Aphasia Flashcards
What is the ICF (international classification of Functioning, Disability and Health)
Used to conceptualize the changes in function that people may experience after the onset of a disease or injury
What is the ICF divided
Body structure, body function, and activities/participation.
Body structure includes
- Structures of nervous system,
- eye, ear, and realted structures
- Voice and perch
- Musculoskeletal structures related to movement.
Body function includes
- Mental
- Sensory
- Voice and speech
- Neuromuscular
Activities and participation include
Life activities
Example: communciaition, self-care, learning and applying knowledge.
Contextual factors influence
Activities
Contextual factors include
Environmental factors (attitudes technology) and personal factors (race, age)
Impairment is a problem with
Body function or structure
Activity limitation is
Difficulty encountered by an individual in executing task or action
Participation restriction
Problem experienced by an individuals with life situations.
Cognition - Murray and Clarke
Encompasses all processes by which we transform , condense, elaborate, store, retrieve, and exploit sensory information, thus allows us to cope with and process incoming information so that we can understands and interface with our environment
Cognition includes what four branches
Executive function, language, attention, memory
Phonological processing
Ability to recognize and produce the individual phonemes in one’s language; follow rules for sequencing sounds,
- suprasegmental processing = processing of intonation, stress and pauses.
Lexical- semantic processing
Accessing meaning through language
Morphosyntactic processing
Encompasses all processes by which we transform, condense, elaborate, stores, retrieve, and exploit sensory info –> allows us to cope an process incoming info to better understand and interact with our environment.
True or false: Morphosyntactic processing is a common focus of aphasia treatment.
False
Syntax refers to
The rules that govern the word order in a sentence
True or false: syntax is a more common focus of treatment to increase PWA’s utterances
True: if we consider treatments that attempt to increase the length and complexity of the utterances
Pragmatics refers to
The ability to correctly interpret and use language based on the social/situational context
What is discourse processing?
The rules that govern conversations
- selection, topic maintenance, switching or ending topics, topic repairs.
What are the three aspects of memory
Encoding, storage, retrieval/recall
Short term memory
Memory held in conscious awareness, which is currently receiving attention
Declarative memory is divided into what two categories
Semantic memory and episodic memory
Semantic memory involves
Facts and knowledge thats been acquired
Episodic memory involves
Time memories, events
True/false Prospective memory is a subsection of episodic memory
True
True or false: attention problems are more pronounced in only individuals with right hemisphere damage
False
Also in TBI because damage after TBI is diffuse, affecting many brain regions.
In clinical practice, how is attention described in terms of its clinical characteristics?
- Sustained attention- ability to maintain attention over time
- Focused or selective attention- ability to direct attention towards one thing while there are other things in the background
- Divided attention - ability to attend to more than one activity
What are the commonly described components of executive function?
- Planning
- Organization
- Inhibition
- Cognitive flexibility
- Problem solving
- Self-monitoring
True or false, executive functioning does not have an affect on basic cognitive functions such as attention and memory.
False, it does. Helps coordinate their functions.
Define Aphasia
Murray and clark: a disruption in using and understanding language following neurological injury or disease that is not related to general intellectual decline or sensorimotor deficit is; any language modality may be affected, including speaking, listening, writing, and reading.
The most common cause of aphasia is
Stroke
What are some symptoms of aphasia
Difficulty with - reading, naming, auditory comprehension, writing, speech fluency, repetition
Naming difficulties is also known as
Anomia
T/F: Anomia (naming difficulties) is most commonly seen in aphasia
True, also seen in TBI and dementia..
Much more pronounced in aphasia.
What is the most primary complaint and most noticeable symptom in persons with aphasia?
Anomia/naming difficulties
Why is repetition used to help refine a diagnosis of aphasia?
Helps identify what areas of speech are impaired and teases apart an apraxia of speech from aphasia.
What are some features of non-fluent aphasia
Effortful
Pause-filled halting speech that consists of short phrases
Slow rather with little melodic variation
What is agrammatism?
Also called telegraphic speech - tendency to leave out grammatical functions words such as articles, conjunctions, and pronouns while keeping content words such as nouns and verbs
What are characteristics of fluent aphasia
Speak at normal rate and melody without significant effort
Frequent errors such as sound or word substitution
What are paragrammatic errors which are seen in fluent aphasia
Misuse grammar and syntax
Ex: they may conjugate a verb incorrectly or use a verb in the position where a noun should be
Marked reduction or misuse of content words has been called ______ ______ because of its lack of content
Empty speech
Name some underlying causes of auditory comprehension diffficulty
Discriminating speech sounds, recognizing whole words, difficulty accessing/activating the meaning of words
Reading difficulties is also known as
Alexia or acquired dyslexia
T/F All individuals with aphasia will have some reading impairments.
True
T/F non-words or unfamiliar words can only be read via that whole word route.
False: phonetic route (sound words out)
Whole word route (site reading)
Agraphia or acquired dysgraphia is a difficulty in
Writing
T/f- writing problems tend not to reflect speech problems in terms of the severity and kinds of errors made
False
Patients with aphasia have difficulty producing gestures due to
- semantic processing impairments
- motor planning issues
- upper extremity weakness/paralysis
T/F gestures are considered to be a strength for person’s with aphasia
False; pragmatics - use this ability to get their message across in any way that can.
a person with aphasia who has impairments in semantic will most likely have what type of errors in their drawing abilities
Semantic like drawing errors- lack detail in their drawing.
What are the two most common given aphasia tests?
Western aphasia battery
Boston Diagnostic Aphasia examination
What are the two subtypes of connectionist classification system
Non-fluent and fluent
What types of aphasia are within the non-fluent subtype
Broca’s aphasia
Global
Transcortical motor
Transcortical mixed
What aphasia’s are included in the fluent aphasia
Wernicke’s
Conduction
Transcortical Sensory
Anomic
True or false
classifications of the aphasia subtypes is based on the identification of impaired underlying process (e.g. Semantics, phonology) not the cataloguing of symptoms (anomia, nonfluency, poor repetition)
False: based on the symptoms not impaired underlying process
What are the four primary language symptoms used for classification of symptoms of aphasia?
Naming
Fluency
Auditory comprehension
Repetition
True or false
Global aphasia is the most severe form of aphasia and has the poorest prognosis for significant recovery
True
Global aphasia results from damage to _____
Both the anterior and posterior language zones of the brain
True/False
Many patients will present immediately as one type of aphasia after their stroke and later rapidly evolve into globally aphasic.
False: immediately present as globally aphasic after their stoke and rapidly evolve into another aphasia type.
Describe Broca’s aphasia
Nonfluent- more pronounced expressive vs. receptive aphasia
- speech is often agrammatic/telegraphic
- naming significantly impaired
- Lesion at Broca’s area and surrounding regions
T/F: Wernicke’s aphasia has significant auditory and written comprehension difficulties
True
T/F Broca’s aphasia and Wernicke’s aphasia are both fluent
False: broca’s a nonfluent
In Transcortical aphasia (motor) where is the lesion
On the periphery of their perisylvian language zone of the frontal lobe
T/F: transcortical sensory aphasia has significant auditory and written comprehension difficulties
True - fluent aphasia
Conduction aphasia is characterized by
Disproportionately poor repetition ability in the context of speech that is fluent with mild-moderate naming difficulties and good auditory comprehension
What is the mildest subtype of aphasia
Anomic - fluent
What is the cause of anomic aphasia
Lesions in any region of the brain related to language processing - usually small
What is thought to be the cause of conduction aphasia
Damage to the arcuate fasiculus fiber (fiber that runs from Broca’s to weirnicke’s area.
T/F: Aphasia is damage to Right hemisphere and primary processors of components of language semantics and phonology
False; damage to the left hemisphere
Communication after right hemisphere damage involves poor ___ but relatively good _____
Poor pragmatics and discourse; good phonology and lexical semantics
Right hemisphere disorder may result in deficits in
The expression and comprehension of emotion
What is the most common problems after right hemisphere damage?
Attention
What are some communication difficulties that may be secondary to attention issues in RHD?
Poor topic maintenance,
difficulty following long conversations,
And poor eye contact
T/F: Left hemisphere damage shows more overt signs of neglect compared to that of right hemisphere damage
False: more commonly apparent in Right hemisphere damage.
- due to right hemisphere is dominate for allocating attention.
T/F: Memory problems is not common in right hemisphere disorders
False, it is common
Associated with difficulties with non-verbal memory but patients may also have poor verbal memory.
RH damage individuals may have a pronounced problem with deficits awareness also known as
Anosognia
Anosognia is most common in individuals who have
Left hemisphere neglect
Anosognia can result in poor
Motivation and adherence to rehabilitation
Traumatic brain injury individuals have a pronounced impairment of _____ vs. ____.
Cognition vs. language.
When a patient is Unresponsive to internal or external stimuli in a period of impaired consciousness is a
Coma
What is a vegetative state
Appears awake in that eyes are open but doesn’t not
What is primary brain damage?
Brain damage caused by external or mechanical forces.
Secondary brain damage includes
Edema - causes increase intracranial pressure and can result in hypoxia if arteries in the brain are squeezed
And
Infections
What are common cognitive symptoms deficits in patients with TBI?
Deficits of perception, attention, memory, and executive function
Attention can influence
Communication skills, memory and executive function.
In a post-traumatic amnesia (PTA) ____ problems are often severe and result in the inability to meaningfully assess patients.
Attention
Retrograde amnesia is
The loss of long term memories that were created before an injury
Anterograde amnesia
The ability to form new memories after an injury
- often due to poor/inadequate use of encoding strategies
Due to the nature of TBI, what area of the brain is usually damaged
Frontal lobes
problems that are present in executive function problems in TBI are
Disinhibition Anosognia (deficit awareness problems) Concrete or inflexible problem solving and reasoning Poor initiation Poor planning
T/F: Communication difficulties in TBI are often at the discourse and pragmatic level and their communication difficulties resemble those difficulties seen after RHD
True
_____ refers to the cognitive communication and behavioral changes that occur in the context of a progressive medical/neurological condition
Dementia
What are the most common areas affected in Dementia
Memory Visio-spatial Language Attention Executive function
Individuals who have cognitive decline greater than would be expected for their age but whose symptoms are milder are often given the diagnosis of
Mild cognitive impairment
Dementias can be classified into what two subtypes?
- Cortical dementia (Alzheimer’s or Pick’s disease)
2. Subcortical Dementia’s (Parkinson’s or Huntington’s disease)
Executive function problems are most pronounced in what area in individuals with dementia? Why?
Behavioral variant of frontal lobe
Because the frontal lobes are the first regions of the cortex affected in this disease process.
T/F: No matter what kind of dementia, at the end stage all forms of memory are impaired
True
T/F: Language impairments (naming, writing, comprehension of complex info), can be seen in the late stages of other cortical dementias
False, early stages
