Glossary – Vendra medical

Activities of Daily Living (ADL): Include personal hygiene, dressing, bathing, leisure, work, recreation, meal preparation, shopping, etc.

Adaptive/ Assistive Equipment: A special device that assists in the performance of self-care, work, play/leisure activities, or physical exercise.

Affect: The observable emotional condition of an individual at any given time.

Agnosia: Failure to recognize familiar objects although the sensory mechanism is intact. May occur for any sensory modality.

Agraphia: Inability to express thoughts in writing.

Ambulate: To walk.

Amnesia: Lack of memory about events occurring during a particular period of time. See also: anterograde amnesia, retrograde amnesia, and post-traumatic amnesia.

Anomia: Inability to recall names of objects. Persons with this problem often speak fluently but have to use other words to describe familiar objects.

Anosmia: Loss of the sense of smell.

Anoxia: A lack of oxygen. Cells of the brain need oxygen to stay alive. When blood flow to the brain is reduced or when oxygen in the blood is too low, brain cells are damaged.

Anterograde Amnesia: Inability to consolidate information about ongoing events. Difficulty with new learning.

Anticonvulsant: Medication is used to decrease the possibility of a seizure (e.g. Dilantin, Phenobarbital, Mysoline, Tegretol).

Astereognosia: Inability to recognize things by touch.

Ataxia: A problem of muscle coordination not due to apraxia, weakness, rigidity, spasticity or sensory loss. Caused by lesion of the cerebellum or basal ganglia. Can interfere with a person’s ability to walk, talk, eat, and perform other self-care tasks.

Awareness Deficit: The patient’s inability to recognize the problems caused by impaired brain function.

Brain Injury (Closed): Occurs when the head accelerates and then rapidly decelerates or collides with another object (for example the windshield of a car) and brain tissue is damaged, not by the presence of a foreign object within the brain, but by violent smashing, stretching, and twisting, of brain tissue. Closed brain injuries typically cause diffuse tissue damage that results in disabilities that are generalized and highly variable.

Brain Injury (Mild): A patient with a mild traumatic brain injury is a person who has had a traumatically-induced physiological disruption of brain function, as manifested by at least one of the following: 1) any period of loss of consciousness, 2) any loss of memory for events immediately before or after the accident, 3) any alteration in mental state at the time of the accident (e.g., feeling dazed, disoriented, or confused), 4) focal neurological deficit(s) which may or may not be transient; but where the severity of the injury does not exceed the following: a) loss of consciousness of approximately 30 minutes or less; b) after 30 minutes, an initial Glasgow Coma Scale score of 13-15; c) Post Traumatic Amnesia not greater than 24 hours.

Brain Injury (Moderate): A Glasgow Coma Scale score of 9-12 during the first 24 hours post-injury.

Brain Injury (Penetrating): Occurs when an object (for example a bullet or an ice pick) fractures the skull, enters the brain, and rips the soft brain tissue in its path. Penetrating injuries tend to damage relatively localized areas of the brain, which result in fairly discrete and predictable disabilities.

Brain Injury (Severe): Severe injury is one that produces at least 6 hours of coma; Glasgow Coma Scale of 8 or less within the first 24 hours.

Brain Injury (Traumatic): Damage to living brain tissue is caused by an external mechanical force. It is usually characterized by a period of altered consciousness (amnesia or coma) that can be very brief (minutes) or very long (months/indefinitely). The specific disabling condition(s) may be orthopedic, visual, aural, neurologic, perceptive/cognitive, or mental/emotional in nature. The term does not include brain injuries that are caused by insufficient blood supply, toxic substances, malignancy, disease-producing organisms, congenital disorders, birth trauma or degenerative processes.

Brain Stem: The lower extension of the brain where it connects to the spinal cord. Neurological functions located in the brain stem include those necessary for survival (breathing, heart rate) and for arousal (being awake and alert).

Brain injury: More specific term than head injury. Damage to the brain that results in impairments in one or more functions, including arousal, attention, language, memory, reasoning, abstract thinking, judgment problem solving, sensory abilities, perceptual abilities, motor abilities, psychosocial behavior, information processing, and speech. The damage may be caused by external physical force, insufficient blood supply, toxic substances, malignancy, disease-producing organisms, congenital disorders, birth trauma or degenerative processes.

balance: The ability to use appropriate righting and equilibrium reactions to maintain an upright position. It is usually tested in sitting and standing positions.

Case Management: Facilitating the access of a patient to appropriate medical, rehabilitation and support programs, and coordination of the delivery of services. This role may involve liaison with various professionals and agencies, advocacy on behalf of the patient, and arranging for the purchase of services where no appropriate programs are available.

Cerebellum: The portion of the brain (located at the back) which helps coordinate movement. Damage may result in ataxia.

Cerebral- Spinal Fluid (CSF): Liquid fills the ventricles of the brain and surrounds the brain and spinal cord.

Cognition: The conscious process of knowing or being aware of thoughts or perceptions, including understanding and reasoning.

Cognitive Impairment: Difficulty with one or more of the basic attentional abilities, and reasoning skills.

Cognitive Rehabilitation: Therapy programs aid persons in the management of specific problems in perception, memory, thinking and problem-solving. Skills are practiced and strategies are taught to help improve function and/or compensate for remaining deficits. The interventions are based on an assessment and understanding of the person’s brain-behavior deficits and services are provided by qualified practitioners.

Coma: A state of unconsciousness from which the patient cannot be awakened or aroused, even by powerful stimulation; lack of any response to one’s environment. Defined clinically as an inability to follow a one-step command consistently; Glasgow Coma Scale of 8 or less.

Community Skills: Those abilities are needed to function independently in the community. They may include telephone skills, money management, pedestrian skills, use of public transportation, meal planning, and cooking.

Concussion: The common result of a blow to the head or sudden deceleration usually causes an altered mental state, either temporary or prolonged. Physiologic and/or anatomic disruption of connections between some nerve cells in the brain may occur. Often used by the public to refer to a brief loss of consciousness.

Confabulation: Verbalizations about people, places, and events with no basis in reality.

Contracture: Loss of range of motion in a joint due to abnormal shortening of soft tissues

Convergence: Movement of two eyeballs inward to focus on an object moved closer. The nearer the object the greater is the degree of convergence necessary to maintain a single vision.

Core Therapies for Brain Injury: Basic therapy services are provided by professionals on a brain injury rehabilitation unit. Usually refers to nursing, physical therapy, occupational therapy, speech-language pathology, neuropsychology, social work, and therapeutic recreation.

Diffuse Axonal Injury (DAI): A shearing injury of large nerve fibers (axons covered with myelin) in many areas of the brain. It appears to be one of the two primary lesions of brain injury, the other being stretching or shearing of blood vessels from the same forces, producing hemorrhage.

Diffuse Brain Injury: Injury to cells in many areas of the brain rather than in one specific location.

Diffuse Brain Injury: Injury to cells in many areas of the brain rather than in one specific location.

Diplopia: Seeing two images of a single object; double vision.

Discrimination (Auditory).: The ability to differentiate and recognize sounds

Discrimination (Sensory): A process requiring differentiation of two or more stimuli.

Discrimination (Tactile): The ability to differentiate and distinguish between objects and stimuli solely through touch. This involves the ability to ascertain shape, size, and texture.

Discrimination (Visual): Involves the differentiation of items using sight, including colors, letters, size, shape, etc.

Disinhibition: Inability to suppress (inhibit) impulsive behavior and emotions.

Dysarthria: Difficulty in forming words or speaking them because of the weakness of muscles used in speaking or because of disruption in the neuromotor stimulus patterns required for accuracy and velocity of speech.

Dysphagia: A swallowing disorder is characterized by difficulty in oral preparation for the swallow, or in moving material from the mouth to the stomach. This also includes problems with positioning the food in the mouth.

Emotional Lability: Exhibiting rapid and drastic changes in emotional state (laughing, crying, anger) inappropriately without apparent reason.

Executive Functions: Planning, prioritizing, sequencing, self-monitoring, self-correcting, inhibiting, initiating, controlling or altering behavior.

Figure-Ground: The differentiation between the foreground and the background of a scene; refers to all sensory systems, including vision, hearing, touch.

Fixation, visual: A pause of the line of sight on something of interest in the visual world.

Flaccid: Lacking normal muscle tone; limp.

Frontal Lobe: The front part of the brain; involved in planning, organizing, problem-solving, selective attention, personality, and a variety of “higher cognitive functions.”

Functional Outcome: The end result of therapeutic intervention; practical activities in which a person is capable of engaging on a regular basis.

Gait Training: Instruction in walking, with or without equipment; also called “ambulation training.”

Glasgow Coma Scale (GCS): A standardized system is used to assess the degree of brain impairment and to identify the seriousness of injury in relation to outcome. The system involves three determinants: eye-opening, verbal responses, and motor response all of which are evaluated independently according to a numerical value that indicates the level of consciousness and degree of dysfunction. Scores run from a high of 15 to a low of 3. Mild Injury = 13 to 15; Moderate Injury = 9 to 12; and Severe Injury = less than 8.

Head Injury: Refers to an injury of the head and/or brain, including lacerations and contusions of the head, scalp, and/or forehead. Also, see Brain Injury.

Hematoma: The collection of blood in tissues or a space following rupture of a blood vessel. There are 4 types of brain hematomas: Epidural – Outside the brain and its fibrous covering (dura), but under the skull. Subdural – Between the brain and its fibrous covering (dura). Intracerebral – In the brain tissue. Subarachnoid – Around the surfaces of the brain, between the dura and arachnoid membranes.

Hemiparesis: Weakness of one side of the body.

Hemiplegia: Paralysis of one side of the body as a result of an injury to neurons carrying signals to muscles from the motor areas of the brain.

Hemorrhage: Bleeding occurs following damage to blood vessels. Bleeding may occur within the brain when blood vessels in the brain are damaged. Also, see Hematoma.

ICP: See Intracranial Pressure.

Impulse Control: Refers to the individual’s ability to withhold inappropriate verbal or motor responses while completing a task. Persons who act or speak without first considering the consequences are viewed as having poor impulse control.

Incoordination: A problem with coordination of movement of parts of the body, resulting from dysfunction of the nervous system rather than a weakness of muscles.

Initiative: Refers to the individual’s ability to begin a series of behaviors directed toward a goal.

Insight Regarding Impairment: The extent to which an individual accurately judges one’s own strengths and limitations; also called metacognition. A patient’s ability in this area may be judged on the basis of actions or statements regarding intended actions. Patients with brain injuries often overestimate their strengths and limitations.

Interdisciplinary: Approach method of diagnosis, evaluation, and individual program planning in which two or more specialists, such as medical doctors, psychologists, recreational therapists, social workers, etc. participate as a team, contributing their skills competencies, insights, and perspectives to focus on identifying the developmental needs of the person with a disability and on devising ways to meet those needs.

Intracranial Pressure (ICP): Cerebrospinal fluid (CSF) pressure is measured from a needle or bolt introduced into the CSF space surrounding the brain. It reflects the pressure inside of the skull.

Ipsilateral: Same side of the body.

Ischemia: A severe reduction in the supply of blood to body tissues.

Ischemia: A severe reduction in the supply of blood to body tissues.

impairment: Loss and/or abnormality of a cognitive, emotional, physiological, or anatomical structure or function; including all losses or abnormalities, not just those attributable to the initial pathophysiology.

Job Analysis: Involves the systematic study of occupation in terms of what the worker does in relation to data, people, and things; the methods and techniques employed, the machines, tools, equipment, and work aids used; the materials, products, subject matter, or services which result, and the traits required of the worker.

Kinesthesia: The sensory awareness of body parts as they move. Also see Position Sense and Proprioception.

Latency of Response/ Delay: The amount of time taken to respond after the stimulus has been presented.

Lethargic: Awakens with stimulation; drowsy but awake.

Log Book or Memory Book: A diary-like listing of the individual’s daily activities which can be used to help remember what happened during the course of the day, names of persons with whom contact occurred, and the order in which events occurred. The brain-injured person, family members and staff are encouraged to make entries. Used to compensate for memory deficits.

Memory (Immediate): The ability to recall numbers, pictures, or words immediately following the presentation. Patients with immediate memory problems have difficulty learning new tasks because they cannot remember instructions. Relies upon concentration and attention.

Memory (Long Term): This refers to recall 30 minutes or longer after the presentation. Requires storage and retrieval of information that exceeds the limit of short-term memory.

Memory (Recall): Ability to retrieve information without renewed exposure to the stimulus.

Memory (Recognition): Ability to recall information when a stimulus cue is presented. Free recall of the information is often deficient if cues must be provided.

Memory (Semantic): Memory for facts, usually learned through repetition.

Memory (Short Term: )Primary or ‘working’ memory; its contents are in conscious awareness. A limited capacity system that holds up to seven chunks of information over periods of 30 seconds to several minutes, depending upon the person’s attention to the task.

Mobility: Ability of an individual to move within, and interact with, the environment, usually involving utilization of public and/or private transportation, wheelchairs or ambulation.

Motivation: Requires initiative and refers to the extent to which an individual desires to reach a goal and demonstrates actual follow-through. A greater level of motivation is required for completion of difficult tasks. A brain-injured person with reduced motivation may need frequent cueing to finish dressing even though being able to verbalize the complete procedure.

Motor Control (Fine): Delicate, intricate movements as in writing or playing a piano.

Motor Control (Gross): Large, strong movements as in chopping wood or walking.

Motor Planning: Action formulated in the mind before attempting to perform.

Muscle Tone: Used in clinical practice to describe the resistance of a muscle to being stretched. When the peripheral nerve to a muscle is severed, the muscle becomes flaccid (limp). When nerve fibers in the brain or spinal cord are damaged, the balance between facilitation and inhibition of muscle tone is disturbed. The tone of some muscles may become increased and they resist being stretched – a condition called hypertonicity or spasticity.

Neglect: Paying little or no attention to a part of the body.

Neurologist: A physician who specializes in the nervous system and its disorders.

Neuropsychologist: A psychologist who specializes in evaluating (by tests) brain/behavior relationships, planning training programs to help the survivor of brain injury return to normal functioning and recommending alternative cognitive and behavioral strategies to minimize the effects of brain injury. Often works closely with schools and employers as well with family members of the brain-injured person.

Non-ambulatory: Not able to walk.

Nystagmus: Involuntary horizontal, vertical, or rotary movement of the eyeballs.

Occupational Therapy (OT): Occupational Therapy is the therapeutic use of self-care, work, and plays activities to increase independent function, enhance development and prevent disability; this may include the adaptation of a task or the environment to achieve maximum independence and to enhance the quality of life. The term occupation, as used in occupational therapy, refers to any activity engaged in for evaluating, specifying, and treating problems interfering with functional performance. Specific areas evaluated and treated include 1) upper extremity range of motion, strength, coordination, and sensation; 2) visual perception and scanning; 3) Activities of Daily Living (ADL).

Orientation: Awareness of one’s environment and/or situation, along with the ability to use this information appropriately in a functional setting. Also see Disorientation.

Paraplegia: Paralysis of the legs (from the waist down).

Paraplegia: Paralysis of the legs (from the waist down).

Paraplegia: Paralysis of the legs (from the waist down).

Parietal Lobes: Located behind the frontal lobe at the top of the brain. Right hemisphere’s parietal lobe responsible for visuo-spatial processing. Left hemisphere’s parietal lobe is responsible for comprehension of spoken and written language.

Perception: The ability to make sense of what one sees, hears, feels, tastes, or smells. Perceptual losses are often very subtle, and the patient and/or family may be unaware of them.

Perception: The ability to make sense of what one sees, hears, feels, tastes, or smells. Perceptual losses are often very subtle, and the patient and/or family may be unaware of them.

Perceptual: – MotorInteraction of the perceptual abilities with motor abilities.

Perceptual- Motor: Interaction of the perceptual abilities with motor abilities.

Perseveration: The inappropriate persistence of a response in a current task which may have been appropriate for a former task. Perseverations may be verbal or motoric.

Physical Therapist: The physical therapist evaluates components of movement, including muscle strength, muscle tone, posture, coordination, endurance, and general mobility. The physical therapist also evaluates the potential for functional movements, such as the ability to move in the bed, transfer, and walking and then proceeds to establish an individualized treatment program to help the patient achieve functional independence.

Physical Therapist: The physical therapist evaluates components of movement, including: muscle strength, muscle tone, posture, coordination, endurance, and general mobility. The physical therapist also evaluates the potential for functional movement, such as ability to move in the bed, transfers and walking and then proceeds to establish an individualized treatment program to help the patient achieve functional independence.

Plateau: A temporary or permanent leveling off in the recovery process.

Position Sense: The sensory awareness of the location and orientation of body parts without moving them. Also see Kinesthesia and Proprioception.

Post Traumatic Amnesia (PTA): A period of hours, weeks, days, or months after the injury when the patient exhibits a loss of day-to-day memory. The patient is unable to store new information and therefore has a decreased ability to learn. The memory of the PTA period is never stored, therefore things that happened during that period cannot be recalled. May also be called Anterograde Amnesia.

Postural Tone (excessive): Greater than the normal tone of muscles used to hold the body in ordinary positions such as sitting or standing.

Posture: The attitude of the body. Posture is maintained by low-grade, continuous contraction of muscles, which counteract the pull of gravity on body parts. Injury to the nervous system can impair the ability to maintain normal posture, for example holding up the head.

Productive Activity: Can be classified into the following categories: 1) Competitive Employment, 2) Vocational Training, 3) Noncompetitive or Sheltered Program, 4) Volunteer, 5) Recreational or Day Activity Program, 6) No Productivity, 7) Independent Homemaker or Retired or 8) Other.

Psychologist: Professional specializing in counseling, including adjustment to disability. The psychologist may provide individual or group psychotherapy for the purpose of behavior management and the development of coping skills by the patient/client and members of the family.

Ptosis: Drooping of a body part, such as the upper eyelid, from paralysis, or drooping of visceral organs from weakness of the abdominal muscles.

Quadriplegia: Paralysis of all four limbs (from the neck down).

Range of Motion (ROM): Refers to movement of a joint to prevent contractures. Active ROM – the muscles around the joint do the work to move it. Passive ROM – Movement of a joint by means other than contraction of the muscles around that joint (e.g. someone else moves the joint).

Recreation Therapist: Individual within the facility responsible for developing a program to assist persons with disabilities plan and manage their leisure activities; may also schedule specific activities and coordinate the program with existing community resources.

Rehabilitation: Comprehensive program to reduce/overcome deficits following injury or illness, and to assist the individual to attain the optimal level of mental and physical ability.

Rehabilitation Team: An organized group of health care specialists, who focus on providing a logical, practical and complete rehabilitation plan for the patient. Upon admission to the rehabilitation program, the patient is evaluated by each team member who defines both short-term and long-term goals for the patient’s rehabilitation. Meetings of the rehabilitation team are held regularly to discuss progress and redefine goals. Family conferences may also be scheduled.

Scanning: The active search of the environment for information; usually refers to “visual scanning” which is a skill used in reading, driving and many other daily activities.

Seizure: An uncontrolled discharge of nerve cells, which may spread to other cells nearby, or throughout the entire brain. It usually lasts only a few minutes. It may be associated with loss of consciousness, loss of bowel and bladder control and tremors. May also cause aggression or other behavioral changes. Commonly occur after head injury.

Sensation: Feeling stimuli which activate sensory organs of the body, such as touch, temperature, pressure and pain. Also, seeing, hearing, smelling and tasting.

Sensorimotor: Refers to all aspects of movement and sensation and the interaction of the two.

Sensory Integration: Interaction of two or more sensory processes in a manner that enhances the adaptiveness of the brain.

Spasm: An involuntary and abnormal muscular contraction; also, a sudden violent and temporary effort or emotion.

Spasticity: An involuntary increase in muscle tone (tension) that occurs following injury to the brain or spinal cord, causing the muscles to resist being moved. Characteristics may include increase in deep tendon reflexes, resistance to passive stretch, clasp knife phenomenon, and clonus.

Spatial Ability: Ability to perceive the construction of an object in both two and three dimensions. Spatial ability has four components: the ability to perceive a static figure in different positions, the ability to interpret and duplicate the movements between various parts of a figure, the ability to perceive the relationship between an object and a person’s own body sphere, and the ability to interpret the person’s body as an object in space.

Spontaneous: RecoveryThe recovery which occurs as damage to body tissues heals.

Tactile Defensiveness: Being overly sensitive to touch; withdrawing, crying, yelling or striking when one is touched.

Tactile Discrimination: The ability to differentiate information received through the sense of touch.

Tone (Muscle): The tension in resting muscles and the amount of resistance that is felt when a muscle is moved.

Tremor (Intention): Rhythmical movements of a body part that become intensified the harder one tries to control them. Intention tremors are usually not observed until the patient initiates movement.

Tremor: Rhythmical movements are present at rest and may be diminished during voluntary movement.

Unilateral Neglect: Paying little or no attention to things on one side of the body. This usually occurs on the side opposite from the location of the injury to the brain because nerve fibers from the brain typically cross before innervating body structures. In extreme cases, the patient may not bathe, dress or acknowledge one side of the body.

Vegetative State: Return of wakefulness but not accompanied by function; eyes open to verbal stimuli; does not localize motor responses; autonomic functions preserved. Sleep-Wake cycles exist.

Ventricles (Brain): Four natural cavities in the brain which are filled with cerebrospinal fluid. The outline of one or more of these cavities may change when a space-occupying lesion (hemorrhage, tumor) has developed in a lobe of the brain.

Vocational Counseling: Process of assisting a person to understand vocational liabilities and assets, provide occupational information to assist one in choosing an occupation suitable to one’s interests and abilities.

Vocational evaluation: comprehensive process that systematically utilizes work, real or simulated, as the focal point for assessment and vocational exploration, the purpose of which is to assist individuals in vocational development. Vocational evaluation incorporates medical, psychological, social, vocational, educational, cognitive, cultural and economic data in the attainment of the goals of the evaluation process.