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Neuro 1 > Aphasia > Flashcards

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

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2
Q

a complex and dynamic (rule based) system of conventional symbols that is used in various modes for thought and communication.

A

language

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3
Q

Two types of language?

A

Expressive language

Receptive language

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4
Q

ability to communicate one’s thoughts, ideas, & feelings

A

Expressive language

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5
Q

ability to understand what another person is communicating

A

Receptive language

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6
Q

how we say sounds and words

A

speech

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7
Q

how we make speech sounds by manipulating our articulators.

ex: Boat versus Tote

A

articulation

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8
Q

how we use our vocal folds and breath to make sounds

ex: bad vs pad

A

voice

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9
Q

the rhythm of our speech (ex: continuity, smoothness, rate, and effort in speech production)

A

Fluency

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10
Q

a fluency deficit, stutter (ex: My name is Sarah. My name is S-S-S-S-Sarah)

A

dysfluency

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11
Q

Non-verbal communication:

A
  • facial expressions
  • the tone and pitch of the voice
  • “I love you.” Or “I love you?”
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12
Q

gestures displayed through body language

A

Kinesics

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13
Q

physical distance between the communicators

A

proxemics

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14
Q

social rules we follow when we talk (ex: taking turns in conversation)

A

Pragmatics

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15
Q

aspects that shape a communicative exchange (ex: “sorry” purpose of activity has different application)

A

context

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16
Q

vocabulary of a language (likely varies from your grandmother’s)

A

Lexicon

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17
Q

language system that refers to the meanings of words

ex: Dog bark versus tree bark

A

Semantics

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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

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19
Q

stress and intonation used in language to help make distinctions between questions, statements, expressions of emotions, shock, exclamations etc.

A

Prosody

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20
Q

What cranial nerves assist in speech production?

A 
Fifth (Trigeminal) 
Seventh (Facial) 
Ninth (glossopharyngeal) 
Tenth (vagus) 
Twelfth (hypoglossal)
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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.

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22
Q

General functions CN 7 on speech?

A

Seventh (facial) – Movement of facial muscles, taste, and salivary glands.

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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.

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24
Q

General functions CN 10 on speech?

A

Tenth (Vagus) – Taste, swallowing, elevation of palate, phonation, parasympathetic outflow to visceral organs

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25
Q

General functions CN 12 on speech?

A

Twelfth (hypoglossal) – Movement of the tongue

- SLPs do an Oral Mechanism/Cranial Nerve Exam prior to language or swallow evals.

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26
Q

the area of the dominant hemisphere where the major neurologic components of language are located

A

Perisylvian Zone

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27
Q

Motor programming for articulation (expression of language) (Frontal lobe)

A

Broca’s area

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28
Q

activation of muscles for articulation (dorsal of frontal lobe)

A

primary motor cortex

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29
Q

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)

A

Arcuate fasciculus

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30
Q

integrates visual, auditory, and tactile information and carries out symbolic integration for reading (Parietal lobe)

A

Angular gyrus

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31
Q

Comprehension of oral language (Temporal lobe)

A

Wernicke’s area

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32
Q

symbolic integration for writing (the parietal lobe)

A

Supramarginal gyrus

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33
Q

stretches across the midline of the brain, connecting the left and right cerebral hemispheres; transmission of information between hemispheres

A

corpus callosum

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34
Q

naming and memory mechanisms (subcortical)

A

thalamus

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35
Q

play a general role in speech and language (subcortical - part of basal ganglia)

A

Internal capsule, Striatum, Globus pallidus

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36
Q

tracts underlying the perisylvian cortical regions known to be associated with language function (subcortical)

A

white matter

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37
Q

complex process of comprehending and formulating verbal messages that result from newly acquired disease of the central nervous system

A

Aphasia

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38
Q

T/F Aphasia is not a development disorder.

A

True

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39
Q

T/F Dysarthria, apraxia, and aphasia are all the same.

A

False,
dysarthria (motor voice deficit – scratchy voice)
apraxia (disconnect to muscles)

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40
Q

T/F With apraxia, communication loss can not be attributed to dementia, confusion, sensory loss (hearing loss), or motor dysfunction

A

True

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41
Q

What is the most common cause of aphasia?

A

Stroke/cva

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42
Q

Brain injuries resulting in aphasia?

A
  1. head trauma
  2. brain tumors
  3. infections
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43
Q

T/F Aphasia can happen in all four language modalities expressive language, receptive language, reading, and writing

A

True

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44
Q

Expressive aphasia is generally associated with lesions where?

A

anterior lesions

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45
Q

Receptive aphasia is generally associated with lesions where?

A

posterior lesions

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46
Q

(term for) anatomical abnormality of brain due to trauma/disease that causes inflammation, malfunction, or destruction of brain cells/tissue.

A

brain lesion

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47
Q

Aphasia tests/screeners generally include:

A
  1. Naming tasks– visual confrontation (name items in room or picture cards
    - Word retrieval/finding – measuring the ability to generate words
  2. Speech sample-spontaneous conversation—analyzed for fluency of output, effort, articulation, phrase length, prosody, word substitutions, and omissions
  3. Repetition – of different targets (digits, single words, multisyllable words and sentences of increasing length and complexity)
  4. Comprehension of spoken language-
    - Item identification – understanding single words
    - Yes/no questions
    - 1-step commands to more complex 2-step commands, etc.
  5. Reading
  6. Writing
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48
Q

Fluent speech pattern -

A
  • Defined by rate of speech (wpm or words per minute), length of utterance, ease of production, prosody
  • Fluent speech normal or excess >200 wpm
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49
Q

In fluent speech pattern, what is long utterances?

A

9 or more words per utterance

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50
Q

T/F Prosody is normal in fluent speech pattern

A

True

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51
Q

What is logorrhea?

A
  • produces lots and lots of speech, not necessarily meaningful speech
  • related to fluent speech pattern
52
Q

What is pressed for speech?

A
  • the person seems compelled to keep going, getting out lots of ideas through fast and continuing ideas
  • related to fluent speech pattern
53
Q

Non-fluent speech pattern -

A
  • Rate is slow (10-50 wpm) with lots of long pauses

- Speaking seems effortful

54
Q

In non-fluent speech pattern, what are their utterances?

A

1-3 words

55
Q

T/F Prosody often lost in non-fluent speech pattern.

A

True

56
Q

Auditory comprehension task -

A

Can the person select appropriate items, answer yes or no questions, and/or follow commands.

57
Q

Pure word deafness (auditory verbal agnosia)

A

person hears the word but cannot tell you the meaning of the word; inability to comprehend speech

58
Q

Writing task -

A

Write your name, your address, this simple phrase etc

59
Q

Agraphia -

A

the loss of the ability to write

60
Q

Pure agraphia -

A

agraphia is the only communication deficit resulting from focal lesion (very rare).

61
Q

Paragraphias -

A

Incorrect spelling errors caused by brain damage

62
Q

Response Dynamism -

A

Utterances that are uncontrolled; spontaneous conversation

63
Q

A short utterance used exclusively in all speaking attempts it can be a word of a phrase “son of a bitch” or only “shit”

A

stereotypy

64
Q

when a patient only has one word available…this is usually a swear word likely due to the emotional gravity of the word.

A

monoaphasia

65
Q

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

A

verbal perserveration

66
Q

Uninhibited repetition of one’s own utterances (ex: John Smith, John Smith, John Smith)

A

Pallilalia

67
Q

Uninhibited repetition of another’s utterances (ex: where do you live? Where do you live? Where do you live?)

A

Echolalia

68
Q

Broca’s Aphasia is a (fluent/nonfluent) type of aphasia

A

Nonfluent

69
Q

Occlusion of what artery usually leads to broca’s aphasia?

A

Left MCA (superior division)

70
Q

Broca’s aphasia characteristics?

A

awkward articulation, restricted vocabulary, restriction to simple grammatical forms in the presence of a relative preservation of auditory comprehension

71
Q

T/F With Broca’s aphasia writing mirrors speech

A

True

72
Q

T/F With Broca’s aphasia, reading may be less impaired than speech and writing

A

True

73
Q

Wernicke’s Aphasia is a (fluent/nonfluent) aphasia

A

Fluent

74
Q

Occlusion of what artery usually leads to Wernicke’s aphasia?

A

L MCA (inferior division)

75
Q

Characteristics of wernicke’s aphasia?

A

Impaired auditory comprehension and fluently articulated speech marked by word substitutions

76
Q

T/F With Wernicke’s aphasia, reading and writing are usually severely impaired.

A

True

77
Q

How does Wernicke’s aphasia affect rate of speech?

A

Speech is often produced at a greater rate than normal

78
Q

T/F With Wernicke’s aphasia, production of speech is often precise but patients may reverse phonemes and/or syllables

A

True

79
Q

Jargon aphasia

A
  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
Q

Damage to what area of the brain will cause jargon aphasia?

A

damage to the temporal lobe, and more specifically, Wernicke’s area

81
Q

Word finding difficulty within fluent, grammatically well-formed speech

A

Anomic aphasia

82
Q

Lesion where can cause anomic aphasia?

A

usually variable but is common in left angular gyrus (near Wernicke’s).

83
Q

circumlocution -

A

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
Q

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

A

True

85
Q

T/F Anomic disturbances predominate aphasia secondary to TBI

A

True

86
Q

T/F Anomia is the most prominent symptom with only limited receptive or expressive deficits

A

True

87
Q

T/F Anomic aphasia may appear as the isolated syndrome or may be the final stage of recovery from other syndromes (like Wernicke’s).

A

True

88
Q

Conduction aphasia - (associative aphasia)

A
  • The main impairment is in the inability to repeat words or phrases.
  • Other areas of language are less impaired (or not at all).
89
Q

T/F Conduction aphasia is considered a mild form of aphasia and is relatively rare

A

True

90
Q

A lesion where will cause conduction aphasia?

A

lesion in the arcuate fasciculus, a bundle of nerve fibers connects Wernicke’s and Broca’s areas.

91
Q

Severe aphasia with complete dysfunction across ALL language modalities

A

global aphasia

92
Q

Damage where will cause global aphasia?

A

Generally extensive damage, anywhere in the left hemisphere and sometimes bilateral – affecting Wernicke’s and Broca’s area

93
Q

Wernicke’s term for any aphasic syndrome whose lesion falls outside of the Perisylvian area

A

Transcortical aphasia

94
Q

T/F Ability to repeat with good accuracy is retained with transcortical aphasia

A

True

95
Q

Transcortical motor aphasia? Lesion location?

A
  • 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
Q

Transcortical sensory aphasia? Lesion location?

A
  • 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
Q

Mixed transcortical aphasia? Lesion location?

A
  • 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
Q

T/F Subcortical aphasias are generally characterized with preserved repetition

A

True

99
Q

Thalamic aphasia?

A
  • 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
Q

Striato-capsular aphasia and aphasia associated with white matter paraventricular lesions?

A
  • characterized with lack of speech fluency, occurrence of literary paraphasias, mainly preserved comprehension and naming.
  • phonetic impairment of language
101
Q

Progressive aphasia?

A
  • 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
Q

What is often an early sign of progressive aphasia?

A

Anomia

103
Q

T/F Progressive aphasia is not due to stroke, trauma, tumor, or infection

A

True

104
Q

spontaneous recovery -

A
  • 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
Q

Factors that may negatively affect improvement of aphasia post-stroke?

A

poststroke depression and social isolation after onset of aphasia.

106
Q

Which has better prognosis, posttraumatic aphasia or aphasia due to vascular lesions?

A

posttraumatic aphasia

107
Q

T/F studies support better clinical outcome for patients who receive early intensive treatment

A

True

108
Q

Re-education is proven to do what three things to patients with aphasia?

A
  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
Q

For individuals with aphasia, what is the true test of rehabilitation outcome?

A

perception of quality of their lives or in most cases wanting to be back to their baseline level of language performance

110
Q

How to talk to patient with aphasia?

A
  • 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
Q

How can I help-coordinate with SLP for feeding position/posture and speech?

A
  • 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
Q

Cognitive Communication Disorders -

A

Caused by TBI, strokes-especially right hemisphere, dementia, brain tumors, degenerative neurological disease, alcohol abuse, medications

113
Q

How to work with patient with Cognitive Communication Disorders?

A
  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
Q

impairment of speech production resulting from damage to the central or peripheral nervous system, causing weakness, paralysis or incoordination of motor-speech system

A

Dysarthria

115
Q

What is included in the motor speech system?

A

Respiration, Phonation, Articulation, Resonance, or Prosody

116
Q

T/F Not unusual for dysarthria to coincide with aphasia for TBIs or CVAs

A

True

117
Q

Anarthria -

A

Speech completely unintelligible

118
Q

Treatment for patient’s with dysarthria -

A
  1. slow rate of speech
  2. over-articulate
  3. speak louder
119
Q

Apraxia of speech -

A

impaired capacity to plan or program sensorimotor commands necessary for directing movements that result in phonetically and prosodically normal speech

120
Q

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.

A

True

121
Q

Labored speech -

A
  • 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
Q

How diagnose apraxia?

A

Sing happy birthday

123
Q

Treatment of apraxia -

A

Sound shaping, Singing, Imitation, Stress, Writing

124
Q

Swallowing disorder occurring as a result of various medical conditions in the oral cavity, pharynx or esophagus.

A

Dysphagia

125
Q

T/F Patient with dysphagia is not at risk for aspiration

A

False

Neuro 1 (5 decks)

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