Aphasia Flashcards
1
Q
active process of exchanging information and ideas.
(Gestures, vocalizations, verbalizations, signs, pictures, symbols, printed words, and output from augmentative and alternative (AAC) devices)
A
communication
2
Q
a complex and dynamic (rule based) system of conventional symbols that is used in various modes for thought and communication.
A
language
3
Q
Two types of language?
A
Expressive language
Receptive language
4
Q
ability to communicate one’s thoughts, ideas, & feelings
A
Expressive language
5
Q
ability to understand what another person is communicating
A
Receptive language
6
Q
how we say sounds and words
A
speech
7
Q
how we make speech sounds by manipulating our articulators.
ex: Boat versus Tote
A
articulation
8
Q
how we use our vocal folds and breath to make sounds
ex: bad vs pad
A
voice
9
Q
the rhythm of our speech (ex: continuity, smoothness, rate, and effort in speech production)
A
Fluency
10
Q
a fluency deficit, stutter (ex: My name is Sarah. My name is S-S-S-S-Sarah)
A
dysfluency
11
Q
Non-verbal communication:
A
- facial expressions
- the tone and pitch of the voice
- “I love you.” Or “I love you?”
12
Q
gestures displayed through body language
A
Kinesics
13
Q
physical distance between the communicators
A
proxemics
14
Q
social rules we follow when we talk (ex: taking turns in conversation)
A
Pragmatics
15
Q
aspects that shape a communicative exchange (ex: “sorry” purpose of activity has different application)
A
context
16
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vocabulary of a language (likely varies from your grandmother’s)
A
Lexicon
17
Q
language system that refers to the meanings of words
ex: Dog bark versus tree bark
A
Semantics
18
Q
the grammar of a language determines the sequence of words that are acceptable in the formation of sentences (ex: English adjectives usually come before the name: “fabulous actor”)
A
Syntax
19
Q
stress and intonation used in language to help make distinctions between questions, statements, expressions of emotions, shock, exclamations etc.
A
Prosody
20
Q
What cranial nerves assist in speech production?
A
Fifth (Trigeminal) Seventh (Facial) Ninth (glossopharyngeal) Tenth (vagus) Twelfth (hypoglossal)
21
Q
General functions CN V on speech?
A
Fifth (trigeminal) – Chewing and sensation to face, soft and hard palate, nasopharynx, teeth, and anterior 2/3 of tongue.
22
Q
General functions CN 7 on speech?
A
Seventh (facial) – Movement of facial muscles, taste, and salivary glands.
23
Q
General functions CN 9 on speech?
A
Ninth (glossopharyngeal) – Taste, swallowing, elevation of pharynx and larynx, parotid salivary gland, sensation to posterior tongue & upper pharynx.
24
Q
General functions CN 10 on speech?
A
Tenth (Vagus) – Taste, swallowing, elevation of palate, phonation, parasympathetic outflow to visceral organs
25
General functions CN 12 on speech?
Twelfth (hypoglossal) – Movement of the tongue
| - SLPs do an Oral Mechanism/Cranial Nerve Exam prior to language or swallow evals.
26
the area of the dominant hemisphere where the major neurologic components of language are located
Perisylvian Zone
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Motor programming for articulation (expression of language) (Frontal lobe)
Broca's area
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activation of muscles for articulation (dorsal of frontal lobe)
primary motor cortex
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transmission of linguistic information to anterior areas from posterior areas (a bundle of axons that generally connects the Broca's area and the Wernicke's area in the brain)
Arcuate fasciculus
30
integrates visual, auditory, and tactile information and carries out symbolic integration for reading (Parietal lobe)
Angular gyrus
31
Comprehension of oral language (Temporal lobe)
Wernicke's area
32
symbolic integration for writing (the parietal lobe)
Supramarginal gyrus
33
stretches across the midline of the brain, connecting the left and right cerebral hemispheres; transmission of information between hemispheres
corpus callosum
34
naming and memory mechanisms (subcortical)
thalamus
35
play a general role in speech and language (subcortical - part of basal ganglia)
Internal capsule, Striatum, Globus pallidus
36
tracts underlying the perisylvian cortical regions known to be associated with language function (subcortical)
white matter
37
complex process of comprehending and formulating verbal messages that result from newly acquired disease of the central nervous system
Aphasia
38
T/F Aphasia is not a development disorder.
True
39
T/F Dysarthria, apraxia, and aphasia are all the same.
False,
dysarthria (motor voice deficit – scratchy voice)
apraxia (disconnect to muscles)
40
T/F With apraxia, communication loss can not be attributed to dementia, confusion, sensory loss (hearing loss), or motor dysfunction
True
41
What is the most common cause of aphasia?
Stroke/cva
42
Brain injuries resulting in aphasia?
1. head trauma
2. brain tumors
3. infections
43
T/F Aphasia can happen in all four language modalities expressive language, receptive language, reading, and writing
True
44
Expressive aphasia is generally associated with lesions where?
anterior lesions
45
Receptive aphasia is generally associated with lesions where?
posterior lesions
46
(term for) anatomical abnormality of brain due to trauma/disease that causes inflammation, malfunction, or destruction of brain cells/tissue.
brain lesion
47
Aphasia tests/screeners generally include:
1. Naming tasks– visual confrontation (name items in room or picture cards
- Word retrieval/finding – measuring the ability to generate words
3. Speech sample-spontaneous conversation—analyzed for fluency of output, effort, articulation, phrase length, prosody, word substitutions, and omissions
4. Repetition – of different targets (digits, single words, multisyllable words and sentences of increasing length and complexity)
5. Comprehension of spoken language-
- Item identification – understanding single words
- Yes/no questions
- 1-step commands to more complex 2-step commands, etc.
6. Reading
7. Writing
48
Fluent speech pattern -
- Defined by rate of speech (wpm or words per minute), length of utterance, ease of production, prosody
- Fluent speech normal or excess >200 wpm
49
In fluent speech pattern, what is long utterances?
9 or more words per utterance
50
T/F Prosody is normal in fluent speech pattern
True
51
What is logorrhea?
- produces lots and lots of speech, not necessarily meaningful speech
- related to fluent speech pattern
52
What is pressed for speech?
- the person seems compelled to keep going, getting out lots of ideas through fast and continuing ideas
- related to fluent speech pattern
53
Non-fluent speech pattern -
- Rate is slow (10-50 wpm) with lots of long pauses
| - Speaking seems effortful
54
In non-fluent speech pattern, what are their utterances?
1-3 words
55
T/F Prosody often lost in non-fluent speech pattern.
True
56
Auditory comprehension task -
Can the person select appropriate items, answer yes or no questions, and/or follow commands.
57
Pure word deafness (auditory verbal agnosia)
person hears the word but cannot tell you the meaning of the word; inability to comprehend speech
58
Writing task -
Write your name, your address, this simple phrase etc
59
Agraphia -
the loss of the ability to write
60
Pure agraphia -
agraphia is the only communication deficit resulting from focal lesion (very rare).
61
Paragraphias -
Incorrect spelling errors caused by brain damage
62
Response Dynamism -
Utterances that are uncontrolled; spontaneous conversation
63
A short utterance used exclusively in all speaking attempts it can be a word of a phrase “son of a bitch” or only “shit”
stereotypy
64
when a patient only has one word available…this is usually a swear word likely due to the emotional gravity of the word.
monoaphasia
65
a word or phrase temporarily becomes the response to all stimuli. At the outset of this period, the response was appropriate to a particular stimulus
verbal perserveration
66
Uninhibited repetition of one's own utterances (ex: John Smith, John Smith, John Smith)
Pallilalia
67
Uninhibited repetition of another's utterances (ex: where do you live? Where do you live? Where do you live?)
Echolalia
68
Broca's Aphasia is a (fluent/nonfluent) type of aphasia
Nonfluent
69
Occlusion of what artery usually leads to broca's aphasia?
Left MCA (superior division)
70
Broca's aphasia characteristics?
awkward articulation, restricted vocabulary, restriction to simple grammatical forms in the presence of a relative preservation of auditory comprehension
71
T/F With Broca's aphasia writing mirrors speech
True
72
T/F With Broca's aphasia, reading may be less impaired than speech and writing
True
73
Wernicke's Aphasia is a (fluent/nonfluent) aphasia
Fluent
74
Occlusion of what artery usually leads to Wernicke's aphasia?
L MCA (inferior division)
75
Characteristics of wernicke's aphasia?
Impaired auditory comprehension and fluently articulated speech marked by word substitutions
76
T/F With Wernicke's aphasia, reading and writing are usually severely impaired.
True
77
How does Wernicke's aphasia affect rate of speech?
Speech is often produced at a greater rate than normal
78
T/F With Wernicke's aphasia, production of speech is often precise but patients may reverse phonemes and/or syllables
True
79
Jargon aphasia
1. Fluent aphasia in which an individual's speech is incomprehensible but appears to make sense to the individual
2. will either replace a desired word with another that sounds or looks like the original one, or has some other connection to it, or they will replace it with random sounds
Ex: "Potatoe gropes the long table.”
80
Damage to what area of the brain will cause jargon aphasia?
damage to the temporal lobe, and more specifically, Wernicke’s area
81
Word finding difficulty within fluent, grammatically well-formed speech
Anomic aphasia
82
Lesion where can cause anomic aphasia?
usually variable but is common in left angular gyrus (near Wernicke’s).
83
circumlocution -
using wordy and indirect language to express an idea when unable to retrieve the desired word or words.
ex: grandfather" as "the father of one's father"
84
T/F With anomic aphasia, speech output is somewhat vague, and patient may use circumlocution as a compensatory strategy to skirt the lack of specificity of language use
True
85
T/F Anomic disturbances predominate aphasia secondary to TBI
True
86
T/F Anomia is the most prominent symptom with only limited receptive or expressive deficits
True
87
T/F Anomic aphasia may appear as the isolated syndrome or may be the final stage of recovery from other syndromes (like Wernicke’s).
True
88
Conduction aphasia - (associative aphasia)
- The main impairment is in the inability to repeat words or phrases.
- Other areas of language are less impaired (or not at all).
89
T/F Conduction aphasia is considered a mild form of aphasia and is relatively rare
True
90
A lesion where will cause conduction aphasia?
lesion in the arcuate fasciculus, a bundle of nerve fibers connects Wernicke’s and Broca’s areas.
91
Severe aphasia with complete dysfunction across ALL language modalities
global aphasia
92
Damage where will cause global aphasia?
Generally extensive damage, anywhere in the left hemisphere and sometimes bilateral – affecting Wernicke’s and Broca’s area
93
Wernicke’s term for any aphasic syndrome whose lesion falls outside of the Perisylvian area
Transcortical aphasia
94
T/F Ability to repeat with good accuracy is retained with transcortical aphasia
True
95
Transcortical motor aphasia? Lesion location?
- nonfluent speech with greater effort required than Broca’s
- repetition and comprehension intact
- Typically caused by a lesion located nearby Broca’s area or just in front of it.
96
Transcortical sensory aphasia? Lesion location?
- fluent speech marked with paraphasias with semantic and neologistic substitutions, poor comprehension, good repetition
- Typically caused by a lesion to areas of the brain which surround Wernicke’s language area
97
Mixed transcortical aphasia? Lesion location?
- severely disordered language except in repetition. - Echolalia is common.
- rare type of aphasia, Broca's and Wernicke’s areas are typically not damaged, but the surrounding areas are injured - thought to leave Broca's and Wernicke's areas isolated from the rest of the language system
- cause of mixed transcortical aphasia is a watershed stroke of the language association areas as a result of severe internal carotid stenosis
98
T/F Subcortical aphasias are generally characterized with preserved repetition
True
99
Thalamic aphasia?
- characterized by relatively consistent fluent expressive speech and impaired comprehension marked by verbal paraphasia and neologisms
- Auditory and reading comprehension usually remains intact (lexical-sematic processing impairment)
100
Striato-capsular aphasia and aphasia associated with white matter paraventricular lesions?
- characterized with lack of speech fluency, occurrence of literary paraphasias, mainly preserved comprehension and naming.
- phonetic impairment of language
101
Progressive aphasia?
- type of dementia
- Generally characterized by gradual loss of language function in the context of relatively well-preserved memory, visual processing, and personality until the advanced stages
- Adult-onset degenerative disease language disorder
- Other intellectual functions are spared
102
What is often an early sign of progressive aphasia?
Anomia
103
T/F Progressive aphasia is not due to stroke, trauma, tumor, or infection
True
104
spontaneous recovery -
- gradual recovery over time with or without therapeutic intervention.
- Several studies concluded that the greatest improvement occurs in the first 2-3 months after onset while other studies say 6 months or up to 1 year.
105
Factors that may negatively affect improvement of aphasia post-stroke?
poststroke depression and social isolation after onset of aphasia.
106
Which has better prognosis, posttraumatic aphasia or aphasia due to vascular lesions?
posttraumatic aphasia
107
T/F studies support better clinical outcome for patients who receive early intensive treatment
True
108
Re-education is proven to do what three things to patients with aphasia?
1. increased rate of recovery
2. assisted in facilitating the use of compensatory means of communication
3. improved overall morale or psychotherapeutic benefits of tx
109
For individuals with aphasia, what is the true test of rehabilitation outcome?
perception of quality of their lives or in most cases wanting to be back to their baseline level of language performance
110
How to talk to patient with aphasia?
* Simple, short phrases
* Give additional time
* Do not talk over them, like they are kids, speak too loud
* Simple yes/no versus elaborate questions
* Gestures to facilitate understanding
* Consult speech therapy
* Never tell a patient they WILL get better!
111
How can I help-coordinate with SLP for feeding position/posture and speech?
* Providing a supportive conversation atmosphere
* Provide a successful verbal interaction
* Limit distractions
* Gage auditory comprehension (can they follow 1-step commands/simple yes/no, item id)
* I often stop PTs in the hallway to discuss how a pt is doing
112
Cognitive Communication Disorders -
Caused by TBI, strokes-especially right hemisphere, dementia, brain tumors, degenerative neurological disease, alcohol abuse, medications
113
How to work with patient with Cognitive Communication Disorders?
1. Limit environmental factors for visual and auditory distraction
2. Create routine – Visual aids clock calendar
3. Carry over skill from treatment to real life – safety problem solving versus math problem solving
4. Pragmatics - expressing feelings, initiating conversation, taking turns in discourse
114
impairment of speech production resulting from damage to the central or peripheral nervous system, causing weakness, paralysis or incoordination of motor-speech system
Dysarthria
115
What is included in the motor speech system?
Respiration, Phonation, Articulation, Resonance, or Prosody
116
T/F Not unusual for dysarthria to coincide with aphasia for TBIs or CVAs
True
117
Anarthria -
Speech completely unintelligible
118
Treatment for patient's with dysarthria -
1. slow rate of speech
2. over-articulate
3. speak louder
119
Apraxia of speech -
impaired capacity to plan or program sensorimotor commands necessary for directing movements that result in phonetically and prosodically normal speech
120
T/F Apraxia does not involve muscle weakness, paralysis, spasticity, or involuntary movements typically associated with dysarthria, or language comprehension or production deficits that characterize aphasia.
True
121
Labored speech -
- articulatory difficulty, speech errors, slow rate “halting”, slow transition between sounds, and impaired prosody in the absence of impaired strength or coordination of the motor speech system
- Difficult to initiate speech
- Periods of error free speech followed by errors as speech progresses
122
How diagnose apraxia?
Sing happy birthday
123
Treatment of apraxia -
Sound shaping, Singing, Imitation, Stress, Writing
124
Swallowing disorder occurring as a result of various medical conditions in the oral cavity, pharynx or esophagus.
Dysphagia
125
T/F Patient with dysphagia is not at risk for aspiration
False
