from flat position to an upright position, which result in manifestations such as dizziness or fainting |
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syncope |
dizziness or fainting |
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pyelonephritis |
infection of the kidney |
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septicemia |
infection of blood |
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renal calculi |
kidney stones |
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ureters |
tubes leading to the kidneys |
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urinary reflux |
causing urine to back up to the kidneys |
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impaction |
poop that becomes hardened and is unable to be evacuated |
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paralytic ileus |
intestine ceases to function |
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diaphoresis |
profuse sweating |
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paresthesia |
abnormal painful sensation below level of injury |