Chapter 12 Flashcards
Cognitive communication disorder
Difficulty with any aspect of communication that is affected by disruption of congition
What are some difficulties that people have with a cognitive communication disorder?
Attention, memory, organization, problem solving, reasoning, executive functions
Can a cognitive communication disorder effect both verbal and non verbal communication?
Yes (speaking, listening, reading, writing, social interaction)
Why was there a sudden burst in neurogenic communication disorders?
WW2 many soldiers survived TBI’s so there was a burst in these disorders and a need to provide rehabilitation
What are the 3 types of disorders that neurogenic communication disorders affect?
Language, motor speech, and cognition
Acquired disorder (adult)
Had typical speech, language, communication before neurological incident
Developmental disorder (child)
Difficulty developing language, speech, or cognitive skills for communication
What is a cerebrovascular accident?
stroke (acquired)
What are the 3 types of strokes?
Thrombotic, embolic, hemorrhagic
Thrombotic
Clot from gradual accumulation of plaque in the brain
Embolic
Clot that moved from another part of the body
Hemorrhagic
Bleeding in the brain (an aneurysm/artery burst and there is blood in the brain)
What is the perisylvian fissure?
Area on the lateral left hemisphere near the sylvian fissure/lateral suclus
What may damage to the sylvian fissure result in?
Aphasia
What are some secondary results of CVA?
Edema or swelling in the brain, infarct or tissue death in the area of the stroke, or spontaneous recovery which is when the brain reorganizes and takes over the function that was lost in different areas
Aphasia
Disorder of language (receptive & expressive)
Receptive
Difficulty understanding language (listening & reading)
Expressive
Difficulty using language (talking & writing)
Heschel’s gyrus
Primary auditory cortex responsible for perception and discrimination of the auditory stimuli
Wernicke’s area
Responsible for sematics, storage/retrieval of mental representations of words, word meanings, grammar/linguistic rules (attaching meaning to language/understanding)
Arculate Fasciculus
White matter pathway connecting wernickes area to brocas area
Broca’s area
helps with grammar, responsible for planning/organizing speech movements, and articulation (production of speech)
What are the 4 lobes?
Frontal, parietal, occipital, temporal
What lobe is broacs in?
Frontal
What lobe is wernickes in?
Temporal
What is the hearing/auditory comprehension pathway?
Ears - auditory pathway - CN 8 - temporal lobe - Heschl’s gyrus - wernickes area
What is the speaking pathway?
Wernickes - arculate fasiculus - broca’s area - primary motor cortex - brainstem - cranial nerves
Why do we test repetition for aphasia?
Can the word get in & can the word get out (listening & producing)
Brocas Aphasia
Fluency = impaired, auditory comprehension = good, repetition = impaired, naming = impaired
Wernickes Aphasia
Fluency = good, auditory comprehension = impaired, repetition = impaired, naming = impaired
Global Aphasia
Fluency, auditory comprehension, repetition, naming = impaired
What is fluency?
Effortless speech, normal rate, grammar okay, syntax okay, intonation okay, uses all types of words
What is non-fluency?
Effortful speech, slow rate (under 100 wpm), grammar reduced, syntax poor, monotone, leave out function words and rely on nouns
Broca’s aphasia example
agrammatic speech (lots of nouns), loss of function words, nouns and verbs, misarticulating (dysarthria), frustration and awareness
Wernicke’s aphasia example
verbal paraphasias (fork for spoon), right category but wrong word, neologisms (new words/jargon), get overall just of convo but could not understand specifics, could not follow instructions or comprehend reading
Global aphasia example
stereotypical utterances, over learned phrases, single words, speech limited, can hardly respond to yes/no questions
Does a person with slow laborious speech, grammatical, and phonemic errors have slow and laborious writing with grammatical errors as well?
Yes
Motor speech disorders
Disorders of speech resulting from neurologic impairment affecting the motor programming and/or neuromuscular execution of speech (apraxia and dysarthria)
Apraxia
Disorder of motor programming for speech (planning, not caused by paralysis, weakness, incoordination, or sensory. loss, damage to CNS, oral groping, inconsident, write fine
Dysarthria
A group of speech disorders resulting from disturbances in muscle control of speech mechanism (neuromuscular execution), damage to CNS/PNS, speech problems result from paralysis, weakness, incoordination, sensory loss (drunk slurred speech), execution problem
Problem with cognitive linguistic process (throughs translated to language)
Aphasia, right hemisphere disorder, cognitive communicative disorders in TBI
Problem with motor speech planning/programming (language translated into motor movements)
Apraxia of speech
Neuromuscular execution of motor speech (motor movement carried out by CNS and PNS)
Dysarthria
Damage to wernickes
Aphasia
Damaga to Brocas
Aphasia and/or Apraxia
Damage to arcuate fasciculus
Aphasia
Damage to motor strip
Dysarthria
Damage to cranial nerves
Dysarthria
Dementia
Cognitive Communication disorder
Alzheimers
Memory
Frontal lobe
Decision making, personality
Primary progressive aphasia
Language
Cognition
Language, memory, attention, decision making
TBI risk factors (more likely to get it if..)
Alcohol and drugs, poor school adjustment, socioeconomic status, personality type, pervious history of TBI, participation in sports
First injury
2 seconds direct effect of the injury where the brain is accelerated, decelerated, or rotated
Can first injuries occur twice?
Yes, hit head on windshield and then flung out of the car
Second injury
Occurs in first few hours post onset, it is the physiological response to injury (could include oxygen deprivation to brain, blood loss, hematomas, increased inter cranial pressure, decreased blood pressure, swelling
Open head injury
The skull is open/cracked, brain is exposed (gunshot)
Closed head injury
Skull is closed/intact (falls)
Mild brain injury
Brief or no loss of consciousness, the CT and MRI is negative (looks normal), symptoms could be vomiting, dizziness, lack of recall
Moderate brain injury
Coma less than 24 hours, could see things on a CT or MRI, could be hemorrhage (bleeding) or skull fractures (tissue damage)
Severe brain injury
Comas is greater than 24 hours
Cognitive deficits following TBI
focusing problems, delayed response time, organization, difficulty multitasking, poor judgement, bad spacial functions, etc
Language Cognitive deficits following TBI
Word finding is hard, prosody is flat, topic selection, maintenance, turn-taking, and consciousness are off
