Addressing Patient Behavior by Brain Lesion Site: Clinical Tools & Strategies Specific to Patient Deficits

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Jerome Quellier, MS, CCC-SLP Related seminars and products

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Jerome Quellier, MS, CCC-SLP, is a clinical specialist in traumatic brain injury and communication disorders at a 450+ bed level 1 trauma hospital in Saint Paul, MN with almost 25 years of acute, residential, and outpatient rehabilitation experience. He has focused on neuro-based diagnostics and intervention for dysphagia, cognitive-linguistic deficits, head and neck cancer management, patient advocacy, and curriculum development. Mr. Quellier completed advanced training in brain dissection at Marquette University, actively engages in staff development training, and recently joined a surgery team in preserving language function during tumor resections.

Mr. Quellier is excited to bring this topic to the forefront after working with the interdisciplinary team’s challenges in understanding the “what and why” of traumatic brain injury, stroke, neurodegenerative diseases and tumor resections as they apply to behavioral changes.

 

Speaker Disclosures:
Financial: Jerome Quellier has an employment relationship with Regions Hospital. He receives a speaking honorarium and recording royalties from PESI, Inc. He has no relevant financial relationships with ineligible organizations.
Non-financial: Jerome Quellier is a member of the American Speech-Language and Hearing Association.

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Objectives

1. Identify the gross anatomy and function of lobes of the brain as they apply to behavioral control
2. Define neurophysiology of memory and effect of fear/anger upon new learning and memory
3. Analyze the effect of traumatic and non-traumatic injuries upon cognitive centers
4. Classify neurotransmitters and the communication system within the brain
5. Discover optic system and lesion locations that affect engagement and accuracy in therapy
6. Discover and apply simple neuroanatomy-based techniques to rapidly de-escalate stress for patients and caretakers
7. Explain neuro-behavioral barriers that impact new learning

Outline

NEUROANATOMY AND THE IMPACT ON COGNITIVE PROCESSING  (CASE STUDY ICON)

• Basic neuronal anatomy
• Brain wiring: Association, projection, and commissural fiber tracts
• Brain lobes locations and ties to cognitive processes
• Cerebellum and impact upon cognition
• Case Study 1: Jacob’s anxiety and how pacing the halls became therapeutic

OPTIC SYSTEM AND VISUAL PERCEPTION (CASE STUDY ICON)

• Optic constructs, anterior-posterior fiber tracts
• Visual cortices and unique roles in visual processing
• Effect of tumors, shear injuries, CVA lesions upon visual perception
• Case study 1: Why can’t my patient just see the whole worksheet like I do?
• Group Exercise: Review of vision diagnostics by discipline (PT/OT/SLP)

HOW NEUROTRANSMITTERS DRIVE THE BUS

• Internal communication systems within the brain
• Dopamine pathways and effects on cognition and reward systems
• Serotonin pathways and mood modulations

EXECUTIVE FUNCTIONS OF THE FRONTAL LOBE

• The Cognitive Pyramid and moving patients upward
• Skull anatomy and effects of shear injury
  • Shear injury as it affects anxiety and behavioral health

• Therapy implications for PT/OT/SLP
• Group Exercise: Review of executive function diagnostics by discipline (PT/OT/SLP)

COMMUNICATION AND THE LEFT HEMISPHERIC FUNCTIONS

• Broca’s vs. Wernike’s areas
• Function of the arcuate fasciculus upon communication

SPATIAL PROCESSING AND THE RIGHT HEMISPHERIC FUNCTIONS

• Neurophysiology vs neuropathology, understanding patients’ nonverbal challenges
• Inferential language and social cognition
• A sense of time and spatial organization revealed

THE HIDDEN PROCESSORS-THALAMIC INFLUENCES

• Auditory pathways and neuroanatomy
• Thalamic engagement on sensory information
• Modulation of sleep and vigilance

MEMORY: HOW THE HIPPOCAMPUS AND THE AMYGDALA PARTNER  (CASE STUDY ICON)

• Memory processes
• Memory types: Right vs Left hippocampal functions
• Hypoxia and anoxia upon memory function
• Sleep and memory consolidation, effect of exercise on memory structures
• Amygdala’s influence upon fear-based learning and hijacking executive control
• Case study 3: Nile’s hypoxia and long tern rehab outcomes

RECOVERY FROM ACCELERATION/DECELERATION INJURIES: DIFFUSE AXONAL INJURY (DAI)

• Microanatomical features of DAI
• CTE: Chronic Traumatic Encephalopathy
• Where medications have failed

AGITATION MANAGEMENT STRATEGIES

• Review how working knowledge of the Rancho Los Amigos levels and Practitioner tips can avoid confrontation
• Learn trick of the trade for avoiding escalation
• Confabulation and denial—addressing the elephant in the room

ENRICHING PATIENT AND CLINICIAN RELATIONSHIPS

• The science behind mediations and mindfulness
• Reigning in the runaway situation 

Target Audience

• Physical Therapists
• Physical Therapist Assistants
• Occupational Therapists
• Occupational Therapy Assistants
• Speech-Language Pathologists
• Nurses
• Social Workers
• Recreational Therapists

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