RHD and TBI Examination Review

Comprehensive vocabulary flashcards covering Right Hemisphere Damage (RHD) and Traumatic Brain Injury (TBI), including symptoms, severity levels, consciousness states, and the Rancho Los Amigos Scale.

Focal lesion

Localized damage to a specific area of the brain, such as frontal damage leading to expression language deficits.

Left Hemisphere Role

Dominant for language, skilled motor movement, sequential and analytical calculating skills in arithmetic, and detail-oriented following of written directions.

Right Hemisphere Role

Non-dominant for prosody, inferences, themes, non-literal language, spatial attention, visual-spatial analysis, and the ability to correctly line up columns of numbers in arithmetic.

Anosognosia

Reduced awareness or denial of physical, sensory, communication, or cognitive deficits secondary to neurological changes.

Etiologies of RHD

Common causes include stroke, tumor, and Traumatic Brain Injury (TBI).

Prosopagnosia

Inability to recognize or remember familiar faces.

Constructional impairment

Trouble copying geometric shapes, drawing clocks, or arranging blocks.

Topographic Disorientation

Getting lost in familiar places or failing to read maps.

Aprosidia

Loss of emotional inflection, sounding monotone, or having difficulty understanding emotions in the voices of others.

MIRBI

Mini Inventory of Right Brain Damage, an assessment for cognitive, communicative, and perceptual deficits, including visual scanning and lexical knowledge.

Diffuse Axonal Injury (DAI)

Widespread tearing of nerve fibers occurring during severe rotational brain tissue movements where axons shear over one another.

Coup vs. Contrecoup

Damage at the specific point of impact versus damage on the opposite side of the impact due to inertia.

Mild TBI (mTBI) / Concussion

A severity level defined by loss of consciousness (LOC) for less than $30$ minutes and post-traumatic amnesia (PTA) for less than $24$ hours.

Moderate TBI

A severity level defined by LOC between $30$ minutes and $24$ hours and PTA between $1$ and $7$ days.

Severe TBI

A severity level defined by LOC of more than $24$ hours and PTA for more than $7$ days.

Coma

A state of consciousness where the patient does not respond purposefully to stimuli, has brainstem reflexes, no sleep-wake cycle, and severely depressed EEG patterns.

Persistent Vegetative State (PVS)

A state with no purposeful responses to stimuli, but the patient possesses brainstem reflexes, a sleep-wake cycle, and severely depressed EEG patterns.

Minimally Conscious State (MCS)

A state where the patient sometimes responds to purposeful stimuli and has brainstem reflexes, a sleep-wake cycle, and variable EEG patterns.

Locked-in Syndrome (LIS)

A condition where individuals are aware and conscious but cannot move except for the eyes; they have brainstem reflexes, a sleep-wake cycle, and normal EEG patterns.

Rancho Level I

No response: Unresponsive to visual, auditory, and tactile stimuli.

Rancho Level II

Generalized response: Non-specific, inconsistent, and non-purposeful reaction to stimuli.

Rancho Level III

Localized response: Responses are directly related to the type of stimulus but remain inconsistent or delayed.

Rancho Level IV

Confused-agitated: Response is heightened, severely confused, disoriented, and potentially aggressive.

Rancho Level V

Confused-inappropriate, non-agitated: Responds to simple commands but exhibits high distractibility and confusion with complex commands.

Rancho Level VI

Confused-appropriate: Shows goal-directed response but requires cues; disoriented but can complete some activities of daily living with assistance.

Rancho Level VII

Automatic-appropriate: Response is robot-like; oriented in familiar settings but judgment is impaired and unrealistic about the future.

Rancho Level VIII

Purposeful-appropriate: Adequate response to familiar tasks; oriented and has insight into impairments, but requires standby assistance for social situational needs.

Glasgow Coma Scale (GCS)

A formal assessment tool used to determine the acute severity of a Traumatic Brain Injury.

Spaced Retrieval Training

An EBP intervention that facilitates the recall of personal biographical information or procedures through repeated practice.

Metacognitive Strategy Training

Intervention targets executive functions and self-monitoring, including goal management training and strategic thinking.