TBI

Question 1

Penetrating (open) head injuries

Answer 1

• In such injuries a sharp object may penetrate the skull and enter the brain
• Severity of head injuries may depend on type of object, velocity of missile, and secondary damage occurring from infection, bleeding and subsequent hydrocephalus

Question 2

Low velocity vs high velocity injuries

Answer 2

• low velocity injuries have concentrated force that fracture the skull and drive bone debris into the brain (examples: injury due to knife glass, some types of air rifles, axe, tree branches)
• High velocity injuries may enter the brain more clearly but may cause relatively more destruction of the tissue around and along the projectile’s paths (examples: car accidents, projectiles)
• Blast injuries (the textbook classifies these as penetrating or open head injuries) includes injuries due to rocket-propelled grenades, landmines, and improvised explosive devices

Question 3

Non-penetrating (closed) head injuries

Answer 3

Examples: Motor vehicle accidents, skiing accidents, sports-related events (boxingn, football, soccer)

Question 4

types of non-penetrating (closed) head injuries

Answer 4

non-acceleration and acceleration injuries

Question 5

Non-acceleration injuries

Answer 5

these injuries are caused when an individual’s fixed or restrained head is struck by a oving object. E.g. A man standing on the street and getting hit by a car, a man sitting on a chair and being hit by a bullet

Question 6

Acceleration injuries

Answer 6

these injuries are caused when an individual in motion is struck by a stationary or moving object. E.g. car accident in motion, skiing accident, person falling from hieght

Question 7

Assessments of memory

Answer 7

• Recognition memory test
• Wechsler memory scale

Question 8

Recognition memory test

Answer 8

here an individual is shown words, faces, or designs and then asked to indicate the images that were presented before. Useful in assessment of individuals who have difficulties in drawing, copying, or responding verbally

Question 9

Wechsler memory scale

Answer 9

provides information about immediate and delayed recall, recognition of short paragraphs, a word list, unfamiliar faces, and abstract design. It also includes measures of immediate and working memory (digit span, spatial span, letter-number sequencing)

Question 10

Assessments for executive functioning

Answer 10

• Wisconsin card sorting test
• stroop color and word test
• tower test
• controlled oral word association test

Question 11

wisconsin card sorting test

Answer 11

assesses set shifting

Question 12

Stroop color and word test

Answer 12

assesses set shifting, inhibition of prepotent responses

Question 13

tower test

Answer 13

assesses planning

Question 14

controlled oral word association test

Answer 14

assesses word generation according to initial letter while following a set of rules

Question 15

General measures of disability and outcomes

Answer 15

• functional independence measures
• The disability rating score for severe head trauma

Question 16

functional independence measures

Answer 16

• one of the most widely used tests
• assesses level of assistance required to perform different ADLs

Question 17

The disability rating score for severe head trauma

Answer 17

More sensitive that GOS and has fewer ceiling effects than the FIM (functional independence measures) and FAM (functional assessment measures)

Question 18

Katz adjustment scale

Answer 18

assesses personality changes following brain injury and their psychosocial effects
- consists of 127 items with both patient and relative report form. Detects changes following rehab and correlates well with other measure of social outcomes

Question 19

Neurobehavioral rating scale

Answer 19

assesses wide range of cognitive behavioral and psychiatric symptoms. Shown to be sensitive to personality changes following brain injury, changes over time, and different patterns of frontal lobe-associated psychopathology

Question 20

Mayo-portland adaptability inventory

Answer 20

assesses temperament and emotionality (anxiety, depression, agitation) activities and social behavior (social contacts, leisure activities) and physical capabilities (use of hand, dysarthria)

Question 21

Treatment to restore/improve memory function

Answer 21

• memory practice drills: repeated testing w/out strategy
• maintenance rehearsal training: simple repetition to facilitate working memory

Question 22

Types of rehearsal training for memory

Answer 22

• Scene rehearsal practicing a scene with eyes closed
• Fact rehearsal remember an event by referencing to facts
• Self-referencing relating new information into old information
• Semantic, rehearsal; organized information into semantic categories

Question 23

Working memory training

Answer 23

• Card games
• Mental math/word games

Question 24

memory encoding strategies

Answer 24

• Improve acquisition (attention)
• Check perceptual abilities
• Teach memory cues
• Persistence

Question 25

Treatment recommendations for memory deficits

Answer 25

- restore/improve memory function - teach retrieval strategies - mnemonic devices

Question 26

Retrieval strategies

Answer 26

- Good encoding cues help retreival also (good encoding–good retrieval– good memory) - search; use of phonemic cues for nearly learned information - Free association - Reinstate mood; have client reinstate the mood they are in at the same time - First letter cue - - time-related reconstruction of events - Primacy and recency effects

Question 27

Mnemonic devices

Answer 27

- Visual imagery, trying to remember pictures - Verbal organization. Paired association of new information with prior stimulation - Semantic elaboration. Make a story - First letter mnemonic ; use first letter of each word - Sentence generations: use of sentences or words to remember things - Prospective memory training: it is the memory to do somethingin the future. Use of memory books for future appointments and schedule

Question 28

Assessment of TBI-related pragmatic deficits

Answer 28

- Systematic observation: include use of checklists or indicates listing different communication parameters ------Pragmatic protocol: considered the gold standard for observational checklists. Includes 32 pragmatic behaviors into 4 categories. Items are judged as appropriate, inappropriate, or not observed ------Communication profiling system: incudes a cyclical collection and analysis of naturalistic communication data