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Neuro Final > Acquired Neurogenic Communication Disorders > Flashcards

Acquired Neurogenic Communication Disorders Flashcards

1
Q

What do SLPs do?

A

diagnose and treat communication, swallowing, and related disorders of the oropharyngeal mechanism

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2
Q

SLP settings:

A

schools
SNF
private practices
hospitals
NICU
acute care

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3
Q

Neurological Processes of Communication:

A

Cognitive – linguistic processes

Motor speech programming

Neuromuscular execution

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4
Q

Aphasia =

A

acquired communication disorder caused by brain damage

characterized by an
impairment of language modalities: speaking,
listening, reading and writing

not the result of a
sensory deficit, a general intellectual deficit, or a
psychiatric disorder

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5
Q

Multimodality Deficit
Language is a Central Process

A

3 levels:
1) word
2) sentence
3) discourse

comprehension:
> listening
> reading

production:
> speaking
> writing

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6
Q

word:

A

comprehension:
> listening: listen to word & point to object/picture

> reading: read work & point to object/picture

production:
> speaking: name objects/pictures

> writing: write names of objects/pictures

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7
Q

sentence:

A

comprehension:
> listening: follow command
> reading: follow instruction

production:
> speaking: describe actions
> writing: describe actions

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8
Q

discourse:

A

comprehension:
> listening: listen to story & answer questions

> reading: read paragraph & answer questions

production:
> speaking: describe complex picture

> writing: write letter/story

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9
Q

Aphasia multimodal language problem

A

Basic pattern of relative intact function / deficit

listening comprehension is the most preserved function

writing is the most impaired

auditory comprehension (listening) is relatively intact compared to expressive language functions (speaking and writing), especially in cases of more severe impairment

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10
Q

Aphasia is an acquired impairment of the cognitive
system specialized for:

A

comprehending and formulating
language, leaving other systems relatively intact

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11
Q

Aphasia Symptoms - Expression

A

anomia
non-fluent aphasia
telegraphic speech
agrammatism
telegraphic speech
paraphasia
neologism
jargon

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12
Q

anomia =

A

Having difficulty finding words

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13
Q

non-fluent aphasia =

A

Speaking haltingly or with effort

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14
Q

telegraphic speech =

A

names of objects

Speaking in single words

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15
Q

agrammatism =

A

Speaking in short, fragmented phrases

Making grammatical error

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16
Q

telegraphic speech =

A

Omitting smaller words like the, of, and was

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17
Q

paraphasia =

A

Substituting sounds or words

semantic word level
paraphasia “table” for bed

phonemic sound level paraphasia
“wishdasher” for dishwasher

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18
Q

neologism =

A

Making up words

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19
Q

jargon =

A

Fluently stringing together nonsense words and real words, but leaving
out or including an insufficient amount of relevant content (e.g., fluent
aphasia with empty speech, paucity of content

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20
Q

Aphasia Symptoms - Comprehension

A

difficulty understanding
spoken utterances

Requiring extra time to
understand spoken messages

Providing unreliable answers to “yes/no” questions

Failing to understand complex grammar

Finding it very hard to follow fast speech (e.g., radio or television news)

Misinterpreting subtleties of
language (e.g., taking the literal meaning of figurative speech such as “It’s raining cats and dogs.”)

Lacking awareness of errors (e.g., anosognosia)

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21
Q

classification of aphasia:

A

nonfluent = speech production is halting and effortful, grammar is impaired, content words may be preserved

fluent = person is able to produce connected speech, sentence structure is relatively intact but lacks meaning

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22
Q

nonfluent aphasia:

A

language comprehension relatively intact -> broca’s aphasia & transcortical motor aphasia

language comprehension impaired -> global aphasia

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23
Q

broca’s aphasia =

A

repetition of words/phrases poor

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24
Q

transcortical motor aphasia =

A

strong repetition skills

may have difficulty spontaneously answering questions

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25
Q

global aphasia =

A

severe expressive and receptive language impairment

may be able to communicate using facial expression, intonation, and gestures

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26
Q

fluent aphasia:

A

language comprehension relatively intact -> conduction aphasia & anomic aphasia

language comprehension impaired -> wernicke’s aphasia & transcortical sensory aphasia

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27
Q

conduction aphasia =

A

word finding difficulties, difficulty repeating phrases

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28
Q

anomic aphasia =

A

repetition of words/phrases good

word finding difficulties

uses generic fillers (“thing”) or circumlocution

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29
Q

wernicke’s aphasia =

A

repetition of words/phrases poor

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30
Q

transcortical sensory aphasia =

A

repetition of words/phrases good

may repeat questions rather than answering them “echolalia”

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31
Q

Characterize the communication output?

A

Non-fluent – Speech production is halting and effortful
*grammar is impaired, content words may be relatively preserved

Fluent - produces connected speech
*sentence structure is relatively intact, but lacks meaning

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32
Q

Characterize the auditory comprehension?

A

Language comprehension relatively intact

Language comprehension relatively impaired

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33
Q

If the repetition abilities were good, what type of aphasia do you think this person has?
a) Broca’s
b) Transcortical motor
c) Conduction
d) Global

A

b) Transcortical motor

pattern of relatively preserved listening ability, but impaired speaking and writing, along with moderate difficulties in reading, fits with transcortical motor aphasia

anomia (difficulty finding words) and agrammatism (telegraphic speech with missing function words) are common

Paraphasias (word substitutions) might be minimal or absent

argon or neologisms (nonsense words) are typically not prominent

34
Q

If the repetition abilities were poor, what type of aphasia do you think this person has?
a) Broca’s
b) Transcortical motor
c) Conduction
d) Global

A

c) Conduction

(listening) is relatively intact

Fluent speech but with frequent phonemic paraphasias (word or sound substitutions)

Anomia (difficulty finding words) is present, but agrammatism is less common compared to Broca’s or transcortical motor aphasia

no jargon or neologisms

35
Q

Broca’s aphasia also involves poor repetition, but the speech is typically ____

A

non-fluent, and the graph shows moderate to severe impairments across

36
Q

Transcortical motor aphasia is characterized by ___

A

good repetition

37
Q

Global aphasia involves severe deficits across ____

A

all modalities, including listening

including listening, speaking, reading, and writing, with very little preserved ability

38
Q

If the repetition abilities were poor, what type of aphasia do you think this person has?
a) Wernicke’s
b) Transcortical sensory
c) Anomic
d) Global

A

a) Wernicke’s

Listening comprehension is typically significantly impaired in Wernicke’s aphasia

Fluent speech is common, but it often includes paraphasias (word substitutions), jargon, and neologisms (nonsense words)

Anomia (difficulty finding the right words) is also typica

39
Q

Transcortical sensory aphasia would involve good ___ despite poor ___

A

repetition

comprehension

40
Q

Anomic aphasia is primarily characterized by ____

A

word-finding difficulties (anomia) but good comprehension and good repetition

41
Q

If the repetition abilities were good, what type of aphasia do you think this person has?
a) Wernicke’s
b) Transcortical sensory
c) Anomic
d) Global

A

b) Transcortical sensory

typically have poor comprehension

Fluent speech is common, but often filled with paraphasias (word substitutions) or even neologisms (made-up words)

Anomia (difficulty finding words) is present

42
Q

Wernicke’s aphasia typically involves:

A

poor repetition, despite fluent speech and poor comprehension

43
Q

Anomic aphasia involves:

A

good comprehension and good repetition, but it is primarily characterized by word-finding difficulties

44
Q

Screening tool for aphasia

A

Language Screening Test

45
Q

Motor Speech Disorders

A

Dysarthria(s)

Communication through vocal symbols = Speech

46
Q

Speech =

A

embodies language into the physical (acoustic)
properties for the purposes of recognition and interpretation

47
Q

Motor Speech Disorders – Dysarthria(s)

A

group of neurogenic speech disorders characterized
by “abnormalities in the strength, speed, range, steadiness, tone, or accuracy of movements required for breathing, phonatory, resonatory, articulatory, or prosodic aspects of
speech production

48
Q

abnormalities are due to one or more sensorimotor problems—

A

weakness or paralysis

incoordination

involuntary movements

excessive, reduced, or variable muscle tone

49
Q

predominant framework for differentially diagnosing
dysarthria is based on ___

A

a perceptual method of classification

50
Q

perceptual method of classification relies on _____

A

auditory perceptual
attributes of speech that point to the underlying
pathophysiology

perceptual attributes are used to characterize the dysarthrias and, along with pathophysiological
information, can help identify underlying neurologic illness

51
Q

Motor Speech Disorders: Dysarthria types

A

congenital

degenerative diseases

demyelinating and inflammatory diseases

infectious diseases

neoplastic diseases

toxic/metabolic diseases

trauma

vascular diseases

52
Q

congenital =

A

cerebral palsy, chiari malformation

53
Q

degenerative diseases =

A
54
Q

demyelinating and inflammatory diseases =

A

multiple sclerosis, encephalitis

55
Q

infectious diseases =

A

acquired immune deficiency syndrome (AIDS), herpes zoster

56
Q

neoplastic diseases =

A

CNS tumours, cerebral, cerebellar, or brainstem tumours

57
Q

toxic/metabolic diseases =

A

botulism, carbon monoxide posioning

58
Q

trauma =

A

traumatic brain injury

chronic traumatic encephalopathy

59
Q

vascular diseases =

A

stroke (hemorrhagic or ischemic)

60
Q

flaccid =

A

associated with disorders of the lower motor neuron
system and/or muscle

Weakness, flaccidity, atrophy, fasciculations, hypoactive gag reflex, facial myokymia (involuntary, spontaneous, localized
quivering of a few muscles), nasal backflow while swallowing

61
Q

Spastic =

A

associated with bilateral disorders of the upper motor
neuron system

Pathologic oral reflexes (sucking reflex; snout reflex; jaw jerk reflex), lability of affect, hypertonia, hyperactive gag reflex

62
Q

Ataxic =

A

associated with disorders of the cerebellar control circuit

dysmetric jaw, face, and tongue AMRs, head tremor

63
Q

Hypokinetic =

A

associated with disorders of the basal ganglia control
circuit

Masked facial expression, tremulous jaw, lips, tongue, reduced range of motion on AMR tasks, resting tremor, rigidity

64
Q

Hyperkinetic =

A

associated with disorders of the basal ganglia
control circuit

Involuntary head, jaw, face, tongue, velar, laryngeal, and
respiratory movements, relatively sustained deviation of head position, multiple motor tics, myoclonus of palate, pharynx, larynx, lips, nares, tongue, or respiratory muscles

65
Q

Traumatic Brin Injury -
Cognitive-Communicative Disorders

A

form of nondegenerative acquired brain injury, resulting from an external physical force to the head (e.g., fall) or other mechanisms of displacement of the brain within the
skull (e.g., blast injuries)

66
Q

Traumatic Brin Injury -
Cognitive-Communicative Disorders: symptoms

A

Changes in levels of consciousness

Memory disturbances

Changes in cognitive function (e.g., attention,
memory, executive function)

Disturbances of sensory & motor function

Confusion associated with deficits in orientation

Neurological signs, such as brain injury observable
on neuroimaging, new onset or worsening of seizure
disorder, visual field deficits, hemiparesis, etc.

67
Q

TBIs can result in focal damage =

A

(e.g., gunshot wound) or be more diffuse in nature (e.g., diffuse axonal injury)

symptoms can vary depending on the site of lesion and extent of damage to the brain

TBI is often associated with polytrauma (injury to the brain in addition to one or more other body systems)

68
Q

TBI can be categorized as:

A

mild, moderate, or severe based on the extent and nature of injury, duration of loss of consciousness, post-
traumatic amnesia, and the severity of confusion at initial assessment during the acute phase of the injury

69
Q

Potential Consequences/Impact of Cognitive-Communication Impairment Can Include:

A

Reduced ability to effectively communicate needs

Reduced awareness of impairment and its degree

Reduced memory, judgment, and ability to initiate and effectively exchange routine
information

Difficulty performing personal lifestyle management activities (i.e., pay bills)

Reduced ability to anticipate potential consequences, lack of judgment and problem
solving

Reduced social communication skills and/or ability to manage emotions

70
Q

Cognitive-Communicative Disorders – Potential
Impact on Everyday Function

A

Difficulty anticipating consequences of own actions

Poor organization, with limited problem solving and judgment

Difficulty with concepts of time and money

Difficulty self-disciplining and self-monitoring to follow rules; exhibits socially inappropriate behavior

Difficulty changing routine or schedule; difficulty learning new rules

71
Q

Limited communication:

A

difficulty selecting appropriate words and remembering names

limited memory and/or knowledge of current events and/or personal history

responses in conversation may be verbose, redundant, or tangential

missing or misunderstanding humor

difficulty understanding nonverbal communication (i.e., facial expressions and/or body language)

difficulty understanding abstract information

72
Q

Difficulty managing home or maintaining a job or business due to:

A

Difficulty following directions

Difficulty comprehending or applying abstract written information

Difficulty analyzing personal and/or business problems, identifying and applying solutions

Difficulty assessing own strengths and weaknesses, developing effective plans to
improve weaknesses

Difficulty managing multiple responsibilities simultaneously

Difficulty managing emotions (especially anxiety, frustration, or anger) related to performance difficulties

Difficulty making, following, and modifying plans as needed

Difficulty effectively communicating with colleagues and/or customers

73
Q

Traumatic Brin Injury – Observations: Cognition

A

Orientation

Attention

Learning & Memory

Recognition, prosopagnosia,
gnosis, etc.

Executive/Goal directed behavior

Self-Awareness

74
Q

Traumatic Brin Injury – Observations: Language &
Communication

A
  • Verbose
  • Tangential
  • Paucity of thought
  • Slow processing speed
  • Word finding
  • Expressive impairments
  • Receptive impairments
  • Dysarthria
75
Q

Traumatic Brin Injury – Observations: Behavioral
Regulation

A
  • Affect
  • Agitation
  • Lability
  • Sensitivity
  • Impulsivity
76
Q

Traumatic Brin Injury - Neurocognitive Effects

A

Deficits in shifting attention between tasks

Difficulty with selective attention

Impaired sustained attention (e.g., for task completion)

Increased response latencies
Reduced processing speed

Impaired goal directed behavior

Deficits in short-term memory that negatively affect new learning or planned tasks

Post-traumatic amnesia (retrograde)

Lack of insight for monitoring one’s strengths, weaknesses, functional abilities, problem situations, and so forth

Reduced awareness of deficits (anosagnosia)

Impaired goal directed behavior

Deficits in orientation to self, situation, location, and/or time

Impaired spatial cognition that can affect ability to navigate and ambulate

76
Q

Traumatic Brin Injury - Language & Communication Effects

A
  • Pragmatic/Social Communication
  • Spoken Language
76
Q

Traumatic Brin Injury - Neurobehavioral Effects

A

Affective changes, including over-emotional or over-reactive affect or flat (i.e.,
emotionless) affect

Agitation and/or combativeness

Anxiety disorder, depression

Difficulty identifying emotions in others (alexithymia)

Emotional lability and mood changes or mood swings

Excessive drowsiness and changes in sleep patterns, including difficulty falling or
staying asleep (insomnia), excessive sleepiness (hypersomnia)

Feeling of disorientation or fogginess

Increased state of sensory sensitivity accompanied by exaggerated response to
perceived threats (hypervigilance)

Impulsivity, irritability and reduced frustration tolerance

Stress disorders

77
Q

Pragmatic/Social Communication

A

Conversational turns marked by verbosity

Difficulty initiating conversation and maintaining topic

Difficulty inhibiting inappropriate language or behavior

Impaired ability to use nonverbal communication effectively (e.g., tone of voice, facial expression, body language)

Impaired social cognition skills (e.g., regulating emotion; expressing emotion and perceiving emotion of others; ability to take the perspective of others and to modify language accordingly)

Tendency to be tangential

78
Q

Spoken Language =

A

Anomia or word retrieval deficits

Decreased ability to formulate organized discourse or conversation

Difficulty following directions

Difficulty understanding abstract language/concepts

Difficulty making inferences

Tendency to perseverate in verbal responses

Use of incoherent or confabulatory speech

79
Q

Difficulty functioning independently due to:

A

unresponsiveness to all external stimuli

may open eyes, suck, and/or yawn

does not attend to others

no purposeful speech

extremely impaired attention and memory with impulsivity

extremely limited communication:

80
Q

extremely limited communication:

A

difficulty responding to and/or saying name

difficulty expressing basic needs to others using simple words and/or gestures (i.e., yes/no

difficulty saying greetings (i.e., “hi” and “bye”) on own

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