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Neuromuscular Conditions I > Aphasia, Dysarthria, & Dysphagia > Flashcards

Aphasia, Dysarthria, & Dysphagia Flashcards

1
Q

Scope of Practice

A

Eval/Diagnose/Treat: communication & swallowing delays and disorders

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2
Q

What do SLPs Do?

A
  • Expressive/receptive language
  • cognitive linguistic skills (attn, memory, processing, visuo-spatial, executive functioning)
  • Speech (dysarthria, apraxia)
  • Voice
  • Fluency (stuttering, cluttering)
  • Swallowing
  • Pragmatics
  • MORE
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3
Q

Aphasia

A
  • loss or impairment of language skills in adults who have a history of normal language skills.
  • impairment associated with recent cerebral pathology or trauma (mostly left side of brain)
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4
Q

Anomic

A

trouble naming/finding words

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5
Q

Modalities of Communication with Aphasic pts

A

Input: reading, writing
Output: speaking, writing, gesturing

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6
Q

When does aphasia occur?

A
  • Immediately post CVA

- Gradual with degenerative disease (MS, Parkinson’s, Dementia)

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7
Q

Aphasia can occur with:

A
  • Dysarthria
  • Apraxia of speech
  • Cognitive disorders
  • Dysphagia
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8
Q

Classifications of Aphasia

A

Expressive vs Receptive
-OR-
Fluent vs Nonfluent

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9
Q

Expressive Aphasia

A
  • difficulty communicating message (verbal, written, gestural)
  • Associated with lesions in Broca’s Area
  • AKA Nonfluent Aphasia
  • Can understand
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10
Q

Receptive Aphasia

A
  • Problem understanding Communication (auditory, gestural, reading)
  • Associate with lesion to fissure of rolando
  • AKA Fluent Aphasia
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11
Q

Fluent Aphasia

A

Mimics actual language even if you can’t understand the words

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12
Q

Nonfluent Aphasia

A

Break down of flow, ineffective communication

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13
Q

Fluency

A
  • Refers to flow of speech (flows, not hesitant, no repetitions)
  • Not stuttering
  • Prosodic and Melodic features of speech
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14
Q

Types of aphasia

A
  • Broca’s
  • Wernicke’s
  • Transcortical Motor
  • Transcortical Sensory
  • Mixed Transcortical
  • Conduction
  • Anomia
  • Global
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15
Q

Characteristics of Fluent Aphasia

A
  • Deficits in: auditory/reading comprehension
  • Speaking rate of 100-200 words per min (normal)
  • Syntactic errors
  • Normal articulation, prosodic features and fluency
  • Omission of content words (“bbe boop AND oop dopp but um oo bee doo”)
  • Circumlocutions
  • Paraphasias (“gat” instead of “Cat”)
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16
Q

Types of Fluent Aphasia

A
  • Wernicke’s
  • Anomic
  • Conduction
  • Transcortical Sensory
  • Mixed Transcortical
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17
Q

Associated Lesion Sites of Fluent Aphasia

A
  • Fissure of Rolando (post to central sulcus)
  • Temporal lobe of left hemisphere
  • Temporal-parietal
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18
Q

Impaired Auditory Comprehension

A
  • Impaired comprehension of:

- -Single words, sentences, simple directions/commands, conversations

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19
Q

Alexia

A

Disorder of Reading

20
Q

Agraphia

A

Disorder of writing

21
Q

Acalculia

A

Disorder of math

22
Q

Paraphasias

A
  • literal/phonemic
  • Verbal/semantic
  • neologisms
  • jargon
23
Q

Literal/phonemic paraphasia

A

substitute unintended sounds for intended sounds of words

24
Q

verbal/semantic paraphasia

A

word errors in which error is semantically related to correct word

25
Q

neologisms

A

combo of consanants and vowels with appropriate syllable structure and inflection to create new words

26
Q

Jargon

A

pt is unaware he is speaking in paraphasisias and believes everyone understands him

27
Q

Propositional Language

A
  • Novel language
  • pts have difficulty with this
  • conversation
28
Q

Nonpropositional language

A

-autonomic/overlearned language

29
Q

Rule of 5s

A
  • keep it simple
  • 5 letter words
  • 5 words per sentence
30
Q

Keep the language similar

A
  • “point to the apple”
  • “point to the apple”
  • Not: point, then touch then where is it, then point
31
Q

Nonfluent Aphasia Types

A
  • Broca’s
  • Transcortical Motor
  • Global
32
Q

Associated Lesion Sites of Nonfluent Aphasia

A
  • Central Sulcus–ant to fissure of rolando
  • Broca’s Area
  • Motor strip
33
Q

Characteristics of Nonfluent Aphasia

A
  • Good auditory comprehension
  • difficulty initiating speech
  • reduced speech rate
  • effortful speech
  • Abnormal intonation and prosody
  • increase of content words
  • deletion of gramatical morphemes
  • uses short phrases/sentences
  • reluctance to speak (know they’re having troubles)
34
Q

Broca’s Aphasia

A
  • right-sided weakness/paralysis
  • deficits in auditory comprehension
  • difficulty understanding syntactical morphemes
  • Agrammatic speech
  • Telegraphic speech (like Sarah from video)
  • slow effortful speech
  • difficulty reading/writing
  • oral reading effortful and nonfluent
  • writing difficulties mirror verbal expression
  • can occur with motor speech disorders
35
Q

Global Aphasia

A
  • combo of fluent and nonfluent aphasia
  • more severe
  • Cause: occlusion of L MCA
  • Severe impairments of comprehension, integration and formulation of language in ALL modalities
  • hard talking, reading, writing etc
36
Q

Dysphagia

A
  • Swallowing disorder
  • difficulty swallowing that occurs when impairments affect any of the 4 phases of swallowing and put an individual at risk for aspiration of food and liquid and potential aspiration pneumonia
37
Q

4 Phases of Swallowing

A
  • Oral preparatory
  • oral
  • pharyngeal
  • esophageal
38
Q

Modified Barium Swallow Study

A
  • Gold standard
  • dynamic imaging of bolus from entering mouth to entering stomach
  • AKA: MBS (modified barium swallow), VFSS (video fluoroscopic swallow study)
39
Q

Fibro Endoscopic Eval of Swallowing

A
  • (FEES)
  • info about pharyngeal phase
  • endoscope passed through nose into nasopharynx
  • laryngopharynx can be viewed while pt eats
  • black out when pt swallows (not visible)
40
Q

Penetration

A

-Material enters larynx and remains above vocal folds

41
Q

Aspiration

A

material goes beyond vocal folds

42
Q

Aspiration Pneumonia

A
  • acute inflam caused by material entering lungs

- symptoms: spiked temp, myalgia, productive cough

43
Q

Silent Aspiration

A
  • aspiration without productive cough or choking because of a lack of sensation in larynx
  • no sensation=no protective maneuvers (cough, choke)
44
Q

Treatments for Dysphagia

A
  • Vital stim (NMES for swallowing)
  • traditional dysphagia exercises
  • Different postures/positions/techniques
  • diet modifications
45
Q

Diet Modifications

A

Liquid consistencies (thin, nectar-like, honey-like, spoon thick/pudding thick)

Solid Consistencies: (National Dysphagia Diet: NDD1, NDD2, NDD3, Regular)

46
Q

Swallow Precautions Seen

A
  • diet modification (or NPO)
  • chin tuck
  • chin tilt (L, R)
  • head turn (L, R)
  • Double swallow
  • alternate solids and liquids
  • small bites/sips
  • 24/7 supervision

Neuromuscular Conditions I (11 decks)

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