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NM PT > (1) Communication Disorders: Aphasia and Cognition > Flashcards

(1) Communication Disorders: Aphasia and Cognition Flashcards

1
Q

how many adults will have a stroke in their lifetime?

A

1 in 4

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2
Q

communication disorder resulting from damage to portions of the brain controlling language
- can have difficulty with speaking and writing
- can have difficulty with listening and reading

A

aphasia

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3
Q

which speech disorder is considered a “language problem”

A

aphasia

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4
Q

a pt with difficulty with speaking and writing will also be called

A

expressive

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5
Q

a pt with difficulty listening and reading has issues with?

A

receptive

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6
Q

difficulty with motor planning (oral, laryngeal, verbal or limb)

A

apraxia

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7
Q

inability to complete action/mvmt sequence

A

apraxia

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8
Q

disorder caused by impaired control of m

A

dysarthria

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9
Q

what condition is often referred to as “garbled speech”

A

dysarthria

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10
Q

what are the 2 types of aphasia

A

fluent and non-fluent

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11
Q

what are the 4 types of fluent aphasia

A

wernicke’s
transcortical sensory
conduction
Anomic

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12
Q

what are the 4 types of non-fluent aphasia

A

broca’s
transcortical motor
mixed transcortical motor
global

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13
Q

determining the type of aphasia is importanct for determining …

A

prognosis

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14
Q

what is the most important thing to determin during the eval

A

strengths and weaknesses to help facilitate communication

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15
Q

for most aphasic pts, how is cognition impacted

A

usually intact

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16
Q

when determining type of aphasia, what 3 things do we see if the pt can do?

list in order

A
  • fluent
  • comprehend
  • repeats
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17
Q

what is a hallmark of wernicke’s aphasia

A

cannot comprehend AND cannot repeat

they ARE fluent

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18
Q

if a pt is:
- not fluent
- non comprehensive
- not able to repeat

A

global aphasia

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19
Q

if a pt is:
- non-fluent
- non comprehensive
- can repeat

A

mixed transcortical aphasia

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20
Q

if a pt:
- is non fluent
- can comprehend
- cannot repeat

A

brocas aphasia

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21
Q

if a pt:
- is non-fluent
- can comprehend
- can repeat

A

transcortical motor

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22
Q

if a pt is:
- fluent
- non comprehensive
- not able to repeat

A

wernickes

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23
Q

if a pt is:
- fluent
- non comprehensive
- can repeat

A

transcortical sensory

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24
Q

if a pt is:
- fluent
- can comprehend
- cannot repeat

A

conduction aphasia

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25
Q

if a pt is:
- fluent
- can comprehend
- can repeat

A

anomic aphasia

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26
Q

what is the prominent deficit of wernickes

A

auditory comprehension

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27
Q

what is the prominent deficit in conduction aphasia

A

repetition - not able to

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28
Q

what is the prominent deficit in transcortical sensory

A

auditory comprehension

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29
Q

what is the prominent deficit in pts with anomic aphasia

A

word finding

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30
Q

what is the most common type of fluent aphasia

A

wernickes

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31
Q

your pt presents with wernickes aphasia, where is the lesion

A

posterior aspect of L temporal lobe

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32
Q

your pt presents with:
- poor comprehension and limited awareness of deficits
- sentences full of neologisms, jargon, paraphasic errors
- preserved sentence structure

A

wernickes

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33
Q

your pt presents with transcortical sensory aphasia, where is the lesion

A

angular gyrus and posterior aspect of middle temporal gyrus

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34
Q

your pt presents with:
- poor comprehension
- able to repeat words and phrases
- possible echolalia or perseveration
- semantic paraphasias

A

transcortical sensory aphasia

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35
Q

how can perseveration present?

A

words, topics, and tasks

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36
Q

your pt presents with conduction aphasia, where is the lesion

A

arcuate fasciculus and parietal lobe

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37
Q

your pt presents with:
- spared comprehension
- expression characterized by some word retrieval deficit
- repetition becomes worse as length and complexity increases

A

conduction aphasia

38
Q

what is one of the biggest ways to differentiate apraxia vs conduction aphasia

A

fluency vs non-fluency
conduction = fluent

39
Q

what is the most mild form of aphasia

A

anomic

40
Q

your pt has anomic aphasia, where is the lesion

A

least focal region - peri-sylvian region

41
Q

your pt presents with:
- spared comprehension with exception of reduced self awareness of word retrieval problem
- pt talks around the word or uses non-specific terminology
- content words replaced with fillers (um, well)
- repetition preserved

A

anomic aphasia

42
Q

when does anomic aphasia most likely show up

A

usually in conversation

43
Q

what is circumlocution

A

talking around the word when cannot find the right one

  • anomic aphasia
44
Q

what is the most prominent deficit of brocas aphasia

A

verbal fluency - stuck all the time

auditory comprehension is intact

45
Q

what is the prominent deficit of transcortical motor aphasia

A

spontaneous speech and perseverations in verbal fluency

46
Q

your pt has broca’s aphasia, where is the lesion

A

anterior aspect of L hemisphere - posterior inferior frontal gyrus

47
Q

pt presents with:
- preserved comprehension
- impaired expression
- decreased sentence length and total word count
- telegraphic speech
- content words are present
- pt frustrated

A

brocas aphasia

48
Q

your pt has transcortical motor aphasia, where is the lesion

A

junction of supplementary motor strip of frontal perisylvian area

49
Q

pt presents with:
- preserved comprehension
- expression markedly impaired with telegraphic speech
- repetition preserved, even for long sentences

A

transcortical motor aphasia

50
Q

what is the least common and most severe of the 3 transcortical aphasias

A

mixed

51
Q

what is another name for mixed transcortical aphasia

A

isolation aphasia

52
Q

your pt has mixed transcortical aphasia, where is the lesion

A
  • usually NOT In brocas or wernickes area
  • areas surrounding these areas so there is no connection to other parts of brain
53
Q

what type of aphasia occurs with a watershed stroke

A

mixed transcortical

54
Q

what type of aphasia is rare and often misdx in acute stage

A

global

55
Q

your pt has global aphasia, where is the lesion

A

LARGE L hemisphere lesion in frontal, parietal and temporal lobes

56
Q

your pt present with:
- severe comprehension and expression deficits
- cannot imitate gestures or makes few attempts
- difficulty following commands related to apraxia

A

global aphasia

57
Q

your pt has apraxia, where is the lesion

A

brocas

58
Q

your pt presents with:
- difficulty initiating and continuing flow of speech
- speech pattern lacks appropriate prosody and much groping for correct mvmt

A

apraxia

59
Q

aphasia or apraxia
- semantic paraphasias or jargon prevalent
- difficulty following commands
- groping or trial and error behaviors NOT seen

A

aphasia

60
Q

aphasia or apraxia
- significant effort and struggle to produce intentional speech
- accuracy improved with repetition
- more difficulty with multisyllabic words
- prosody impaired
- large disparity b/w reding comprehension and ability to follow commands

A

apraxia

61
Q

inability to control m of speech

A

dysarthria

62
Q

what is often referred to as garbled speech that results in poor articulation, decreased breath support and poor intelligibility

A

dysarthria

63
Q

pt has flaccid dysarthria, where is the lesion

A

CN involvement or midbrain

64
Q

pt has spastic dysarthria, where is the lesion

A

motor regions of cortex (L or R)

65
Q

pts with dysarthria most often also have …

A

dysphagia

66
Q

dysphagia can present as what 3 deficits?

A

oral, pharyngeal or esophageal

67
Q

if a pt has dysphagia with oral deficits, what should you look for? (4 things)

A
  • presence or absence of teeth and condition
  • difficulty chewing
  • difficulty with bolus formation and cohesion
  • pocketing
68
Q

if a pt has dysphagia with pharyngeal deficits, what should you look for?

A
  • delayed or incomplete swallow leading to penetration or aspiration
69
Q

pts with dysarthria and esophageal deficits may also have…

A

GERD
- strictures, webs, or obstruction
- esphageal cancers
- hiatal hernias
- zenker’s diverticulum

70
Q

what is the premise of water protocol

A

aspiration of water will NOT lead to adverse outcomes if mouth is clean and void of food particles

71
Q

who is water protocol used with?

A

pts receiving thickened liquids

72
Q

describe how the water protocol is followed

A
  • b/w meals after oral care
  • NOT administered 30 min b4 meals or 30 min after
  • oral care completed after any food intake PO (including meds)
73
Q

what are the advantages of water protocol

A
  • pt satisfaction
  • better compliance with liquid restrictions during meals
  • better hydration and faster swallow recovery
74
Q

where is the stroke?
- apathy, impulsivity, poor initiation and confabulation, slowed processing and executive dysfunction

A

ACA

75
Q

where is the stroke:
- visual field deficits
- visual and auditory inattention
- perceptual deificts
- memory deficits and poor insight

A

MCA

76
Q

where is the stroke:
- Homonymous Hemanopsia

A

PCA

77
Q

what things do you look for in a clock drawing activity? (4)

A
  • are the #s evenly spaced
  • are there 12 #s
  • do they know if they are right or wrong and if wrong can they correct it
  • do they remember what time you told them to put
78
Q

the following are ways to facilitate communication for what disorder?
- gain pt visual attention before speaking
- keep commands simple and concrete
- break down complex instructions
- slow speaking rate
- rephrase command if dont understand 1st time

A

receptive aphasia

79
Q

the following are ways to facilitate communication for what disorder?
- avoid abrupt topic changes
- verify comprehension by having pt repeat instructions
- DO NOT assume pt understands when they nod yes or no
- have them point to written yes/no

A

receptive aphasia

80
Q

the following are ways to facilitate communication for what disorder?
- encourage use of gestures
- ask simple yes/no questions - start broad
- give binary choices
- take cues from pt
- provide single word answer choices

A

expressive aphasia

81
Q

the following are ways to facilitate communication for what disorder?
- allow pt to attempt writing
- ask questions regarding pts specific wants/needs
- use pictures and written words to clarify
- be aware of how we facilitate perseveration - give them breaks
- be aware of communication board

A

expressive aphasia

82
Q

the following are ways to facilitate communication for what disorder?
- encourage use of gestures and pointing
- use written yes/no or single written words to communicate
- use visual and touch to activate part of body to move
- encourage use of communication book

A

apraxia

83
Q

the following are ways to facilitate communication for what disorder?
- encourage slow rate of speech to allow for time for pt to find correct sequence of mvmts
- understand that simple words are easier for pt to say
- accuracy improves with repetition
- take break to avoid frustration
- use “lead ins” –> I need a…

A

apraxia

84
Q

the following are ways to facilitate communication for what disorder?
- SLOW
- have pt clue listener to topic and avoid abrupt topic changes or gesture regarding a general area of discussion
- avoid trying to listen with a lot of ambient noise

A

dysarthria

85
Q

the following are ways to facilitate communication for what disorder?
- encourage breath support
- try to have pt look at your when talking
- have note pad for pt to write
- model SLOW speech

A

dysarthria

86
Q

How can we support pts with dysphagia?

A
  • aware of diet and swallowing strategies
  • adhere to safe eating
    water protocol
  • verbally cue pts to swallow before task
  • report difficulty with any of these tasks to ST
87
Q

what is WRAP and what does it stand for

A

Writing down
Repeating
Associating
Picturing info

  • strategy to assist pt with recall
88
Q

how can we reinforce cognition?

A
  • collaborate with ST on processes and procedures
  • be aware of complexity of instructions
  • avoid dual task unless specific goal
  • give extra time to respond
  • be aware that visual-perceptual deficits can impact cognition
89
Q

what pt population should you make sure you use the SLOW acronym with?

A

dysarthria

90
Q

what does SLOW stand for

A

SLow down rate of speech
Louder
Over-exaggerate mouth mvmts
Wide open mouth

NM PT (16 decks)

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