3 - Intro to Aphasia Flashcards
What hemisphere is language dominant in most RIGHT handed adults?
Left hemisphere (99%)
What hemisphere is language dominant in most LEFT handed adults?
70% Left hemisphere
15% Right hemisphere
15% bilateral
What percentage of the population is right handed?
90%
The left hemisphere is language dominant for ___% of all individuals.
97%
__________ brains may be more flexible about which hemisphere gets language responsibility.
Left-handers
Left-handers who become aphasic seem to have less _________ and _________ regardless of which hemisphere is affected
Severe aphasia
Recover better
What are the three parts to language?
Form
Content
Use
What is involved in Language Form?
2
Grammar
Syntax
What is involved in Language Content?
2
Vocabulary
Semantics
What is involved in Language Use?
2
Pragmatics
Social communication
What is Aphasia?
What does it affect? (2)
Impairment of language
Affects comprehension and production of speech
Affects ability to read and write
What causes Aphasia?
2
Pathology affecting the language competent half of the brain
Stroke, head trauma, brain tumors, infections
What is the most common cause of Aphasia?
Stroke
Aphasia affects about _________ (or __ in _____) Americans.
1 million
1 in 250
How many Americans acquire aphasia every year?
More than 200,000
What is Aphasia NOT?
3
Slurred speech
Confused language
Pragmatic problem
What is a motor speech disorder?
2
Dysarthria
Apraxia
Aphasia is present in ___-___% of individuals during acute stroke
21-38%
In right handed individuals, post-stroke aphasia is nearly always the result of __________; only rarely (2-10%) does it follow right hemisphere (__________).
Left-hemisphere lesions
Crossed aphasia
Vascular damage to the left hemisphere mostly involves the ___________ and ___________.
Perisylvian cortex
Subcortical structures
What is contained in the Subcortical Structures?
Where does their blood supply come from?
Basal ganglia
Internal capsule
Middle Cerebral Artery
Ischemic infarctions account for approximately ___% of cases
80%
Changes in brain activity can occur both _______ and ________ to the
lesion
Ipsilateral
Contralateral
Since the brain is capable of employing different compensatory mechanisms to promote recovery, patterns of cerebral activity __________________.
May be different from patient to patient
Some pathophysiology strategies are automatically generated, allowing improvement in function in \_\_\_\_\_\_\_ post-stroke.
Weeks-months
Compensatory mechanisms in cases showing incomplete recovery are ignited in the long term either _______ or in ____________.
Spontaneously
Response to SLP treatments
Possible mechanism of recovery is the ___________ in the area of ischemic penumbra.
Restitution of cerebral blood flow and oxygen
What is an ischemic penumbra?
Viable neural tissue surrounding the infarction which may recover or die
What is Neuro Plasticity?
The ability to reassign brain region functions when the brain tissue is damaged
Whose brain contains more plasticity: children or adults?
Children
What four areas of impairment are seen in Aphasia?
Speech fluency
Paraphasia
Repetition
Language Comprehension
What is the Perisylvian Regio?
Area of the brain encompassing Broca’s, Wernicke’s, Auditory Cortex, and the Angular Gyrus
What is the neural pathway for Spontaneous Speech?
4
Wernicke’s Area –>
Arcuate Fasiculus ->
Broca’s –>
Primary Motor Cortex
What is the neural pathway for Repetition?
6
Auditory Cortex –>
Wernicke’s Area –>
Arcuate fasiculus –>
Broca’s Area –>
Primary Motor Cortex –>
[Wernicke’s
Area (monitoring)]
What is the neural pathway for Oral Reading?
6
Visual Cortex –>
Angular Gyrus ->
Wernicke’s Area –>
Arcuate fasiculus –>
Broca’s Area –>
Primary Motor Cortex
What is the neural pathway for Comprehension of Speech?
3
Ears ->
Auditory Cortex –>
Wernicke’s Area
What is the neural pathway for Reading Comprehension?
3
Eyes –>
Visual Cortex –>
Wernicke’s Area
What is the neural pathway for Writing?
5
Wernicke’s Area –>
Arcuate fasiculus –>
Premotor Cortex –>
Arm
[Eyes and Wernicke’s Area (monitoring)]
What is the neural pathway for Gestural Responses to Spoken Commands?
Same as speech except sent to Premotor Area contralateral to arm rather than Broca’s Area
What area of the cortex is affected in NON-Fluent Aphasia?
Anterior
What area of the cortex is affected in Fluent Aphasia?
Posterior
What are the prosodic/melodic characteristics seen in NON-Fluent Aphasia?
(4)
Speaking slowly, haltingly and with great effort
Pausing between syllables and words
Machine-like quality to speech
Diminished or absent intonation and emphatic stress patterns
What are the prosodic/melodic characteristics seen in Fluent Aphasia?
(2)
Smooth and
effortless speech
Speech rate, intonation, and emphatic stress similar to normal speakers
Are normal/near normal speech rates a symptom of Fluent or Non-Fluent Aphasia?
Fluent Aphasia
Is slow, labored speech a symptom of Fluent or Non-Fluent Aphasia?
Non-Fluent Aphasia
Is the use of a variety of grammatical constructions a symptom of Fluent or Non-Fluent Aphasia?
Fluent Aphasia
Are restricted grammatical constructions a symptom of Fluent or Non-Fluent Aphasia?
Non-Fluent Aphasia
Are present and usually appropriate intonation patterns a symptom of Fluent or Non-Fluent Aphasia?
Fluent Aphasia
Is reduced or absent intonation a symptom of Fluent or Non-Fluent Aphasia?
Non-Fluent Aphasia
Are present function words a symptom of Fluent or Non-Fluent Aphasia?
Fluent Aphasia
Are omitted function words a symptom of Fluent or Non-Fluent Aphasia?
Non-Fluent Aphasia
Is appropriate syntax a symptom of Fluent or Non-Fluent Aphasia?
Fluent Aphasia
Is relying on a lot on nouns a symptom of Fluent or Non-Fluent Aphasia?
Non-Fluent Aphasia
Is using more than 5-6 words per breath group a symptom of Fluent or Non-Fluent Aphasia?
Fluent Aphasia
Is using 3-4 words per breath group a symptom of Fluent or Non-Fluent Aphasia?
Non-Fluent Aphasia
Is paragrammatism a symptom of Fluent or Non-Fluent Aphasia?
Fluent Aphasia
Is agrammatism a symptom of Fluent or Non-Fluent Aphasia?
Non-Fluent Aphasia
What is Paragrammatism?
2
“Word salad”
“Grammatically incorrect sentences
What types of aphasia are NON-fluent?
2
Broca’s
Global
What types of aphasia are Fluent?
5
Wernicke’s
Conduction
Anomic
Transcortical Motor (can be fluent but sparse)
Transcortical Sensory
What is Paraphasia?
Word substitution errors produced by individuals with aphasia
What are the two types of paraphasia?
Literal (phonemic)
Semantic (verbal)
What is Literal Paraphasia?
(Phonemic)
Phonologic errors in which incorrect sounds replace correct sounds
(“table” -> “trable” or “fable”)
What is Semantic Paraphasia?
(Verbal)
Incorrect word is substituted for the target word (usually semantically related)
(“table” -> “chair”; “hospital” -> “jail”)
What is Agrammatism?
2
Telegraphic speech
Grammar disturbances in labored non-fluent aphasia
What is Anomia?
Broad term for the difficulty finding words
What is Circumlocution?
Talking around or about the word that cannot be recalled
i.e., watch = “I wear it right here” while pointing to his wrist
What is the most
consistent aphasia feature?
Anomia
What is Localization of Function?
Damage to specific areas of the brain creates specific patterns of impairment
What are the limitation so Localization Models?
2
Damage localized to Broca’s area or Wernike’s area does not produce aphasia
Aphasia can be caused by damage to subcortical structures and association fibers
What do Anti-Localizationist believe?
What is this model called?
The brain operates as an integrated whole
The Connectionist Model
Who were some early Anti-Localizationists?
4
Marie Jean-Pierre (1830’s)
John Huglings Jackson (1860’s)
Pierre Marie (early 1900’s)
Henry Head (1920’s)
