Afasia, amnesia e outras funcoes corticais Flashcards
Quais os seis dominios da linguagem do exame neurologico?
The clinical examination of language should include the assessment of naming, spontaneous speech, comprehension, repetition, reading, and writing
Como avaliar nomeação?
When asked to name a common object (pencil or wristwatch), the patient may fail to come up with the appropriate word, may provide a circumlocutious description of the object (“the thing for writing”), or may come up with the wrong word (paraphasia). If the patient offers an incorrect but related word (“pen” for “pencil”), the naming error is known as a semantic paraphasia; if the word approximates the correct answer but is phonetically inaccurate (“plentil” for “pencil”), it is known as a phonemic paraphasia. Asking the patient to name body parts, geometric shapes, and component parts of objects (lapel of coat, cap of pen) can elicit mild forms of anomia in patients who otherwise can name common objects. In most anomias, the patient cannot retrieve the appropriate name when shown an object but can point to the appropriate object when the name is provided by the examiner. This is known as a one-way (or retrievalbased) naming deficit. A two-way naming deficit exists if the patient can neither provide nor recognize the correct name, indicating the likely presence of a comprehension impairment for the word
Como avaliamos a fala espontanea?
Spontaneous speech is described as “fluent” if it maintains appropriate output volume, phrase length, and melody or as “nonfluent” if it is sparse and halting and average utterance length is below four words. The examiner also should note if the speech is paraphasic or circumlocutious; if it shows a relative paucity of substantive nouns and action verbs versus function words (prepositions, conjunctions); and if word order, tenses, suffixes, prefixes, plurals, and possessives are appropriate.
Como avaliamos a compreensão?
Comprehension can be tested by assessing the patient’s ability to follow conversation, asking yes-no questions (“Can a dog fly?”, “Does it snow in summer?”) or asking the patient to point to appropriate objects (“Where is the source of illumination in this room?”). Statements with embedded clauses or a passive voice construction (“If a tiger is eaten by a lion, which animal stays alive?”) help assess the ability to comprehend complex syntactic structure. Commands to close or open the eyes, stand up, sit down, or roll over should not be used to assess overall comprehension since appropriate responses aimed at such axial movements can be preserved in patients who otherwise have profound comprehension deficits.
Como avaliar a repetição?
epetition is assessed by asking the patient to repeat single words, short sentences, or strings of words such as “No ifs, ands, or buts.” The testing of repetition with tongue twisters such as “hippopotamus” and “Irish constabulary” provides a better assessment of dysarthria and pallilalia than of aphasia. Aphasic patients who have little difficulty with tongue twisters may have a particularly hard time repeating a string of function words. It is important to make sure that the number of words does not exceed the patient’s attention span. Otherwise, the failure of repetition becomes a reflection of the narrowed attention span rather than an indication of an aphasic deficit
Como testar a leitura e a escrita?
Reading should be assessed for deficits in reading aloud as well as comprehension. Writing is assessed for spelling errors, word order, and grammar. Alexia describes an inability to either read aloud or comprehend single words and simple sentences; agraphia (or dysgraphia) is used to describe an acquired deficit in the spelling or grammar of written language
Quais os tipos de memória que devem ser analisadas?
Memory should be analyzed according to three main time scales: (1) immediate memory is assessed by saying a list of three items and having the patient repeat the list immediately, (2) short-term memory is tested by asking the patient to recall the same three items 5 and 15 min later, and (3) long-term memory is evaluated by determining how well the patient is able to provide a coherent chronologic history of his or her illness.
Quais as principais áreas cerebrais associadas as funções cognitivas?
Five anatomically defined large-scale networks are most relevant to clinical practice: (1) a perisylvian network for language, (2) a parietofrontal network for spatial cognition, (3) an occipitotemporal network for face and object recognition, (4) a limbic network for retentive memory and (5) a prefrontal network for cognitive and behavioral control.
