4 - Aphasia Syndromes Flashcards

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1
Q

In the connectionist model, what are the three layers of units?

A

Semantic features

Words

Phonemes

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2
Q

In the connectionist model, what does each word corresponds to?

A

A single unit in the word layer

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3
Q

In the connectionist model, what links words to their semantic features and phonemes?

A

Bidirectional Excitatory Connections

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4
Q

In the connectionist model, what is each word connected to?

(2)

A

Semantic features

Phonemes

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5
Q

In the connectionist models, what is lexical access achieved by?

A

Interactive Spreading Activation

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6
Q

In the connectionist model, when Semantic Units are ___________, this activation spreads throughout the ___________, and ultimately the sounds of the ___________ are retrieved.

A

Activated

Neural network

Intended words

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7
Q

What is the FIRST step in the connectionist model?

(4)

A

[Semantic Step/Lemma Selection]

Activation begins and spreads for a fixed amount of time

Bilateral Excitatory Connections activate all three network levels (phonemic: /k, a, t/; words: “cat”, semantic: “pet with claws, etc.”)

Semantic neighbors (“dog”) become activated due to shared semantic features

Phonemically similar words are activated due to shared phonemes (“mat,” “rat”)

(The word with the highest level of activation is from the most appropriate grammatical category)

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8
Q

What is the SECOND step in the connectionist model?

(4)

A

[Phonological Step/Phonological Encoding]

Chosen word from first step is activated

Activation Process becomes nonlinear allowing network to handle the arbitrary mapping between semantic features and phonemes

The phonemes with the highest activation are linked into slots in a phonological frame (number and kind of syllables, stress patterns)

This linking concludes phonological encoding.

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9
Q

When do errors in phonological encoding tend to occur?

What to these errors tend to result in?

A

Due to noise, one or more wrong phonemes are more active than those of selected word.

Typically results in nonword (e.g., “lat” for CAT) but can be form‐related words (e.g. “mat” or “sat” for CAT).

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10
Q

What are the five error patterns that can occur in the connectionist model?

A

Semantic (“dog”)

Formal (“mat,” “cap)

Mixed (“rat”)

Unrelated (“log”)

Nonword (“lat”)

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11
Q

What aphasia syndromes could appear from cortical damage?

(3)

A

Broca’s

Wernicke’s

Global

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12
Q

What aphasia syndromes could result from damage of an unknown origin?

A

Anomic

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13
Q

What aphasia syndromes could appear when there is damage to the fiber tracts?

(4)

A

Conduction

Transcortical motor

Transcortical sensory

Mixed Transcortical

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14
Q

What is the most frequently occurring aphasia?

A

Anomic

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15
Q

Besides Anomia, what other aphasia types are common?

A

Broca’s

Wernicke’s

Global

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16
Q

What type of aphasia account for 50% of cases admitted to acute stroke units?

(2)

A

Global

Nonclassified aphasias

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17
Q

When are Anomia, Brocas, Conduction, Wernickes, and Transcortical more frequent in patients?

A

When patients have single lesions

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18
Q

What are different names for Broca’s Aphasia?

(4)

A

Expressive Aphasia

Motor Aphasia

Anterior Aphasia

Non-fluent Aphasia

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19
Q

What are the characteristics of Broca’s Aphasia?

(5)

A

Non-fluent (Slow, laboriously and halting speech + frequent pausing between syllables, words)

Agrammatic output (telegraphic)

Comprehension relatively preserved (as opposed to expression)

Poor, nonfluent repetition

Preserved self monitoring

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20
Q

Why do patients with Broca’s Aphasia struggle with repetition?

A

Poor language and motor planning

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21
Q

How does Broca’s Aphasia affect writing?

(4)

A

Writing similar to verbal output

Agrammatic

Large letters

Function words are absent

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22
Q

In Broca’s Aphasia, what produces Chronic Agrammatic Aphasia?

(2)

A

Lesions in Broca’s areas that extend into anterior insula cortex + temporal and parietal regions

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23
Q

What is needed to produce Broca’s Aphasia?

A

Damage to deep regions

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24
Q

What is considered Little Broca’s?

A

Smaller lesions limited to Brodman Area 44 cause aphasia that resolves quickly

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25
Q

What is considered Big Broca’s?

A

Large lesions producing full-blown, complex Broca’s aphasia

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26
Q

What are different names for Wernicke’s Aphasia?

(4)

A

Sensory Aphasia

Receptive Aphasia

Posterior Aphasia

Fluent Aphasia

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27
Q

What are characteristics of Wernicke’s Aphasia?

(8)

A

Fluent (Smooth + effortress output, long + syntactical sentences, normal intonation and stress patterns)

Frequent paraphasia (Semantic, occasional phonemic)

Paragrammatism

Jargon (strings of neologism with connecting words)

Impaired repetition

Poor comprehension

Poor self-monitoring

Anosognosia (non-awareness of deficits)

28
Q

Why do patients with Wernicke’s Aphasia struggle with repetition?

A

Comprehension deficits

29
Q

How does Wernicke’s Aphasia affect writing?

(3)

A

Handwriting mirrors verbal output

Small Letters

Significant word errors

30
Q

What are characteristics of Global Aphasia?

(4)

A

Severe impairments in all language functions

Difficulty with basic comprehension deficits

Some respond in conversation suggesting basic comprehension skills

Limited verbal output + some stereotypical output.

31
Q

What causes Conduction Aphasia?

(2)

A

Lesions in upper temporal lobe, lower parietal lobe or insula

This damages the arcuate fasiculus but spares Broca’s and Wernicke’s.

32
Q

What are characteristics of Conduction Aphasia?

(4)

A

Fluent verbal output with occasional verbal paraphasias

Grossly Impaired Repetition

Relatively preserved language comprehension

Poor oral reading

33
Q

How does Conduction Aphasia affect writing?

A

Handwriting typically functional - can be variable

34
Q

What causes Transcortical Aphasias?

(2)

A

Dominant hemisphere is damage but Broca’s and Wernicke’s areas are spared

Damage (hypoperfusion) to watershed region surrounding perisylvian region (isolates this region, usually due to severe narrowing of MCA)

35
Q

What is the defining characteristic of transcortical aphasias?

A

Preserved repetition

36
Q

What are the characteristics of transcortical motor aphasia?

(3)

A

[Damage to anterior superior frontal lobe of language dominant hemisphere]

Reduced speech output

Good Repetition (imp)

Good Auditory comprehension

37
Q

What are the characteristics of Transcortical Sensory Aphasia?

(3)

A

[Posterior isolation syndrome - damage to high parietal lobe in dominant language hemisphere]

Poor comprehension (listening and reading)

Good repetition (imp)

Fluent, empty speech with paraphasia (Like Wernicke’s but with good repetition)

38
Q

What are the characteristics of Mixed Transcortical Aphasia?

(3)

A

[Isolation of Broca’s, Wernicke’s and arcuate fasciculus from rest of the brain]

Good repetition (imp)

Profound impairment in all communicative areas (Global???)

Typically nonfluent

39
Q

What are the characteristics of Anomic Aphasia?

(4)

A

Word retrieval in verbal output and writing are the only obvious symptoms

Fluent and grammatically correct spontaneous output

Unusual pausing and circumlocutions

Residual state of many aphasic syndrome AFTER time of improvement (imp)

40
Q

What is fluency like for Broca Aphasia?

Comprehension?

Repetition?

A

Poor

Intact words and simple sentences

Poor, Nonfluent

41
Q

What is fluency like for Wernicke Aphasia?

Comprehension?

Repetition?

A

Good

Poor

Poor, fluent jargon

42
Q

What is fluency like for Conduction Aphasia?

Comprehension?

Repetition?

A

Fair-good

Intact words and simple sentences

Poor

43
Q

What is fluency like for TCM Aphasia?

Comprehension?

Repetition?

A

Poor

Intact words and simple sentences

Good

44
Q

What is fluency like for TCS Aphasia?

Comprehension?

Repetition?

A

Good

Poor

Good

45
Q

What is fluency like for Anomic Aphasia?

Comprehension?

Repetition?

A

Good

Good

Good

46
Q

What are the Aphasia taxonomies?

(4)

A

Traditional Syndrome Classification

Fluent Vs. Non-fluent

Expressive Vs. Receptive

Intentional (non-fluent) Vs. Attentional (fluent

47
Q

Most of the tasks performed poorly by patients with Non-Thalamic Subcortical (NS) Lesions appear to involve some degree of ____________-___________ flexibility in dealing with _______ __________, devising __________ _______________, and organizing and monitoring responses.

A

Cogntive-linguistic

Novel situations

Linguistic strategies

48
Q

When there is a stroke in the Basal Ganglia, language issues probably stem from what?

A

A combination of damage resulting from the stroke and hyperfusion affecting language issues.

49
Q

Language deficits in Non-Thalamic Subcortical (NS) Lesions resemble what?

A

A frontal-type language disorder

50
Q

Thalamic Aphasia most frequently found in lesions to dominant what?

A

Tuberothalamic and paramedian arteries

51
Q

In Thalamic Aphasia, why is there a low probability of associated cortical dysfunction?

A

They are small arteries

52
Q

What are disorders are associated with Thalamic Aphasia?

(4)

A

Nuclei specific

Dysfluency and conditions similiar to transcortical aphasias

Arousal disturbances

Comprehension deficits

53
Q

What do we call Alexia with Agraphia?

A

Pareto-Temporal Alexia

54
Q

What are the characteristics of Pareto-Temporal Alexia?

(4)

A

Oral reading grossly impaired

Cannot identify words spelled out by the examiner

Copying printing material is better than writing to dictation

Common component of aphasia syndromes and rare in isolation

55
Q

What kind of profile are you likely to have when there is damage to the basal ganglia?

A

Atypical profile

56
Q

What is alexia?

A

Decline in reading ability

57
Q

What is agraphia?

A

Decline in writing ability

58
Q

What do we call Alexia without Agraphia?

A

Occipital Alexia

59
Q

What is an another name for Occipital Alexia?

A

Pure Word Blindness

60
Q

What are characteristics of Occipital Alexia/Pure Word Blindness?

(3)

A

Ability to write complex sentences or narratives without ability to read what they have written

May retain the ability to identify familiar words

Difficulty copying material

61
Q

What type of lesions frequently cause Apraxia to accompany Aphasia?

(2)

A

Frontal lobe lesions

Anterior parietal lobe lesions

62
Q

What are the two types of Apraxia which may accompany Aphasia?

A

Ideational Apraxia

Ideomotor Apraxia

63
Q

What is Ideational Apraxia?

A

Inability to Conceptualize, Plan, and Execute the complex sequence of motor actions involving the use of tools or objects in everyday life.

64
Q

What is Ideomotor Apraxia?

A

Inability to correctly imitate hand gestures and voluntarily mime tool/object use.

65
Q

What must you consider before diagnosing Ideomotor Apraxia?

(4)

A

Paralysis

Weakness

Incoordination

Poor comprehension

66
Q

What is the Pseudobulbar Affect?

(2)

A

Neurologic disorder characterized by involuntary, severe emotional displays

Usually uncontrollable crying and/or laughing