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Nature of Disorders of Language and Communication > Aphasia > Flashcards

Aphasia Flashcards

1
Q

causes of aphasia

A
  • stroke
  • TBI
  • infections (meningitis)
  • tumors
  • neurotoxicity (drugs, chemicals)
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2
Q

most common cause of aphasia

A

stroke

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3
Q

stroke cause

A

insufficient blood flow to the brain

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4
Q

brain receives ?% of cardiac output and ?% of O2

A

15% cardiac output
20& O2

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5
Q

lack of blood flow after ? seconds leads to dysfunction

A

8-10 seconds

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6
Q

lack of blood flow after ? minutes leads to irreversable damage

A

5 minutes

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7
Q

types of stroke

A
  • ischemic
  • hemorrhagic
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8
Q

ischemic stroke

A

blockage (clot, thrombus, or embolism)

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9
Q

hemorrhagic stroke

A

rupture (aneurysm)

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10
Q

transient ischemic attack (TIA)

A
  • mini stroke
  • brief, lasts only a few minutes
  • no permanent damage
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11
Q

FAST

A
  • face
  • arms
  • speech
  • time
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12
Q

TBI cause

A
  • falls
  • accidents
  • attacks
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13
Q

TBIs can cause what injury types

A
  • focal injury
  • diffuse injury
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14
Q

focal injury (TBI)

A
  • caused by a hit
  • brain bruise or bleed
  • injury to one, specific area
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15
Q

diffuse injury (TBI)

A
  • caused by a car accident
  • brain moves and rotates inside the skull
  • tearing of axons in the brain
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16
Q

infections (TBI)

A
  • encephalitis (inflammation caused by an infection or autoimmune response)
  • injury is typically more diffuse
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17
Q

tumors (TBI)

A
  • typically more focal (area of difficulty is in line with the area of the tumor)
  • with metastasis (spread) there can be more area affected
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18
Q

what types of damage can occur in a TBI

A
  • primary injuries
  • secondary injuries
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19
Q

primary injuries (TBI)

A
  • localized
  • tissue necrosis and apoptosis (cell death) occur in response to a clot, hemorrhage, or hit
  • in stroke there is a core area where cell death has occurred and the ischemic penumbra
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20
Q

ischemic penumbra meaning

A

region around the damaged area that is at risk of dying but can be salvaged with timely treatment and restoring blood-flow

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21
Q

secondary injuries (TBI)

A
  • diffuse, can be acute and chronic
  • linked to neurodegenerative disease
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22
Q

ABI associated communication disorders

A
  • aphasia
  • apraxia of speech
  • dysarthria
  • dysphonia
  • cognitive communication disorders
  • pragmatic/social communication disorders
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23
Q

what is A-FROM

A
  • Living with Aphasia - A Framework for Outcome Measurement
  • adaptation of the WHO’s ICF
  • provides a framework for thinking about aphasia
  • assess and treat all parts of aphasia
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24
Q

what is recovery in aphasia

A
  • many understandings
  • guided by A-FROM, recovery should include a focus on impairment, participation, and quality of life
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25
Q

language includes

A
  • concepts/semantic knowledge (red, juicy)
  • phonology (apple v. grapple)
  • vocabulary (apple)
  • morphology (apple-s)
  • syntax (I ate the apple.)
  • pragmatics (He’s a bad apple)
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26
Q

characteristics of aphasia

A
  • ranges from mild to severe
  • affect any language modality (speaking, writing, reading)
  • heterogeneous
  • can have fully intact cognition (insight, attention, memory, problem solving)
  • can co-occur with other communication disorders (dysarthria, apraxia)
  • can co-occur with motor, emotional, sensory difficulties that can impact communication and therapy
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27
Q

motor changes in aphasia

A
  • weakness (hemiparesis, paralysis)
  • postural stability and head control
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28
Q

sensory changes in aphasia

A
  • deafness
  • visual changes
  • hypothesia (reduced feeling)
  • pain
  • agnosia
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29
Q

cognitive changes in aphasia

A
  • reduced insight
  • fatigue
  • memory
  • attention
  • executive function
  • orientation
  • arousal levels
  • awareness
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30
Q

emotional changes in aphasia

A
  • depression
  • agitation
  • anxiety
  • lability (emotional switching)
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31
Q

semantic paraphasia definition

A
  • a word that is conceptually/meaningfully related to the target
  • fork and knife
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32
Q

phonemic paraphasia definition

A
  • a word that is phonologically similar to the target
  • fork and cork
33
Q

anomia definition

A

difficulty naming

34
Q

word finding definition

A
  • difficulty finding the particular word
  • pauses, filler words/phrases, circumlocution
35
Q

neologism definition

A
  • making new words (no phonemic or semantic connection)
  • mation
36
Q

circumlocution definition

A
  • talking about a word
  • mango = the sweet yellow fruit
37
Q

jargon definition

A
  • output which is not comprehensible to a listener (can be semantic)
  • the dinner platomin pice
38
Q

agrammatism definition

A
  • difficulty with grammatical morphemes (free or bound), word order
  • tomorrow, I walked shop to
39
Q

telegrammatic definition

A
  • a term to describe halting output with omission of free or bound morphemes
  • walk shop
40
Q

perseveration definition

A
  • an unintentional production of a unit of information that has been previously produced or head
  • can be continuous, stuck-in-set, or recurrent
  • can operate at different levels (word, syntactic, etc.(
  • wa wa walk walk walk
41
Q

aphasia classifications

A
  • dichotomous
  • anatomical
  • symptom-based
42
Q

dichotomous aphasia classification

A
  • receptive (understanding) versus expressive (output)
  • fluent versus non-fluent
43
Q

anatomical aphasia classification

A
  • Broca’s
  • Wernicke’s
  • conduction
44
Q

symptom-based aphasia classification

A
  • anomic
  • global
45
Q

receptive language and aphasia classifications associated with it

A
  • affecting understanding or input (listening, reading)
  • global, wernicke’s, transcortical sensory
46
Q

expressive language and aphasia classifications associated with it

A
  • affecting output (talking, writing)
  • conduction, transcortical motor, anomic, broca’s, global
47
Q

pros and cons of associating receptive and expressive language with specific aphasia classifications

A

pros:
- provides brief description of primary nature of difficulty

cons:
- doesn’t tell us anything about what is actually affected (semantics, syntax)
- doesn’t tell us about level of ability (word level)
- heterogeneous

48
Q

fluent aphasia and aphasia classifications associated with it

A
  • able to produce fluent speech, grammar relatively intact
  • conduction, anomic, transcortical sensory, wernicke’s
49
Q

non-fluent aphasia and aphasia classifications associated with it

A
  • output halting and effortful, grammar impacted, content words might be preserved
  • broca’s, transcortical motor, global
50
Q

pros and cons of associating fluent and non-fluent aphasia with specific aphasia classifications

A

pros:
- non-specific description of primary nature of difficulty

cons:
- doesn’t tell us what is affected or level of ability
- doesn’t tell us about language modality affected
- heterogeneous

51
Q

boston classification system

A

use language profiles and localization to classify into classic syndromes

52
Q

pros and cons of boston classification system

A
  • pros: more specific, slightly more homogeneous
  • cons: doesn’t inform therapy
53
Q

aphasia syndromes

A
  • Broca’s aphasia
  • Wernicke’s aphasia
  • Conduction aphasia
  • Global aphasia
  • transcortical sensory aphasia
  • transcortical motor aphasia
54
Q

Broca’s aphasia

A
  • left inferior frontal lobe (Broca’s area)
  • non-fluent
  • lack of grammatical structure and content
  • comprehension stronger than expression
  • words produced contextually correct
  • ex: “want coffee”
55
Q

Wernicke’s aphasia

A
  • posterior superior temporal gyrus (Wernicke’s area)
  • impaired understanding with fluent speech
  • syntax (grammat) preserved but full of paraphasias (word errors)
  • ex: “I walked the dog in the poll under the saw.”
56
Q

Conduction aphasia

A
  • arcuate fasciculus damage
  • fluent
  • cannot repeat, better spontaneous speech
  • generally good comprehension
  • phonological issues
  • ex: “Where is my hat”, correct
    What’s this? (hat) “bat, bat, mat, hat”, wrong (cannot perceive difference)
57
Q

Global aphasia

A
  • large lesion in frontal/parietal/temporal lobe
  • severe aphasia
  • involves expression and comprehension in all modalities
  • little output except automatic phrases
  • severe comprehension difficulties
58
Q

Transcortical sensory aphasia

A
  • associated with infarcts of posterior cerebral artery
  • fluent with normal repetition
  • speech filled with paraphasias and sometimes echolalia
  • impaired auditory comprehension
  • ex: can repeat a long sentence, cannot understand it
59
Q

Transcortical motor aphasia

A
  • lesions of left supplementary motor cortex (initiation)
  • Broca’s aphasia can evolve to transcortical during recovery
  • non-fluent
  • similar to Broca’s however able to repeat (repeat > spontaneous speech)
  • good comprehension
  • word finding difficulties and tip of tongue phenomenom characteristic
60
Q

full ability profile is built on:

A
  • theory based on area of infarct
  • discrete impairment-based assessment results (psychometric testing)
  • information on functional ability in context
61
Q

how are models useful

A
  • conceptualize abstract, complex, and confusing processes
  • inform specific targets
62
Q

Cognitive Neuropsychological Model of Language Processing

A
  • cognitive neuropsychology aims to understand how the brain’s structure and function relates to psychological processes (language, memory)
  • describes word level only (not sentences)
  • helps identify highly specific therapy targets
63
Q

Garrett’s Model of Speech Production

A
  • can hear a word and then say it (repeat) without knowing the meaning
  • can read and then write a word without knowing the meaning
64
Q

Garrett’s Model of Sentence Production

A
  • conceptual level: message
  • formulation level: functional, positional
  • formulation and articulation level: phonetic and articulatory
65
Q

conceptual level: message (Garrett’s Model of Sentence Production)

A
  • objective and subjective
  • ideas about people, places, and things
66
Q

formulation level: functional (Garrett’s Model of Sentence Production)

A
  • content words: lexical-semantic concepts (word meanings) are selected to represent the message
  • verb, noun, adjective: lexical-semantic concepts are assigned syntactic functions
  • predicate argument structure (PAS) is created, meaning only words not arranged yet
67
Q

formulation level: positional (Garrett’s Model of Sentence Production)

A
  • word selected at the functional level are slotted into order (syntactic form)
  • retrieval of lexical phonological representations (i.e. k - a - t = cat)
68
Q

formulation and articulation level: phonetic and articulatory (Garrett’s Model of Sentence Production)

A

phonetic
- motor planning and programming
- plan: structure specific (tongue)
- program: muscle specific (genioglossus)

articulation
- execution and adaptation
- completing movement and changing it to suit the environment
- involves pyramidal system, cranial nerves, basal ganglia, and cerebellum

69
Q

how might difficulties with sentence production present in aphasia? (Garrett’s Model of Sentence Production)

A
70
Q

sentence comprehension model

A
  • psycholinguistics steps in reverse to decode messages
  • complex networks
71
Q

discourse definition

A
  • connected language, beyond the sentence level used for a specific function
  • does not have a strict set of rules
  • has a communicative function (commenting, directing, attention, requesting, showing)
  • involves complex interplay between cognitive and linguistic elements
72
Q

primary progressive aphasia (PPA)

A
  • neurodegenerative disorder (Parkinsons, MS, dementia)
  • gradual emergence of language difficulties
  • complete diagnosis requires language difficulties for >2 years
  • cognitive decline emerges as the disease progresses
  • onset of symptoms between 50 and 70
73
Q

PPA causes

A
  • degeneration of the frontotemporal brain region (usually left)
  • often have a build up of protein tau and TDP-43
74
Q

PPA types

A
  • logopenic
  • non-fluent agrammatic
  • semantic
75
Q

logopenic PPA

A
  • impaired word finding, naming, repetition
  • left temporoparietal region affected
  • ex: telling story about their dog, cannot retrieve the word “ball”
76
Q

non-fluent agrammatic PPA

A
  • non-fluent, effortful speech
  • lacking in grammatical structures
  • inferior frontal gyrus and premotor regions affected
  • ex: “Restaurant…dinner…pasta…good”
77
Q

semantic PPA

A
  • impaired object knowledge
  • anomia
  • comprehension difficulties with single words (lacking context to take clues from)
  • atrophy in anterior parts of temporal lobe
  • ex: show them an apple, doesn’t recognize it and can’t name it. person wants an apple - asks “can I have an apple?”
78
Q

childhood aphasia considerations

A
  • must be considered in a developmental context
  • more varied presentation
  • more plasticity
79
Q

what does observation include

A
  • extended factual notes (after observation, note what is seen, heard, smelled in detail and factually)
  • interpretative notes (interpret notes as an SLT)
  • personal notes (record your thoughts and feelings)

Nature of Disorders of Language and Communication (9 decks)

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