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Aphasia & RHS > Ch. 10: Syndromes and Characteristics of Aphasia > Flashcards

Ch. 10: Syndromes and Characteristics of Aphasia Flashcards

1
Q

What is fluent aphasia?

A

o Fluent aphasias (or fluent types of aphasia) are those in which people can speak readily and have few hesitations or struggles when generating language, even though the words that are spoken or written may not be real words or may not accurately convey the intended meaning.

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2
Q

People with fluent aphasia tend to have more difficulty _______ language as opposed to ______ language

A

Understanding language as opposed to formulating language.

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3
Q

Fluent aphasias are also sometimes called _______ and _______ aphasias.

A

o Receptive and Posterior types of aphasias.

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4
Q

Fluent aphasias tend to be caused by ______.

A

temporal lobe lesions

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5
Q

What is nonfluent aphasia?

A

o Nonfluent aphasias are those in which people generate few words, content units (elements of meaning), or utterances per unit of time.

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6
Q

Individuals with ______ aphasias tend to understand language better than they produce language.

A

Nonfluent

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7
Q

Expressive aphasias are categorized as ______?

A

o nonfluent aphasias

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8
Q

Frontal lobe lesions tend to cause what type of aphasia?

A

Nonfluent aphasias.

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9
Q

What are sometimes called anterior types of aphasia?

A

Nonfluent aphasias.

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10
Q

What is dissociation syndrome?

A

Aspects of language are affected differently than others for any given syndrome has led some authors to refer to aphasia as dissociation syndrome. The term dissociation in this context refers to the fact that some abilities remain relatively intact while others are relatively impaired.

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11
Q

Wernicke’s aphasia

A

Receptive/Fluent/Posterior

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12
Q

In Wernicke’s aphasia how is auditory and reading comprehension impacted?

A

o Auditory and reading comprehension impairment is Moderate to severe

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13
Q

In Wernicke’s aphasia how is oral and written expression impacted?

A

o Oral and Written Expression impairment is Moderate to severe;

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14
Q

What are the linguistic characteristics of a patient with Wernicke’s aphasia?

A

o semantic and literal paraphasias, jargon, neologisms, circumlocutions, press of speech, logorrhea

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15
Q

Patient’s with Wernicke’s aphasia have more difficulty with comprehension instead of production of language; True or False?

A

True

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16
Q

Transcortical sensory aphasia

A

Receptive/Fluent/Posterior

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17
Q

Patient’s diagnosed with transcortical sensory aphasia will have moderate to severe impairment with?

A

Auditory and reading comprehension.

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18
Q

Patient’s diagnosed with transcortical sensory aphasia will have moderate to severe impairment with oral and written expression specifically with the following characteristics?

A

especially with paraphasias, logorrhea, poor self-monitoring; intact repetition; paraphasias and neologisms

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19
Q

Broca’s aphasia

A

Expressive/Nonfluent/Anterior

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20
Q

Broca’s aphasia has mild to moderate impairment with auditory and reading comprehension, what are the two specific deficits they have?

A

Difficulty with passives and complex grammar

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21
Q

Broca’s aphasia has mild to severe impairment with oral and written expression, what are the specific deficits they have?

A

agrammatism/telegraphic speech, anomia, literal paraphasias more common than semantic; circumlocutions (talking in circles/around a word)

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22
Q

What are other defining features of Broca’s aphasia?

A

Patient is typically aware of deficits, sometimes with catastrophic reaction and emotional lability; often concomitant apraxia of speech, dysarthria, contralateral hemiparesis

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23
Q

Global Aphasia

A

Expressive/Nonfluent/Anterior

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24
Q

In Global aphasia the auditory and reading comprehension impairment is _____?

A

Severe

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25
Q

In global aphasia the oral and written expression impairment is _____?

A

Severe

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26
Q

In global aphasia the oral and written expression impairment has the following specific defining characteristics?

A

Patient may be nonverbal; may have jargon and stereotypy

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27
Q

Transcortical motor aphasia

A

Expressive/Nonfluent/Anterior

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28
Q

Auditory and reading comprehension impairment in transcortical motor aphasia is?

A

Mild to moderate

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29
Q

Patients with transcortical motor aphasia experience the following deficits with auditory and reading comprehension?

A

Difficulty with Passives and Complex grammar

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30
Q

Patients with transcortical motor aphasia experience the following deficits with oral and written expression?

A

Telegraphic speech, intact repetition, literal and semantic paraphasia.

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31
Q

Oral and written expression impairment in transcortical motor aphasia is?

A

Mild to moderately impaired

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32
Q

Mixed transcortical aphasia

A

Expressive/Nonfluent/Anterior

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33
Q

Auditory and reading comprehension impairment in patients with mixed transcortical aphasia is?

A

Mild to moderately impaired

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34
Q

Oral and written expression impairment in patients with mixed transcortical aphasia is?

A

mild to moderately impacted.

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35
Q

Patients with mixed transcortical aphasia have auditory and reading difficulty with?

A

Passives and complex grammar

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36
Q

Patients with mixed transcortical aphasia have oral and written expression difficulty characterized by?

A

telegraphic speech

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37
Q

Conduction aphasia

A

Can be fluent or nonfluent - Depends on the severity

38
Q

Patients with mixed conduction aphasia have oral and written expression difficulty characterized by?

A

impairment with repetition, phonemic paraphasias, conduit d’approche

39
Q

Patients with mixed conduction aphasia have auditory and reading impairment characterized as?

A

Mild to moderate in severity

40
Q

Hallmark of Wernicke’s: What is Jargon Aphasia?

A

o Wernicke’s aphasia is sometimes called jargon aphasia because of the tendency to produce nonwords

41
Q

Hallmark of Wernicke’s: What is paraphasias in Wernicke’s aphasia?

A

o hallmark feature is the production of paraphasias, or words substituted for target words. Paraphasias may be semantic or literal.

42
Q

Hallmark of Wernicke’s: What is an example of semantic paraphasias in wernicke’s aphasia?

A

Examples are saying the word ear instead of nose (in this instance sharing the same semantic category) and saying the word car instead of ladder (where the paraphasia has less of a clear semantic relationship with the target word).

43
Q

Hallmark of Wernicke’s: What are neologisms?

A

o nonwords, or neologisms (literally, “new words”) in patient’s with Wenicke’s aphasia.
o An example is saying, “Bring me a trunket,” instead of, “Bring me a drink.”

44
Q

Hallmark of Wernicke’s: What is semantic paraphasias?

A

o Also called verbal or global paraphasias - entail the substitution of a real word for the target word.

45
Q

Hallmark of Wernicke’s: What is phonemic paraphasias?

A

o Also called literal paraphasias - entail the substitution of one or more sounds in the target word.
o Examples are saying “tegetable” instead of “vegetable” and “bady” for “baby.”

46
Q

Hallmark of Wernicke’s: What is neologistic paraphasia?

A

o When a neologism is substituted for a real word, it is sometimes called a neologistic paraphasia.

47
Q

Hallmark of Wernicke’s: What is Press of speech?

A

o continuing to speak even when what they are saying makes no sense to the listener, and often without attending to social conventions about turn taking in conversation.

48
Q

Hallmark of Wernicke’s: What are the three forms of perseveration that are common in people with a variety of acquired neurogenic disorders?

A

o Recurrent perseveration
o continuous perseveration
o stuck-in-set perseveration

49
Q

Hallmark of Wernicke’s: What is recurrent perseveration?

A

o the recurrence of a previous response to a subsequent stimulus within the context of an established set
o Recurrent preservation is the most common in people with aphasia and tends to occur in all forms of aphasia;
o it is most common in Wernicke’s aphasia.

50
Q

Hallmark of Wernicke’s: What is Verbal perseveration?

A

o Used synonymously with the term lexical preservation.
o It is the tendency to say a word or sounds within a word spoken previously but not the word intended at the moment;
o It is common in most types of aphasia.
o It is especially prevalent in people with Wernicke’s aphasia.
o This is typically exacerbated when asking a person to name objects or pictures.
o For example, after having said the word fork when shown a fork, a person may continue to say the word fork when a pencil, book, or chair is shown.

51
Q

Hallmark of Broca’s: Where is the site of lesion classically located in Brocas aphasia?

A

o Broca’s aphasia is classically associated with a lesion in Broca’s area, in the inferior, posterior portion of the frontal lobe.
o Broca’s area is often said to correspond to Brodmann’s areas 44 and 45, also called the frontal operculum

52
Q

Hallmark of Broca’s: What are examples of three forms of recurrent perseveration?

A

o Semantic perseveration: When asked to name body parts, a person correctly names arm, nose, and knee but then repeats the word nose when the clinician points to an ear. The actual response is semantically related to the intended response.

53
Q

Hallmark of Broca’s: Lexical perseveration:

A

The individual names the following items, colors, and letters correctly: feather, glove, yellow, brown, P, T, but then says “brown” when shown the letter H. The actual response is a word that was spoken previously and is not semantically related to the intended response.

54
Q

Hallmark of Broca’s: Phonemic perseveration:

A

When asked to name body parts, a person correctly names arm, and nose, but then, instead of naming “ear” when the clinician points to an ear, he says “near”; when the clinician points to an ankle, he may say “nearkle” or “nackle.” The actual response has phonemic features in common with a previous word spoken and is not semantically related to the intended response.

55
Q

Hallmark of Broca’s: What is the primary hallmark feature of Broca’s aphasia?

A

o agrammatism, a deficit in formulating and processing syntax

56
Q

Hallmark of Broca’s: What are reversible passives in Broca’s aphasia?

A

o Auditory comprehension is impaired especially for more complex types of grammatical constructs.
o One example of a grammatical construct that people with Broca’s aphasia tend to have trouble with is reversible passives.
o For example, it may be hard to tell who did the kissing and who got kissed when trying to process the sentence, “Yangfan was kissed by Jacques”; this is because it would make logical sense for either the subject (Jacques in this case) or the object (Yangfan in this case) to do the kissing.
o In contrast, a passive sentence such as, “The ball was kicked by Wanda,” is not reversible (in that a ball cannot kick a person) and would be relatively easy for a person with Broca’s aphasia to understand.

57
Q

Hallmark of Broca’s: What are grammaticality judgments in Broca’s Aphasia?

A

o Decisions about whether sentence constructions are correct or incorrect.
o Generated evidence that their knowledge of grammatical rules tends not to be lost; rather, it seems that their access to and implementation of grammatical rules is what is impaired.

58
Q

Hallmark of Broca’s: What is telegraphic speech in Broca’s Aphaisa?

A

o People with Broca’s aphasia tend to produce short and simple phrases and tend not to produce complex grammatical constructions.
o Language production is typically telegraphic.

59
Q

Hallmark of Broca’s: What are the words called that are missing when a person with Broca’s aphasia is talking?

A

o The words that are missing tend to be function words,
o prepositions
o pronouns
o determiners
o conjunctions
o auxiliary verbs
o Function words are also referred to as closed-class words because there is a relatively small set of these in a language compared to open-class words, and there are rarely new words in this category added to a language.

60
Q

Hallmark of Broca’s: What are the words that tend to be spoken or written?

A

o The words that are spoken or written tend to be content words.
o primarily nouns
o verbs
o adjectives
o adverbs
o Content words are also referred to as open-class words because words in this class continue to be added to languages and the way such words are used and combined with others continues to evolve in a language.

61
Q

Hallmark of Broca’s: What is dysnomia in people with Broca’s Aphasia?

A

o problems with word finding

62
Q

Hallmark of Broca’s: When an individual with Broca’s Aphasia is struggling with dysnomia (word retrieval) what do they typically use to help them?

A

o Often, they use circumlocutions, or words other than the intended words, to get around the words they are striving to say and yet still communicate their intended meaning.
o An example might be saying, “Hand me the cutters,” rather than “Hand me the scissors.”

63
Q

Hallmark of Broca’s: When a patient has Broca’s aphasia what does it mean when they have disfluent speech?

A

o Their speech tends to be disfluent in that fewer words and less meaningful content are conveyed per unit of time compared to people without aphasia and also to most people with Wernicke’s aphasia.

64
Q

Hallmark of Broca’s: Are patients with Broca’s aphasia or Wernicke’s aphasia considered more disfluent?

A

o Patient’s with Broca’s aphasia are considered to be more disfluent than Wernicke’s patients.

65
Q

Hallmark of Broca’s: What is catastrophic reaction in patient’s that have Broca’s Aphasia?

A

o Their speech tends to be effortful and they tend to be aware of their errors, especially in contrast to people with aphasia who have more posterior (temporal lobe) lesions. Some have extreme frustration when struggling to communicate, referred to by some authors as catastrophic reaction.

66
Q

Hallmark of Broca’s: What is emotional liability in patients with Broca’s aphasia?

A

o Some also experience emotional lability, the tendency to cry, swear, and otherwise openly emote, in a way that is uncharacteristic of how the person typically responded prior to a stroke or brain injury.

67
Q

Hallmark of Broca’s: True or False: Patient’s with Broca’s aphasia can have concomitant motor speech deficits. This makes Broca’s aphasia a motor speech disorder.

A

o False: Broca’s aphasia is a language disorder.
o The reason this is important to emphasize is that many people tend to get distracted by concomitant motor speech deficits that so many people with Broca’s aphasia have.
o The proximity of areas or structures essential to speech production may be the reason that there is such a high incidence of a Broca’s type of aphasia in patients who have apraxia of speech (and vice versa).

68
Q

Where is Global aphasia lesion site located?

A

o Global aphasia is classically associated with multiple areas of the frontal, parietal, and temporal areas of the brain that receive their blood supply from branches of the middle cerebral artery in the language-dominant hemisphere.
o That is, large lesions throughout the planum temporale tend to be affected.
o Global aphasia entails a combination of expressive and receptive language deficits in all modalities.
o Some people with global aphasia are not able to speak at all, especially soon after stroke.

69
Q

What is stereotype in global aphasia?

A

o Some speak only via stereotypy, the production of the same few words or nonwords regardless of the meaning intended.
o For example, a person may say only “hello,” “wonderful,” or “kippish” in any verbal context and no other words.
o Communication is carried out largely through gesture, tone of voice, and facial expression.

70
Q

What is the hallmark symptom of conduction Aphasia?

A

o Impaired repetition relative to good comprehension and spontaneous production of spoken and written language.
o The longer and more complex the words, phrases, and sentences people with conduction aphasia are asked to repeat, the more difficulty they have with the task.

71
Q

What is conduit d’approche in regard to conduction aphasia?

A

o repeated attempts to articulate a verbal stimulus that they are trying to repeat

72
Q

What is the hallmark symptom for transcortical sensory aphasia?

A

o The hallmark symptoms are similar to Wernicke’s aphasia, with the exception that repetition is intact in transcortical sensory aphasia.
o People with this type of aphasia also sometimes echo others’ words as they are listening to others speak.

73
Q

What is the hallmark symptom for transcortical motor aphasia?

A

o The hallmark symptoms are similar to Broca’s aphasia, with the exception that repetition is intact in transcortical motor aphasia.

74
Q

True of False: Sensory and motor in the labels for transcortical aphasia are misnomers in that, by definition, no form of aphasia is a motor or sensory disorder.

A

o True – Aphasia no matter the subtype is an acquired language disorder.

75
Q

What is the hallmark for mixed transcortical aphasia?

A

o It is similar to global aphasia, with the exception of intact repetition ability.

76
Q

What is the hallmark feature of anomic aphasia?

A

o Word-finding difficulty
o What differentiates this from other syndromes of aphasia in which anomia is common is that comprehension and syntactic production in anomic aphasia are relatively spared.
o Typical symptoms are circumlocutions, the use of generic terms (e.g., “thing” instead of an intended noun or “girl” instead of a specific girl’s name), and production of fillers such as “uh,” “you know,” and “like.”
o Lesion sites tend to be around the intersection of the superior temporal and inferior parietal lobes.

77
Q

Define Primary Progressive Aphaisa?

A

o The ongoing loss of language abilities in the face of relatively preserved cognitive abilities, caused by neurodegenerative disease.

78
Q

What are the distinguishing factors of PPA?

A

o PPA has an insidious onset, whereas other forms of aphasia tend to develop suddenly.
o The cause of PPA is neurodegenerative as opposed to being due to a sudden disruption in blood supply.

79
Q

What is crossed aphasia?

A

o Crossed aphasia is any form of aphasia that is due to damage to the right hemisphere instead of the left in a person who is right-handed.
o It is extremely rare (probably less than 3% to 4% of people with aphasia).
o Many people with crossed aphasia also have concomitant symptoms that are typically associated with right hemisphere lesions, such as left visual neglect and visuospatial deficits.

80
Q

What is subcortical aphasia?

A

o Subcortical aphasia is any form of aphasia that is associated with a lesion below the cortex.

81
Q

Here is a bank of aphasias:

A 
o	Broca’s aphasia
o	Wernicke’s aphasia
o	Conduction aphasia
o	Anomic aphasia
o	Global aphasia
o	Transcortical sensory aphasia
o	Transcortical motor aphasia
o	Subcortical aphasia
82
Q

What are the three reasons a beginning SLP needs to be able to classify subtypes of aphasia?

A

o The terms are commonly used in practice and research. So, I can then use them and understand them.
o Many standardized aphasia tests output results in such a way as to classify aphasia subtypes.
o Provides a starting point of knowledge for the SLP can compare clients to.

83
Q

What is the best way to classify subtypes of aphasia?

A

o Aphasia is manifested in many ways, with varying symptoms and severity levels
o General patterns of communication deficits (symptoms) are often associated with certain subtypes (syndromes) of aphasia.
o Each individual person with aphasia is a unique, complex individual regardless of how anyone might categorize his or her linguistic symptoms.

84
Q

What is the best way to classify subtypes of aphasia?

A

o Aphasia is manifested in many ways, with varying symptoms and severity levels

85
Q

What are the key characteristics of anomic aphasia?

A

o Word-finding difficulty; spared comprehension/syntactic production; circumlocutions: the use of generic terms; fillers

86
Q

What are the key characteristics of primary progressive aphasia (PPA)?

A

o The ongoing loss of language abilities in the face of relatively preserved cognitive abilities
o Subtypes: Semantic, logopenic, agrammatic (non-fluent).

87
Q

What are the key characteristics of Crossed aphasia?

A

o Any form of aphasia that is due to damage to the right hemisphere instead of the left in a person who is right-handed.
o The lesion sites most often mirror the

88
Q

What are the key characteristics of subcortical aphasia?

A

o Any form of aphasia that is associated with a lesion below the cortex
o Lesion sites: thalamus; basal ganglia; cerebellum; internal capsule

89
Q

How might dyslexia and dysgraphia be conceptualized as symptoms versus syndromes?

A

o Symptoms:
o An observable behavior or state
o Not an implication of an underlying problem or a physical etiology
o The simplest level of analyzing a presenting problem
o Syndrome:
o The next higher level of analysis
o A constellation of symptoms that occur together or co-vary over time
o Carries no direct implications in terms of underlying pathology

90
Q

In all types of aphasia

A

Reading abilities will tend to mirror auditory comprehension abilities and writing abilities tend to mirror speaking abilities.

Aphasia & RHS (3 decks)

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