Aphasia for Praxis/Comps Flashcards
Left hemisphere is more efficient with what tasks?
Language
Skilled motor formation
Arithmetic: sequential and analytical calculating skills
Musical ability: sequential and analytical skills in trained musicians
Sense of direction: following a set of written directions in sequence
Right hemisphere is more efficient with what tasks?
- prosody
- visual/spatial analysis and spatial attention
- arithmetic: ability to correctly line up columns of numbers on a page
- musical ability: in untrained musicians and complex musical pieces in trained musicians
- Sense of direction: finding one’s way by overall sense of spatial orientation
- emotional perception
How to the hemispheres of split-brain patients function?
Independently-
e.g. if you present a picture to the right visual field (left brain), the left hemisphere can tell you what it was and the right hand can show you, but the left hand can’t. if you present a picture to the left visual field, the opposite will happen
Symptoms of Broca’s Aphasia
-Nonfluent, effortful, halting, uneven speech
-Limited word output; short phrases and sentences
-Misarticulated words or distorted sounds
- Agrammatic or telegraphic speech
- Impaired repetition of words and sentences
- Impaired naming, especially confrontation naming
- Rarely normal, but better auitory comprehension of spoken language than production
-Difficulty in syntactic understanding
- Poor oral reading and poor comprehension of material that has been read
- Slow laborious writing that is full of spelling errors and letter omissions
- Monotonous speech
May also exhibit apraxia of speech or dysarthria
Symptoms of transcortical motor aphasia
- Lesion on the anterior superior frontal lobe below or above Broca’s area
- Speechlessness
- Echolalia
- Absent or reduced spontaneous speech
- Nonfluent, paraphasic, agrammatic, telegraphic speech
- Intact repetition
- Awareness of grammaticality
- Unfinished sentences
- Limited word fluency
- Simple and imprecise syntactic structures
- Attempt to initiate speech w/ clapping, vigorous head nodding, hand waving
- Generally good comprehension of simple conversation; possibly impaired for complex speech
- Slow and difficult read aloud
- Seriously impaired writing
Symptoms of mixed transcortical aphasia
Lesion in the watershed area or the arterial border zone of the brain
- Limited spontaneous speech
- Automatic, unintentional, involuntary nature of communication
- Severe echolalia
- Repetition of examiner’s statement
- Severely impaired fluency
- Severely impaired auditory comprehension
- Naming difficulty and neologism
Symptoms of global aphasia
- Profoundly impaired language skills, no significant profile of differential skills
- Greatly reduced fluency
- Expressions limited to a few words, exclamations, and serial utterances
- Impaired repetition
- Impaired naming
- Auditory comprehension limited to single words at best
- Perseveration (repetition of short utterances)
- Impaired reading and writing
Symptoms of Wernicke’s aphasia
- Incessant, effortlessly produced, flowing speech with normal or even abnormal fluency (logorrhea) with normal phrase length
- Paraphasic speech (semantic, literal paraphasias, extra syllables
- Neologisms
- Circumlocution
- Empty speech (this, stuff, that)
- Poor auditory comprehension
- Impaired conversational turn taking
- Reading comprehension problems
- Impaired repetition (?)
- Reading comprehension problems (phoneme/grapheme correspondence, word meanings)
- Writing problems (similar to spoken language problems)
Transcortical sensory aphasia symptoms
- Lesion in the temporoparietal region of the brain
- Fluent speech with normal phrase length, good prosody, normal articulation, and apparently appropriate grammar and syntax
- Paraphasic and empty speech
- Severe naming problems and pauses
- Good repetition, poor comprehension of repeated words
- Echolalia of grammatically incorrect forms, nonsense syllables
- Impaired auditory comprehension
- Difficulty in pointing, obeying commands, answering simple yes/no questions
- Normal automatic speech
- Good oral reading
- Bad reading comprehension
- Better oral reading skills than other language skills
Conduction aphasia symptoms
- Lesion in the region between Broca’s area nd Wernicke’s area, especially in the supramarginal gyrus and the arcuate fasiculus-
- Impaired repetition
- Variable fluency. Less fluent than Wernicke’s
- Paraphasic speech
- Marked word finding problems, especially content words
- Effort to correct speech errors
- Good syntax, prosody, articulation
- Severe to mild naming problems
- Near normal auditory comprehension
- Point to named stimulus but does not label it
- Highly variable reading problems
- Writing problems
- Buccofacial apraxia
Anomic aphasia symptoms
- Lesion in angular gyrus, second temporal gyrus, juncture of the temporoparietal lobe
- Word finding difficulty but pointing to objects is unimpaired
- Generally fluent speech
- Normal syntax except for pauses
- Use of vague and non-specific words
- Verbal paraphasia (word substitution)
- Circumlocution
- Good comprehension
- Intact repetition
- Unimpaired articulation
- Normal oral reading and reading comprehension
- Normal writing
50% of TBIs are caused by ____
Vehicle Crashes
____ results from sudden acceleration, decceleration, and/or rotation of the brain following a blunt impact
Diffuse brain injury (concussion/ diffuse axonal injury)
_____ may be due in part to the decreased compliance of the older brain and its vasculature
Focal brain injury (epidural hematoma, subdural hematoma, cerebral contusion)
______ results from a foreign object (e.g. bullet) penetrating the bone and brain
Penetrating brain injury
Leading cause of death until age 44 is ____
TBI
3 reasons that TBI is a silent epidemic
- Most individuals don’t know about brain injury or its consequences or impact on behavior
- Minor blows to the head or concussions are often not perceived as “brain injuries”yet 15% of these individuals will have chronic problems post injury
- Most people assume one needs to lose consciousness to have a brain injury
___ TBIs constitute 85% of all TBIs. The patient is seen at the ER or MD’s office. The injury is identified as a concussion and is not followed by the medical community
Mild
___ account for 15% of all TBIs. Patients are typically hospitalized, identified as a TBI and followed by the medical community
Moderate to severe
Describe characteristics of a concussion
Temporary consciousness and/or memory loss
Describe characteristics of a contusion
Brain bruising with longer term losses
Describe characteristics of a laceration
Brain tissue tearing with intracranial bleeding and increased pressure
This kind of damage may result from coup and contra coup damage
focal
Frontal lobe injury can result in…
Personality change (irritable, euphoric apathy) as well as disturbances in cognition and memory
Occipital lobe injuries might result in…
Vision problems or blindness