Aphasia for Praxis/Comps Flashcards

1
Q

Left hemisphere is more efficient with what tasks?

A

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

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2
Q

Right hemisphere is more efficient with what tasks?

A
  • 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
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3
Q

How to the hemispheres of split-brain patients function?

A

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

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4
Q

Symptoms of Broca’s Aphasia

A

-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

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5
Q

Symptoms of transcortical motor aphasia

A
  • 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
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6
Q

Symptoms of mixed transcortical aphasia

A

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
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7
Q

Symptoms of global aphasia

A
  • 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
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8
Q

Symptoms of Wernicke’s aphasia

A
  • 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)
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9
Q

Transcortical sensory aphasia symptoms

A
  • 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
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10
Q

Conduction aphasia symptoms

A
  • 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
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11
Q

Anomic aphasia symptoms

A
  • 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
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12
Q

50% of TBIs are caused by ____

A

Vehicle Crashes

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13
Q

____ results from sudden acceleration, decceleration, and/or rotation of the brain following a blunt impact

A

Diffuse brain injury (concussion/ diffuse axonal injury)

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14
Q

_____ may be due in part to the decreased compliance of the older brain and its vasculature

A

Focal brain injury (epidural hematoma, subdural hematoma, cerebral contusion)

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15
Q

______ results from a foreign object (e.g. bullet) penetrating the bone and brain

A

Penetrating brain injury

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16
Q

Leading cause of death until age 44 is ____

A

TBI

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17
Q

3 reasons that TBI is a silent epidemic

A
  • 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
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18
Q

___ 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

A

Mild

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19
Q

___ account for 15% of all TBIs. Patients are typically hospitalized, identified as a TBI and followed by the medical community

A

Moderate to severe

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20
Q

Describe characteristics of a concussion

A

Temporary consciousness and/or memory loss

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21
Q

Describe characteristics of a contusion

A

Brain bruising with longer term losses

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22
Q

Describe characteristics of a laceration

A

Brain tissue tearing with intracranial bleeding and increased pressure

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23
Q

This kind of damage may result from coup and contra coup damage

A

focal

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24
Q

Frontal lobe injury can result in…

A

Personality change (irritable, euphoric apathy) as well as disturbances in cognition and memory

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25
Q

Occipital lobe injuries might result in…

A

Vision problems or blindness

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26
Q

Temporal lobe injuries might result in…

A

auditor comprehension defecits

27
Q

Problems with executive functioning in patients with TBI might include

A
  • Difficulty planning/setting goals
  • Problems being organized
  • Difficulty being flexible
  • Difficulty problem solving
  • Difficulty prioritizing
  • Decreased awareness of thinking changes in self
28
Q

RHD patients are most often _____ in that they can process most words and sentences in isolation

A

not aphasic

29
Q

One difference that patients with RHD might have from an aphasic person related to processing emotion

A

RHD will have difficulty processing emotion in pictured scenes while aphasics will not

30
Q

Difficulty of person with RHD related to discourse

A

Have difficulty recalling explicit info, tend to “miss the point”

31
Q

Difficulty of person with RHD in metaphor comprehension

A

have difficulty with these because of inference comprehension

32
Q

Difficulty in RHD related to emotion and prosody

A

Aprosodia- flat contour or monotone. Failure to identify emotional tone in mundane sentences

33
Q

Reading difficulty in RHD

A

Tend to misread beginning of words, omit or misread words on the left side of the page (neglect dyslexia)

34
Q

RHD patients may experience auditory agnosia which is…

A

impaired ability to recognize sounds despite adequate hearing

35
Q

RHD patients often display ___ neglect

A

left

36
Q

RHD patients may display ____ or lack of awareness or recognition of disease or disability

A

Anosognosia

37
Q

Three phases of service delivery in aphasia

A
Acute phase (weeks 0-6)
Rehabilitation phase (weeks 6-24)
Long term care (6 months- 10 years post stroke)
38
Q

Name assessments that might be used in the acute phase

A

Informal eval, CAT, BDAE, Boston Naming Test, Bedside Evaluation Screening Test, WAB

39
Q

Name assessments that might be used in the chronic phase

A

BDAE, PALPA, Minnesota Test for Differential Diagnosis of Aphasia, Porch index of communicative ability

40
Q

Intervention needs for clients with low insight and high environmental dependency

A

Environmental supports/structure
Functional routines
Behavioral interventions

41
Q

Intervention needs for clients with emerging insight and some self-regulation

A
  • Process training
  • Active compensations
  • Self regulatory and meta-linguistic interventions
  • Cognitive linguistic interventions
42
Q

Needs of the patient, family, and therapist in the acute phase

A
  • Establish current and pre morbid communication skills
  • Establish baseline communication skills
  • Give info about aphasia
  • Identify immediate communication needs
  • Provide counseling and support
43
Q

Needs of the patient, family, and therapist in the rehabilitation phase

A
  • Assessment of specific impairment needs
  • Ongoing info giving and updates
  • Building communication links and skills with family and friends
  • Setting individual therapy goals
  • Implementing individual and group therapy
  • Developing hospital based communication skills
  • Ongoing counseling and support
44
Q

Needs of the patient, family, and therapist in long term care

A
  • Making therapy functional and relevant
  • Developing sense of self awareness and self identity
  • Preparing patient for living with aphasia
  • Developing autonomy and independence
  • Ongoing support and training courses
45
Q

Factors that might influence recovery from aphasia include

A
  • Site and size of lesion (improved recovery associated with lesions that are less extensive and limited to the cerebral cortext)
  • Initial severity of aphasia
  • Handedness (left handed may be more likely to recover)
  • Type of aphasia (patients with severe deficits are likely to improve more overall but are less liekly to obtain as high aof a level of premorbid function as patients with milder forms
46
Q

Name some signs and symptoms of a stroke

A

Sudden numbness or weakness of the face, arm, or leg, especially on one side of the body

Sudden confusion, trouble speaking or understanding

Sudden trouble seeing in one or both eyes

Sudden trouble walking, dizziness, loss of balance or coordination

Sudden severe headache with no known cause

47
Q

What is a TIA?

A

Transient Ischemic Attack
- Stroke like event lasting minute or hours that occurs when the brain is deprived of oxygen rich blood temporarily but in which the effects wear off completely after the blood flow returns

48
Q

Brain derives its blood supply from the ___ and ___ arteries

A

carotid and vertebral

49
Q

Ischemic strokes are the result of ___

A

blood clots or occlusions

50
Q

Hemorrhagic strokes are the result of ____

A

bleeds, rupture

51
Q

Three types of ischemic strokes are

A

embolic, thrombotic , lacunar

52
Q

An embolism is ___

A

A blot clot that has traveled up to the brain

53
Q

A thrombosis is a _____

A

vein blockage

54
Q

____ strokes are more serious medically but have better overall recovery

A

hemmorhagic

55
Q

Key treatment for ischemic strokes is ___

A

tPA (clot busting drug that dissolves blood clots)

56
Q

Process by which an artery narrows to the point of obstruction is

A

atherosclerosis

57
Q

A lacunar stroke is caused by _____

A

Thrombosis of small, deep penetrating arteries causing a small lake or cavity.

58
Q

Lacunar strokes usually seen with what medical condition?

A

Chronic hypertension

59
Q

Hemorrhagic strokes often caused by AVMs which are..

A

arteriovenous malformation. malformed collection of blood vessels within the brain, characterized by tangles of veins and arteries

60
Q

Name some risk factors for stroke

A
Blood pressure over 120/80
Smoker
Overweight
Diabetes
High cholesterol
Heart disease
Family history of stroke
Physical activity less than 30 minutes on most days 
Men over 45, women over 55
61
Q

____ was the father of modern neuropsychology and brought the seat of neurology to England. He suggested that the brain was organized hierarchically

A

Hughlings Jackson

62
Q

___ introduced the classical model of aphasia. He was the father of modern behavioral neurology in America

A

Geschwind

63
Q

What are the three principle sof parallel distributed processing

A
  • The representation of information is distributed (not local)
  • Memory and knowledge for specific things is not stored explicitly, but in the connections between unites
  • Learning can occur with gradual changes in connection strength by experience