Chapter 10 Flashcards
In most people, language is controlled by the right hemisphere of the brain
False
The frontal love is concerned with motor control, including motor speech control.
True
Wernicke’s area controls language formulation and comprehension.
True
Aphasia is a speech disorder associated with brain injury
false
Apraxia of speech is not due to muscle paralysis
True
The stages of normal swallowing are discrete events
False
some forms of dementia may be temporary
True
SLPs do not treat the esophageal stage of swallowing disorders
True
dysarthria affects only articulation of speech sounds
false
in all children with a diagnosis of childhood apraxia of speech, there is evidence of brain injury or pathology
False
anomia results in
naming difficulty
found in patients with aphasia
a word substitution problem
paraphasia
creation of nonsensical words
neologism
hardening of the cerebral arteries
arteriosclerosis
there are muscle problems of neurological origin
there is no language problem
there are articulation problems
pure dysarthria
left neglect is a characteristic of _____ ______ _____
right hemisphere syndrome
communicative disorders included under medical SLP are associated with neurological disease or trauma.
dual diagnosis
How is the relationship between the brain and language studied
autopsy
neurosurgery
brain imaging or brain scanning
_______ in aults is a language disorder associated with acquired brain damage. It affects all aspects of language
Aphasia
Aphasia is not a:
speech disorder
language associated with dementia or confusion seen in some brain-injured patients
its is not the bizarre language of schizophrenic patients
Number one cause of aphasia is ______
stroke
Cause of a stroke:
embolus
thrombosis
aneurysm
a traveling blood clot
embolus
a blood clot at the point of its origin
thrombosis
a sack like bulge on the wall of a weakened artery that eventually ruptures causing cerebral hemorrhage
aneurysm
Potential causes of brain injury that result in aphasia
epilepsy meningitis encephalitis brain tumors accidents during brain surgery brain infections
substituted words sound like the correct words
phonemic paraphasias
the substituted words have meanings similar to the correct words
verbal paraphasia
omission of grammatical elements
agrammatism
somewhat fluent but irrelevant or meaningless speech
jargon
involve the use of certain expressions even obscene ones in response to any questions asked
verbal stereotypes
writing disorders
agraphia
reading problems
alexia
sensory deficits which may be independent of aphasia and include auditory verbal agnosia and visual agnosia
Agnosias.
exists when the person can hear but cannot recognize the meaning of the words
auditory verbal agnosia
exists when the person cannot tell what something is by looking at it
visual agnosia
How is aphasia classified?
fluent or non-fluent
an assessment of communication skills in everyday sitiations
functional assessment
The clinician uses pictures, drawings, or cultural objects and models the correct response to evoke the target behaviors.
Behavioral treatment procedures
speech disorders that result from central or peripheral nervous system damage are called ___
motor speech disorders or neurogenic speech disorders
disorder or sequnced movement of body parts in teh absence of muscle weakness or paralysis.
apraxia
when asked to, the patients cannot move the muscles of the throat, soft palate, tongue, and the cheek for nonspeech purposes. On their own, they can make the same movements.
Oral apraxia
The patients cannot comply when requested to move their hand to wave good bye or to show how a hammer is used. On their own they can execute these movements
limb apraxia
is difficulty in initiating andexecuting the movement patterns necessary to produce speech whn there is no paralysis, weakness, or discoordination of speech muscles.
apraxia of speech
The main feature of apraxia of speech is a marked difficulty in articulating ____ ____ ___
sequenced speech sounds
Causes of AOS
-lesions in Broca’s area in the left frontal love
-strokes
-external trauma to the frontal love
tumors
accidental surgical injury
degenerative neurological diseases
Lesions in broca’s area affect motor programming for speech causing errors in ______ ______
speech production
Pure AOS is rare it is more frequently associated with _______
aphasia
Speech problems associated with AOS
-difficulty positioning articulators correctly
-repeated attempts to correct the articulation errors, each attempt causing a different kind of mistake
-more errors on consonants and consonant clusters than vowels
-wrong sequencing of sounds in words
-variable mistakes on repeated attempts
-greater difficulty on complex, longer or less frequently used words
disturbed rhythm and intonation
Apraxia of speech in children can be diagnosed in three groups:
-Children with neurological problems
children who have complex neurobehavioral disorders or certain genetic syndromes
children who seem to be otherwise normally developing
Treatment targets for adults and children with Apraxia of speech
- correct sequenced production of speech sounds
- functional communication
- improved intelligibility
speech disorders due to paralysis, weakness, or in-coordination of the speech muscles.
dysarthria
Impaired muscle functions affects all aspects of speech production
respiration
articulation
phonation
prosody
Patients with ______ _______ have no problems with language or reading.
pure dysarthria
What causes dysarthria?
vascular and neurological diseases
About _____ of people who experience a stroke have dysarthria
25%
about _____% of people who have traumatic brain injury have dysarthria
30
______ disease is a major contributor of dysarthria
parkinson’s
Communicative problems in dysarthria include the following:
respiratory, phonatory, resonance, articulatory, and prosodic problems
damage to cerebellum is what type of dysarthria?
ataxic dysarthria
People with ataxic dysarthria are characterized by
articulatory disorder
slow speech and prosodic problems because of excessive and uneven stress on syllables.unstable stand and walking
Monopitch monoloudness harsh voice and a drunken voice quality also may be part of _____ dysarthria
ataxic
damage to speech related cranial nerve is _____ dysarthria
flaccid
lesions in the pyramidal and extrapyramidal systems
spastic dysarthria
flaccid dysarthria damages cranial nerves
VII facial nerve and vagus nerve
all aspects of speech inlcuding articulation phonation and prosodic aspects may be impaired in patients with ________ dysarthria.
spastic
Individuals with _______ dysarthria may also have swallowing disorders.
spastic
damage to the basal ganglia can cause ________ and ______ dysarthrias
hyperkenetic
hypokinetic
ecvessive and involuntary movement of muscles
hyperkinetic dysarthria
speech disorders in hyperkinetic include
slow and imprecise articulation unpredictable speech errors variable speech rate monopitch momnoloudness or excessive variations in loudness of voice harsh voice intermittent hypernasality
voice disorders include: a hoarse, breathy and unsteady voice with monopitch and monoloudness. imprecise articulation of speech sounds, a mild hypernasality in some cases, and irregular fast breathing are additional features of ______ dysarthria
hypokinetic
when teh damage is limited to motor neurons in only one hemisphere
upper motor neuron dysarthria
Treatment of dysarthria
-training to improve posture, tone and strength of muscles
-exercise to reduce respiratory problems so that speech production is facilitated
-surgical and behavioral ethods to promote improved phonation
-behavioral treatment to reduce such resonance problems as hypernasality
behaviora traiining to achieve better articulation
-procedures to modify problems of prosody
The _______ hemisphere controls visual and spatial functions including facial recognition and geographic orientation attention emotional expression and certain aspects of communication.
right
Causes of right hemisphere syndrome
strokes in the right hemisphere
tumors in the right hemisphere
traumatic brain injury
degenerative neurological diseases
Behavioral deficits associated with right hemisphere syndrome
-left neglect and attention deficits
-disorientation; spatial and geographic confusion
-facial recognition deficits (prosopagnosia)
-reasoning and planning deficits
communicative deficits
Communication treatment in right hemisphere syndrome includes
-turn taking in conversational speech
reading without neglecting the left side of printed pages
-maintainng a topic of conversation
a neurological syndrome associated with persistent or progressive deterioration in intellectual functions
dementia
diseases associated with dementia
Alzheimer's disease Parkinson's disease pick's disease huntington's disease vascular disorders that affect cerebral blood supply creutzfeldt Jakob disease
There’s a _____ onset of progressive dementia
slow
memory loss, impaired or lost reasoning and judgement, deterioration in daily living skills, delusions hallucinations emotional outbursts paranoia, inappropriate or obscene social behavior, sleep disturbance, profound disorientation to space and time
intellectual and behavioral problems associated with dementia.
communication problems associated with dementia
naming problems and paraphasia
speech comprehension problems
picture description problems
picture description and narrative difficulties
difficulty maintaining topics of conversation
progressively shrinking vocabulary
injury to the brain from physical trauma or external force
traumatic brain injury
Causes of TBI
automobile accidents pedestrian accidents motorcycle/bicycle accidents accidental falls interpersonal violence, gunshot wounds sports and workplace accidents
the skull is fractured or perforated the meninges are torn and the brain tissue is damaged.
penetrating brain injuries
indirect damage to the brain with intact meninges
nonpenetrating brain injuries
injuries that result from a brain moving within the skull are known as ______
acceleration/deceleration injuries
injuries caused by forces that strike stationary heads are known as _______
nonacceleration
communication problems of people with TBI include
dysarthria confused language anomia perseverative verbal responses dificulty in language comprehension pragmatic language problems rambling speech difficulty understanding facial expressions reading and writing difficulties
speech language pathologists design a treatment program in which _____ ___ ___ __ are targeted
orientation
attention
narrative skills
word selection
deglutation disorder; is a disorder of swallowing food and liquid
Dysphagia
causes of dysphagia
strokes
tumors of the mouth adn throat
neurological diseases
transportation of fodd from teh plate to the mouth
feeding
transportation of food from teh mouth to the stomach
swallowing
Normal process of swallowing
A) The tongue propels the bolus
B)the pharyngeal swallow is triggered
C) Bolus arrives in the valleculae
D)the base of the tongue retracts to the anterior moving pharyngeal wall
D) the bolus begins to move through the esophagus
Interrelated phases of swallowing
oral preparatory phase
oral phase
pharyngeal phase
esophageal phase
solid food placed in the mouth is prepared for swallowing; with lips sealed, the food is mixed with saliva and masticated to form a bolus; liquid is briefly held between the tongue and the anterior palate before initiating the swallow.
oral preparatory phase
a front-to-back rolling action of the tongue moves the bolus toward the back portion of the tongue; the soft palate is elevated to let the bolus pass through the anterior faucial pillars.
oral phase
this phase of swallowing is triggered when the bolus makes contact with, and begins to pass through, the faucial pillars; breathing is interrupted, the vocal folds close to seal the airway; from then on, the action is involuntary
pharyngeal phase
an involuntary phase of swallowing, the esophageal phase is not under conscious control; food is transported from the lower end of the pharynx to the stomach.
esophageal phase
The structures involved in swallowing are under ______ and ________ control
neural
cortical
a round _____ weeks of gestation, the fetus begins to swallow the amniotic fluid.
12.5
around ____ months of age, suckling changes into sucking.
6
factors that affect abnormal and normal swallowing
nature of the food being swallowed
body positioning during swallow
causes of swallowing disorders
- strokes
- neurological and degenerative diseases
- cancer
- surgical treatment of brain, head, neck, skull base
- chemotherapy for cancer of the head and neck
- brain injury
- HIV AIDS
difficulty chewing the food or forming the bolus; holding the food in the mouth too long
disorders of the oral preparatory phase
tongue difficulty and weakness in moving the bolus toward the pharynx; food residue in various parts of the mouth
disorders of the oral phase
difficulty triggering the swallowing reflex when the head of the bolus passes through the base of the tongue; difficulty propelling the bolus through the pharynx
disorders of the pharyngeal phase
phase not under voluntary control; characterized by inefficient movement of food from the esophagus to stomach; food propelled back, causing gastroesophageal reflux disease
disorders of the esophageal phase
SLP administers test swallows of food of various consistencies mixed with barium sulfate to assess breakdown in the swallowing response.
modified barium swallow study/videofluroscopy
invovles efforts at strengthening the muscles involved in swallow by oral motor exercises.exercises designed to improve the tongue and jaw strength and range of movement may be prescribed and practiced. no food involved.
indirect treatment
includes food of various consistencies, including liquid. the clinician designs specific procedures to treat the disorders of mastication
direct treatments
treatment of disorders of mastication
teach patient to keep the food in the side of the mouth, where the chewing muscle strength is greater
treatment of oral preparatory phase
teach patient to tilt the head forward to keep the food in the front of the mouth until the or she is ready to swallow and then to tilt the head back to promote the swallow
treating oral phase
teach a patient to hold the food at the back of the tongue before initiating a swallow. the patient may also learn to push the food back toward the pharynx by placing the tongue on the alveolar ridge and initiating a swallow with an upward and backward movement of the tongue.
treatment of pharyngeal phase
teach patient to tilt the head forward while swallowing to compensate for a delayed or absent swallowing reflex
Do SLPs treat disorders of esophageal phase?
no, because its an involuntary process.
